House Of Commons
Wednesday 15 January 2003
The House met at half-past Eleven o'clock
Prayers
[Mr. SPEAKER in the Chair]
Oral Answers To Questions
Wales
The Secretary of State was asked—
Urban Deprivation
1.
What new proposals he has to assist deprived urban areas. [89725]
The Government have designated the 360 most deprived areas in Wales as enterprise areas to boost jobs and enterprise, and our child tax credit and working tax credit will help to eradicate child poverty and to make work pay.
That is absolutely true, but does the Secretary of State realise that, although the businesses in the rural part of my constituency that lost out financially because of the foot and mouth epidemic received generous grants from the Government, other businesses in the urban area that lost out because of closures and redundancies did not receive a penny? Does he also realise that the Government are about to spend more than £500 million keeping open post offices in the rural areas, and more than £100 million on closing them down in urban areas, and that the objective 1 map for Wales is heavily distorted against the interests of the cities, towns and valleys in Wales in favour of the least deprived areas? Is it not time that we had another look at our—
Order. The Secretary of State has heard enough to be able to answer the hon. Gentleman's question.
I understand the points made by my hon. Friend, but, as he will undoubtedly be aware, unemployment has fallen hugely in his constituency. Newport has some of the fastest growing companies in the United Kingdom, and last year it was one of the places with the highest proportion of companies growing by more than 25 per cent. He will also certainly have noted this morning's survey, which shows that the Welsh economy is outperforming the British economy in key areas of output and new orders.
The Secretary of State must pay some heed to our deprived urban areas, which are suffering greatly from an increase in crime and hard drug use. He must be well aware of the figures that show a 14 per cent. increase in hard drug use. Crack cocaine is responsible for 54 per cent. of all crime committed in urban areas. When a recent BBC poll asked people—64 per cent. of whom were Labour voters—whether they believed that the Government were tough on crime and tough on the causes of crime, they said that they did not. Is it not time that the Government made our deprived urban areas safer places in which to live by taking a tougher stance on drug pushers and establishing a tougher sentencing regime, particularly for burglars?
It is nice to hear that the Conservatives want tough action against burglars, because they were responsible for burgling the Welsh economy and communities in Wales during every year that they were in power. Now, they are planning a 20 per cent. cut in public spending, which would reduce our effectiveness and our ability to implement exactly the kind of anti-crime measures that are needed in Newport and across Wales, and which we are implementing.
Given the importance of manufacturing to deprived urban areas, will my right hon. Friend ensure that during the transition period before accession to full membership of the European Union, the Governments of countries in central and eastern Europe are not permitted to operate regimes that allow their manufacturers to have an unfair competitive advantage? I have in mind particularly the steel sector.
I understand my right hon. Friend's point, and the steel sector in Newport has indeed been a matter of great concern to its Members of Parliament and to the Government. It is important to recognise that we are undergoing a process of fundamental change. As he says, we are experiencing stiff competition from countries in eastern Europe, but also from countries even further to the east, notably China. However, Wales is doing much better than many of our competitors—in stark contrast to the Tory years, when we were doing much worse than the rest of the world.
Farming
2.
If he will make a statement on the state of the farming industry in Wales. [89726]
My right hon. Friend and I have regular meetings with the First Minister, and I meet Assembly Ministers and Ministers from the Department for Environment, Food and Rural Affairs to discuss a variety of issues, including the Welsh farming industry.
I thank the Minister for that answer, but what discussions have he and the Secretary of State had with farmers in Wales about the latest diktat from Brussels, whereby all horses, ponies and donkeys must have passports, which are to be carried with them at all times? Is the Minister aware that this crazy bureaucracy has come about because the French want to know whether equine drugs are entering the food chain? Will he make the strongest possible representations to Brussels to stop this nonsense and tell the French that British horse owners will not stomach extra paperwork just to satisfy their deeply unsatisfactory eating habits?
Far be it from me to comment on the eating habits of our friends and neighbours across the channel. I take account of the point that the hon. Gentleman makes, and I am sure that it will be brought to the attention of my colleagues at DEFRA. Welsh farmers have had a tough time, as we all know, but I was pleased to see the recent report from the Farmers Union of Wales that shows increased confidence in farming in Wales and a 40 per cent. increase in farming incomes. That is a good move in the right direction.
The Farmers Union of Wales has also highlighted the fact that the 20-day rule has added to the heavy bureaucratic burden that farmers in Wales and across the country have to deal with. Since the Welsh Assembly has not got the powers to address the bureaucratic burden and paperwork, is the Minister willing to accept a submission that may help him to have a debate with DEFRA to try to reduce that work load so that farmers can do what they want to do—farm?
I am always happy to receive submissions from the hon. Gentleman. I think that he has made quite a few to me since I have been in this job.
On the 20-day standstill, we are trying to achieve a balance between risk and free trade. The standstill has been relaxed several times in the past year or so. The Government must consider the risk assessment and cost-benefit analysis, and take account of scientific and veterinary advice. Until that process is complete, it is not possible to give any undertaking about changing the standstill period.May I, through the hon. Gentleman, congratulate the Secretary of State on having done rather well despite being a South African?
On a slightly more serious note, I want to return to the 20-day rule. This Government are proud of the partnership with the National Assembly. Given that the National Assembly is adamant across the political spectrum that the 20-day rule is ruinous to Welsh agriculture, is it not time for Ministers to speak up for Welsh farming in Cabinet, reflect the views of people in the National Assembly, who have been voted in by the people of Wales, and do something about the crisis in Welsh agriculture?Of course, if the hon. Gentleman's party had its way, there would be no Welsh voice in Cabinet or in this Parliament. Discussions are under way between colleagues in my office, DEFRA and the National Assembly in seeking, with the industry in Wales, to try to overcome some of the problems that farming faces, especially in terms of the 20-day rule. We would further complicate the whole process by simply making a decision to reduce the period without proper evidence. When we have the proper scientific evidence, and the risk assessment and cost-benefit analysis are completed, we will be in a position to take a decision.
When?
The hon. Gentleman asks when. When we have that information, it will be proper to take the decision. It would be irresponsible to do so without that evidence.
The Minister is being disingenuous in saying that incomes have risen by 40 per cent. He knows that they started from a very low level and that the average farming income is less than £10,000 a year, while some highland livestock farmers earn less than £4,000. Farming communities are still reeling from low incomes and escalating costs, but we have learned that objective 1 money that was intended for farming communities may well be clawed back because it is not going to be spent. Will he have talks with his Welsh Assembly colleagues to ensure that the bureaucracy that surrounds the objective 1 money, which acts like a dead hand, is lifted from the schemes? Will he guarantee that no money directed towards these poor farming communities will be clawed back by Brussels this year?
I take the hon. Gentleman's point. Yes, I accept that farming incomes have risen from a very low point, but that is a move in the right direction. The FUW survey showed that 52 per cent. of farmers in Wales are planning to invest in new machinery, stock and infrastructure on their farms, which is again a good signal. I understand his point, but as far as this Government are concerned, in partnership with our colleagues in the National Assembly, we have no intention of handing any money back to Brussels; it will all be spent.
One reason why farming incomes declined so disastrously last year was the outbreak of foot and mouth. There is no way the farming community could withstand another outbreak of foot and mouth.
The Minister will know that new rules on the importation of meat and other food products came into force on 1 January this year. Will he tell the House what action has been taken to publicise those new rules about the importation of meat and foodstuffs into the United Kingdom and what extra resources are going into providing the extra manpower and sniffer dogs that will be necessary to make our ports of entry secure?We have to accept that DEFRA and our colleagues in the Assembly, in close contact with the farming unions in Wales, will ensure that all the appropriate information gets to farmers directly. It is important that we take every opportunity to ensure that they are aware of any changes. My experience, on the basis of knowing farmers in my constituency, is that farmers are very well up to speed on these matters and know what is happening.
School Transport
3.
If he will meet the First Minister to discuss school transport. [89727]
My right hon. Friend the Secretary of State and I meet the First Minister to discuss a range of matters, including school transport.
Does my hon. Friend accept that the current law allows gross overcrowding on scheduled buses taking children to school and that, although overcrowding may have been a factor in the Vale of Glamorgan bus crash, it was within the legal limits? Does he agree that bus companies exploit the law and that local authorities enter into contracts in which overcrowding is in-built? Will he commend Monmouthshire county council for trying to address the problem? Does he agree that where Monmouthshire leads, the rest of the country should follow, although legislative action may well be needed?
I am sure that the entire House was profoundly saddened by the death of 12-year-old Stuart Cunningham Jones in a bus accident in Cowbridge just before Christmas, and our sympathies go to his family. I take note of my hon. Friend's point. Last year, he secured a debate in Westminster Hall on school transport that went some way in helping to overcome the problem in Monmouthshire. The three-for-two concession allows transport operators to have three children in a seat that, in normal circumstances, would take two people, but they must be sure that the children can physically sit in the seats. There is no statistical evidence that the concession puts children at greater risk, but new legislation ensures that since 1 October 2001 all new buses coming on to the road are fitted with seat belts, and that will lead to the death of the three-for two concession, to which I look forward.
Many school children in Wales still have to rely on their parents for transport to school because of the lack of public transport, and that increases congestion, road danger and CO2emissions. Will the Minister discuss with the First Minister whether all school children in Wales can have access to public transport to school?
There is a formula for funding public transport and children's transport to school, and, in Wales, local authorities have been generous in going beyond the formula and providing additional transport facilities. The Government are committed to a massive investment in public transport. In partnership with our colleagues in the Labour-led Assembly, that will benefit children, ensuring that they travel to school as safely as possible.
Pensioners (Living Standards)
4.
What recent discussions he has had with ministerial colleagues on improving pensioner living standards in Wales. [89729]
Regular ones. We want all pensioners to have a decent and secure income in retirement and to share fairly in the rising prosperity of Wales.
Is the Minister aware that the National Assembly is forcing local authorities to bear the costs of means-testing the elderly on the services that they provide to them? Does he agree that those costs will lead to cuts in services, and will he try to stop the National Assembly forcing those costs on to the local authorities?
No, I do not agree with the hon. Gentleman. The National Assembly is providing extra care for elderly citizens on top of free bus travel, free eye tests and all the other initiatives that have been taken by the Labour-led Assembly to support not just pensioners but all citizens in Wales.
I endorse what my right hon. Friend says, but will he look at another aspect of pensioner living standards in Wales, in particular the plight of the former Allied Steel and Wire workers from Cardiff? Will he join me in welcoming the fact that Celsa has announced that it will reopen the steel plant in Cardiff and create several hundred jobs? Will he pledge to use his considerable reputation as a fixer and problem solver to look at the whole issue of the loss of the occupational pensions of hundreds of workers from Cardiff?
I acknowledge the important points that my hon. Friend makes, and he will be involved in an important meeting next week with my hon. Friend the Under-Secretary to take the matter forward. The plight of the pensioners of Allied Steel and Wire in Cardiff is extremely important and we shall work hard to solve it.
Are not pensioners in Wales doubly disadvantaged because they face an extended means test as a deliberate effect of Government policy but are also less able to contribute to occupational pensions because of the lower rate of economic activity among older workers in Wales, 61 per cent. of whom are economically active compared with 75 per cent. in London and the south-east?
We are injecting record help for pensioners in Wales. In October, an extra 250,000 pensioners in Wales will benefit from the pension tax credit, which will support thrifty, hard-working pensioners, some of whom have small savings or a small occupational pension. That is part of an increase in support that, by October, will bring pensioners in Wales between £21 and £30 extra on average a week. The hon. Gentleman should acknowledge that, and the fact that, if his plans for an independent Wales were ever introduced, all that support would disappear.
My right hon. Friend will agree that, for pensioners in Wales and elsewhere, an important part of their living standards is the quality of the health services that they receive. Will he confirm that the Commission for Health Improvement, established by the House to monitor the health service in England and Wales, will continue to do so independently for the foreseeable future?
Yes. I acknowledge the expertise of my hon. Friend, who is a former Welsh Minister, and I welcome his point. Discussions are going on with the Department of Health to resolve this issue.
Miners' Pension Fund
5.
What discussions he has had with his colleagues in the Department of Trade and Industry on the renegotiation of the surpluses to the miners' pension fund. [89730]
I am aware of this ongoing matter. Issues related to the current guarantee arrangements are under discussion by the Department of Trade and Industry and the trustees of the mineworkers pension scheme and the British Coal staff superannuation scheme. As a representative of an area in which many former miners live, I will certainly continue to take a keen interest in this matter.
I thank my hon. Friend for his response. I do not underestimate the influence of the Wales Office among his Cabinet colleagues. I therefore urge him to continue to push strongly on this issue so that we get more money back into the pockets of miners and their families and into the mining communities, too.
As the House will be aware, the Government guarantee that miners' pensions will rise in line with inflation even if the pension scheme were in deficit. The Government, of course, have a 50 per cent. share of the surplus from the pension scheme. Any changes to the pension scheme, as far as I am concerned, should benefit the pensioners, the miner pensioners and their widows. That should be our top priority.
Rail Services
6.
What recent discussions he has had with ministerial colleagues regarding rail services in former mining constituencies. [89731]
Regular discussions. We are determined to deliver better rail services.
I know that my right hon. Friend is aware that the rail operators in Wales seem to find it impossible to provide a decent railway service after rugby matches at the millennium stadium. Is he also aware that the last train leaving Cardiff for the valleys is at 10.30 pm, well before most shows at the new millennium centre will finish? Is not it time that we banged some more heads together to make sure that the millennium centre does not become a millennium matinee centre and that English people do not find it impossible to attend matches at the best stadium in the country?
I strongly agree with my hon. Friend. Indeed, last night, I was told by both the chairman of the Strategic Rail Authority and the Minister for Transport that, despite all their efforts, the necessary return London services to the England-Wales international next month could not be provided. That is a bitter disappointment. The rail companies have failed abysmally to provide the standard of service that Wales and Cardiff expect, and I have told them that they had better get their act together. Meanwhile, I have been promised temporary arrangements, including extra rail shuttles to Newport, to link with additional coach services. The 10,000 English fans who usually return by train, however, will be guaranteed a warm Welsh welcome—including in the Rhondda, I am sure—if they decide to stay overnight in Wales in many of the communities that will welcome them.
The Secretary of State knows that the Strategic Rail Authority is looking to cut, under the new franchise for Wales, rail services in coalfield areas and the rest of Wales by 10 or 20 per cent. He has made much of the fact that we cannot get back out of Cardiff after hours, but what does he say about this huge reduction in services promised for Wales? With regard to the Strategic Rail Authority, will he insist that there cannot be any reduction in the funding for, or provision of, rail services in Wales?
As the hon. Gentleman knows, funding for rail services across Britain, including Wales, has been rising from the abysmally low level that we inherited in 1997. Over a two-year period, it has risen from £3.1 billion last year to £4.3 billion next year. Certainly, the issue that he raised will be addressed.
The Secretary of State will recognise that one way of overcoming deprivation and regenerating communities such as Blaenau Gwent is to improve the communication system. Although we welcome the planned reintroduction of the railway service between Ebbw Vale and Cardiff, does he accept that the plans are inadequate as long as they exclude Newport, where many of our people work, while many people come from Newport to Blaenau Gwent for jobs and leisure opportunities?
I agree. We are therefore working hard with the Assembly and the SRA on the passenger service requirement to provide the extra services. [Interruption.]
Order. Before I call the next question, the House should come to order.
Youth Unemployment
8.
If he will make a statement on youth unemployment in Wales. [89734]
The new deal has been a huge success in Wales, especially in helping young people back into work, with 27,400 Welsh youngsters securing jobs.
In 2002, unemployment fell faster in my constituency than in most other areas in Wales. During my right hon. Friend's recent visit to my constituency, he met many young people who were optimistic and enthusiastic about the future. Does he agree that, to maintain the enthusiasm, we need a proper skills strategy to identify crafts where there are skills deficiencies, such as plumbing and electrical work? Will he push for such shortages to be identified because such qualifications and skills are as vital as academic qualifications in building a better economy in Wales and further reducing youth unemployment?
Yes. When I visited Holyhead high school, which my hon. Friend attended, I was impressed by the pupils and the new atmosphere in Holyhead as a result of the Government's record investment, falling unemployment and increasing job creation.
New Deal
9.
What discussions he has had with Cabinet colleagues about the operation of the new deal in Wales. [89735]
My right hon. Friend and I meet Cabinet colleagues regularly to discuss a range of issues, including the operation of the new deal. I am also pleased to have the opportunity to discuss its operation in Wales with the new deal taskforce in Abergavenny on Friday.
Has not the new deal been enormously effective in tackling unemployment not only in Wales but throughout the United Kingdom? Does my hon. Friend agree that Labour Members at Westminster and in the Assembly, for which an election will shortly take place, can rightly be proud of that achievement?
The new deal has been a huge success in Wales, where 27,000 young people have secured jobs since its launch. Of those, 80 per cent. have retained them for 13 weeks or more. My attendance at new deal taskforce meetings last year encouraged me about its progress.
In my hon. Friend's constituency, long-term youth unemployment has fallen by 91 per cent. since 1997 and the claimant count for Clwyd, West is down by 44 per cent. We can all be proud of that achievement by the Labour Government.What assessment has the hon. Gentleman made of the statistical evidence that shows that those who undertake the training and education option on the new deal for young people are twice as likely not to get a job at the end of it as they are to get one?
It would be a change if the hon. Gentleman and the Conservative party said something valuable and good about the new deal. They opposed it and voted against it. Under the Conservative Government, unemployment between 1979 and 1997 reached 3 million. The Government are doing something about that. We should be congratulated on our success, not criticised. It is time that he woke up to that.
Rail Franchises
10.
What recent bilateral discussions he has had with the Secretary of State for Transport on the Wales and Borders rail franchise. [89736]
I have regular discussions with the Secretary of State for Transport about transport issues that affect Wales.
Does the Secretary of State acknowledge that the 20 per cent. cut that the Strategic Rail Authority demands would mean a real cut in services on vital lines such as the Cambrian coast line in my constituency? Earlier, he referred to the increase in investment in rail. If it is so good, why is the service so bad?
I acknowledge that the hon. Gentleman properly raises some issues as a local MP, and we are dealing with them. However, we inherited a dreadful legacy from the Conservatives of a collapsing rail industry and under-investment. We are putting in a record amount of investment, which increases year by year, in rail in Wales, including west Wales, as well as elsewhere in Britain.
Flooding
13.
What recent discussions he has had with the First Minister on flooding in Wales. [89739]
I have regular discussions with the First Minister about issues affecting Wales, including flooding and flood prevention measures.
I am most grateful for that unexpected reply from the Secretary of State. He will be aware that, in particular, flooding has caused enormous damage to farmland. What discussions has he had with the farming community and what representations has he received? What compensation might he make to the farming community for the damage that has been done to its crops?
I am grateful for the unexpected question from the hon. Lady, especially as it is from her. This is an issue that we are addressing, and I recognise the point that she makes.
Prime Minister
The Prime Minister was asked —
Engagements
Q1. [90579]
If he will list his official engagements for Wednesday 15 January.
This morning I spoke to Michael Todd, the chief constable of Greater Manchester police, about last night's tragic murder.
I also had meetings with ministerial colleagues and others. In addition to my duties in the House, I have further such meetings later today.In view of last night's tragic events in Manchester, will my right hon. Friend ensure that there is a review for police officers undertaking these very difficult operations, to see whether anything can be done to increase their safety? What further steps are planned to protect the public now from the all too visible threat from fanatics, with their obvious contempt for human life?
First, I am sure that the whole House would wish to express our shock and outrage at this wicked murder and our deepest sympathy with, and prayers for, the family of DC Oake. Once again we see the courage and commitment of police officers to the service of our country and the dangers they face daily on our behalf. I met DC Oake when he worked with my security team on visits to the north-west. His family has lost a very fine man; the community has lost a very fine police officer. We mourn his death and it should redouble our determination to tackle terrorism in all its forms.
As my hon. Friend knows, my right hon. Friend the Home Secretary will make a statement shortly. My hon. Friend will also know that the chief constable is doing all that he can to establish the precise facts of what happened.I join the Prime Minister in his sentiment and his words. Everyone in the House and across the whole country will feel a sense of shock at the murder of Stephen Oake in Manchester last night. As the Prime Minister said, our thoughts and prayers are with the families of Stephen Oake and the injured police officers. The whole House will recognise that we owe them an enormous debt of gratitude
Obviously, it is too early to comment on the details of the police operation; we shall wait for a fuller report of events. But does the Prime Minister agree that the terror raid in Manchester is a wake-up call to the nation, reminding us all of the increased threat that we now face?Without any doubt at all, it reminds us of the threat that international terrorism poses here in Britain and of the need to take all the measures we possibly can to stamp it out in all its forms, which is why the House was right after 11 September to pass the emergency legislation that we did. We must make sure that groups of fanatics, who have no compunction about taking human life and who have no demands that any political system could possibly accede to, are defeated. The only way to defeat them is to make sure that we give every support to the security services and the police in the difficult and, as we can see, dangerous work that they do.
The Prime Minister's answer begs a wider question as well. Our ambassador in Paris, we have learned, has told the Government that he shares the French Government's incredulity at this country's response to the threat from extremists. Does the Prime Minister agree that the priority for the Government must be that no person should be allowed to enter the country if he or she poses a risk to our security, and that those who do should be detained or deported immediately?
Of course that is right. The terrorism legislation that the House passed included a specific derogation from the European convention on human rights precisely to allow us to detain without trial those who are suspected terrorists. In addition, the asylum legislation that we passed last year gave us a power to prevent suspected terrorists from entering the country at all. There is now very strong co-operation right across European frontiers to deal with this.
I would point out that, unfortunately, the scourge of international terrorism is not limited to this country. Just in the past few days there have been arrests in France, Germany, Belgium and Holland, and there were arrests recently in Sweden. This is an international problem. We must take every measure we can here, but also every measure we can with other countries to cooperate abroad.I agree with the Prime Minister: we must, but we also know that Home Office officials apparently advised Ministers after the events of 11 September that the key to fighting international terrorism would be to detain all asylum seekers entering the country in secure centres until their age, nationality and identity can be properly established. Will the Prime Minister now ensure that we make our borders secure and stop terrorists abusing the asylum system?
Of course. That is why we introduced the legislation that we did, and we have the ability for the first time not just to detain people, but to detain them without trial if they are suspected terrorists. I remind the House that, when that legislation was passing through the House, many people were opposed to it because they thought it was unacceptable in terms of our civil liberties. That is why it is important, I hope, that we continue to take the measures necessary here and abroad to make sure in so far as we possibly can that there is no hiding place for the terrorists. Of course, the arrests in the past few weeks have taken place precisely because the police and the security services are working closely to arrest and detain those whom they suspect of terrorism and, if it were not for the powers that we now have, we would have been unable to take the action that we have taken.
When the Prime Minister meets the American President at the end of the month, will he tell George Bush that there is almost certainly a majority of the British people against the idea of a war with Iraq? Will he tell him that a lot of the British people are against the war because they can see that it is all about America getting its hands on the oil supplies in the middle east? Will he also tell him that we are not prepared to fight a war based on the fact that this vain American President is concerned more about finishing the job that his father failed to complete 12 years ago?
It will not surprise my hon. Friend to hear that I am afraid I cannot agree with him. Let me first deal with the conspiracy theory that this is somehow to do with oil. There is no way whatever, if oil were the issue, that it would not be infinitely simpler to cut a deal with Saddam, who, I am sure, would be delighted to give us access to as much oil as we wanted if he could carry on building weapons of mass destruction. The very reason why we are taking the action that we are taking is nothing to do with oil or any of the other conspiracy theories put forward. It is to do with one very simple fact: the United Nations has laid down—indeed, it has been laying down for 10 years—that Saddam Hussein has to disarm himself of weapons of mass destruction and that he poses a threat because he used those weapons, and I believe that we have to make sure that the will of the United Nations is upheld. I also believe, incidentally, that a majority of the British people—who, I think, always take a firm view of the need for action in the face of dictators such as Saddam Hussein—knows that the UN, having laid down its mandate, has to see that mandate through.
Does the Prime Minister accept that we share the expressions of sympathy and support for the family and colleagues of Detective Constable Stephen Oake and the other officers injured last night? Is it not a reminder of how much we owe to those who risk their lives to protect our freedom—those in the police, including the special branch, and in the security and intelligence services who do that day by day?
Turning to the threat posed by Saddam Hussein, now that the full complement of inspectors is in place and equipped with more intelligence than before, what will happen if they report on 27 January that they need more time to complete their work? Does the statement made by the Prime Minister's official spokesman that they will be given the time and space that they need reflect President Bush's view or not?First, in relation to Detective Constable Oake and the other injured officers, obviously I entirely agree with what the right hon. Gentleman says.
The inspectors are now seized of this issue. It was only last week that they began with a full complement, and they are being allowed to do their job. As I said on Monday, I am not getting into the position of speculating on arbitrary timetables. However, it is simply worth reading, if I may, what Kofi Annan, the UN Secretary-General, said yesterday because I agree with these sentiments entirely. He said:That states the position exactly. We have a UN inspection regime in there. If there is a finding that is a breach of the UN resolution, I expect that action will follow, and, incidentally, I believe that action will follow with the full support of the UN."If…it were to come out that Iraq continues to defy, and that disarmament has not happened, as I have said, the Council will have to face up to its responsibilities and take the necessary action. But, of course, this is the understanding and the spirit of the resolution, which I hope we will all respect."
Is the Prime Minister satisfied that, if the inspectors, perhaps with the support of Kofi Annan, say that they need more time, the US Administration will be ready to grant them that time? Surely this is about disarming Saddam Hussein, with the widest international support and a UN mandate. The consequences of military action, before the case for it had been made would be very serious indeed. As my right hon. Friend the Member for Ross, Skye and Inverness, West (Mr. Kennedy) asked the Prime Minister last week, are there any circumstances in which his Government would decide not to commit our troops in support of US military action?
As I said last week, I would put it round the other way. I explained the circumstances in which we would be prepared to use force. In respect of the action by the United States, let me remind the right hon. Gentleman that the United States has gone down the United Nations route. I remember that, before the resolution was passed last November, many people were insisting to me that the US would not bother with the United Nations and that it was impatient with the whole process and would not give it a chance to work. That has not been the case, and I do not believe that it is the case. So we have the international community united, but the single most dangerous thing that we could do at the moment—which, in my view, would increase the likelihood of conflict—would be to send out a signal of any weakness in our determination to see the mandate laid down by the UN carried through.
While I recognise the importance of the work of the weapons inspectors, is it not a fact that the regime constantly denied that it had any biological weapons until the two sons-in-law of the dictator defected in August 1995 and gave information that the regime then admitted was true? Why should we believe that dictator now? However much I dislike George Bush and his politics, I dislike the murderous dictator in Baghdad a million times more.
What my hon. Friend says about the regime of Saddam Hussein is right. It has always been a puzzle to me how liberal-minded people could possibly line up and support the continuation of one of the most repressive, murderous and barbaric regimes in the world. The point that my hon. Friend makes is worth underlining. People talk of the impatience of the United States, Britain or anyone else, but this has been going on for more than a decade. Saddam Hussein has had the opportunity time and again to comply with the United Nations resolutions. What we did last November was to lay it down again in a fresh resolution so that he would be in absolutely no doubt. People say that the choice is ours as to whether conflict happens, but actually the choice is his. If he wants to avoid conflict, he can comply with the UN resolution, cooperate with the inspectors, tell us where this material is, and have it destroyed as it should be. Conflict would then be avoided. So we have made the choice that we had to make, and set it out in the UN resolution. The choice is now for Saddam.
Q2. [90580]
If the Prime Minister still supports an ethical foreign policy, and does not want to see our cricketers playing in Zimbabwe, will he consider paying compensation to the cricket board so that the cricketers are not forced to play there?
No, for the reasons that my right hon. Friend has already set out.
Q3. [90581]
The Prime Minister's new year message was a timely reminder of the clear and present danger facing this country, but for some of my constituents who live in areas of high flood risk, global warming is as worrying as global terrorism. The Local Government Association and the Emergency Planning Society have suggested that the current civil defence grant of some £19 million for England, Wales and Northern Ireland is inadequate and some £50 million short of what is required. Will the Prime Minister now review the resources available to the emergency planning officers and ensure that they have the tools properly to protect public safety in these circumstances?
I sympathise with my hon. Friend's constituents who have faced the problem of flooding over recent weeks. We are reviewing the flood defences not only in the Reading area but in all areas in which flooding has occurred. I would point out to him, however, that we are now spending about £500 million on flood defences. That is some 80 per cent. up on where we were five years ago, so we are putting in the extra money and obviously we must make sure that it is properly used.
When it comes to dealing with Iraq, the Prime Minister said that a second United Nations resolution is preferable. The International Development Secretary says that it is essential. Which is the Government's position?
Both I and the International Development Secretary have set out the position, which is that of course we want a UN resolution. I have set out continually, not least in the House on 18 December, that in circumstances where there was a breach, we went back to the UN and the spirit of the UN resolution was broken because an unreasonable veto was put down, we would not rule out action. That is the same position that everybody has expressed, and I think it is the right position. However, having said that, it is not merely preferable to have a second UN resolution. I believe that we will get one.
Let me tell the Prime Minister what the right hon. Lady said. [Interruption.] They do not want me to. She said that Britain must
When asked if that meant that Britain should not go along with any unilateral action, she replied:"not divert from the UN route."
Everyone knows that most of the Cabinet back her position, not his, so I ask him: was she right or was she wrong?"That is the logic of the position."
We have all made it clear that it is right to go down the UN route; that is precisely the route that we are going down. The right hon. Gentleman is quoting my right hon. Friend selectively, because if he looks at other parts of the interview he will see that she made it clear that she did not want to confine herself to a second UN resolution, but of course we want a second UN resolution.
The point is that we have gone down the UN route very deliberately. That is because it is best that this were done with the maximum international support. [Interruption.] That is the position that everybody has taken on this issue. With the greatest respect, rather than trying to pretend that there is some difference where there is none, we should all surely unite around the position. I hope the whole House will unite around the sensible position that we have a UN resolution and that if it is breached action must follow, because the UN mandate has to be upheld.Last week, the Defence Secretary contradicted the Foreign Secretary; this week, the International Development Secretary contradicts the Prime Minister. As we speak, British troops are being deployed, yet the Government are incapable of speaking with one voice. Does not the Prime Minister understand that he and his Cabinet must be clear and united to send a right message to Saddam Hussein, British troops and the British people?
The position that I have set out is very clear. We have chosen to go down the UN route; I think it is important that we do. That is because if Saddam is to be disarmed, it is important that he is disarmed with the support of the international community. We want the inspectors to do their work. If the inspectors come back and we find that there is a breach of the UN resolution, action will follow. We have said that a second UN resolution is preferable, because it is far better that the UN come together. We have also said that there are circumstances in which a UN resolution is not necessary, because it is necessary to be able to say in circumstances where an unreasonable veto is put down that we would still act. That is the position that the Government have set out throughout, and it is the position that remains.
Q4. [90582]
The Prime Minister will he aware that Doncaster awaits a Government decision on the proposed Finningley airport in my constituency. Some 150,000 people have signed letters and petitions in favour of Finningley, because they recognise the jobs and consumer choice that it will bring, unlike people in other parts of the country. Will he ensure that the forthcoming airports White Paper gives due consideration to building on the achievement of regional airports to contribute to the economic development of the whole country, not just the south-east?
On my hon. Friend's general point, I totally agree. I have Teesside airport in my area, so I understand the vital importance of regional airports to an area's economic well-being. In respect of Finningley airport, again I understand her strong support for the proposals, and the planning inspector's report is with the Office of the Deputy Prime Minister. I can tell her that the aim is to take a decision in the early part of this year. Obviously, until that decision is taken, it would not be appropriate for me to comment on the merits of the case.
Q5. [90583]
At his press conference on Monday, the Prime Minister implied that he had information that went beyond that contained in the British Government's dossier on Iraqi weapons of mass destruction. Has he given that information to the House of Commons Intelligence and Security Committee? If not, will he be doing so?
Of course intelligence about the situation in Iraq is coming in all the time, so it would be perfectly natural for there to be additional intelligence subsequent to the publication of the dossier. As for sharing that intelligence with the Intelligence and Security Committee, I am not sure of the exact position, but I can certainly find out and let the hon. Gentleman know. Of course we have very good relations with the Committee; we do share intelligence with it, and we have always found that it treats that intelligence in a very confidential way.
As I have said, we are gathering intelligence about this all the time, and we are also working closely with the UN inspectors.Although it is welcome news that the number of people waiting longer than 12 months for NHS treatment has fallen by 20,000 in the last year, there are still 12,000 in that position, which is not acceptable. Can my right hon. Friend say how and when he will bring an end to the long waits?
We are, of course, getting those long waits down all the time. We have eliminated the 18-month and 15-month waits, and a timetable is set for the 12-month waits to be dealt with shortly. Moreover, the waiting times themselves are coming down. I think that well over 70 per cent. of people are now being seen within three months, and I believe I am right in saying that not a single national measurement of waiting does not show a better position than that of five years ago. That is a result of additional investment in the health service—which is why it is so important for us to keep it up, and certainly not to cut the extra investment by 20 per cent. across the board.
Q6. [90584]
Today the Seventh Armoured Brigade waits in limbo for the Government to decide on its deployment to the Gulf. Twenty thousand more service men wait on standby to cover the firemen's strike, while the Prime Minister will not even try to obtain an injunction to stop the strike under existing law that makes a strike in which strikers knowingly endanger life illegal. When will he put the interests of the armed forces before his own narrow party interests?
I pay tribute to the armed forces and the work that they do, not just in any deployment for possible military action but in relation to the firefighters' dispute. They handled themselves magnificently during the strike.
As I have explained before to the Leader of the Opposition, the decision whether to seek an injunction is taken by the Attorney-General, on the basis of whether such an injunction would succeed or not. It is a decision for him, and not one that I can or should take.The Prime Minister referred to the United Nations 15 times during last week's Prime Minister's Questions, thereby demonstrating his support for the will of the international community. Does he agree that any breach of UN Security Council resolution 1441 should be a matter for the weapons inspectors and the Security Council, not President Bush and the American Administration? Does he also agree that if President Bush takes unilateral action against Iraq, he will be defying the United Nations?
It is, of course, a matter for all of us in the international community, including President Bush. Of course the weapons inspectors should be allowed to do their job. I must point out, however—because I think this is important—that the only reason we have UN weapons inspectors back in there is the firm stand that has been taken. Does anyone seriously believe that we would have UN weapons inspectors back in Iraq if there were a possibility of disarmament happening in a peaceful way? Does anyone really believe that they would be there if we had not sent the clearest possible signal?
It is also important at this time to ensure that we continue to send that signal of strength. If Saddam believes for a single instance that the will of the international community has abated—that the international community does not have the solidity of purpose that it needs to see this thing through—the consequences of either conflict or prolonged conflict are increased. As I have said, if we can avoid conflict we should, but the choice is Saddam's. Let me tell my hon. Friend and others that if we do come to conflict and Saddam is removed, the people who rejoice first and foremost will be the Iraqi people themselves.Q7. [90585]
Does the Prime Minister agree that eight days allows a paedophile more than long enough to abuse a child? If so, will he act to close the loophole that allows registered sex offenders to travel abroad for short visits without notifying the authorities in the country of their destination?
My right hon. Friend the Home Secretary has said to me that the new sex offenders Bill will address that issue. It is obviously important that we legislate on it, and that we do so in a way that allows the House to debate such matters in full.
Q8. [90586]
In May last year, Mr. Andrew Shirley of Birmingham came within minutes of drowning at Durclle Door in my constituency. He was saved thanks to the eight-minute response time of the Portland search and rescue helicopter, which is based in my constituency. Is my right hon. Friend aware that the Maritime and Coastguard Agency is considering relocating that helicopter to Lee on Solent, adding 30 minutes to the response time—time that Mr. Shirley and the many others saved by the helicopter simply do not have? I have done all that I can to raise the issue in the House and with Ministers, but is not it time now for the Department for Transport to improve its response time and decide whether it is willing to commit £2 million as a one-off payment to save our lifesaver?
My hon. Friend is absolutely right about the magnificent work that the coastguard does for us. I am aware that the Maritime and Coastguard Agency has been debating whether to move one of the helicopters, and the matter is being studied by my right hon. Friend the Secretary of State for Transport. Urgent discussions are continuing, and we will let my hon. Friend know the results of those discussions as soon as we can.
Given that record numbers of people are applying for asylum, that Ruud Lubers has said that Britain takes more than its fair share, and that there is now a link between suspected terrorism and asylum seeking, does the Prime Minister consider his asylum policy to have been a success or a failure?
We took additional measures on asylum in the legislation last year precisely because we recognise that there is far more to do. I point out to the right hon. Lady that when we introduced legislation that, for example, gave us the ability to deport people who were asylum seekers convicted of criminal offences, its provisions were watered down by Conservative Members who opposed them. We introduced measures that allowed us to derogate from the European convention and to make sure that suspected terrorists were not subject to the normal asylum procedures, but those measures were also opposed by certain Conservatives. So I entirely agree that we need to do far more to reduce the number of asylum applications. That is what the measures that we are taking are currently doing. However, it is no use the right hon. Lady asking us to take tough action unless she and her colleagues are prepared to back us.
Q9. [90587]
Does my right hon. Friend share the view of many hon. Members that the decision by Nestlé to sue the Ethiopian Government at a time of famine is morally repugnant? Will he promise to give every assistance to the Government of Ethiopia in resisting that claim, and will he take the lead in urging the international community to take urgent action to tackle the famine facing many people in Ethiopia and throughout Africa?
First, we provided about £32 million in assistance to Ethiopia last year. We are looking at what more we can do in response to the famine there. My hon. Friend will know that the work done by the Department for International Development has to a significant extent enabled the proper cooperation between Ethiopia and the UN famine relief programme to take place. I assure her that we will continue to do all we that can in respect of the famine in Ethiopia and of the coming famine in southern Africa.
The Prime Minister often says that he likes to do things because they are right. How could it possibly be right to risk the lives of young British service men and women on a venture in Iraq that does not have the backing of international law, or the support of the majority of British people?
The hon. Gentleman says that there is no backing in international law, but let us wait and see what happens in the coming weeks in relation to the United Nations. I will tell him why I think that it is right that we are prepared to take action if necessary in respect of Saddam's regime. It is right because weapons of mass destruction—the proliferation of chemical, biological, nuclear weapons and ballistic missile technology along with it—are a real threat to the security of the world and this country. [Interruption.] Someone mentions North Korea. I agree; we have to deal with North Korea too, but that is not a reason for failing to deal with Iraq.
The truth is that this issue of weapons of mass destruction is a real threat to the world. I believe, incidentally, that it is only a matter of time before it is linked with international terrorism. Does anyone believe that, if we do not take a stand as an international community now in respect of weapons of mass destruction, some terrorist group is not in future going to get hold of that material and use it? Supposing I came along in August 2001 and said to the hon. Gentleman that there was an al-Qaeda terrorist network; no one would have heard of it. Suppose I said that we would have to invade Afghanistan in order to deal with it; no one would have believed that that was necessary. Yet, my goodness, a few weeks later, thousands of people were killed on the streets of New York. This is a difficult time. I understand the concerns that people have, but sometimes the job of a Prime Minister is to say the things that others do not want them to say but that we believe are necessary to say because the threat is real and if we do not deal with it the consequences of our weakness will haunt future generations.Greater Manchester Police Incident
12.31 pm
With permission, Mr. Speaker, I wish to make a statement on yesterday's events in Manchester.
I know that the House would want to reiterate the words of the Prime Minister in expressing great sadness, regret and outrage at yesterday's tragic events in Greater Manchester, which resulted in the death of Detective Constable Stephen Oake and the injury of four other police officers. Our deepest condolences go to Detective Oake's family; our thoughts must be with them and the injured and their families at this time. Yesterday, I used my powers under the Antiterrorism, Crime and Security Act 2001 to certify the detention, pending deportation, of two foreign nationals who are suspected of involvement in terrorism and of posing a threat to national security. The Greater Manchester police were acting with immigration officers in support of the operation to detain one of those individuals. Police in Manchester detained three men in total. The second national certified by me has now been detained in London. In total, 15 people have so far been detained under the provisions of the Act. Greater Manchester police have activated their major incident procedures and are conducting a murder inquiry. I shall, of course, report further to the House when I am in a position to do so. On 7 November, I outlined in a written statement the scale and nature of the threat that we face from international terrorists. In the past few months, my right hon. Friends the Prime Minister and the Foreign Secretary and I have made it clear that that threat is a continuing and dangerous one. I know that the whole House supports the efforts of the police and the security services to detect and prevent terrorist incidents. Parliament has provided the authorities with extra powers through the Terrorism Act 2000 and the Antiterrorism, Crime and Security Act, and I regularly discuss with the security services and the police how those powers are being used and whether they are being used effectively. Yesterday's events highlighted the ongoing threat that we face. In combating that threat, we rely on the bravery and commitment of police officers and security services in defending us against dangerous criminals and those who threaten the very safety of our country. I commend their bravery to the House.As my right hon. Friend the Leader of the Opposition made clear, we all share the Home Secretary's admiration for the efforts of police officers involved in protecting our lives against terrorism. Our condolences go to the bereaved and our thoughts are with those officers who have been wounded.
