House of Commons
Wednesday 11 January 2017
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
UK development assistance has helped to reduce poverty and promote stability in Tajikistan since 2002. Between 2011 and 2016, DFID’s work has improved rural lives, promoted women’s economic empowerment, and delivered an important investment climate and managed public financial reforms.
I am grateful for that information. During a recent visit to Tajikistan, I saw the good work that DFID had been doing, but many people have expressed concern about the fact that certain projects have been quite slow to be approved. Will my right hon. Friend update the House on the Department’s commitment to Tajikistan and on when those projects might be signed off?
I thank my hon. Friend, both for his question and for going to see DFID’s work in-country. The Minister of State, my hon. Friend the Member for Penrith and The Border (Rory Stewart), is overseeing new international development programmes, details of which will be published in due course.
Central Asia, including Tajikistan, represents an important strategic imperative in terms of our wider development objectives. We are, of course, committed to ensuring that commitments are implemented and that we start to deliver on those programmes later in the year.
Tajikistan is very much at risk from climate change, which could threaten all the good work that is being done to improve livelihoods and economic development. Is dealing with that an element of DFID’s programme?
As the hon. Lady will know, a variety of challenges exist in this part of central Asia. Dealing with climate change is one, but others are economic security, financial management and performance issues. DFID’s combined approach will help to deliver greater economic security in the long run.
Occupied Palestinian Territories
The Department’s assessment, in line with long-standing British Government policy, is that demolitions are illegal under international humanitarian law, and that they undermine the credibility and viability of a two-state solution.
The Bedouin village of Umm-al-Hiran remains under threat from a demolition that would cast out 800 villagers, and the number of demolitions in the occupied territories in the first two weeks of January is almost four times greater than the number at this point last year. What support is being given to the people who are being driven out of their homes, and what message is being sent to the Israeli Government that such demolitions are completely unjustifiable?
The hon. Lady raises two important issues, the first of which is long standing. Along with our international partners, we continue to lobby the Israeli Government, who are undertaking the demolitions, to stop doing so, both because they are illegal and because they undermine the two-state solution.
The Under-Secretary of State for Foreign and Commonwealth Affairs, my hon. Friend the Member for Bournemouth East (Mr Ellwood), had a meeting with the Israeli Defence Minister, Mr Lieberman, just before Christmas and raised the issue of demolitions with him directly.
Will the Minister ensure that human rights non-governmental organisations operating on the west bank continue to receive support from the British Government?
We are absolutely focused on supporting NGOs, but above all we are focused on investment in health and education. It is getting the natural capital right, and providing opportunities and hope for the Palestinians, that will lead to security and stability for both sides in the conflict.
Many of the demolitions occur because it is virtually impossible for Palestinians to obtain building permits. What legal support can the Department give to those who are contesting the process?
As I have said, DFID is focusing on health and education, but the Foreign Office has legal support programmes. This issue goes to the heart of the Israeli planning system and involves controversies with the Israeli Attorney General. As my hon. Friend says, it is very difficult to obtain planning permission, which is one of the reasons why settlements are built and demolitions then take place.
The British taxpayer has not funded any structures that have been demolished by the Israeli Government. The European Union has funded structures that have been demolished by the Israeli Government, but so far it has not decided to seek compensation.
Will the Minister confirm that DFID, notwithstanding the efforts of a senior Israeli diplomat to “take down” a Minister, will continue to fight against collective punishment, demolitions in the OPTs and the expansion of the illegal settlements?
We are conflating two different issues here. As the Foreign Secretary said yesterday, the Israeli ambassador has already apologised for that incident, and the diplomat concerned has been removed from his post and sent home. I think I have dealt with the overall questions of settlements and demolitions in my answers to the other questions.
I thank the Minister for his responses, but I would like him to be a bit clearer and tell us how DFID has supported those people who are now homeless due to the systematic policy of settlement expansion.
The central story is that DFID is doing three types of things for Palestinian people. First, we are supporting Palestinian state structures, in particular health and education—doctors, teachers and nurses. Secondly, we are working on making sure that we can create a viable economy and employment, particularly through support to small businesses. Thirdly, we invest in human capital; in other words, we invest in making sure that the Palestinian people are educated, healthy and have opportunities for security and stability in the region in the short term. But in the long term there cannot be a two-state solution unless we address the needs of the Palestinian people.
What has happened in Aleppo is a tragedy and underlines the regime’s callous tactics of siege, starvation and indiscriminate bombardment. Through the UK’s humanitarian leadership and diplomatic efforts, we are doing all we can do to support the protection of civilians and, importantly, ensure that they receive the aid they so desperately need.
I thank the Secretary of State for that answer. The UK committed £510 million in support at the London Syria conference in February last year. Is she on course to hit that target?
I thank my hon. Friend for his question on this important issue, which gives me the chance to restate to the House the British Government’s commitment to, and long-standing support for, Syria. We have surpassed that pledge of £510 million made at the Syria conference last year. It is fair to say not only that the UK can be proud of its support, but that we have ensured that there is the right support in terms of humanitarian supplies and the focus for the region, while at the same time using our international convening power to work with others globally to ensure that we do everything we possibly can to support Syria and the region.
At the world humanitarian summit in Istanbul last year, the United Kingdom committed to the centrality of protection as a fundamental principle. How has that guided DFID’s approach to the situation in Aleppo, and what lessons will we learn from the tragedy of Aleppo for future civilian protection?
The hon. Gentleman makes an important point in relation to the conference last year and how the humanitarian community can come together and not just learn lessons, but understand ways of working in times of severe crisis and of conflict. There are a number of lessons we can learn, including on agencies working together, the pooling of resources, and making sure that Governments across the world are working together strategically in terms of both resource allocation and, importantly, our convening power—the leverage we all have collectively in the international space to challenge Governments where they are inflicting harm and causing grief and devastation, and to make sure that we stand shoulder to shoulder and are united in how we tackle the challenge.
First, I commend my hon. Friend on her work on, and leadership in, Singing for Syrians; it is an incredible organisation and has been very successful in raising important funds. On making sure that the money is not wasted and goes directly into the region and in-country, we not only support, fund and collaborate with trusted partners, but, importantly, measure the outcomes that we are delivering in these essential humanitarian policies.
The Secretary of State is already talking about Aleppo in the past tense, but the besiegement is still happening right now, and the British Government must do more. What representations has she made to the Foreign Secretary about putting in place more and harder sanctions on Russia?
The hon. Lady is absolutely right. The situation not only in Aleppo but in Syria full stop is beyond comprehension. She asks about representations. The Foreign Secretary and I work hand in hand on international issues, and the Government are calling for greater collaboration on access to humanitarian routes into besieged areas. This is not a case of one Department versus another; it is the voice of the British Government working together to make public representations and representations behind the scenes.
Before the war, Aleppo had Syria’s largest population of Christians. Now it is estimated that 90% of them have fled. In Parliament today, Open Doors will launch its World Watch List, which shows that religious persecution is one of the key drivers of migration. What can my right hon. Friend’s Department do to help the poor, persecuted Christians of Aleppo?
My right hon. Friend is absolutely right to highlight the plight of persecuted Christians, especially in the context of Aleppo and Syria. She asks what we can do. This is not just a matter for DFID; the whole Government must speak out on the issue and constantly make it clear that the persecution of minorities and religious groups is totally unacceptable. That is the right thing to do. We also need to make that case within the international community and work collaboratively with donor countries and other countries across the world.
Following the announcement during the Christmas recess that DFID would be piloting the use of drones to deliver medical supplies in Tanzania and to map weather damage in Nepal, what discussions has the Secretary of State had with Ministers in the Ministry of Defence about how drone technology could be used to deliver aid or assess humanitarian need in Aleppo and other parts of Syria?
The hon. Gentleman is right to highlight the fact that we have been innovating and looking at new technology in relation to aid provision via drones. A lot of work is taking place in that space, and we have had a number of debates in the House about other ways of delivering humanitarian assistance, particularly in besieged areas. In the specific context of besieged areas in Syria, work is taking place and there have been discussions. I can assure the House that we are actively pursuing this issue, not just in DFID but across the Government.
The Secretary of State’s heart is very much in the right place, as we all know, but the fact is that the greatest humanitarian catastrophe of modern times is taking place in Aleppo, Raqqa and Mosul today. In contrast to the warm words that we have heard in the exchanges of the past few minutes, should we not now admit that there is precious little that we in the liberal west can do to alleviate the appalling circumstances in Aleppo unless we have the support of the United Nations and Russia?
My hon. Friend makes an important point. In terms of the work that the Government are doing, we must never lose sight of the fact that we are leading in humanitarian assistance and support. People are in desperate need, and we have the right focus on giving them all the necessary support. The other point is diplomacy. It is the job of the Government to carry on putting on the pressure, and we must use all the avenues of international diplomacy to put that pressure on, where it is needed.
I should like to focus on Idlib in north-western Syria, where civilians who have fled Aleppo are the main target of Government strikes. Will the Secretary of State tell the House how DFID is supporting those wounded and displaced civilians?
I thank the hon. Lady for her focus on the humanitarian issue in Syria, which is of course associated with Idlib as well. She asks about the work that is taking place. There are extensive humanitarian efforts in terms of relief, food and shelter in what is a desperate situation. As she and the whole House will know, I have spent a great deal of time working with all the agencies that we are directly supporting and funding to ensure that supplies are getting through, and they are. I would add the caveat that this is taking place in a challenging environment and climate. We are getting supplies through, but it is increasingly difficult to do so.
Energy Access: Africa
Access to energy is a prerequisite driver of economic growth and development. Over 620 million people in sub-Saharan Africa have no access to energy. When able to secure it, the world’s poorest people can pay up to 80 times what we pay. That is why the UK and this Department are playing a key role in providing both on and off-grid energy access, such as through the Energy Africa campaign, which will help to secure energy supplies for over 4.5 million of the world’s poorest people.
I know from my visits to east Africa that providing access to reliable, sustainable, clean energy is crucial for economic growth and prosperity in Africa. Does the Minister agree that the CDC and its investment in Africa present one of the best opportunities to provide that?
I absolutely agree that the CDC can play a key role. I am pleased that the House showed support for its work only yesterday in a debate led by the Minister of State, my hon. Friend the Member for Penrith and The Border (Rory Stewart), with support from the Secretary of State. A good example is Globeleq, in which the CDC has a majority stake, which will drive forward energy provision of 5,000 MW in Africa—1,000 MW can support 800,000 jobs. That is the scale of the difference we can make when and where we get this right, and that is why we are doing it.
I have set out some of the reasons why energy supply is so important in driving development. Of course, it is also important that that supply is sustainable and environmentally friendly. In all the projects that DFID pursues, we seek to ensure that that is the case, including in our discussions with the World Bank. Given our contributions and their impact, we recognise that it is particularly important that the World Bank appreciates and works towards that agenda.
Middle-income Countries: Aid Withdrawal
Programme sustainability is crucial, and all DFID programmes are designed with long-term sustainability and impact in mind. No decisions have been made to exit countries in the context of my hon. Friend’s question. When and where that happens, we want to ensure that a positive legacy is left and that the “leave no one behind” agenda is adhered to, so that some of the poorest and most vulnerable people in the world receive the protection and support that they ought to be able to expect.
The American Government operate the Global Equality Fund to ensure that marginalised groups are not left behind. Will my hon. Friend consider whether the UK should initiate a similar fund?
My hon. Friend is absolutely right. Marginalised groups, particularly in countries that are not the poorest, are sometimes the most vulnerable. We rightly focus our efforts and attention on the world’s poorest countries with the largest number of people in greatest need of support, but other groups elsewhere also need support. We must always be aware of that and ensure that our programmes have a sustainable impact. I will be delighted to have further discussions with my hon. Friend about his idea.
The Department will always consider what we need to do to ensure sustainable and long-lasting transition, and programmes must be designed in that way. That is a common thread that runs through every programme that DFID supports and every decision that Ministers make. We will continue to work in this area and are happy to consider further proposals for what might improve the quality of the work that is done.
Whether by giving to Syrian refugees, providing access to food or clean water, or creating jobs across Africa, UK aid helps us to meet our obligations to the world’s poorest. Such investment is also firmly in Britain’s national interest because it tackles the root causes of global problems while focusing on delivering world-class programmes that deliver value for money for UK taxpayers.
The Secretary of State has previously said that she is looking at allocating DFID funding to peaceful co-existence projects, including Save a Child’s Heart, whose valuable work brings Palestinians and Israelis together. Can she update the House on that very worthy project?
I am pleased to confirm that we are indeed working on a range of co-existence programmes in Israel and the Occupied Palestinian Territories to support tangible improvements, as my hon. Friend the Minister of State has said. The programme is now in its final design phase and will be launched at the beginning of the financial year. [Interruption.]
Order. I understand the air of anticipation in the Chamber just before Prime Minister’s questions, but I remind the House that we are discussing matters that affect the poorest people on the face of the planet. They should be treated with respect.
The protection of civilians in Aleppo must remain our absolute priority, but if we are to provide food, water, shelter and humanitarian relief to civilians who, for four years, have faced the horrors of an inhumane war, we need to ensure that the ceasefire, although currently holding, remains more than a brief pause. Can the Secretary of State therefore say what efforts the Government are making to ensure that conflict does not reignite in Aleppo? What contingency plan does DFID have in place to continue providing aid to civilians should the conflict reignite? We must not see humanity in meltdown again.
The hon. Gentleman is right that the UK will do everything it possibly can to support the current ceasefire and, importantly, to safeguard humanitarian support in the region, too. That is down to our diplomatic tools and diplomatic efforts, but, importantly, we are also making sure that all agencies work together to deliver the vital humanitarian support that is required.
