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Patient Transport Volunteer Drivers

Volume 639: debated on Monday 23 April 2018

Motion made, and Question proposed, That this House do now adjourn.—(Mike Freer.)

I thank you, Mr Speaker, and all those Members who have remained at this late hour. In a way, my contribution tonight feels not unlike my maiden speech, because it is necessary to frame what I will say with a kind of tour d’horizon, because as Members will understand, the horizons in my constituency are massive. It is the second biggest in the UK—it is truly huge. The sheer distances involved in travelling in the highlands always come as a surprise to people who do not know the area.

As I have said in the Chamber before, a simple hospital appointment for my constituents living on the north coast can involve a return trip of well over 200 miles from the north coast to Raigmore Hospital in Inverness. In a part of the world where there is extremely limited rail travel, from Wick and Thurso going down the east coast to Inverness, and where buses are sporadic at best, my constituents have little choice other than to rely on the good old-fashioned motor car—either their own or private cars driven by volunteer drivers.

My hon. Friend mentions the distances involved. Does he agree that in Caithness, Sutherland and Easter Ross, as in many other parts of Scotland, it is not simply the distance, but the fact that the roads make the journey even more difficult? Often we are talking not about dual carriageways, but about roads that are single track, and no more, and extremely difficult to travel on.

My hon. Friend makes an extremely good point. She holidays in Portmahomack and will know, as well as I do, that in winter weather, some of these roads can be absolutely impassable.

I want to read from an email that I was sent by a constituent of mine called Fiona who lives in Durness in north-west Sutherland. She wrote:

“I currently have an 83 year old neighbour who has had a stroke, has memory problems as well as other medical conditions and lives alone with no family in the area. He is having investigative work done at Raigmore”—

the hospital in Inverness—

“and 4 times I have tried (very hard) to arrange a hospital car for him. I have yet to be successful and end up taking him there myself. It is physically impossible for him to make the journey by public transport for his timed appointments even if he was physically fit!”

I think that sums up the nature of the problem in my constituency.

Does the hon. Gentleman not agree that the current trend of closing down small hospitals and creating centres of excellence that are miles away from rural communities makes it difficult for those taking loved ones on long journeys for necessary treatment? People should not be penalised for living in rural areas, such as those in my constituency of Strangford in Northern Ireland.

That is absolutely correct. The hon. Gentleman and I have to be careful about straying into devolved areas, but the fact is that the NHS changes that are happening in our constituencies impact on people. We can say it is devolved, but nevertheless, the two of us represent our constituents and are bound to take up their issues, and, as best we can within the rules of devolution, air them in this Chamber.

I mentioned volunteer drivers a minute or two ago, and they are the people I wish to draw to the attention of the House tonight. That is the peg on which I hang my hat, because one has this balancing act between what is devolved and what is reserved to Westminster.

Does the hon. Gentleman agree that without proper reimbursement for volunteer patient transport drivers, we are at risk of having a deeply unfair postcode lottery in which people in rural and remote areas lack the access to the healthcare that they are entitled to?

The hon. Gentleman makes a sage point, which I will come to shortly. The issue is the taxation regime—it is a UK function, hence it being the peg on which I hang my hat—that applies to these drivers. I shall describe the problem. In 2011, the then Chancellor, George Osborne, set thresholds and payments for volunteer drivers that would not incur additional taxation over and above their PAYE. These rules, which still govern us today, were: a reimbursement of 45p per mile for the first 10,000 miles and of 25p per mile for any additional miles.

I shall work that into a typical example of a volunteer driver in my constituency. In my part of the world, it would be no surprise if a driver did as many as 50,000 miles a year—believe it or not—driving patients to and from their much-needed appointments. As I have said, he or she receives the higher rate of 45p for the first 10,000 miles and then the lower rate of 25p for the following 40,000 miles. As Members will understand, it does not take a financial genius to work out that the reimbursement for these higher mileages represents a net loss for the driver. It is for this reason that for far too long volunteer drivers have sadly been packing it in—giving it up. As I say, this is particularly worrying in constituencies such as mine where we have huge issues of distance, inclement weather and so on. Where a volunteer driver continues to drive and accept this taxation regime, just one 200-mile return trip a week will take them in a year up to the 10,000-mile point.