It is far too early to make comments or ask detailed questions about the operation, which clearly went badly wrong in some respects. I am sure that in due course the Home Secretary will give the House some information on the way in which the operation was conducted, on what can be done better to protect police officers under such circumstances, and on whether it is appropriate, in such circumstances, for them to be armed. However, this episode also draws our attention to wider questions. For many months, I have been attempting to alert the Home Secretary and the Government as a whole—and the country as a whole—to the fact that although the Government very clearly have the protection of citizens at heart, and although they do have some machinery to achieve that effect, there are worrying signs that there is not yet the level of urgency that is needed to match the level of threat that the Government rightly acknowledge. The recent entry into Sizewell B power station by some protesters was a worrying sign; signs from the civil defence community that the level of preparedness on the ground is not all that it might be are also worrying. I hope that the Home Secretary will tell us today that he will redouble his efforts to increase co-ordination to match the level of threat; but, beyond that, as my right hon. Friend the Leader of the Opposition pointed out in Prime Minister's questions a moment ago, this episode raises the question of whether our current chaotic system of asylum arrangements, of which the Home Secretary is very well aware and which he has attempted in one way and another to mend, notwithstanding the fact that his predecessor left them in probably the worst state of any country in the civilised world—The right hon. Gentleman should not say things like that.
The right hon. Gentleman says that I should not say things like that, but they happen to be true, and have been known to be true. They have been known by the current Home Secretary to be true, which is why he has been trying to put them right. However, I regret to say that there is ample evidence that, at present, people are getting through the asylum system who do not have the best interests of this country at heart, and who intend to pursue terrorist activities. What will the Home Secretary do over the coming weeks and months urgently to intensify the security vetting of those who seek to enter this country? That is clearly the question that the House needs to ask, and it is clearly the question that the Home Secretary needs to answer.
I am deeply sorry that the right hon. Gentleman has chosen to attack the record and actions of my right hon. Friend the Foreign Secretary—[HON. MEMBERS: "Why"?] He inherited a system that was on the verge of breakdown. I, at another time—[Interruption.]
Order. Opposition Front Benchers have asked the Home Secretary several questions, so it is only courteous to listen to what the Home Secretary has to say.
At another time and in a more appropriate setting I shall be happy to explain why we had to put in place a new computerised fingerprinting operation, why we had to restore a system following the collapse of the computer that had been ordered in 1996 and why my right hon. Friend the Member for Blackburn (Mr. Straw) had to take the actions that he did; but let us deal now with last night's events.
The right hon. Member for West Dorset (Mr. Letwin) is right to say that, as part of the inquiry, proper facts about what happened will be laid out. It is my understanding, however, that the initial incursion by a very large number of police, supported by immigration services, was made with the support of armed police officers and with the necessary body armour. It was subsequent events that led to the tragic death of Stephen Oake. It is my understanding also, and I think that it will be the understanding of the House, that the work of MI5 and of special branch and the police, leading to the arrests, shows how well our system is working in identifying and taking action against those who threaten our lives and security. It is precisely because we certificated those people whom we believed to be a risk that Greater Manchester police were acting on the advice given to me, through the security services. That affirms that the system is working—tragically, it led to the death of Stephen Oake—and underpins the fact that we are on top of those who threaten our lives and livelihoods. We do not need to be reminded by the right hon. Gentleman that he has drawn my attention to the urgency of the matter. After all, the Government were held to account by the Opposition parties and by some elements of the press for what they described as acting too urgently and precipitately in autumn 2001. We were opposed for that very reason again and again in the House and we were ridiculed for it. In the past 12 months, certain elements of the Opposition and the press have constantly said that our action was disproportionate and that we did not have a balanced approach to the protection of our nation vis-à-vis the freedom of the individual. It is those who believe in global trade, global movements and the freedom of the individual who are now calling for even more draconian measures. Let me deal head on with the issue raised by the Leader of the Opposition and, on his behalf, by the shadow Home Secretary, who must have to eat his words as he repeats his leader's decision to up the ante on asylum. Let us be clear about what we have done. We have introduced a warning system, whereby everyone who goes through the immigration process is identified to check whether they are on the security services' warning index. I assure the House that, first, we will look into further refining that system by using the computerised fingerprinting and surveillance systems that Opposition Members so often oppose, which were in part introduced by the present Foreign Secretary. Secondly, on 29 October 2001 I announced the introduction of a range of new processes—induction, reporting centres and an asylum registration card, which is now virtually completely in place—to make registration meaningful and enable us to track those moving through the asylum process. We strengthened the entire immigration process, as the Prime Minister reiterated, to ensure that those who commit a crime can be removed, that there is a fast-track system for doing that and that we can quickly reject those who come into our country clandestinely. On the basis of expediency, the very people who have chosen to use asylum in the way they have this afternoon have opposed so much of what we have done. Let me make it clear that whatever the basis on which people enter our country—on a visa for tourism or for short stays, with a visa for a work permit or as asylum seekers—we will deal with them if they pose a threat to our country. In the interests of community and race relations, however, let no one suggest that we can assume that asylum seekers pose the sole threat and that it is asylum that we need to fear. It is those people who use asylum and freedom of movement throughout the world and who organise against our interests whom we must fear. It is the people who are helping us to arrest, hold and secure those who pose that threat of whom we should be so proud today.First, I join my right hon. Friend the Member for Berwick-upon-Tweed (Mr. Beith) and all my colleagues around the country, especially those in Greater Manchester and Cheshire, in associating ourselves with expressions by the Prime Minister and the Home Secretary of love, sympathy and gratitude to Stephen Oake's family, and of support and solidarity to chief constable Mike Todd and all those who work with him in Greater Manchester police. Many of us have personal experience of their calibre and quality and want to put on record the debt we all owe them.
I endorse entirely the tone of the Home Secretary's response to the previous intervention. The raids in Wood Green, in Edinburgh, in Bournemouth and in Crumpsall yesterday show that the intelligence services and the police are very much in command of the situation. They are a tribute to the work done behind the scenes and in difficult circumstances, and the public need to know that the Home Secretary has every confidence that we are managing the terrorist threat and the threats from individuals to our liberties in a very professional, effective and advanced way. I share the right hon. Gentleman's views in that respect. Will the Home Secretary deal with three matters that I hope are appropriate to raise now? Will he confirm that the police's view remains that the presumption should be that they are not routinely armed, but that any police force that feels that, to do their job, its officers need to be armed or to have special protective clothing or other protective equipment can use such equipment when the judgment on the ground is that it is appropriate? Will he also confirm that there are no restrictions on that? Secondly, will the right hon. Gentleman confirm that the reality today, even if it was not 50 years ago, is that the special branch of the Met, the National Crime Squad and the National Criminal Intelligence Service show that we have a level of national policing because there is national activity that has to cross the boundaries of police forces? Does not the reality of policing today mean that we must recognise, formally and openly, that, built on the foundations of local policing, we now need regional, national and international policing; and that unless that level of policing is fully supported, we will not be able to counter those who work internationally and are no respecters of police authority or police force boundaries? Finally, while I share the Home Secretary's view that terrorism in this country is no more the province of asylum seekers than of other foreign nationals who come here or British-born persons who are persuaded of that awful route, is it not worth re-examining the recommendation of the Select Committee on Home Affairs that we could do well by toughening our border controls and replacing the three different agencies that share responsibility at our airports and seaports with one common border force? If the Home Secretary reconsidered that course of action, he would have considerable support. It would allow our liberties, including liberty of movement, to remain, but be the most effective way of ensuring that those who seek to undermine liberty are caught, dealt with and prosecuted according to law.I am grateful for the hon. Gentleman's opening remarks.
It is not our intention that the police should be routinely armed, but our clear objective, and that of chief constables across the country, is that they should be able to make a local decision in the light of circumstances. I understand that the chief constable of Greater Manchester, Mike Todd, had made that decision in respect of the original incursion into the buildings last night. Secondly, I share the view that we need the best possible co-ordination between existing crime and intelligence agencies. We are considering how to make sure that, as we do at European level and internationally, we do that more effectively nationally and regionally. SO13, led by David Veness from the Met, performs that role in anti-terrorist and special branch functions very well indeed. On the third question, if memory serves, my hon. Friend the Member for Thurrock (Andrew Mackinlay) raised that issue with me at the time of the proscription of the four organisations that we dealt with in the autumn. I said at the time that I did not rule out a change in the organisation of border and port controls. It is worth examining that, as we have in respect of security at airports, within the context of having a clearly focused, prioritised and objective way of using the services available to us to target those whom we know form a genuine risk. Those people, whether in the press or in this House, who believe that we could surveil, secure details of and verify 100 per cent. the security ratings of the 90 million people who pass through our ports and airports each year are living in a totally different world. From talking to the Attorney General of the United States, it appears that the US takes the same view. Through intelligence work and security, we must take a prioritised and focused approach; it is the only way in which we can proceed, and it is all that we can do. Despite our best efforts and the efforts of those who work for us, in the end, in a global economy with global movements, we cannot create a fortress Britain.I pay tribute to Stephen Oake and the other officers who were injured in my constituency last night. I wish particularly to pass on my condolences to the family. I have just realised, having read the front page of The DailyTelegraph, that I know Stephen's father quite well from the world of international sport. He chaired the Isle of Man commonwealth games committee and we worked together on the Manchester games and in the run-up to them. I therefore feel particularly emotional and upset. My thoughts are with Robin and the family.
I pay tribute to the refreshingly open way in which the new chief constable of Greater Manchester has provided a great deal more information than we have come to expect. I suspect that he has provided as much information as he can to reassure the local community and the country as a whole. I live within a couple of hundred yards of where last night's incident took place. I know that the relationships in what is a very mixed cultural and ethnic community are extremely good. I ask my right hon. Friend to agree with me that there is a national problem of international terrorism, and that it is not a Manchester or north London problem.Once again, we reiterate our condolences and understand my hon. Friend's words. I can confirm entirely what he said. The actions taken arising from the decision to certify one individual were taken on the basis that we want action wherever and whenever it is necessary.
Detective Constable Stephen Robin Oake was one of my constituents. He lived with his wife of 20 years, Lesley, and his son and two daughters in the village of Poynton in my constituency. He was a thoroughly committed, dedicated and brave career professional policeman. His father, as we heard from the hon. Member for Manchester, Blackley (Mr. Stringer), was an assistant chief constable in Greater Manchester, following which he was chief constable of the Isle of Man constabulary.
I make a plea that the media and others respect the grief and the privacy of the Oake family. I ask for a total commitment from the Home Secretary and express the hope—I am grateful, on behalf of the family, for the sympathy that has been expressed by the Home Secretary, by the Prime Minister, by the Leader of the Opposition and by the spokesman for the Liberal party—that the Government, the House and all political parties will do all within their power to ensure that Stephen's life was not lost in vain and to ensure that terrorism does not succeed.We all join the hon. Gentleman in requesting that the privacy and integrity of the family be respected and agree that we have an obligation, whatever debates take place across the Dispatch Boxes, to ensure that Stephen Oake did not die in vain. We must learn lessons from what is happening and what happened last night, and apply them in protecting ourselves.
Following the dignified and moving intervention of the hon. Member for Macclesfield (Sir Nicholas Winterton) and the question of my hon. Friend the Member for Manchester, Blackley (Mr. Stringer), may I say that the people of Manchester and the family of the murdered police officer, who are mourning that death and lamenting the injuries to the other police officers, will not take kindly to politicians seeking to score cheap political points over a deeply sad, tragic and alarming event? Hon. Members who seek to do so will win scorn rather than support.
I agree with what the hon. Member for Macclesfield and my hon. Friend the Member for Manchester, Blackley said, but this terrible event demonstrates that terrorism knows no frontiers inside the country or outside it, and that the measures that we are taking against terrorism are justified.I share entirely the points made by my right hon. Friend.
I, too, extend my condolences to the family of DC Oake. It may be too soon for the Home Secretary to comment, but I ask him to assure the House, if he is able to do so, that last night's tragic events were not in any way caused by a co-ordination failure between the security services, the local special branch and Greater Manchester police. Does the right hon. Gentleman feel that any lessons can be learned in improving that co-ordinaton, which might save other tragedies in future?
On the latter point, I think that there will be lessons to be learned; the review arising from the major incident report will highlight the lessons. I can give an assurance that co-ordination between the security services, SO13—the anti-terrorism branch—and the local police was very good, and that the initial incursion was a success. As I said earlier, arms and body armour were available and were used. It was a subsequent part of the process of dealing with the three people in the dwelling and with what was discovered that led, tragically, to Stephen Oake's death.
I join my right hon. Friend the Home Secretary and the whole House in offering my commiserations to the family of Stephen Oake. Does my right hon. Friend agree that it is at times such as this that we are forced to focus on the great bravery that we ask of servicing officers in Greater Manchester police and in police forces generally? It is a dangerous job. Fortunately, this sort of tragedy does not happen too often, but it is something that is in the very nature of the role that the police perform.
My right hon. Friend had to act against those suspected of involvement in terrorism. Will he make it clear from the Dispatch Box that asylum seekers in Manchester or elsewhere in Britain are not collectively accused of involvement in terrorism? We must recognise that the vast majority of those who seek refuge in this country want to contribute to the British way of life and do not, sadly, as in this case, want to take from it.I reiterate my hon. Friend's point. We must make it clear that we deal with individuals who threaten our lives, not with groups of individuals whom we can dub in a particular way at a particular time for a particular purpose.
We have all commented on police bravery. High-profile events such as yesterday's capture the headlines, but it is worth remembering those who lost their lives in less high-profile events because of the bravery that they showed. I think that our families would want us to do that as well.Like my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton), I represent members of Greater Manchester police who live in east Cheshire. I know that Stephen's death will be felt deeply in the police community and throughout the Manchester area and the Cheshire area.
May I ask the Home Secretary about the nature and scale of the terrorist threat? I have heard informed Government sources say that there are about 1,000 people in this country who are potential international terrorist operatives. Is that figure really correct—are we talking about a threat of that magnitude?I do not think that the hon. Gentleman seriously expects me to speculate on the number of people who may or may not pose a terrorist threat. What I can say clearly to the House is that anyone who is suspected of posing a terrorist threat, or who is suspected of dealing with or succouring terrorists, will of course be under surveillance and will be dealt with appropriately. There are no meaningful and verifiable figures of the sort used in the media, and I do hope that the considered and sensible way in which we have normally dealt with these matters in the House not only prevails here, but is reflected in the media. One of the great strengths of our country is that we are not just stoical; we deal with things with a clear and hard head, and we know what does and does not make sense.
May I also associate myself with condolences offered to the family of Stephen Oake, and to those officers who were injured? I agree with my right hon. Friend the Member for Manchester, Gorton (Mr. Kaufman), in that the Opposition Front-Bench spokesman's response to today's statement constituted a misjudgment. Will my right hon. Friend the Home Secretary comment on the progress that is being made in international co-operation among law enforcement agencies, particularly within the European Union, to try to anticipate such threats, and to prevent the threats to our country and our way of life that the arrests of Algerian terrorist gangs in the past week have demonstrated?
I pay tribute to my hon. Friend's work in helping to secure precisely that co-operation across Europe, both in terms of immigration and of the policing and security services, and I thank her for it. We have been building on that through genuine cooperation between the services, and by enabling people to share data. Eurodac—the fingerprinting database that was announced only a day or two ago by the relevant Minister—assists us by enabling the sharing of that information and the tracking of those who pose a threat to us all.
May I add my condolences to those eloquently expressed by other Members; and can the Home Secretary say how long the suspected terrorists involved in this case have been in this country, and in the north-west in particular?
I can deal with the individual who was certified yesterday, and who was arrested in Manchester. He has been in this country, off and on, for about four years. He sought asylum and was refused, took his case to appeal, absconded and disappeared, and was then tracked. This is the real issue for the House: he was not let go and forgotten about; he was tracked by the security services, to the point where we were about to arrest and deal with him under legislation passed in autumn 2001.
In passing on my condolences to the Oake family, may I ask my right hon. Friend the Home Secretary to look again at taking action against those who incite such violence? I am referring to Abu Hamza, for example, who, incidentally, was given permission to remain in the United Kingdom by the previous Government. May I remind my right hon. Friend that when Abu Hamza spoke in Burnley four years ago—Burnley is not that far from Manchester—he used language to incite precisely such violent knife attacks on what he called "non-believers"? What happened last night was exactly the sort of incident that Abu Hamza has been inciting for many years. Is it not time to take such threats and statements seriously, and to take action against Abu Hamza and others of his ilk?
My hon. Friend has been assiduous in rightly pursuing these incidents and issues—as have I—to ensure that the Metropolitan police and, where necessary, the security services evaluate the words and the actions of individuals such as the one mentioned this afternoon. We all know how difficult this matter is, given that there are those who are very careful not to overstep the mark. Baroness Thatcher had exactly the same problems with this individual—this is not a party political point—way back in 1990–91. Real attempts were made to deal with him, but his care in not crossing the line caused the then Government and the police to back off. However, make no mistake about it: every word and every action is being monitored, and we need to do so in a way that secures the confidence of people who are sick and tired of individuals like him abusing our hospitality.
May I briefly touch on one point that has been raised on several occasions? The fact that my right hon. Friend the shadow Home Secretary asks questions that occasionally discomfit the Government does not mean that they are illegitimate, and it is a pity that the manner in which his questions have been considered has created that reaction.
Yesterday's events in Manchester, about which people have spoken movingly, demonstrate—if ever it needed to be demonstrated—that the distinction between our domestic security and our foreign security is not a real one. I therefore suggest to the Home Secretary that he and his right hon. Friends the Prime Minister and the Foreign Secretary discuss a means whereby we can have a debate in this House during which the security of this country at home and abroad is considered in a calm, rational and mature atmosphere, so that the Government can explain their overall policy on international terrorism overseas, and its effects on our national security in this country. That would help us to avoid being reactive, and therefore ill tempered.On the first point, I do not want to get sidetracked into considering the actions or words of the shadow Home Secretary, the right hon. Member for West Dorset (Mr. Letwin). I have reflected, however, on whether my first reaction if I were in opposition would have been to appear on "Newsnight" and to make the remarks about asylum that he made. I can only presume that the dramatic change of character and approach of the past few weeks has been engendered from elsewhere. I have a great deal of time for the right hon. Gentleman, and it is very sad indeed to see this transformation taking place.
On the point made by the hon. and learned Member for Harborough (Mr. Garnier) about having a debate, we had a measured, sane and rational debate on 11 July, but as I have said before, I think that it was reported in only one column of one newspaper. I commend that newspaper—I think that it was The Independent—because it usually has a real go at me; in fact, I have never known it not to do so. Secondly, we will shortly be debating the renewal of some of the powers in part 4 of the Anti-terrorism, Crime and Security Act 2001. I hope that that will also provide an opportunity to reflect on these matters, and that we are able, as we so often are, to transcend party politics in not only addressing the issues, but making sensible suggestions that a wise Government are clever enough to take on board.I am one whose voice and vote have always supported the current Home Secretary in his attempts to deal with difficult questions, and for everyone in this House difficult questions do indeed surround this issue. As he knows, my constituency office deals with a high number of asylum seekers, the vast majority of whom are here genuinely. However, last week an Afghan refugee came into my office and said that he was claiming asylum as a former fighter with the Taliban. One needs to question whether this is a sensible system. If we have a war in Iraq, at the end of it supporters of Saddam Hussein would presumably be entitled to claim asylum in the west. This is a ridiculous position.
I do not consider that it is not possible for people to return to Afghanistan. After the fall of Saddam Hussein, I would not consider that it was impossible for people to return to a free and democratic Iraq. However, I take my hon. Friend's point entirely. Sanity has to prevail in the way in which we legislate and process matters, and in the way in which the judicial system deals with appeals. If the individual in question was trying to hide his intent or past history, he was not doing a particularly good job of it by coming into my hon. Friend's surgery and announcing his past endeavours.
Speaking as the wife of a former Chief Constable of the Royal Ulster Constabulary, which of course lost 302 officers at the hands of those involved in terrorist activity, may I say how desperately sorry I was that we learned last night of the murder of a young police officer doing his duty in Manchester? Mercifully, we have been spared such acts in Northern Ireland in recent years. I am terribly sorry for Stephen Oake's family that they have been put through such pain and suffering, as well as his colleagues and the community of Manchester. Such an event is a terrible tragedy in any community.
May I urge the Home Secretary to consult the present Chief Constable of the Police Service of Northern Ireland, Hugh Orde, to see what lessons can be learned further to protect police officers, to ensure that there is no repetition of last night's appalling incident in Manchester?Yes, I am very happy to do that. We all accept that the hon. Lady was closer to such events through her husband than any of us have been. We respect and understand her very strong feelings.
May I add my condolences to the family of Stephen Oake? [also pay tribute to the security and intelligence services, which have obviously twice now got the right information and managed to track down activity that is dangerous to all of us.
Nevertheless, will the Home Secretary answer the questions asked by my right hon. Friend the Member for West Dorset (Mr. Letwin) from the Front Bench? Will he specifically tell me what his reasons are for not adopting a policy of securely housing all new applicants for asylum until either, under my proposed policy, their cases are determined, or, according to the advice that he received from his officials, at least until their identity has been determined?First, I did not receive such advice. I am aware of the disclosure to the right hon. Lady under the appropriate Act and of the e-mail sent by a junior official shortly after I had made a statement to Parliament laying out how the induction reporting and ARC—application registration card—system would register and track those who came to the immigration service in a way that was not possible before June 2001. Secondly, I said that the logistical cost of providing wholly secure accommodation for every single asylum seeker and their dependents while they are assessed and their security rating is evaluated is enormous. As we have seen in respect of planning consents, we could still be in the process of trying to secure those centres without the reporting, the ARC card and induction in a way that would not have ensured our security—but might have made her feel better.
Having finished the admirable 20-day parliamentary police service scheme in Brixton only last Friday, may I express my especial sympathy to the family of DC Oake and to the officers who were injured in Manchester? It is our duty to the police service and the country as a whole to ensure that our systems of immigration control really work and that those who are in breach of the immigration regulations are returned promptly. In respect of applications for asylum, we must ensure that the provisions of the Dublin convention are upheld. Thus, applicants who come from EU countries should not, prima facie, have to be dealt with in this country, but should be returned to the EU country in which they first arrived.
I agree entirely. I know that the whole House will support the Government in future when we deal with those cases, as we had to with the Ahmadi family.
As someone who has been present at the scene of the murder of several police officers, I should like to join the rest of the House in expressing my sympathy for Constable Oake and my admiration for the security services in the success that they have achieved. However, when such an incident occurs, it is not currently clear whether the Security Service, the chief constable of the region concerned, or the national co-ordinator of the Metropolitan police's anti-terrorist branch is in charge. If some good is to come from the death of this brave constable, can we ensure that that situation is resolved?
The Security Service does its job in detecting, conducting surveillance and advising. The anti-terrorism branch works, as it always has, with the local police, as they are the enforcement and arresting authorities. The police are therefore co-ordinated through the anti-terrorism branch in incidents such as yesterday's. It obviously behoves those immediately in charge to ensure that at each stage of the process—there are different stages, as I am sure will become clear as the evidence emerges—the appropriate force is in charge of the aspect in question. I do not want to go further in that regard, as it is important that the major incident programme be undertaken. It is also important that the evaluation of the evidence from those involved be brought forward at a time when, after the terrible trauma caused to those who were present at the incident and had to deal with the attack on the officers who were injured, as well as the death of Stephen Oake, we can evaluate it more carefully.
The Home Secretary is undoubtedly correct to say that what has ended as a police tragedy began as a Security Service success, but does he recall a not dissimilar incident in a prison camp in Afghanistan, when an American interrogator was murdered by someone whom he was interrogating in circumstances in which one would normally have thought that violence was unlikely? Is not one of the lessons that should be drawn from what happened that the mentality of fundamentalist Islamic terrorists is such that they will lash out whenever they can, even if it is to their own obvious disadvantage? Should he not, without prejudging the circumstances of this case, perhaps consider when all those circumstances are known whether guidelines should be issued saying that people who are arrested on suspicion of such terrorist activities should be held in handcuffs until they are removed to a secure environment?
I am sure that the lessons of yesterday's incident will be learned and that there will be an evaluation of the process that took place in terms of the unhandcuffing of the individual who committed the act and obtained a knife. At this stage, I think that it would better if we said no more about the incident.
Missile Defence
1.18 pm
With permission, Mr Speaker, I should like to make a statement on missile defence.
The House will recall that in the defence debate on 17 October I described the work in the United States on the development of ballistic missile defence systems and the Government's thinking on the issue. Subsequently, on 9 December, as I informed the House during defence questions that day, I placed in the Library a discussion paper produced by the Ministry of Defence setting out the role that active missile defence might play within a comprehensive strategy for tackling the threat from ballistic missiles. On 17 December, I informed the House of the receipt of a request from the United States Government to upgrade the early warning radar at Fylingdales for missile defence purposes. I have repeatedly emphasised that the Government would not respond to such a request without a further opportunity for discussion in the House. Next week's defence debate is a timely further occasion for the House to discuss the challenges that the United Kingdom faces in the new international security environment, including those posed by the proliferation of weapons of mass destruction and ballistic missile technology. I hope that the House will find it helpful if today I set out the Government's thinking on the US request. The Government recognise that missile defence raises important strategic issues, as well as local concerns in North Yorkshire. Following the release of the discussion paper in December, with its invitation to all interested parties to contribute their views, we have had around 300 responses. In addition, I visited North Yorkshire last week, and heard the views of local people and their elected representatives, as well as meeting representatives from the planning authorities. We have taken those views into account as we have considered the central question, which is the key test that the Government will apply to the US request: would agreeing to the upgrade of Fylingdales ultimately enhance the security of the UK and the NATO Alliance? The background to the US request is the marked increase in the threat to our security from weapons of mass destruction and their means of delivery. The Prime Minister has described weapons of mass destruction as the key issue facing the world community. It is a real threat to our security, fanned by proliferation from irresponsible regimes. As we all know, threat is a combination of intention and capability. Intentions can be debated, but they can also change at very short notice. The evidence of expanding capabilities, therefore, cannot responsibly be ignored. The hard fact is that a number of states of concern are making major investments in developing ever-longer range ballistic missiles. We are not referring here to countries developing standard military technology against the risk of conventional conflict. These ballistic missile programmes are being developed solely in order to threaten the delivery of mass destruction—nerve gas, toxins, biological agents or even nuclear warheads. It is the combination of ballistic missiles and the possession of these weapons of mass destruction, together with the demonstrated willingness to use those capabilities, that makes Iraq the most immediate state threat to global security. Elsewhere, if North Korea ends its moratorium on flight testing, it could flight test a missile with the potential to reach Europe and the United States within weeks. Other countries may acquire similar missile systems, not least through the proliferation of missile technology from North Korea. Based on the analysis and discussion that we have undertaken so far, I have therefore come to the preliminary conclusion that the answer to the US request must be yes, and that we should agree to the upgrade as proposed. RAF Fylingdales has operated since 1963 as a ballistic missile early warning system, which together with other radars in the United States and Greenland provides tactical warning and attack assessment of a missile attack against the United Kingdom, North America or western Europe. It has been upgraded a number of times over the years. Many hon. Members will recall the old "golf balls" that were dismantled in the late 1980s and replaced with the existing pyramid-like structure. Indeed, a life extension programme is under way to maintain its capabilities to provide early warning and track objects in space. These missions will continue to be the primary function of RAF Fylingdales. I have sought to dispel a number of misapprehensions about the US request in various meetings in North Yorkshire. The proposal is for an upgrade of the existing radar, not some massive new construction. No change to the external appearance of the radar should be involved. The upgrade essentially comprises modification to the hardware and software of the computers within the base. There will be no change in the power output of the radar, which is many times below statutory safety limits. We therefore believe that no health risk to people or livestock could arise. We have already explained to the local planning authorities that we see nothing in the upgrade proposals that would require formal planning consultation, and we have promised to provide them with full supporting evidence in due course. The upgrade of the Fylingdales radar can and should be considered as a discrete proposition. It does not commit us in any way to any deeper involvement in missile defence, although it gives us options to do so, should we decide on that at a later date. It will not involve huge costs. The upgrade will be performed at US expense, and we do not expect any significant variation in the running costs of RAF Fylingdales, which, as is appropriate for an RAF station, we already bear. Agreeing to the upgrade is not at odds with the wider approach of our NATO allies. The Prague summit agreedThe Danish Government have received a parallel request to upgrade the early warning radar in Greenland. Missile defence is a defensive system that threatens no one. We see no reason to believe fears that the development of missile defences will be strategically destabilising. Reactions from Russia and China have been measured. Missile defence would need to be used only if a ballistic missile has actually been fired. At that point, no matter how much we emphasise our other means of addressing the threat—non-proliferation, intelligence, law enforcement, conflict prevention, diplomacy and deterrence—those means will have failed and cannot be of further help. There would be no way of preventing a devastating impact without intercepting and destroying the missile. Once the missile is in the air, it is unthinkable that anyone could not want us to be in a position to shoot it down. Those are the reasons for concluding that agreeing to the US request would not prejudice the UK's interests. But beyond that, the key consideration is that it would represent an invaluable extra insurance against the development of a still uncertain, but potentially catastrophic, threat to the citizens of this country. There is not yet an immediate threat to us of this kind, but there is a distinct possibility that this threat could materialise in the relatively near future. It would therefore be irresponsible for the Government to leave the United Kingdom without a route map to acquire a defence against this threat. An upgraded Fylingdales radar would be a vital building-block on which missile defence for this country and for our European neighbours could later be developed, if the need arises and if we so decide. We are confident that agreeing to this request will not significantly increase the threat to the UK. The security interests of the UK are already closely identified with those of the US and other NATO allies. That will not change, regardless of decisions on missile defence. Keeping a low profile and hoping for the best is simply not an option. We also believe that any increased threat to RAF Fylingdales itself is negligible. For the foreseeable future, states of concern are very unlikely to have the sophisticated capability or size of arsenal to consider targeting specific points or military installations. Long-range missiles in their hands will essentially be weapons of terror, and, as with all military installations in the UK, the station is well defended against terrorist attack. But we must not forget that what drives the threat against the UK is not the deployment of missile defences, but those states of concern who develop or acquire weapons of mass destruction and their means of delivery. The upgrade would indicate no commitment to further involvement with missile defence deployments. Separately, we intend to agree a new technical memorandum of understanding with the United States that would give us full insight into the development of their missile defence programme and the opportunity for UK industry to reap the benefits of participation. But any UK acquisition of missile defence would be subject to a separate decision, at the relevant time. We must approach this in stages, considering each step in the light of how both the threat and the relevant technologies evolve. The Government have not yet formally replied to the US Administration on their request to upgrade the Fylingdales radar. I await with interest the views that hon. Members will wish to put forward, today and in next week's debate. But it is only right that the House should know the Government's preliminary conclusion that it is in the UK's interests to agree to the request. From the UK's national perspective, this specific decision is one that has real potential benefits at essentially no financial cost. It will ensure that if, in the coming years, we find that a potentially devastating threat is becoming a reality, we have the opportunity to defend against it. Weapons of mass destruction present the gravest risk to UK security. A ballistic missile launched at the UK is the most catastrophic potential threat to our people in the future. A Government's first duty is to protect their citizens, and that is a duty that this Government will not shirk from undertaking."to examine options for addressing the increasing missile threat to Alliance territory, forces and population centres".
I thank the Secretary of State for giving me an advance copy of his statement. However, I start by lamenting the fact that Parliament seems to have been the last to know of this significant and controversial decision. By 5.30 pm yesterday, the Press Association wires were reporting that there would be a statement today and
The way in which the announcement has been dribbled out is all too typical of the way in which the Government treat Parliament. I welcome next week's opportunity for debate, but rather than a general debate, which will inevitably be taken up by other defence issues such as the preparation for military action against Iraq or the outcome of the NATO Prague summit, should it not be a specific debate on missile defence? Is that not what the House of Commons is truly for? Her Majesty's Opposition have consistently made the case for missile defence. We therefore welcome the decision as far as it goes, as we believe that it is in the interests of British national security. Many of our European allies—France, Germany, the Netherlands, Italy, Greece—are already involved in missile defence programmes, particularly theatre missile defence, some of them in co-operation with the United States. Given that some 276 Labour Members have signed an early-day motion against the Secretary of State's policy, does the right hon. Gentleman not recognise that he must now convince those who would prefer to believe that the Government are simply a slave to the United States agenda? After all, it was only on 10 May 1999 that his predecessor Lord Robertson said:"Mr. Hoon is expected to say…he is minded to accept the American request to use Fylingdales."
Incidentally, that is a treaty whose demise the Government have now accepted without a hint of protest. It was only on 21 March 2000 that the then Foreign Office Minister, now Secretary of State for Wales, the right hon. Member for Neath (Peter Hain) said on the BBC's "Newsnight":"We are not in favour of developing ballistic missile defence systems. We are in favour of the anti-ballistic missile treaty".— [Official Report,10 May 1999; Vol. 331, c. 10.]
Of course, we are not talking about "star wars". The Secretary of State has spent most of the past year stonewalling on this issue, and I now welcome the refreshing tone that he has adopted towards British participation in missile defence. Does it reflect the fact that the Government are now confident that the technology will be successfully developed to make missile defence a practical reality? What Government control will there be over the use of the facilities at Fylingdales and the information gathered there? Is it possible that Menwith Hill will also be included in the programme at some future date? On the wider issue, the Secretary of State says that the decision does not commit us to deeper involvement in missile defence, but why is it necessary to approach the issue, as he says, in stages? Surely the conclusion from his statement must be that we should be fully committed in principle to global missile defence now. What is the Government's policy on the possibility of having ground-based interceptor missiles on British soil, or sea-based interceptors on British ships? The Secretary of State has made a clear case for missile defence. He refers to the possibility of North Korea representing potentially an imminent missile threat "within weeks"? What is the benefit of putting off those decisions? Full support for UK partnership with the United States on missile defence will not only enhance the opportunities for the British defence industry but is clearly vital for our national security. We therefore urge the Government to be candid with the House and to state now that a full commitment to missile defence is their real intention."I don't like the idea of a star wars programme, limited or unlimited."
I am sorry that the hon. Gentleman chooses to criticise the fact that, in a short space of time, the Government are making available a full day for debating defence issues. That will be an opportunity for right hon. and hon. Members to debate this and other issues. If the hon. Gentleman feels so strongly about the issue, it is open to the Opposition to use the time that they have available to debate the question as soon as next Monday, which is the next Opposition day. He and other Opposition Front Benchers can use that time to debate the issue in the way that he suggests is so important. I anticipate that he does not really regard the matter as so important; otherwise, he would use the time as he has advocated—[Interruption.] I look forward to any debate. As I said, the Government have made time available next week, and if the Opposition want an extra debate, I will be delighted to be here to respond to any motion that they care to put down.
On the hon. Gentleman's more detailed points about the process, it is important that he examine carefully the way in which the United States is approaching developing a missile defence system. The United States has taken outline decisions only, and has specifically indicated that it is important that there should be a test bed—for the moment, a Pacific test bed designed to provide emergency protection to the United States against the threat from North Korea. As a result, the United States has not taken specific decisions about the kind of system that it would ultimately like to deploy. Again, I have made the point to the hon. Gentleman and Opposition Front Benchers over many months that it does not make sense to anticipate decisions that have not yet been made in the United States. That remains the position. We are in close consultation with the United States about the development of these systems, but it simply does not make sense to anticipate decisions that it has not yet taken.I thank the Secretary of State for the advance copy of his statement, but I must agree entirely with the view of the Conservative spokesman, the hon. Member for North Essex (Mr. Jenkin), that we already knew what he would say today.
The decision, whether one agrees with it or opposes it, has seemingly been made with an astonishing lack of consultation. It is a major strategic decision, and to suggest that it should be debated in an Opposition-day debate is outrageous. The Government issued the public discussion paper only last month, and the request was issued only last month, yet the House of Commons has still not had a proper opportunity to discuss the matter. The costs, the strategic dimensions and the feasibility of the scheme are not well understood by those on either side of the argument. Many questions remain unclear—not least the question of why the Secretary of State chose to announce the decision today. If Fylingdales is to be upgraded, will Britain be protected by the current US missile defence scheme? If not, why are we participating? How will participation enhance the security of Britain? What is the position of our allies in NATO and our partners in the EU on this programme? Will they be participating? Have the Danes agreed that their site should be used? How much does the UK need to invest to be able to keep the option of participating in the future? What could be achieved by spending that money on other defence issues? Is there a risk of further terrorist attack at Fylingdales? Will extra security be required there? In short, is this a good deal for Britain? [HON. MEMBERS: "You tell us."] If Conservative Front Benchers will hold their lines, I will. If the Secretary of State says that his preliminary conclusion is to say yes—that he is minded to agree—what might make him change his mind and say later that he does not agree? At the moment, while the Secretary of State may be minded to say yes, many on the Liberal Democrat Benches would be minded to say no. The reality is that, today, the House of Commons is being presented with a fait accompli.To be fair to the hon. Gentleman, he is not noted for the kind of bluster that we have just heard from him—[HON. MEMBERS: "Oh!"] No, I think it is important to be charitable to the Liberal Democrats from time to time. But it was not clear from the hon. Gentleman's contribution, if I can call it that, whether he was for or against the proposal. I assure him that there is a very large fence around RAF Fylingdales on which he can sit for as long as he likes, and which will protect him and the occupants of the base against any kind of terrorist threat or rhetoric.
This is a good deal for the United Kingdom. If the hon. Gentleman listened to the explanations that I gave, he will have heard me set out clearly the arrangements as regards support to the United Kingdom and other allies, which would be the key test for our decision. As regards the protection of the United Kingdom, I made it clear that the test bed that the United States is developing in the Pacific is specifically designed to deal with the threat from North Korea. Clearly, as the system evolves and the United States learns lessons from the operation of the test bed, there will be an opportunity for coverage that includes the United Kingdom, as the request from the United States suggests. That is why I said that we were preserving an option to protect United Kingdom citizens.I thank my right hon. Friend for coming to my constituency after his visit to the RAF station at Fylingdales on 6 January. He listened to local people, who are perhaps most concerned about the subject. As promised, I kept a record of the exchanges and presented it to the Defence Committee for consideration. On behalf of my constituents, and especially the people of Whitby and the Esk Valley, I welcome the opportunity to put some of the issues on the record in next week's debate.
My right hon. Friend knows of my engineer's scepticism about whether the system will work in the long run. He heard the views of the people who spoke to him at the Inn on the Moor in Goathland, which is two and a half miles away from the RAF station. They clearly expressed concerns, not so much about a ballistic attack on the base and the area but about a terrorist attack. As well as giving help and information to North Yorkshire police, will my right hon. Friend review the status of installations such as the mothballed station at RAF Staxton, for the protection of the area?I am grateful to my hon. Friend for organising several excellent meetings in North Yorkshire that produced useful and lively discussions that greatly assisted to clarify my thinking and the Government's decision.
As I hope I have made clear, the system that the United States is developing is evolving. Part of the reason for its request is to ensure the development of a comprehensive system. That will not be in place for several years. However, I have no reason to doubt the determination of the United States to make the system fully comprehensive and effective. I have received no request from the United States about any other installations in this country.As the Secretary of State knows, Fylingdales is in my constituency. He also knows that, by and large, I have supported his position. I support his statement, as will most right-thinking people in North Yorkshire, let alone Ryedale.
I urge the right hon. Gentleman to do three things. First, he should take every opportunity to confirm that his comments today mean that we have signed up not to missile defence but to an upgrade of existing radar, which has happened previously. The previous upgrade put millions of pounds into the local economy, and I do not doubt that that will happen again. Secondly, will the right hon. Gentleman acknowledge that many local people will fear that what he has announced today is only phase 1 and that phase 2, involving missile defence, will follow? Will he therefore continue to consult local authorities such as North Yorkshire county council, the North York Moors national park authority and Ryedale council, as well as local people? I urge him to take them with him. Thirdly, will the right hon. Gentleman recognise that, although he has denied the more lurid descriptions of what may have been involved in the decision, the local tourist industry is worried? Apart from Fylingdales, there is little else on the North York moors except sheep rearing and tourism. Will the right hon. Gentleman therefore urge his colleagues in the Government to help the local economy, tourism and our transport infrastructure? We are prepared to continue to accommodate the radar in our area, but we should like some Government recognition that we have other needs.I pay tribute to the hon. Gentleman for his consistent approach. He has not ducked the difficult issues that are necessarily involved. I stress that we are discussing a specific request about the internal functioning of the radar and communications systems at RAF Fylingdales. As I learned when I visited the hon. Gentleman's constituency, local anxiety is sometimes about things that have not been determined and may never be determined. The United States is considering locating phase 2 largely at sea and may never require land-based X-band radars. The phrase, "X-band radar" was used regularly when I dealt with questions in North Yorkshire. It is important to deal with each decision at the stage at which it is presented. There is no need to go further at this stage and speculate as some perhaps less helpful commentators have done. I shall ensure that the hon. Gentleman's observations about the local economy are passed on to the appropriate Department.
Given the weight of expert criticism of missile defence, the unanimous conclusions of the Foreign Affairs Committee, the extent of anxiety in the House, and, according to repeated polls, the opposition of more than 70 per cent. of the British public, will we have an opportunity for a specific debate and democratic vote on the issue in the House?