Like all Conservatives, I, too, want to focus on making sure that every penny of taxpayers’ money goes to helping the world’s poorest, which is exactly the mission of our Department. At the same time, my hon. Friend will know that overseas development assistance saves lives and transforms lives. He specifically refers to money spent on consultants, which is something that my Department is currently reviewing. [Interruption.]
Order. The Secretary of State’s replies must be heard with courtesy. It is rather alarming when some of her own Back Benchers are not according her the proper respect. She must be accorded the proper respect.
The hon. Gentleman makes a fundamental point. We have talked a great deal about demolitions and settlements, but the only long-term stability in that region requires protecting the security of Israel as an absolutely essential plank, along with guaranteeing an autonomous, independent Palestinian state.
My hon. Friend will know that our priority is, of course, economic development and making sure that, through our aid, we are delivering long-term sustainable economic development and prosperity in everything we do. He is also right to note that DFID is working across the Government as we leave the European Union to look at unilateral trade preferences and the work we can do to grow our trade footprint across the world.
We have been unequivocal in our commitment to 0.7% and, in addition, it is a manifesto commitment. Let me restate again, for the benefit of the House, that the focus of my Department is on poverty reduction and on ensuring that that money is spent to drive taxpayer value and deliver programmes for the poorest in the world.
I call Pauline Latham. The hon. Lady wanted to ask a question earlier. Is she no longer inclined to do so?
I am here. Thank you very much, Mr Speaker. The Select Committee visited the Democratic Republic of the Congo last year and saw the amazing work done by the CDC, which is creating not only more energy for millions of people, but a lot of jobs. May we encourage the CDC to do even more schemes like that?
I thank my hon. Friend very much for paying tribute to the incredibly important role of the CDC. By bringing the rigour of the private sector with the genuine values of the public sector, we have demonstrated in the DRC the ability to provide hydro power that benefits thousands of people. I also wish to pay testament to the Chair of the International Development Committee for his tribute to that project in particular.
I thank the hon. Gentleman for his question. He will have heard in the previous responses our commitment to co-existence programmes and how they will not just drive the right values, but help to bring the two communities together in a very constructive way—this is in addition to our focus on targeted spending on public schemes such as health and education programmes within the region.
The Prime Minister was asked—
This morning, I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
A very happy new year to you, Mr Speaker, and I would like to extend that to everyone in this House.
It has been more than six months since the European referendum. Embarrassingly for the Prime Minister, the Scottish Government are the only Administration on these islands to have published a plan on what to do next. Has she read it yet? When will she be publishing her own plan?
I join the hon. Gentleman in wishing everybody in the House, not only Members, but all the staff of the House, a very happy new year.
As I said to the Liaison Committee when I appeared in front of it before Christmas, I will, in a matter of weeks, be setting out some more details of our proposals on this issue. I would like just to remind the hon. Gentleman, when he talks about the Scottish Government’s plan, that of course it is his party, the Scottish nationalist party, that wants to leave the United Kingdom and therefore leave the European Union.
I certainly agree with my hon. Friend that new nuclear does have a crucial role to play in securing our future energy needs, especially as we are looking to move to a low-carbon society. The industrial strategy that the Government will be setting out will have a strong emphasis on the role of regions in supporting economic growth and ensuring that the economy works for everyone. Like him, I very much welcome the proposals from NuGen and Toshiba to develop a new nuclear power station at Moorside in Cumbria. The Department for Business, Energy and Industrial Strategy continues to work closely with NuGen and other developers as they bring their proposals forward.
I call Jeremy Corbyn.
Hon. Members: “Hear, hear!”
Thank you, Mr Speaker. It is nice to get such a warm welcome, and may I wish all Members, as well as all members of staff in the House, a happy new year?
I hope the whole House will join me—I am sure it will—in paying tribute to 22-year-old Lance Corporal Scott Hetherington, who died in a non-combat incident in Iraq last Monday. I am sure the whole House will also join in sending its heartfelt condolences to the family and friends of seven-year-old Katie Rough, who tragically died in York earlier this week. I think it is right that we send condolences to her family.
Last week, 485 people in England spent more than 12 hours on trolleys in hospital corridors. The Red Cross described this as a “humanitarian crisis”. I called on the Prime Minister to come to Parliament on Monday, but she did not—she sent the Health Secretary. But does she agree with him that the best way to solve the crisis of the four-hour wait is to fiddle the figures, so that people are not seen to be waiting so long on trolleys in NHS hospitals?
First, may I join the right hon. Gentleman in sending our condolences to the family of Lance Corporal Hetherington, who, as he said, died in a non-combat incident in Iraq? From everything I have seen and read about Lance Corporal Hetherington, he was a very fine young man. He delighted in being in the armed forces, and we are proud that such a fine young man was in our armed forces. I also join the right hon. Gentleman in expressing condolences to the family and friends of little Katie, who died so tragically.
The right hon. Gentleman talks about the pressures on the NHS, and we acknowledge that there are pressures on the national health service. There are always extra pressures on the NHS during the winter, but, of course, we have at the moment those added pressures of the ageing population and the growing complex needs of the population. He also refers to the British Red Cross’s term, “humanitarian crisis.” I have to say to him that I think we have all seen humanitarian crises around the world, and to use that description of a national health service that last year saw 2.5 million more people treated in accident and emergency than six years ago was irresponsible and overblown.
Some 1.8 million people had to wait longer than four hours in A&E departments last year. The Prime Minister might not like what the Red Cross said, but on the same day the British Medical Association said that
“conditions in hospitals across the country are reaching a dangerous level.”
The Royal College of Nursing has said that NHS conditions are the worst ever. The Royal College of Physicians has told the Prime Minister that the NHS is
“under-funded, under-doctored and overstretched.”
If she will not listen to the Red Cross, who will she listen to?
I have said to the right hon. Gentleman that I of course acknowledge that there are pressures on the national health service. The Government have put extra funding into the national health service. The fact is that we are seeing more people being treated in our NHS: 2,500 more people are treated within four hours every day in the national health service because of the Government putting in extra funding and because of the hard work of medical professionals in our national health service. It is not just a question of targets for the health service, although we continue to have a commitment to the four-hour target, as the Health Secretary has made clear. It is a question of making sure that people are provided with the appropriate care for them, and the best possible care for them in their circumstances.
The right hon. Lady seems to be in some degree of denial about this. She will not listen to professional organisations that have spent their whole lifetimes doing their best for the NHS, but will she listen to Sian, who works for the NHS? She has a 22-month- old nephew. He went into hospital, but there was no bed. He was treated on two plastic chairs pushed together with a blanket. Sian says that
“one of the nurses told my sister that it’s always like this nowadays”.
She says to us all:
“Surely we should strive to do better than this.”
Do the Prime Minister and the Health Secretary think that is an acceptable way to treat a 22-month-old child in need of help?
I accept that there have been a small number of incidents in which unacceptable practices have taken place. We do not want those things to happen, but what matters is how you deal with them, which is why it is so important that the NHS looks into the issues when unacceptable incidents have taken place and learns lessons from them. I come back to the point that I was making earlier: the right hon. Gentleman talks about the hard-working healthcare professionals, like Sian, in the national health service, and indeed we should be grateful for all those who are working in the NHS, but on the Tuesday after Christmas we saw the busiest day ever in the national health service, and over the few weeks around Christmas we saw the day on which more people were treated in accident and emergency within four hours than ever before. That is the reality of our national health service.
We all thank NHS staff and we all praise NHS staff, but the Prime Minister’s Government are proposing, through sustainability and transformation, to cut one third of the beds in all our hospitals in the very near future. On Monday, she spoke about mental health and doing more to help people, particularly young people, with those conditions, which I welcome, except that last night the BBC revealed that, over five years, there had been an 89% increase in young people with mental health issues having to go to A&E departments. Does she not agree that the £1.25 billion committed to child and adolescent mental health in 2015 should have been ring-fenced rather than used as a resource to be raided to plug other holes in other budgets in the NHS?
If we look at what is happening with mental health treatment in the national health service, we see 1,400 more people every day accessing mental health services. When I spoke about this issue on Monday, I said that there is of course more for us to do—this is not a problem that will be resolved overnight. I have set out ways in which we will see an improvement in the services in relation to mental health, but it is about the appropriate care for the individual. As I mentioned earlier, that is not just about accident and emergency. When I was in Aldershot on Monday, I spoke to service users with mental health problems who said that they did not want to go to A&E. The provision of alternative services has meant that the A&E locally has seen its numbers stabilising rather than going up. It is about the appropriate care for the individual. We want to see that good practice spread across the whole country.
Nobody wants people with mental health conditions to go to A&E departments—the A&E departments do not want them to go there. Under this Government, there are 6,000 fewer nurses and 400 fewer doctors working in mental health. It is obvious that these people will go somewhere to try to get help when they are in a desperate situation. Our NHS is under huge pressure. Much of that is caused by cuts to social care, which the Royal College of Physicians says
“are pushing more people into our hospitals and trapping them there for longer.”
Will the Prime Minister do what my hon. Friend the Member for Leicester South (Jonathan Ashworth) has called for and bring forward now the extra £700 million allocated in 2019 and put it into social care, so that we do not have this problem of people staying too long in hospital when they should be cared for by a social care system?
The right hon. Gentleman asked me those questions in the last PMQs before Christmas. [Interruption.] He may find it difficult to believe that somebody will say the same thing that they said a few weeks ago, but we have put extra money into social care. In the medium term, we are ensuring that best practice is spread across the country. He talks about delayed discharges. Some local authorities, which work with their health service locally, have virtually no delayed discharges. Some 50%—half of the delayed discharges—are in only 24 local authority areas. What does that tell us? It tells us that it is about not just funding, but best practice. If he comes back to me and talks to me about funding again, he should think on this: we can only fund social care and the NHS if we have a strong economy, and we will only have that with the Conservatives.
I am sorry to have to bring the Prime Minister back to the subject of social care, which I raised before Christmas. The reason I did so, and will continue to do so, is that she has not addressed the problem. The Government have cut £4.6 billion from the social care budget. The King’s Fund says that there is a social care funding gap of almost £2 billion this year.
Earlier this week, the Prime Minister said that she wanted to create a “shared society”. Well, we certainly have that: more people sharing hospital corridors on trolleys; more people sharing waiting areas in A&E departments; and more people sharing in the anxiety created by this Government. Our NHS is in crisis, but the Prime Minister is in denial. May I suggest to her that, on the economic question, she should cancel the corporate tax cuts, and spend the money where it is needed—on people in desperate need in social care and in our hospitals?
The right hon. Gentleman talks about a crisis. I suggest he listen to the right hon. Member for Don Valley (Caroline Flint), a former Labour Health Minister, who said that, with Labour,
“It’s always about ‘crisis...the NHS is on its knees’… We’ve got to be a bit more grown up about this.”
And he talks to me about restoring the cuts in corporation tax. The Labour party has already spent that money eight times. The last thing the NHS needs is a cheque from Labour that bounces. The only way that we can ensure that we have funding for the national health service is with a strong economy. Yesterday, the right hon. Gentleman proved that he is not only incompetent, but that he would destroy our economy, and that would devastate our national health service.
My right hon. Friend raises an important point. One of the things I spoke about, when I spoke about mental health on Monday, was trying to ensure that we can provide some better training for staff and teachers in schools to identify the early stages of mental health problems for young people, so that those problems can be addressed. Something like half of all mental health problems start before the age of 14, so this is a real issue that we need to address. We are going to look at how we can provide that training. We will also review the mental health services provided for young people to ensure that we can identify what is working and make sure that good practice is spread across the country.
May I begin with a tribute to Father George Thompson, who died shortly before Christmas? He led a remarkable life as a teacher, as a priest and as the Scottish National party Member of Parliament for Galloway. We extend our sympathies to his family.
All of us in this House and across these islands care about the peace process and about the democratic institutions in Northern Ireland, so may I wish the Prime Minister well and the Taoiseach, the Northern Ireland Secretary and the political parties all the best in trying to resolve the serious political difficulties there? Will the Prime Minister tell us what the consequences will be if no agreement can be found?
First, may I join the right hon. Gentleman in offering condolences to the family and friends of the Rev. George Thompson, who, as he says, was the MP for Galloway between 1974 and 1979 and, I believe, was the first former MP in modern times to be ordained a Roman Catholic priest.
On the issue that the right hon. Gentleman raises about the political situation in Northern Ireland, we are obviously treating this with the utmost seriousness. As he will know, my right hon. Friend the Northern Ireland Secretary made a statement in the House earlier this week on this issue. He has spoken to the First Minister and the former Deputy First Minister, and he is urging all parties to work together to find a way forward. I have also spoken to the Taoiseach about this issue, so we are putting every effort into this. The legislation says that if, within seven days, we do not have a nomination for a Deputy First Minister, the matter would go to an election.
The Prime Minister has indicated that she wants to take the views of the elected representatives and the devolved institutions on Brexit seriously. So it stands to reason then that if there is no Northern Ireland Assembly and no Northern Ireland Executive for much of the time before the March timetable that she has set for invoking article 50, she will be unable to consult properly, to discuss fully and to find agreement on the complex issues during this period. In these circumstances, will the Prime Minister postpone invoking article 50—[Interruption]—or will she just plough on regardless?
