House of Commons
Monday 8 January 2018
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
Fire and Rescue Services
I recognise the vital role that firefighters play in the protection of communities, as demonstrated recently during the tragic fires at the Liverpool Echo Arena car park and in Manchester. Fire and rescue services have the resources they need and will receive around £2.3 billion in 2018-19 to continue their vital work. Single-purpose authorities’ non-ring-fenced reserves increased by 88% to £615 million between March 2011 and March 2017. That is equivalent to 49% of net expenditure.
The Home Secretary will be aware that there are 20% fewer firefighters in Plymouth today than there were in 2010, but the risk has not gone down. With combustible cladding still on the tower blocks in Mount Wise and Devonport, the risk remains high. Will the Home Secretary reassure us that there will be no further reductions in the number of firefighters in Plymouth and no further reductions in firefighting funding?
The hon. Gentleman raises an interesting point. He is right that there are 20% fewer firefighters, but there are 50% fewer fire incidents that firefighters have to attend. It seems to me that that means we are still able to get the very best service from our firefighters. If the hon. Gentleman has requirements in respect of tower blocks in his community, in which he has shown a particular interest, I urge him to approach the Department for Communities and Local Government, which sometimes allows some financial flexibility to assist with additional needs.
Yes; my hon. Friend is absolutely right that an excellent way to use resources most efficiently is to make sure that we have those sorts of mergers. In fact, there is now an obligation under legislation passed last year to make sure that fire authorities work more closely with the police.
The Home Secretary has already referred to the major fire that ravaged the car park at the Liverpool Echo Arena on new year’s eve, when around 1,400 vehicles were destroyed. It was only because of the magnificent efforts of Merseyside firefighters that there was no loss of life. Will she take that as a warning that Government cuts, which have slashed 42 full-time appliances down to 26 now and 18 next year, are putting lives at risk? Will she undertake urgently to review funding for the Merseyside fire and rescue authority?
I would point out to the hon. Lady the scale of the reserves that I have already highlighted and ask her to work closely with her local fire authority to ensure that it is using that money wisely. To follow up on her comments, I have the utmost respect and admiration for the firefighters who did such an excellent job in that particular incident.
In Lichfield, we have a brand new fire station, but one fewer fire appliance, which seems an odd sense of priorities in the way that the fire service is run in Staffordshire. There would be a £10 million saving if only the police and the fire service were to merge their back-office functions. What can the Home Secretary do to encourage them to do just that?
That is an excellent point from my hon. Friend, and it reinforces the point that was just made by my hon. Friend the Member for Kettering (Mr Hollobone) that the best way to achieve such efficiencies is through closer working between police and fire services. I urge him to encourage his authority—if it has not done so already—to put in the business case review for us to look at.
May I wish you a happy new year, Mr Speaker?
The Secretary of State has already mentioned the fire in the Lighthouse tower in the northern quarter in Manchester. Will she join me in praising the very quick efforts of the Manchester fire service, which meant that everybody was safely evacuated from what looked to be a very serious fire in that tower block? Will she also reassure me, and communities in Manchester and across the country, that the fire services will have not only the resources that they need, but the powers to inspect and ensure that private as well as social housing residential blocks are fire safe and that these fires do not spread?
I happily join the hon. Lady in congratulating and thanking the fire fighters for doing such an excellent job. She raises an important point: it is about not just resources but having the right powers. That is why we commissioned a report on building regulations from Dame Judith Hackitt, who reported her interim findings in December. We will be hearing from her later in the spring, in a few months’ time—or even in weeks—with her final report. I hope that that will give us additional guidance about what powers are necessary to ensure that these fires do not take place in future.
Tackling waste fires represents a significant financial burden for fire and rescue services; the fire at Slitting mill has cost Staffordshire fire and rescue service in the region of £70,000 to date. Will my right hon. Friend meet me to discuss the measures that can be taken to reduce the risk of waste fires?
We constantly hear Ministers at the Dispatch Box talking about reserves in the fire and rescue service as if there is some sort of magic money tree, but is the Secretary of State aware that most of the reserves are already earmarked for future spend? The annual budget for the fire and rescue service in England is £2.3 billion, yet it holds only £143 million in unallocated reserves. That is less than a month’s operating costs. Is she seriously suggesting that capital reserves of just 6% are an adequate buffer for all emergencies? If she is, she is living in cloud cuckoo land.
I can generously deny that I am living in any cloud cuckoo land—to wipe that immediately from the hon. Gentleman’s views. I just think he is being too lenient on these enormous reserves that have been accumulated. They have grown by 150%; they are now 40% of annual revenue. I know that the Labour party is not familiar with careful public finance guarding, but I urge him to take a little more scrutiny to this matter, rather than treating it like some Venezuelan dictatorship.
Frontline Police Officers
Before Christmas, the Government proposed a new police funding settlement for 2018-19 which will increase funding by up to £450 million across the police system. It is for police and crime commissioners and chief constables to determine the number of officers required for their force areas.
On new year’s eve in West Norwood, 17-year-old Kyall Parnell became the 39th victim of a fatal knife attack in England and Wales in 2017. To solve the growing tragedy of knife crime, the police need to be able to work creatively in partnership with communities, the NHS, and other public sector agencies, but the loss of 20,000 officers since 2010 means that forces across the country are stretched to breaking point. Will the Minister guarantee that there will be no further drop in police numbers?
The short answer is that that is down to the Mayor and the leader of the Met. The hon. Lady is entirely right to talk about these tragic losses of life in tragic terms; lives have been cut very short. However, she is wrong to focus entirely on the question on police officers, because the last time London saw a spike in deaths from knife crime was in 2008, when there were roughly the same number of police officers as there are now.
In December, I went out with my local Safer Neighbourhood team. Despite the tremendous work they do, two officers per ward is not enough. Added to that, my local police station in Penge recently closed. Met police numbers are set to fall below 30,000. Given the rise in violent crime in London, will the Government now commit to investing in our police and reversing the cuts?
Police numbers in London have been stable for some time, going back to 2008. Any decisions on future projections are to be taken by the Mayor and the head of the Met. If the Mayor does what we are empowering him to do, this settlement will mean an additional £43 million for the Met on top of £200 million of reserves. The force has made great strides in efficiency but, according to Her Majesty’s inspectorate of constabulary, continues to require improvement. Of course, public safety in the capital matters a great deal, which is why the Met police have 1.6 times the number of officers per head than the national average.
Constituents in Leigh are bearing the brunt of the Government’s police cuts, with Greater Manchester police officers cut by 23% since 2010. That is nearly 2,000 fewer officers on the streets of Manchester. The Home Secretary rightly praised the officers involved in the response to last year’s terror attack in the city, yet GMP face further real-terms cuts to their resources. What steps will she now take to ensure that our local police force is adequately resourced to keep the people of Leigh safe?
I am sure that the hon. Lady will welcome the fact that the number of police officers in Greater Manchester actually rose in 2016, and the fact that the police funding settlement will result in an additional £10 million going into Greater Manchester policing. She may also want to ask the Mayor why reserves for Greater Manchester have gone up by £29 million.
In 2014-15, the provisional grant allocation for the police was just over £8 billion. However, the Home Office announced in December last year that it would be just £7.325 billion for 2018-19, despite the fact that inflation is predicted to be 7% over that period, according to the Office for Budget Responsibility. As this is a substantial real cut in police funding, would the Minister like to suggest where savings could be made on a scale that would protect police numbers?