I have outlined the nature of the debate that the Government propose. There will be an opportunity for my hon. Friend to contribute to it as he has done in the past. However, I do not accept his assertions about the weight of expert criticism. Even if it were overwhelming, my hon. Friend and other critics have to face the central point of my statement's conclusion. If a missile is in the air and targeted at the United Kingdom, threatening catastrophic consequences to the people of this country, does he seriously claim that we should not use every effort to try to protect them?
Would it not have been better for the Secretary of State to state clearly that, if the United States believes the system to be essential to its security and requests United Kingdom assistance, it would be politically almost inconceivable to deny the request given the importance of our relations? That would be more convincing than relying on the thin arguments in the consultation document and the serious doubts about the efficacy of the technology, especially the identification of decoy missiles, to which the document specifically refers. Can we be absolutely certain that subsequent developments, including any that involve Menwith Hill in my constituency, will be subject to a separate consultation and decision-making process?
No one who holds a position such as mine is in any doubt about the importance of our political relationship and close friendship with the United States. I do not qualify that in any way. However, as I have said on several occasions, it is important to show that this matter is of interest and beneficial to the people of the United Kingdom and to our wider relationships in the NATO alliance. That is the test that the people of the United Kingdom want satisfied. I believe that it is satisfied and I therefore recommend accepting the United States request.
I have received hundreds if not thousands of letters, including some from constituents of the hon. Member for Ryedale (Mr. Greenway). They all oppose national missile defence and upgrading Fylingdales. I do not think that those people are stupid or misguided. They point out that they believe that it will make them more of a target, and that far from protecting them it endangers them even more. They have a right to express that opinion. I agree with them. It is absolutely dreadful that once again we are acquiescing to President Bush's requests, in opposition to the people who elected us. The last opinion polls showed that more than 70 per cent. of the people of this country were opposed. The consultation has been a sham. I repeat the request of the shadow Secretary of State that we should have a debate purely on the implications of our going down this very dangerous path.
I dealt in my statement with the suggestion, which I recognise is made by those opposed to the proposals, that somehow certain parts of the country might become more of a target as a result of this decision. I dealt with those arguments. I do not believe that there is an enhanced specific threat to Fylingdales or the immediate area, or for that matter to North Yorkshire.
Equally, my hon. Friend must think through the implications of such concerns. There are, rightly, defence bases around the country. The armed forces are located in different parts of the United Kingdom. It is important that we recognise that the decisions that the Government take in relation to matters of this kind are in the interests of the country as a whole and of our national security, and it is right that each part of the country plays its part in contributing to that national security.The Secretary of State has this absolutely right. I am sure he will agree that this is not the most difficult decision he will have to make this year. I agree with my right hon. Friend the Member for Skipton and Ripon (Mr. Curry) that it is inconceivable that we would have said no to the United States.
However, I think the need for British decisions is perhaps slightly closer than the right hon. Gentleman is letting on. The United States has made a great deal of progress—much faster progress than was originally envisaged—with its test programme. While it may not have decided what systems to deploy, I think it has taken a decision to deploy. At boost phase, missile defence benefits the whole world, because at that stage nobody knows exactly where the missile is going. The Secretary of State shakes his head, but I think that that is probably so. But if we are to defend against missiles in re-entry phase there is a need for locally based and probably ground-based interceptors. Does the memorandum of understanding with the United States to which the right hon. Gentleman referred effectively give us an option to use United States technology to base re-entry defence interceptors in and around the United Kingdom?I assure the hon. Gentleman that I have, in the words of the Opposition Front-Bench spokesman, been entirely candid with the House. We have not received any further requests from the United States. We recognise that there is a range of options that the United States is looking at. That is precisely the purpose of the test bed that the United States is establishing. I entirely accept from the hon. Gentleman that the United States has made remarkable scientific progress in the work that it has concluded so far, but in many respects that has led it away from a decision to site X-band radar on land. It has given it a range of options that will allow a system to evolve and develop that may not require any further basing in the United Kingdom. I assure the hon. Gentleman and the House that as and when any such decisions are required in the United Kingdom the House will be the first to hear of them.
If the technology is successfully developed, what are the prospects of extending the missile defence umbrella to the United Kingdom and the rest of NATO?
That is one of the aspects of the United States request that have led me to conclude that this would be in the security interests of the United Kingdom, because, unlike the situation with an earlier version of these proposals, which was specifically entitled national missile defence—"national" referring to the United States—President Bush has indicated his concern that missile defence and the programme being developed by the United States should be made available to the United Kingdom and other NATO allies, should that be appropriate, and should those countries decide on it at an appropriate stage. That is a remarkably helpful offer for the United Kingdom.
Does the right hon. Gentleman accept that even those of us who doubt the cost-effectiveness and utility of missile defence think that he is right to respond positively to a proper request by an ally? Would he remind the House of, and put a note into the Library explaining, the precise command allocations of responsibility as between the United States and the United Kingdom within the Fylingdales base?
Those are matters that the right hon. and learned Gentleman is entirely right to raise. They are still the subject of further detailed negotiations. As regards the upgrade implications, the right hon. and learned Gentleman will understand that I shall not be able to inform the House of all the aspects, but I undertake to ensure that the House is properly informed of the general outline of those arrangements.
My right hon. Friend will be aware of the extensive press coverage that there has been, particularly in the defence press, about the development of X-band radar. Members of the Defence Committee this week received a document from Yorkshire CND raising concerns that the upgrade of RAF Fylingdales is part of the development programme for X-band. Can my right hon. Friend assure the House that it is not?
What I can assure the House is that there has been no specific decision about the deployment of X-band radar. As I have already said, the developments so far in the United States indicate that in fact an X-band radar may not necessarily have to be located on land, and certainly not anywhere in the immediate vicinity of RAF Fylingdales.
The Secretary of State's decision today is a wise and prudent precautionary measure that should have the full support of the House. Would the battle of Britain have been won in 1940 if Dowding had not been allowed to deploy radars around our coast from 1936? In these circumstances, surely vulnerability cannot be the best policy.
Not for the first time, the hon. Gentleman makes an appropriate historical analogy. As someone who has looked carefully at the history of that conflict, I think that he is absolutely right to recognise that as our technology develops we must use it to provide greater security for our people.
I would have liked to give a personal perspective on Fylingdales, but unfortunately my written request to the Secretary of State to visit was refused, unlike that of the hon. Member for Hereford (Mr. Keetch), I understand.
Does my right hon. Friend agree that his slavish devotion to American policy in this area adds further to global destabilisation? That destabilisation is evidenced by, for example, North Korea's alleged withdrawal from the non-proliferation treaty, a treaty that the United States never ratified, following on from its abrogation of the 1972 anti-ballistic missile treaty. It is also reflected in the Chinese military's plan to reconfigure its nuclear forces to overcome missile defence, as and when it is ever developed, and most recently lately by the Indians, who are developing an Agni-3 rocket and are discussing dropping the nonuclear-first-strike option from their military planning. In the Government's Gadarene rush to embrace every crackpot notion foisted on us by the ideologues in Washington, I should like the Secretary of State to point out where the independence of thought and the independence of policy are in the British Government, reflecting true British needs.I am sorry to hear my hon. Friend and former Ministry of Defence colleague make those observations. I am sure that he would have had the opportunity to visit RAF Fylingdales when he was a Defence Minister, had he chosen to take it. Indeed, I do not recall his making those kinds of observations at that time. I accept that his views have changed in the interim, but even allowing for those changes I would ask him to look carefully at, for example, the details of the Moscow treaty. The views that he now espouses are the views of people who have long advocated the importance of reducing the numbers of offensive systems available to the then Soviet Union, now to Russia, and to the United States. The Moscow treaty, as a result of the confidence that the United States now has because of the potential developments of missile defence, has seen the most significant reduction of deployable defensive systems in history. That remarkable success is the result of the end of the treaty that he says should continue.
Again, looking at the missile defence situation, I simply do not understand—I am perfectly willing to hear any argument—why a purely defensive system attracts so much criticism. I could certainly understand my hon. Friend setting out criticism of the further development of offensive systems, but hardly of this kind of defensive proposal.The Secretary of State should be aware that his statement will be greeted with dismay by many people in Wales, Scotland and other parts of the United Kingdom, not least among members of his own party. Given that the United States has refused to rule out the first use of nuclear weapons, will he not concede one fact: that missile defence is a misnomer—if it works, it might indeed be a defence, but it might also provide the very shield that the United States requires to launch the very first use of nuclear weapons?
The United Kingdom has also consistently refused to rule out a no-first-use policy, for understandable and clearly well-established reasons. The hon. Gentleman is perfectly entitled to his views and to express them, but, if he is to put them in the context of wider defence policy and thinking, he needs to set out more clearly his objections to what is, as I have just said, a purely defensive system that threatens no one and can ultimately only protect people in countries such as the United Kingdom and the United States, which are fully functioning democracies.
As the Government believe that what they have presented as the greatest threat to world peace—Iraq—can be eradicated by conventional military means, from whom do the Government believe that the threat will come that warrants an anti-ballistic missile system? It was not radar that won the battle of Britain, but Spitfires, so it is perfectly clear that radar alone will not act as a defence for this country. Are we considering a situation in which anti-ballistic missiles will be placed in the United Kingdom?
I am now at risk of sparking a historical debate, but I accept for the avoidance of doubt that a combination of radar, Spitfires and other aircraft won the battle of Britain.
As for Iraq, I set out very clearly in my statement that we regard the threat from Iraq as the single most significant threat, particularly if Iraq is allowed the opportunity to continue to develop not only its weapons of mass destruction, but its means of delivery. I am somewhat puzzled by my hon. Friend's question because, understandably, for reasons that I well recognise, she has been among the most assiduous opponents of any proposal to deal with the threat from Iraq by conventional means. She cannot have it both ways: she cannot argue against conventional means of dealing with Iraq, as well as against the proposal to defend this country and other countries against the threat that Iraq poses. One or other must be a way forward.The Secretary of State and I have different ideas of candour. I do not think that it is particularly candid to come to the House on 17 December and say, "Surprise, surprise—we have just had a formal request from the Americans to upgrade the radars at Fylingdales" and then, eight sitting days later, come to the House and say, "We are minded to accept it." The fact is that this issue has been around for a very long time.
The Secretary of State's Parliamentary Private Secretary and I visited Washington and attended a briefing at the Pentagon in 1998, when it was made absolutely clear to us that the United States welcomed full British involvement in ballistic missile defence. It would have been much better had we been fully on board as early as possible, not least because the United States would have known in planning, preparing and designing the system that it could have relied on the United Kingdom as a full partner to base in the United Kingdom whatever would be required to make the system a success. If the Secretary of State continues to insist that he will make decisions as he gets formal requests, he is, frankly, not being candid with the House. It is about time that he made it clear, as he did in making a strong case for the system, that the Government fully support it and are fully committed to it.Not for the first time recently, I would urge the hon. Gentleman to look carefully at what I have said and to reflect on whether he is suggesting that in any way I have not been candid with the House.
On timing, I am sure that the hon. Gentleman will be able to look at the relevant White House website, which will indicate precisely when the President took the decision on the development of missile defence for the United States. He will see that that decision was taken towards the end of last year and that the request to the United Kingdom followed shortly after. I would be perfectly content with any criticism that might be made from the United States if in any way the hon. Gentleman could verify it, but he is wrong to try to interpret that. There is no such criticism; the United States recognises the contribution that the United Kingdom is prepared to make, and I understand that it is extremely appreciative of the decision-making process in which the United Kingdom has engaged.If the technology works, why should it not be given to India and Pakistan?
What is interesting about my hon. Friend's question is that, if the technology can be made to work, the United States has indicated that, in quite a short timeframe, it would be willing to go beyond simply protecting United States territory and consider making such a system available to NATO allies. I see no reason in principle why, if such a system can be made to work, it should not be extended further, but that is obviously a matter for the United States.
I welcome the spirit of the Secretary of State's announcement this afternoon because it could have important benefits for the security of the United Kingdom and, indeed, for that of our NATO allies. In considering the whole issue, is it not important to recall that, throughout the cold war, the old Soviet Union maintained a BMD system of sorts—the ABM-1 Galosh system, which ringed Moscow—and that, even today under the new partly democratic Russia, elements of that system still remain in place? If it is all right for the Russians to have such technology in some form, should not we be thinking about it too?
The hon. Gentleman makes an extremely accurate and well-informed observation, with which I entirely agree.
Will my right hon. Friend acknowledge that this is an act of proliferation, that star wars technology, when eventually developed, can have an offensive capacity as well as a defensive one, that it will spur Russia and China to have serviceable nuclear weapons and that it will be another blow to arms control treaties? If, as the Prime Minister has said, the Government are passionately for non-proliferation, why were arms control treaties not even on his listen-back agenda for the United States that he announced last week?
I have debated such issues before with my hon. Friend. I entirely accept his sincerity, but, if he will forgive me for saying so, given that he has long and understandably argued against the proliferation of weapons of mass destruction, which he has done in a very principled way, I do not understand why he regards the development of a defensive system as strategically threatening, particularly when Russia is cutting its deployable offensive systems as a result of agreements made with the United States.
If a missile defence system can be developed, it will not only act as a very clear deterrent to the development of long-range ballistic missiles, but, of course, encourage those countries—for example, North Korea—that could spend their hard-earned foreign currency much better on feeding their own people to do so. My hon. Friend could well apply the logic that he properly applies to such issues but reach an entirely different conclusion: that the development of missile defence systems was encouraging a reduction in proliferation.The Secretary of State will be aware that there are several key United States bases in East Anglia and that they contribute a vast amount to the local economy. The overwhelming majority of people in East Anglia will welcome this strategic move as a good way to cement the special relationship. In his statement, he mentioned a new technical memorandum of understanding. Surely British businesses want not just an MOU, but firm assurances that they will be able to bid for some of those key contracts.
I am grateful to the hon. Gentleman for his observations. As I said earlier, such decisions are ultimately about ensuring national security, which includes East Anglia and other parts of the United Kingdom. Part of our approach is certainly to give opportunities to British industry, and there have already been discussions about the potential involvement of leading companies in the United Kingdom in missile defence. Obviously, we shall now wish to pursue that in the light of the decision that I have taken and the proposal that I have made to the House.
Does my right hon. Friend agree that China's rational response to the development of missile defence would be to increase the number of its missiles and warheads—possibly including dummy missiles—to get through an American missile defence system? If that is China's rational response—I believe that it will be—does my right hon. Friend accept that that could have a serious knock-on effect on other regional neighbours such as India and Pakistan, and on into the middle east? Does he also accept that that is why these systems are potentially so destabilising for the whole world?
As my hon. Friend will be aware from his time in the Foreign Office, China has had an extensive programme for developing ballistic missile defence systems for many years. Given that US proposals for missile defence have never been designed to deal with multiple missiles addressing a particular target, and that they are solely designed to deal with individual missiles from states of concern—which do not include China, as my hon. Friend will be aware—I do not believe that China would need to respond in any way to this proposal. Indeed, China has reacted in a very calm way to the United States' announcement, towards the end of last year, of its intention to develop missile defence systems.
The Secretary of State will be aware that, outside the ranks of the Conservative party, there is very little support for our involvement in George W. Bush's national missile defence programme. That is partly because there are technical doubts as to whether the system will actually work, and partly because, although the Secretary of State may not deem this to be proliferation, some nation states, notably China, certainly do, privately, deem it to be proliferation and, as has been said earlier, may well step up their response, which would destabilise things internationally. It is also because the real and present threat to the people of Britain is not a long-range missile from North Korea, but the kind of terrorism that we saw so tragically on 9/11, and the kind of terrorism that was identified last night. The question that many people outside the ranks of the Conservative party will be asking is whether, when George Bush says "Jump!", our only response is to be "How high?"
I fundamentally disagree with my hon. Friend. I have spent years travelling the country, visiting not only Labour party organisations up and down the United Kingdom but other groups as well, and it has not been my experience that there is very little support for the proposals. Indeed, my experience is that, when the threat is discussed, there is a completely different response: people want to know what we propose to do about it. My hon. Friend needs to look a little more carefully at North Korea. I would not place any confidence in decisions being taken there, not least because, if it goes ahead and abandons its commitment not to test-fly longer range missiles, the United Kingdom would come within range of a missile from that country. I think that my hon. Friend's constituents would want to know, as would mine, what action the Government were taking to deal with such a threat.
Given that national missile defence was originally aimed at protecting the United States, are there no plans for facilities similar to Fylingdales to be established elsewhere in Europe, so that both the United Kingdom and an enlarged Europe can be protected?
As I said in my statement, the United States made a parallel request to Denmark in relation to a radar facility in Greenland. As the US President has said, part of the process that the United States is undertaking involves the need to ensure that any deployable system would, as it is developed, protect not only the United States but its NATO allies.
May I urge my right hon. Friend to reconsider his interim decision? I acknowledge his duty to protect the citizens of the United Kingdom and that the system is a defensive system. Nevertheless, I believe that it will unwittingly add to proliferation. In his further assessment, will he look at the role of the military industrial complex and decide whether it is the real driver in this matter? May I also refer him to the then President Eisenhower's statement of 40 years ago, which highlighted the dangers of the military industrial complex being involved in just this kind of programme?
I appreciate the sincerity with which my hon. Friend puts his case, but I would invite him to consider this point. He says that missile defence might unwittingly add to proliferation, but it will be developed to protect democracies. It will be developed to protect the United States, the United Kingdom and members of the NATO alliance—a fundamental prerequisite of which is that its members should be democratic societies. My hon. Friend is saying that if we do not develop missile defence to protect those democracies, we will be relying on countries such as Iraq or North Korea—neither of which could remotely be described as democracies at present—not to threaten the United Kingdom. If I went to my hon. Friend's constituency and discussed those issues with his constituents, I am pretty sure on which side of the line they would fall, because I suspect that they are not greatly dissimilar to my own. They would say, "Why shouldn't you protect us against the kind of threat that could come from countries like North Korea and Iraq?" With the greatest possible respect to my hon. Friend, I do not think they would say that those countries could be relied on not to develop a threat to the United Kingdom and its citizens.
It is a very sad day indeed when a Secretary of State comes to the House 29 days after confirming that an application has been received from the United States to tell us that he is minded to accept it. Will he confirm that, in reality, the decision to go ahead with national missile defence was made a long time ago, and that it will mean that we are no longer able to support the ABM treaty? I suspect that, as my hon. Friend the Member for Leyton and Wanstead (Harry Cohen) has said, in future, the Secretary of State will ask us to remove ourselves from a series of other disarmament treaties as well. Is this not the day on which the United States, with British support, has started proliferation again? This is not an interim or technical decision; it is a fundamental departure from the process of disarmament of the past 30 years in the direction of re-armament, and it is being done in a very dangerous way, which can only result in a similar response from China and other nuclear powers.
I believe that I have already dealt with most of the arguments set out by my hon. Friend. He has referred previously to support for the ABM treaty—I have mentioned this to him before—as though somehow the treaty still existed. It no longer exists. It was a treaty between the United States and, originally, the Soviet Union—now Russia, as its successor—and both parties now accept that it has served its useful purpose. In place of that treaty we now have something for which my hon. Friend has long argued: a very substantial reduction in the number of offensive systems. Given the consistency of my hon. Friend's approach to these matters, I should have thought that he would welcome the fact that the ABM treaty has been replaced, and that the Moscow treaty has allowed for that significant reduction for which he has understandably and rightly argued.
Will the Secretary of State concede that, had missile defence been in place, and had it worked, it would not have made a ha'p'orth of difference to the events of 11 September? Does he accept that it takes at least some explaining that, on the day on which the Prime Minister warned against weapons proliferation in an international context, we are signing up to something that will require us fundamentally to breach the outer space treaty, because missile defence will require the militarisation of space in ways that will take us not only into a vast territorial unknown but into a political unknown, allowing weapons use from space? To settle some of the wagering that has been taking place on the Back Benches, will the Secretary of State confirm just how many nanoseconds it took him to say yes to the United States' request for a further annexation of facilities in the United Kingdom—the 51st state of the USA?
My hon. Friend always manages to put his difficult questions with a good deal of courtesy. I can assure him that, as yet, the Government have no plans to install any facilities in Nottingham, South, but I am sure that, if he requests it in his normally persuasive way, that decision could be reconsidered.
More seriously, I do not understand the argument that the terrorist threat manifested in the appalling events of 11 September should take overwhelming priority in relation to any other threats that might happen in the world. I accept that there is an appalling terrorist threat—we have seen the tragic consequences of it in recent times in this country—but to suggest that that means that we should ignore all other threats, if that is what my hon. Friend was doing, is simply wrong. We have a responsibility to protect the citizens of this country against all the threats that we reasonably detect and to take appropriate action. That is what we are doing. I shall report to the House regularly on developments that the United States proposes, including any that have implications for the outer space treaty. However, I do not approach the matter in the same way as my hon. Friend; I approach it in a way that I believe is in the interests and for the protection of the people of this country.Confiscation Of Alcohol (Young Persons)
2.21 pm
I beg to move,
The Bill's aim is simply to restore to the police the power to remove all alcohol from young people in public places so that they do not consume it, get into trouble and cause mayhem in our communities. Let me first establish evidence of current youth drinking habits. The health and science section of the 11 January edition of The Week, under the heading "Teenage binge-drinkers", states:That leave be given to bring in a Bill to amend the Criminal Justice and Police Act 2001; to make further provision relating to the confiscation of intoxicating liquor held by or for use by young persons in public and certain other places; and for connected purposes.
Andrew McNeill of the Institute of Alcohol Studies said:"British teenagers are drinking more heavily than ever before—and they do it with the sole purpose of getting seriously drunk. Alcohol consumption among children aged 11 to 15 has almost doubled in the past decade…Of the 85 per cent. of 15-year-olds who drink, boys admit to consuming an average of 13.8 units a week—the equivalent of seven pints of lager—and girls 10.7 units. Most of this drinking occurs in just two nights."
I was inspired to do something about this partly by Peggy Grant, who sadly passed away on 23 December. When Peggy was Castle Point's mayor in 1995, she went on to the streets on dark, cold, wet nights at 9 and 10 o'clock, although she was 70, to meet, talk with and understand young people. She tried to solve the problems that we are all so vividly aware of to help the kids and the rest of the community. She found that alcohol was a major contributor to those problems. She had courage, enthusiasm and genuine warmth. She also had dedication, determination and great dignity as mayor of Castle Point. She cared for young and old alike, and was a role model for all politicians—a truly great Conservative mayor who will be much missed in Castle Point. In 1995, there was, remarkably, no law to prevent young people and children from abusing alcohol in public places. So, with Peggy Grant's encouragement, I introduced a private Member's Bill to give the police powers to stop under-age alcohol abuse and take back control of our streets. My Bill was enacted in 1997 and it worked well across the nation, but then new Labour became the Government and the then Home Office Minister—not, I hasten to add, the Minister for Policing, Crime Reduction and Community Safety, who is in his place—issued a press release stating that the under-age drinking confiscation measure, which meant my Bill, showed"What we're seeing is an epidemic of binge-drinking. By the time you're 15, getting slaughtered is a central part of your social activities."
Last year, the Government's Criminal Justice and Police Act 2001 removed the power that I had given the police to take unopened cans and bottles of alcohol from youngsters in public places. That was pure, unadulterated new Labour stupidity. The Prime Minister then claimed that he was giving all possible powers to the police to tackle antisocial behaviour, street crime and drugs. That was pure, unadulterated new Labour hypocrisy. To claim that my Bill was a new Labour initiative and try to take credit for it was a lie; to remove police powers to take alcohol from young children on our streets was stupid; and to claim that all is well and that all is being done on our streets is hypocrisy. So there we have it. New Labour says that it listens and that it acts to tackle crime. It says that it will protect our children and our communities, but it is simply arrogant, stupid and hypocritical—and the Prime Minister is personally responsible. Let me set out some evidence on under-age drinking. A constituent who said that she would be honoured to be named in this place—I shall just call her Rosemary, however—bravely wrote to me to say:"Labour's determination to crack down on crime and disorder". That was pure, unadulterated new Labour duplicity.
"The recent change in law has undoubtedly confused youngsters in believing that it is now legal to smoke cannabis in public. I have observed over the past weekend two separate groups of youngsters in the bus shelter outside our house so doing…I wonder how many of them would actually indulge if they were not swigging alcohol at the same time.
It is my opinion that the overindulgence of alcohol is to blame for our youngsters experimenting in the first place…This does not only pertain to the 'odd joint' but harder drugs…crime, and mindless vandalism, the latter of which we see all too frequently…clear rules and laws must be set out to protect our youth and our future society from the somewhat soft approach of the left wing!
The House should listen to Rosemary's wisdom. Let me set out what Basildon's Evening Echo said on 25 October. An article by Gary Pearson says:My husband and myself do not want to live in fear of street crime but it is always now in the front of our minds."
"As many as 40 areas in Castle Point may be plagued with the problem of boozy youngsters, according to Tory councillor Bill Dick.
In another edition, the Evening Echo reported:The St. Peter's ward representative voiced his concerns about drink-fuelled teenage nuisance after residents complained".
On 12 April last year, Inspector Steve Rawlings of Castle Point police wrote to me:"Sgt Matt Bell, of Southend's Licensing Unit, said: 'We all know that there is a link between alcohol consumption and violence."'
"Youth nuisance and associated damage is a major problem…In the last few months I have spent many thousands of pounds in police overtime to try to resolve the problems…I am sure alcohol will only fuel the situation again. It is unfortunate that the powers you fought so long and hard to get introduced have once again been watered down, to make them virtually useless.
Those may be children of nine, 10 or 11 who are out at 10 o'clock on a Friday night. Inspector Rawlings continues:I refer of course to the seizure of alcohol from juveniles. The power was used to good effect during last year…but now its effectiveness has been substantially reduced. As we can now only seize open containers, it will mean that if we find someone with a four pack of lager, and only one tin is open, that is the only one we can seize leaving them with the remainder."
Bournemouth's The Daily Echo ran a campaign called "Where are your children?", which was launched just after my private Member's Bill became law. It said:"Isn't it a wonderful use of police time making us return four times (and maybe more) to carry out what we used to be able to do on the first occasion."
"Children as young as 13 are hitting the bottle in an epidemic of under-age drinking in Bournemouth.
They were using my Bill. The newspaper continued:Now police—increasingly on the receiving end of violence and abuse from drunken teenagers—have begun a major crackdown using new powers to seize alcohol from youngsters."
"In just two and a half hours, 51 young people aged between 13 and 17 were stopped and searched and alcohol with an estimated value of £110 seized.
The hon. Member for South Ribble (Mr. Borrow) told me that his local police are ignoring new Labour's new law and continuing to take unopened cans and bottles from youngsters in public places. Thus the Government have contrived to make criminals of the police and to help youngsters into crime and drugs. All of us in this place know that the first use of drugs by young people most often takes place under the influence of alcohol. Such is the reality of a bankrupt, arrogant Government who have simply stopped listening. This raises the question of why the Prime Minister removed the police power last year. Did he think that the police were improperly harassing young drunkards and thugs on our streets? Or he is simply out of touch? Or does he simply not care? Perhaps the Government will now revert to the common-sense law that worked so well: my original Bill. They may use the Licensing Bill, although I doubt that that would be terribly appropriate. In the meantime, I ask the House to support my new Bill giving the police powers to stop out-of control, dangerous under-age drinking on our streets.Question put and agreed to. Bill ordered to be brought in by Bob Spink, Mr. David Amess, Mr. Peter Lilley, Mr. Frank Field, the Rev. Martin Smyth, Mrs. Angela Browning, Andy King, Andrew Mackinlay, Mr. Henry Bellingham, Mr. Elfyn Llwyd, Sir Nicholas Winterton and Miss Ann Widdecombe.A search of a 15-year-old boy also revealed a craft knife capable of inflicting serious wounds."
Confiscation Of Alcohol (Young Persons)
Bob Spink accordingly presented a Bill to extend and improve methods of electoral registration: And the same was read the First time; and ordered to be read a Second time on 11 July, and to be printed [Bill 43].
Orders Of The Day
Community Care (Delayed Dischargesetc) Bill
As amended in the Standing Committee, considered.
New Clause 8
Free Provision Of Services In Wales
'The Assembly may by regulations made by statutory instrument make in relation to local authorities in Wales any provision which may be made by the Secretary of State under section 12 in relation to local authorities in England.'—[Jacqui Smith.]
Brought up, and read the First time.
2.33 pm
I beg to move, That the clause be read a Second time.
With this it will be convenient to discuss the following:
Government amendment No. 38.I understand that the new clause would tighten up section 12(7), but would be grateful for confirmation from the Minister.
Will the new clause give the Welsh Assembly powers simply to emulate the statutory instruments from the Secretary of State under section 12, or will it have any powers itself to produce fresh statutory instruments, within the confines of the section?It depends how "tighten up" is defined, but the aim of the new clause is probably not to tighten up the position relating to Wales. The Government seek to balance the commitment to devolution of health matters to the Assembly with maintaining the original purpose of the new power, which was to make community equipment and intermediate services only free of charge. The new power in part 2 has been taken with specific services in mind, and with a clear purpose—to help reduce delayed discharge caused by services in which integration is hampered by charging.
The new clause, and the regulation-making power that it gives the Assembly, will allow the Assembly to decide how to use the new power in Wales. The present wording would require Wales to replicate the regulations set by the Government in England. The new clause gives the Assembly more flexibility.I have just received an answer from the Department of Health concerning the number of Welsh patients treated in English hospitals. More than 4,000 are treated just in the five hospitals most commonly used along the border—the Countess of Chester hospital, the Royal Shrewsbury hospital, the Hereford hospital, the Robert Jones and Agnes Hunt orthopaedic hospital, the Royal Liverpool University children's hospital, the Cardiothoracic centre in Liverpool, the Central Manchester hospital, the Walton Centre for Neurology and Neurosurgery, the Royal Liverpool and Broadgreen University hospitals and the United Bristol healthcare trust.
What reciprocal arrangements will be made in regard to charging for any patients from Welsh local authorities whose discharge from English hospitals may be delayed?I understand that the Assembly has decided not to introduce in Wales the incentives that we are introducing in the Bill. As for reciprocal arrangements, I understand that the discharge of fewer than three Welsh patients in English hospitals is being delayed. Because Wales has decided that it does not want to introduce reimbursement at this time, we currently have no plans for reciprocal arrangements. If Wales decides to implement reimbursement proposals, we shall need to consider the details then.
Question put and agreed to.
Clause read a Second time, and added to the Bill.
New Clause 3
Meaning Of 'Carer' And 'Carers' Assessment'
'(1) In this Part "carer", in relation to a qualifying hospital patient, means a person aged over 16 who—
(2) In subsection (1), "voluntary organisation" has the same meaning as in the National Assistance Act 1948.
(3) The responsible authority shall inform any person where it appears to them that they may be entitled under section (1) of the Carers (Recognition and Services) Act 1995 and section (1) of the Carers and Disabled Children Act 2000 to request an assessment of their ability to provide and continue to provide care.
(4) The assessment of the patient's needs under section (3)(3)(a) must take account of the results of any assessment undertaken of the carer's ability to provide and continue to provide care for the patient under the Carers (Recognition and Services) Act 1995 or the Carers and Disabled Children Act 2000 or both those Acts.'.— [Mr. Burstow.]
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
With this it will be convenient to discuss the following:
New clause 9—Carers: duties—'(1) Further to fulfilment of the requirements under section 2(2) and (3) it shall the duty of the responsible authority to—
(2) Where, for the purposes of satisfying the fitness for purpose of proposed accommodation under the Care Standards Act 2000, the assessment procedure exceeds three days, the delayed discharge period shall be disapplied.'.
Amendment No. 41A, in page 2, line 9, [Clause 2], after 'body', insert—
'to consult with the patient and his carer, if he has one, to ascertain their views and preferences, and—(a) where informed consent is given, record that on the patient's file or (b) in the case where a patient lacks the mental capacity to give such consent, record on the file what steps it has taken to ensure that the patient's best interests have been duly considered, and'. Government amendment No. 27.
Amendment No. 5, in page 2, line 41, [Clause 3], at end insert—
'(3A) Before making a decision under subsection (3) the responsible authority must—(a) consult the patient and his carer, if he has one; (b) inform them of the cost of the proposed care plans; and (c) obtain the consent of the patient and any carer and— (i) where informal consent is given, record that on the patient's file, or (ii) in the case where a patient lacks the mental capacity to give such consent, record on the file what steps it has taken to ensure that the patient's best interests have been duly considered.'. Government amendments Nos. 28 to 30.
Amendment No. 3, in page 3, line 7, [Clause 3], at end insert—
'(6A) The responsible NHS body must consult the patient and—
before deciding what services (if any) it will make available following discharge.'.
Amendment No.4, in page 3, line 7, [Clause 3], at end insert—
'(6A) The responsible NHS body must take into account the views of the patient's carer, if he has one, before deciding what services (if any) it will make available following discharge.'.
Amendment No. 2, in page 3, line 9, [Clause 3], at end insert—
'(7A) The responsible NHS body must give the patient and his carer, if he has one—(a) notice of the day on which it proposes to discharge the patient and— (i) where informed consent is given, record that on the patient's file, or (ii) in the case where a patient lacks the mental capacity to give such consent, record on the file what steps it has taken to ensure that the patient's best interests have been duly considered, and (b) information about their right to request a review if they disagree with the decision to discharge.'.
Government amendments Nos. 32 to 34, 36 and 37, 39 and 40.
This is far the largest group of new clauses and amendments with which we shall deal, and it enables us to explore quite a few of the issues we touched on in Committee. I hope we shall receive further clarification from the Government today, not least on issues raised by our amendments and those tabled by the hon. Member for Woodspring (Dr. Fox), which deal with some of Opposition Members' most fundamental criticisms of the Bill. We hope that even at this stage the Government will be minded to accept some of the amendments.
New clauses 3 and 9, and Government amendments Nos. 27, 30, 32, 39 and 40, address a number of concerns that I raised in Committee. As drafted, the Bill says nothing about the rights of carers. They are seen as innocent bystanders who are left to pick up the pieces resulting from the discharge process. Research by Carers UK has repeatedly demonstrated poor hospital discharge practice. The new clauses are intended to ensure that carers do not bear the brunt of poor practice and are not victimised by over-zealous implementation of the Bill across the country. Research published about a year ago by Carers UK showed that anything between 70 and 77 per cent. of carers said that they had no choice about taking on caring responsibilities when the person for whom they cared left hospital. In other words, seven carers out of 10 were effectively dumped on and left to get on with it. That cannot be a satisfactory outcome of the way in which discharge is currently being handled in far too many hospitals across the country. The guidance published by the Government over the years says that carers should be consulted about discharge planning and that they should play an integral role at each stage of a patient's progress. However, all too often that does not happen in practice. The new clauses deal with that lack of consultation and assessment of carers' needs. Carers UK has followed up the research that it has done over the years and monitored how things have changed over time, so it is educational to look more closely at its research. For example, it has found that there has been a near doubling in the number of people being readmitted to hospital within two months of discharge—from 19 per cent. in 1999 to 43 per cent. in 2001. When the most recent survey by Carers UK asked why the rise had occurred, 45 per cent. of carers said that they felt that premature discharge was the cause of what might be considered a revolving door syndrome that meant that people returned to hospital as emergency readmissions. The problem of premature discharge from hospital was highlighted by last year's Audit Commission report entitled "Fully Equipped 2002—Assisting Independence". I referred to that report in Committee. The quotation that I shall read out now was referred to but the Minister did not then respond to the point that the Audit Commission was making. The report stated:In other words, the policy becomes self-defeating: ejecting people prematurely from the hospital only results in them returning for additional care. I raised the matter with the Minister in Committee, but on checking the record I found that she did not deal with the point in that debate. I hope that she will be able to do so today. By introducing a system of fines to bear down on delayed discharge problems in the NHS, new perverse incentives will be created elsewhere in the system that will distort priorities. The district auditors and the Audit Commission have found that that is already happening: the delayed discharge targets are already causing hospitals to become the priority of social services departments at the expense of others. There is nothing in the Bill to prevent that from happening. In fact the Bill promotes it. Many people wait in their homes for assessment by social services departments, and are often in desperate need of an appropriate package of care and support. It is bizarre to discover that the Bill means that the quickest way for them to get what they need will be to get themselves admitted to hospital. The fine will cause social services to focus on their need once they are occupying a hospital bed. However, because there is no fine attached to the fact that those people are not being assessed at home, that will not be prioritised. That is the perverse incentive that the Bill will create."In the case of community equipment services in particular, social services departments were finding themselves under increasing pressure to cope with the demand of people being discharged earlier from acute hospitals. The policy to support the immediate needs of the NHS was putting pressure on other parts of social services' home-care budgets and driving up eligibility criteria for those who needed less intensive support to help them to stay at home—risking unnecessary hospital admissions and increasing demands on the NHS."
2.45 pm
I am following the hon. Gentleman's argument closely. Does he accept the Alzheimer Society's contention that the point that he makes about carers applies even more strongly to those looking after people suffering from that disease? Almost by definition, such patients are unable to give any input about what should happen to them. Carers often feel under enormous pressure to allow an inappropriate discharge and subsequent placement.
The hon. Gentleman makes a good point about mental incapacity, and the amendments in the name of the hon. Member for Woodspring in part deal with that. I shall return to matters connected with dementia later in my remarks.
I want to follow up an undertaking that the Minister gave in response to an amendment that I moved in Committee that dealt with the question of charging carers for services. I pursued this matter in the previous Parliament in connection with the Carers and Disabled Children Act 2000. It remains a concern for many carers. In Committee, the Minister acknowledged that it would not be right for carers to end up footing the bill for equipment. She said that the Government would return to the matter on Report. It is not clear which of the Government amendments under consideration deals with that point. I should be grateful if the Minister will make clear which amendment deals with the question of charging carers. In Committee, the Minister said that she would deal with matters to do with the regulations, several of which directly affect carers. It was useful that the Minister wrote to members of the Committee setting out in summary terms the issues that the Government indented to cover through regulation. My first question is about clause 2(4)(a), which deals withof likely need, and the manner in which they are to be given. The explanatory notes say:"the form and contents of notices"
However, I hope that the Minister will reassure the House about whether carers and relatives will be notified at that stage. Neither the notes nor the Bill makes that clear. Will they be part of the process? I hope that the Minister will confirm that the regulations will recognise and acknowledge the role that carers play. The notes also stated:"The intention is that the regulations ensure that the notice given by the NHS body is brief, but still contains necessary information. The notice only need contain the patient's name and location, the name of the NHS contact, the date of admission if this has not yet occurred, and the likely date of discharge if known."
The phrase "shared database" reminded of last year's Audit Commission report entitled "Forget Me Not", which stated:"Notice does not need to be a formal letter but will most likely consist of a fax or an email, either providing the necessary information or alerting social services to an update on a shared database".
No one would disagree. The report continued:"Effective information sharing between health and social care practitioners is a prerequisite to successful co-ordination."
When one goes on reading the report to see what that meant in practice, one realises that in 89 per cent. of the areas surveyed by the Audit Commission there was no compatibility between the systems—yet the Government are planning to predicate regulations on such an ability. I hope that the Minister will say a little more about that, too. How will the proposal work in practice given that the systems will hamper the sharing of information? We on the Liberal Democrat Benches welcome amendments Nos. 27, 30, 32, 39 and 40 because they make provision for some of the concerns that Carers UK, my hon. Friend the Member for Cheadle (Mrs. Calton) and I have been raising. However, the amendments seem to fall short of placing a duty on social services departments to inform carers of their entitlement to an assessment. Indeed, Government amendment No. 27 states that the carer must ask for the assessment. In other words, the onus is placed on the carer. Surely during the stressful time in hospital associated with the planning of discharge it would not be unreasonable to place a duty on social services departments to give the carer notice of the fact that they are entitled to such an assessment if they want one. I look forward to the debate on the Opposition amendments on consent. The Liberal Democrats strongly support their purpose. The Bill is silent not only on carers but on patients; there is absolutely no mention of patients. The provisions reflect an obsession with getting patients out of their beds as quickly as possible—and not necessarily in their best interests. The amendments are about ensuring that the interests of the patient are brought back into play. Under the Bill, the patient is seen as a passive recipient of whatever care or services the NHS or social services departments choose to supply. The issue of consent is particularly relevant to patients with dementia, to which the hon. Member for Eastbourne (Mr. Waterson) referred. Indeed, when giving evidence last year during the Health Committee's excellent inquiry into delayed discharge, Professor Ian Philp, the national director of older people's services, made the following relevant point:"Joint working and the single assessment process would be weakened without it. However, auditors found that shared case files, or easy access to each other's files, only existed in a tenth of areas, and partly so in only a further third…In other words, case notes were not shared in three-fifths of areas…Many agencies have developed. Or are in the process of developing, computerised patient or service user records. But auditors reported that health and social services IT systems were compatible in only a few areas."
He went on to make the point that 70 per cent. of occupants of ordinary nursing homes are elderly mentally infirm patients—people with dementia and other problems. There are serious pressures on services currently available to provide support for people with dementia and for their carers. We know that from the Audit Commission report, "Forget Me Not", in which there are some important findings on home care services, to which the hon. Gentleman also referred. Last year's report said:"dementia is a principal cause of delayed discharge because of the complexity that having dementia plus a physical illness produces in terms of developing a good discharge plan."