As the right hon. Gentleman says, we want to ensure that we do hear the views from all parts of the United Kingdom. That is why we have established the JMC European committee specifically to take views and the JMC plenary, which is also obviously meeting more frequently than previously. I am clear that, first of all, we want to try to ensure that, within this period of seven days, we can find a resolution to the political situation in Northern Ireland, so that we can to see the Assembly Government continuing. But I am also clear that, in the discussions that we have, it will be possible—it is still the case that Ministers are in place and that, obviously, there are executives in place—that we are still able to take the views of the Northern Ireland people.
Economy/Public Services (Staffordshire)
The fundamentals of the UK’s economy are strong, including in Staffordshire and the west midlands. Employment in Staffordshire has risen by over 20,000 since 2010. We have protected schools and police budgets. We see more doctors and more nurses in the Burton hospitals trust. Of course, we are going further than this in the west midlands by giving new powers to the west midlands with the devolution deal and with the election of a directly elected Mayor. I have to say that I think Andy Street, with his business and local experience, would be a very good Mayor for the west midlands.
I thank my right hon. Friend the Prime Minister for that answer. Unemployment in my constituency—my beautiful Lichfield constituency—is around 0.7%, and that is fantastic, but I want it even lower. I found out that 24% of my constituents work in the area of the West Midlands Combined Authority, so can I press my right hon. Friend just a little further about what she thinks is needed in the West Midlands Combined Authority to improve employment still more?
I thank my hon. Friend, and, of course, I have had the advantage of having visited his beautiful constituency. But in relation to the midlands, we have a very strong ambition to make the midlands an engine for growth in the UK. That is why we have plans for the midlands engine that demonstrate that, when we say we are going to build an economy that works for everyone, we actually mean it. In the autumn statement, my right hon. Friend the Chancellor confirmed things such as the £5 million for a Birmingham rail hub and a £250 million midlands engine investment fund, and we will shortly be publishing a strategy for the midlands engine. But I repeat the point that I made: for the west midlands, having the devolution deal, having the Mayor and having the right person elected as Mayor, who I think will be Andy Street, is absolutely crucial.
The hon. Gentleman will be very well aware that I want to see the best possible trade deal for the United Kingdom with the EU and the best possible deal for trading with and operating within the single European market. When we enter the negotiations, obviously, that is one of the issues that I have said that I want to see, and we will be out there and be delivering on it. Unlike the sort of downplaying that the hon. Gentleman does about the approach that we are taking, I have to say that it is this Government who are ambitious for the opportunities that are available to this country once we leave the European Union.
I think everybody recognises that the way that schools have been funded in the past has been unfair and many pupils have been missing out. That is why I think it is right for us to look at bringing forward a new fair funding formula, making sure that funding is attached to children’s needs. Of course we recognise the particular issues of rural areas in this, and that is why, within the fair funding formula, additional funding for such schools has been included. But, of course, the Department for Education has this out for consultation at the moment, and I would urge my hon. Friend to make her representations as part of that consultation.
What the hon. Lady is referring to, of course, is the plans that are being put forward at local level to consider—[Interruption.]
Order. There is far too much noise. I must say to the hon. Member for Dewsbury (Paula Sherriff) that if she were behaving like this in another public place she would probably be subject to an antisocial behaviour order.
I return to the point, Mr Speaker. Decisions about services in the local area are rightly taken by the local national health service, because we believe that it is local clinicians, and also local patients and leaders, who know what is best for their areas. So it is about trying to tailor the services to provide the best possible services for the needs of local people, modernising the care and facilities and making services appropriate to the local area. This trust has an extensive improvement plan to ensure that both hospitals within it can care for patients attending accident and emergency in as timely a way as possible.
I can absolutely give my hon. Friend that commitment. What is important is that the industrial strategy will be looking to the economy of the future—what sort of economy we want in this country. Crucial to that will be the growth that is generated by entrepreneurs and by small businesses—by the very passion that he has spoken about. We want to see an environment in which those who can grow can emerge and develop to provide future jobs for people and contribute to the strength of our economy. That is what the industrial strategy is about; I absolutely agree with my hon. Friend.
I recognise, obviously, the interest and the attention that the right hon. Gentleman has given to these issues—of course, he is a former Health Minister—and I would be happy to meet him and others, as he suggests.
My hon. Friend raises a very important point. I am very happy to join him in paying tribute to these two campaigners. Indeed, I am sure that the whole House would want to pay tribute to the work that they are doing. As he says, I remain committed to ensuring that the voices of victims are heard. That is what I did when I was Home Secretary, if we look at issues such as introducing new measures to tackle modern slavery, strengthening the Independent Police Complaints Commission and legislating in relation to police complaints and discipline systems to strengthen public confidence in policing, and a number of other actions that I took. I am very pleased to say that my right hon. Friend the current Home Secretary is taking that same passion to ensuring that the voices of the victims of crime are heard and is taking that forward.
The issue of bank branches and, indeed, of the accessibility of bank services is one that is for individual banks themselves to take and consider, and of course there are many ways in which people are now accessing bank services other than by going physically into an actual bank branch, but I will certainly look at the issue that the hon. and learned Lady has raised.
I welcome the establishment of the north Wales and Mersey-Dee rail taskforce and the work that it is doing. The plan that my hon. Friend mentions sets out an ambitious programme of improvements for the area, and I am sure it will be prioritising the most promising options. I can say to him that the Department for Transport will continue to work closely with the taskforce and with the Welsh Government to consider what can be jointly accomplished.
Action has been taken on the issue in relation to women’s pensions. The Government took action to ensure that the number of people who were affected and the period for which they were affected would be reduced, and money was put in to ensure that that was possible. If the hon. Gentleman looks at the new structure that is being put in place for pensions, he will see that women will actually be some of the greater beneficiaries of the new structure.
My hon. Friend raises an important issue, which was of course alluded to earlier in this session of Prime Minister’s questions. We are investing more in mental health than ever before—we are spending a record £11.4 billion a year—and it was of course the Conservative-led Government that introduced parity of esteem between mental and physical health, but as I said earlier, there is more for us to do in ensuring that appropriate care is available for people. I cited an example earlier of where I saw excellent work being done to provide care and support for people in the community, which was relieving pressure on accident and emergency, but also ensuring that people were getting the best possible care for them, and that is obviously what we want to see.
The problems that are facing the health service in Cumbria are widely recognised, and I do understand the concerns of local people about the services that will be available for them. We have put robust national support in place to address some of the long-standing challenges in Cumbria, and we are developing a lasting plan to deliver the high-quality, sustainable services that patients rightly expect.
The hon. Gentleman is right that these specific decisions are being taken locally, and no final decisions have been taken. I recognise the concern that he has raised previously, particularly about services at West Cumberland hospital. There will be considerable involvement in taking those decisions, but as I say, we do recognise the local concerns about some of the long-standing challenges for health service provision in Cumbria.
I know from my career in medicine that the men and women of our East Midlands ambulance service do a brave and sterling job for the people of Sleaford and North Hykeham and others, saving people’s lives every day. East Midlands ambulance service responded to a total of 11,662 999 calls over the Christmas bank holiday weekend alone, 2,500 of which were in Lincolnshire. Will the Prime Minister join me in paying tribute to their dedication, particularly over the busy winter period, and tell the House what more the Government can do to support our ambulance services and improve response times in rural areas such as Sleaford and North Hykeham?
May I thank my hon. Friend for her question, and also for bringing her personal experience as a medical professional to this issue? I am very happy to join her in paying tribute to the men and women of the ambulance service for the dedication and commitment that they show. She asks what the Government have been doing. We recognise that ambulance services are very busy, which is why we see over 2,000 more paramedics now compared with 2010, and we are increasing paramedic training places by over 60% this year. Also, the Department of Health, NHS Employers and ambulance unions have agreed changes to the compensation for paramedics, potentially giving them a pay increase of up to £14,000 as they progress. We recognise the excellent work that they do.
May I commend the Prime Minister for her considered statement last night and, indeed, for the words that she has given this afternoon? She knows our commitment to the institutions in Northern Ireland, but does she agree that nothing can be, or should be, gained from threatening the peace process, the progress that we have made or the institutions that we have fought so hard to sustain in Northern Ireland?
The progress that has been made in Northern Ireland has been hard won, and we must all recognise that we do not want to put that progress in jeopardy. That is why it is so important for the Government, and for all parties, to work as hard as we can to see a resolution to this issue, so that we can see a return to the power-sharing institutions and ensure that the hard-won progress can be continued.
I warmly welcome what my right hon. Friend said about children’s mental health earlier this week, but may I draw her attention to another burning injustice? My constituent, Paula Edwards, has been battling cancer for four years. She is recovering from an operation and has taken 28 weeks off work. She is still employed and is on half pay, yet her working tax credits have been stopped, which means that she is worrying about how to make ends meet rather than focusing on her recovery. Will my right hon. Friend ask the Treasury to look at this, perhaps in the course of Budget preparations?
I thank my right hon. Friend for her comments about the mental health announcements that I have made. I am sorry to hear of the particular difficulties that her constituent is experiencing and the distress that they have caused her. Of course, working tax credits provide support for low-income families in work and are designed to incentivise people to increase their working hours. With the new universal credit system, we will obviously have a system of benefits with single, streamlined payments that encourages work, but I am sure the Financial Secretary to the Treasury would be happy to look at the individual case that my right hon. Friend has raised and the issue that she has set out.
Green Investment Bank
(Urgent Question): To ask the Secretary of State for Business, Energy and Industrial Strategy if he will make a statement on the sale of the Green Investment Bank.
The Government set out their plans for the sale of the Green Investment Bank in the document “Green Investment Bank: Sale of Shares” laid before Parliament on 3 March 2016. The Government intend to move the GIB into the private sector, so that it can increase its access to private capital and increase its green impact free from the constraints of Government ownership. Potential bidders are interested in the GIB precisely because of its green specialism. We are asking potential investors to confirm their commitment to GIB’s green values and investment principles, and how they propose to protect them, as part of their bids for the company. In addition, the Government have approved the creation of a special share, held by independent trustees, to protect GIB’s green purposes in future.
As I am sure the House will appreciate, the sale is commercially sensitive, so I cannot comment on the identity of any bidders or the discussions taking place between the Government and potential bidders. All parties have been required to sign confidentiality agreements that place strict restrictions on the disclosure of information. The restrictions apply both to bidders and the Government.
I thank the Minister for his reply, but it gives very little reassurance, given that everybody knows who the preferred bidder is. The preferred bidder, Macquarie, has a very, very worrying and dubious track record. I am putting this question today with support from across the House.
This week, we heard that the Green Investment Bank stands on the brink not just of being flogged off but broken up, with its green purposes discarded. Founded in 2012, the GIB has been widely recognised as a true success story, kick-starting truly innovative low-carbon projects across the UK, yet the preferred bidder—Macquarie—not only has a dismal and terrible environmental record but an appalling track record of asset stripping. So why have the Government given preferred bidder status to this company? What assessment have the Government made of Macquarie’s record, given that in 2005 the board of the London stock exchange deemed Macquarie unfit to conduct a takeover?
Furthermore, research this week uncovered changes to the GIB’s corporate structure. Between 22 November and 1 December, 10 new companies were incorporated and registered to the GIB’s London offices. The changes suggest that Macquarie is planning to fundamentally hollow out the GIB. Why have the 10 new companies been set up? Will the Minister confirm whether the changes made at the end of last year were made at the behest of Macquarie? Why are the Government setting up a structure to invite in a property asset stripper? If the GIB has been restructured in such a way as to allow it to be stripped of its assets, how can the Government guarantee that the special share, supposedly introduced to protect the future of the GIB, will have the intended effect?
Is this not exactly the wrong time to be selling off the GIB, given that the Government have decided to embark on a new industrial strategy, which must, to be in accord with our own climate change commitments, have low-carbon projects at its core? Finally, will the Minister admit that this selling off could lead to the bank being fatally undermined as an enduring institution? Will he stop the killing off of the Green Investment Bank? Will he halt the sale process with immediate effect?
As I think the hon. Lady knows, she has asked a stream of questions to which I cannot give direct answers. She will also know, being an experienced Member, that I cannot comment publicly on the identity of bidders or the process under way, for the reasons I elaborated at the start. She draws a lot of conclusions from media speculation, on which it would be irresponsible for me to comment, but I will try to give her some reassurance, flowing back to the objectives behind the sale that I set out in my answer. It is precisely because we want the GIB to be able to do more, unfettered by the constraints of the state, that we are seeking to put it into the private sector.
The objectives that we set out in the sale could not have been clearer and have been discussed in the House, and they include clear objectives around securing value for money for the taxpayer, which must be our primary responsibility. We want to ensure that the GIB can be reclassified to the private sector, but we have also been clear that we want to move it into the private sector to enable the business to grow and continue as an institution that supports investment in the green economy. We are selling it as a going concern, and potential investors would have to buy into the company’s green business plan and project pipeline. These are the criteria that we have set and against which we are evaluating the proposals before us.
The GIB is a tremendous Conservative success story. It was devised by the Conservatives pre-2010, probably by my hon. Friend the Minister, and was introduced by a Conservative-led Government, and it has been a great catalyst for investment in the green economy—I am thinking, in particular, of the Galloper wind farm off the East Anglian coast. There is a concern, however, if the press stories regarding asset stripping and job losses are to be believed, that it will not be able to perform that role in the future. In that light, will he consider a pause in the process, so that we can ensure that the GIB continues to perform the great role it has played since 2012?