I am sure that the hon. Gentleman will welcome the fact that, if the police and crime commissioner exercises the flexibility that we are offering, Thames Valley police will benefit from an initial £12.7 million in 2017-18. How that works out to a cut, I do not know.
I thought I had better get in quick before the Prime Minister’s inevitable call to me. [Laughter.]
There has been a very worrying increase in crime across the Shipley constituency over recent months, and my constituents and I expect to see more police officers. The first duty of the Government is to protect the public and keep them safe, and I have to say to the Government that they are not putting enough focus on police resources. Will they please give the police the resources that they need to keep our constituents safe? The Government are in danger of being very greatly out of touch with public opinion on this issue.
I had better keep my answer short then, Mr Speaker. I understand my hon. Friend’s point. The police funding settlement means that there is more cash going into policing in Yorkshire. How that money is allocated is up to police and crime commissioners and to chief constables; they are directly accountable to the public they serve and to the Members of Parliament who serve those constituents, so these representations need to be made directly. What is not in doubt is that up to £450 million of new investment will be going into British policing next year as a result of the funding settlement.
The Met’s budget is set to grow to £2.5 billion. There are reserves of £200 million in the Met. In addition, the Mayor has his own reserves. Funding per head for officer numbers is running at over one and a half times the national average in London. It is time—I speak as a Londoner and a London MP—for the Mayor of London to give a serious answer to the question, “What are you doing?”, because at the moment the answer is just writing letters to the Home Secretary, and that is not good enough.
Although the number of police officers is very important, so are their skills and the nature of the crime they are dealing with. Given that we are now 20 times more likely to be a victim of online crime than offline crime, can the Minister assure us that the police have the skills to deal with crime in the digital age?
I thank my hon. Friend for making an incredibly important point. I know that my constituents are much more vulnerable to crime on their computers at home than they are when walking down Ruislip High Street. We have to respond to the changing nature of crime in this country. The number of police officers matters a great deal, but the capabilities inside the service matter enormously. That is why this Government are investing £1.9 billion in cyber-security.
Happy new year to you, Mr Speaker.
This is really all about getting the best service for the funds we have invested. Avon and Somerset police have seen a 180% rise in sexual offences and a 42% rise in recorded domestic abuse in the past four years. Can the Minister confirm that any new funding, either from Government—that is most welcome—or raised through an increase in the precept, can be directed to these growing areas of crime?
If the PCC uses its new powers, Avon and Somerset should receive £8 million of new investment next year, and that will need to be allocated to local priorities. The numbers that my hon. Friend states about the growth in reporting of crimes such as domestic violence are striking, and I would expect that to be reflected in local priorities.
Police and Fire Services: Collaboration
The Government are very keen to encourage further collaboration between the blue-light services and have taken actions through the Policing and Crime Act 2017 to empower exactly that.
I wish you and your family a happy new year, Mr Speaker. I congratulate my right hon. Friend the Home Secretary on retaining her job. She is doing splendid work.
Can the Minister reassure me and my constituents that, given that collaboration is potentially leading to a sort of patchwork quilt of service across the country, he will ensure that the integrity of services will be maintained?
My hon. Friend makes an important point. I would say two things. First, joint police and fire governance will improve accountability because there will be a single point of accountability, democratically elected. Secondly, in relation to the efficiency and integrity of fire services, I hope that he will welcome a very significant reform introduced by this Government—the introduction of independent inspection of fire services.
I recently held meetings with the chief constable and the chief fire officer for the Humberside area, and welcomed the fact that they are collaborating more closely. Can the Minister reassure my constituents that in an area that contains chemical plants, oil refineries and other dangerous plant, the fire service will not take its eye off the ball in its main role?
Twenty-two-year-old Steven Dyson’s body was found in the River Irwell in Ramsbottom on Saturday morning, six days after he went missing on new year’s day. It is at the worst of times that we often see the best of people. Will the Home Secretary join me in thanking Greater Manchester police, our fire service, and the hundreds of local volunteers who spent last week looking for Steven, as well as Ramsbottom British Legion, which hosted the campaign centre, and all the local businesses that donated items to our cause? The outpouring of support was incredible, and I hope that it goes some way to giving strength to Steven’s dear mum and everyone mourning.
I am sure that the whole House would want to associate itself with the hon. Gentleman’s remarks and to pass on our condolences to the young man’s family. Of course I join him in paying tribute to the hard work of all the emergency services involved in that tragic circumstance.
Does the Minister accept that there is already a great degree of co-operation and collaboration between our blue-light services and that any move by the Government to force further formal collaboration through mergers could be detrimental to all services?
I entirely agree with the hon. Lady that there are fantastic examples of collaboration across the country —fire and fire, police and police, and across the blue-light services—and evidence is building about the benefits, not just financial but in terms of service to the public. We are simply saying that where police and crime commissioners want to seize such an opportunity to improve accountability for local performance, we will enable them to do so, but they still have to deliver a strong business case and they still have to consult their communities.
Like my hon. Friend the Member for South Dorset (Richard Drax), I was very uneasy about the amalgamation of the Wiltshire fire service and the Dorset fire service last year. Does my hon. Friend the Minister not agree that it makes subsequent co-operation with the ambulance service or the local authority very much more difficult? Is their amalgamation irreversible, and if so, what will he do about the other amalgamations he seeks?
I thank my hon. Friend for that question. My understanding is that that amalgamation is actually working well, and has largely been welcomed across the system. It does present challenges for further amalgamations because of boundary issues, but I would ask him to open his mind to the benefits of that merger, which appear to me to be very real.
Mental Health Assessments: Detention
Provisions in the Policing and Crime Act 2017 ban the use of police cells as places of safety for under-18s, restrict their use for adults and reduce the maximum period of detention to 24 hours. Information on the length of time for which people are detained under the Mental Health Act 1983 pending an assessment is not held by the Home Office, but we are seeking to ascertain the scale and nature of this issue and we are reviewing the available information that we were provided with last month by the College of Policing.
Under the Police and Criminal Evidence Act 1984, the police have just 24 hours to hold someone with a mental illness. The College of Policing shared with the BBC last December the fact that 264 people were held for longer than this, including a mentally ill child who was held for five days. Is the Home Secretary aware of this report, and what steps have been taken to remedy the situation?
Very much so, and I thank the hon. Lady for raising this important issue. We know that there is an issue in this area, and she will be pleased to know that her constabulary—the West Midlands—in fact does very well on this. It did not use police cells at all for such detentions last year; indeed, since 2013 it has used them on only 14 occasions. Of course, however, any such occasion is one occasion too many. She will I am sure join me in being pleased that the use of police stations as places of safety nearly halved last year, but we need to do more.
Does the Minister agree that a police cell or a police station is not a suitable place for an innocent person suffering from mental health problems, and will she support initiatives such as the mental health triage projects in the West Midlands to make sure that people with mental health problems get the medical support they need when they need it?
On the question of detention, the Minister will have read recent reports that immigration detainees are being paid £1 an hour. Will the Minister assure the House that no children are currently being held in detention, that no pregnant women are currently being held in detention and that no one is being paid below the legal minimum wage in any of the immigration detention centres?
As I say, we are determined to ensure that places of safety are in appropriate places—health places—and we are investing £30 million to try to ensure that happens. If there are any individual cases that the right hon. Lady would like to bring to my attention, I will of course consider and review them very carefully.