Only one in seven areas have people who are equipped with the skills to provide the services necessary to promote confidence in the fact that those with dementia will be safely discharged from hospital and will receive the support at home that they need. Surely that ought to concern the Government, although it does not appear to have been factored into the time scale for implementation of the Bill. Indeed, the Government have been hasty in introducing the legislation. Is the Minister confident that matters have been remedied since the Audit Commission's finding just last year? Surely the patchiness of provision of services for people with dementia ought to be addressed. Even the extra resources, which are welcome and for which I and my hon. Friends voted, will not deliver from clay one the extra EMI-trained staff to provide such home care and other much needed support. Amendment No. 5, which was tabled by the hon. Member for Woodspring, would rightly ensure that patients and carers are informed about the costs of the proposed care. That raises some questions for the Minister. First, clause 3 sets up the process of partial assessments—what package of community care services ought to be provided for the carer. The assessment is not of the carer's financial circumstances, so how on earth can social services departments complete a financial assessment in the time scales proposed, especially given the intrusive nature of such assessments? My second question is about consistency in NHS continuing care. As the Audit Commission found, there are wide variations in how the Government's guidance on continuing NHS care provision is implemented. Over the past months there have been some very damning health ombudsman inquiry findings against strategic health authorities that have acted unlawfully in saying that someone is not entitled to free NHS continuing care and therefore must instead be means-tested by social services departments. As a result people have given up resources to which they are entitled, whether by selling their home or running down their bank balance. Given such evidence, will the Minister ensure, if and when the Bill is enacted, that we can be confident that there will be an assessment of a person's entitlement to such care from the outset? In Berkshire, the strategic health authority has been told as a result of the health ombudsman inquiries to trawl through records of the past few years to find when people have been wrongly pushed down the social services route and subjected to means-testing rather than receiving free continuing NHS care. That is the case not just in Berkshire but in Dorset, Wigan and Cambridgeshire. Will the Minister ensure that strategic health authorities will conduct those trawls, which have been requested by the health ombudsman; otherwise many people will feel that the guidance issued by the Department and the way in which it has been interpreted by health authorities run contrary to the decisions of the courts and rob people of money? People are having to pay for what is fundamentally NHS care. Clause 3(8) deals with the circumstances for the withdrawal or cessation of the effect of a notice, where someone is awaiting discharge from hospital. If that person is told that they are not entitled to free continuing NHS care and they appeal, will the Minister confirm that the clock-on fines imposed on the local authority will stop? We hope that the Government will be able to offer answers to some of the issues raised by the amendments that I have highlighted. I hope that my hon. Friend the Member for Cheadle will be able briefly to address Government amendment No. 37 to which I have not spoken. Unless both carers and patients are covered by the Bill and their rights are properly protected, the measure will not be satisfactory and should not pass through this House."Home care is one of the key services for supporting older people with mental health problems at home, provided it is given flexibly and sensibly. However, auditors found home-care workers with additional training in mental health in only one in seven areas."
I will speak to amendments Nos. 41A, 5, 3, 4 and 2, which deal with empowering patients and particularly carers. In many ways, as has been said, the amendments complement and add to the new clauses moved by the hon. Member for Sutton and Cheam (Mr. Burstow).
It is right to say from the outset that it is extraordinary that throughout what the Opposition regard as a nasty and counterproductive measure there are no references to carers and patients or any powers and entitlements granted to them. Yet it is patients who are at the receiving end of the Bill, as are the carers, who are, as no one in the House would disagree, the unsung heroes of our society because of the tremendous work that they do in looking after loved ones and family members. 3 pm Clause 3 highlights the fact that all too often carers are ignored—taken for granted—and there is an assumption that they will do their duty and look after their relatives or those whom they care for. I consider that situation to be the wrong way round, which is why I believe it so important that these amendments and new clauses put on the face of the legislation protections and aids and assistance to patients and, particularly, to carers.Does the hon. Gentleman accept that some of the amendments that he is speaking to are completely unnecessary, that some of what he has said is an insult to the social work profession, and that we cannot simply lay down in the House what social care professionals should do in every aspect of their work? Will he celebrate with me the fact that we can rely on the professionalism and ability of social workers in local authorities?
What complacent rubbish.
Unusually, I am inclined to agree with the Liberal Democrats. I think that I am right in saying that the hon. Member for Lancaster and Wyre (Mr. Dawson) was a social worker, so may I first say that, despite his cheap jibe, what I have said so far in no way criticises or attacks social workers, because they also have a very difficult job to do, and are often not given the credit for the work that they do? I think that carers' organisations and carers will be slightly surprised by the hon. Gentleman's comments, because they do feel aggrieved, and if he has bothered to take the time to read any of the briefings on the Bill from carers' organisations he will know that they do feel very aggrieved that the Bill makes no mention of carers or the role of carers.
Does my hon. Friend agree that the point here is not the dedication of individual social workers but the pressures that social services departments will feel under? Indeed, the Bill is designed to make them feel those pressures, which will in turn distort the priorities that they might otherwise have in terms of care and packages for individual patients?
My hon. Friend has picked up an extremely relevant and important point. I wish the Government had better appreciated the implications of what the Bill seeks to do, because, as the Minister knows, it will be carers who bear the brunt of poor discharge procedures, and we believe that those will arise as a result of the Bill.
Will the hon. Gentleman give way?
No, I will not; I want to make some progress.
We tabled the amendments because between 1999 and 2001 readmissions of patients within two months of being discharged nearly doubled, from 19 per cent. to 43 per cent. The proportion of carers who felt that early discharge was at fault rose correspondingly from 23 per cent. to 45 per cent., and 77 per cent. of carers said that they were not given a choice about taking on caring responsibilities. That is why—rose—
rose—
I will not give way.
We need to have the new clause and the amendments on the face of the Bill to enshrine in law the proper procedures.Will the hon. Gentleman give way?
I am sorry; I want to make some progress.
I want to deal in order with the amendments that the official Opposition have tabled. Amendment No. 5 is intended to ensure that the patient—and, where applicable, the carer—is aware of what will be provided on discharge, so that they know whether they would wish to accept that plan. The amendment also addresses issues where the patient lacks capacity. As clause 3(3) currently reads, there is no involvement with the patient, only agreement between the national health service and social services—Will the hon. Gentleman give way?
No, I will not.
The amendment would ensure that the patient and, just as important, their carer were fully aware of the cost of their continuing care and aware that they had consented to it. The importance of such knowledge and consent is emphasised by a case that my right hon. Friend the Member for Skipton and Ripon (Mr. Curry) drew to my attention. He has a constituent who has been confronted with what I think the House would rightly agree is a grave injustice with regard to free care under the Coughlan case. A Mrs. Airey, who is the mother of my right hon. Friend's constituent and holds power of attorney, was suddenly sent a bill for £7,000 by the care home to which her mother had been transferred from hospital by social services in Yorkshire. She had made no agreement, written or verbal, to pay anything. When she replied that the contract with the care home had been made by social services, and that her mother could not be asked to pay, she received a telephone call last Sunday week from the home manager, who said that he had consulted social services and that her mother would not be able to continue in the home if she did not pay. Social services wrote last week to say that my right hon. Friend's constituent must pay "to protect her mother's place in the home", and that she had made the contract with the home. Mrs. Airey is adamant that she had done no such thing. As the House will appreciate, there is now a major dispute as to who placed the contract and who is financially responsible for paying the bill. I believe that an amendment like amendment No. 5, with the plans in the new clause and the other supplementary amendments, would overcome that sort of confusion and argument, because there would be greater clarity at the point of discharge.rose—
I will give way, but then I shall make progress.
I thank the hon. Gentleman for being so generous. He obviously has a different copy of the Bill from the one that I had. Perhaps he could point out where in the Bill it repeals legislation that already requires care plans to be in place and legislation that gives every carer the right to an individual assessment.
The hon. Lady is missing the point because—
No, she is not.
She is. If I could explain for a minute, perhaps the hon. Lady will understand. The trouble is that, regardless of the legislation that the hon. Lady is referring to, the Bill will, in effect, cause serious problems by putting pressure on local authorities to ensure that patients are often wrongly or inappropriately discharged from hospital and inappropriately placed in alternative forms of care, so as to avoid a fine under the Bill. That is why I, my hon. Friends and, I think, the Liberal Democrats believe that to protect against that occurrence and to minimise that possibility, the Bill, if it reaches the statute book, should have clearly defined rights and protections for carers and for patients, so as to seek to avoid an unpleasant and unfortunate by-product of a piece of legislation that is deeply flawed.
Will the hon. Gentleman give way?
No. I told the hon. Member for Sheffield, Heeley (Ms Munn) that I would take one intervention and then would make progress.
Amendment No. 3 ensures that national health bodies will consult patients as well as local authorities before it is decided what services, if any, will be made available following their discharge from hospital. The amendment ensures that the patient is informed and consents to whatever NHS services are to be provided. It also aims to deal with those people who are unable to give such consent in the absence of mental incapacity legislation. Amendment No. 4 would place a further duty on NHS bodies simply to ensure that the views of the carer are considered when making arrangements for health services following the discharge of a patient. The wording is deliberate. The NHS body must simply take into account the views of the carer. It need not necessarily agree or act on those views, but it will have a duty to take them into account. Amendment No. 2 would introduce a new subsection to ensure that patients and carers are also aware of when they are likely to be discharged and can ask for a review. It also aims to deal with people who are unable to give consent due to mental incapacity. The amendments and new clauses are needed in the Bill. For that reason, and given that we discussed the subject at considerable length in Committee, I hope that the Minister has had time to reflect and is now minded to accept this strengthening of the legislation. I am sure that she will not doubt, as I certainly do not, that carers and patients need to be protected under this part of the Bill.If memory serves me correctly, the hon. Member for West Chelmsford (Mr. Burns) has surely come somewhat late to concerns about carers. I cannot remember one piece of Conservative health service legislation between 1992 and 1997 that enshrined the rights of carers on the face of a Bill. In that five-year period, they may have introduced the possibility of the carer's needs being assessed, but no statutory duty was placed on local authorities and they did not have to deliver.
I frankly acknowledge to the Minister that my reason for speaking to this group of amendments is anecdotal, but some of my constituents have expressed concern to me. They perceive that, as carers for someone who is frail or, in one instance, suffers from dementia, pressure could conceivably be placed upon them, as social services could be fined under the Bill if the NHS facility that is caring for their loved one says that he or she is ready to leave hospital but no alternative facilities can be provided. Even though Camden is an excellent authority in that respect, there are difficulties with finding available facilities locally. That is the overriding concern of my constituents. In some instances, the carer is as frail as the individual who is in hospital, as I pointed out when we discussed the Bill in the House before. One such case involves a wife whose husband was in hospital. She became ill and, even though he had recovered, there was no one at home who could care for him. No interim placement was available in the locality and the couple had no relatives who could visit him in the place where he was to be temporarily cared for. Those are the sorts of issues that are causing concern among carers and patients. They believe that undue pressure will be placed on their local authority to move their loved one from an NHS facility. In some instances, they know that the loved one will be returned not to their home, because no one there is capable of caring for them, but to a facility outside the local area. My constituents are also concerned about what will happen when someone is to be cared for at home but the home requires a great deal of work to make it feasible for the carer to care for them, or for a carer with additional domiciliary care to do so. There again, some of my constituents believe that unnecessary pressure will be placed on local authorities as a result of the fines in the Bill and that the authority will in turn put additional pressure on them. I hope that my hon. Friend the Minister will be able to say something to calm the fears of my constituents.3.15 pm
I speak in support of the majority of the amendments in the group, but in particular those tabled by my hon. Friends, especially my hon. Friend the Member for Woodspring (Dr. Fox)—amendments Nos. 41A, 5, 3 and 4 on the consent of patients and their carers.
Those of us who were members of the Committee and who tried to improve the Bill were disappointed not least at this important—indeed, central—flaw in the legislation. The Bill is a consent-free zone. Patients are treated as a sort of commodity, or as counters to be moved around the board to the best advantage of the agencies involved. It does not ensure that they or their families or carers will be consulted, let alone have their views taken into account when it comes to the timing of their discharge and the sort of care that they will be discharged into. We will return to that issue, but as hon. Members on both sides of the House said on Second Reading and in Committee, it is extraordinary that the Government want to introduce this sledgehammer measure at a time when there are encouraging signs throughout the country and in east Sussex in particular—part of which I represent—of closer working between the different agencies. There have been problems. I do not think that any sensible observer of that aspect of the care scene would argue otherwise. However, there is now much greater evidence of better organisation within the different bodies and of greater co-operation. For example, although there continues to be a problem with bed blocking and delayed discharges in my area, the figure is much lower than it was a year ago. Indeed, my local hospital, Eastbourne District General, recently opened a discharge suite that is designed to ease the transition of patients out of beds that they no longer need to occupy earlier in the day and to the form of care to which they are to move.Does the hon. Gentleman regard those new levels of co-operation as a new Labour achievement? They were certainly not evident in any Tory legislation or policy during the 18 years for which the Tories were in power.
The hon. Member for social workers, or whatever his constituency is, misses the point again. If the Government are going to try to take credit for solving the problem, they should certainly take the credit for creating it in the first place. In my part of east Sussex, the problem can solely be placed at the door of the Government.
There has been closer working between the agencies, in particular since control of the county council changed hands. The Tory administration has gone to great lengths to work more closely with the NHS and so forth. If blame is to be allocated locally—perhaps an element of consensus may spring up across the Chamber on this—the eight years during which the Liberal Democrats ran the county council contributed to the problem.Opposition Members have short memories. I was first introduced to the term "bed blocking" during my social work training back in 1985–86, under a Government of the political persuasion of the current official Opposition. The problem has existed for many years. Why, after all this time, are the Conservatives so concerned about the fact that the Government have decided to do something about it, especially in areas where the progress made is not as it should be?
I have not had the benefit of social work training—I am sure that that is a massive failing on my part. Two things need to be said. First, there has always been bed blocking, although the title attached to it has changed over the years. However, my constituency experience during the past 10 years is that whereas it used to be largely a winter phenomenon, it has become an all-year-round phenomenon of substantial proportions. At different times in the past couple of years, my local hospital has had the equivalent of two or three wards full of people who should not be in hospital. It is one of the lasting monuments to the Labour Government that they have created waiting lists not only to get into hospital but to get out.
Secondly, the Government appear to be convinced that the Bill is the solution, even though what they propose flies in the face of the conclusions reached by everyone else with any experience of the problems—not only Conservative Members of Parliament, but the Local Government Association, the Association of Directors of Social Services and the NHS. The Bill has not a friend in the world, apart from some Labour Members, and quite a few of them have expressed disquiet since the idea was stumbled across. It is another example of the Government's knee-jerk reaction to problems. All I can say to them is, "Welcome to Government." Normally, there are no simple solutions to complex problems. If the hon. Lady is saying that the Bill is the answer—that some genius boffin at the Department of Health has produced a wonderful solution to the problem—why not pilot it? Why not follow the advice of bodies such as Age Concern and not implement the Bill across the board until 2004? Why not try it first in one or two areas? By all means choose those areas where the problem is perceived to be chronic. The Minister will concede, if she has not already done so in previous debates, that good progress is being made in east Sussex, but if there are pockets where the problem is extremely bad, why not pilot the provisions of the Bill in those areas and wait and see, rather than wasting the time, effort and resources of hard-pressed social services departments and NHS staff throughout the country? Moving on to the practical details, I have already said that the Bill has no friends, but in an intervention on the hon. Member for Sutton and Cheam (Mr. Burstow) I mentioned what the Alzheimer's Society has to say. The society is extremely worried. It makes the point thatand that"There are over 700,000 people with dementia in the UK",
In its briefing, the society rightly states:"Three-quarters of people in long term care have Alzheimer's or another form of dementia."
and adds that"The Bill makes no reference to issues of consent",
The concerns that were rightly expressed by my hon. Friend the Member for West Chelmsford (Mr. Burns) and the hon. Member for Sutton and Cheam about carers generally apply in spades to carers of people with Alzheimer's or other forms of dementia. The Alzheimer's Society briefing continues:"the proposals place undue pressure on unpaid carers."
The briefing ends:"Many carers feel pressured into moving a person with dementia into a care home that they feel is unable to care appropriately for the needs of the person with dementia."
"The Alzheimer's Society is concerned that the proposals will increase pressure on people with dementia and their carers to accept care that is inappropriate."
The hon. Gentleman talks about what carers have to fear from the Bill. Surely carers in this country have far more to fear from a 20 per cent. cut in public spending, proposed by Opposition Front-Bench spokesmen just before Christmas? What would that do to social services budgets and what could carers expect as a result of such cuts?
The hon. Gentleman is behind the game. Despite the assurances of the Prime Minister, it has been made clear that no Opposition Member is suggesting a 20 per cent. across-the-board cut, or anything like it. I am talking about the Labour Government's loony proposal to charge fines—the Minister was careful not to use the word "fines" in Committee; she used various other, somewhat cuddlier, expressions—
Incentives.
I am grateful to my right hon. Friend—I think that that was the word the Minister used. There would be charges to "incentivise" people, although I doubt that any criminal who is fined regards himself as being incentivised. In any event, the game was blown when the Secretary of State used the old term "fines" in the Chamber the other day. The Government are erecting a tremendous bureaucracy to fine social services departments—but may give back the fines because they are also setting up various appeal tribunals—to deal with a problem that in some places is visibly being tackled by the agencies themselves.
The next brief we received is from Help the Aged, which makes similar points. It says that the BillAs I pointed out in Committee and on Second Reading, the Bill cuts right across the requirements of the NHS plan and the national service framework for older people. I do not know why Ministers publish all those worthy documents if they have no intention of paying any attention to them in legislation. Age Concern provides a powerful voice for the sort of people who will be most adversely affected by the Bill and whom the Opposition parties are trying to help by amending the Bill. The organisation does not pull any punches, stating:"fails to recognise the involvement of the patient in determining their future care."
It refers to the finding of the Select Committee on Health inquiry into delayed discharges, that"We believe that there is a stark omission from the Bill of the rights of the patient."
There is no talk of partnership in the Bill—patients will not necessarily be told what is to happen to them, and neither they nor their carers will be asked about it. Age Concern talks about the need for the consent of the patient and their carer, for the provision of adequate and proper information, for consultation and advocacy, for the patient to have the right to dispute the discharge decision, and for details of what will happen to the patient when there is a dispute—a subject that we will discuss later. I return to what I have said throughout our consideration of the Bill. Consent of the patient, let alone the carer, is entirely absent from the Bill. We can only assume that it is a wholly Treasury-driven measure. It has nothing to do with the care of patients. It is designed to save money. As I have also said, in the area that I represent the problem is very much one that has been created by government."it is essential that patients should as much as possible be partners in the discharge process."
We should all welcome the recognition of the problems that are faced by carers, however late it has come. We must also recognise that legitimate points are being raised by organisations representing older people as well as by organisations representing the interests of carers.
The specific concerns that I would like the Minister to address do not revolve around personnel issues in terms of a care package but relate to the circumstances in which people were admitted to hospital in the first instance and to the place to which they will be returned. Those points were made by my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson). I would welcome a reference from my hon. Friend the Minister to the way in which these matters fit in with our approach to a fuel poverty strategy that will tackle the root cause of many elderly people's admission to hospital. No matter how much personal care we build into a return package, fuel poverty will be the cause of further readmissions. 3.30 pm For a long time, many of us have been concerned about the revolving-door syndrome in terms of hospital admissions for older people. Much of the blocking of discharges relates not to the specific illness but to home conditions that may make it almost certain that the illness will recur. Will the Minister clarify whether she will be issuing fresh guidance about home circumstances. I think that the issue is covered in amendment No. 27, which refers to the need to identify "any services" thatWe have been the first Government ever to introduce statutory targets for the elimination of fuel poverty in the home. Home warmth, home conditions and home safety are central to the health interests of older people and to safety when discharging older people from hospital to return to their homes. The amendments that were tabled in my name and in the names of other Members on a cross-party basis have not been selected, but perhaps the Minister will be kind enough to set out her proposals in the context of recognising that it is not only the human care package but the physical care package that needs to be considered in removing or addressing the bed-blocking problem? I would hate us to find that we had merely moved the problem from one location to another. I would not want us to replace the revolving-door problem with a pass-the-patient problem that surfaced in temporary locations to which a discharged patient was moved, not least because the people concerned may have been asking for a long time what help they can get from the Government or the responsible agency to make their life-long home a safe place in which to live."need to be made available to the carer in order for it to be safe to discharge the patient".
My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) and I support the remarks of the hon. Member for Nottingham, South (Alan Simpson). We added our names to the amendments to which the hon. Gentleman referred, which sadly have not been selected. We would have liked them to be debated as well. We hope that the Minister will take notice of the hon. Gentleman's comments and take them up when she replies.
We shall press amendment No. 37 to a Division, because it has the effect of ensuring that accommodation and personal care do not have to be free for more than six weeks. Effectively, that means that responsibility is thrown back to local authorities after six weeks. Liberal Democrats disagree with that approach. We believe that personal care should be free for as long as it is necessary. We have never pretended that it does not have to be paid for, but comments about charging that were made in Committee should be addressed. In May 2000, the Audit Commission's document "Charging with Care" said that 94 per cent. of councils were charging for care compared with 72 per cent. in 1992–93. The charges were raising £225 million and funding 12 per cent. of the costs of care, compared with 8 per cent. in 1993–94. It is acknowledged that that income helps councils to maintain and improve services and target subsidies. It is also acknowledged that demand is increasing. Much is made also of the differences in the amount of care that people could expect to get for the same money throughout the country. Councils have had the power to charge for social services care since the enactment of the National Assistance Act 1948. The current powers to charge were set out in the Health and Social Services and Social Security Adjudications Act 1983, which was introduced by a Conservative Government. It gave wide discretion to councils, but they had to be reasonable, and reasonably practicable, in what they brought in. In 1994, an advice note from the social services inspectorate provided further clarification, and a series of legal challenges established case law. The Government's current funding formula assumes that a proportion of costs can be recovered through charges. A note from the Library makes it clear that, for the first time, in 1999–2000—under a Labour Government—the way in which the revenue support grant was distributed to local authorities took into account the fact that they have different capacities to cover costs by raising charges for domiciliary services. In other words, councils were expected to make charges if they could do so. Until 2000, only 6 per cent. of councils—Is the hon. Lady suggesting that distribution should not take into consideration councils' ability to raise charges, given that, as she said, that has been the legal position since 1948? Is she suggesting that we should not bear that in mind when we are distributing—in other words, that we should disadvantage those local authorities whose communities are poorer and less able to pay charges?
I thank the Minister for her intervention, but I would have much more sympathy with her point of view if she acknowledged the level of unmet need throughout the country—in local authority areas considered affluent, and in those considered less affluent. The level of need is simply not being met because the indicators used are not sensitive enough to recognise it.
Against the background of grants allocated on the basis that charges would be made, and of reductions in grant to that end, 94 per cent. of councils were clearly not in a position to avoid charging.This time last year, my father needed care at home, and because of his level of disability at that time he was entitled to claim a higher rate of attendance allowance. Both my mother and father considered it only right that that allowance be used to contribute towards the services that they received, and it is clear that many people are in that position. Is the hon. Lady suggesting that that is not a legitimate way for the Government to proceed?
I am grateful for that intervention, but I need to make progress as we want to press several of the amendments tabled to a vote. Obviously, there will be those who feel able to pay, but I am talking about the most disadvantaged, who are not able to do so.
Will the hon. Lady give way?
No. As I said, I intend to make progress. I have taken several interventions.
Successive Governments have been disingenuous on this front. It suited them to blame local councils, whereas in reality they were pulling the strings. We should remember that we are talking about services that involve assisting people in going to the toilet, using a bedpan, keeping the skin around catheters and stomas clean, changing incontinence pads, and keeping their skin clean because of their incontinence; assisting people with food; dealing with immobility; and medical treatments such the application of creams, lotions, eye drops and dressings. At the moment, people have to pay for all those things. Dressings, surgical appliances, prostheses, getting up and going to bed—all of those count within free personal care. The Liberal Democrats have never suggested that such care could be provided without funding, and it was covered in our last costed manifesto. Given that it is a priority for us, it will undoubtedly be costed for the next manifesto as well. In Scotland, all parties—Labour, the Conservatives, the Scottish National party and the Liberal Democrats—universally supported that move forward. It is a great pity that the Government have not used this opportunity to ensure that free personal care is provided for those who need it in England and Wales. Indeed, they have made it impossible for themselves to do so without further primary legislation.Opposition Members have made much of their concern for individuals and carers, but perhaps I should return to the very principle of the legislation, which they oppose. We introduced the Bill precisely because we recognise that the prime concern of many older people who are trapped in hospital—they tell us this when they come to our constituency surgeries—is that they want to get out, but that the facilities that they need to do so are not available. I am afraid that when it comes to concern about individuals and carers, talk is cheap for Opposition Members. As my hon. Friend the Member for Leigh (Andy Burnham) pointed out, it has to be cheap for the Conservative party, given their plans to cut the public spending that we are pledging.
As we shall see later, the Liberal Democrats seem to think that the problem can be solved with a few more plans. I am sorry, but every single older person who is trapped in hospital and wants to get out is an argument for a change to the system. Opposition Members can talk as much as they like about individuals, but if they are willing neither to invest nor to reform in order to make the necessary difference, that talk is hollow.When I intervened on the hon. Member for Eastbourne (Mr. Waterson), he responded that he was not aware that any Opposition Member was suggesting public spending cuts. I draw my hon. Friend's attention to a comment made by the Opposition's Treasury spokesman:
That was what he told The Daily Telegraph on 28 December."I am digging through current spending, finding opportunities for cuts. It is too early to say how much but it could be up to 20 per cent."
My hon. Friend makes a very important point. That is why I say that talk is cheap for Opposition Members.
There has been much talk about carers and issues relating to consent. I should like to address some of those issues, and I hope to provide some reassurance. My hon. Friend the Member for Hampstead and Highgate (Glenda Jackson) said that the Government's attitude to carers was different from that of previous Governments. We are committed to supporting carers in the vital care that they provide. Between 1999–2000 and 2001–02, the number of carers' assessments carried out increased. The carers grant introduced by the Government in 1999 provided an extra £140 million over three years to increase the number of breaks for carers. It has now been extended to provide £85 million this year and £100 million next year, and will continue to 2006. During that time, it will more than double to £185 million to provide extended care and 130,000 further breaks for carers. This is a Government who are willing to put resources behind concern about carers. However, I understand the concern that the Bill may not have taken into account some of the previous legislation that we introduced in relation to carers' rights. We tabled Government amendments Nos. 27, 28, 29, 30, 32, 33, 34, 39 and 40 to remedy an omission from the Bill that would have meant that carers and carers' services were not fully provided for. As the Bill is drafted, the financial incentive promptly to carry out an assessment and provide services will apply to individuals in hospital, but not to their carer. It was never our intention that the services that need to be provided to the carer to ensure safe discharge should be considered a lesser priority than the services to be provided to the individual. As my hon. Friend the Member for Hampstead and Highgate rightly pointed out, there may well be important cases where services provided to a carer are crucial in order to enable the safe discharge from hospital. Carers' needs are important in ensuring that an individual receives the services that he needs when he needs them and in the most appropriate place. 3.45 pm The amendments add the carer's assessment—upon request from the carer—and decision about provision of services to the carer to the duties of a local authority when it receives a notice under section 2. Amendment No. 27 states that a carer's assessment should be carried out either when it has been requested by a carer—in response to the hon. Member for Sutton and Cheam (Mr. Burstow), I can say that we have issued section 7 guidance, alongside the Carers and Disabled Children Act 2000, which outlines carers' entitlement to be informed about their right to assessment—or when a carer has had an assessment in the previous year, in order to check whether the carer's needs have changed or to identify those services specifically necessary for the safe discharge of the person cared for. The amendments therefore mean that if any carer's services necessary for a safe discharge are not in place by the end of the relevant day, the local authority will incur a charge in the same way as if community care services were not in place, and provide a strong incentive for local authorities to ensure that the needs of the carer are given priority when the patient discharge from hospital is being arranged. I am pleased to say that the amendments are strongly supported by Carers UK, which rightly raised the concerns that I have outlined. It believes that they will do much to improve current practice with respect to carers and hospital discharge. The amendments will ensure that carers' needs are taken into account, looking holistically at what they realistically can and cannot manage, and that services are put in place to meet those needs prior to the patient's discharge from hospital. The hon. Member for Sutton and Cheam raised a point that I made in Committee: that, although services are provided free to individuals, under the Bill as drafted equivalent services provided to a carer would not also be free. Amendment No. 36 rectifies that error, which has the effect that, although local authorities will no longer be able to charge individuals for the provision of certain community care services, they will still be able to charge their carers. It was never our intention that local authorities should remain able to charge carers for the same services that could be provided free of charge to the individuals themselves. The amendment will ensure that those services, whether provided to carers or to individuals, will be free in a similar way. Given those Government amendments, I agree with my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson) that new clause 3 is otiose. It seeks to overload the Bill with unnecessary definitions. The definitions in the first two subsections are taken into consideration by Government amendments. Subsections (3) and (4) place further duties on local authorities that are unnecessary and achieve nothing over and above what the Government have achieved through their amendments. The Carers and Disabled Children Act 2000 already provides that carers are entitled to request assessment of their ability to provide care, and I can assure hon. Members that statutory guidance on the Act will state that carers are entitled to be informed that they have that right. Similarly, section 1 of the Carers (Recognition and Services) Act 1995 already provides that the local authority is under a duty to take into account the results of any assessment of the carer's ability to provide care when deciding what community care services it will provide to the person cared for. It is unnecessary to repeat that duty here. The single assessment process and the hospital discharge workbook will also reinforce that good practice.On the publication of the workbook, it has been almost two years since the Government first said that they were working on revising it. Is it the case that the Department has not done the necessary work to enable the workbook to be published sooner because it has been distracted by drafting this Bill?
No, that is not the case. Secondly, legislation that ensures that older people get out of hospital more quickly and get the care that they need when they need it is not a distraction. I consider it a rather important part of Government business.
The hon. Member for Sutton and Cheam repeated quite a few of the discussions that we had in Committee. First, on the concern about levels of readmission, may I emphasise for hon. Members the points that I made earlier? While the Government have had considerable success in reducing levels of delayed discharge, levels of readmission have remained pretty stable. We also know, for example, that more than a third of local areas have below average rates of delayed discharge and below average rates of emergency readmission. That shows that it is possible to perform well on both indicators. As I have said before, however, we take that potential risk seriously, which is why we will be covering it in the hospital discharge workbook and the statutory guidance that we will publish alongside the Bill. Both will make it clear that discharge must be properly planned, patients must not be discharged until it is safe to do so, hospitals will be judged, and, therefore, rewarded on the basis of their ability to control readmission rates, and, under new financial flows, acute trusts will not receive funding for patients who are readmitted to hospital within a certain period. A financial incentive therefore exists for those trusts to ensure that a patient is genuinely ready for discharge before leaving an acute hospital bed. The hon. Member for Sutton and Cheam also raised concerns about whether patients in the community will be disadvantaged. Perhaps I could remind hon. Members of the context within which the Government propose to introduce this legislation: one of significant extra funding for older people's services. That will provide additional carer services, as I have spelled out, 500,000 more pieces of community equipment, 70,000 more social care intermediate care services, and 30,000 more home care services of five or more hours a week. If the hon. Gentleman's point is that, given the inheritance of the previous Government's spending on local authority social services, social services departments have had a difficult job, I agree. This Government, however, are significantly increasing investment in ensuring that social services departments can provide precisely the sort of community alternatives and support necessary for people to come safely out of hospital and to be where they tell us that they want to be—in their own home or in extra care supported accommodation. In that context, it is also right to ensure that the responsibilities of local authorities are carried out in a timely fashion and that older people are placed at the centre of care and not relegated to being trapped in hospital, a practice that Opposition Members would seem to want us to continue. My hon. Friend the Member for Nottingham, South (Alan Simpson) made some important points about the need to ensure that action is taken on fuel poverty for older people in particular, and that people have the kind of changes made to their homes that enable them to continue living in them and to keep well. I assure him that, for example, my Department's "Keep Warm Keep Well" campaign, in partnership with Help the Aged, Age Concern, National Energy Action, the Women's Royal Voluntary Service, the Department for Environment, Food and Rural Affairs and the Department for Work and Pensions, which was launched again this year, provides an advice line, a free winter guide and advice about financial assistance available, such as that offered by the warm front team, which helps people to heat and insulate their homes. I also assure my hon. Friend that the Department of Health is, for the first time, investing more money in home improvement agencies precisely to make some of the changes to housing that will enable people to leave hospital more safely. We are also investing in intensive home care packages and extra care accommodation, which may well provide a safer and more secure environment for older people while allowing them to maintain their independence. Let us consider consent and involvement. It is important to involve and inform patients and carers and obtain consent when appropriate. However, as my hon. Friend the Member for Sheffield, Heeley (Ms Munn) rightly pointed out, the Bill does not alter existing legal or good practice requirements for social services or the NHS to inform, involve and, when necessary, obtain patients' or carers' consent. Amendment No. 41A proposes that local authorities should consult patients and carers before informing social services of a possible community care need and obtain their consent to that notification. When exercising their functions, the NHS and social services must give people all proper information to enable them to decide whether to accept care or services. Those fundamental duties stern from their status as public bodies that exercise public functions. Of course, good practice dictates that the patient should be kept informed and consulted at all stages of the assessment process. The statutory guidance for the Bill will also make it plain that patients, carers and families should be kept fully informed and consulted at every stage of the discharge process. The revised hospital discharge workbook includes a chapter specifically on patient and carer involvement. We expect the NHS and social services staff to follow it. However, the Bill does not alter the existing right of the NHS to notify social services of a person's need of such services. I do not believe that giving people a veto over the ability of the NHS to notify social services will help us either to provide the sort of care that people need to leave hospital safely or to plan better the care that especially older people require. The Committee accepted that that early notification of social services would help everybody to plan such care better.Will the Minister confirm whether the regulations under clause 2(4)(a) that deal with notification include carers? Will carers and patients be notified?
I assure the hon. Gentleman that we believe that the need to involve carers is crucial. That will be spelt out in the statutory guidance and the hospital discharge workbook. However, it may not be possible to give carers the same legal right as patients when patient confidentiality is involved.
Could a carer or a patient veto a plan that cannot be provided locally? If there is no carer and the patient is incapable of making a decision, will there be an advocate? There should be an advocate for an individual who cannot make decisions. Will the advocate be informed of the plan?
My hon. Friend raises several issues. Circumstances in which people cannot get the care that they need locally are partly due to existing provision and investment. A key purpose of the measure is to ensure investment in providing local alternatives. Of course, carers' rights to ask for an assessment of their needs, and to have that taken into consideration when the care plan for the older person is prepared, remain in place. In fact, as I suggested, the position will be improved by some of the Government amendments.
Of course, individuals' rights to raise concerns about the package put together by a social services department remain through the complaints system as well. Therefore, while I am not sure I can give my hon. Friend all the reassurance that she wants, I can reiterate that nothing in the Bill removes rights that currently exist, and in fact the Government amendments will improve the position of carers with respect to their role in discharge.
4 pm
Will the regulations covering the form and content of notices be subject to the affirmative procedure of the House or to its negative counterpart?
As I said in the letter that I wrote to members of the Committee, in all of those cases they will be subject to the negative procedure. We had quite a lengthy discussion about this matter in Committee.
I move on to Opposition amendments Nos. 2, 3, 4 and 5. Amendment No. 2 is unnecessary. It would require the NHS to inform the patient and carer of the proposed discharge date. This of course should be covered in guidance and is not something that it is necessary to state in the Bill. Throughout guidance to the NHS, since Patient and Public Involvement in the NHS, published in 1999, and including the new hospital discharge workbook, we have made it clear that that sort of information should be provided to both patients and carers. Any guidance for the Bill will make it clear that the patient is to be provided with information and advice throughout the discharge process. Amendment No. 3 seeks to place on the NHS a duty to gain a patient's consent to services being provided following discharge. Just as with any treatment provided by the NHS, a patient has the right to withhold consent to services that the NHS plans to provide when the patient leaves hospital. The Bill does not alter the existing requirement for the NHS to gain this consent when discussing with the patient his or her future care. Amendment No. 4 seeks to place on the NHS a duty to involve carers. I have covered that in the points that I have made so far. The proposals in amendment No. 5 are already standard practice, most recently emphasised in statutory guidance on the single assessment process and fair access to care services. The amendment proposes that social services must inform patients of the cost of care plans—presumably, the cost to the individual. Social services must already, in exercising their functions, give all proper information to the person so that he or she can make an informed decision as to whether or not to accept services. That includes information about the costs of any care that they will receive. That has been part of statutory guidance to councils since at least the 1991 community care changes. I have outlined where existing legislation remains to safeguard the position with respect to the consent and the rights of both patients and carers, and I have outlined how the Government action being taken today will improve the position of carers. I hope that I have provided some reassurance to hon. Members. I have also outlined the position with respect to both the hospital discharge book and the statutory guidance to be published alongside the Bill, and the emphasis that that will place on ensuring that patients and carers are fully consulted. The hon. Member for Sutton and Cheam raised specific points about continuing care that I think we covered in Committee. As to his question whether someone involved in a dispute over the right to continuing care would be able to remain in hospital, I think I gave that assurance in Committee. I would add that of course, as we have made very clear, the first decision that should be made in the assessment process is whether patients are eligible and entitled to NHS continuing care, and clearly if they are there will be no responsibility on the social services department. If patients want to dispute that, they can appeal to the continuing care panel. We are currently producing directions to strategic health authorities to outline the need to ensure that they produce continuing care criteria and that any such decision is taken very quickly, within two weeks.I want to ask the Minister two questions. First, can she confirm therefore whether there will be a charge, or fine, to the local authority during the appeal process on continuing care? Secondly, can she confirm whether the Department will follow the health service ombudsman's requirements for individual health authorities to carry out trawls to find those people who have been wrongfully denied access to free continuing care?
On the first question, the Bill makes it clear that a charge would apply only if there were no social services provision in place; therefore, if health service provision were also not in place, a fine would not exist.
A fine.
The hon. Gentleman has succeeded.
Clearly, to reinforce a point that I made earlier, people also have the right to stay in hospital while decisions about the continuing care criteria are made. On the question about health service ombudsman cases, my understanding is that those final judgments have not yet been produced. Clearly, it would be important to take those judgments into consideration as strategic health authorities determine their continuing care criteria. Government amendment No. 37 will make it clear that personal care may not be provided free for more than six weeks. As my hon. Friend the Member for Sheffield, Heeley made clear in her contribution, this is a matter of choice. As a Government, we have made a choice to spend significant new resources on improving the equality and range of care services provided to older people, providing services that deliver what most older people say that they want: independence, support in their own homes, services tailored to their needs and not to remain in hospital unnecessarily when they can be cared for elsewhere. When I suggested that this is about choice, the hon. Member for Sutton and Cheam said from a sedentary position that the Liberal Democrats have made a different choice from that of the Government, so he has a responsibility to explain to his constituents that they would not therefore benefit from what we have decided to spend the extra £1 billion on: 130,000 additional carer services, 500,000 more pieces of community equipment, 70,000 more intermediate care places, 30,000 more home care places, 6,000 more residential care places supported by councils and nearly 7,000 extra care housing places. I am afraid that government is about making choices. The Government have chosen to extend choice, opportunity and services. The Bill will ensure that that extra investment is spent for the benefit of older people, so that they receive the right care at the right time and in the right place.Having listened very carefully to what the Minister has had to say in response to this group of amendments, I wish to say briefly that it is our clear view that the Government have not addressed our main concern: the onus should be on social services departments to ensure that assessments are given to carers; they should not have to ask for them. We do not accept the Government's argument, so we wish to press the motion to a Division and, later, to vote on Government amendment No. 37.
Question put, That the clause be read a Second time:—
The House divided: Ayes 195, Noes 334.