I agree with my hon. Friend’s opening comments about saluting what has been a great success story of the coalition—let us maintain the season of good will—but Conservative-led Government. It was the right thing to set up; it was we who did it; and it has been a great success, having mobilised £8 billion of private capital into a critical area of infrastructure, according to the last figures. I can, however, assure him—he is far too experienced to be drawn or influenced too much by media speculation—that we are not being naive in this process. We have set clear criteria for the sale. We have run a genuinely competitive process, and we are now evaluating the proposals before us, through the lens of the criteria we have set, which include value for money and reclassification. We are selling a going concern, and what we want to hear about are forward plans for a dynamic, ongoing concern seeking to mobilise more private capital into the green economy. He knows as well as anyone in the House that we need to mobilise a lot of private sector capital to get the clean energy we need.
I hope the Minister would agree that the GIB is a great British success story—he has already said as much—but let us put the record straight: it is also a Labour success story, having first appeared in our 2010 manifesto, and I am glad that the coalition Government took it up. If it is a success story, however, why are they selling it off? Is it simply a case of “public good, private bad”? That is what we think on the Opposition Benches, but Conservatives think it is “private good, public bad”. I am telling the House, quite simply, that from the assessment of Macquarie and what we have seen of it, we see that it has a history of asset stripping, so how exactly will the Minister protect this valuable public institution from having its assets sold off? That is a very fair question.
We know that the Government had planned to hold a share in the bank, which would have helped to maintain its green purposes, but new evidence has shown that Macquarie has already set up new companies that will control the GIB’s major assets. Will the Minister elaborate on the purpose of those companies and what oversight the Government will have of them once the sale goes through? The Prime Minister told us that the industrial strategy would be at the heart of her Government, yet the Government are now selling off an institution that has succeeded, from scratch and against the odds, in attracting capital for our green infrastructure on commercial lines. The Minister has already been outmanoeuvred by Macquarie bank and, frankly, we do not have much confidence that it will not happen again. Will the Government agree to stop the sale of the Green Investment Bank today until such time as its green purpose and core assets can be genuinely protected? If the Minister will not, does he accept that the GIB’s fate rests on his shoulders?
I will pass over the bizarre claim that the GIB is a Labour success story by virtue of its simply being mentioned in a 2010 manifesto, with nothing done for 13 years in government prior to that. This meant that in 2010, we started with far too low levels of clean energy in this country—a situation transformed by the coalition Government.
Again, I caution Members against making assumptions on the basis of speculation in the media, and I am not going to comment on that or identify any bidders.
The hon. Gentleman reflects the different view across the House about the benefits and values of the private sector. He should be aware, holding the position that he does, that we need to mobilise a huge amount of private capital. It is private capital, not public capital, that is going to make the difference when it comes to the big shift in infrastructure. What he misses is the critical role that the state has played in setting up the GIB to correct a market failure.
The fact that we have run a competitive process and that private sector bidders have come up and said, “We want to buy this as a going concern because of its green specialism,” indicates that the market failure has, to a large extent, been corrected. The fact that this institution has mobilised billions of pounds of private capital into this critically important area of infrastructure is a success story. Our whole instinct now is that because we want it to do more, it will do more and be an even more successful institution in the private sector as a going concern.
The Government have always been clear that the GIB was designed with a view to a possible transfer to the private sector, so will the Minister assure the House that the purpose of the GIB is, and will remain, green investment? I know that the Minister is dedicated to environmental issues, so will he also assure us that we will stick to our laudable manifesto pledge of leaving the environment in a better situation than we found it?
I thank my hon. Friend for her positive observation, and I pay tribute to her record and her absolute integrity and authenticity on protection of the environment and climate change, which are well respected across the House. I can give her this assurance. We have put before Parliament the whole procedure for protecting the green purpose of the GIB through the special share arrangements. It will be held by an independent company and it will have the power to approve or reject any proposed changes to the GIB’s green purposes. This is going to be set in company law. The five trustees were announced on 31 October 2016, selected through a genuinely independent process. If my hon. Friend looks at the names, she will see that they are independent and extremely credible. That is the mechanism that we have set out. I return to the point about the objectives of the sale. We want this to go into the private sector, so that it can do more of what it is doing—unfettered by the inevitable restrictions that the state has to put on it at this stage.
I thank you for granting this urgent question, Mr Speaker, and I thank the hon. Member for Brighton, Pavilion (Caroline Lucas) for putting it. We support it wholeheartedly. The Minister has repeatedly said that he wants to see more money raised through this, but it will not happen if the assets are stripped from the company and taken abroad. Also, this is happening at precisely the worst possible time. There are reports that we will see a 90% fall in renewables investment. That must be addressed, and the GIB should be the vehicle for doing that.
What assurances can the Minister provide that capital from existing assets will be reinvested in green projects in the UK? How will the golden share work when it comes to subsidiaries and, in particular, to having a say over asset sales? What reassurances can he give us that the headquarters in Edinburgh will continue? How will the Government ensure that the shortfall in investment in renewables will be met? Finally, in the light of the forthcoming industrial strategy and emissions reduction plan, will the Minister pause this sale, so that Parliament can properly look at these and see what role the GIB can play in that process?
The hon. Gentleman quite rightly talks about the need for investment in renewables, but it would be nice if he could give more recognition of the extraordinary progress this country has made in respect of the profound transition to clean energy and the fact that we have generated more electricity from renewable energy than from coal this year, which is a pivotal moment in our history. Investment continues to flow, and the GIB has played and I am sure will continue to play a very important role as a catalyst for all that.
I understand that the hon. Gentleman seeks reassurances and share his sentiments, but this is part of our process of evaluating the proposals before us against the criteria transparently set out and agreed through the House. It is through that lens that we now evaluate the proposals, which obviously includes attitudes to the workforce and sensitivities around jobs in Scotland. This is all part of the criteria and is, as I say, the lens through which we look at the proposals. Beyond that, I cannot say much because of confidentiality, and I hope the hon. Gentleman will respect that.
For the Opposition business spokesman to make the sweeping generalisation that “private is bad” is, I find, an appalling indictment, which provides evidence of why millions of private sector workers cannot rely on the Opposition. When the Minister looks at the golden share, will he consider whether some guarantees could be provided for future investment and in relation to the existing portfolio, perhaps for the first couple of years during the transfer to any bidder?
I thank my hon. Friend for that constructive observation. He is quite right in his first point—“public good, private bad” could not have been clearer from the Opposition Front Bench. That will have been noted in the business community and across the country, reinforcing the question mark that the country’s business community has about the Labour party’s attitudes towards it.
On the green share and the maintenance of assets, I have set out the mechanisms; I think they are robust, and Parliament agreed that they were. As for so-called asset stripping and the freedom to sell assets, let us not get ourselves into a position in which we view holding assets for ever as a good in itself. I do not think we would want that for the GIB under its current structure. The management of the organisation has to be free to manage a portfolio. As a Government, we have to be practical about the limitations we would place on a private sector bid. I come back to the point that we have been very clear about the criteria we are setting for this sale, and we are looking at proposals by taking a holistic view of those criteria, which include the need for reassurance about the forward plans for the organisation and the level of ambition for mobilising private sector capital into this critical area of clean infrastructure.
In the interests of consensus, we can agree that there was cross-party support for the Green Investment Bank right from the get-go. I would say to the Minister that there is also cross-party concern about this sale—and I could mention Lord Barker, who was a Minister in the last Parliament, Vince Cable and of course people on the Labour side. Is not the key question for the Minister and the Secretary of State this one? They promised a new approach to industrial strategy with a new Department, by contrast with their predecessors who did not even use the phrase “industrial strategy”. The question to the Minister is: what has changed since they took over? If there is a moment to prove commitment to the new industrial strategy, it is this one in respect of their plans for the GIB.
The right hon. Gentleman may be right about the cross-party agreement on the need for a GIB; the difference is that we did it, and he did not. His party had plenty of opportunity to do it. He talks about the need for a continued commitment to investment in renewables, and I think we have shown that. In fact, one of the most decisive steps this Department has taken in the short time we have been in power is the announcement of the new contract for difference auctions, which will be the next stage of support for the more mature renewable tech choice. There is no issue about this Government’s commitment to the low-carbon economy and the green infrastructure that needs to underpin it. The Secretary of State could not have been clearer about that. Where I think there is a divergence of view is that the Labour party seems to think that state ownership is a good in itself, whereas in this situation we feel we have moved on from that. When it comes to this very important organisation, which has done a great job, we want to liberate it so that it can do more in future. It is partly through that lens that we are looking at the proposals before us.
Does my hon. Friend agree that the test—the proof of the pudding—lies not in how many existing assets of a given kind are owned, but in whether there will be a greater or smaller amount of investment in renewable and other green energy projects in the future? Does he agree that this privatisation will prove to have been a success if investment in new projects increases as a result?
I am delighted to respond to that question from my right hon. Friend, who was, in many respects, the guardian angel of the coalition Government, and who was intricately involved in the deliberations that led to the establishment of the Green Investment Bank. He is absolutely right, and he has made a fundamental point. We should not necessarily judge the bank on the basis of what it is at the moment; this is about what it can become, about levels of future investment and about commitment to the green purpose of the organisation. I do not think that the Government could have been clearer about the priority that we attach to those considerations. This is about the future.
May I give the Minister another opportunity to answer the question that I asked him in the Select Committee yesterday? How can he reconcile insisting on preserving the green purposes of the bank and preventing asset stripping from a new buyer with satisfying the classifications of the Office for National Statistics in respect of public sector control and balance-sheet requirements post disposal?
I have great respect for the Chairman of the Business, Energy and Industrial Strategy Committee, and we had a useful exchange about this issue yesterday, but he is again making assumptions about asset stripping. He is aware of the structure that we have established, having doubtless been involved in the parliamentary debate about it. There is a great deal of concern on both sides of the House about protecting the integrity of the green purpose of the GIB, which is why we have gone through the process—which I think is robust—of setting up what is effectively a green share, along with the mechanism for its governance. That system was, I think, agreed to by Parliament and was introduced formally with the protection of corporate law.
I return, however, to the human motive of those who want to buy this organisation, which is to enable it to grow and do more. It is the authenticity, sincerity and integrity of those proposals that we are now evaluating.
I am sure the Minister shares my slight amusement at the Opposition’s argument that we can believe everything we read in the press about the Green Investment Bank, given that they spent all yesterday afternoon arguing that we cannot believe everything we read in the press. Does he agree that the Green Investment Bank was set up to deal with a market failure, that the fact that private investors are now keen to come in demonstrates the purpose it has served and, in particular, that without the restrictions imposed by EU state aid it can deliver more investment, not less?
My hon. Friend has made—much more eloquently than I have so far succeeded in doing—exactly the fundamental point that we are trying to convey. The test of an organisation that was set up to correct a market failure is whether that failure has indeed been corrected. We believe that it has, and our view is supported by the large amounts of private sector investment that are flowing into green infrastructure in the United Kingdom and around the world. What we must do now is ensure that the GIB is free and unfettered by the state, so that it can do more.
The Environmental Audit Committee’s report on the sale of the bank stated that Ministers had rushed to privatise it without consultation or proper consideration of the alternatives, and that either it should continue to exist as a low-carbon investor or its sale should not proceed. Taxpayers do not want a repeat of the Royal Mail debacle, when a public asset was sold off at £1.4 billion below its true value, and they do not want this landmark British institution to be sold off to an asset stripper.
Is it not extraordinary that the bank’s assets were restructured in November? Can the Minister tell us whether that was done at the request of the UK Shareholder Executive, to facilitate its sale to the preferred bidder?
I do not believe that that was the case at all, although I understand the points that the hon. Lady has made. Like any other Government, we have a responsibility to deliver value for money to taxpayers, and we are very conscious of the need for this deal, if it materialises, to present itself well to the public whom we serve and represent. That is why, as one would expect, value for money is at the top of our list of criteria. We are embarking on a very good process, and we are setting ourselves very high standards for the presentation of the deal.
I remind the Minister that during the passage of the Bill that became the Enterprise Act 2016, the Government rejected a Labour amendment that would have guaranteed the green purpose of the bank. Will he give an assurance today? After privatisation, will the bank be free to invest in fracking projects?
Let me respond to the hon. Gentleman’s substantive point about the protection of the green purpose. If he doubts the integrity of the mechanism that we have established, that is fine, but I think Parliament has recognised that it is a robust mechanism, whereby the green purpose is set in the articles of association and any change must to be given effect by an affirmative resolution of the trustees. It is worth our noting the integrity of those people: James Curran MBE, Trevor Hutchings, Tushita Ranchan, Robin Lord Teverson—a very public sceptic of this process—and Peter Young. That is a very good group of people, selected by a rigorously independent process to safeguard the integrity of the green purpose, which is a priority for the Government.
We were told that we were to have the greenest Government ever, but the failed green deal collapsed, investment in renewable sources has been slashed, and we have slipped in the world rankings for investment in the low-carbon economy. If the Minister is not persuaded by the moral and environmental reasons why supporting the green economy is vital, will he consider, as a matter of urgency, the financial and economic reasons why it is crucial for us to invest in it, and will he then reverse his decision on the Green Investment Bank?
The hon. Lady is flogging rather an old horse, and, if I may say so, that is completely misplaced. Significant investment is being made in clean energy in this country and around the world. Indeed, with the Hinkley deal, the Government made one of the biggest commitments in the world to low-carbon energy. There is no question about our commitment to the transition to a low-carbon economy and a clean energy structure, and we are well along the track. I would add that we inherited an arrangement whereby we were operating on far too low a base in terms of renewable energy. It was a coalition Government led by Conservatives who changed that.
The Minister refused to name the bidders for the Green Investment Bank, but went on to tell us that private companies were saying that they wanted to buy the bank because of its success. Will the Minister tell us which private companies were saying that, or did he make up the quotation?