Immigration: Effect on the Economy
The Government are clear that carefully controlled migration benefits the economy, our Exchequer and our communities in general.
I thank the Secretary of State for that answer. The Scottish Government, as well as Scottish National party Members of this place, have been calling for immigration to be devolved. Does my right hon. Friend agree that any separate immigration systems would do nothing except lead to chaos, confusion and extra barriers for those looking to live and work in Scotland as well as in the rest of our United Kingdom?
My hon. Friend is absolutely right. Immigration is a reserved matter, and applying different rules of immigration to different parts of the UK would complicate the system. He might share my view that if Scotland wants to attract the brightest and the best, as the rest of the country does, it might think twice about raising its own taxes, because that might put people off.
The NHS reports that almost 10,000 European Union doctors, nurses and support staff left the country in the year following the referendum. Is the Home Secretary aware of those levels of staff shortages, and how does she see the situation developing if there are further restrictions on migration for work purposes?
We really value the incredibly important work that EU migrants do in our health service, and there are no plans to restrict the way in which they can come and work here. They make such an important contribution. I am aware that some of them have gone back to work in countries that have had a strong economic recovery, such as Spain. There has also been a higher level of English language test to make sure that all health professionals in our service are able to communicate very clearly and effectively with patients.
I thank my hon. Friend for her question. I know that she is very concerned to make sure that agriculture has the support it needs from overseas workers. The Migration Advisory Committee will be looking at the issue for us, and we expect it to report later in the year.
May I congratulate the Home Secretary on having just made a positive economic case for immigration? However, how does she think that the message given by the immigration cap, Brexit, a hostile approach to immigrants and the general rhetoric of many of her Conservative colleagues help to make that case?
The right hon. Gentleman cannot take the moral high ground on immigration. We wholly recognise the value that immigrants bring when they arrive in the UK, with the brightest and the best working in our hospitals and attending our universities. We are wholly positive about immigrants. We want to do this in a way that controls our borders and delivers on the reductions to which we have committed.
Education is vital for the economy. A constituent of mine, Heather Cattanach, returned to Canada, but Home Office delays in looking at her application left a vacancy in the Moray Primary School where she taught. I have previously raised this issue with Ministers. Will the Home Secretary now look at it urgently so that the case can, I hope, be concluded?
International students make an enormous contribution to our economy—Labour estimates the figure to be £25 billion a year. Will the Secretary of State confirm that the Government now support Labour’s policy of removing international students from the net migration target?
I would like to reassure the hon. Gentleman that we value the contribution that those students make to our economy, cultures and university towns. In the past 10 years there has been a 25% increase in their number, and in recent years there has been a 9% increase in the number of them attending Russell Group universities. Those numbers remain uncapped and we continue to welcome them.
Business, trade unions and universities in Scotland have all asked this Government to look at devolving immigration to Scotland. In a report just before Christmas, the Institute for Public Policy Research think-tank said that devolving immigration would assist the Scottish economy. Will the Home Secretary now look seriously at those recommendations and at the request of business, the unions, think-tanks and universities in Scotland to devolve immigration?
The hon. and learned Lady and I have discussed this issue before, privately as well as publicly. She is aware that the Migration Advisory Committee will look at different areas and regional areas in the United Kingdom, so I respectfully suggest that she come back to me to continue the conversation when it reports, but we have no plans to devolve immigration.
I thank the Home Secretary for saying that she will at least look at the issue. Bunessan Primary School on the island of Mull has received only one application for its vacancy for a Gaelic teacher. It came from a fully qualified teacher who was Canadian but had trained in Scotland. Despite her being the only candidate for the job, the Home Office has refused her visa application twice. Does that not show that a one-size-fits-all UK immigration policy is not working for the Scottish economy and not working for rural communities?
I am surprised to hear that there are not more Gaelic speakers in Scotland who might apply for the job, rather than Canadians. Again, I suggest that the hon. and learned Lady come to see the new Immigration Minister at some stage because there may be more to the matter than what she has said in the House. It is difficult to comment on individual cases.
Border Force: Boats
I am standing in for the Immigration Minister, but hopefully not for too long.
In addition to the recent introduction of new coastal patrol vessels, Border Force has an ongoing upgrade programme for its cutters. It recently installed new electro-optic surveillance systems on its cutters, and it is currently upgrading radars and replacing the rigid inflatable boats used by cutters to deploy boarding teams to ensure that they remain a highly effective maritime security platform.
Does the Minister believe that the UK Border Force is adequately resourced to safeguard small harbours and landing sites, such as those in my Chichester constituency? Our harbourmaster has already been involved in apprehending people smugglers, working with coastal communities who look out for suspicious activity. Is he considering using volunteers to support patrols in areas such as Chichester harbour or Selsey Bill? Does he agree that there is no substitute for trained and qualified Border Force professionals?
By the end of the financial year, the Border Force maritime fleet will have six CPVs and three cutters in the UK, plus two cutters deployed overseas to deal with the issue upstream—one in the Aegean and one in the central Mediterranean. Border Force has invested £108 million in new technology and capability to deal with some of those challenges and will commit a further £71 million this year.
While I was volunteering with the lifeboats at Walton-on-the-Naze, I learned how important local maritime knowledge is. I believe that such intelligence would be useful to Border Force when solving and preventing crime. Is Border Force engaging with other agencies, including the Royal National Lifeboat Institution, the coastguard and pilot boats, to share intelligence, tackle crime and keep our coastline safe and secure?
The key to improving our coastal security is better collection and exploitation of data. Some of that happens through full-time people, but it also happens through the many volunteers who populate the coastal paths and watch stations of our communities. That is why Border Force has set up the multi-agency general maritime intelligence bureau to bring together the existing organisations of HM Coastguard, HM Revenue and Customs, Border Force, the Ministry of Defence, and the bureaux linked directly to the National Maritime Information Centre.
Border Force, the National Crime Agency, the police and other law enforcement agencies are working with international partners to secure our borders from a range of threats, including modern slavery, human trafficking and terrorism. Over the past two years, Border Force has invested £108 million and £71 million.
Many people forget that our border is manned not just by Border Force but by HM Revenue and Customs, the Royal Navy, which does an amazing job on fisheries protection, and volunteers, both through the Royal National Lifeboat Institute and the coastguard. Together, they form a large set of eyes to keep watch on our coastline. That is why we have developed Operation Kraken to ensure that all reported threats go to a central place where they are analysed and acted on.
Happy new year, Mr Speaker.
The Daily Telegraph today reports that new checks will be introduced at ports to help to stop the import of dangerous high-powered laser pens. Does this mean that the ports of Immingham and Grimsby will see more Border Force staff to help with these new checks?
What the hon. Lady will see is better use of the information we have now to target our resources in the right places. Just sending Border Force officers or customs officers to turn up randomly usually has no effect at all. If we can base it on information and work well with shippers, such as Fast UK Parcel, and all sorts of organisations shipping such contraband into the country, we can make sure that the right resources are delivered to the right places.
The right hon. Gentleman will know from his previous job that the borders are policed not just by Border Force but by counter-terrorism officers, HMRC officers, coastguard officers and fishery protection officers. On top of that, as he will also know, the voluntary network of people such as the RNLI are the eyes and ears, and when a report is made, a suspicion raised or intelligence received, the National Crime Agency and others attend the scene to deal with it.