This was for a long time a big issue for me during my time as a Member of the Scottish Parliament, and every time I raised it in Holyrood with the Scottish Government, they would say—with truth on their side—“We’re sorry but this is a matter for Westminster”. I am here now—some might say by a dreadful accident of the electorate, but there we are—and it is precisely because it is a matter for Westminster that I raised it with the Leader of the House not very long ago. It is also the reason I applied for this debate—and now I have been lucky enough to be chosen to place the issue before Members tonight.

It would be easy for me to say to the Minister, “Will Her Majesty’s Government please go away and think about it?”, but I know from previous ministerial responses that he might well respond, “If the volunteer driver thinks he is losing money on this deal, he can always present his books to Her Majesty’s Revenue and Customs and say, ‘You’re being unfair to me’”. But let’s face it: how many volunteer drivers have such a detailed grasp of accountancy or the time to do that? It would take up too much of their time or be beyond their capabilities. They just want to get on with helping their friends and neighbours get the medical treatment they need.

I have instead a suggestion for the Treasury—if it chooses to take it apart, so be it, but I will argue my corner. It seems extraordinary that the 10,000-mile threshold and the rate of reimbursement have not been looked at since 2011, when George Osborne put in place the current arrangements; it was seven years ago. If nothing else, surely the time is now right for the matter to be revisited. One way forward would be to raise the threshold to, say, 15,000 miles—or another figure that Her Majesty’s Government might suggest. The beauty of this is that, while it could be argued that other drivers—for instance, employees using their own cars for business, which is governed by the same taxation law—might be tempted, in a bad world, to incur extra mileage to ramp up their income, a simple change in taxation rules to recognise the specific and special role of NHS volunteer drivers would be a safeguard and could easily be written into law.

Sticking to volunteer drivers, some have expressed the fear that increasing the threshold might encourage NHS drivers in urban areas, or perhaps in the home counties of England, to up their mileage to cash in, but there are only so many working hours in a day and one can only drive for so long in a day. As a highlander who has come down to these strangely populated parts of England, I have discovered it can take an awfully long time to travel from A to B, even when the mileage is comparatively short, owing to urban hold-ups and so on.

There are lessons to be learnt from northern Lincolnshire, where Thames Ambulance Service Ltd took over the contract and changed the arrangements for rewarding volunteer drivers, as a result of which the whole contract became very difficult to run. I congratulate the new chief executive on changing the arrangements again, as a result of which volunteer drivers are now coming back. As the hon. Gentleman has said, they make a big contribution to the health service, and they need to be properly remunerated.

I thank the hon. Gentleman for his intervention, which was thoughtful and to the point. Ultimately, however, whether the matter is devolved or reserved, I am left with the problem of trying to help people whom I know and love to reach hospitals and medical centres so that they can be given the treatment that they need.

I am grateful to the hon. Gentleman for securing a debate on such an important issue. I was concerned to hear about the volunteer drivers who have given up driving for the reasons that he has explained. Does he agree that it is not just their driving that we lose, but the extra service that they provide? The drivers who work for the Speyside community car sharing scheme in Moray do not just drop people off at the doctor’s surgery or the hospital and then pick them up again; they wait for them, and take them back to their homes to ensure that they are safe after what can sometimes be a traumatic experience.

That point is incredibly well made. The hypothetical Mrs Mackay who goes to Moray or Caithness, Sutherland and Easter Ross will know the local people. She will know, when she picks up Mrs Mackenzie, that she may have forgotten to take her heart tablets with her. That is crucial. Local knowledge will also inform her if Mrs Mackenzie has been bereaved, or if there is some difficulty in her family. That makes life so much better.

At the end of the day—and at the end of this day, too—patient transport in my vast and beautiful constituency is exceedingly challenging. I acknowledge that. However, no challenge should be ducked, and I think that sensitive law making can take on some of the nuances. I am bound to say that, in my 11 months in this place, I have been grateful to Her Majesty’s Government for their recognition that I represent a very remote and rural part of Scotland and of the United Kingdom, with a fragile economy. I look forward to the Minister’s reply, and I stake my claim for the future by saying that I should be more than happy to meet him, talk about this problem, and work towards a constructive solution as the days, months and years go by—although I hope that it will not be years.