The right hon. Gentleman is extremely experienced, and I am not sure what part of a confidentiality agreement he does not understand. As I have said, the Government’s criteria could not be clearer: we are selling a going concern, and we are not interested in proposals that do not respect that.
When are the Government going to learn the lessons of the past when it comes to selling off public assets? I was here when Mrs Thatcher decided to sell off not only electricity but gas, and then, finally, water. She said we were going to be a British share-owning democracy: that was the phrase. If we look at the list now, we find that some of those companies are owned in Germany and some are owned in France—and Macquarie, in Australia, bought the Birmingham toll road in a flash under a Tory Government.
Today we are being given another lecture on how the Minister will preserve the identity of the Green Investment Bank. History tells us that that is not possible. The bank will go to those who are bidding for it, and they will not be just in Britain. We are in the process of leaving the EU, and the chances are that somebody in the EU will be buying up British assets—although maybe not this one. Why don’t you learn the lessons?
Of course, one of the lessons of privatisation can be seen in the record levels of investment that have flowed into those organisations since they were privatised. I respect the hon. Gentleman’s experience, and I respect his sincerity and integrity, but I think he is totally wrong. All I will say is that I have a strong instinct that he would like British Telecom still to be a public company. I will leave it at that.
The Minister is being very dismissive about speculation in the press. However, in the Financial Times the former Business Secretary, Vince Cable, has expressed concern about asset stripping, which he thinks was Macquarie’s objective, and Ed Davey, the former Energy and Climate Change Secretary, has said he considers it unlikely that the golden share would give Ministers enough clout to influence the bank’s investment strategy. Does the Minister not think that those two people—who, after all, were very much involved in the setting up of the bank—should be taken seriously and that we should act on their concerns?
Let me assure the hon. Lady that I take seriously all the concerns expressed by politicians past and present. It is important that through this urgent question the concerns that people have go from this House to potential bidders. I absolutely respect that and the individuals she mentions, but she says I am dismissing media speculation. I am not; I am just not commenting on it, because Ministers should not.
I thank the hon. Member for Bristol East (Kerry McCarthy) for reminding the House of the involvement of Liberal Democrats in initiating the Green Investment Bank. Can the Minister address the point raised by Sir Vince Cable in a letter to the Secretary of State that he remains unconvinced that the golden share will prevent the asset stripping of the company and therefore the original intentions of the green bank at its inception will be under threat?
There was a whole set of arrangements under which the special share solution was reached. It was debated through Parliament and settled through that process. My personal view is that it is a robust mechanism in itself, given its legal underpinning and the integrity and independence of the people selected to be the trustees and guardians of the process. I also come back to the fundamental point about the motivation of people who might want to buy this organisation, and the lens, criteria and disciplines we will have in evaluating their proposals and deciding whether or not to go ahead.
I, along with many colleagues, fought for the headquarters of the GIB to come to Edinburgh, where it now has more than 50 staff. Can the Minister tell us how many of those 50 staff will remain in Edinburgh after privatisation?
Many people have mentioned Vince Cable, but the legacy of Vince Cable as Business Secretary is the botched privatisation of Royal Mail, and that is why people have concerns about the GIB. The reason why we have concerns about the sale of assets is that by its nature the GIB invests in projects that the market will not touch, and therefore when those projects come on-stream they are much more profitable than normal projects, and if a preferred bidder then sells them off, they will sell them at great profit at the taxpayer’s expense.
I recognise the importance of the GIB to Edinburgh and have agreed to meet with the Members of Parliament for that area to discuss this process. It was entirely the right decision to locate part of the organisation there, and jobs are a part of what we want to hear from bidders; we want to hear about commitment to staff and the ongoing organisation.
As the hon. Gentleman has mentioned staff, let me place on record—I hope this is shared by Members across the House—the Government’s admiration and respect for the senior management team and all staff at the GIB, led by Lord Smith and Shaun Kingsbury, not just for what they have achieved in a relatively short period, but for the professionalism with which they have conducted themselves during this process.
The GIB has made substantial investments in Wales, most recently at Parc Adfer on Deeside in partnership with five local authorities. That model works pretty well. What guarantees can the Minister give that the new owners will continue to invest in that sort of way, and invest in the regions and nations of the UK rather than abroad, or possibly even in the golden south-east?
I return again to the main point about the questions we ask of bidders and the criteria we set. We want to achieve value for money; we are selling an ongoing concern, and we are determined to protect the integrity of the green purpose of the organisation, so we want to hear plans for the mobilisation of future investment and future capital. If models are working, I am sure that any bidders that are professional organisations that view the GIB as a business will have regard to them. That is what we want to hear from bidders, and we are at the point in the process where we are evaluating that. I am afraid I cannot say a great deal more beyond that.
For the sake of transparency, can the Minister tell the House whether the GIB will be able to invest in fracking in the future?
The GIB will be required under this process to continue to respect the green purpose of the organisation, as set out in the articles of association. The degree to which investment proposals fit those criteria is a judgment to be made by management and the trustees that we have set up to be independent guardians of this process.
When Vince Cable was legislating for the GIB, we got assurances that it would operate throughout the UK and support projects in Northern Ireland, and, importantly, would not be precluded from supporting cross-border projects. In fairness, one of its first investments was in Northern Ireland, and indeed in my constituency. However, many of us are concerned that the quality of its investments, reach and support will be lost in this sell-off. The Minister talks about integrity but that is not something people associate readily with the preferred bidder.
I am not going to comment on either the identity, character or values of any bidder at this stage, but I join the hon. Gentleman in recognising the good work done and the approach taken by the GIB in making sure its investments are spread across the country. I come back to the point that the motivation for our wanting the GIB to be in the private sector is to enable the business to grow and continue as an institution supporting investment in the UK green economy—the reference to the UK there is important.
I have been listening to the Minister rewrite the history of this Government’s appalling record in this area since 2010, but the GIB is the one success story, and it did have cross-party support. It does a magnificent job in supporting risky businesses that the rest of the market will not invest in. Without breaking any confidentialities around the ongoing negotiations, what guarantees can he give to this House that such risky investments will continue and that green investment will be in as good a state as now, or even better, in five years?
I am forced to repeat myself again. We have set up, in a process agreed through Parliament, a mechanism for protecting the integrity of the green purpose of the organisation. Beyond that, because we are serious about selling the bank as a going concern and want to see positive proposals for growth and future investment, we are evaluating proposals from bidders through that lens. We are, and will continue to be, influenced in that process by the attitudes of the senior management team and what they feel about the proposals.
Last year, Macquarie—to cite a company at random—made its largest ever profit, and it did so, as the markets will tell the Minister, by selling off Moto, Britain’s largest motorway service company, taking the cash out of the company and giving it to shareholders. Will the Minister tell us what in the current safeguards will prevent the future buyer, whoever they may be, from doing what Macquarie has always done: selling assets, taking the money out of the company and using it to pay its shareholders?
Again, I must repeat myself. The hon. Gentleman has chosen a company at random, but I am not going to talk about any companies. What I have tried to labour is the seriousness of purpose behind this process and the safeguards we have set up, which are protected in law and also by the criteria we have set in evaluating any bids. An important part of that is the forward intention and the intention to mobilise private capital in future.
Given Brexit and the uncertainty around it, is it not risky to sell the GIB at this time? How does the Minister envisage the Government ensuring that money will be available for the new innovative technologies that will be very important for areas such as mine in Hull and the Humber?
With respect to the hon. Lady, I am not entirely sure why Brexit is relevant to this process or to the decisions underpinning it. I agree 110% with her fundamental point about the need to invest in energy innovation, which is why our Department has a £500 million spending review portfolio dedicated to energy innovation that sits in a wider system of budgetary support for energy efficiency. The point she makes is entirely the right one: if we are to achieve what we want to achieve in decarbonisation and the transition to abundant sources of affordable low-carbon energy, we have to continue to innovate. The Government have a role in that, which is why budgetary support is available for it.
The Green Investment Bank employs 55 people at its head office in my constituency. When it was set up in 2012, the then Business Secretary, Vince Cable, said:
“Edinburgh has a lot going for it, both in terms of it asset management and finance sectors…also its proximity to green energy activity”.
He also said that choosing Edinburgh supported what he described as the “wider narrative” of binding Scotland into the UK in the run-up to the independence referendum. Will the Minister meet me to discuss how such promises can now be delivered to those 55 employees who work in the head office in my constituency?
I extend to the hon. and learned Lady the same offer that I made to a colleague earlier. Of course I will meet any colleagues whose constituencies may be affected by this process.
My question relates to the bidding process. What is the Minister’s view of the Macquarie bank, the potential bidder also known as the “cuff-linked buccaneers”? What is his opinion of the bank’s recent activity as the owner of Thames Water when it shipped off hundreds of millions in dividend payments to investors, paid minimal taxes and made disappointing investment in the network?
The hon. Lady has made her point, and she will know what point I am going to make. I cannot possibly comment on the identity of any bidder at this stage.
Does the Minister agree that, if green investments are as profitable, sound and attractive as their supporters have claimed in the House today, there should be no concern about the introduction of private finance for such projects? Indeed, given the pressure on the public purse at the moment, is he not surprised that the House is not welcoming another source of funding for these activities?
The hon. Gentleman makes an important point about the increased attractiveness of investment in renewable energy and low-carbon infrastructure. Governments in the UK and around the world have helped to facilitate that investment over the years and have seen dramatic falls in the cost of those technologies and the cost of the capital attached to them, making them a more investable proposition. This helps to reinforce our argument that this is the right time to liberate the GIB from state control to enable it to play a bigger part in the market.
The Aldersgate Group has highlighted the fact that the strength of the Green Investment Bank is that it has supported innovative projects throughout the UK that help us not only to tackle climate change but to drive down costs in the NHS and local government through energy efficiency. Will the Government heed the warning of the former Conservative Energy Minister, Lord Barker, that the bank is heading for break-up? Will they halt the sale to ensure that the bank remains a single public institution that is one step ahead of the market in the green projects that it backs?
Lord Barker is a good friend of mine for whom I have great respect. I would like to reassure him and, I hope, the House that the Government are not being naive. We are very clear about the criteria we have set, and we are in the process of a robust and rigorous evaluation of the proposals against those criteria.
The Minister has been very clear that the creation of a special share in the governance arrangements will protect the integrity of the bank’s green purpose and future investments, but may I press him for a little more detail on precisely how that special share would prevent successful bidders—Macquarie or others—from offloading current projects?
I want to make two points on that. First, the special share is being set up to protect the integrity of the green purpose, which is set out in the articles of association. It is there for all to read. Any proposed changes would need to be approved by the trustees, who have been selected independently. That is the mechanism involved. Secondly, I made the point earlier that I do not think it is sensible for investment institutions to hold on to assets forever. Part of their role is to manage a portfolio, and if they get attractive offers to divest assets we expect them to look at those offers seriously. We are interested in the plans for future investment, and in what this organisation could become under private ownership. That is what we are evaluating.
The Minister was right to say that there was cross-party support for the Green Investment Bank. There was, however, no such cross-party support—or support in Scotland—for the removal of support for carbon capture and wind energy. The fact that his party’s policies have been so disastrous in Scotland might explain why it does not do so well with the electorate there. Will he absolutely commit to all the projects that the Green Investment Bank has invested in—totalling hundreds of millions of pounds in Scotland—and assure us that, regardless of who the buyer is, they will continue?
I dispute the hon. Lady’s analysis. This country has made enormous progress in the shift to clean energy, and Scotland has been a big part of that. I point her to the recent commitment to the next round of contract for difference auctions and to the fact that last year I think we generated 25% of our energy from renewable sources. If she looks at the starting point of 2010, I think her argument falls away. On her point about continued investment in Scotland, I repeat what I have already said to colleagues.
When taken alongside the cuts to renewable energy and the abolition of the Department of Energy and Climate Change last year, does not the sell-off of the Green Investment Bank show that the Government are no longer committed to being a world leader on climate change and sustainability?
No. I am afraid that that is total nonsense. If the hon. Lady wants proof points on that, I can tell her that one of the first actions of this Department, within days of the new Government being formed, was to put into law the fifth carbon budget. I am sure that she knows the detail of that, so she will know how ambitious it is. That was not the action of a Government who are shirking their responsibilities in relation to Britain’s role in mitigating climate change.
Is the Minister seeking assurances that 100% of the return on any sales of existing assets will be reinvested in green energy in the UK?
I think I have laboured to exhaustion the point that one of our priorities is to protect the integrity of the green purpose of the organisation. What we want to hear from bidders is their plan for future investment.
Point of Order
On a point of order, Mr Speaker. The Attorney General is making a speech today—indeed, he might already have made it—that will apparently pave the way for more military drone strikes against jihadis. This looks like, smells like and walks like a policy announcement. You, Mr Speaker, will be aware of the concerns that have been expressed in the House about the use of drones, about the lack of parliamentary scrutiny of their use and terms of engagement and about the risk—acknowledged by the Attorney General—of civilian casualties associated with their deployment. Given the controversial nature of drones, do you agree that any step change in their use—in other words, a policy shift—should be raised and debated in this House, not trailed in a speech?
I am grateful to the right hon. Gentleman for his courtesy in giving me notice of his intention to raise this point of order. I certainly share his view that significant policy announcements by the Government should first be made in this House rather than outside it. I am not familiar with the contents of the Attorney General’s speech today, and I am not in a position to pronounce on whether it amounts to such an announcement of policy change. That said, the right hon. Gentleman has made his concern clear, and it will no doubt have been heard by those on the Treasury Bench. He can be sure that it will be conveyed to the relevant Ministers. The fairest thing I can say is: let us await events. I might add that as the right hon. Gentleman is a former Deputy Leader of the House, he will be well aware of—and personally closely familiar with—the instruments available for Back-Bench scrutiny of the Executive in this place.