And there is another body to be added to that list. Over Christmas we learned of the Government’s plans to put in place a special volunteer force to help police our coastal communities. This Dad’s Army-type operation is apparently to be responsible for helping keep us safe and protect us from terrorism. I wonder if the Minister is going to come to the Dispatch Box and say, “We’re doomed”, or complacently tell us, “Don’t panic!”
The only people who are doomed are the Scottish National party. Unlike the hon. Gentleman, I have actually worn a uniform. He will know that uniformed services rely on a range of specials and Territorial Army support to meet the specialist requirement we need. All uniformed services should be able to take advantage of the good will people want to provide, and if we want to use specials and Territorial Army support, we will.
Happy new year from my party, Mr Speaker.
Given what the Minister just said about the role of the Royal Navy, is it not rather worrying when we read about all these Royal Navy warships being tied up at harbour and not at sea?
I am sure the hon. Gentleman wants to make sure that our naval ships put to sea are properly serviced and properly equipped for their latest patrol. That is why ships tie up in port—not for any other reason—and why we deploy ships when needed to match the threat. He will also know that fishery protection vessels are often up and down the north-east of Scotland, where his constituency is located.
The Government take the threat of cyber-crime extremely seriously, which is why we have committed to spending £1.9 billion to support the national cyber-security strategy. This includes boosting the capabilities of the National Crime Agency’s national cyber-crime unit and investing in the cyber teams within regional organised crime units to bolster our response.
The Jazz Centre UK, a UK-wide charity with its headquarters in Southend—yet another reason why Southend should be a city—recently had £10,000 hacked from its account. Will my right hon. Friend reassure us on what further safeguards can be put in place for vulnerable charities to protect them from cyber-crime?
I am grateful to my hon. Friend. If he writes to me with the details of that case, I will be happy to look into it for him. I am particularly concerned because where something is hacked, it is usually called a “cyber-enabled” crime, which often gets a reimbursement from financial institutions. In general, we have invested in the National Cyber Security Centre in order to stop that type of fraud. It is out there, busy advising many organisations, voluntary and large scale, about what they can do to make themselves safer online. It is also why we are investing in technology to try and counter it.
Cyber-crime is one of the fastest-growing forms of crime, but after we have left the EU, the European Commission will still issue directives that relate to tackling cyber-crime; Europol will still continue to operate to apprehend criminals; and the European Court of Justice will still issue rulings. What steps is the Home Office taking to ensure the continued alignment of UK laws and regulations in this field—
We are working on a third party treaty to address just that. It is absolutely our intention to continue collaborative working in all areas of security with our international partners, whether they be in Europe or further afield, because that is the way to solve it.
I do apologise if I missed something extremely valuable. If I did, I suggest that the right hon. Member for Hackney North and Stoke Newington (Ms Abbott) place it in the Library of the House, where I imagine it will be regularly and exhaustively consulted.
The Government’s counter-extremism strategy, which was published in October 2015, established a comprehensive approach to the tackling of extremism through a wide range of activities aimed at countering extremist ideology. We are also launching a new commission for countering extremism, which will identify and challenge extremism and advise the Government on new policies to address it. The appointment of a lead commissioner will be announced shortly.
Flying the flag of the political wing of the anti-Semitic terrorist organisation Hezbollah is provocative, incites extremism and is deeply offensive to our Jewish community, but the flag can still be seen flying at events such as the al-Quds day marches in London. Will the Home Secretary update the House on what steps are being taken to prevent that from happening?
I am aware of, and very sympathetic to, the issues that my hon. Friend has raised. I have discussed the matter with Assistant Commissioner Mark Rowley, and I know that the police are not ignoring it. As my hon. Friend has rightly said, only Hezbollah’s military wing is currently a proscribed terrorist organisation, but its flags are the same as those of the political wings that are not proscribed. For an offence to be committed, the context and manner in which the flag is displayed must demonstrate that it is specifically in support of the proscribed military wing of the group.
Last month, in Turkey, I met a British national who was due to be deported back to the United Kingdom on suspicion of terrorism. The Turkish authorities gave us details of six other British nationals who have been accepted back to the UK. What is the total number of Brits who have been deported back from Turkey on suspicion of terrorism and joining Daesh, and how many of them are facing charges in the UK?
The hon. Gentleman has drawn attention to a very important aspect of our relationship with Turkey. When people who have been potentially fighting for ISIS are returning to this country, we have a managed return process so that we can prosecute. I will certainly come back to the hon. Gentleman with an update on the numbers, but I can reassure him and the House that we take every return very seriously and that, when we can, we will always prosecute.
Violence against Women and Girls
In March 2016 we published the cross-Government violence against women and girls strategy, which sets out an ambitious programme of reform and is supported by increased funding of £100 million. We will also introduce a draft domestic abuse Bill to transform our approach to domestic abuse, to support victims better, and to bring perpetrators to justice.
My hon. Friend is right: excellent work is being done in the Black country to support women and children. When I visited a Women’s Aid Black country refuge, it was impressive to see the excellent work that was being done there. I can reassure my hon. Friend that Walsall Council received a share of £639,000 of funding from the Department for Communities and Local Government—it is £40 million in all—in partnership with local authorities across the Black country. In addition, Wolverhampton and Birmingham received £1.1 million between them from the Department for early intervention projects.
Women in custody in our prisons are experiencing psychological abuse as they struggle to gain access to sanitary products, which is a potential breach of their human rights. Does my right hon. Friend agree that it is essential that women in custody have access to those products?
I thank my hon. Friend for raising that important point. I completely agree that it would be outrageous if detained women were not given access to sanitary products. I have seen the report that the Home Office commissioned. We will act immediately to ensure that where that is not on a statutory footing, it will be put on a statutory footing, so that nothing like this happens in the future.
The Home Secretary will be aware of the deep public concern about the Parole Board’s decision to release the serial sex offender and rapist John Worboys after only eight years. I am sure that she will also be shocked to learn that some of the victims have still not been contacted by either probation or victim liaison officers. I realise that the issues surrounding the Parole Board’s decision are matters for the Ministry of Justice, but can she say whether she has had any contact with the police to establish whether they are able to pursue further the cases of 19 women who came forward after the conviction, and whether those cases can be prosecuted so that justice can be done and women can be kept safe?
I share the right hon. Lady’s views on this matter, and I am sure she will have seen today’s comments from the Secretary of State for Justice, my right hon. Friend the Member for Aylesbury (Mr Lidington), about ensuring that there is more transparency in the Parole Board. I am aware that certain victims are talking about possible judicial reviews and talking to the police, but I cannot say any more than that at this point because these matters are subject to potential legal proceedings.
Further to the answer that the Home Secretary gave to the hon. Member from Sussex—[Interruption.] The hon. Member for Lewes (Maria Caulfield); I do apologise. Lewes is close to Sussex, I am sure.
I want to clarify a point with the Home Secretary. We would not find it acceptable to deny someone access to loo roll, so why do we think it is acceptable to deny someone access to tampons? She has said that she is committed to putting these matters on to a statutory footing. Does that include amending code C of the Police and Criminal Evidence Act 1984 and meeting the Independent Custody Visitors Association which has been working on this issue?