Division No. 50]
| [4.09 pm
|
AYES
| |
| Ainsworth, Peter (E Surrey) | Davis, rh David (Haltemprice & Howden) |
| Allan, Richard | |
| Amess, David | Dodds, Nigel |
| Ancram, rh Michael | Dorrell, rh Stephen |
| Arbuthnot, rh James | Doughty, Sue |
| Atkinson, Peter (Hexham) | Duncan Smith, rh Iain |
| Bacon, Richard | Evans, Nigel |
| Barker, Gregory | Fabricant, Michael |
| Baron, John (Billericay) | Fallon, Michael |
| Barrett, John | Field, Mark (Cities of London & Westminster) |
| Beith, rh A. J. | |
| Bellingham, Henry | Flight, Howard |
| Bercow, John | Flook, Adrian |
| Blunt, Crispin | Forth, rh Eric |
| Boswell, Tim | Foster, Don (Bath) |
| Brady, Graham | Fox, Dr. Liam |
| Brake, Tom (Carshalton) | Francois, Mark |
| Brazier, Julian | Gale, Roger (N Thanet) |
| Brooke, Mrs Annette L. | Garnier, Edward |
| Browning, Mrs Angela | George, Andrew (St. Ives) |
| Bruce, Malcolm | Gibb, Nick (Bognor Regis) |
| Burnet, John | Gidley, Sandra |
| Burns, Simon | Gillan, Mrs Cheryl |
| Burnside, David | Gray, James (N Wilts) |
| Burstow, Paul | Grayling, Chris |
| Burt, Alistair | Green, Damian (Ashford) |
| Cable, Dr. Vincent | Green, Matthew (Ludlow) |
| Calton, Mrs Patsy | Grieve, Dominic |
| Cameron, David | Hague, rh William |
| Campbell, Gregory (E Lond'y) | Hammond, Philip |
| Carmichael, Alistair | Hancock, Mike |
| Cash, William | Harris, Dr. Evan (Oxford W & Abingdon) |
| Chapman, Sir Sydney (Chipping Barnet) | Harvey, Nick |
| Hawkins, Nick | |
| Chope, Christopher | Hayes, John (S Holland) |
| Clarke, rh Kenneth (Rushcliffe) | Heald, Oliver |
| Clifton-Brown, Geoffrey | Heath, David |
| Collins, Tim | Heathcoat-Amory, rh David |
| Cormack, Sir Patrick | Hendry, Charles |
| Cotter, Brian | Hermon, Lady |
| Cran, James (Beverley) | Hoban, Mark (Fareham) |
| Curry, rh David | Hogg, rh Douglas |
| Davey, Edward (Kingston) | Holmes, Paul |
| Davies, Quentin (Grantham & Stamford) | Horam, John (Orpington) |
| Howard, rh Michael | |
| Howarth, Gerald (Aldershot) | Robathan, Andrew |
| Hughes, Simon (Southwark N) | Robertson, Hugh (Faversham & M-Kent) |
| Hunter, Andrew | |
| Jack, rh Michael | Robertson, Laurence (Tewk'b'ry) |
| Jackson, Robert (Wantage) | Robinson, Mrs Iris (Strangford) |
| Jenkin, Bernard | Robinson, Peter (Belfast E) |
| Johnson, Boris (Henley) | Roe, Mrs Marion |
| Keetch, Paul | Rosindell, Andrew |
| Key, Robert (Salisbury) | Ruffley, David |
| Kirkbride, Miss Julie | Russell, Bob (Colchester) |
| Kirkwood, Sir Archy | Sanders, Adrian |
| Knight, rh Greg (E Yorkshire) | Sayeed, Jonathan |
| Laing, Mrs Eleanor | Selous, Andrew |
| Lait, Mrs Jacqui | Shephard, rh Mrs Gillian |
| Lamb, Norman | Shepherd, Richard |
| Lansley, Andrew | Simmonds, Mark |
| Laws, David (Yeovil) | Simpson, Keith (M-Norfolk) |
| Leigh, Edward | Smyth, Rev. Martin (Belfast S) |
| Letwin, rh Oliver | Soames, Nicholas |
| Lewis, Dr. Julian (New Forest E) | Spelman, Mrs Caroline |
| Liddell-Grainger, Ian | Spicer, Sir Michael |
| Lidington, David | Spink, Bob (Castle Point) |
| Llwyd, Elfyn | Spring, Richard |
| Loughton, Tim | Steen, Anthony |
| Luff, Peter (M-Worcs) | Streeter, Gary |
| McIntosh, Miss Anne | Swayne, Desmond |
| Mackay, rh Andrew | Swire, Hugo (E Devon) |
| Maclean, rh David | Syms, Robert |
| McLoughlin, Patrick | Tapsell, Sir Peter |
| Malins, Humfrey | Taylor, Ian (Esher) |
| Maples, John | Taylor, John (Solihull) |
| Marsden, Paul (Shrewsbury & Atcham) | Taylor, Matthew (Truro) |
| Taylor, Dr. Richard (Wyre F) | |
| Mates, Michael | Thomas, Simon (Ceredigion) |
| Mawhinney, rh Sir Brian | Thurso, John |
| May, Mrs Theresa | Tonge, Dr. Jenny |
| Mercer, Patrick | Tredinnick, David |
| Mitchell, Andrew (Sutton Coldfield) | Turner, Andrew (Isle of Wight) |
| Tyrie, Andrew | |
| Moore, Michael | Walter, Robert |
| Moss, Malcolm | Waterson, Nigel |
| Murrison, Dr. Andrew | Watkinson, Angela |
| Norman, Archie | Webb, Steve (Northavon) |
| Oaten, Mark (Winchester) | Whittingdale, John |
| O'Brien, Stephen (Eddisbury) | Wiggin, Bill |
| Öpik, Lembit | Wilkinson, John |
| Osborne, George (Tatton) | Willetts, David |
| Ottaway, Richard | Williams, Hywel (Caernarfon) |
| Page, Richard | Williams, Roger (Brecon) |
| Paice, James | Willis, Phil |
| Paterson, Owen | Wilshire, David |
| Pickles, Eric | Winterton, Sir Nicholas (Macclesfield) |
| Price, Adam (E Carmarthen & Dinefwr) | |
| Yeo, Tim (S Suffolk) | |
| Prisk, Mark (Hertford) | Young, rh Sir George |
| Pugh, Dr. John | |
| Redwood, rh John | Tellers for the Ayes:
|
| Reid, Alan (Argyll & Bute) | Richard Younger-Ross and
|
| Rendel, David | Mr. Andrew Stunell
|
NOES
| |
| Adams, Irene (Paisley N) | Begg, Miss Anne |
| Allen, Graham | Benn, Hilary |
| Anderson, Janet (Rossendale & Darwen) | Bennett, Andrew |
| Benton, Joe (Bootle) | |
| Armstrong, rh Ms Hilary | Best, Harold |
| Atherton, Ms Candy | Betts, Clive |
| Atkins, Charlotte | Blackman, Liz |
| Austin, John | Blears, Ms Hazel |
| Bailey, Adrian | Blizzard, Bob |
| Baird, Vera | Boateng, rh Paul |
| Banks, Tony | Borrow, David |
| Barnes, Harry | Bradley, rh Keith (Withington) |
| Barron, rh Kevin | Bradley, Peter (The Wrekin) |
| Beard, Nigel | Bradshaw, Ben |
| Beckett, rh Margaret | Brennan, Kevin |
| Brown, Russell (Dumfries) | Foster, Michael Jabez (Hastings & Rye) |
| Bryant, Chris | |
| Buck, Ms Karen | Foulkes, rh George |
| Burgon, Colin | Francis, Dr. Hywel |
| Burnham, Andy | Gapes, Mike (Illford S) |
| Cairns, David | Gardiner, Barry |
| Campbell, Alan (Tynemouth) | George, rh Bruce (Walsall S) |
| Campbell, Mrs Anne (C'bridge) | Gerrard, Neil |
| Campbell, Ronnie (Blyth V) | Gibson, Dr. Ian |
| Caplin, Ivor | Gilroy, Linda |
| Casale, Roger | Godsiff, Roger |
| Caton, Martin | Goggins, Paul |
| Cawsey, Ian (Brigg) | Griffiths, Jane (Reading E) |
| Challen, Colin | Griffiths, Win (Bridgend) |
| Clapham, Michael | Grogan, John |
| Clark, Mrs Helen (Peterborough) | Hain, rh Peter |
| Clark, Paul (Gillingham) | Hall, Mike (Weaver Vale) |
| Clarke, rh Tom (Coatbridge & Chryston) | Hall, Patrick (Bedford) |
| Hamilton, David (Midlothian) | |
| Clelland, David | Hanson, David |
| Clwyd, Ann (Cynon V) | Harman, rh Ms Harriet |
| Coaker, Vernon | Harris, Tom (Glasgow Cathcart) |
| Coffey, Ms Ann | Healey, John |
| Cohen, Harry | Henderson, Doug (Newcastle N) |
| Coleman, Iain | Henderson, Ivan (Harwich) |
| Connarty, Michael | Hendrick, Mark |
| Cook, rh Robin (Livingston) | Hepburn, Stephen |
| Cooper, Yvette | Heppell, John |
| Corbyn, Jeremy | Hesford, Stephen |
| Corston, Jean | Hewitt, rh Ms Patricia |
| Cousins, Jim | Hill, Keith (Streatham) |
| Cox, Tom (Tooting) | Hodge, Margaret |
| Cranston, hon. Ross | Hoey, Kate (Vauxhall) |
| Hood, Jimmy (Clydesdale) | |
| Crausby, David | Hoon, rh Geoffrey |
| Cruddas, Jon | Hope, Phil (Corby) |
| Cryer, Ann (Keighley) | Hopkins, Kelvin |
| Cryer, John (Hornchurch) | Howarth, rh Alan (Newport E) |
| Cummings, John | Howarth, George (Knowsley N & Sefton E) |
| Cunningham, Jim (Coventry S) | |
| Cunningham, Tony (Workington) | Hughes, Kevin (Doncaster N) |
| Darling, rh Alistair | Humble, Mrs Joan |
| Davey, Valerie (Bristol W) | Hutton, rh John |
| David, Wayne | Iddon, Dr. Brian |
| Davidson, Ian | Ingram, rh Adam |
| Davies, Geraint (Croydon C) | Irranca-Davies, Huw |
| Dawson, Hilton | Jackson, Glenda (Hampstead & Highgate) |
| Dean, Mrs Janet | |
| Denham, rh John | Jackson, Helen (Hillsborough) |
| Dhanda, Parmjit | Jamieson, David |
| Dismore, Andrew | Jenkins, Brian |
| Dobbin, Jim (Heywood) | Johnson, Miss Melanie (Welwyn Hatfield) |
| Dobson, rh Frank | |
| Donohoe, Brian H. | Jones, Helen (Warrington N) |
| Doran, Frank | Jones, Jon Owen (Cardiff C) |
| Dowd, Jim (Lewisham W) | Jones, Kevan (N Durham) |
| Drew, David (Stroud) | Jones, Lynne (Selly Oak) |
| Drown, Ms Julia | Jones, Martyn (Clwyd S) |
| Dunwoody, Mrs Gwyneth | Joyce, Eric (Falkirk W) |
| Eagle, Angela (Wallasey) | Kaufman, rh Gerald |
| Eagle, Maria (L'pool Garston) | Keeble, Ms Sally |
| Edwards, Huw | Keen, Alan (Feltham) |
| Efford, Clive | Keen, Ann (Brentford) |
| Ellman, Mrs Louise | Kelly, Ruth (Bolton W) |
| Ennis, Jeff (Barnsley E) | Kidney, David |
| Etherington, Bill | Kilfoyle, Peter |
| Farrelly, Paul | King, Andy (Rugby) |
| Field, rh Frank (Birkenhead) | King, Ms Oona (Bethnal Green & Bow) |
| Fisher, Mark | |
| Fitzpatrick, Jim | Knight, Jim (S Dorset) |
| Fitzsimons, Mrs Lorna | Ladyman, Dr. Stephen |
| Flint, Caroline | Lammy, David |
| Flynn, Paul (Newport W) | Laxton, Bob (Derby N) |
| Follett, Barbara | Lazarowicz, Mark |
| Foster, rh Derek | Lepper, David |
| Foster, Michael (Worcester) | Leslie, Christopher |
| Levitt, Tom (High Peak) | Purnell, James |
| Lewis, Ivan (Bury S) | Quin, rh Joyce |
| Lewis, Terry (Worsley) | Quinn, Lawrie |
| Liddell, rh Mrs Helen | Rapson, Syd (Portsmouth N) |
| Linton, Martin | Raynsford, rh Nick |
| Lloyd, Tony (Manchester C) | Reed, Andy (Loughborough) |
| Love, Andrew | Reid, rh Dr. John (Hamilton N & Bellshill) |
| Lucas, Ian (Wrexham) | |
| Luke, Iain (Dundee E) | Robinson, Geoffrey (Coventry NW) |
| Lyons, John (Strathkelvin) | |
| McAvoy, Thomas | Rooney, Terry |
| McCabe, Stephen | Ross, Ernie (Dundee W) |
| McCafferty, Chris | Roy, Frank (Motherwell) |
| McCartney, rh Ian | Ruane, Chris |
| McDonagh, Siobhain | Ruddock, Joan |
| MacDonald, Calum | Russell, Ms Christine (City of Chester) |
| MacDougall, John | |
| McFall, John | Ryan, Joan (Enfield N) |
| McGuire, Mrs Anne | Salter, Martin |
| McIsaac, Shona | Savidge, Malcolm |
| McKechin, Ann | Sawford, Phil |
| McKenna, Rosemary | Sedgemore, Brian |
| McNamara, Kevin | Shaw, Jonathan |
| McNulty, Tony | Sheerman, Barry |
| MacShane, Denis | Sheridan, Jim |
| Mactaggart, Fiona | Shipley, Ms Debra |
| McWalter, Tony | Simon, Siôn (B'ham Erdington) |
| Mahmood, Khalid | Singh, Marsha |
| Mahon, Mrs Alice | Skinner, Dennis |
| Mallaber, Judy | Smith, Angela (Basildon) |
| Mann, John (Bassetlaw) | Smith, rh Chris (Islington S & Finsbury) |
| Marris, Rob (Wolverh'ton SW) | |
| Marsden, Gordon (Blackpool S) | Smith, Geraldine (Morecambe & Lunesdale) |
| Marshall, David (Glasgow Shettleston) | |
| Smith, Jacqui (Redditch) | |
| Marshall, Jim (Leicester S) | Smith, John (Glamorgan) |
| Martlew, Eric | Smith, Llew (Blaenau Gwent) |
| Meacher, rh Michael | Soley, Clive |
| Meale, Alan (Mansfield) | Southworth, Helen |
| Merron, Gillian | Spellar, rh John |
| Milburn, rh Alan | Squire, Rachel |
| Miller, Andrew | Starkey, Dr. Phyllis |
| Mitchell, Austin (Gt Grimsby) | Steinberg, Gerry |
| Moffatt, Laura | Stevenson, George |
| Mole, Chris | Stewart, David (Inverness E & Lochaber) |
| Moonie, Dr. Lewis | |
| Moran, Margaret | Stewart, Ian (Eccles) |
| Morgan, Julie | Stinchcombe, Paul |
| Morley, Elliot | Stoate, Dr. Howard |
| Mountford, Kali | Strang, rh Dr. Gavin |
| Mudie, George | Straw, rh Jack |
| Mullin, Chris | Stringer, Graham |
| Munn, Ms Meg | Stuart, Ms Gisela |
| Murphy, Denis (Wansbeck) | Sutcliffe, Gerry |
| Murphy, Jim (Eastwood) | Tami, Mark (Alyn) |
| Naysmith, Dr. Doug | Taylor, rh Ann (Dewsbury) |
| Norris, Dan (Wansdyke) | Taylor, Dari (Stockton S) |
| O'Brien, Bill (Normanton) | Taylor, David (NW Leics) |
| O'Brien, Mike (N Warks) | Thomas, Gareth (Clwyd W) |
| O'Hara, Edward | Thomas, Gareth (Harrow W) |
| Organ, Diana | Timms, Stephen |
| Osborne, Sandra (Ayr) | Tipping, Paddy |
| Owen, Albert | Todd, Mark (S Derbyshire) |
| Picking, Anne | Touhig, Don (Islwyn) |
| Pickthall, Colin | Trickett, Jon |
| Pike, Peter (Burnley) | Truswell, Paul |
| Plaskitt, James | Turner, Dennis (Wolverh'ton SE) |
| Pollard, Kerry | Turner, Dr. Desmond (Brighton Kemptown) |
| Pond, Chris (Gravesham) | |
| Prentice, Ms Bridget (Lewisham E) | Turner, Neil (Wigan) |
| Twigg, Derek (Halton) | |
| Prentice, Gordon (Pendle) | Twigg, Stephen (Enfield) |
| Prescott, rh John | Tynan, Bill (Hamilton S) |
| Primarolo, rh Dawn | Vaz, Keith (Leicester E) |
| Prosser, Gwyn | Vis, Dr. Rudi |
| Purchase, Ken | Walley, Ms Joan |
| Ward, Claire | Woolas, Phil |
| Wareing, Robert N. | Worthington, Tony |
| Watts, David | Wright, Anthony D. (Gt Yarmouth) |
| White, Brian | |
| Whitehead, Dr. Alan | Wright, David (Telford) |
| Wicks, Malcolm | Wright, Tony (Cannock) |
| Williams, rh Alan (Swansea W) | Wyatt, Derek |
| Williams, Betty (Conwy) | |
| Winnick, David | Tellers for the Noes:
|
| Wood, Mike (Batley) | Mr. Nick Ainger and
|
| Woodward, Shaun | Mr. Fraser Kemp
|
Question accordingly negatived.
New Clause 5
Action Plans And Joint Local Protocols
'.—(1) The responsible NHS body and responsible authority are required to agree the following as regards the discharge of qualifying hospital patients as defined in section 1 of this Act—
(2) An action plan under subsection (1) above is a document drawn up by the relevant bodies specifying action intended to reduce delayed discharges, and to change procedures and arrangements which may cause or contribute to the failure to comply with duties under section 3.
(3) Joint local protocols will include named persons responsible for coordinating all stages of the patient journey up to and beyond discharge, and ensuring that all necessary arrangements are put in place at the right time.
(4) Local protocols may include joint agreement on how payments made under section 4 are used to encourage a whole system approach to services for older people, and to ensure that all stakeholders are involved in deciding how the payments are spent.'.—[Mrs. Calton.]
Brought up, and read the First time.
I beg to move, That the clause be read a Second time.
With this it will be convenient to discuss the following: new clause 6— Written discharge plan—
'.—(1) Further to the fulfilment of the requirements under section 3(3)(a) and (b) a written discharge plan shall be produced and taken to include—
Government amendment No. 26. Amendment No. 42, in page 2, line 19, at end insert—(2) Regulations may prescribe the form of a written discharge plan.'.
Government amendment No. 31. Amendment No. 43, in page 3, line 11, at end insert—''(1a) The form of a written discharge plan.'.
(2a) The form of a written discharge plan.'.
New clause 5 is intended to enhance joint working. The thrust of the Bill has been to disturb absolutely everyone who has anything to do with this area of work. All the organisations have expressed the view that the Minister's planning measures will worsen joint working arrangements. We want joint action plans, joint protocols between social services and other agencies, joint targets and joint administration arrangements. The new clause would ensure that there would be a named person to co-ordinate the patient journey, and that joint planning would take place on how fines or payments were used to encourage a whole-system approach.
Subsection (2) of the new clause states:Let me ask the Minister a question to which I have still not had a reply so far, although it was asked in Committee. Has the Secretary of State or the Minister assessed the success of plans that had to be submitted by social services departments last August to reduce delayed discharges? A special grant report was produced in July 2002, and we heard then that money was being made available. We still do not know whether the plans made then have benefited the situation. We believe that the Bill is premature, given that measures introduced only in this financial year remain to be properly assessed. New clause 6 would require the preparation of a written discharge plan that would include an assessment of community needs, arrangements for after care, and carers. I listened to what the Minister said earlier, and have been somewhat reassured, so I shall not rehearse all the points raised by carers organisations and Age Concern. However, those organisations have been in touch with all hon. Members and have made it clear that they are unhappy with what is being proposed. Government amendment No. 26 deals with the bodies that appear to the NHS to be the ones to which notice is supposed to be given. We are concerned that all decisions will rest, arbitrarily, with the NHS. Because the amendment allows for no give and take, the process will be all one way. Amendments Nos. 42 and 43 are consequential on new clauses 5 and 6. Government amendment No. 31 would require consultation to ensure safe discharge, but does not say when the consultation should take place. Would it be before the section 2 notice is served, or after? I look forward to the Minister's responses to the questions that I have raised."An action plan under subsection (1) above is a document drawn up by the relevant bodies specifying action intended to reduce delayed discharges".
One of the main problems that Opposition Members have with the Bill is that we believe that the imposition of fines would have a damaging impact. I am glad that the Minister has come to accept that the word "fines" properly defines what the Government propose. The Secretary of State used the word "fines" in the House on 11 December so perhaps, after that slap on the wrist, the Minister decided that she would have to swallow her pride and accept that fines are what the Bill is all about.
The Opposition have always argued that the introduction of fines would disrupt and have an adverse impact on the discharge process, and that it would seriously damage the partnerships built up over the past decade or 15 years, when the NHS and social service departments have worked more closely together. That closer working has been a genuine and positive step forward, and has helped to create a seamless service that will be undermined and adversely affected by the fining proposals in the Bill. I appreciate the motives behind new clauses 5 and 6. They are meant to protect and encourage joint working, but they are far too bureaucratic and costly to warrant inclusion on the face of the Bill. For that reason, I believe that more work needs to be done. I support the broad aims and aspirations of the new clauses, but the clauses themselves are the wrong vehicles, for the reasons that I have given. So I warn the Government that we will certainly want to look at the issue in another place and try to come up with proposals that will advance and enhance joint working, but not in such a bureaucratic and costly way. For that reason, I fear that I shall not be able to support the new clauses.4.30 pm
That was a pretty short-lived consensus between the Opposition parties.
I agree with the analysis by the hon. Member for West Chelmsford of new clause 5 in particular. It is designed to impose another layer of bureaucracy on the NHS and social services; it is a planner's charter. The sum total of the Liberal Democrat approach to the matter is to come up with the idea that producing a few more plans would somehow help us to ensure that older people received the care that they deserve. I do not believe that that will do the trick, and it is of course just what staff on the front line do not want. We in the Department have worked hard to reduce and streamline the planning requirements on the NHS and social services. We have been removing the requirement for social services to submit plans to central Government as part of grant conditions or other monitoring, so that the number of plans submitted will reduce from 13 to two between 2001–02 and 2002–03. A new gateway procedure was introduced in December to reduce the planning burden on the NHS and ensure that the focus is on core priorities. The hon. Member for Cheadle asked what assessment we have made of the plans. My definition of success is the difference that we have made to the people who depend on the service. For that reason, the fact that we have been successful in reducing the number of delayed discharges of patients of all ages from 7,065 in September 2001 to 5,385 in September 2002 is much more important than whether somebody has produced an elegant plan.I am somewhat surprised to hear that the Minister does not think that plans are such a good idea, given that they were precisely what social services departments were asked to produce last July. I agree that the proof of the pudding is in the eating. I suspect that September 2002 was too soon to make a judgment, but I shall leave that to her.
The hon. Lady has reinforced her position as planning supremo for the Liberal Democrat party.
Suggesting that we can solve the problem with planning is very much at odds with the approach that we are trying to take. In "Delivering the NHS Plan", for example, we pointed out that, although ring-fenced grants—the £300 million—and close central monitoring had brought about a significant drop in the number of delays, such top-down targeting was not sustainable. It does not fit with the new approach in the NHS and local government of devolving responsibility and earning autonomy through good performance. The publication in October of the priorities and planning framework for the NHS and social services set clear priorities for the next three years so that local partnerships can plan with confidence.Has the Minister withdrawn the guidance, "Reflecting the True Patient Experience", issued by the Department in 2001, which did require NHS chief executives and directors of social services to draw up joint protocols around discharge, to minimise waiting times and so on? Given that that requirement was part of the guidance then, what was wrong with that? Why have the Government withdrawn it? Have they withdrawn it?
I do not think that I am wrong when I say that we have not withdrawn that. If the hon. Gentleman is saying that at a local level it is a good idea for partners to work together and develop protocols, I have no argument with that. I do have an argument with the Liberal Democrat approach, which appears to consist of opposing what the Government propose in the Bill and supposing that we shall solve the problem merely by asking for a few more plans and protocols. I identify that as a weakness of new clause 5.
The hon. Members for West Chelmsford and for Cheadle both mentioned partnership between health and social care. I agree that partnership is an essential element in delivering the right care for an individual. At the moment, delays can occur because health and social care partners have not communicated very well or because they are unclear or are arguing about responsibility, or even because one is trying to shift costs to the other. The Bill gives areas where partnership is not very well developed the incentive to get all these things right, and to ensure that locally the partnership is totally clear about procedures—who is responsible for which actions. Much has been said about the Bill damaging partnership, as though partnership was an aim in itself. In fact, the Bill will strengthen partnerships, and strengthen them in order to deliver results. Strong partnerships are based on shared priorities, clearly agreed roles and responsibilities, and a joint commitment to progress, all of which the Bill will strengthen. However, we do notwant partnerships for partnership's sake; we do not want partnerships simply to be able to produce a plan. The real test of the partnership is: what is it delivering? Have local people noticed the difference in the services that they receive? The proof of partnership is in delivery, not in planning. For that reason we have made older people's services a core priority, not by increasing the planning burden but by making this area one of the priority areas for investment and reform. Over the next three years there will be £1 billion of new resources for older people's social care services and for the reform to the system that the Bill will enable us to bring about with respect to delayed discharge. I address the following point to the hon. Member for Sutton and Cheam (Mr. Burstow). If people locally want to make further detailed local arrangements, that is up to them, but we are introducing the reimbursement system and the new resources because a system of incentives backed up with resources should be more effective than a further raft of plans and protocols. We need to take a proactive approach; the Bill enables us to do so. New clause 5 should be opposed, because it does not fit the need to make a difference or the new approach to devolving responsibility and developing earned autonomy. New clause 6 would place a further requirement on social services to produce a written discharge plan that must take into account two assessments, once the NHS has notified them of likely patient need for community care services. I suspect unintentionally, the new clause is so drafted that failure by social services to meet those new duties would also act as a trigger to the reimbursement charge if a patient was delayed. I do not believe that we want to create that additional trigger for the charge. The biggest problem with the amendment is that it is unnecessary. In the first instance, written records of the results of assessments are already standard practice as part of carrying out an assessment under section 47 of the National Health Service and Community Care Act 1990. Clause 3(9) of the Bill already provides that assessments undertaken by social services in receipt of a section 2 notice must be regarded as part of a section 47 assessment, and the section 47 duties still apply. So we expect people to get a written plan outlining what needs to be in place for them to have a safe discharge. The requirement to include a carer's assessment in the written discharge plan is also not necessary. It is already the case that carers are entitled to request assessment of their ability to provide care, and existing good practice already directs that carers will be fully consulted in the patient's assessment process. I was a little disappointed by the reason given by the hon. Member for Sutton and Cheam for pushing new clause 3 to the vote. I think that I said specifically that statutory guidance issued around the Carers and Disabled Children Act 2000 had pointed out to local authorities their responsibility to inform individual carers of their right to request an assessment. Local authorities are already required to take account of the results of such an assessment of the carer when deciding what community care services they will provide to the patient. The provisions of new clause 6 are already covered by current arrangements and new clause 5 would do nothing more than introduce planning requirements with little emphasis on what those would achieve, so I hope that the hon. Member for Cheadle will feel able to withdraw the new clause. If not, I hope that hon. Members will vote against it.I thank the Minister for tackling some of the issues that I mentioned. Perhaps this was just an omission, but I am concerned that she did not mention our proposal that a named person should co-ordinate the patient journey. The Government have said that they would be in favour of that in other respects and it would be useful if it were a part of the Bill.
I am also concerned that the opportunity to provide for joint planning on how to use payments or fines to encourage a whole-system approach has also been missed. I accept what the Minister says about the preparation of a written discharge plan and I am pleased if that is already expected. Clearly, we think that it is important. On the assessment for carers, I agree that carers can already request a separate assessment, but all too often that does not happen and the Minister should have some regard to the question of ensuring that it does. It is clear from reading all the evidence from carers that they are not being consulted and assessed every step of the way as they should be. The Minister said that the Bill would strengthen partnership. In one respect, I think I can agree that it may do so in the sense that it provides a common enemy. Sometimes, a common enemy in the form of the Government may well be what is needed to bring organisations together when they are warring with each other.Will the hon. Lady give way on that matter?
I have almost finished. That remark was made with tongue in cheek; I hardly think it needs to be taken too seriously.
We would have liked to press the new clause to a vote, but, with your permission, Mr. Deputy Speaker, we will withdraw it, as we understand that time is limited this afternoon and we expect our arguments to be revisited in the other place. I beg to ask leave to withdraw the motion.Motion and clause, by leave, withdrawn.Government amendments Nos. 26 to 34 agreed toClause 4
Liability To Make Delayed Discharge Payments
I beg to move amendment No. 7, in page 4, line 30, at end insert—
'(10) The amount prescribed under subsection (4) shall not exceed—
With this it will be convenient to discuss amendment No. 8, in page 4, line 30 [Clause 4], at end insert—
'(10) The amount prescribed under subsection (4) shall not exceed—
4.45 pm
I want to make it clear at the outset that although I will speak to both amendments in the group, I will press only amendment No. 8 to a Division. Before the Minister has fun at my expense, let me make it clear that the reason why both were tabled is, first, that I do not have the advantage of having the Government's lawyers and draftsmen at my disposal and, secondly, that those in opposition never know in advance which amendments will be selected. To be frank, I thought that even though amendment No. 8 is far more important and relevant to local authorities throughout the country, it would be pushing my luck to presume that it would be selected. You cannot imagine my unbridled joy, Mr. Deputy Speaker, when I noticed yesterday evening that it had been selected.
The nub of the Conservatives' opposition to this nasty and unnecessary Bill is the concept that the Government are introducing fines on local authorities—fines that are across the board in their application, regardless of whether there is any justification for them. As we said in Committee, circumstances will quite frequently arise in which for various reasons it will not be a local authority's fault that a person does not leave a hospital bed and go to either domiciliary or residential care, whichever is the most appropriate, yet the Government are to impose fines of, we understand, £120 per day for those living in London and the south-east, and £100 for those living elsewhere. We believe that that is wholly the wrong way to try to overcome the problem of bed blocking. Like many outside the House, we believe that the Bill will set the national health service against social services and vice versa, and undo the great strides forward accomplished in the past decade or so in terms of those agencies working together to provide a seamless service for patients. Regardless of the announcement made by the Secretary of State on 11 December of extra money for three years, we believe that the legislation will result in local authorities being penalised financially. Anyone who asks social services departments in England for their estimate of the potential cost to them of the fines will be given a figure that far exceeds the £100 million that the Government are making available. The departments' estimate also far exceeds the results of the calculations done on the back of an envelope by the hon. Member for Sutton and Cheam (Mr. Burstow), who is no longer in his place. All of us who know the Liberal Democrats know that they never let a fact get in the way of a "Focus" or a press release, especially if that press release can be got into a national newspaper by conning some journalist who does not want to do the research himself—after all, the Liberal Democrats, with their clipboards and their anoraks, are the font of all accuracy in surveys and calculations of a mathematical nature.There is a man who has been scarred.
Too right, I have been scarred. I have had to deal with that party for 10 years. Fortunately, the people of West Chelmsford saw through the Liberal Democrats long ago. From getting within 378 votes of capturing Chelmsford in 1983—I might add that that was before I was the candidate—they are now a very poor third behind Labour. The clipboard experience has disappeared from our streets.
I can only think that a figure like 25 per cent. is making a difference. Would the hon. Gentleman like the Liberal Democrats' support for the amendment? I think that it would be useful and perhaps entertaining for us to know.
I shall answer the hon. Lady in two ways. First, on the mathematics, the hon. Lady has proved my point, although I may be arguing unwisely in a way, given that Liberal Democrats can never get any mathematical calculation right. The hon. Lady said 25 per cent. The Government say 20 per cent. I think that the hon. Lady meant 20 per cent. rather than 25 per cent.
Secondly, the hon. Lady asks whether the Conservatives want the hon. Lady's support on the amendment. The Conservative party, for reasons that I am outlining, has produced a first-rate amendment to minimise the damage that the Government can do to social service departments with their fines. I would advise not only Liberal Democrat Members but Members of any Opposition party—and any Labour Member who has listened carefully to their social services department, although given those Members who are in their places, I suspect that they have not—to join us in seeking to help social service departments and other organisations throughout the country so as to ensure that we minimise the damage that the Bill would do to social service departments.The hon. Gentleman may recall that on Second Reading I produced the figures for Doncaster, which has been working really well on this issue and has an extremely good record. These matters start at the front end, not the back end. Instead of trawling round social service departments looking for negatives, the hon. Gentleman might be better trawling round looking for positives, and asking what will be done to ensure that our constituents receive the treatment that they deserve in hospitals and get out when they no longer need medical treatment.
If the hon. Gentleman were correct in his assumption, his point would be valid, but I can assure him that I did not trawl social services departments for bad news stories. Instead, and at random, I telephoned social services department after social services department. Amazingly—or not amazingly, given the damage that the Bill will do—they all had the same complaint, which was that there would be a problem with fines to some degree.
As for the hon. Gentleman's second point, he is absolutely right. We all want a system whereby people do not have to remain in hospital for a day longer than they otherwise should. Unfortunately and regrettably, owing to a number of circumstances including the crisis in long-term care the closure of more than 60,000 beds and of 2,000 homes since 1997 and the fact that in certain areas there are not enough beds available—there are bound to be some delayed discharge cases. None of us wants that. Of course social services departments and the national health service have been seeking to minimise delayed discharges for a considerable time. However, factors beyond their control have thwarted them in achieving anywhere near a 100 per cent. success rate in eliminating the problem. I am saying, as my party is saying—Will the hon. Gentleman give way?
No.
We want to come up with positive and sensible ideas to seek to overcome the problem. We do not believe that the best way to achieve that is through fines. That is why to my mind amendment No. 8 is the most attractive alternative within the scope of the Bill. We believe that it will deal with the problem. Bringing down to a more or less nominal level the fines that the Minister is seeking to introduce and including that figure in the Bill would prevent the Chancellor from using the proposals as a new form of stealth tax. Without primary legislation, he could not seek to increase the level annually, or whenever the Government wanted to raise more money.rose—
Will the hon. Gentleman give way?
I am sorry, but I cannot.
It is for those reasons that I hope that my right hon. and hon. Friends will join me in the Division Lobby. I further hope that any other hon. Members who care about coming up with positive solutions to the long-term care crisis, and who have said consistently on the Floor of the House and in Committee that they oppose the fining system, will join us in seeking to thwart the Government's intentions.I shall be very brief. The Liberal Democrats will support the amendment, but in spite of, rather than because of, the arguments advanced by the hon. Member for West Chelmsford (Mr. Burns). I should correct him on one point—I realise that I did not make myself clear: the figure of 25 per cent. referred to the opinion polls, rather than to whatever it was that he thought it referred to.
I was glad to see some of the Opposition harmony return at the end of the debate. The hon. Member for West Chelmsford (Mr. Burns) was a little unfair. After talking about Liberal Democrat clipboards and anoraks—amusing though that was—he proceeded to talk about his own survey. I do not know whether he used a clipboard; it is more likely that he got someone else to carry out the survey, and perhaps they used a clipboard.
Perhaps I can help the Minister. No, I did not use a clipboard, because I try to distance myself from the Liberal Democrats as much as possible. Directors of social services were telephoned in their offices, and they provided the information. I put it on a piece of paper and added it up, and I got a total. [Interruption.]
As has just been pointed out, I am sure that the hon. Gentleman would never be seen wearing an anorak, either.
The Bill seeks to provide an incentive for local authorities to supply prompt onward care for patients who are ready to leave hospital by introducing a charge that broadly reflects the cost to the hospital of providing a bed for a delayed patient. We had some lengthy discussions in Committee about the justifiable basis for expecting that, where the responsibility rests with social services departments to provide for a person's needs—usually, it is an older person—it is not unreasonable to expect them to take responsibility for payment as well, given that they will receive the necessary funding from the Government. The alternative is a system that is effectively a fine on the NHS, because the NHS is expected to pay the costs of people whose needs would be better served out of hospital, but who remain in hospital because alternatives are not available in the community. Anybody who opposes that principle must answer the question of whether it is justifiable for the NHS to bear costs for which it has neither legal nor practical responsibility. Nor, indeed, is it best suited to provide that particular form of care.Let us accept for one moment the principle that the Minister has just enunciated. Why does it not work the other way around? When the NHS imposes costs on social services, why does it not pay them?
5 pm
I would be interested to know what examples the right hon. Gentleman has in mind. We explored in detail in Committee the principles of some of the financial incentives that are being introduced into the NHS. I made the point that it is possible to introduce financial incentives through the sort of financial flows work that we will be introducing into the NHS, some of which I spelt out earlier, without legislation. However, the interface between social services and health is such that we need to legislate in order to introduce financial incentives in that context.
I return to my original question, which has not been satisfactorily answered by anybody who opposes the legislation. The incentive is that the daily charge that we propose is higher than the daily costs that the local authority would otherwise incur in providing either residential or domiciliary care for the person in question. I hope that hon. Members will understand that there are very good reasons why the Bill makes no mention of the actual reimbursement charge. We have chosen to set out the charge in regulations rather than in the Bill, as that will give us greater flexibility to amend the rates in line with inflation or other cost pressures. The hon. Member for West Chelmsford was either on a flight of fancy or lacks understanding about the nature of the charge, which is a transfer from one part of the public system to another reflecting the costs that have been borne. It is not raising money for the Government, but focusing the attention of social services departments on areas in which they already have responsibility and ensuring that they spend the extra investment that the Government are making available to them on the sort of alternatives that older people want to enable them to get out of hospital more quickly. In the letter that I sent to members of the Standing Committee about the regulations, I spelt out that the charge will be based on the cost to the NHS of providing bed, board and personal care in an acute environment, but having removed indirect overheads and the cost of capital medical input and specialist nursing in order to reflect the lower costs of caring for a patient at the end of a hospital stay when medical needs have been reduced. In most cases, the figure will also represent a higher charge to the local authority than the daily costs of providing community care in a residential setting or in the person's home. Our intention is to remove what sometimes operates as perverse incentive in the system, enabling local authorities not to live up to their responsibilities, with the NHS bearing the costs of people's care because the necessary alternatives are not in place. In our consultation, we asked whether a charge of 100 a day and £.120 in London and the south-east would be appropriate. Responses suggested that that seemed about the right amount to create the incentive that we want. We will issue the regulations for consultation and consider any further responses about the amount of the charge and the boundary for the higher rate. The hon. Member for West Chelmsford made clear what the amendments are about. They are not a serious attempt to consider the incentive effect or the appropriate level for the charges that will justifiably be put in place. They are simply wrecking amendments that continue for the Opposition the approach on which I commented during the debate on the previous group of amendments but one. Opposition Members are keen to oppose our proposals, but have no ideas about how we can cut delayed discharge. I am afraid that they are therefore letting down the older people who depend on all of us to provide a better system to ensure that they get the right care in the right place.I listened carefully to the Minister, and it will come as no surprise to the House that I was not convinced by her arguments. Moreover, her comments towards the end of her speech were absolute and unadulterated rubbish. Therefore, I beg to ask leave to withdraw the amendment and I ask my right hon. and hon. Friends to join me in the Lobby in support of amendment No. 8.
Amendment, by leave, withdrawn.Amendment proposed: No. 8, in page 4, line 30, at end insert—'(10) The amount prescribed under subsection (4) shall not exceed—
Question put, That the amendment be made:—
The House divided: Ayes 188, Noes 317.