Guardianship (Missing Persons)
Motion for leave to bring in a Bill (Standing Order No. 23)
I beg to move,
That leave be given to bring in a bill to make provision about the property and affairs of missing persons; and for connected purposes.
Sooner or later, all parents come to a certain realisation: our children are gradually slipping away from us—first crawling, then toddling, then running. The gentle, guiding hand is no longer needed as, with great delight, they discover the trick of balancing on two wheels and there they go pedalling off down the lane. There is that first day at school and then, a few years later, their hand starts to slip from ours when they get anywhere near the school gates. The teenage bedroom years are spent in self-imposed solitary confinement. Then comes the day when they cram all their stuff into the boot of the car and are off to university or the first job or to move into their first home.
All are bittersweet moments for most parents, because most of us know that our children will return. That is not so for Mr and Mrs Lawrence, parents of Claudia, a missing person since 18 March 2009—nearly eight years ago. We can never imagine the rising panic of those first minutes, hours and days when they realised something was wrong. Increasingly frantic calls and prayers go unanswered. Voicemails are never retrieved. Days turn into weeks, weeks into months, and months into years. Claudia’s fate is still unknown and still the subject of a police investigation. Many false hopes have been raised over the years. A lead? A prosecution? Nothing. Hopes raised; hopes dashed.
When a person disappears with no explanation, all the unanswered questions and difficult emotions leave their friends and family an unbelievable amount to cope with. Such desperate situations are worsened by the need to pick up the pieces of their lives, such as paying the mortgage, the rent, the car loan or insurance. Data protection and financial services contract law currently prevent even the closest relative from dealing with their finances. Mr Lawrence told me:
“Banks, insurance companies, mortgage lenders, all say, ‘We can’t accept your instructions, as you’re not our customer’.”
He went on to say:
“You’re at your lowest ebb and you have to fight all these problems... it’s terribly distressing.”
I believe that the vast majority of Members join this House because they want a better world for all our children, but there are some problems that we will never be able to solve. The flaws of mankind will always exist. Our police forces cannot prevent and solve all crimes, but we can help by easing the burden in a small but important way.
Under current English and Welsh law, when a person disappears their property is effectively left ownerless. No one has the legal authority to protect it on their behalf. That can lead to assets depreciating and property falling into disrepair and leaves those left behind without access to the resources that the missing person would have provided. The creation of a new status of guardian of the property and affairs of a missing person will fill that void and provide a sensible and helpful solution to the practical and financial difficulties faced by families and others following a disappearance.
The core of the proposal is that the court will have power to appoint a guardian on the application of a person with sufficient interest in the property and affairs of someone who is missing. The Bill provides that the person will generally have to have been missing for at least 90 days and that the guardian will take control of the property and financial affairs of the missing person and will have authority to act on behalf of the missing person. The guardian will be able to use the property of the missing person to help those left behind, will be accountable for his or her actions and will be supervised by the Office of the Public Guardian. The terms of the appointment will be for a period of up to four years but will be renewable by application to the court. The small fee involved will be payable by the missing person’s estate, so there will be little or no cost to the taxpayer. Crucially, the guardian will be required to act in the best interests of the missing person.
The proposals draw on the precedents of systems used in other countries, particularly certain states in Australia, and for deputies appointed under the Mental Capacity Act 2005. Many of us have benefited from similar powers in other difficult circumstances, such as when someone passes away or when someone close to us is no longer able to manage their own affairs due to dementia or other mental capacity issues. Quite simply, this Bill fills a gap in the law that few people know exists.
There are some 4,000 missing-people occurrences every year, and I thank everyone connected to Missing People, a support and campaign organisation, many of whom are involved because they have lost a loved one. I offer particular thanks to Mr and Mrs Lawrence, who have a deep connection with my constituency and have championed the cause of guardianship even though it can no longer help their situation. I am also grateful to Members from across the House and from the other place who have pledged their support for this motion, particularly my hon. Friends the Members for York Outer (Julian Sturdy) and for Selby and Ainsty (Nigel Adams) and the hon. Member for York Central (Rachael Maskell), who have done so much work on this topic already.
Missing People has many tragic stories of loved ones lost and those left behind having their hearts broken: husbands, wives, fathers, mothers, brothers, sisters and children. This is possibly one of those all too rare occasions when Members can make a huge difference simply by supporting this straightforward Bill.
I am grateful to the Justice Committee, for the work of the all-party parliamentary group on runaway and missing children and adults, and, crucially, to Ministers, who have pledged their full support for the Bill. All I respectfully ask for is the support of all hon. Members to guarantee the Bill’s passage through the House and into legislation.
Question put and agreed to.
That Kevin Hollinrake, Ann Coffey, Julian Sturdy, Christian Matheson, Sir David Amess, Christina Rees, Nigel Adams, David Warburton, Liz Saville Roberts, Rebecca Pow, Amanda Solloway and Dr Philippa Whitford present the Bill.
Kevin Hollinrake accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 3 February, and to be printed (Bill 120).
[17th Allotted Day]
NHS and Social Care Funding
I advise the House that Mr Speaker has selected amendment (a) in the name of the Prime Minister.
I beg to move,
That this House supports NHS England’s four-hour standard, which sets out that a minimum of 95 per cent of all patients to A&E will be treated within four hours; notes the widespread public and medical professional support for this standard; further notes that £4.6 billion has been cut from the social care budget since 2010 and that NHS funding will fall per head of population in 2018-19 and 2019-20; and calls on the Government to bring forward extra funding now for social care to help hospitals cope this winter, and to pledge a new improved funding settlement for the NHS and social care in the March 2017 Budget.
I begin by paying tribute to the staff working in the NHS. To nurses, midwives, GPs, consultants, junior doctors, paramedics—all staff—we say thank you for your hard work, goodwill, commitment and dedication though this winter crisis. I had the pleasure of meeting some of those hard-working staff with my hon. Friend the Member for Tooting (Dr Allin-Khan) at St George’s hospital on Monday, and they told me of the pressures they face. Last night, I convened a summit of representatives of various royal colleges and trade unions working in the health service to meet staff and hear directly from the frontline of the pressures we now see in hospitals every day. Many royal colleges have spoken out today, warning of underfunding and understaffing. Over the past few days, I have received messages from doctors and clinicians from across the country who tell of the immense pressure, strain and, yes, crisis that we face this winter.
Let me share with the House some of the stories that I have been told, and I deliberately exclude the names of hospitals and trusts so as not to cause undue stress and alarm. This is a flavour of what I have heard. One doctor told me:
“There was a point when A&E was completely full and we had no space for a major trauma call that was coming in. The trauma case was going to have to be put into a corridor because the resuscitation area was full.”
“In my A&E ‘Corridor Care’ isn’t unusual, it’s now the norm. Patient buzzers have actually been installed on the walls in said corridor.”
How about this:
“We’re…trying our best to keep patients safe but there aren’t enough of us and we’re on our knees. Doctor and nurses in tears”?
“Over the weekend my bosses repeatedly asked for ambulances to be diverted away from our hospital because we had no beds, but we had multiple requests denied.”
Finally, another one:
“The A&E is perpetually rammed with the corridor full of ambulance trolleys and paramedics.”
I have many more examples, but I am sure the House understands the broader point that I am trying to make.
There is unprecedented pressure in Wirral, too. As recently as last week A&E attendances and GP referrals were massively up. Unprecedentedly, 84 additional beds are being laid on, and they are now full. Last week, all elective in-patient appointments were cancelled and ambulance turnarounds reached up to five hours. At Prime Minister’s questions, the Prime Minister did not seem to think that there is a crisis in the NHS. If this is not a crisis, can my hon. Friend tell us what is?
My hon. Friend makes her point eloquently and represents her constituents powerfully, as she always does in this place. I hope the Secretary of State will respond to some of those points.
The Royal Stoke in my city is under intense pressure. No doubt, we will hear shortly from the Secretary of State that that is winter pressure. Winter has not really started. We have not really had a winter, yet we have been under this pressure not for a few weeks but for months. The whole NHS system is broken. That is the problem that we really face.
My hon. Friend makes an eloquent point about the particular situation that has been facing Stoke for some time, of which many of us are aware. I hope the Secretary of State will touch on the situation in Stoke, because sadly it is one that we have had to raise previously.
If I may, I will make a little progress. I promise to try to give way to as many hon. Members as possible.
I assure the Secretary of State that I will pass on the names of the trusts and hospitals that I highlighted, so perhaps he can look into them. Let us be absolutely clear that these desperate stories are not the words of politicians trying to score political points but are the honest, heartfelt, considered testimonies of doctors and clinicians on the frontline in our hospitals. They simply want to do the very best for their patients. Indeed, many clinicians want to speak out but feel that they cannot, which is why the remarks were made anonymously.
According to reports on the BBC’s “You and Yours”, the Prime Minister has sent instructions to hospital trust chief executives telling them not to speak out. I would be grateful if the Secretary of State verified those reports.
I worked in the NHS over the Christmas period. Although it has been a very tough winter so far, this is nothing new. I have worked in the NHS for more than 20 years, and under previous Governments we had ambulances queuing around the block to get into A&E. Major incidents were declared in A&Es because they were too full. Will the hon. Gentleman accept that this is not a new problem?
I entirely respect the hon. Lady’s work as a nurse before she came into this place—[Hon. Members: “She still is.”] I beg her pardon. She is still a nurse, and I genuinely respect her, but if we are not raising these matters on behalf of our constituents, we are failing in our responsibility as Members of Parliament. We must never forget that this is not just about the staff in our NHS; it is about patients and their safety, which must always be our absolute priority.
I am grateful to my hon. Friend for kindly giving way and for his important remarks. I echo his point that this is about patients across the country. My constituent’s mother, Angela, has been waiting for an acute mental health bed for more than a week. She was taken in an ambulance to A&E, but she could not be treated locally in Liverpool because the department was full. She was treated for the physical effects of her mental health condition in an ambulance and sent home. Her family are devastated and are concerned about her condition. Her story is one of countless stories across the country, and we need to recollect and focus on those stories today.
My hon. Friend speaks passionately, as she always does, on behalf of her constituents and, more broadly, on mental health provision. Again, I hope the Secretary of State will respond to her on the specifics of that case.
My hon. Friend talks about patient care, and she is absolutely right. All of us, or at least many of us, in this House will have been getting stories from constituents telling us of their recent experiences in hospitals. I have been given a few, and I will share some heart-breaking examples with the House. Again, I will not reveal the names of trusts and hospitals, but I will pass them on to the Secretary of State after the debate.
Example No. 1 is of a mum of four children under 10 years old who has a secondary tumour in her liver. She was due to go into hospital this Thursday to have the tumour removed. Her surgery has been delayed for at least two weeks, so that the hospital could cope with the winter crisis and because no beds are available. She has not yet been given a new date.
Someone else got in touch with me this morning. Their wife has been on the waiting list for a knee replacement since April last year. An appointment for early December was cancelled owing to the hospital being on black alert. A few weeks later, the hospital phoned with an appointment for today, which was cancelled yesterday.
Again, these patients are not trying to score political points or to politicise matters. They are decent, hard-working people who are simply desperate for something to be done.
Conservative Members care deeply about patients. I personally follow up on the individual stories and challenges experienced by my constituents, but the hon. Gentleman has surely seen the guidance this week from NHS Providers, which is not always a friend of the Government, that said that we need to be careful when extrapolating from individual incidents in hospitals that are under particular pressure and implying that they constitute a wider trend. Yes, times are tough in the NHS, and there are winter pressures, but he should not make inappropriate use of individual stories.
The hon. Lady should be careful. I will be charitable, but she would not want to give the impression that she is dismissing the stories and examples that I am highlighting. NHS Providers has continually warned of the chronic underfunding of the NHS under this Government, and it has continually warned that, head for head, spending in this country will fall next year. If she wants to quote NHS Providers, she should quote all the facts from NHS Providers.
My hon. Friend is telling some shocking stories. Was he as shocked as I was to hear Government Members shouting at and heckling the Leader of the Opposition during Prime Minister’s questions? They shouted, “What about Wales?” Does my hon. Friend agree that there is actually a stark contrast in Wales? Welsh Labour is delivering 6% more funding than in England for the NHS and social care. We have brand new hospitals, including in my constituency, and an £80 million new treatment fund was announced yesterday to allow better access to treatments.
My hon. Friend makes a powerful point about Wales. As a Member for Cardiff, he understands what is happening in the Welsh health service. I wish Conservative Members understood that better.
Will the hon. Gentleman give way?
I will give way to the right hon. and learned Gentleman, but I will then make some progress.
Does the hon. Gentleman accept that every winter, for as long as I can recall, we have had a winter crisis in the NHS? It usually happens after Christmas. In winter the demands on the service become unpredictable, infections spread and the NHS starts losing staff. There are bound to be parts of the system that come under very real strain, and no one is trying to minimise the fact that they do. Apart from just producing this year’s crop of stories of very unfortunate incidents in various places, does he have any policy proposal at all, apart from simply spending more money wherever the reports are coming from?