We commissioned the Independent Custody Visitors Association to produce the report. I share the hon. Lady’s view, but I respectfully say that I do not need reminding about this. I completely agree that of course women should have access to sanitary products, just as anyone should have access to loo roll, and yes I will put this on to a statutory footing if it is confirmed that the current guidance is inadequate. It looks likely that that is the case, but I just need to confirm it for myself.
Further to the Home Secretary’s response to the question about the John Worboys case, can she explain why her Department is still pursuing two of John Worboys’ victims, knowns as DSD and NBV, all the way to the Supreme Court in an apparent effort to avoid paying compensation? She will be aware that those victims are women whose cases the lower courts have already found not to have been investigated properly. How will pursuing them through the courts reassure the public that the Government are serious about keeping women and girls safe?
The Government are committed to keeping women and girls safe, and I hope that some of the points I have set out today will reassure the House that that is the case. I recognise the point that the right hon. Lady raises, but because this matter is sub judice, I cannot comment on it at the moment.
This Government are committed to doing everything we can to tackle domestic abuse. We have introduced a new offence of coercive and controlling behaviour. We have introduced measures such as domestic violence protection orders and Clare’s law. We have put domestic homicide reviews on to a statutory footing and committed £100 million to supporting the victims of violence against women and girls. We look forward to introducing a draft domestic abuse Bill.
My hon. Friend has spoken many times about domestic abuse issues, and particularly about the help that Sutton women’s centre provides to the victims of domestic abuse in his constituency. The Government have made available £40 million of dedicated funding for specialist accommodation, and refuges and bed spaces have increased 10% since 2010. We are committed to reviewing funding for refuges and to ensuring that all victims get the support they need, when they need it. The supported housing consultation is ongoing, and we will of course explore all models within the sector.
I should like to update the House on plans for the royal wedding in May. The marriage of Prince Harry and Meghan Markle is an occasion of national celebration, and that is why I launched a public consultation yesterday seeking views on the proposal to relax licensing hours in England and Wales over the weekend of the royal wedding. Extending the licensing hours on the nights of Friday 18 and Saturday 19 May until 1 o’clock the following morning will enable licensed premises in England and Wales to sell alcohol for consumption on site to those who want to continue their celebrations beyond the normal licensing hours. Whether toasting the royal couple or celebrating a football triumph, everyone should have the opportunity to make the most of this historic weekend in May.
I thank my right hon. Friend for that answer. Following last year’s police funding settlement, does she agree that now is the right time to work with and alongside police forces in Hertfordshire and across the country to keep improving and reforming the service to ensure that it is fit for the future?
I thank my hon. Friend for that question. We are able to confirm that this year up to £450 million of new money is going to support the police, while another £50 million is going towards counter-terrorism policing. However, that does not mean that we want to slow down the pace of reform in any way, so we will work with the police to ensure that there are reforms to make them more efficient and better servants to the community so that everybody has a better service overall.
Last week, Theodore Johnson, a serial killer and repeated domestic violence perpetrator, was sentenced to 26 years in prison for his crimes. However, despite the fact that two women are murdered every week, high-risk perpetrators such as Johnson face little intervention from statutory services. With less than 1% of perpetrators of domestic violence receiving any form of intervention, will the Minister reassure us that the Government will look urgently at innovative programmes such as Drive that challenge the behaviours of high-harm perpetrators?
I thank the hon. Lady for her question and offer our condolences not only to the family of Angela Best, but to the families of Yvonne Johnson and Yvonne Bennett. The case shows how manipulative the most violent domestic abusers can be, and I join the hon. Lady in wanting to ensure that we treat perpetrators to try to stop the cycle of violence. With the hon. Member for Bristol West (Thangam Debbonaire), I had the pleasure of speaking at a recent event for Respect, which works with perpetrators, and the hon. Member for Swansea East (Carolyn Harris) is correct that we must look at perpetrators as well as, of course, at supporting victims.
The answer to an invitation to visit sunny Clacton-on-Sea is, of course, yes.
Funding for fire services is basically being held flat against a backdrop of a welcome decline in fire incidents. At the same time, the single fire authority system is sitting on hundreds of millions of pounds of public money in reserves, so we still believe that fire services are adequately resourced.
My hon. Friend and I have already met to discuss this, and it was a pleasure to meet him and various colleagues to discuss their concerns about the continuation of peaceful protests. I hope that I was able to reassure him that it is this Government’s plan always to ensure that peaceful protests can continue, wherever that is. It is also this Government’s commitment to make sure that women can access abortion safe from harassment and intimidation.
Among the many things we can do is to carry out effective inspections, which we already have. We will be introducing a domestic abuse and violence Bill, on which we will consult. I hope we will get lots of contributions to the consultation, perhaps including from the hon. Gentleman, so that we can ensure that we stop domestic abuse and violence at an early stage and ensure that perpetrators are properly dealt with.
I share my hon. Friend’s concerns and thank him for raising this important issue. We have developed mobile drug-driving enforcement devices to help the police to identify suspected drug-drivers at the roadside, and they help to enforce the drug-driving offence that was introduced in 2015 to make it illegal to drive with a specified drug in the body above certain limits. The Government commissioned an evaluation of that new drug-driving legislation, and we are considering its findings and recommendations as part of future work to strengthen the law.
As the Immigration Minister, the right hon. Member for Great Yarmouth (Brandon Lewis), has done a runner, what will the Home Secretary do to clear up his lamentable record? In particular, does she think six months is an acceptable benchmark for resolving immigration cases? The Department is avoiding even that low aspiration via spurious excuses about cases being “complex.”
I would not characterise the former Immigration Minister in that way—he has done an excellent job—and nor do I share the right hon. Gentleman’s characterisation of the Department. If he has particular concerns, I would urge him to bring them to us. The vast majority of our cases are dealt with within the time set out in statutory guidance.
I congratulate my right hon. and learned Friend on his ten-minute rule Bill. The Government share his view that attacks on service animals are unacceptable and should be dealt with severely under the law. As he will know, the Department for Environment, Food and Rural Affairs has published the draft Animal Welfare (Sentencing and Recognition of Sentience) Bill, which will increase the maximum penalties available for animal cruelty, including attacks on service animals. The short answer to his question is that of course I would be delighted to meet him.
Cuts in police services do not just mean fewer pumps, as the cuts also fall on the crews of those pumps. Some brigades, instead of sending out crews of five, are now cutting them to four. Instead of four, they are sometimes sending out crews of three or even two. Is that not dangerous and unsustainable?
The hon. Gentleman referred to police services, but I think he meant to say “fire”, so I refer him to my earlier answer: funding for fire services has kept pretty flat against a background of fire incidents falling; we feel that fire services are adequately resourced; and how resources are allocated is down to local authorities and leaders.
My hon. Friend has been a constant representative for his constituents on this issue. We rely on UNHCR to identify and process the most vulnerable refugees as it is uniquely placed to determine refugee status, and to assess vulnerabilities, needs and suitability for resettlement. If UNHCR decides that resettlement is the most appropriate solution, it will then consider which resettlement scheme best suits people’s needs, which may be a UK scheme.
Crime is rising sharply in the west midlands, yet police numbers are falling—2,000 have gone and yet more are to go in the next stages. How can it be right or fair that Hampshire, which has nowhere near the same problems or challenges, gets treated more favourably than the west midlands?