Division No. 51]
| [5:05 pm
|
AYES
| |
| Ainsworth, Peter (E Surrey) | Gale, Roger (N Thanet) |
| Allan, Richard | Garnier, Edward |
| Amess, David | George, Andrew (St. Ives) |
| Arbuthnot, rh James | Gibb, Nick (Bognor Regis) |
| Atkinson, Peter (Hexham) | Gidley, Sandra |
| Bacon, Richard | Gillan, Mrs Cheryl |
| Baker, Norman | Gray, James (N Wilts) |
| Barker, Gregory | Grayling, Chris |
| Baron, John (Billericay) | Green, Damian (Ashford) |
| Barrett, John | Green, Matthew (Ludlow) |
| Beggs, Roy (E Antrim) | Grieve, Dominic |
| Beith, rh A. J. | Gummer, rh John |
| Bellingham, Henry | Hammond, Philip |
| Bercow, John | Hancock, Mike |
| Blunt, Crispin | Harris, Dr. Evan (Oxford W & Abingdon) |
| Boswell, Tim | |
| Brady, Graham | Harvey, Nick |
| Brake, Tom (Carshalton) | Hawkins, Nick |
| Brazier, Julian | Hayes, John (S Holland) |
| Brooke, Mrs Annette L. | Heald, Oliver |
| Browning, Mrs Angela | Heath, David |
| Bruce, Malcolm | Heathcoat-Amory, rh David |
| Burns, Simon | Hendry, Charles |
| Burnside, David | Hoban, Mark (Fareham) |
| Burstow, Paul | Hogg, rh Douglas |
| Burt, Alistair | Horam, John (Orpington) |
| Cable, Dr. Vincent | Howard, rh Michael |
| Calton, Mrs Patsy | Howarth, Gerald (Aldershot) |
| Cameron, David | Hunter, Andrew |
| Campbell, Gregory (E Lond'y) | Jack, rh Michael |
| Carmichael, Alistair | Jackson, Robert (Wantage) |
| Cash, William | Jenkin, Bernard |
| Chapman, Sir Sydney (Chipping Barnet) | Johnson, Boris (Henley) |
| Keetch, Paul | |
| Chope, Christopher | Key, Robert (Salisbury) |
| Clarke, rh Kenneth (Rushcliffe) | Kirkbride, Miss Julie |
| Clifton-Brown, Geoffrey | Kirkwood, Sir Archy |
| Collins, Tim | Knight, rh Greg (E Yorkshire) |
| Cormack, Sir Patrick | Laing, Mrs Eleanor |
| Cotter, Brian | Lait, Mrs Jacqui |
| Cran, James (Beverley) | Lamb, Norman |
| Curry, rh David | Lansley, Andrew |
| Davey, Edward (Kingston) | Laws, David (Yeovil) |
| Davies, Quentin (Grantham & Stamford) | Leigh, Edward |
| Lewis, Dr. Julian (New Forest E) | |
| Dodds, Nigel | Lidington, David |
| Dorrell, rh Stephen | Lilley, rh Peter |
| Doughty, Sue | Llwyd, Elfyn |
| Evans, Nigel | Loughton, Tim |
| Fabricant, Michael | Luff, Peter (M-Worcs) |
| Fallon, Michael | McIntosh, Miss Anne |
| Field, Mark (Cities of London & Westminster) | Mackay, rh Andrew |
| Maclean, rh David | |
| Flight, Howard | McLoughlin, Patrick |
| Flook, Adrian | Malins, Humfrey |
| Forth, rh Eric | Maples, John |
| Foster, Don (Bath) | Mates, Michael |
| Fox, Dr. Liam | Mawhinney, rh Sir Brian |
| May, Mrs Theresa | Spelman, Mrs Caroline |
| Mercer, Patrick | Spicer, Sir Michael |
| Moore, Michael | Spink, Bob (Castle Point) |
| Moss, Malcolm | Spring, Richard |
| Murrison, Dr. Andrew | Steen, Anthony |
| Norman, Archie | Streeter, Gary |
| Oaten, Mark (Winchester) | Stunell, Andrew |
| O'Brien, Stephen (Eddisbury) | Swayne, Desmond |
| Öpik, Lembit | Swire, Hugo (E Devon) |
| Osborne, George (Tatton) | Syms, Robert |
| Ottaway, Richard | Tapsell, Sir Peter |
| Page, Richard | Taylor, Ian (Esher) |
| Paice, James | Taylor, John (Solihull) |
| Paterson, Owen | Taylor, Matthew (Truro) |
| Pickles, Eric | Thomas, Simon (Ceredigion) |
| Price, Adam (E Carmarthen & Dinefwr) | Thurso, John |
| Tonge, Dr. Jenny | |
| Prisk, Mark (Hertford) | Tredinnick, David |
| Pugh, Dr. John | Turner, Andrew (Isle of Wight) |
| Redwood, rh John | Tyler, Paul (N Cornwall) |
| Reid, Alan (Argyll & Bute) | Tyrie, Andrew |
| Rendel, David | Viggers, Peter |
| Robathan, Andrew | Walter, Robert |
| Robertson, Hugh (Faversham & M-Kent) | Waterson, Nigel |
| Watkinson, Angela | |
| Robertson, Laurence (Tewk'b'ry) | Webb, Steve (Northavon) |
| Whittingdale, John | |
| Robinson, Mrs Iris (Strangford) | Widdecombe, rh Miss Ann |
| Robinson, Peter (Belfast E) | Wiggin, Bill |
| Roe, Mrs Marion | Wilkinson, John |
| Rosindell, Andrew | Willetts, David |
| Ruffley, David | Williams, Hywel (Caernarfon) |
| Russell, Bob (Colchester) | Williams, Roger (Brecon) |
| Sanders, Adrian | Winterton, Sir Nicholas (Macclesfield) |
| Sayeed, Jonathan | |
| Selous, Andrew | Yeo, Tim (S Suffolk) |
| Shephard, rh Mrs Gillian | Young, rh Sir George |
| Shepherd, Richard | Younger-Ross, Richard |
| Simmonds, Mark | |
| Simpson, Keith (M-Norfolk) | Tellers for the Ayes:
|
| Smyth, Rev. Martin (Belfast S) | Mr. David Wilshire and
|
| Soames, Nicholas | Mr. Mark Francois
|
NOES
| |
| Adams, Irene (Paisley N) | Burgon, Colin |
| Allen, Graham | Burnham, Andy |
| Anderson, Janet (Rossendale & Darwen) | Cairns, David |
| Campbell, Alan (Tynemouth) | |
| Armstrong, rh Ms Hilary | Campbell, Mrs Anne (C'bridge) |
| Atherton, Ms Candy | Campbell, Ronnie (Blyth V) |
| Atkins, Charlotte | Casale, Roger |
| Austin, John | Caton, Martin |
| Bailey, Adrian | Cawsey, Ian (Brigg) |
| Baird, Vera | Challen, Colin |
| Banks, Tony | Clapham, Michael |
| Barnes, Harry | Clark, Mrs Helen (Peterborough) |
| Barron, rh Kevin | Clark, Paul (Gillingham) |
| Bayley, Hugh | Clarke, rh Tom (Coatbridge & Chryston) |
| Beard, Nigel | |
| Beckett, rh Margaret | Clelland, David |
| Begg, Miss Anne | Clwyd, Ann (Cynon V) |
| Bell, Stuart | Coaker, Vernon |
| Benn, Hilary | Coffey, Ms Ann |
| Bennett, Andrew | Cohen, Harry |
| Benton, Joe (Bootle) | Coleman, Iain |
| Best, Harold | Connarty, Michael |
| Blackman, Liz | Cook, rh Robin (Livingston) |
| Blears, Ms Hazel | Cooper, Yvette |
| Blizzard, Bob | Corbyn, Jeremy |
| Borrow, David | Corston, Jean |
| Bradley, rh Keith (W'rthington) | Cousins, Jim |
| Bradley, Peter (The Wrekin) | Cox, Tom (Tooting) |
| Bradshaw, Ben | Cranston, hon. Ross |
| Brown, Russell (Dumfries) | Crausby, David |
| Bryant, Chris | Cruddas, Jon |
| Buck, Ms Karen | Cryer, Ann (Keighley) |
| Cummings, John | Hutton, rh John |
| Cunningham, Jim (Coventry S) | Iddon, Dr. Brian |
| Cunningham, Tony (Workington) | Irranca-Davies, Huw |
| Darling, rh Alistair | Jackson, Glenda (Hampstead & Highgate) |
| Davey, Valerie (Bristol W) | |
| David, Wayne | Jackson, Helen (Hillsborough) |
| Davidson, Ian | Jamieson, David |
| Davies, rh Denzil (Llanelli) | Jenkins, Brian |
| Davies, Geraint (Croydon C) | Johnson, Miss Melanie (Welwyn Hatfield) |
| Dawson, Hilton | |
| Dean, Mrs Janet | Jones, Helen (Warrington N) |
| Dhanda, Paimjit | Jones, Jon Owen (Cardiff C) |
| Dismore, Andrew | Jones, Kevan (N Durham) |
| Dobbin, Jim (Heywood) | Jones, Lynne (Selly Oak) |
| Dobson, rh Frank | Jones, Martyn (ClwydS) |
| Donohoe, Brian H. | Joyce, Eric (Falkirk W) |
| Doran, Frank | Kaufman, rh Gerald |
| Dowd, Jim (Lewisham W) | Keeble, Ms Sally |
| Drew, David (Stroud) | Keen, Alan (Feltham) |
| Drown, Ms Julia | Keen, Ann (Brentford) |
| Dunwoody, Mrs Gwyneth | Kemp, Fraser |
| Eagle, Angela (Wallasey) | Kidney, David |
| Eagle, Maria (L'pool Garston) | Kilfoyle, Peter |
| Edwards, Huw | King, Andy (Rugby) |
| Efford, Clive | King, Ms Oona (Bethnal Green & Bow) |
| Ellman, Mrs Louise | |
| Ennis, Jeff (Barnsley E) | Knight, Jim (S Dorset) |
| Etherington, Bill | Ladyman, Dr. Stephen |
| Farrelly, Paul | Lammy, David |
| Field, rh Frank (Birkenhead) | Laxton, Bob (Derby N) |
| Fisher, Mark | Lazarowicz, Mark |
| Fitzpatrick, Jim | Lepper, David |
| Fitzsimons, Mrs Lorna | Leslie, Christopher |
| Flint, Caroline | Levitt, Tom (High Peak) |
| Flynn, Paul (Newport W) | Lewis, Ivan (Bury S) |
| Follett, Barbara | Lewis, Terry (Worsley) |
| Foster, rh Derek | Liddell, rh Mrs Helen |
| Foster, Michael (Worcester) | Linton, Martin |
| Foster, Michael Jabez (Hastings & Rye) | Lloyd, Tony (Manchester C) |
| Love, Andrew | |
| Foulkes, rh George | Lucas, Ian (Wrexham) |
| Francis, Dr. Hywel | Luke, Iain (Dundee E) |
| Gapes, Mike (IlfordS) | Lyons, John (Strathkelvin) |
| Gardiner, Barry | McAvoy, Thomas |
| Gerrard, Neil | McCabe, Stephen |
| Gibson, Dr. Ian | McCafferty, Chris |
| Gilroy, Linda | McCartney, rh Ian |
| Godsiff, Roger | McDonagh, Siobhain |
| Goggins, Paul | MacDonald, Calum |
| Griffiths, Jane (Reading E) | MacDougall, John |
| Griffiths, Win (Bridgend) | McFall, John |
| Grogan, John | McGuire, Mrs Anne |
| Hall, Mike (Weaver Vale) | McIsaac, Shona |
| Hall, Patrick (Bedford) | McKechin, Ann |
| Hamilton, David (Midlothian) | McKenna, Rosemary |
| Hanson, David | McNamara, Kevin |
| Harris, Tom (Glasgow Cathcart) | McNulty, Tony |
| Healey, John | MacShane, Denis |
| Henderson, Doug (Newcastle N) | Mactaggart, Fiona |
| Henderson, Ivan (Harwich) | McWalter, Tony |
| Hendrick, Mark | Mahmood, Khalid |
| Hepburn, Stephen | Mahon, Mrs Alice |
| Heppell, John | Mallaber, Judy |
| Hesford, Stephen | Mann, John (Bassetlaw) |
| Hill, Keith (Streatham) | Marris, Rob (Wolverh'ton SW) |
| Hodge, Margaret | Marsden, Gordon (Blackpool S) |
| Hoey, Kate (Vauxhall) | Marshall, David (Glasgow Shettleston) |
| Hood, Jimmy (Clydesdale) | |
| Hope, Phil (Corby) | Marshall, Jim (Leicester S) |
| Hopkins, Kelvin | Martlew, Eric |
| Howarth, rh Alan (Newport E) | Meacher, rh Michael |
| Howarth, George (Knowsley N & Sefton E) | Meale, Alan (Mansfield) |
| Merron, Gillian | |
| Howells, Dr. Kim | Milburn, rh Alan |
| Hughes, Kevin (Doncaster N) | Miliband, David |
| Humble, Mrs Joan | Miller, Andrew |
| Moffatt, Laura | Smith, Angela (Basildon) |
| Mole, Chris | Smith, rh Chris (Islington S & Finsbury) |
| Moonie, Dr. Lewis | |
| Moran, Margaret | Smith, Geraldine (Morecambe & Lunesdale) |
| Morgan, Julie | |
| Morley, Elliot | Smith, Jacqui (Redditch) |
| Morris, rh Estelle | Smith, John (Glamorgan) |
| Mountford, Kali | Smith, Llew (Blaenau Gwent) |
| Mudie, George | Soley, Clive |
| Mullin, Chris | Southworth, Helen |
| Munn, Ms Meg | Squire, Rachel |
| Murphy, Denis (Wansbeck) | Starkey, Dr. Phyllis |
| Murphy, Jim (Eastwood) | Steinberg, Gerry |
| Naysmith, Dr. Doug | Stevenson, George |
| Norris, Dan (Wansdyke) | Stewart, David (Inverness E & Lochaber) |
| O'Brien, Bill (Normanton) | |
| O'Brien, Mike (N Warks) | Stewart, Ian (Eccles) |
| O'Hara, Edward | Stinchcombe, Paul |
| Organ, Diana | Stoate, Dr. Howard |
| Osborne, Sandra (Ayr) | Strang, rh Dr. Gavin |
| Owen, Albert | Stringer, Graham |
| Palmer, Dr. Nick | Sutcliffe, Gerry |
| Picking, Anne | Tami, Mark (Alyn) |
| Pickthall, Colin | Taylor, rh Ann (Dewsbury) |
| Pike, Peter (Burnley) | Taylor, Dari (Stockton S) |
| Plaskitt, James | Taylor, David (NW Leics) |
| Pollard, Kerry | Thomas, Gareth (Clwyd W) |
| Pond, Chris (Gravesham) | Thomas, Gareth (Harrow W) |
| Prentice, Ms Bridget (Lewisham F) | Timms, Stephen |
| Tipping, Paddy | |
| Prentice, Gordon (Pendle) | Touhig, Don (Islwyn) |
| Primarolo, rh Dawn | Trickett, Jon |
| Prosser Gwyn | Truswell, Paul |
| Turner, Dennis (Wolverh'ton SE) | |
| Purchase, Ken | Turner, Dr. Desmond (Brighton Kemptown) |
| Purnell, James | |
| Quin, rh Joyce | Twigg, Derek (Halton) |
| Quinn, Lawrie | Twigg, Stephen (Enfield) |
| Rapson, Syd (Portsmouth N) | Tynan, Bill (Hamilton S) |
| Raynsford, rh Nick | Vaz Keith (Leicester E) |
| Reed, Andy (Loughborough) | Vis, Dr. Rudi |
| Reid, rh Dr. John (Hamilton N & Bellshill) | Walley, Ms Joan |
| Ward, Claire | |
| Rooney, Terry | Wareing, Robert N. |
| Ross, Ernie (Dundee W) | Watts, David |
| Roy, Frank (Motherwell) | White, Brian |
| Ruane, Chris | Whitehead, Dr. Alan |
| Ruddock, Joan | Wicks, Malcolm |
| Russell, Ms Christine (City of Chester) | Williams, rh Alan (Swansea W) |
| Williams, Betty (Conwy) | |
| Ryan, Joan (Enfield N) | Wood, Mike (Batley) |
| Salter, Martin | Woodward, Shaun |
| Sawford, Phil | Wright, Anthony D. (Gt Yarmouth) |
| Sedgemore, Brian | |
| Shaw, Jonathan | Wright, David (Telford) |
| Sheerman, Barry | Wright, Tony (Cannock) |
| Sheridan, Jim | Wyatt, Derek |
| Shipley, Ms Debra | |
| Simon, Siôn (B'ham Erdington) | Tellers for the Noes:
|
| Singh, Marsha | Mr. Nick Ainger and
|
| Skinner, Dennis | Mr. Phil Woolas
|
Question accordingly negatived.
Clause 6
Dispute Resolution
I beg to move amendment No. 6, in page 4, line 42, leave out clause 6.
With this, it will be convenient to consider Government amendment No. 35.
Because of pressure of time, I shall not detain the House for long.
Clause 6 deals with the appeals procedure. I think that seeking to delete it is the right way forward, but not because I believe that there should not be an appeals procedure. I believe that there should, because, given what the Government are doing with fines, there is an urgent need for it; I fear that, as a result of the breakdown of partnerships and working together, the arguing between the health service and social services over whether a fine will be paid will be so intense that an appeals procedure needs to be in place. What I do not find attractive about the Government's proposal, as many of my right hon. and hon. Friends said in Committee, is that unfortunately the way in which they are going about it is to set up the procedure though the strategic health authorities, so that in effect the health service will be both judge and jury. That cannot be right, in the interests of fairness and justice. What we have always argued, and what I remain committed to, is that there should be an appeals procedure, but that it should also include social service departments or local authorities on an equal footing with the health service, with an independent chairman—or chair, in the current politically correct language. The Bill would be greatly enhanced by that. Unfortunately, because of the lengthy discussions in Committee, it would not have been in order to re-table the amendment that we proposed in Committee, and regrettably this is the only way in which one can seek to persuade the Government to think again and adopt a more even-handed approach. I am sure that the Minister will say that it would be nonsense to take the whole appeals procedure out of the Bill, and I would agree. But I should like to persuade her and the House that removing the clause from the Bill now would give the Government time to reflect further on our eminently sensible suggestions of an even-handed approach to an appeals procedure, so that they could reinstate in another place a clause that was more acceptable to my right hon. and hon. Friends and, I suspect, many social service departments, which see this as potentially a fix where justice will not be seen to be done. For those reasons, I hope that the Government will accept the amendment, solely as a temporary measure while they reflect on introducing their own amendment. If they do not, my noble Friends in another place will be in a position to do so instead.We rehearsed a lot of these concerns and arguments in Committee before Christmas. The Liberal Democrats fundamentally share the Conservative position: the arrangements for setting up the dispute panels under strategic health authorities do not guarantee the independence of those panels. Indeed, I noticed that, in Committee, the Minister acknowledged the need to reconsider the independence issue. Simply keeping on saying that the chairmen should be independent does not make them independent. She said that she would consider how to secure such independence and
I want to dwell on that issue. The notes that the Minister has circulated, which give a glimpse of what might be covered in the regulations under clause 6, raise a couple of issues, and I hope that she might be able to give us some further information on them. The first point relates to clause 6(2)(a) on the constitution of the panels. Paragraph 24 of the notes says:"how we guarantee that in the regulations which, like all regulations, will be subject to consultation."—[Official Report, Standing Committee D, 12 December 2002; c. 88.]
Why has the Department used the word "can" in drafting that document? I hope that the Minister can assure us that the regulations will provide for equal numbers of members from local authorities and primary care trusts. It is important to get that confirmation from the Minister today, as that document gives us the opportunity to test further whether that is the intention behind the policy. The second issue relates to paragraph 22 of the notes, which says:"The regulations can provide that local authority and PCT are represented in equal numbers and that representatives of any organisation involved in the dispute (s) to be discussed at any meeting of the panel are excluded from the panel."
It is not unreasonable to say that someone who needs a package of care should have one arranged. However, if there is a dispute about whether a package of care is needed and that matter goes to the dispute panel, what happens if the panel upholds the social service department's position? Who will reimburse the social services department for the expenditure that it incurs to avoid the fine? If it chooses to pay the fine, will the money be repaid to the department? That is not clear in the details that the Minister has given to us, and it would be helpful if she could clarify that. Having said all that, we wish to support the Conservative proposal to delete clause 6 simply because that clause will not be effective in ensuring that dispute resolution is fair and free of the bias that will exist if such issues are vested in the NHS."The local authority which received a section 2 notice from the NHS will still need to put in place arrangements for an individual's on-going care within the time frame set out in the legislation, even if a dispute is in progress, or face a payment."
I should like to make a brief contribution. I cannot support the argument to remove the clause that relates to appeals panels, nor do I share the somewhat cynical view, voiced by the hon. Members for West Chelmsford (Mr. Burns) and for Sutton and Cheam (Mr. Burstow), that strategic health authorities or primary care trusts are so single-minded and blinkered that they believe that they have to preserve their vested interests, if that is what they perceive their responsibilities to be, to the exclusion of all else. My experience of the individuals in my strategic health authority or, indeed, PCT is that they are more than aware that there has to be particularly close working with social services on such issues to ensure that the patient drives the reforms in the NHS.
5.30 pm I wish to ask my hon. Friend the Minister a question, and I hope that she can reassure me. It would be good if the chairmen of the panels were independent, but whomsoever serves on them, it is important that someone must speak for patients and carers. One of the problems that I have come across in my constituency is that—with the best will in the world—medical professionals often speak to an individual about their illness, or their care requirements once they leave hospital, in a language that is totally foreign to them. It is entirely understandable that they often speak in a form of professional shorthand. There must be brought to bear in the dispute panels an informed perspective of what is being discussed, from the perspective of the health professionals and of those who work within social services, but it is important that the individual or carer at the centre of the discussion should have someone who can speak a language that everyone understands and who can understand the concerns of the individual in the case. I hope that my hon. Friend the Minister will be able to reassure me on this.I find myself agreeing with much of what the hon. Member for Hampstead and Highgate (Glenda Jackson) has just said. I hope that that will not cause too much damage to her socialist credentials. She is absolutely right. If nothing else, the Bill is consistent, and anyone with any optimism turning to a clause headed "Dispute resolution" is going to be severely disappointed because all that the Bill is concerned about is arguments between two or more public authorities. The words "patient" and "carer" are simply missing again. This provision involves two faceless bureaucracies fighting out in front of a panel. That disappointment is reflected in the comments of Age Concern, which states that
No such process is being proposed here. I want to raise a few points about the practicalities of the proposals, particularly in view of all the bureaucracy involved, and I endorse some of the points already made on that by the hon. Member for Sutton and Cheam (Mr. Burstow). The proceedings of this panel have the smell of something that could go on for a long time, with all the arguments going on between the public authorities, so there is no prospect of any quick decisions being taken. There is certainly nothing here for the patient or carer who says that what is being proposed for them for today, tomorrow or next week is inappropriate, and who wants someone else to appeal to. I do not believe that that kind of time scale is being envisaged, although if the Minister thinks otherwise, she will no doubt say so. Amendments were also tabled in Committee at the behest of Age Concern and Help the Aged about having a fast-track complaints process for just this kind of situation, but, as is so often the case nowadays, they did not get debated due to time constraints. Age Concern also reflects concerns that have been expressed by at least two hon. Members in this debate when it asks whether"our concern remains that the Bill does not offer a speedy dispute resolution process for the patient, if they disagree with the discharge plan being offered."
It asks the Government"a panel established by a strategic health authority can be independent in resolving disputes between the health service and social services."
It was helpful, up to a point, to have the Minister write to us following the Standing Committee about the likely contents of some of the regulations under the Bill. It was helpful, but it raised a whole series of other questions. Her document talked about the constitution of the panels under clause 6(2)(a), saying:"to clarify whether the proposed panel's decisions will be binding, or simply for advice only."
here come the key words—"The panel will seek information from the relevant professional staff (hospital, social services, PCT) and from the patient and family"
Who can imagine a more damning comment, albeit one buried in the small print, on this legislation? How can any reasonable person envisage a situation in which it would not be appropriate to get information from the patient, the family or any other carer? Will a patient or carer be allowed to address the panel? Will they be allowed to be represented? What sort of evidence will be required? What standards or burdens of proof will be required? How is all that going to be dealt with? If people are still unhappy at the end of these proceedings, will the process be subject to procedures such as judicial review or other complaints procedures within the NHS, or could those procedures take place in parallel with the new arrangements for a panel? How many layers of dispute resolution are we talking about? Ostensibly, we are discussing a panel hearing, but the document on the likely regulations also says:"if appropriate."
again, that reflects the Bill's philosophy, which is that it is all to do with the staff and nothing to do with the patient—"The regulations could provide, for example, that a panel should not be established to hear a particular case unless the staff involved…"—
There we have alternative dispute resolution, as the lawyers would call it—an informal way of trying to establish a solution to a dispute, although one would hope that that would happen automatically in the real world. The document goes on to talk about the dispute being resolved at"cannot reach agreement on an informal basis".
Those seem to be steps to be addressed before the panel is even convened. Finally, the document says:"a higher management level between the relevant healthcare provider and the local authority."
What is "attempted" supposed to mean? How far does the panel have to go in considering all the evidence and all the arguments to allow parties to go on to the next stage of a legal challenge? When we read the small print, we see that we are being asked to establish not only a new bureaucracy and a new panel to determine such matters, but, on the face of it, a series of hoops through which people have to leap, none of which will happen in a hurry."The regulations will provide that neither party can take the dispute to court until they have attempted to resolve it via the panel."
I am pleased that the hon. Member for West Chelmsford (Mr. Burns), in moving the amendment, recognised that it is right and responsible to have in place a system for dispute resolution, because, of course, disputes can already exist between health and social services. In fact, it is sometimes precisely because of such disputes that people are delayed inappropriately in hospital. Through the Bill, we are trying to ensure that the relative responsibilities of health and social services are clearly understood and that there is a process to ensure that individuals are not stuck in hospital, losing out because disputes cannot be sorted out.
I am not quite clear whether the hon. Member for Eastbourne (Mr. Waterson) was suggesting that people should not try to settle disputes before they reach the panel. Of course, that is the obvious way to settle them. Many disputes are settled between the staff concerned in an individual case of discharge or by managers from health and social care. Disputes do not inevitably need to be discussed formally by a panel and the guidance will point out that, for reasons of time and resources, it is desirable to have a system under which two public bodies are encouraged to reach an amicable agreement rather than have constant recourse to the panel. Senior health and social services managers want to resolve matters, wherever possible, before spending time on dispute mechanisms, but we need a body that can arbitrate to achieve a satisfactory resolution if informal attempts to resolve problems are unsuccessful. In England, we think that the right body for that is the strategic health authority. The hon. Member for West Chelmsford repeated some of his concerns about whether that will create a bias to the NHS. I do not believe that it will. It is a practical response to the situation and the system. Strategic health authorities are, as the House would expect, strategic bodies. They do not have operational responsibility and they will not be running the acute hospital trusts that may be involved in a dispute. They have a performance management function one step removed from the day-to-day workings of the NHS. There is no equivalent strategic body for councils, so it makes sense for strategic authorities to be the bodies with responsibility for setting up the panels. They also have an interest in ensuring that acute trusts and PCTs meet their obligations, but not through rewarding the NHS at the expense of local authorities. I hope that I can reassure Members that the intention is that the panel will be composed of a local authority and an NHS representative with an independent chair. I have confidence in the integrity of the people who will be appointed to that panel. Being charged with such a function, the panels will of course have to act properly and in accordance with the rules of natural justice. The regulations will ensure that panel members are not from the bodies that are in dispute, and that the chair is independent of both NHS and local authority. There is no reason to suppose, therefore, that the panel will look more favourably on the NHS than on local councils. The regulations will also cover situations in which not all the bodies in dispute are located in the same strategic health authority. They will probably follow a simple rule, such as the rule that a dispute should be heard by the panel of the strategic health authority in whose area the hospital is situated. Several Members have asked about the particular rights of individuals. Clause 6 does not affect an individual's right to complain to either the NHS or social services about the care he or she has received, using the normal complaints procedures already established, or to take legal action in the courts. The panels are not being established to divert individuals from the complaints procedures—although when they or their families have information that may help to resolve a dispute, they may be involved. Perhaps I can give some reassurance, at least to my hon. Friend the Member for Hampstead and Highgate (Glenda Jackson), by describing some of the improved safeguards—especially those relating to advocacy, about which my hon. Friend was concerned. Individuals wanting to know whether they should receive fully funded continuing NHS care should be informed as part of the assessment process. As I said earlier, the single assessment process and all other guidance make it clear that that is the first question NHS and social services need to consider when assessing the ongoing needs of someone who, potentially, has a primary need for health care. If an individual wishes to dispute an NHS decision that he or she is not a case for fully funded NHS care, the decision should be made within two weeks, and the individual can remain in hospital while the continuing care panel considers the case. If individuals wish to complain about the services offered by social services departments, that should be dealt with by the social services complaints system, which was established to enable individuals to make such representations. If they are not satisfied with the local authority's response, they can go to the local government ombudsman. If they are concerned about the whole care package and about whether it is safe for them to return home with that package, they should be able to raise that at an early stage with both NHS and social services representatives. The current system requires all trusts to have patient advocacy liaison services to give exactly the kind of support demanded by my hon. Friend. People raising what will clearly be difficult issues may well need such support. The representatives I have mentioned may be able to change the package, or to reassure patients and their families about its adequacy. There may be further recourse to the complaints provision, which will depend on the nature of the concerns involved. I hope I have reassured Members that our proposals are logical and sensible. I am not suggesting that the complaints procedure should be biased in favour of the health service; I am saying that the strategic health authority is the appropriate body to convene the complaints panel, which itself will be represented equally by the NHS and local authorities. It will also have an independent chair. Nothing about the panel will undermine what I agree is the important ability of individuals to raise concerns and complain when that is necessary.5.45 pm
I listened carefully to the Minister, and I appreciate that she is seeking to reassure the House, but I remain unreassured. I get the impression that she is talking about an idealised world, but things do not work out that way in the real world. We should improve the Bill now rather than repent when it is too late.
No one doubts that dispute panels are needed. Heaven knows, we will need them if the Bill becomes law. However, I am still worried about making them the responsibility of the strategic health authorities—in other words, the NHS, which has half of the vested interest in the problem. Even if every panel reached a judgment of Solomon in 100 per cent, of cases, the suspicion would remain among individuals and social services departments, if they did not like the decision that was reached, that a fair decision was impossible because of the way the panel was set up. I do not believe that there is a major difference between us on this matter, but I do not understand why the Minister has not agreed to bring the local authorities in to work on an equal footing with the strategic health authorities on the panels, subject to the regulations to be issued by the Minister. No accusation that the Government had fixed the system—and made the NHS, through the strategic health authorities, the judge and jury in a dispute—would then have an iota of justification. I should have thought that the Minister would welcome my advice. I am only trying to help to improve and enhance a rotten Bill. Despite my entreaties, it seems that the Minister is not going to budge. I am hurt about that, but it is an unfortunate fact. As a result, I intend to press the amendment to a Division. I invite my hon. Friends to join me in the Aye Lobby in an attempt to save the Minister from herself.Question put, That the amendment be made:—
The House divided: Ayes 198, Noes 318.
Division No. 52]
| [5:48 pm
|
AYES
| |
| Ainsworth, Peter (E Surrey) | Clifton-Brown, Geoffrey |
| Allan, Richard | Collins, Tim |
| Amess, David | Cormack, Sir Patrick |
| Ancram, rh Michael | Cotter, Brian |
| Arbuthnot, rh James | Cran, James (Beverley) |
| Atkinson, Peter (Hexham) | Curry, rh David |
| Bacon, Richard | Davey, Edward (Kingston) |
| Baker, Norman | Davies, Quentin (Grantham & Stamford) |
| Barker, Gregory | |
| Baron, John (Billericay) | Davis, rh David (Haltemprice & Howden) |
| Barrett, John | |
| Beggs, Roy (E Antrim) | Dodds, Nigel |
| Beith, rh A. J. | Dorrell, rh Stephen |
| Bellingham, Henry | Doughty, Sue |
| Bercow, John | Duncan Smith, rh Iain |
| Blunt, Crispin | Evans, Nigel |
| Boswell, Tim | Fabricant, Michael |
| Bottomley, rh Virginia (SW Surrey) | Fallon, Michael |
| Field, Mark (Cities of London & Westminster) | |
| Brady, Graham | |
| Brake, Tom (Carshalton) | Flight, Howard |
| Brazier, Julian | Flook, Adrian |
| Brooke, Mrs Annette L. | Forth, rh Eric |
| Browning, Mrs Angela | Foster, Don (Bath) |
| Bruce, Malcolm | Fox, Dr. Liam |
| Burnett, John | Francois, Mark |
| Burns, Simon | Gale, Roger (N Thanet) |
| Burnside, David | Garnier, Edward |
| Burstow, Paul | George, Andrew (St. Ives) |
| Burt, Alistair | Gibb, Nick (Bognor Regis) |
| Cable, Dr. Vincent | Gidley, Sandra |
| Calton, Mrs Patsy | Gillan, Mrs Cheryl |
| Cameron, David | Gray, James (N Wilts) |
| Campbell, Gregory (E Lond'y) | Grayling, Chris |
| Carmichael, Alistair | Green, Damian (Ashford) |
| Cash, William | Green, Matthew (Ludlow) |
| Chapman, Sir Sydney (Chipping Barnet) | Grieve, Dominic |
| Gummer, rh John | |
| Chope, Christopher | Hammond, Philip |
| Clarke, rh Kenneth (Rushcliffe) | Hancock, Mike |
| Harris, Dr. Evan (Oxford W & Abingdon) | Prisk, Mark (Hertford) |
| Pugh, Dr. John | |
| Harvey, Nick | Redwood, rh John |
| Hawkins, Nick | Reid, Alan (Argyll & Bute) |
| Hayes, John (S Holland) | Rendel, David |
| Heath, David | Robathan, Andrew |
| Heathcoat-Amory, rh David | Robertson, Hugh (Faversham & M-Kent) |
| Hendry, Charles | |
| Hermon, Lady | Robinson, Mrs Iris (Strangford) |
| Hoban, Mark (Fareham) | Robinson, Peter (Belfast E) |
| Hogg, rh Douglas | Roe, Mrs Marion |
| Holmes, Paul | Rosindell, Andrew |
| Horam, John (Orpington) | Ruffley, David |
| Howard, rh Michael | Russell, Bob (Colchester) |
| Howarth, Gerald (Aldershot) | Sanders, Adrian |
| Hughes, Simon (Southwark N) | Sayeed, Jonathan |
| Hunter, Andrew | Selous, Andrew |
| Jack, rh Michael | Shephard, rh Mrs Gillian |
| Jackson, Robert (Wantage) | Shepherd, Richard |
| Jenkin, Bernard | Simmonds, Mark |
| Johnson, Boris (Henley) | Simpson, Keith (M-Norfolk) |
| Keetch, Paul | Smyth, Rev. Martin (Belfast S) |
| Key, Robert (Salisbury) | Soames, Nicholas |
| Kirkbride, Miss Julie | Spelman, Mrs Caroline |
| Kirkwood, Sir Archy | Spicer, Sir Michael |
| Knight rh Greg (E Yorkshire) | Spink, Bob (Castle Point) |
| Laing, Mrs Eleanor | Spring, Richard |
| Lait, Mrs Jacqui | Steen, Anthony |
| Lamb, Norman | Streeter, Gary |
| Lansley, Andrew | Stunell, Andrew |
| Laws, David (Yeovil) | Swayne, Desmond |
| Leigh, Edward | Swire, Hugo (E Devon) |
| Lewis, Dr. Julian (New Forest E) | Syms, Robert |
| Liddell-Grainger, Ian | Tapsell, Sir Peter |
| Lidington, David | Taylor, Ian (Esher) |
| Lilley, rh Peter | Taylor, John (Solihull) |
| Llwyd, Elfyn | Taylor, Matthew (Truro) |
| Loughton, Tim | Taylor, Dr. Richard (Wyre F) |
| Luff, Peter (M- Worcs) | Thomas, Simon (Ceredigion) |
| McIntosh, Miss Anne | Thurso, John |
| Mackay, rh Andrew | Tonge, Dr. Jenny |
| Maclean, rh David | Tredinnick, David |
| McLoughlin, Patrick | Turner, Andrew (Isle of Wight) |
| Malins, Humfrey | Tyler, Paul (N Cornwall) |
| Maples, John | Tyrie, Andrew |
| Marsden, Paul (Shrewsbury & Atcham) | Viggers, Peter |
| Walter, Robert | |
| Mates, Michael | Waterson, Nigel |
| Mawhinney, rh Sir Brian | Watkinson, Angela |
| May, Mrs Theresa | Webb, Steve (Northavon) |
| Mercer, Patrick | Whittingdale, John |
| Moore, Michael | Widdecombe, rh Miss Ann |
| Moss, Malcolm | Wiggin, Bill |
| Murrison, Dr. Andrew | Willetts, David |
| Norman, Archie | Williams, Hywel (Caernarfon) |
| Oaten, Mark (Winchester) | Williams, Roger (Brecon) |
| O'Brien, Stephen (Eddisbury) | Willis, Phil |
| Öpik, Lembit | Winterton, Sir Nicholas (Macclesfield) |
| Osborne, George (Tatton) | |
| Page, Richard | Yeo, Tim (S Suffolk) |
| Paice, James | Young, rh Sir George |
| Paterson, Owen | Younger-Ross, Richard |
| Pickles, Eric | |
| Portillo, rh Michael | Tellers for the Ayes:
|
| Price, Adam (E Carmarthen & Dinefwr) | Mr. David Wilshire and
|
Mr. Laurence Robertson
| |
NOES
| |
| Abbott, Ms Diane | Atkins, Charlotte |
| Adams, Irene (Paisley N) | Austin, John |
| Ainsworth, Bob (Cov'try NE) | Bailey, Adrian |
| Allen, Graham | Baird, Vera |
| Anderson, Janet (Rossendale & Darwen) | Banks, Tony |
| Barron, rh Kevin | |
| Armstrong, rh Ms Hilary | Beard, Nigel |
| Atherton, Ms Candy | Beckett, rh Margaret |
| Begg, Miss Anne | Fisher, Mark |
| Bell, Stuart | Fitzpatrick, Jim |
| Benn, Hilary | Fitzsimons, Mrs Lorna |
| Bennett, Andrew | Flint, Caroline |
| Benton, Joe (Bootle) | Flynn, Paul (Newport W) |
| Best, Harold | Follett, Barbara |
| Blackman, Liz | Foster, rh Derek |
| Blears, Ms Hazel | Foster, Michael (Worcester) |
| Blizzard, Bob | Foster, Michael Jabez (Hastings & Rye) |
| Borrow, David | |
| Bradley, rh Keith (Withington) | Francis, Dr. Hywel |
| Bradley, Peter (The Wrekin) | Gapes, Mike (Ilford S) |
| Bradshaw, Ben | Gardiner, Barry |
| Brennan, Kevin | George, rh Bruce (Walsall S) |
| Brown, Russell (Dumfries) | Gerrard, Neil |
| Bryant, Chris | Gibson, Dr. Ian |
| Buck, Ms Karen | Gilroy, Linda |
| Burgon, Colin | Godsiff, Roger |
| Burnham, Andy | Goggins, Paul |
| Cairns, David | Griffiths, Jane (Reading E) |
| Campbell, Alan (Tynemouth) | Griffiths, Win (Bridgend) |
| Campbell, Mrs Anne (C'bridge) | Grogan, John |
| Campbell, Ronnie (Blyth V) | Hall, Mike (Weaver Vale) |
| Casale, Roger | Hall, Patrick (Bedford) |
| Caton, Martin | Hamilton, David (Midlothian) |
| Cawsey, Ian (Brigg) | Hanson, David |
| Challen, Colin | Harman, rh Ms Harriet |
| Clapham, Michael | Harris, Tom (Glasgow Cathcart) |
| Clark, Mrs Helen (Peterborough) | Healey, John |
| Clarke, rh Tom (Coatbridge & Chryston) | Henderson, Doug (Newcastle N) |
| Henderson, Ivan (Harwich) | |
| Clelland, David | Hendrick, Mark |
| Clwyd, Ann (Cynon V) | Hepburn, Stephen |
| Coaker, Vernon | Heppell, John |
| Coffey, Ms Ann | Hesford, Stephen |
| Cohen, Harry | Hill, Keith (Streatham) |
| Coleman, Iain | Hodge, Margaret |
| Connarty, Michael | Hoey, Kate (Vauxhall) |
| Cook, Frank (Stockton N) | Hood, Jimmy (Clydesdale) |
| Cook, rh Robin (Livingston) | Hope, Phil (Corby) |
| Cooper, Yvette | Hopkins, Kelvin |
| Corston, Jean | Howarth, rh Alan (Newport E) |
| Cousins, Jim | Howarth, George (Knowsley N & Sefton E) |
| Cox, Tom (Tooting) | |
| Cranston, hon. Ross | Howells, Dr. Kim |
| Crausby, David | Hughes, Beverley (Stretford & Urmston) |
| Cruddas, Jon | |
| Cryer, Ann (Keighley) | Hughes, Kevin (Doncaster N) |
| Cummings, John | Humble, Mrs Joan |
| Cunningham, Jim (Coventry S) | Hutton, rh John |
| Cunningham, Tony (Workington) | Iddon, Dr. Brian |
| Darling, rh Alistair | Irranca-Davies, Huw |
| Davey, Valerie (Bristol W) | Jackson, Glenda (Hampstead & Highgate) |
| David, Wayne | |
| Davidson, Ian | Jackson, Helen (Hillsborough) |
| Davies, rh Denzil (Llanelli) | Jamieson, David |
| Davies, Geraint (Croydon C) | Jenkins, Brian |
| Dawson, Hilton | Johnson, Miss Melanie (Welwyn Hatfield) |
| Dean, Mrs Janet | |
| Dhanda, Parmjit | Jones, Helen (Warrington N) |
| Dismore, Andrew | Jones, Jon Owen (Cardiff C) |
| Dobbin, Jim (Heywood) | Jones, Kevan (N Durham) |
| Donohoe, Brian H. | Jones, Lynne (Selly Oak) |
| Doran, Frank | Jones, Martyn (Clwyd S) |
| Dowd, Jim (Lewisham W) | Joyce, Eric (Falkirk W) |
| Drew, David (Stroud) | Kaufman, rh Gerald |
| Drown, Ms Julia | Keeble, Ms Sally |
| Dunwoody, Mrs Gwyneth | Keen, Alan (Feltham) |
| Eagle, Angela (Wallasey) | Keen, Ann (Brentford) |
| Eagle, Maria (L'pool Garston) | Kemp, Fraser |
| Edwards, Huw | Kidney, David |
| Efford, Clive | Kilfoyle, Peter |
| Ellman, Mrs Louise | King, Andy (Rugby) |
| Ennis, Jeff (Barnsley E) | King, Ms Oona (Bethnal Green & Bow) |
| Etherington, Bill | |
| Field, rh Frank (Birkenhead) | Knight, Jim (S Dorset) |
| Ladyman, Dr. Stephen | Prentice, Ms Bridget (Lewisham E) |
| Lammy, David | |
| Laxton, Bob (Derby N) | Prentice, Gordon (Pendle) |
| Lazarowicz, Mark | Primarolo, rh Dawn |
| Lepper, David | Prosser, Gwyn |
| Leslie, Christopher | Purchase, Ken |
| Levin, Tom (High Peak) | Purnell, James |
| Lewis, Ivan (Bury S) | Quin, rh Joyce |
| Lewis, Terry (Worsley) | Quinn, Lawrie |
| Liddell, rh Mrs Helen | Rapson, Syd (Portsmouth N) |
| Linton, Martin | Reid, rh Dr. John (Hamilton N & Bellshill) |
| Lloyd, Tony (Manchester C) | |
| Love, Andrew | Robinson, Geoffrey (Coventry NW) |
| Lucas, Ian (Wrexham) | |
| Luke, Iain (Dundee E) | Rooney, Terry |
| Lyons, John (Strathkelvin) | Ross, Ernie (Dundee W) |
| McAvoy, Thomas | Roy, Frank (Motherwell) |
| McCabe, Stephen | Ruane, Chris |
| McCafferty, Chris | Ruddock, Joan |
| McDonagh, Siobhain | Russell, Ms Christine (City of Chester) |
| MacDonald, Calum | |
| MacDougall, John | Ryan, Joan (Enfield N) |
| McFall, John | Savidge, Malcolm |
| McGuire, Mrs Anne | Sawford, Phil |
| McIsaac, Shona | Sedgemore, Brian |
| McKechin, Ann | Shaw, Jonathan |
| McKenna, Rosemary | Sheerman, Barry |
| McNamara, Kevin | Sheridan, Jim |
| McNulty, Tony | Shipley, Ms Debra |
| Mactaggart, Fiona | Simon, Siôn (B'ham Erdington) |
| McWalter, Tony | Singh, Marsha |
| Mahmood, Khalid | Skinner, Dennis |
| Mallaber, Judy | Smith, Angela (Basildon) |
| Mann, John (Bassetlaw) | Smith, rh Chris (Islington S & Finsbury) |
| Marris, Rob (Wolverh'ton SW) | |
| Marsden, Gordon (Blackpool S) | Smith, Geraldine (Morecambe & Lunesdale) |
| Marshall, David (Glasgow Shettleston) | |
| Smith, Jacqui (Redditch) | |
| Marshall, Jim (Leicester S) | Smith, John (Glamorgan) |
| Martlew, Eric | Smith, Llew (Blaenau Gwent) |
| Meacher, rh Michael | Soley, Clive |
| Meale, Alan (Mansfield) | Southworth, Helen |
| Merron, Gillian | Squire, Rachel |
| Michael, rh Alun | Starkey, Dr. Phyllis |
| Milburn, rh Alan | Steinberg, Gerry |
| Miliband, David | Stevenson, George |
| Miller, Andrew | Stewart, David (Inverness E & Lochaber) |
| Moffatt, Laura | |
| Mole, Chris | Stewart, Ian (Eccles) |
| Moonie, Dr. Lewis | Stinchcombe, Paul |
| Moran, Margaret | Stoate, Dr. Howard |
| Morgan, Julie | Strang, rh Dr. Gavin |
| Morley, Elliot | Sutcliffe, Gerry |
| Morris, rh Estelle | Tami, Mark (Alyn) |
| Mountford, Kali | Taylor, rh Ann (Dewsbury) |
| Mudie, George | Taylor, Dari (Stockton S) |
| Mullin, Chris | Taylor, David (NW Leics) |
| Munn, Ms Meg | Thomas, Gareth (Clwyd W) |
| Murphy, Denis (Wansbeck) | Thomas, Gareth (Harrow W) |
| Murphy, Jim (Eastwood) | Timms, Stephen |
| Murphy, rh Paul (Torfaen) | Tipping, Paddy |
| Naysmith, Dr. Doug | Todd, Mark (S Derbyshire) |
| Norris, Dan (Wansdyke) | Touhig, Don (Islwyn) |
| O'Brien, Bill (Normanton) | Trickett, Jon |
| O'Brien, Mike (N Warks) | Truswell, Paul |
| O'Hara, Edward | Turner, Dennis (Wolverh'ton SE) |
| Organ, Diana | Turner, Dr. Desmond (Brighton Kemptown) |
| Osborne, Sandra (Ayr) | |
| Owen, Albert | Twigg, Derek (Halton) |
| Palmer, Dr. Nick | Twigg, Stephen (Enfield) |
| Picking, Anne | Tynan, Bill (Hamilton S) |
| Pickthall, Colin | Vaz, Keith (Leicester E) |
| Pike, Peter (Burnley) | Vis, Dr. Rudi |
| Plaskitt, James | Walley, Ms Joan |
| Pollard, Kerry | Ward, Claire |
| Pond, Chris (Gravesham) | Wareing, Robert N. |
| Watts, David | Worthington, Tony |
| White, Brian | Wright, Anthony D. (Gt Yarmouth) |
| Whitehead, Dr. Alan | |
| Wicks, Malcolm | Wright, David (Telford) |
| Williams, rh Alan (Swansea W) | Wright, Tony (Cannock) |
| Williams, Betty (Conwy) | Wyatt, Derek |
| Wills, Michael | |
| Winnick, David | Tellers for the Noes:
|
| Wood, Mike (Batley) | Mr. Phil Woolas and
|
| Woodward, Shaun | Mr. Nick Ainger
|
Question accordingly negatived.