I am very grateful to the right hon. and learned Gentleman, who is a very experienced parliamentarian, for his intervention, but he will know that this is one of the worst winters for probably 20 years. He casually suggests that this happens every year, but I remember the years of a Labour Government when it did not happen. I remember the years of a Labour Government when we went further than the financial settlements he delivered as Chancellor of the Exchequer and were more than doubling the money going into the NHS—and tripling it in cash terms.
If I may, I would like to make a bit of progress. I promise my hon. Friends, and indeed Conservative Members, that I will try to give way as much as possible, but I am very aware that many Members have put in to speak.
We are all becoming familiar—far too familiar perhaps—with the grim statistics: in December, 50 of the 152 English hospital trusts called for urgent action to cope with demand; the number of patients being turned away from A&E and sent to other hospitals is at a record high; A&E departments have turned patients away more than 140 times; and 15 hospitals ran out of beds in one day in December. Last night, the BBC revealed that leaked documents from NHS Improvement showed that there were more than 18,000 trolley waits of four hours or more; that almost a quarter of patients waited longer than four hours in A&E last week, with just one hospital—just one—hitting its target; and that since the start of December, hospitals have seen only 82.3% of patients who attended A&E within the four-hour target. We will return to the four-hour target in a few moments.
Ministers can try to deny what is going on, but they cannot deny these facts about what is happening this winter in the NHS on their watch. We know that what happens in the NHS in the winter is a signifier of a wider crisis, because across the piece bed occupancy levels now routinely exceed the recommended maximum level of 85%—often to levels higher than 95%. As I have said, the NHS is going through the largest financial squeeze in its history. Indeed, the former Secretary of State, Lord Lansley, said that five years of NHS austerity had been planned for, but having 10 years of it was never expected. We have seen £4.6 billion cut from social care budgets—
I will give way in a moment. As the King’s Fund said, the reason there is a problem is quite simply because there is a
“mismatch between funding and activity”
affecting our hospitals. The response of Ministers, from the Prime Minister downwards, has been one of utter complacency. The Secretary of State told “Sky News” on Monday that things had only been
“falling over in a couple of places”.
When he came to the House on Monday to make his statement, he did not commit to extra emergency funding for social care and he did not promise that the financial settlements would be reassessed in the March Budget. It is worse than that, because while he was making his statement, his spin doctors were telling the Health Service Journal—this on the day when the winter crisis is leading the news and he is making a statement in the House—and letting it be known that there is “no prospect” of
“additional funding to support emergency care any time before the next election.”
So there is nothing for social care, nothing for emergency care, nothing to tackle understaffing and nothing to tackle underfunding—well thank you very much. What did we get as a response? We got a downgrade of the four-hour A&E target.
The Secretary of State shakes his head and says, “Nonsense”, but let me remind him of what he said in the House on Monday:
“we need to have an honest discussion with the public about the purpose of A&E departments.”
He began by saying he wanted to provoke a discussion. He has certainly provoked a backlash, not least by blaming the public, it seems, for turning up at A&E departments. He went on to say that the four-hour target
“is a promise to sort out all urgent health problems within four hours”,
but he added a little clarification, continuing:
“but not all health problems, however minor.”—[Official Report, 9 January 2017; Vol. 619, c. 38.]
That is what he said in the House, and now we have seen the letter from NHS Improvement to trusts a few weeks ago, which talks of
“broadening our oversight of A&E”.
On the four-hour standard, it said that it believed
“there is merit in broadening our oversight approach, beyond a single metric”.
So in the interests of that discussion the Secretary of State wants to engage in, perhaps he can answer our questions, although I know he avoided the questions on Sky yesterday. Does he recall that in 2015, when he asked Sir Bruce Keogh to review these matters on waiting times, Sir Bruce said:
“The A&E standard has been an important means of ensuring people who need it get rapid access to urgent and emergency care and we must not lose this focus”?
I will give way in a few moments. Sir Bruce continued:
“I do not consider that there is a case for changing the 4 hour standard at this time.”
Does the Secretary of State still agree with Bruce Keogh? If he does, why did he make his remarks on Monday about needing to have a discussion about the future of the A&E standard?
I will give way in a few moments. If the Secretary of State wants to lead a discussion about the future of the four-hour A&E standard, will he tell us what discussions he has had with the Royal College of Emergency Medicine? It argues that the four-hour standard is a vital measure of performance and safety, and believes the standard should apply to at least 95% of all patients attending emergency departments. If he says he is still committed to that four-hour standard, is he still committed to maintaining it at 95%?
Will my hon. Friend give way?
My hon. Friend has had one bite of the cherry, so if he does not mind I shall make a little progress and then I will do my best to get as many people in as possible.
Does the Secretary of State agree—
I will give way in a few moments.
Does the Secretary of State agree that the four-hour standard is a reasonable proxy for patient safety? Does he agree that every breach of the four-hour standard can be regarded as a potentially elevated risk?
I will give way to the hon. Lady, as she has been very persistent.
If the hon. Gentleman were to read the Government amendment, he would see that the Secretary of State says he “supports and endorses” the 95% target for A&E waiting times.
I pay tribute to the hon. Lady for the work she is doing on tackling loneliness. I know that all Labour Members very much appreciate the work she is doing on that, along with my hon. Friend the Member for Leeds West (Rachel Reeves). The Government amendment is conspicuous in not referring to all patients.
The Secretary of State did distinguish between “urgent” and “minor”—[Interruption.] The hon. Member for Beverley and Holderness (Graham Stuart) says I should get a haircut. Did he say that? No? I beg his pardon, but he heckles so much it is sometimes difficult to hear what he is saying. Can the Secretary of State tell us how he would define the difference between urgent and minor care for instances relating to this four-hour standard? Can he tell us what will be the minimum severity of physical injury or other medical problem which will be needed for a patient to qualify for access to an A&E? How will we determine these new access standards? How quickly will they be available? Will patients with visible injuries be exempt from a new triage system? If so, which injuries will qualify? If the Secretary of State is not moving away from this four-hour standard, he needs to clarify matters urgently, because the impression has been given that he is doing so. [Interruption.] Not by me, but by his own remarks in the House on Monday. If he is not moving away from that standard, will he guarantee that he will not shift away at all from it throughout this Parliament and that it will remain at its current rate?
I will give way to the former Government Chief Whip.
I, too, was in the Chamber on Monday and I listened carefully to the Secretary of State then. He was challenged by the right hon. Member for Exeter (Mr Bradshaw) on the target and was asked whether he was watering it down. He said explicitly that “far from watering down” he was recommitting the Government to it. He was generous to the Labour party in saying that it was one of the best things the NHS did. I think that was very clear.
Let me say to the former Chief Whip that the Secretary of State said that
“we need to be clear that it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor.”—[Official Report, 9 January 2017; Vol. 619, c. 38.]
The Secretary of State did not need to come to the House to make those remarks and set these various hares running, so the right hon. Member for Forest of Dean (Mr Harper) should make his objections not to me, but to the Secretary of State—
I am going to move on a little.
If the Secretary of State is not abandoning the four-hour standard, as he insists he is not, we look forward to hearing him make that absolutely clear. He also said and has implied that we need to educate the public better, so that they do not turn up at A&E departments. That was the implication of his remarks on Monday. Will he tell us how he is going to do that? What will be the cost implications of explaining to the public that they must not turn up at A&E departments? Are we expecting to see a large advertising campaign? Will the cost fall on local authorities’ public health budgets, which have already been cut? Will local authorities be given more resources for this new public education campaign?
My hon. Friend is making an important point. The key similarity is that back in 1997, when Labour took over, the health service was in crisis, and it is again today. Is not part of the problem that people are having to go to A&E because they cannot get in to see their GP?
Absolutely. It is so difficult to get to a GP, which is why there are all these pressures on our A&Es. Of course, it is only going to get worse, because this year we are going to see cuts to community pharmacies—3,000 will be lost from our towns and streets because of the cuts that are being pursued. Let us not forget that the figure of 3,000 community pharmacies being lost was what the previous Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), told MPs.
Will the hon. Gentleman give way?
I will give way one last time, but then I really must make some progress.
I led a debate in Westminster Hall this morning on pharmacies and integrated services in the NHS, and not one Back-Bench Labour MP could be bothered to take part—not one!
Labour MPs have been raising these matters in this House for weeks, including at urgent questions and in Opposition day debates.
I presume what the hon. Member for St Albans (Mrs Main) meant to say was that two Back-Bench Labour Members took part in the debate—I was one of them. Does my hon. Friend agree that the point about community pharmacies, GPs and investment in social care is that they save the Government money? That is why they should invest in them now to take pressure off A&Es.
I thank my hon. Friend for correcting the record about that debate in Westminster Hall.
The Secretary of State denies that he is going to water down the A&E target; we welcome that, but we will watch carefully to ensure that he does not sneakily water it down throughout the remaining years of the Parliament. Will he tell us what he expects to happen next as we go through the winter? Weather warnings have been issued, and we could be heading for a cold snap. Will he update us on what urgent preparations he is putting in place to ensure that the NHS can cope? Is the NHS prepared for a flu outbreak, and what is his assessment of whether overstretched hospitals will be able to cope if there is one? It appears that, so far, Ministers have been burying their heads in the sand, but that will no longer do.
My right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) and my hon. Friend the Member for Lewes (Maria Caulfield) both made the point that the issues in the NHS are historical. On Radio 4 this morning the right hon. Member for Leigh (Andy Burnham) said he accepted that the previous Labour Government had not spent the right amount of money on social care. Will the hon. Gentleman accept that these issues are historical—they are not new—and that Labour does not have all the answers?
The hon. Lady refers to history; under this Government the NHS is going through the largest financial squeeze in its history. When we had a Labour Government, we more than doubled investment into the NHS.
Will the hon. Gentleman give way?
Because he is a Member from the east midlands, I shall give way to the hon. Gentleman from Corby.
I agree with the shadow Secretary of State that we need to have an honest debate, so does he accept that he stood on a general election manifesto that would have seen Labour spend billions less on our national health service? Will he set out for the House exactly what NHS services he would be spending less on now?
We stood on a manifesto that would have delivered more doctors and nurses for our NHS; the hon. Gentleman stood on a manifesto that said the Conservatives would cut the deficit and not the NHS. They are cutting the NHS and failing on the deficit.
I have a few direct questions for the Secretary of State about Royal Worcestershire hospital. I was grateful for his remarks on Monday, but I want to press him a little further. It has been reported that NHS England was warned of a bed crisis as early as 22 December. Will he update the House on what urgent meetings he is having on Royal Worcestershire? When will we be closer to knowing the outcome of an inquiry? In that context, there is a proposal in the sustainability and transformation plan for the Worcestershire area for a significant reduction in the number of acute beds. The Secretary of State will say that these are local plans and so on, but in the context of the issues in Worcestershire, will he comment on whether he thinks that is the right proposal to follow?
On STPs more generally, the NHS is going through a winter crisis, and it is about to go through another top-down reorganisation—[Interruption.] Someone says it is bottom-up, but it is not; we know it is coming from the top. Those making the STPs are being told that they have to fill a financial gap of £21.764 billion—that is the reality that STPs throughout the country now have to face. We have seen the plans, so we know that that is going to mean a number of community hospitals being closed, a number of A&Es being downgraded, and acute beds being lost.
In places such as Devon, where the STP talks of an over-reliance on hospital beds, the implication is that beds will be lost. Closures and downgrades are being considered throughout Somerset, with their priority list of vulnerable services including maternity and paediatrics. In London, a city with the very worst health inequalities, the STPs are expected to deliver better health outcomes for the city’s growing 10 million residents with £4.3 billion less to spend. Will the Secretary of State explain to the House how he expects the NHS to perform in future winters, when we have a growing elderly population and STPs are pursuing multibillion-pound cuts to beds, A&Es and wider services?
I was recently briefed by an excellent and well-respected local GP and a clinical psychiatrist, who were the authors of our county’s STP. Will the shadow Secretary of State explain how on earth they are responsible for a top-down reorganisation?
Because they were being told by NHS England, which was in turn told by the Secretary of State.
The right hon. and learned Member for Rushcliffe (Mr Clarke) mentioned infections spreading in the NHS. Does my hon. Friend share my concern about the infection that is spreading on the Government Benches? It is the infection of arrogance, complacency and being completely out of touch with the patients and their families who are suffering under the current crisis. We are witnessing inaction on an epic scale.
My hon. Friend makes his point extremely well, although I would not want to be so mean about the Secretary of State—[Hon. Members: “Go on!”] No, I am not going to be mean about the Secretary of State.
In the past few moments, we have heard the ludicrous suggestion that Labour did not deliver on either spending or performance, but in fact our track record was excellent. That is not just my opinion; the former Prime Minister, David Cameron, said in 2011:
“I refuse to go back to the days when people had to wait for hours on end to be seen in A&E, or months and months to have surgery done. So let me be absolutely clear: we won’t.”
He knew that Labour had a good record and that the NHS used to be good; why will these Tories not admit it?
My hon. Friend makes a powerful point. Indeed, I remember, when we were in government, shadow Health Secretaries standing at this Dispatch Box opposing every penny piece of money that Labour was putting into the NHS. I remember a shadow Health Secretary, who now sits in the Cabinet as the Secretary of State for International Trade, standing at this Dispatch Box and saying that the A&E target was “indecent.” That was the Tories’ attitude when we were in government, so it is no wonder that we are sceptical about the Government’s intentions for the A&E target when we look at their history.
The shadow Secretary of State is talking about the Labour record on the NHS. Does he recall Labour closing not only maternity at Crawley hospital, but accident and emergency in 2005?
I do not have the details of the Sussex STP to hand, but presumably if it contains any suggested closures the hon. Gentleman will be campaigning against them and knocking on the door of the Secretary of State, if those remarks are an indication of his point of view on these matters.