In the past two years alone, we have lost more than 160 police officers in my area, yet we are seeing rising levels of antisocial behaviour and youth disorder. Rather than passing the buck to police and crime commissioners, why will the Home Secretary not give Northumbria police the funding that it needs to tackle this blight in our community?
It is not a question of passing the buck; we have a devolved system whereby PCCs are accountable to the public for the performance of the police. On Northumbria’s police force, I am sure the hon. Lady will welcome the fact that it is due to get another £5.1 million next year.
Will the Home Secretary tell the House what we are doing to support schools to identify when the dark web is accessed through apps that are free to download? This is how some of our most vulnerable children are accessing footage of ISIS beheadings and other disturbing imagery, which is fuelled by extremists who are trying to get new recruits.
My hon. Friend is right to raise these real concerns about online access, which is why the Department for Education and the Home Office work together on campaigns such as Cyber Aware to bring good computer hygiene and caution into the classroom so that children are not exploited online. It is also why the Government invest in the Prevent programme to make sure that the people doing this are brought to justice and that the online space is not the dangerous place it could be.
In Staffordshire, 106 councillors from Staffordshire County Council and Stoke-on-Trent City Council unanimously oppose the commissioner’s proposal to take over the running of the fire service. He is progressing with that despite there being no public support. Why are the opinions of one commissioner worth more than those of 106 councillors?
The hon. Gentleman misrepresents the situation entirely, because the obligation on a police and crime commissioner is to produce a business case and demonstrate that he or she has consulted the local community. In this case, Matthew Ellis has done just that, which is why we are reviewing it.
Despite the rhetoric that we heard earlier, does the Home Secretary agree that what the vast majority of people in this country want is an immigration system that delivers both fairness and control, and that is underpinned by common sense? Will she deliver just that?
I thank my hon. Friend for his question. He makes an excellent point and sets out exactly what we want: fair, rational, controlled immigration that not only is good for this country, but gives the public confidence that we are protecting our borders and we are absolutely clear about the numbers that we are targeting.
I reassure the hon. Lady that we are committed to ensuring that there are fully funded refuges. I point out to her that 10% more beds are available to women now than in 2010. She may know that a review is going on with DCLG to make sure that we have the best outcomes for supported housing, and I will ensure that we engage with that so that we continue to maintain high levels of availability of beds for women fleeing violence.
In 2009, John Worboys was rightly found to be a dangerous, predatory sex offender. It is a feature of those sorts of offender that they are also clever and cunning. What assurances can the Home Secretary give us that, upon his release—if he has to be released—women will be safe?
Making women safe and ensuring that we have the legislation in place for that is a priority for me and this Government overall. The particular case that my right hon. Friend raises was under discussion part way through this Question Time. She may know that there will be a review of some of the procedures, the Parole Board element and the transparency required. The Prime Minister has already said that she wants this looked at.
Control operators in North Yorkshire fire and rescue service are working under such pressure that sometimes just trainees are on duty. Will the Minister look at this issue and meet me to assess the risk to our fire and rescue service?
NHS Winter Crisis
I thank the hon. Gentleman for applying to ask the urgent question as I agree that it is helpful for colleagues in the House to be updated on the current performance of the NHS during this challenging time.
We all know that winter is the most difficult time of the year for the NHS, and I start by saying a heartfelt thank you to all staff across the health and care system who work tirelessly through the winter, routinely going above and beyond the call of duty to keep our patients safe. They give up their family celebrations over the holiday period to put the needs of patients first. Those dedicated people make the NHS truly great.
Winter places additional pressure on the NHS and this year is no exception. The NHS saw 59,000 patients every day within four hours in November. That is 2,800 more every day compared with the previous year. The figures for December will be published on Thursday. We have done more this year in preparing and planning earlier than ever before. That means that the NHS is better able to respond to pressure when it arises. In the words of Professor Sir Bruce Keogh, the national medical director:
“I think it’s the one”
“that we’re best prepared for. Historically we begin preparing in July/August. This year we started preparing last winter. We have, I think, a good plan.”
Let me tell the House about some of the things that have been done differently this year. We further strengthened the NHS’s ability to respond to risk, and the NHS set up the clinically-led national emergency pressures panel to advise on measures to reduce the level of clinical system risk.
We are supporting hospital flow and discharge. We allocated £1 billion for social care this year, meaning that local authorities have funded more care packages. Delayed transfers of care have been reduced, freeing up 1,100 hospital beds by the onset of winter. Additional capacity has been made possible through the extra £337 million we invested at the Budget, helping 2,705 more acute beds to open since the end of November.
We have also ensured that more people have better access to GPs. We allocated £100 million to roll out GP streaming in A&E departments and I am pleased that 91% of hospitals with A&E departments had this in place by the end of November. For the first time, people could access GPs nationally for urgent appointments from 8 am to 8 pm, seven days a week, over the holiday period. In the week to new year’s eve, the number of 111 calls dealt with by a clinician more than doubled compared with the equivalent week last year, to 39.5%, thereby reducing additional pressures on A&E.
We extended our flu vaccination programme, already the most comprehensive in Europe, even further. Vaccination remains the best line of defence against flu and this year an estimated 1,175,000 more people have been vaccinated, including the highest ever uptake among healthcare workers, which had reached 59.3% by the end of November.
We all accept that winter is challenging for health services, not just in this country but worldwide. The preparations made by the NHS are among the most comprehensive, and we are lucky to be able to depend on the extraordinary dedication of frontline staff at this highly challenging time.
Order. For a moment I thought that the Minister intended to treat this as though it were an oral statement, to judge by the length. I think it is fair and correct for those following our proceedings to point out that this is not an oral statement offered by the Government: it is a response to an urgent question applied for to, and granted by, me.
It is always a delight to see the Minister, but the Secretary of State for Health should be here to defend his handling of the crisis, not pleading for a promotion in Downing Street as we speak.
I join the Minister in paying tribute to all those NHS staff working flat out. Many of them have said that this winter crisis was entirely predictable and preventable. When you starve the NHS of resources, when you cut beds by 15,000, when you cut district nurses, when walk-in centres are closed, when we have vacancies for 40,000 nurses, when you fragment the NHS at a local level and drive privatisation and when social care is savaged, is it any surprise that we have a winter crisis of this severity?
More than 75,000 patients, including many elderly and frail, were stuck in the back of ambulances for over 30 minutes in the winter cold this December and January. A&Es were so logjammed that they were forced to turn away patients 150 times. In the week before new year’s eve, 22 trusts were completely full for up to five days. The blanket cancellation of elective operations means that people will wait longer in pain, distress and discomfort. Children’s wards have been handed over to the treatment of adults. Of course, we do not know the full scale of the crisis, because NHS England refuses to publish the operational pressures escalation levels alerts revealing hospital pressures. Given Ministers’ keenness on duty of candour, why are OPEL alerts data not being collected and published nationally for England?
The Minister mentioned the winter pressures funding, but that money was announced in the Budget on 22 November. Why were trusts not informed of allocations until a month later? That is not planning for the winter: it is more like a wing and prayer. He will know that cancelling elective operations has an impact on hospital finances. What assessment has he made of the anticipated loss of revenue for trusts from cancelling electives? Will he compensate hospitals for that loss of revenue, or should we expect deficits to worsen? Can he tell us when those cancelled operations will be rescheduled?