It being after Six o'clock, MR. DEPUTY SPEAKER proceeded to put forthwith the Questions necessary for the disposal of the business to be concluded at that hour, pursuant to Standing Order No. 9 and to Orders [29 October and 28 November 2002].
Clause 12
Free Provision Of Certain Community Careservices
Amendment proposed: No. 37, in page 7, line 32, leave out from 'require' to end of line 33 and insert
'any of the following services to be provided free of charge for a period of more than six weeks—(a) the provision of accommodation under Part 3 of the National Assistance Act 1948; (b) the provision of personal care to a person in any place where that person is living, other than accommodation provided under that Part of that Act; (c) a service provided to a carer under section 2 of the Carers and Disabled Children Act 2000 which consists of the provision of personal care delivered to the person cared for (in accordance with subsection (3) of that section):.—[Jacqui Smith]
Question put, That the amendment be made:—
The House divided: Ayes 464, Noes 50.
Division No. 53]
| [6:03 pm
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AYES
| |
| Abbott, Ms Diane | Benn, Hilary |
| Adams, Irene (Paisley N) | Bennett, Andrew |
| Ainger, Nick | Benton, Joe (Bootle) |
| Ainsworth, Bob (Cov'try NE) | Bercow, John |
| Ainsworth, Peter (E Surrey) | Best, Harold |
| Allen, Graham | Blackman, Liz |
| Amess, David | Blears, Ms Hazel |
| Ancram, rh Michael | Blizzard, Bob |
| Anderson, Janet (Rossendale & Darwen) | Blunt, Crispin |
| Borrow, David | |
| Arbuthnot, rh James | Boswell, Tim |
| Armstrong, rh Ms Hilary | Bottomley, rh Virginia (SW Surrey) |
| Atherton, Ms Candy | |
| Atkins, Charlotte | Bradley, rh Keith (Withington) |
| Atkinson, Peter (Hexham) | Bradley, Peter (The Wrekin) |
| Austin, John | Bradshaw, Ben |
| Bacon, Richard | Brady, Graham |
| Bailey, Adrian | Brazier, Julian |
| Baird, Vera | Brennan, Kevin |
| Banks, Tony | Brown, Russell (Dumfries) |
| Barker, Gregory | Browning, Mrs Angela |
| Baron, John (Billericay) | Bryant, Chris |
| Barron, rh Kevin | Burgon, Colin |
| Battle, John | Burnham, Andy |
| Beard, Nigel | Burns, Simon |
| Beckett, rh Margaret | Burnside, David |
| Begg, Miss Anne | Burt, Alistair |
| Beggs, Roy (E Antrim) | Caborn, rh Richard |
| Bell, Stuart | Cairns, David |
| Bellingham, Henry | Cameron, David |
| Campbell, Alan (Tynemouth) | Fisher, Mark |
| Campbell, Mrs Anne (C'bridge) | Fitzpatrick, Jim |
| Campbell, Gregory (E Lond'y) | Fitzsimons, Mrs Lorna |
| Campbell, Ronnie (Blyth V) | Flight, Howard |
| Casale, Roger | Flint, Caroline |
| Cash, William | Flook, Adrian |
| Caton, Martin | Flynn, Paul (Newport W) |
| Cawsey, Ian (Brigg) | Follett, Barbara |
| Challen, Colin | Forth, rh Eric |
| Chapman, Sir Sydney (Chipping Barnet) | Foster, rh Derek |
| Foster, Michael (Worcester) | |
| Chope, Christopher | Foster, Michael Jabez (Hastings & Rye) |
| Clapham, Michael | |
| Clark, Mrs Helen (Peterborough) | Foulkes, rh George |
| Clarke, rh Kenneth (Rushcliffe) | Fox, Dr. Liam |
| Clarke, rh Tom (Coatbridge & Chryston) | Francis, Dr. Hywel |
| Francois, Mark | |
| Clelland, David | Gale, Roger (N Thanet) |
| Clifton-Brown, Geoffrey | Gapes, Mike (Ilford S) |
| Clwyd, Ann (Cynon V) | Gardiner, Barry |
| Coaker, Vernon | Garnier, Edward |
| Coffey, Ms Ann | George, rh Bruce (Walsall S) |
| Cohen, Harry | Gerrard, Neil |
| Coleman, Iain | Gibb, Nick (Bognor Regis) |
| Collins, Tim | Gibson, Dr. Ian |
| Connarty, Michael | Gillan, Mrs Cheryl |
| Cook, rh Robin (Livingston) | Gilroy, Linda |
| Cooper, Yvette | Godsiff, Roger |
| Corston, Jean | Goggins, Paul |
| Cousins, Jim | Gray, James (N Wilts) |
| Cox, Tom (Tooting) | Grayling, Chris |
| Cran, James (Beverley) | Green, Damian (Ashford) |
| Cranston, hon. Ross | Grieve, Dominic |
| Crausby, David | Griffiths, Jane (Reading E) |
| Cruddas, Jon | Griffiths, Win (Bridgend) |
| Cryer, Ann (Keighley) | Grogan, John |
| Cryer, John (Hornchurch) | Gummer, rh John |
| Cummings, John | Hall, Mike (Weaver Vale) |
| Cunningham, Jim (Coventry S) | Hall, Patrick (Bedford) |
| Cunningham, Tony (Workington) | Hamilton, David (Midlothian) |
| Curry, rh David | Hammond, Philip |
| Darling, rh Alistair | Hanson, David |
| Davey, Valerie (Bristol W) | Harman, rh Ms Harriet |
| David, Wayne | Harris, Tom (Glasgow Cathcart) |
| Davidson, Ian | Hawkins, Nick |
| Davies, rh Denzil (Llanelli) | Hayes, John (S Holland) |
| Davies, Geraint (Croydon C) | Healey, John |
| Davies, Quentin (Grantham & Stamford) | Heathcoat-Amory, rh David |
| Henderson, Doug (Newcastle N) | |
| Davis, rh David (Haltemprice & Howden) | Henderson, Ivan (Harwich) |
| Hendrick, Mark | |
| Dawson, Hilton | Hendry, Charles |
| Dean, Mrs Janet | Hepburn, Stephen |
| Dhanda, Parmjit | Heppell, John |
| Dismore, Andrew | Hermon, Lady |
| Dobbin, Jim (Heywood) | Hesford, Stephen |
| Dodds, Nigel | Hill, Keith (Streatham) |
| Donohoe, Brian H. | Hoban, Mark (Fareham) |
| Doran, Frank | Hodge, Margaret |
| Dorrell, rh Stephen | Hoey, Kate (Vauxhall) |
| Dowd, Jim (Lewisham W) | Hood, Jimmy (Clydesdale) |
| Drew, David (Stroud) | Hope, Phil (Corby) |
| Drown, Ms Julia | Hopkins, Kelvin |
| Duncan Smith, rh Iain | Horam, John (Orpington) |
| Dunwoody, Mrs Gwyneth | Howard, rh Michael |
| Eagle, Angela (Wallasey) | Howarth, rh Alan (Newport E) |
| Eagle, Maria (L'poolGarston) | Howarth, George (Knowsley N & Sefton E) |
| Edwards, Huw | |
| Efford, Clive | Howarth, Gerald (Aldershot) |
| Ellman, Mrs Louise | Howells, Dr. Kim |
| Ennis, Jeff (Barnsley E) | Hughes, Beverley (Stretford & Urmston) |
| Etherington, Bill | |
| Evans, Nigel | Hughes, Kevin (Doncaster N) |
| Fabricant, Michael | Humble, Mrs Joan |
| Fallon, Michael | Hunter, Andrew |
| Field, rh Frank (Birkenhead) | Hutton, rh John |
| Iddon, Dr Brian | Mahmood, Khalid |
| Irranca-Davies, Huw | Malins, Humfrey |
| Jack, rh Michael | Mallaber, Judy |
| Jackson, Glenda (Hampstead & Highgate) | Mann, John (Bassetlaw) |
| Maples, John | |
| Jackson, Helen (Hillsborough) | Marris, Rob (Wolverh'ton SW) |
| Jackson, Robert (Wantage) | Marsden, Gordon (Blackpool S) |
| Jamieson, David | Marshall, David (Glasgow Shettleston) |
| Jenkin, Bernard | |
| Jenkins, Brian | Marshall, Jim (Leicester S) |
| Johnson, Boris (Henley) | Martlew, Eric |
| Johnson, Miss Melanie (Welwyn Hatfield) | Mates, Michael |
| Mawhinney, rh Sir Brian | |
| Jones, Helen (Warrington N) | May, Mrs Theresa |
| Jones, Jon Owen (Cardiff C) | Meale, Alan (Mansfield) |
| Jones, Kevan (N Durham) | Mercer, Patrick |
| Jones, Martyn (Clwyd S) | Michael, rh Alun |
| Joyce, Eric (Falkirk W) | Milburn, rh Alan |
| Kaufman, rh Gerald | Miliband, David |
| Keeble, Ms Sally | Miller, Andrew |
| Keen, Alan (Feltham) | Mitchell, Austin (Gt Grimsby) |
| Keen, Ann (Brentford) | Moffatt, Laura |
| Kemp, Fraser | Mole, Chris |
| Key, Robert (Salisbury) | Moonie, Dr. Lewis |
| Kidney, David | Moran, Margaret |
| Kilfoyle, Peter | Morgan, Julie |
| King, Andy (Rugby) | Morley, Elliot |
| King, Ms Oona (Bethnal Green & Bow) | Morris, rh Estelle |
| Kirkbride, Miss Julie | Moss, Malcolm |
| Knight, rh Greg (E Yorkshire) | Mountford, Kali |
| Knight, Jim (S Dorset) | Mudie, George |
| Ladyman, Dr. Stephen | Mullin, Chris |
| Laing, Mrs Eleanor | Munn, Ms Meg |
| Lait, Mrs Jacqui | Murphy, Denis (Wansbeck) |
| Lammy, David | Murphy, Jim (Eastwood) |
| Lansley, Andrew | Murphy, rh Paul (Torfaen) |
| Laxton, Bob (Derby N) | Murrison, Dr. Andrew |
| Lazarowicz, Mark | Naysmith, Dr. Doug |
| Leigh, Edward | Norman, Archie |
| Lepper, David | Norris, Dan (Wansdyke) |
| Leslie, Christopher | O'Brien, Bill (Normanton) |
| Levitt, Tom (High Peak) | O'Brien, Mike (N Warks) |
| Lewis, Ivan (Bury S) | O'Brien, Stephen (Eddisbury) |
| Lewis, Dr. Julian (New Forest E) | O'Hara, Edward |
| Lewis, Terry (Worsley) | Organ, Diana |
| Liddell, rh Mrs Helen | Osborne, George (Tatton) |
| Liddell-Grainger, Ian | Osborne, Sandra (Ayr) |
| Lidington, David | Owen, Albert |
| Lilley, rh Peter | Page, Richard |
| Linton, Martin | Paice, James |
| Lloyd, Tony (Manchester C) | Palmer, Dr. Nick |
| Loughton, Tim | Paterson, Owen |
| Love, Andrew | Picking, Anne |
| Lucas, Ian (Wrexham) | Pickles, Eric |
| Luff, Peter (M-Worcs) | Pickthall, Colin |
| Luke, Iain (Dundee E) | Pike, Peter (Burnley) |
| Lyons, John (Strathkelvin) | Plaskitt, James |
| McAvoy, Thomas | Pollard, Kerry |
| McCabe, Stephen | Pond, Chris (Gravesham) |
| McCafferty, Chris | Portillo, rh Michael |
| McDonagh, Siobhain | Prentice, Ms Bridget (Lewisham E) |
| MacDonald, Calum | |
| MacDougall, John | Prentice, Gordon (Pendle) |
| McFall, John | Primarolo, rh Dawn |
| McIntosh, Miss Anne | Prisk, Mark (Hertford) |
| McIsaac, Shona | Prosser, Gwyn |
| Mackay, rh Andrew | Purchase, Ken |
| McKechin, Ann | Purnell, James |
| McKenna, Rosemary | Quin, rh Joyce |
| Maclean, rh David | Quinn, Lawrie |
| McLoughlin, Patrick | Rapson, Syd (Portsmouth N) |
| McNamara, Kevin | Redwood, rh John |
| McNulty, Tony | Reid, rh Dr. John (Hamilton N & Bellshill) |
| Mactaggart, Fiona | |
| McWalter, Tony | Robathan, Andrew |
| Robertson, Hugh (Faversham & M-Kent) | Sutcliffe, Gerry |
| Swayne, Desmond | |
| Robertson, Laurence (Tewk'b'ry) | Swire, Hugo (E Devon) |
| Robinson, Geoffrey (Coventry NW) | Syms, Robert |
| Tami, Mark (Alyn) | |
| Robinson, Mrs Iris (Strangford) | Tapsell, Sir Peter |
| Robinson, Peter (Belfast E) | Taylor, rh Ann (Dewsbury) |
| Roe, Mrs Marion | Taylor, Dan (Stockton S) |
| Rooney, Terry | Taylor, David (NW Leics) |
| Rosindell, Andrew | Taylor, Ian (Esher) |
| Ross, Ernie (Dundee W) | Taylor, John (Solihull) |
| Roy, Frank (Motherwell) | Thomas, Gareth (Clwyd W) |
| Ruane, Chris | Thomas, Gareth (Harrow W) |
| Ruddock, Joan | Timms, Stephen |
| Ruffley, David | Tipping, Paddy |
| Russell, Ms Christine (City of Chester) | Todd, Mark (S Derbyshire) |
| Touhig, Don (Islwyn) | |
| Ryan, Joan (Enfield N) | Tredinnick, David |
| Salter, Martin | Trickett, Jon |
| Savidge, Malcolm | Truswell, Paul |
| Sawford, Phil | Turner, Andrew (Isle of Wight) |
| Sayeed, Jonathan | Turner, Dennis (Wolverh'ton SE) |
| Sedgemore, Brian | Turner, Dr Desmond (Brighton Kemptown) |
| Selous, Andrew | |
| Shaw, Jonathan | Twigg, Derek (Halton) |
| Sheerman, Barry | Twigg, Stephen (Enfield) |
| Shephard, rh Mrs Gillian | Tynan, Bill (Hamilton S) |
| Shepherd, Richard | Tyrie, Andrew |
| Sheridan, Jim | Vaz, Keith (Leicester E) |
| Shipley, Ms Debra | Viggers, Peter |
| Simmonds, Mark | Vis, Dr Rudi |
| Simon, Siôn (B'ham Erdington) | Walley, Ms Joan |
| Simpson, Keith (M-Norfolk) | Walter, Robert |
| Singh, Marsha | Ward, Claire |
| Skinner, Dennis | Wareing, Robert N |
| Smith, rh Andrew (Oxford E) | Waterson, Nigel |
| Smith, Angela (Basildon) | Watts, David |
| White Brian | |
| Smith, rh Chris (Islington S & Finsbury) | Whitehead, Dr Alan |
| Smith, Geraldine (Morecambe & Lunesdale) | Whittingdale, John Wicks, Malcolm |
| Widdecombe, rh Miss Ann | |
| Smith, Jacqui (Redditch) | Wiggin Bill |
| Smith, John (Glamorgan) | Willetts, David |
| Smith, Llew (Blaenau Gwent) | Williams, rh Alan (Swansea W) |
| Smyth, Rev Martin (Belfast S) | Williams, Betty (Conwy) |
| Soames, Nicholas | Wills, Michael |
| Soley, Clive | Wilshire, David |
| Southworth, Helen | Winnick, David |
| Spelman, Mrs Caroline | Winterton, Sir Nicholas (Macclesfield) |
| Spicer, Sir Michael | |
| Spink, Bob (Castle Point) | Wood, Mike (Batley) |
| Spring, Richard | Woodward, Shaun |
| Squire, Rachel | Worthington, Tony |
| Starkey, Dr Phyllis | Wright, Anthony D (Gt Yarmouth) |
| Steen, Anthony | |
| Steinberg, Gerry | Wright, David (Telford) |
| Stevenson, George | Wright, Tony (Cannock) |
| Stewart, David (Inverness E & Lochaber) | Wyatt, Derek |
| Yeo, Tim (S Suffolk) | |
| Stewart, Ian (Eccles) | Young, rh Sir George |
| Stinchcombe, Paul | |
| Stoate, Dr Howard | Tellers for the Ayes:
|
| Strang, rh Dr Gavin | Mr. Phil Woolas and
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| Streeter, Gary | Gillian Merron
|
NOES
| |
| Allan, Richard | Calton, Mrs Patsy |
| Baker, Norman | Carmichael, Alistair |
| Barrett, John | Cotter, Brian |
| Beith, rh A J | Davey, Edward (Kingston) |
| Brake, Tom (Carshalton) | Doughty, Sue |
| Bruce, Malcolm | Foster, Don (Bath) |
| Burnett, John | George, Andrew (St Ives) |
| Burstow, Paul | Gidley, Sandra |
| Cable, Dr Vincent | Green, Matthew (Ludlow) |
| Hancock, Mike | Pugh, Dr. John |
| Harris, Dr. Evan (Oxford W & Abingdon) | Reid, Alan (Argyll & Bute) |
| Rendel, David | |
| Harvey, Nick | Russell, Bob (Colchester) |
| Heath, David | Sanders, Adrian |
| Holmes, Paul | Stunell, Andrew |
| Hughes, Simon (Southwark N) | Taylor, Matthew (Truro) |
| Keetch, Paul | Taylor, Dr. Richard (Wyre F) |
| Kirkwood, Sir Archy | Thomas, Simon (Ceredigion) |
| Thurso, John | |
| Lamb, Norman | Tonge, Dr. Jenny |
| Laws, David (Yeovil) | Tyler, Paul (N Cornwall) |
| Llwyd, Elfyn | Webb, Steve (Northavon) |
| Marsden, Paul (Shrewsbury & Atcham) | Williams, Hywel (Caernarfon) |
| Williams, Roger (Brecon) | |
| Moore, Michael | Willis, Phil |
| Oaten, Mark (Winchester) | |
| Öpik, Lembit | Tellers for the Noes:
|
| Price, Adam (E Carmarthen & Dinefwr) | Mrs. Annette L. Brooke and
|
Richard Younger-Ross
|
Question accordingly agreed to.
Government amendments Nos. 35, 36 and 38 to 40 agreed to.
Order for Third Reading read.
6.18 pm
I beg to move, That the Bill be now read the Third time.
Throughout Second Reading, in Committee and during today's deliberations, we have given this Bill fair and measured consideration, and I want to thank all who were involved in Committee for that. Combined with a significant package of extra funding for older people's services, the Bill will bring an end to widespread delayed discharges, and ensure that older people get the services that they need when they need them. It is a Bill that is about the approximately 5,000 mainly elderly people who are delayed unnecessarily in an acute hospital bed. We know that an acute ward is very much the wrong place for someone to be when they are no longer in need of acute hospital care. To be delayed on an acute ward is demoralising for the individual; it can damage their confidence and their prospects for living independently or returning home in future. It is worrying for their families and carers, and bad for the taxpayer and the NHS, and that is why we are determined to tackle the problem. We have made progress. Fewer people are delayed in hospital now than in 1997, but each person stuck in hospital when they want to be out is an argument for change. Throughout the passage of the Bill, Opposition Members have been quick to oppose but slow to suggest alternatives. As we have heard this afternoon, the Liberal Democrats propose lots of plans, but they have been short on solutions. We know that the Conservatives, who we have learned are the new-found friends of local government, oppose the extra investment that the Government propose—they voted against it—but they cannot even claim to be reformers. In their opposition to the Bill, they certainly cannot claim to be the friends of older people. The Bill reflects our determination to match our extra investment with reform of the system to ensure that the needs of older people come first. It will do that, first, by creating a strong financial incentive for local authorities to comply with their existing duties to assist the needs of individuals who are likely to need community care services on discharge from hospital and to provide services to those individuals. Secondly, the Bill strengthens partnerships and brings about increased co-operation between the NHS and local authorities by introducing new duties for them to consult each other in assessing the patient's needs and deciding what services they will make available within set time scales. Thirdly, by removing local authorities' power to charge for community equipment and intermediate care, the Bill simplifies the existing charging system, making it easier for users to understand and easier for local authorities and the NHS to provide those vital services jointly. Contrary to the concern that has been expressed today about partnership between health and local authorities, I believe that the Bill will lead to increased co-operation and joint working. For the first time, there will be a strong incentive for partners to get together to ensure that their discharge procedures work. In certain ways, the Bill is already having a positive impact. Local authorities and their NHS partners are coming together in order to find common solutions to common problems and acknowledging the different parts that they have to play in achieving success. We know that planning for the implementation of reimbursement has led many partners to agree, for example, that they need to speed up their plans to implement fully a single assessment process. I feel confident that with so much good work and innovation already going on around the country, by the time reimbursement is implemented later this year, many local authorities and their NHS partners will have been able to find new and creative solutions to the problem of delayed discharge. Opposition Members have worked hard during the Bill's passage to paint local authorities as victims. In fact, there is only one victim—the older people who are stuck in hospital when they should be out there getting the sort of services and support that we know they want and deserve. Let us be clear: the Bill does not place new responsibilities on local authorities. It simply seeks to add maximum time scales for the assessment and provision of services for which local authorities already have responsibility and places communications between a hospital and a local authority about a patient's case on a formal legal basis. Of course, the Bill places new responsibilities on the NHS to inform local authorities when someone may need ongoing care in order to leave hospital and when people are fit to be discharged. We know that the NHS has not always taken its responsibilities to communicate with social services departments as seriously as it should. The Bill rectifies that and places the responsibility for payment where the responsibility for provision already lies. As I have said already, these are not new responsibilities. Councils have had 18 months and £300 million in building care capacity grant, which has provided vital funding for councils to invest in the services and capacity needed to prevent delays. That investment has brought results. Almost 7,000 older people were trapped in hospital in March 1997, but by September last year that level had been reduced to 4,147. However, we have recognised that there are funding pressures for social services. That is why, in addition to the £1 billion package for older people announced on 23 July and the local government allocation announced on 5 December, on Second Reading my right hon. Friend the Secretary of State announced that an extra £100 million per full year of the scheme will be transferred from the NHS budget to local authorities in order to help them to build the capacity that will help them to avoid the costs of reimbursement and, most importantly, ensure that people will get the services that they need. There has quite rightly been a focus during our debates here and in Committee on the needs of individual patients and their carers. That is right, because it is that focus that is at the centre of the Bill. As I have explained this afternoon, the Bill does nothing to weaken a patient's right to consent or not to treatment. By creating a financial incentive for local authorities to carry out their duties, it will help to ensure that the needs of individual patients are met more quickly, and it will increase the choice that is available to them in terms of the services that they receive. In the amendments that we have tabled today we have recognised the concerns about the needs and role of carers. We have also ensured that carers' services for discharge will need to be in place and that carers can benefit from free community equipment where they need it for their caring. Reimbursement and other proposals in the Bill will lead to increased quality and choice for older people. If local authorities are to avoid delays, in the long term they will need to use the extra investment made available by the Government to invest in a wide range of services and capacity so that they can respond flexibly to an individual's needs, not just with residential care but also with intermediate and interim care, extra sheltered housing, equipment and adaptation services, and packages of intensive support at home, among other provisions. The Bill presents an important opportunity to end widespread delayed discharge and to ensure that thousands of older people do not wait needlessly on an acute ward every day but are provided with a range of high quality community care services to meet their needs as soon as they are ready to leave. Ultimately, a safe transfer from an acute ward to a place where their needs can be more appropriately met is the minimum that older people should be entitled to and expect. That is what the Bill will ensure happens and I commend it to the House.6.26 pm
To listen to the Minister, one might think that the Bill, which has almost completed its passage through this House, had emanated from a group of young Labour researchers meeting in some chi-chi wine bar in Islington, who, as the chardonnay got to them, thought they had come up with the most wonderful wheeze to deal at a stroke with the problem of delayed discharges. More worryingly, it seems that when they awoke the next morning they did not realise that the hazy wheeze of the night before was not such a good idea, and proceeded to pass the idea on to Ministers who, desperate for a quick fix, immediately embraced their ridiculous proposal and got the parliamentary draftsmen to produce a Bill which the Minister tells us is a series of incentives. We all know that the Bill is not a series of incentives: it is a straightforward system to fine local authorities.
On 11 December 2002, the Secretary of State gave the game away when, in answer to an hon. Member's question on a statement in the House, he referred quite blatantly to fines. The Minister, heroically—partly, I suspect, because she does not read Hansard on a daily basis—continued to maintain the myth that the Bill was an incentive measure. Even she finally slipped up today. She saw truth staring her in the face and the F-word passed her lips. She admitted that the Bill was a series of measures to fine local authorities. What is so deeply disturbing about the Bill and the complacency of Ministers in the Department of Health is that the Bill in no shape or form recognises the crisis in long-term care in Britain—a crisis that has been gathering speed since 1997. Nowhere does the Bill address the problem of the loss of more than 60,000 care home beds, the closure of more than 2,000 care homes, or the fact that 100,000 households are no longer receiving domiciliary care compared with five years ago. That is what is so disgraceful about the Bill. It is a wasted opportunity. By creating a system in part 1 that will effectively bamboozle local authorities into ensuring that patients are discharged from hospitals to avoid a fine, the Government think they have found a panacea, whereas in fact it is a short-term fix that will end in disaster. I predict now that in the next two years readmission rates for elderly people leaving hospital will increase at a higher level than the current rises. People will be taken from hospital and placed in what is not necessarily the most appropriate care for their needs because the local authority may be charged a fine. The Government have got it wrong; that is not the right approach. As hon. Members have said, it will undo and damage partnerships between the health service and social services, which have taken a long time to achieve because of natural problems and jealousies in relation to who is responsible for funding. Under the previous Government—and, to their credit, this Government—the process of breaking down the barriers between the health service and social services has moved significantly forward, which is to be welcomed. This Bill will do great damage to that process, as it will create tensions between the two sides and reintroduce a blame culture that we all hoped was being banished as a thing of the past. Although the Government have made money available for three years for local authorities to try to offset, in theory, the impact that the fines will have on social service funding and spending, there are also problems with that, as the fines are to be introduced on 1 April this year, as is the money. If we had had more time on Report we could have debated this matter, but if the money is to come in on 1 April 2003, and if the legislation is passed and the Government proceed with their cock-eyed scheme, the policy should have been to introduce the fines in April 2004 to give local authorities a 12-month breathing space to seek to resolve further the problems of delayed discharges. Bringing in those measures at the same time is a mistake. In addition, I believe that the money that the Government are making available will not match the level of fines that local authorities think they may incur, particularly in the early stages of the new policy. For all of those reasons, I remain implacably opposed to part 1 of the Bill. I am disappointed that the Government have not been prepared to listen more carefully to those who oppose the Bill and who have highlighted its failings. I am a realist—I know my lot in life—and I understand that the Minister of State, charming as she is, will not necessarily listen to my helpful advice. But she does not have to listen to my advice: from her point of view, there are far more credible critics of this policy. There are Back-Bench Labour Members with great experience of social services and local government or the health service who are gravely concerned about this aspect of the Bill. There is the Local Government Association, whose leader, Sir Jeremy Beecham, unless I am wrong, is the Labour leader of Newcastle city council. There are most of the voluntary groups and charity groups in the long-term care sector. The care home owner associations and operators also believe that the Bill is a disaster. Many local authorities throughout the country genuinely believe that the Government are wrong and that the Bill will not solve the problems that they expect it to tackle. I do not know whether the Minister has had an opportunity to phone social services departments in England and Wales. My office had a charming conversation with her social services department. We also contacted that of the Under-Secretary, the hon. Member for Salford (Ms Blears) and of the other Minister of State. We even spoke to the social services department in the Prime Minister's constituency. Not one had a smidgen of enthusiasm for fines, and they were worried about the amount that they might have to pay in fines in the next 12 months. Despite that, Ministers have not been prepared to reconsider. We are now beginning the last 25 minutes of debate in the House on this nasty and flawed measure. Of course, it will leave the House with a majority in the next hour and go to another place. I assure the Minister that we shall continue to oppose it there, because we believe that there is a serious problem that needs tackling. I agree with her that the real losers are the patients who experience delayed discharge from hospital. However, the Bill is not the way in which to help them and minimise the problem. I therefore urge my hon. Friends to join me in vehemently opposing Third Reading.6.37 pm
The Government deserve much credit for the steps that they have taken and the measures that they have introduced to improve collaborative working between health and social services departments. However, the Bill does not deserve credit and I agree with some of the points that the hon. Member for West Chelmsford (Mr. Burns) made and the anxieties that several hon. Members have expressed.
The Health Committee examined delayed discharges, and we did not receive evidence from any source—health departments, social services departments or voluntary organisations—in support of the principles at the heart of the Bill. Not even Department of Health officials appeared especially enthusiastic about it. I made my anxieties known on Second Reading, but the Minister did not respond to them. She is a competent Minister, for whom I have a high regard, but I remain convinced that the Bill does not tackle those concerns. The model is based on the policies that were applied 10 years ago in Sweden. It was interesting to visit that country shortly before Christmas and discuss with political colleagues in the Swedish Parliament whether the measure could work. I admit that some improvements have occurred in Sweden, but colleagues were concerned about the number of people whose discharge from hospital was delayed. In Sweden, county councils run hospitals and municipalities run social services, and integration is being considered. I humbly suggest that the Government may eventually want to consider that the lack of an integrated health and social care system is the genuine problem. An increasing number of Labour Members who have examined the matter are beginning to agree that integration is the way forward. I cannot support the Bill. It is a bad measure that has not been thought through. It will damage the good, positive relationships between health and social services departments that the Government have created in some areas. I hope that, even at this late stage, they will see sense and take advantage of opportunities in another place to withdraw the measure.6.40 pm
I hope that the Government will take to heart the very measured comments that we have just heard from the Chairman of the Select Committee on Health.
I preface my brief remarks by saying that, given the terrible hand the Minister was dealt in being asked to take the Bill through, she did so with competence and patience, both in Standing Committee and on Report. I said on Second Reading, which seems very recent, given the speed at which the Bill has gone through the House, that the Bill was one of the worst I had seen in some 30 years. Despite the heroic attempts by the Opposition parties and the welcome amendment that we have just passed on carers, I think that it is one of the worst Bills to go through the House in those 30 years. If there is one discharge that should be delayed, it is the discharge of this Bill from the other place. I hope that the Government will find that their ambitions to get the Bill through quite quickly, by April this year, are dashed by the very serious consideration that those in another place give it. We have not had proper time to consider it. There were chunks that we did not debate in Standing Committee. We lost an amount of time on Report because of the statements that, understandably, were made. Not only has the Bill been rushed through, but the timetable for implementation is very challenging. The Minister has ignored the many pleas from those who have to implement the Bill to delay it until April 2004. That was a concession that she might well have made. Of course, the Bill is unwanted by local authorities, but it is also unwanted by the health service. We heard in Standing Committee of representatives of the NHS Confederation and of the medical profession saying that they did not want it either, because it will damage the relationships that they value between them and social services. The Bill has been condemned by all the voluntary organisations. Just today, we heard from Help the Aged, Age Concern and the Alzheimer's Society. I cannot think of a single voluntary organisation that has welcomed the Bill. The point made by those to whom I have referred is that the Bill is misguided, because it focuses on one very narrow part of the problem—the discharge from hospital to care in the community, a care home—instead of standing back and taking a holistic look at the problem from start to finish. The Bill is unfair and unilateral. It involves a unilateral fine by one part of the public sector on another, with no opportunity for that other sector to obtain reimbursement when it faces costs because of delays by the NHS. If there is a dispute, as we heard earlier today, the jury is not wholly unbiased. The Bill ignores the role that the Government have played in reducing the capacity in the care home sector, which is one of the strategic reasons behind delayed discharges. It will distort local government priorities. Local authorities will spend less time and energy on prevention to avoid the fines. As we heard today, if one wants to get somebody into a care home, the best way to do it now is to get them into hospital first. The law of unintended consequences and perverse incentives will apply. On Second Reading, the Bill was virtually friendless on the Government Benches. Indeed, the only contribution from Labour Members on Third Reading has been deeply hostile. At a time when the NHS needs less bureaucracy it will get more, with invoices flying backwards and forwards between social services and the NHS. I know of no right-wing economist in this country who ever proposed an internal market of this nature to deal with the problem. I believe that the Bill is flawed in concept and will be divisive in its consequences. I shall walk through the No Lobby with a spring in my step to register in the only way still available to me my deep-rooted objection to this legislation.6.44 pm
I welcomed the Bill on Second Reading, and I assure my hon. Friend the Minister that I shall support her in the Lobby tonight.
The Bill is an instrument, albeit a blunt instrument, as described by the Select Committee of my hon. Friend the Member for Wakefield (Mr. Hinchliffe), to concentrate people's minds. The hon. Member for West Chelmsford (Mr. Burns) and my hon. Friend the Member for Wakefield, for whom I have a great deal of time and respect, seem able to see only the negative points. They seem to think that the Bill will create a combat atmosphere between social services and the health services. I do not see it that way. The Bill will concentrate people's minds on better co-operation.
Like the Whips Office.
No, not like that.
We are talking about people, mostly old people, being trapped in hospital, and some social service departments and health authorities are doing very little to tackle that. Fortunately, in my constituency, they are doing something. Planning for discharge starts before patients are admitted for elective surgery, and that is how it should be. The team that works in Doncaster can call on a range of options. If necessary, it can use an intermediate care ward, which has been provided by joint funding, as well as aids, adaptations and all the rest of it. The proposals need not be combative at all; they can lead to more co-operation. Let us not forget that the Bill is about getting people out of the hospital beds in which they are trapped even though they no longer need health care treatment. That is why I shall walk through the Lobby tonight in support of my hon. Friend the Minister and the Government.6.46 pm
I note that the hon. Member for Doncaster, North (Mr. Hughes) will not walk through the Lobby with a spring in his step, unlike the right hon. Member for North-West Hampshire (Sir George Young).
I thank the hon. Member for Wakefield (Mr. Hinchliffe) and his Select Committee for the report on delayed discharge that they published last year. It is an invaluable piece of research, which I found very useful in Committee, and many of the questions put to officials during the inquiry provided useful answers. As I read through the evidence given to the inquiry, it suggested to me that there was a great lack of enthusiasm among officials and, indeed, anyone who gave evidence about this approach. Indeed, officials said that delayed discharges are a symptom of a wider, whole system problem and that we are lacking in capacity, in planning and in preventing admissions in the first place. Four Committee sittings and consideration on Report later, nothing fundamental has changed in the Bill. Rather than building on and continuing to encourage the partnership between the NHS and social services departments that hon. Members on both sides of the House would wish to develop, the Bill will create an adversarial approach of game playing and cost shunting between the two. Worse still, it will turn the patient into a commodity to be haggled over by social services departments and the NHS. There is no room in the Bill for informed consent. As the Bill has progressed through the House, I have been drawn to the conclusion that it is about beds, not the needs or interests of patients. It is a strange sort of partnership that gives one partner a stick to beat the other. That sounds rather more like domestic violence than addressing the real needs of the health service. The Bill, as it leaves the House, will put in place a system of fines, as the Minister has confirmed from the Dispatch Box today, that will distort the spending priorities of local social services departments. Those departments will have to prioritise hospital patients for assessments and services, because a fine is attached, at the expense of those who are hidden, frail and isolated, in their own homes and who count only when they wind up in hospital because of a fall or some other mishap. In Committee, the Minister talked about the introduction of financial flows—she did so again today—that will lead to hospitals picking up a penalty if emergency admissions take place. She conveniently did not mention that that reform would not start until April 2004. She did not tell us that the single assessment process will not start until that date; nor did she tell us that, although some extra cash for some councils will arrive in April this year, councils did not know the details of those budgets until December and are only now beginning to find out what they mean for them and their communities in terms of council tax rises and investment in services. It is hardly surprising that the services to bridge the gap in capacity have not yet been put in place. The Minister has remained blind to the issues of capacity throughout this debate. When the Bill makes its way to the House of Lords, I can assure the Government that my colleagues on the Liberal Democrat Benches will do all that they can to ensure that it does not have a safe passage through the other place. I thank my hon. Friend the Member for Cheadle (Mrs. Calton) and my staff for their hard work on the Bill. This is a bad Bill, and the Liberal Democrats reject it. It puts beds before patients and sets the NHS up against social services. It makes it much more likely that, in future, more people will get the wrong care in the wrong place at the wrong time.6.50 pm
I have sat here all afternoon listening to an unending stream of negativity and doom from the Opposition Benches. I feel compelled to rise to speak, because the Bill offers two major benefits to which the two Opposition parties have given no regard whatever. First, it will lead us, as a society, to support more people at home and lead to much less reliance on institutional care than at present. Secondly, it will bring down the average length of stay in acute beds, which will allow more patients to be treated on the NHS. All Opposition Members agreed that it would bring down the average length of stay, yet they seemed to suggest that that was purely negative. I put it to them that it might actually be positive.