The hon. Gentleman is saying that everything was rosy under Labour, but he should remember that it was 10 years ago when the scandal at Mid Staffs broke, in which hundreds more elderly patients died than was projected. It was a terrible scandal and he should remember that. What our shadow team was doing at the time was holding the Labour Government to account.
I take all deaths in hospitals seriously. My commitment to patient safety is unswerving. I will continue to raise matters, whether it is at Royal Worcestershire or elsewhere, but not in a partisan way with the Secretary of State—[Interruption.] I was not being partisan when I was asking questions about the Royal Worcestershire. The Government Whip, the hon. Member for Beverley and Holderness (Graham Stuart), really needs to calm down. I will raise these matters, because that is the responsible thing to do. It is unbecoming to play politics with patients in that way.
Culpability for the state that the NHS is in today lies at the door of Downing Street. The Government promised to protect the NHS and to cut the deficit, and they have not done so. The Government give away billion-pound tax cuts to corporations—[Interruption.] Yes, this Government. The Government waste billions, pushing the NHS in the direction of fragmentation and greater outsourcing, while ignoring the ever-lengthening queues of the sick and the elderly in all our constituencies.
Yesterday, we saw the Secretary of State on Sky losing his ministerial car and being chased down the street. It was his whole approach laid bare: not a clue where he is going; nothing to say; and not facing up to the problems. Last year, he blamed the junior doctors. On Monday, he blamed the patients. Today, he blames Simon Stevens. Tomorrow, he will blame the weather. It is time that the Health Secretary started pointing the finger at himself and not at everybody else. The NHS is in crisis, and Ministers are in denial. I say to the Government, on behalf of patients, their families and NHS staff, please get a grip. I commend our motion to the House.
I beg to move an amendment, to leave out from “House” in line 1 to the end and add:
“commends NHS staff for their hard work in ensuring record numbers of patients are being seen in A&E; supports and endorses the target for 95 per cent of patients using A&E to be seen and discharged or admitted within four hours; welcomes the Government's support for the Five Year Forward View, the NHS's own plan to reduce pressure on hospitals by expanding community provision; notes that improvements to 111 and ensuring evening and weekend access to GPs, already covering 17 million people, will further help to relieve that pressure; and believes that funding for the NHS and social care is underpinned by the maintenance of a strong economy, which under this administration is now the fastest growing in the G7.”
I thank the shadow Health Secretary for bringing this afternoon’s debate to the House. He is right to draw attention to the pressures in the NHS, but, regrettably, I will have to spend much of my time correcting some totally inaccurate assertions that he has made, and that is a shame. This is an important debate for our constituents—for his and for mine—and for the NHS. The country deserves a proper debate, but that is difficult when we are given misinformation at a time when the NHS is under sustained pressure.
I am also very pleased to see the Leader of the Opposition in his place. I think that he has become rather a fan of my parliamentary appearances—[Interruption.] It is a Jeremy thing, he says—if only. I wish to address one part of my speech to him, because it is an area of policy for which he is perhaps more personally responsible.
Winter is always challenging period, and I want to repeat the thanks of the shadow Health Secretary and the thanks that I gave on Monday to NHS staff. According to NHS Improvement, on the Tuesday after Christmas the NHS had its busiest day ever. Earlier in December, it treated a record number of patients within four hours. Overall, as the Prime Minister said this morning, we are seeing 2,500 more patients within the four-hour standard every single day compared with what happened in 2010. As we discussed on Monday, the NHS made record numbers of preparations for this winter, because it is always a difficult time, including having 3,000 more nurses and 1,600 more doctors in full-time employment.
Let me address what the shadow Health Secretary said with regard to Worcestershire. I met colleagues from Worcestershire on Monday. A huge number of actions are now being taken, but we must say right up front that it is totally unacceptable for anyone to wait 35 hours on a trolley and that we expect the hospital to ensure that that does not happen again. There are plans in place to open additional bed capacity this week. We have already had capacity made available by Worcester Community Trust to support the flow. The trust has deployed its chief operating officer on the task of facilitating discharges. The trust is in special measures, so we have a big management change, and a new chief executive will be starting later on in the spring.
What is wrong with what the shadow Health Secretary has just said is the suggestion that winter problems are entirely unusual. As my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) said, the NHS had difficult winters in 1999, 2008, and 2009. He remembers difficult winters from his time as Health Secretary, but there are things that are different today. One of them is that, compared with six years ago, we have 340,000 more over-80s, many of whom are highly vulnerable or have dementia. We know that when people of that age go to an A&E at this time of year, there is an 80% chance that they will be admitted to hospital.
The Secretary of State talks about correcting the points that have been made so that the House has the right information. May I repeat the question that I asked him on Monday? What are the latest figures—he should have them up to this week—for the number of people who could be discharged but have to remain in hospital because there is no community support available for them? Can he give us that figure now? He said that he would write to me, but he must know that figure now.
Last year, on average, it involved around 7,000 beds, which is far too many. That is why the Secretary of State for Communities and Local Government announced in December a new package of support worth around £400 million—
Let me answer the hon. Gentleman’s question. I said that I would write to him, and I will do so. He may have noticed that there are other issues that we are dealing with, which is why I may not have had time to sign the letter. The £400 million extra for local authorities over the next two years will make a significant difference and he should recognise that.
I am attending this debate because there will be constituents in Bedford and Kent who are concerned about the headlines that they have read. I am pleased that the Secretary of State will correct some of the points that have been made. What our constituents want to know is what is being done, or what should be done. I listened for 33 minutes to the shadow Secretary of State—the Labour spokesman on the NHS—on this issue, and there was not a single new idea other than spending money. Will my right hon. Friend please provide some practical answers to the problems that are being raised in the papers?
My hon. Friend is absolutely right, which is why I will be talking later about our solutions to these problems.
I will give way, but first I want to make some progress.
I want to talk about something else that is different in our A&E departments today compared with six years ago. Although we are sticking to the four-hour target, we also insist on much higher standards of safety and quality.
On Monday, I congratulated Labour on the introduction of the four-hour target—I support it—but we should also remember that four years after that standard was introduced, we started to see some horrific problems at Mid Staffs, many of which were in the A&E department. Some were caused because people thought they would be fired if they missed the target. Robert Francis said that the failures at Mid Staffs were
“in part the consequence of allowing a focus on reaching national access targets.”
Therefore, although we retain targets, we will not allow them to be followed slavishly in a way that damages patient care.
Will the Secretary of State give way?
I have already given way to the hon. Gentleman. There are many other Members who want to intervene.
That is why we have a new inspection regime that makes it harder to cut corners in the way that used to happen when beds were not being washed, there was poor infection control and ambulances were being used as waiting rooms.
I am grateful to the Health Secretary for outlining some of the steps that he is taking in the face of this immediate emergency. Does he also recognise that the major cause of the problems in A&E is simply a lack of staff? Consequently, does he regret the huge cuts to training budgets in 2010, 2011 and 2012, which are having a real impact now on the number of nurses and doctors in our NHS?
I agree that staff numbers are critical, but we have, since 2010, 1,500 more doctors in our A&E departments and 600 more consultants. Across the NHS, we have more than 11,000 additional doctors, so we do recognise the pressures that the NHS faces. Indeed, we have 1,600 more doctors than this time last year, so we are doing a great deal to solve the problem.
Does my right hon. Friend agree that we need to learn best practice in the NHS? The hospitals that manage to integrate health and social care, such as those in Wigan and Salford which have managed to create those beds, are providing examples of best practice from which the whole NHS can learn.
My hon. Friend is absolutely right. It is a mistake in this debate to try—as I understand Opposition parties want to do—to boil this all down to the issue of Government funding when there is actually a lot of variability in the country. At this time of year, which is always difficult, some hospitals are doing superbly well in extremely challenging circumstances. We have just heard about some of the hospitals that are doing well, and there are a number of them.
I will give way to as many people as I can, but I also want to address the substantive points made by the shadow Health Secretary. He talked about the four-hour target. In his motion and his speech, he made the totally spurious suggestion that we are not committed to that target. I remind him what my right hon. Friend the former Chief Whip quoted me as saying on Monday. I did not just commit the Government to the target; I said that it was one of the best things that the NHS does. However, I also said that we need to find different ways to offer treatment to people who do not need to be in A&E. It is hardly rocket science. When there is pressure in A&E, it is sensible—indeed, I would argue that it is the duty of the Health Secretary—to suggest that people who can relieve pressure on A&E by using other facilities do so.
Just yesterday at Crawley hospital, an acute care unit was opened, which is designed precisely to ensure that people who do not need to attend A&E are properly directed to the most appropriate care, which is good for them as individual patients and good for the whole system.
That is absolutely right. To back up my hon. Friend’s point, yesterday’s OECD report said that in Australia, Belgium, Canada, France, Italy and Portugal, at least 20% of A&E visits are inappropriate. NHS England’s figure is up to 30%, which is why we need the public’s help to relieve pressure and that is what I meant when I talked about an honest discussion.
The Secretary of State told us just a moment ago that there are now over 300,000 more people over the age of 80. Surely he would have known that information from census and Office for National Statistics data when his Government took over seven years ago, so why is it that we are now seeing on the front pages of our newspapers that one in four of our A&E wards is unsafe and that we have so many challenges across the country, including in my constituency?
We did know that information and that is why we thought it was totally irresponsible to want to cut the NHS budget in 2010, and not to back the NHS’s own plan in 2015. As a result, we have 11,000 more doctors. In the hon. Lady’s local hospital, 243 more people are being treated within four hours every single day.
I will make some progress and then give way. I could have put what I said on Monday another way. I could have said:
“We have to persuade those people not in medical emergencies to use other parts of the system to get the help they need”.
I did not actually say that, but I will tell the House who did. It was the then Labour Health Minister in Wales, Mark Drakeford, in January 2015. Frankly, when the NHS is under such pressure, it is totally irresponsible for the Labour party to criticise the Health Secretary in England for saying exactly the same thing that a Labour Health Minister in Wales also says.
Will the Secretary of State give way to a Welshman?
I would be privileged and honoured to give way to a Welshman.
The Secretary of State has sowed confusion in the House and in the country on this question this week, and he is doing so again today. If he is saying the same as my friend the former Health Minister in Wales—that we want to divert people who do not need to go to A&E from doing so—I am sure that everybody in this House would support him. But we suspect that he is saying that the four-hour wait target will be disapplied to some people turning up to A&E, and that that is the downgrading he is talking about. If that is the case, the Secretary of State should come clean, and he should be clear about whose job it will be to disapply the target to some people with minor ailments.
I did not say that because we are not going to do it. As we have had an intervention from a Welshman, let me tell the hon. Gentleman a rather inconvenient truth about what is happening in Wales. Last year, A&E performance in Wales was 10% lower than in England, and Wales has not hit the A&E target for eight years. We will not let that happen in England.
I noticed that the shadow Health Secretary quoted a number of people, but one that he did not quote was the Royal College of Emergency Medicine. I wonder whether that was because of what it said about Wales this week. It said:
“Emergency care in Wales is in a state of crisis…Performance is as bad, if not worse, as England, in some areas.”
There we have it: in the areas in which Labour is in control, these problems are worse.
Let me make my point. I do not say that to make a political point, but to show that it is patently ridiculous to try to play politics when there are winter pressures in the NHS. This happens in the whole NHS—in Wales as well as in England.
I want to make some progress but I will give way to my hon. Friend the Member for Lewes (Maria Caulfield), who is a serving nurse.
May I reiterate the Secretary of State’s point about the four-hour target? During the Labour Government, I was working in the NHS. Significant pressure was put on us by managers to meet the four-hour target, negating clinical need. Patients were often prioritised according to meeting the target, rather than by clinical need. That was a disgrace.
That is exactly the problem we had with Mid Staffs. We had a culture in the NHS where people were hitting the target and missing the point. Although targets are important management tools in all organisations, it is important that they are followed in a sensible way that puts the interests of patients first.
I would just like to make another point about Wales while we have the privilege of having someone here who aspired to lead the Labour party, as the current leader of the Labour party is no longer in his place.
Something that Wales and England have in common is the need to ensure that, if we want alternatives to A&E, people are able to see their GPs. I have said many times that people wait too long to see their GPs. In all honesty, I think that the GP contract changes in 2004 were a disaster. The result was that 90% of GPs opted out of out-of-hours care. But we have been putting that right. Now 17 million people in England—about 30% of the population—have access to weekend and evening GP appointments. More than that, we have committed to a 14% real-terms increase in the GP budget by the end of this Parliament. That is an extra £2.4 billion and we expect that to mean an extra 5,000 doctors working in general practice.
I can see Wales from my constituency, to continue the theme. I received an email this morning from a very distressed senior NHS manager, who says:
“I truly despair that there will not be an NHS this time next year”—[Interruption.]
You need to listen on the Government Benches, and understand what your Secretary of State is doing to the health service. I will give a precis of what my constituent is talking about.
Order. The hon. Lady will resume her seat. First, when she says “you”, she is addressing the Chair. Secondly, she is making an intervention. There are 33 Members who wish to speak in this very important debate. If she can keep her intervention very brief, I will let her continue.
Apologies, Madam Deputy Speaker. I should not have used the word “you.”
My constituent has written to me saying:
“The NHS is in crisis, the government knows this, CCGs have failed, foundation trusts are failing. GPs are on their knees. So they’re”—
“handing it back to local areas and saying, ‘you fix it, and by the way there’s no money.’ It’s a whole system reorganisation”,
and there is no money.