The Prime Minister defends this crisis by saying nothing is perfect. Patients do not want perfection: they just want an NHS which is properly funded and properly staffed without the indignity of 560,000 people waiting on trolleys in the last year, in which operations are not cancelled on this scale, and in which ambulances are not backed up outside overcrowded hospitals. Patients do not just need a change of Ministers today: they need a change of Government.
I am glad that the hon. Gentleman mentioned the Secretary of State. I want to put on record my tribute to my right hon. Friend, who has served in that position for almost as long as Aneurin Bevan, who was the first Secretary of State for the NHS.
I am delighted to be here to respond to the hon. Gentleman, who, as usual, listed a cacophony of allegations, very few of which are directly related to the challenges that our hospitals face today—the increase in demand and pressure on our NHS as a result of a combination of the increase in population and challenges posed by demographics, as well as the weather and the presence of flu in many parts of the country, adding to the pressure on staff at this time of the year.
The hon. Gentleman asked several questions. On the funding issue, he is well aware that the £337 million announced in the Budget was allocated in December. His own local trust, which includes the Leicester Royal Infirmary, received £4.2 million. It is a great shame that he chose not to welcome that extra money for his local trust. The money announced in the Budget has been allocated, but we have kept £50 million in reserve to allocate this month if particular pressures that become apparent during the course of the month need addressing.
The hon. Gentleman asked about the impact of the cancelled operations. We do not know that operations are cancelled. There have been a few thus far; procedures and treatments are being deferred. It will not become apparent until after this period has finished how many actually do end up being cancelled, so it is not possible to calculate the financial impact on any of the trusts where deferral is taking place.
The hon. Gentleman referred to the situation as unprecedented. I gently remind him that we have a winter crisis of some kind or another every year. He will have been in Downing Street in 2009-10, when, as it happens, the then Conservative shadow Health Secretary chose not to try to take advantage of the near flu pandemic at the time because he recognised that there were operational pressures on the NHS and it was not down to him to score party political points. The hon. Gentleman has unfortunately chosen to do that. At that time, tens of thousands of elective procedures were cancelled to provide capacity to cope with the emergency at the front doors of our hospitals. So this is a routine way to deal with pressure coming through hospital front doors.
What distinguishes this year from previous years is that in the past elective procedures were cancelled within hours of operations being due to take place. Sometimes it was the day before and sometimes it was on the day. That caused patients considerable distress and gave rise to considerable problems for staff. We have set up the national emergency pressures panel to anticipate problems when we see the signals, and we can then give notice to patients that their procedures are going to be deferred. That is a much more humane and sensible way to do things and it provides much more opportunity for hospitals to cope with the pressures that are coming through the door.
NHS acute services have never been better and are among the best in the world. As the Minister just said, every year we have this slightly ritual exchange about winter pressures, but does he accept that the problems are changing because of the increased number of elderly people in the population and the increased urgency of the need to solve the problem of how to admit them promptly to the right part of the service and then discharge them properly and safely as soon as they are recovered? Will he advertise further to the many people who are not aware of it the availability of emergency GP services? Will he concentrate on the reform and integration of the community care system, the social care system and the primary care services and make sure that co-operation among them is steadily improved so that they can cope better in future years, because this problem is undoubtedly going to develop?
I am grateful to my right hon. and learned Friend for making those points. He brings to the House considerable experience of what it is like to be responsible for the NHS. He is absolutely right: the number of over-80s who are presenting to hospital A&Es is going up exponentially each year. Hospitals need to adapt the way that they treat such patients to try to keep them as healthy as possible so that they can live independently for as long as possible. That is why many hospitals are now introducing frail elderly units close to or at the front door of A&E departments so that they can turn around patients and avoid admissions. My right hon. and learned Friend is also right to point to the increasing integration between the NHS and social care that is necessary to encourage more people to live independently out of hospital and leave emergency departments for those people who are urgently ill.
I, too, pay tribute to staff across all four health services, where the normal pressures have been added to this winter by freezing weather and influenza. Scotland still leads in A&E performance across the UK, but we do not need to see four-hour data to understand the stress that NHS England is under. Thousands of patients have been held in ambulances for more than an hour outside A&E before they can even get in, which means that ambulances could not respond to other urgent calls, and that has obviously put other patients in danger. We have heard about patients being held in corridors for hours at a time, causing not just suffering and danger to patients, but enormous stress to those staff to whom we are paying tribute.
The Minister talks about the elderly population. We need to have beds for that population. England has halved its number of beds in the past 30 years, and now has only 2.4 beds per 1,000 population, compared with four in Scotland. Will he and the Secretary of State make sure that there are no further cuts in the sustainability and transformation reorganisation, and will they look at how they replace the money that has been cut from social care so that when elderly patients are ready to go home they can do so and free a bed for someone else?
As I have already said, the social care funding has gone up very significantly this year, and there is a second billion pounds to go into social care over the next two years. The hon. Lady is right to point to Scotland having a slightly better A&E performance than England, and the two countries are far better in performance terms than any other country that we regularly monitor, but she has to be a little careful when she talks about how Scotland is performing so much better. She talked about waits. It is the case that the over-12-hour trolley waits in England for November were half the rate of over-12-hour trolley waits in Scotland. We are providing information, and we are increasingly trying to be more transparent about the impact of winter on our health service in England. I strongly encourage her to take back to her colleagues in the Scottish Government the amount of data that is being published in England and to see whether they can try to match it.
I join the Minister in thanking NHS staff and in commenting that there is nothing new about winter pressures in the NHS. What is different is that they are extending now into traditionally quieter months, and that the depth of those pressures is so much more profound over the current winter, because there has been a failure over successive Governments to plan sufficiently for the scale of the increased demand across both health and social care. Will the Minister think about the forthcoming Green Paper for social care and think about combining it with health, so that we can see this as a truly across-system approach? I would also like to reiterate the points made by the hon. Member for Central Ayrshire (Dr Whitford) about the role of bed-occupancy levels. Can the Minister tell us what the current bed-occupancy levels are in the NHS in England?
On the last point, I can confirm to my hon. Friend that, at Christmas eve, the bed occupancy rate was 84.2%, below the target of 85% that we set going into this particular winter period. Of course the rate fluctuates daily and I do not have the figures for the most recent days. We did at least start this holiday period in that position, which is a great tribute to the work done in preparing for winter. I wish to reiterate to her, as I did to my right hon. and learned Friend, the importance of the integration work being done through the sustainability and transformation partnership process between NHS organisations and social care providers. It is part of the solution for the longer-term arrangements that we need to put in place to try to make sure that people who are living longer live better, more healthily and in a more independent way out of hospital.
Where does the postponement of tens of thousands of operations leave the promise made by the Health Secretary to the Select Committee, the last time he appeared before us, that he would begin to reverse the very bad deterioration in routine waiting times for operations that we have seen in the past seven years?
Many areas of the country are doing very well with their waiting times. There are some—this tends to be concentrated in a relatively small number of trusts—where the referral to treatment targets are not being met, and need to be met. Part of the funding settlement achieved in the Budget in November is designed to bring down waiting time targets, to get more people treated within an 18-week period. That will clearly exacerbate the problem during this immediate period in which procedures are being deferred, but we hope that it will not last long.
As I said in my initial response to the question, it is very important that we improve patient flow through hospitals. One of the critical features that enables this is ensuring that patients can be discharged when they are medically fit. We have put a huge amount of effort into this during the past nine months or so. I am pleased to say that some progress is being made, but we absolutely need to focus on this area. Again, there is huge variability between systems across the country. Some have virtually no delayed transfers of care, but the numbers of DToCs in other areas are much too high. We need to learn from the areas that are doing it right and introduce that in areas that are not.