I thank the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) for raising an important issue about which I know that he feels strongly—as do others, which is evidenced by the fact that so many Members have stayed in the Chamber to listen and contribute to the debate. Like me, the hon. Gentleman represents a rural area where the distances that constituents must travel to visit doctors, dentists, opticians and hospitals are considerable; in his case, they are very large indeed, perhaps larger than those in any other constituency. I know that he raised this issue during his time at Holyrood —I have seen the questions that he asked and the answers that he received—and I am glad that he has had the opportunity to raise it again in the House of Commons.

The Government greatly value the significant contribution of members of the public who, as volunteers, support others up and down the country. We recognise that those who provide transport, particularly in rural areas, enable vulnerable people, such as the elderly and those without cars, to have the access to appointments or treatment that would otherwise be very challenging, very expensive, or both. As was pointed out by my hon. Friend the Member for Moray (Douglas Ross), it is not simply a question of practicality; it is also a question of the care, the kindness and the company that the volunteers give to others. I have seen that myself when I have volunteered once or twice with my own local voluntary transport scheme in Nottinghamshire.

I pay tribute on behalf of the Government to both the individuals and the voluntary transport schemes. The volunteers who staff many of these schemes make them possible. In my constituency, we benefit from a superb scheme run by Lucy Fountain in Newark, who I have got to know and respect enormously. I believe that, as the hon. Member for Caithness, Sutherland and Easter Ross says, the Government do and must play a role in ensuring that the schemes continue, that volunteers are respected for the time and commitment they put in, and that they are not at any financial disadvantage.

As a Treasury, we need to consider carefully the barriers standing in the way of people doing this work—I believe that we have done that, but I hope we will continue to do so. Tonight, I am very happy to outline where we stand and the work we have done in recent years, but I also accept the suggestion of a meeting to take these matters forward.

It is right that the tax system should allow volunteers to be reimbursed for their reasonable expenses and it must be the principle that wherever possible volunteers are not left out of pocket. Organisations are free to reimburse volunteers at whatever rate they choose but, to make it easier for volunteer drivers and to create simplicity in how one is reimbursed for the miles driven, the Government allow organisations to make approved mileage allowance payments, or AMAPs. Payments within the AMAPs scheme do not incur a liability to tax, as the hon. Member for Caithness, Sutherland and Easter Ross explained.

The scheme covers reasonable costs associated with using a private car for business miles or voluntary work and the approved rates, as we have heard, are set at 45p per mile for the first 10,000 miles and 25p thereafter. The reason for the higher rate for the first 10,000 miles has always been to reflect the fixed and variable costs associated with operating a car. No matter how small the number of miles driven, motorists will of course always be liable to pay for insurance, servicing the vehicle and purchasing a new one in due course. In general, that means that when driving a shorter distance the overall cost per mile is higher than when those fixed costs are spread over a greater number of miles. Drivers carrying passengers can also claim an additional 5p per mile per passenger. For volunteer drivers, of course, this is particularly relevant, but it is also designed to incentivise people to take part in drive to work schemes and so on. If a driver is travelling with one passenger, 50p per mile could be paid tax-free for the first 10,000 miles. It should be stressed that 50p is only the maximum outlined by the Government. Many voluntary transport schemes choose, at their discretion, to offer a lower sum. My own in Nottinghamshire offers 42p per mile, so there are questions of variations across the country that are outside the control of the Government.

Volunteers are also afforded one further preferential treatment. Unlike for employees, the reimbursement of a volunteer’s travel expenses covers them from home to the place of voluntary work. When one is travelling from one’s home to pick up a patient in their home, all of that journey is reimbursed. This can be considerable. However hard voluntary transport schemes like my own try to match the patient with the volunteer, the distances in a constituency such as the hon. Gentleman’s can be very large, so that preferential treatment is important.

Seen in the whole, we think that the current rates represent a fair allowance for the vast majority, ensuring that volunteer drivers are not left out of pocket. The system is designed to be simple and clear, as volunteers are required only to record their annual mileage rather than to keep any other motoring records or expenses. As the hon. Gentleman said, such a requirement would be too onerous for volunteers. It has to be said that the vast majority of volunteers do not exceed 10,000 miles of volunteer driving, but I appreciate that regional variations exist.