Why will the Bill help more people to live at home for longer? My own family experience tells me that, once a patient has been deemed fit for discharge—that is, once a clinical decision has been made to discharge them, so there is no question of their being forced home too early—it is in the patient's direct interest that that discharge should happen as soon as possible. We have all seen examples of people who have languished in hospital for too long, then drifted into residential or nursing care and lost the opportunity to go back home and be supported there. The Bill will expedite the discharge process and, together with the provision of free aids and adaptations, get more people home once they are able to cope. Unlike some on the Conservative Front Bench, I do not believe that nursing homes are a good place to be. I saw my grandmother deteriorate rapidly after she went from a long stay in hospital to residential care and then to nursing care. Her personal possessions were stolen while she was in residential care, and her wedding ring was ripped off her finger in the last days before she died. Nursing homes are not a good place to be. We need to encourage more people to live independently at home, which is what I believe the Bill will allow us to do. The Bill will bring down the average length of stay in NHS beds, which will allow us to treat more NHS patients. Like the Health Committee Chairman, I, too, went to Sweden. We visited the Huddinge university hospital and heard from Dr. Lars Collste.Will the hon. Gentleman give way?
The hon. Gentleman did not go to Sweden, so I will not let him intervene.
Dr. Collste told us that, before the cross-charging system was introduced in Sweden, the average length of stay for an in-patient episode was seven to eight days. After the system was introduced, it went down to 4.8 days. His view was that the system worked.Will the hon. Gentleman give way?
I will not, because other Members want to speak.
We also heard, as my hon. Friend the Member for Wakefield (Mr. Hinchliffe) said, that the system was being reviewed by the Swedish Parliament. That is true. It is looking at ways in which the cross-charging system can be reconciled with more co-operation. It is not ditching the system; it is simply looking at how municipalities and counties can co-operate more when the system is introduced. I do not think that that is a bad thing, and the Department might like to look at the experience in Sweden before the measures in the Bill are finalised. I congratulate the Minister on her skilful steering of the Bill through Parliament, and I look forward to it bringing the two major improvements that I have outlined to my constituents.6.54 pm
I welcome the opportunity to speak on this important issue. I shall preface my remarks by saying that I fully support the aims of the Bill. I have listened to my hon. Friend the Minister speak with some passion about the needs of elderly people trapped in hospital beds who ought not to be there and who need an appropriate form of care. It is absolutely vital that those people get the care appropriate to their condition or illness, whether that be a hospital bed, a nursing home bed, a place in a care home or intermediate care home, or support in their own home.
I rehearsed some of my concerns on Second Reading, and I still have concerns about the implications for local authorities, but one aspect of the Bill that I welcome is the introduction of new, robust joint assessment procedures. As I have said to my hon. Friend the Minister before, in my local area we have good working between health and social services, which I want to continue, but I am aware that the situation nationwide is variable, so it is vital that we have a new and comprehensive assessment procedure to benefit patients in hospitals. Will my hon. Friend the Minister look carefully at the implementation timetable and listen to the concerns of local authorities, the health service and, especially, those elderly people who all need caring for? Will she carefully consider the comments that she is getting back to ensure that she is properly monitoring the implementation timetable so that local authorities, health services and, above all, the elderly people we represent are not disadvantaged?6.56 pm
I echo the plea of my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) for clemency for local authorities such as mine, which have been doing their damnedest to do exactly what the Government have asked. They are producing the close working, but, none the less, they face problems and circumstances that are totally beyond their control, such as shortages of nurses and elderly mentally infirm beds as well as trained care workers to provide domiciliary care services. That means that punitive measures in clause 4 will cost them about £1 million a year if they are implemented this spring.
The authorities need more time, and it would be folly and very sad if the £100 million that the Government are giving to extend care capacity for this purpose were simply taken back in fines. That would achieve nothing. Therefore, sensitive timing of the implementation of the more difficult measures is essential.6.57 pm
On Second Reading, I paid tribute to the absolute commitment of Camden, my local authority, to creating a multi-faceted, properly integrated, high-quality service for elderly people. Indeed, my hon. Friend the Minister paid tribute to Camden and, I believe, Croydon on Second Reading and in Committee for their abilities in reducing delayed discharges, but I must tell her that my local authority's concerns are by no means stilled or quieted. I add my voice to those of my hon. Friends who have urged the Government to pay particular attention to the timetabling of the introduction of these measures.
On going into the fine detail, my local authority discovered that, far from getting a 6 per cent. increase, it is receiving only a 3 per cent. increase in social services funding. Certain authorities suffer from a shortage of available places, because the majority of elderly people undoubtedly want to remain in their locality, which can be a particular difficulty for an inner-London authority such as mine. There are also concerns in my local authority over the costs of implementing the examination of throughput on the issue. It urges the Government to allow it time properly to track how it can better integrate the more-than-one service required to ensure that elderly people are not left in hospital past the point required by their medical care. I urge the Government to delay, if possible, the introduction of the measures until all local authorities have properly examined such questions. I accept that not all local authorities are as effective or committed as Camden, but I do not believe that the effective and committed local authorities should be punished because others have still not got their act together.Question put, That the Bill be now read the Third time:—
The House divided: Ayes 323, Noes 188.
Division No. 54]
| [7:00 pm
|
AYES
| |
| Abbott, Ms Diane | Cousins, Jim |
| Adams, Irene (Paisley N) | Cox, Tom (Tooting) |
| Ainger, Nick | Cranston, hon. Ross |
| Allen, Graham | Crausby, David |
| Anderson, Janet (Rossendale & Darwen) | Cruddas, Jon |
| Cryer, Ann (Keighley) | |
| Armstrong, rh Ms Hilary | Cryer, John (Hornchurch) |
| Atherton, Ms Candy | Cummings, John |
| Atkins, Charlotte | Cunningham, Jim (Coventry S) |
| Austin, John | Cunningham, Tony (Workington) |
| Bailey, Adrian | Davey, Valerie (Bristol W) |
| Baird, Vera | David, Wayne |
| Banks, Tony | Davidson, Ian |
| Barron, rh Kevin | Davies, rh Denzil (Llanelli) |
| Battle, John | Davies, Geraint (Croydon C) |
| Beard, Nigel | Dawson, Hilton |
| Beckett, rh Margaret | Dean, Mrs Janet |
| Begg, Miss Anne | Denham, rh John |
| Bell, Stuart | Dhanda, Parmjit |
| Benn, Hilary | Dismore, Andrew |
| Bennett, Andrew | Dobbin, Jim (Heywood) |
| Benton, Joe (Bootle) | Dobson, rh Frank |
| Best, Harold | Donohoe, Brian H. |
| Betts, Clive | Doran, Frank |
| Blackman, Liz | Dowd, Jim (Lewisham W) |
| Blears, Ms Hazel | Drew, David (Stroud) |
| Blizzard, Bob | Drown, Ms Julia |
| Boateng, rh Paul | Eagle, Angela (Wallasey) |
| Borrow, David | Eagle, Maria (L'pool Garston) |
| Bradley, rh Keith (Withington) | Edwards, Huw |
| Bradley, Peter (The Wrekin) | Efford, Clive |
| Bradshaw, Ben | Ellman, Mrs Louise |
| Brennan, Kevin | Ennis, Jeff (Barnsley E) |
| Brown, rh Nicholas (Newcastle E Wallsend) | Etherington, Bill |
| Field, rh Frank (Birkenhead) | |
| Brown, Russell (Dumfries) | Fisher, Mark |
| Bryant, Chris | Fitzpatrick, Jim |
| Burgon, Colin | Fitzsimons, Mrs Lorna |
| Burnham, Andy | Flint, Caroline |
| Caborn, rh Richard | Flynn, Paul (Newport W) |
| Cairns, David | Follett, Barbara |
| Campbell, Alan (Tynemouth) | Foster, rh Derek |
| Campbell, Mrs Anne (C'bridge) | Foster, Michael (Worcester) |
| Campbell, Ronnie (Blyth V) | Foster, Michael Jabez (Hastings & Rye) |
| Casale, Roger | |
| Caton, Martin | Foulkes, rh George |
| Cawsey, Ian (Brigg) | Francis, Dr. Hywel |
| Challen, Colin | Gapes, Mike (Ilford S) |
| Clapham, Michael | Gardiner, Barry |
| Clark, Mrs Helen (Peterborough) | George, rh Bruce (Walsall S) |
| Clark, Paul (Gillingham) | Gerrard, Neil |
| Clarke, rh Tom (Coatbridge & Chryston) | Gibson, Dr. Ian |
| Gilroy, Linda | |
| Clelland, David | Godsiff, Roger |
| Clwyd, Ann (Cynon V) | Goggins, Paul |
| Coaker, Vernon | Griffiths, Jane (Reading E) |
| Coffey, Ms Ann | Griffiths, Win (Bridgend) |
| Cohen, Harry | Grogan, John |
| Coleman, Iain | Hall, Mike (Weaver Vale) |
| Connarty, Michael | Hall, Patrick (Bedford) |
| Cook, rh Robin (Livingston) | Hamilton, David (Midlothian) |
| Cooper, Yvette | Hanson, David |
| Corston, Jean | Harman, rh Ms Harriet |
| Harris, Tom (Glasgow Cathcart) | Mahmood, Khalid |
| Healey, John | Mahon, Mrs Alice |
| Henderson, Doug (Newcastle N) | Mallaber, Judy |
| Henderson, Ivan (Harwich) | Mann, John (Bassetlaw) |
| Hendrick, Mark | Marris, Rob (Wolverh'ton SW) |
| Hepburn, Stephen | Marsden, Gordon (Blackpool S) |
| Heppell, John | Marshall, David (Glasgow Shettleston) |
| Hesford, Stephen | |
| Hill, Keith (Streatham) | Marshall, Jim (Leicester S) |
| Hoey, Kate (Vauxhall) | Martlew, Eric |
| Hood, Jimmy (Clydesdale) | Meacher, rh Michael |
| Hoon, rh Geoffrey | Meale, Alan (Mansfield) |
| Hope, Phil (Corby) | Michael, rh Alun |
| Hopkins, Kelvin | Milburn, rh Alan |
| Howarth, rh Alan (Newport E) | Miliband, David |
| Howarth, George (Knowsley N & Sefton E) | Miller, Andrew |
| Moffatt, Laura | |
| Hughes, Kevin (Doncaster N) | Mole, Chris |
| Humble, Mrs Joan | Moonie, Dr. Lewis |
| Hutton, rh John | Moran, Margaret |
| Iddon, Dr. Brian | Morgan, Julie |
| Ingram, rh Adam | Morris, rh Estelle |
| Irranca-Davies, Huw | Mountford, Kali |
| Jackson, Glenda (Hampstead & Highgate) | Mudie, George |
| Mullin, Chris | |
| Jackson, Helen (Hillsborough) | Munn, Ms Meg |
| Jamieson, David | Murphy, Denis (Wansbeck) |
| Jenkins, Brian | Murphy, Jim (Eastwood) |
| Johnson, Miss Melanie (Welwyn Hatfield) | Murphy, rh Paul (Torfaen) |
| Naysmith, Dr. Doug | |
| Jones, Helen (Warrington N) | Norris, Dan (Wansdyke) |
| Jones, Kevan (N Durham) | O'Brien, Bill (Normanton) |
| Jones, Martyn (Clwyd S) | O'Brien, Mike (N Warks) |
| Joyce, Eric (Falkirk W) | O'Hara, Edward |
| Kaufman, rh Gerald | Organ, Diana |
| Keeble, Ms Sally | Osborne, Sandra (Ayr) |
| Keen, Alan (Feltham) | Owen, Albert |
| Keen, Ann (Brentford) | Palmer, Dr. Nick |
| Kemp, Fraser | Picking, Anne |
| Kidney, David | Pickthall, Colin |
| Kilfoyle, Peter | Pike, Peter (Burnley) |
| King, Andy (Rugby) | Plaskitt, James |
| King, Ms Oona (Bethnal Green & Bow) | Pollard, Kerry |
| Pond, Chris (Gravesham) | |
| Knight, Jim (S Dorset) | Prentice, Ms Bridget (Lewisham E) |
| Ladyman, Dr. Stephen | |
| Lammy, David | Prentice, Gordon (Pendle) |
| Laxton, Bob (Derby N) | Primarolo, rh Dawn |
| Lazarowicz, Mark | Prosser, Gwyn |
| Lepper, David | Purchase, Ken |
| Leslie, Christopher | Purnell, James |
| Levitt Tom (High Peak) | Quin, rh Joyce |
| Lewis, Ivan (Bury S) | Quinn, Lawrie |
| Lewis, Terry (Worsley) | Rapson, Syd (Portsmouth N) |
| Liddell, rh Mrs Helen | Reed, Andy (Loughborough) |
| Linton, Martin | Reid, rh Dr. John (Hamilton N & Bellshill) |
| Lloyd, Tony (Manchester C) | |
| Love, Andrew | Robertson, John (Glasgow Anniesland) |
| Lucas, Ian (Wrexham) | |
| Luke, Iain (Dundee E) | Robinson, Geoffrey (Coventry NW) |
| Lyons, John (Strathkelvin) | |
| McAvoy, Thomas | Ross, Ernie (Dundee W) |
| McCabe, Stephen | Roy, Frank (Motherwell) |
| McCafferty, Chris | Ruane, Chris |
| McDonagh, Siobhain | Ruddock, Joan |
| MacDonald, Calum | Russell, Ms Christine (City of Chester) |
| MacDougall, John | |
| McFall, John | Salter, Martin |
| McIsaac, Shona | Savidge, Malcolm |
| McKechin, Ann | Sawford, Phil |
| McKenna, Rosemary | Sedgemore, Brian |
| McNamara, Kevin | Shaw, Jonathan |
| McNulty, Tony | Sheerman, Barry |
| MacShane, Denis | Sheridan, Jim |
| Mactaggart, Fiona | Shipley, Ms Debra |
| McWalter, Tony | Simon, Siôn (B' ham Erdington) |
| Singh, Marsha | Todd, Mark (S Derbyshire) |
| Skinner, Dennis | Touhig, Don (Islwyn) |
| Smith, rh Andrew (Oxford E) | Trickett, Jon |
| Smith, Angela (Basildon) | Turner, Dennis (Wolverh'ton SE) |
| Smith, rh Chris (Islington S & Finsbury) | Turner, Dr. Desmond (Brighton Finsbury) |
| Smith, Geraldine (Morecambe & Lunesdale) | Twigg, Derek (Halton) |
| Twigg, Stephen (Enfield) | |
| Smith, Jacqui (Redditch) | Tynan, Bill (Hamilton S) |
| Smith, John (Glamorgan) | Vaz, Keith (Leicester E) |
| Smith, Llew (Blaenau Gwent) | Vis, Dr. Rudi |
| Soley, Clive | Walley, Ms Joan |
| Southworth, Helen | Ward, Claire |
| Spellar, rh John | Wareing, Robert N. |
| Squire, Rachel | Watts, David |
| Starkey, Dr. Phyllis | White, Brian |
| Steinberg, Gerry | Whitehead, Dr. Alan |
| Stevenson, George | Wicks, Malcolm |
| Stewart, David (Inverness E & Lochaber) | Williams, rh Alan (Swansea W) |
| Williams, Betty (Conwy) | |
| Stewart, Ian (Eccles) | Wills, Michael |
| Stinchcombe, Paul | Wood, Mike (Batley) |
| Stoate, Dr. Howard | Woodward, Shaun |
| Strang, rh Dr. Gavin | Woolas, Phil |
| Stringer, Graham | Worthington, Tony |
| Sutcliffe, Gerry | Wright, Anthony D. (Gt Yarmouth) |
| Tami, Mark (Alyn) | |
| Taylor, rh Ann (Dewsbury) | Wright David (Telford) |
| Taylor, Dari (Stockton S) | Wright, Tony (Cannock) |
| Taylor, David (NW Leics) | Wyatt, Derek |
| Thomas, Gareth (Clwyd W) | |
| Thomas, Gareth (Harrow W) | Tellers for the Ayes:
|
| Timms, Stephen | Joan Ryan and
|
| Tipping, Paddy | Gillian Merron
|
NOES
| |
| Ainsworth, Peter (E Surrey) | Collins, Tim |
| Allan, Richard | Cormack, Sir Patrick |
| Amess, David | Cotter, Brian |
| Ancram, rh Michael | Curry, rh David |
| Arbuthnot, rh James | Davey, Edward (Kingston) |
| Atkinson, Peter (Hexham) | Davies, Quentin (Grantham & Stamford) |
| Bacon, Richard | |
| Baker, Norman | Davis, rh David (Haltemprice & Howden) |
| Barker, Gregory | |
| Baron, John (Billericay) | Dodds, Nigel |
| Barrett, John | Dorrell, rh Stephen |
| Beggs, Roy (E Antrim) | Doughty, Sue |
| Beith, rh A. J. | Duncan Smith, rh Iain |
| Bellingham, Henry | Evans, Nigel |
| Bercow, John | Fabricant, Michael |
| Blunt, Crispin | Fallon, Michael |
| Boswell, Tim | Flight, Howard |
| Bottomley, rh Virginia (SW Surrey) | Flook, Adrian |
| Forth, rh Eric | |
| Brady, Graham | Foster, Don (Bath) |
| Brake, Tom (Carshalton) | Fox, Dr. Liam |
| Brazier, Julian | Gale, Roger (N Thanet) |
| Brooke, Mrs Annette L | George, Andrew (St. Ives) |
| Browning, Mrs Angela | Gibb, Nick (Bognor Regis) |
| Bruce, Malcolm | Gidley, Sandra |
| Burnett, John | Gillan, Mrs Cheryl |
| Burns, Simon | Grayling, Chris |
| Burnside, David | Green, Damian (Ashford) |
| Burstow, Paul | Green, Matthew (Ludlow) |
| Cable, Dr. Vincent | Gummer, rh John |
| Calton, Mrs Patsy | Hammond, Philip |
| Cameron, David | Hancock, Mike |
| Campbell, Gregory (E Lond'y) | Harris, Dr. Evan (Oxford W & Abingdon) |
| Carmichael, Alistair | |
| Cash, William | Harvey, Nick |
| Chapman, Sir Sydney (Chipping Barnet) | Hawkins, Nick |
| Hayes, John (S Holland) | |
| Chope, Christopher | Heathcoat-Amory, rh David |
| Clarke, rh Kenneth (Rushcliffe) | Hendry, Charles |
| Clifton-Brown, Geoffrey | Hermon, Lady |
| Hinchliffe, David | Portillo, rh Michael |
| Hoban, Mark (Fareham) | Price, Adam (E Carmarthen & Dinefwr) |
| Hogg, rh Douglas | |
| Holmes, Paul | Prisk, Mark (Hertford) |
| Howard, rh Michael | Pugh, Dr. John |
| Howarth, Gerald (Aldershot) | Redwood, rh John |
| Hughes, Simon (Southwark N) | Reid, Alan (Argyll & Bute) |
| Hunter, Andrew | Rendel, David |
| Jack, rh Michael | Robathan, Andrew |
| Jackson, Robert (Wantage) | Robertson, Hugh (Faversham & M-Kent) |
| Jenkin, Bernard | |
| Keetch, Paul | Robertson, Laurence (Tewk'b'ry) |
| Key, Robert (Salisbury) | Robinson, Mrs Iris (Strangford) |
| Kirkbride, Miss Julie | Robinson, Peter (Belfast E) |
| Kirkwood, Sir Archy | Roe, Mrs Marion |
| Knight, rh Greg (E Yorkshire) | Ruffley, David |
| Laing, Mrs Eleanor | Russell, Bob (Colchester) |
| Lait, Mrs Jacqui | Sanders, Adrian |
| Lamb, Norman | Sayeed, Jonathan |
| Lansley, Andrew | Selous, Andrew |
| Laws, David (Yeovil) | Shephard, rh Mrs Gillian |
| Leigh, Edward | Shepherd, Richard |
| Letwin, rh Oliver | Simmonds, Mark |
| Lewis, Dr. Julian (New Forest E) | Simpson, Keith (M-Norfolk) |
| Liddell-Grainger, Ian | Smyth, Rev. Martin (Belfast S) |
| Lidington, David | Soames, Nicholas |
| Lilley, rh Peter | Spelman, Mrs Caroline |
| Llwyd, Elfyn | Spicer, Sir Michael |
| Loughton, Tim | Spink, Bob (Castle Point) |
| Luff, Peter (M-Worcs) | Spring, Richard |
| McIntosh, Miss Anne | Steen, Anthony |
| Mackay, rh Andrew | Streeter, Gary |
| Maclean, rh David | Stunell, Andrew |
| McLoughlin, Patrick | Swayne, Desmond |
| Malins, Humfrey | Swire, Hugo (E Devon) |
| Marsden, Paul (Shrewsbury & Atcham) | Syms, Robert |
| Taylor, Ian (Esher) | |
| Mates, Michael | Taylor, John (Solihull) |
| Maude, rh Francis | Taylor, Matthew (Truro) |
| Mawhinney, rh Sir Brian | Taylor, Dr. Richard (Wyre F) |
| May, Mrs Theresa | Thomas, Simon (Ceredigion) |
| Mercer, Patrick | Thurso, John |
| Moore, Michael | Tonge, Dr. Jenny |
| Moss, Malcolm | Tredinnick, David |
| Murrison, Dr. Andrew | Turner, Andrew (Isle of Wight) |
| Norman, Archie | Tyler, Paul (N Cornwall) |
| Oaten, Mark (Winchester) | Tyrie, Andrew |
| O'Brien, Stephen (Eddisbury) | Viggers, Peter |
| Öpik, Lembit | Walter, Robert |
| Osborne, George (Tatton) | Waterson, Nigel |
| Page, Richard | Webb, Steve (Northavon) |
| Paice, James | Whittingdale, John |
| Paterson, Owen | Widdecombe, rh Miss Ann |
| Pickles, Eric | Wiggin, Bill |
| Willetts, David | Young, rh Sir George |
| Williams, Hywel (Caernarfon) | Younger-Ross, Richard |
| Williams, Roger (Brecon) | |
| Willis, Phil | |
| Winterton, Sir Nicholas (Macclesfield) | Tellers for the Noes:
|
Mr. David Wilshire and
| |
| Yeo, Tim (S Suffolk) | Mr. Mark Francois
|
Question accordingly agreed to.
Bill read the Third time, and passed.
Petitions
Ethical Investment
7.15 pm
I have a petition of approximately 1,200 signatures, which has been compiled and organised by Chelsea Financial Services, a business located in my constituency. The petition urges the Government to take further action to support and assist those companies and organisations working in ethical investment. The petition has my complete support and I would very much welcome the support of the House for it.
To lie upon the Table.
Natural Health Products
I have a petition from Consumers for Health Choice from the Ribble Valley and other parts of the United Kingdom who use health shops, with 3,700 signatures on it. It declares that
consumers in the United Kingdom have for many years maintained good health by choosing to take safe vitamin and mineral supplements and Herbal remedies; and fears that the European Food Supplements Directive on Traditional Herbal Medicinal Products would severely restrict the number and range of such products on general retail sale in the future.
The Petitioners therefore request that the House of Commons requires the Secretary of State for Health does all in his power to protect the rights of UK consumers by ensuring that such European legislation does not unnecessarily and unacceptably restrict the availability of natural Health Products.
And the Petitioners remain, etc.
To lie upon the Table.
Food Standards Agency
Motion made, and Question proposed, That this House do now adjourn.— [Mr. Kemp.]
7.16 pm
Outside very large urban areas there are still some small towns that manage to maintain a number of specialist shops. I am rather spoilt in my constituency because we have one or two very good ones, and one of the particular favourites of my constituents is a family firm of bakers called Chatwins, which has in its time done considerable damage to my hips and waistline but is much appreciated by those who enjoy its products. Since it is now, I believe, run by the fourth generation of that family, it has a long tradition of supplying very high quality goods. I therefore was considerably surprised when, in the summer, we were struck by a very upsetting incidence of salmonella and I received a letter from Chatwins, setting out a series of circumstances that I thought rather worrying.
Let me begin by saying that I believe that in this day and age we have very many more manufactured foods than we used to, which frequently contain every known chemical on the face of God's earth, and the circumstances in which food is sold to the public seem to me to be in need of considerable and careful monitoring. I in no way resile from the position that in public health we need not only very high standards but standards that everyone appreciates and accepts. As a very young doctor's wife I knew a senior partner who was then medical officer of health in a Devonian borough where I lived at the time and who once, when I ventured to say that I had seen the kitchens of the local hotel and they left a little bit to be desired, informed me, "Yes, dear, but the food is absolutely marvellous." We have moved on since those days, but it is very important with any kind of public body that is undertaking the role of a statutory body—which is what the Food Standards Agency is—that it should be not only aware of the impact of what it is doing but absolutely certain that it does it in a manner that can not only be defended to the general public but supported by the general public. I was therefore very concerned when I received a letter, saying that after the recent salmonella outbreak, the business received unfair treatment from the Food Standards Agency.their"After our name was mentioned in about half the cases, the local Environmental Health Officers carried out tests in our bakery and shops on Tuesday 8th October. We also followed all"
"recommendations…including only using pasteurised eggs.
We had a follow-up meeting with the EHO on Friday llth October where we were informed that all tests carried out…proved to be negative, and that they would try and keep our name out of any press release.
On Tuesday 15th October we were informed…of the sad news that one man had died over the weekend. They also faxed us a copy of the press release from the FSA…."—
in which the name of the bakery was mentioned, which appeared not only in the local but in the national press—
one of the local papers—"From this point on it appeared to be fair to link Chatwins with the death of the first and also the second gentleman. The front page of"—
that is, a senior member of the firm—"was most damaging…. By saying tests were carried out at the bakery AFTER the second man had died, it implies that we were the cause of death. The facts were that the tests were carried out over a week ago, and from my understanding"—
It is important that we consider the series of events that affected Chatwins bakery. First, it was aware of its involvement only when it became clear that there was a problem. Secondly, I wrote directly to the head of the Food Standards Agency, as a constituency Member of Parliament, and as I would do with any transport question to a stand-alone agency, to inquire exactly what had happened, who was taking responsibility and whether the agency was aware of the impact on a particular firm. I think that I had every justification for doing so. The firm was not trying to shift blame in any way, nor did it run away from its responsibilities at any point, or do anything other than to accept that salmonella is an extremely dangerous disease for many people. Of course, the firm was so concerned that it was not passing on any form of infection to its customers that it undertook to do whatever was necessary. I received a silly letter back from the Food Standards Agency, which said in effect, "Don't speak to us. We're tremendously important. Speak only to the Under-Secretary". Frankly, it was such a bureaucratic and silly letter that I am sorry to say that I sent rather a nasty reply. I have been known occasionally to express myself with some vigour and in fairly straightforward English. I said:"the second man hadn't eaten a Chatwins product."
"Your inadequate, yet fastidiously bureaucratic response to my letter of 24th October arrived this morning. I think it might be helpful for me to remind you that I am a Member of Parliament, and that I wrote to the Chairman of the Food Standards Agency on behalf of one of my constituents, who felt that his business had suffered due to press releases issued by the Food Standards Agency. Given the foregoing, I expected a courteous and prompt reply from or on behalf of Sir John, ideally explaining how the FSA came to damage my constituent's reputation, perhaps apologising and maybe even offering some kind of amends.
Frankly, we must have some sense in this case. My hon. Friend the Under-Secretary then sent me a long reply in which she set out what the Department regarded as the official answer. I found that as worrying as some of my original contacts with the agency—for example, the fact that it stated:What I did not expect, and what I will not accept…is an irrelevant summary of the FSA's internal administrative procedures."
I am from a family that contains five doctors. I have the strange idea that a negative result to a test probably means that there is not infection there. Obviously, that is the view of an outsider. The letter from the Under-Secretary continued:"Turning to the question of lack of evidence, the negative test results from Chatwins are not proof in themselves that the bakery did not supply food contaminated with salmonella."
Let us be clear what happened. There was a problem. When the bakery was made aware of the problem, those who ran it said that they were very concerned. They co-operated with the environmental health officers in every possible way and were told that, at that point, because the results had not been obtained, the name of the bakery would not be used—and the next thing they knew was that they were all over the papers. It is not surprising that an announcement to the general public that there may be salmonella in cream buns has some effect on sales. I do not know why it happens—perhaps it shows how unimaginative customers are. Whatever the reason, the announcement had a direct and immediate effect. What happened then? Did we get any response or explanation from the FSA? Did we get even a gesture of apology—"We're sorry. We had no intention of damaging the business before we had the evidence to back it up."? Not at all. We got only a letter saying, in essence, "Well, tough. This is what we do, this is how we behave, and as far as we're concerned, you'd better get on with it." That is not good enough from a Government agency, not in this day and age and certainly not in the United Kingdom. I notice that today the FSA issued a press notice saying that the consumer would face considerable difficulties because expansion of the European Union will bring in many new countries that do not have the standards of food hygiene that we in the UK have. Perhaps so, but I note that the FSA made no recommendation on what to do about that; nor, as far as I can tell, did it use the same techniques as it used on a poor little baker in Nantwich, so I am not impressed. I have looked carefully, not only at the FSA's website, but at the vast number of reports it has turned out. Although the agency has been in existence for only a year, like many Government Departments it appears to advocate the turning out of a great deal of paper. Whoever else's friend the FSA is, it certainly is no friend of trees. The report states that the FSA wants to"A detailed case control study undertaken by the Public Health Laboratory Service has provided clear statistical evidence implicating contaminated bakery items".
oh, no? That is not what I was told in its long and boring epistle—"earn people's trust by what we do and how we do it…. Although the FSA is a Government agency, it works at 'arm's length' from Government because it doesn't report to a specific minister"—
Under the heading "Who is the FSA accountable to?" it declares, "We're accountable to Parliament"—well, that is me. I am Parliament. I am Crewe and Nantwich in this place and I have something to say about the way in which the FSA behaves. The report adds that the FSA is also accountable to the devolved Administrations. The report contains some interesting facts. I found, much to my astonishment, that the FSA has three parts, but the second biggest, which is almost as big as the part that does the job that the FSA is supposed to do, is the bit that deals with both legal matters and communications. Indeed, that part's budget spending is almost as big as that of the part that monitors health. I am sure that that is a sign of the FSA's efficiency and its desire to spread information around, but that is not what it looks like. We in this place have a special responsibility. No one representing any constituency in the United Kingdom does anything other than support public health. I have spent my entire life battling against those who want to smoke, insisting on better conditions for people in poor accommodation, and doing what I can to improve public health generally and the quality of life enjoyed by the people of this country. We must remember occasionally that Government Departments exist because the electorate want them to exist, but the powers that we give them in legislation passed in this Chamber must be used responsibly and sensibly. What they must not do—this group of people who, despite having studied them extremely closely, I do not recognise at all—is take unto themselves the powers of economic life and death by failing to understand what they, by making public a set of circumstances before they are absolutely sure of the facts, can achieve without any real thought. I am concerned about the way in which the Food Standards Agency has behaved in the case I have described. I am concerned because if a firm is at risk, the least it has the right to expect is a responsible attitude on the part of those with whom it is dealing. If it is being open, not making any difficulty for the environmental health officers and seeking to protect its interests, but not doing so in a way that damages the interests of customers, it has the right to expect that a Government agency will at least consult it and talk to it, and not through a sudden blaze of information and openness that might be considered essential but will do something to ruin the business. It is because the firm is well known that it is beginning to recover. It has a good reputation. The people concerned will continue to be extremely successful bakers and they will give much pleasure to my constitutents. They will do even more damage to my hips in future. The reality is that the House does not frame legislation for those who are bureaucrats or people who are outwith the economic situation, who are not answerable in real terms to the House. The House does not give them powers to exercise without care and without thought, and with astonishingly little awareness of the impact of their behaviour. These people must learn that they are there because we give them powers and because we want them to exercise control. The next time that they want to say that there is a real responsibility and a real problem in public health such as the expansion of the European Union, which will involve taking in the products of many more firms when we have no evidence that they will comply with our food laws, they should say what they will do and not spend all their time seeking to cause enormous problems for others who have no way of hitting back."and is free to publish any advice it issues."
7.31 pm
Iam genuinely grateful to my hon. Friend the Member for Crew and Nantwich (Mrs. Dunwoody) for raising this issue. As she has said, we have been in correspondence. It is important that we try to reflect on public health issues, how they are handled and how we get the right balances between openness and transparency while being sensitive to the important issues that she has raised about the local business in her constituency.
I am delighted that my hon. Friend has given her deep and genuine support for measures that have been taken to protect public health in this country, and has acknowledged how important that process is. She makes the point that the actions of agencies in this sensitive area must be defended and have the consent and support of the public. They are more effective agencies if they have that backing from the community at large. I hope to be able to address some of my hon. Friend's concerns. I am sure that at the end of what I have to say she will remain disturbed about the effect on the business in her constituency. However, I shall do my best to outline how the Food Standards Agency reached the decision that it did and the balance that it drew between a series of competing interests in this instance. It is important to remember that this was a serious outbreak of infection. The Public Health Laboratory Service has described as unprecedented the series of outbreaks of salmonella infection that have taken place recently. Many of them have involved unusual strains of the bacterium, and many have shown an association with eggs. Salmonella is a fairly serious infection. It causes diarrhoea, fever, vomiting and severe stomach pain lasting up to three weeks. In some cases it can cause peritonitis or blood poisoning, and occasionally it can be fatal. Almost 1,000 people have become ill in 18 recent outbreaks, and there have been at least two deaths. This is far above the normal reported levels of salmonella that we would expect. The first evidence of a real problem emerged towards the end of September, with the reporting of an increased number of cases due to an unusual strain of salmonella, which was enteritidis type 14b. Cases initially occurred mainly in London and the south-east, with a cluster of cases in Basingstoke. However, within about a week, cases were beginning to be reported in the north-west, from the Sandbach area, around my hon. Friend's constituency. Local public health officials investigated that cluster of cases. They went to see the people who had been infected. They had with them a lengthy questionnaire. They asked people where they had recently bought products, what sort of products they had been eating and where they had travelled.. They tried to obtain information about where the infections might be originating from. The local public health officials who were carrying out the investigation identified products from two bakery chains as a common link between the cases. This was subsequently confirmed in a study carried out by the Public Health Laboratory Service. The bakeries are in different parts of the country—one is in the south-east and the other is in the north-west—so investigations concentrated on what they had in common, which proved to be a common source of supply of eggs. When the bakeries were visited, it was discovered that both were using pasteurised eggs, as recommended, but both were also using ordinary shell eggs. In the bakery in the north-west— the one in my hon. Friend's constituency—fondant icing was being made with raw eggs. So in addition to clear evidence of people who ate products from the bakery becoming sick, there was also a clear risk that salmonella could be present in the fondant icing, because it was made from raw eggs. Advice was immediately given to the bakery that it should stop using raw eggs in this way, which it indeed followed. As my hon. Friend said, it co-operated with the environmental health office officials involved. After the bakery acted on that advice, there was a rapid fall in the number of cases occurring in the north-west, with an eventual total of 96 cases and one death owing to the outbreak. The investigations highlighted a problem in the way in which commercial food businesses such as bakeries were using or handling eggs. They did not seem to be aware of the longstanding advice that raw eggs should not be used in foods that will not be cooked before being eaten, or that there is a risk of cross-contamination in kitchens where eggs are handled. As the investigation proceeded and eggs supplied to the businesses were tested, it became apparent that some of the eggs used had very high rates of salmonella contamination. The vast majority of those eggs, although not all of them, had come from Spain. In view of my hon. Friend's tremendous personal support for public health issues, I am sure that she will agree that an outbreak such as this does require that action be taken swiftly by the Food Standards Agency. It has a remit to protect public health, and it was clear that public health was being seriously affected by these outbreaks. A picture emerged of a problem with food hygiene practice in the use of eggs, and with Spanish eggs in particular.Forgive me—I know that I should not interrupt my hon. Friend. Is she about to tell me that the Spanish provider of these eggs has been prosecuted?
No, and as I understand it, nor has the bakery in my hon. Friend's constituency. It has been given advice by the relevant officials, which it has followed.
The FSA has reiterated its advice to businesses through various press releases. It has raised the concern about Spanish eggs with its counterpart in Spain, and it has reported the matter to the European Commission. The FSA is not the body that would prosecute in these circumstances. It has also issued advice to egg importers and wholesalers that all Spanish eggs should be heat-treated before use. So action has been taken on the Spanish eggs that seem to have caused the problem. On the naming of this bakery—Chatwins—it is my understanding that it was not in fact named in the press release that was issued by the FSA. I have been supplied with a copy of it, and it states:It further states:"Efforts have been made to identify the source or sources of the outbreaks by local Environmental Health Officers and the Public Health Laboratory Service, centring on London and Cheshire. This work is still underway. A common thread in both outbreaks relates to the use and handling of ordinary eggs by a local food business in each of the outbreak areas."
That is a fact, and the bakery has acknowledged that and has since changed its practice. However, neither bakery was named in that press release. My understanding is that, after the press release was issued, further inquiries were inevitably made by the media to try to find out where the companies were based. It was at that point that the FSA considered this matter carefully, and it decided that the interests of the individual businesses did not outweigh the public interest in making that information available to them. I am told that that decision was not taken in a cavalier fashion, without regard to the interests of the businesses concerned; indeed, those interests were a very relevant consideration for the FSA. However, it does have a code of openness in terms of its operation. If my hon. Friend casts her mind back, she will remember that the FSA was established at a time when public trust in food production, manufacture and sale was almost at an all-time low. People were becoming increasingly concerned that they could not rely on the information that was available about their food. I understand that since the establishment of the Food Standards Agency, which has openness as a key plank of its operation, the proportion of the public who have confidence in information about their food has risen from about 25 per cent. to about 50 per cent. Some 50 per cent. now feel that they can rely on the food information that is provided by the FSA. Public confidence is very important and openness clearly plays a role in that respect. Equally, that needs to be weighed against the interests of businesses and commercial operations and the effect that statements could have on them. I am informed that those considerations were taken into account at the highest level in the Food Standards Agency and that the decision was reached that the businesses would be named in response to further media inquiries. When they were named, however, the media were made well aware that each had co-operated fully with the Food Standards Agency and local environmental health officers. This was not a case in which a local business was seeking to avoid its responsibility, as was made clear at the time. My hon. Friend has given us an opportunity to consider afresh some of the issues that she raised and to look at the way in which such decisions are made and the balance between the competing interests of openness and the commercial considerations of the businesses concerned, and I am grateful to her for doing so."In Cheshire, a bakery was using ordinary eggs in products that were not cooked."
Is the Minister also considering the way in which the Food Standards Agency responded in this case? Will she issue guidelines stating that when a Member of Parliament writes to it about a matter, it should ensure that they get a proper and full response?
I sign an awful lot of correspondence from the Food Standards Agency and it is certainly my experience that when Members of Parliament contact it, an immediate response is given. That usually happens through me, as I am accountable to Parliament for the agency's actions. In my experience, the issues raised by Members of Parliament are treated with seriousness and are certainly not dismissed. I would be very concerned if any Member of Parliament thought that the agency was not taking the matters that they raised extremely seriously indeed. As my hon. Friend said, Members of Parliament give agencies powers, so it is right that those agencies should respond properly, promptly and in considered detail to the issues that they raise. I shall certainly undertake to monitor that issue in my dealings with the agency.
One aspect of the way in which the case was dealt with has caused me concern. I understand that the business was not informed by the Food Standards Agency that it could be named in response to the further inquiries. It was not named in the press release, but if there is to be openness for all the parties involved in such a case, people should be informed if that is likely to happen or if there is any such intention so that they are apprised of the full facts. In this case, as I understand it, it was only when the business contacted the FSA that it found out that it had been named. I think that the FSA may have a responsibility to be more proactive in letting people know how a case may pan out. I shall take up that issue with the agency. My hon. Friend raised another important issue in saying that I had stated in my letter that negative tests do not necessarily show that there is no infection. I stand by that statement. I understand that microbiological samples are often taken some time after the contamination that led to an infection has occurred. If there is a time lapse, the microbiological evidence may well have come and gone by the time that samples are taken, so the fact that there are negative tests does not necessarily mean that a particular location was not the source of the contamination that led to the infection. I ask her to consider that the fact that the tests are negative does not automatically mean that there has been no infection. Certainly, the use of raw eggs at the bakery in products that were not going to be cooked was against longstanding Government advice, and I am delighted that the company has now changed its process. The FSA has done everything that it can to reiterate its advice to food businesses. It is longstanding advice and it is important that all companies be made aware of it. The agency has produced a leaflet targeted at caterers and has produced 400,000 copies for distribution throughout the country, so it has certainly tried to ensure that it gets the message across in order to protect the public's health. The agency has a responsibility to consider the evidence and act appropriately. In this case, the evidence showed that raw eggs were not always being used or handled properly by caterers, and it may be too easy to forget that a raw egg poses a health risk, which is important particularly for vulnerable members of the community such as the elderly, pregnant women and young children. In this case it was the genuine intention of the FSA to try to balance the competing interests of openness and transparency and of the business concerned. I understand that the business has followed the advice that was issued and that, happily, the infections have abated considerably. This was an important matter and I am pleased that my hon. Friend has raised the issue in Parliament in the way that she has. I undertake to consider the points that she has made to see if there is any more general application in this case.Question put and agreed to.
Adjourned accordingly at fifteen minutes to Eight o 'clock.