To progress beyond the tribal arguments about funding, what is the Government’s response to the 90 MPs from both sides of the House who have urged the Government to establish a cross-party consensus to agree a funding formula for integrated health and social care?
As the Secretary of State and the Prime Minister have said, we are always interested to hear ideas for improving the health service. At the moment, we have confidence in the five year forward view; that is the route that we are taking to bring the health service forwards and make it completely fit for the future. If the right hon. Gentleman has specific points that he would like to make, I am always ready to listen.
It has been an extraordinarily difficult winter for hospitals serving my constituents in Kent. May I, too, thank NHS staff for the efforts that they have made to provide the best possible care? I welcome the extra money from the Government that has helped to open extra beds out of hospitals and to employ extra staff, particularly GPs and A&E staff. Will the Minister looks carefully at future capital funding bids and at Kent’s proposal for a medical school, so that we are better prepared for future winters and have the buildings and staff that we need?
My hon. Friend is a consistent champion of efforts to improve health facilities in her constituency. I am acutely aware of the challenge of medical training places in Canterbury, which was one of the reasons that we met last year to discuss what could be done to encourage medical students to come to Kent. I am not able to give her any specific guidance on the allocation of new medical training places because that recommendation will be coming to me over the next few months from Health Education England. We look forward to making decisions on that, and I specifically included in the criteria that rural and coastal areas should have good representation.
The Minister will have seen the images of patients at Mid Yorkshire Hospitals NHS Trust sleeping on the floor because they could not even get a trolley, never mind a bed. We have had over 95% bed occupancy rates and a shortfall of over 200 nursing vacancies, and we will have a multimillion-pound budget shortfall by the end of this year. The Health Secretary and the Prime Minister have been repeatedly warned about this by nurses and doctors at Mid Yorkshire trust and across the country, by the public and by the NHS chief executive, yet they still decided to deny him the funding he needed at the Budget. How many more patients will have to sleep on the floor before this Government act?
I cannot comment on what the right hon. Lady says happened in her hospital regarding individual patients. I acknowledge that there has clearly been a lot of pressure on space for beds, which is in large part down to a multiplicity of factors including the high bed occupancy to cope with the high admission rate. I say gently to the right hon. Lady that her area has received £3.3 million to help to cope with winter pressures; that is not an insignificant amount. As to nursing vacancies, we absolutely recognise that we need to increase the number of nurses in this country, which is why we announced last October a 25% increase in nurses in training. That will start to take effect from next September. In addition, we have introduced the new alternative route into nursing of the nursing associate role, and we expect several thousand of those to start shortly.
Order. It might be helpful to the House if I inform Members that I am looking to move on to the second urgent question at no later than 4.30 pm, so inevitably some people will be disappointed on this question. The longer each question and answer takes, sadly, the more people will be disappointed. I am in favour of fewer disappointments. I am sure that colleagues share that ambition with me, not just in general, but including in terms of its implications for their own question.
I do not think my hon. Friend will be surprised if I say no, I do not agree that the system is broken. I do accept that it requires more funding, and that is why more funding was provided. It also requires local authorities to work more closely alongside the NHS to try to share these problems and find solutions together.
The Minister said earlier that he did not know how many operations had been cancelled—maybe a few. Let me tell him that in one week alone 300 operations were cancelled in Leicester. I find myself unusually agreeing with the hon. Member for Wellingborough (Mr Bone)—social care is broken. Will the new Cabinet Office Minister be leading on the social care Green Paper, as the previous one did, and if not him, who?
I am glad that the hon. Lady has referred to the social care Green Paper, because that will be published this year, providing an opportunity for all Members to participate in it. It does not sit within my set of responsibilities, so I will come back to the hon. Lady on exactly who will be leading on it.
My constituents can access Derby and Nottingham hospitals. The two trusts have been allocated an extra almost £7 million for winter preparedness. Will the Minister reassure me and my constituents that there will be a full analysis of how that extra money is spent, so that we can learn lessons to make sure that we build on good practices for next year?
I am pleased that my hon. Friend welcomes the extra money provided in her area. I can confirm that once this winter period is behind us, we will absolutely look to learn lessons on what works best in ensuring that we get patients seen to as quickly as possible.
Is the Minister aware that on six of the seven days after Boxing day, all of north Middlesex hospitals’ general and acute beds were occupied? Does he agree that this state of affairs is totally unacceptable, that more investment is needed in our emergency health services and that much better planning is required for any future winter crisis?
I confirmed to the House at the beginning of my remarks that we believe that planning is essential. We started planning for this winter at the end of last winter, and I expect that we will continue to do so for the coming winter. As for what happens in individual hospitals with the individual pressures that they have, it is down to the local NHS leaders and clinicians to determine what capacity they need, and they need to plan for that, too.
In Medway, we have seen great pressures in the system over the past few weeks. We have seen advance planning at Medway Maritime Hospital and extra funding going into the clinical commissioning group. Does my hon. Friend agree that the staff at the hospital have done an outstanding job so soon after coming out of special measures and that it is important that we should hold the CCG to account on where this money is spent?
I visited the Medway hospital when it was still in special measures and saw the pressures with the configuration of the A&E and the challenges that that posed to good patient flow. I am pleased that significant investment has already gone into Medway to try to resolve some of those physical characteristics. I absolutely agree that we should praise the staff of the hospital for the work that they have done in turning it around so well.
Three months ago at the Health Committee, Jim Mackey, the head of NHS Improvement, told us that
“we are running tighter than any of us would really want to and we have not had the impact from the social care investment…that we had hoped for; so, it will be difficult—it will be very tight—over winter.”
The Government knew that this crisis was coming, and the social care investment to which the Minister has referred this afternoon has not been enough. Why have this Government not acted?
Will the Minister congratulate the doctors and healthcare workers of Leicestershire on their excellent work over Christmas but recognise that the problems of A&E are not just about the supply of services, but about trying to reduce demand through triage, the involvement of the 111 service at A&Es and dealing with drunks who are abusing the old doctrine of a service free at the point of delivery?
I am very pleased to respond to my hon. Friend on a subject that is not always at the forefront of his mind. He is absolutely right to highlight the abuse of the health service by certain people—revellers—who turn up at hospitals in an unfit state to be treated. In some places, we have introduced holding areas to ensure that they do not disrupt the work of the hospital.
The Minister will be aware that the tragic case of the elderly lady who lost her life while waiting four hours for an ambulance is not an isolated one: there are constant failures of care across the country every day of the week. If he recognises that this is completely intolerable, will he not respond to the 90 MPs from across this House who have demanded that the Government get a grip and work, on a cross-party basis, to come up with a long-term solution?
I am always interested in what the former Health Minister has to say on these subjects, because he speaks with considerable authority. On ambulances, it is obviously unacceptable for there to be delays of that nature and leading to that kind of outcome, and we absolutely need to ensure that all trusts, when these incidents occur, look very carefully at trying to prevent them from occurring again. We have now—in part, in response to the pressures that the ambulance service has been under—set up a national ambulance control centre to try to help co-ordinate ambulance responses where services are not meeting the targets in certain parts of the country or our requirements in individual hospitals.