To take an example from England for context, a QualityWatch report found that only 3% of emergency admissions travelled more than 30 km to a hospital, with an average distance of just under 9 km. Preparing for this debate, I asked my own voluntary transport scheme. It covers a rural area—far less rural than the hon. Gentleman’s constituency, but an area where hospitals are 20 to 30 miles away from the principal town. I appreciate that that is only a fraction of the distances he described. The average mileage for a volunteer driver in that rural area was 4,000 miles a year, and the busiest driver last year completed 9,000 miles. I do not want to dismiss those individuals who drive more than 10,000 miles. I am sure there are some, and the hon. Gentleman and other hon. Members from the highlands of Scotland have mentioned some of them—

Motion lapsed (Standing Order No. 9(3)).

Motion made, and Question proposed, That this House do now adjourn.—(Mike Freer.)

As I was saying, I am sure that the hon. Gentleman is correct and that there are individuals who travel more than 10,000 miles a year. We have to recognise that, by definition, these are the most active and the most public-spirited members of the public. They are giving up enormous amounts of time; they are almost professional volunteers, given the amount of time they are willing to give up. Their generosity should be provided for and their costs reimbursed wherever possible.

We are focusing in this debate on volunteer drivers, but will the Minister also take this opportunity to acknowledge that there are others in our communities who help? For example, Keith Cancer Link, which was established 35 years ago in Moray, raises money to pay for taxis to take people from Keith to Aberdeen and Elgin for their treatments. It is right that we highlight what the drivers do, but we should also highlight what others in our constituencies do to help.

I am happy to agree with my hon. Friend. There is a range of schemes across the country, particularly in the rural areas that most of the hon. Members here tonight represent. They include volunteer driver schemes and community bus schemes, as well as schemes run by the whole range of charities supporting hospitals and healthcare across the country.

Returning to the question of those travelling more than 10,000 miles a year, I am pleased to report to the hon. Member for Caithness, Sutherland and Easter Ross that there is provision for them, but it is slightly different from what he has outlined this evening. HMRC allows individuals to claim their actual costs if they travel more than 10,000 miles—or indeed any mileage—at the discretion of the individual or the community transport scheme. Those who travel particularly long distances and feel that the rates do not cover their costs should ask their community transport scheme for the actual costs of their motoring. The individual will need to keep records to show that no taxable profit has been made, but there is no need for them to make any declaration to HMRC or to include the information on a tax return unless they make a profit, which presumably they do not.

I would encourage the hon. Gentleman’s constituents to consider asking the organisations they volunteer for to reimburse their actual costs, if they feel that that would more accurately reflect the costs of their motoring. The organisations might wish to do so, at their discretion, for the small number of volunteers who exceed 10,000 miles. I do not doubt that some individuals will fall into that category, and that in some parts of the country, such as his own, there will be a considerable number. There is an opportunity for them to do this with relatively little burden on themselves. It will certainly not involve the level of reporting that he thought would be required. To ensure that all those who use AMAPs understand their entitlement, HMRC last week published new guidance relating specifically to volunteer drivers, which includes the point that I have just made. We hope that it will provide a useful resource, and I will place a copy of it in the Library of the House.

To conclude, I again thank the hon. Gentleman for raising this issue. I should also like to thank the volunteer drivers across the country who play such a valuable role in many of our communities, particularly in the rural parts of the United Kingdom. I have listened closely to his comments, and to those made by others who have spoken in the debate tonight, and I would be more than happy to continue the conversation in a meeting with him and any other rural Members who would like to join in. As with all taxes, the Treasury keeps the AMAPs system under review, to ensure that it continues to be fit for purpose and to achieve its stated aim. I am happy to do that again, as I am sure the Chancellor will do as we approach the Budget in November.

As I have set out this evening, we believe that the current system is fair and consistent for the majority. For the small number who go the extra mile and who travel more than 10,000 miles, there is that additional system under which they can claim their actual costs with only a relatively low burden to themselves and the organisations they volunteer for. I hope that the guidance published at my request on Friday by HMRC will provide further clarity, and I suggest that the hon. Gentleman looks at it. I am happy to provide it to him. If he has comments or concerns about it, we can discuss them in the conversation that I hope we will have in the coming weeks. I hope this has been helpful, and I look forward to continuing this conversation and to ensuring that volunteer drivers across the country are properly respected and reimbursed for the important contribution that they make.

Question put and agreed to.

House adjourned.