House of Commons
Wednesday 20 October 2004
The House met at half-past Eleven o'clock
Prayers
Mr Speaker in the Chair
Oral Answers to Questions
Deputy Prime Minister
The Deputy Prime Minister was asked—
Park Homes
If he will make a statement on further reform of legislation on park homes. [192476]
The Housing Bill contains key measures to improve the position of park home owners, which have been widely welcomed on both sides of the House. We are currently consulting on secondary legislation to take forward the provisions in the Housing Bill. We will consult further in the coming months on additional measures recommended by the park homes working party.
I thank the Minister for that response. I praise the Government for the measures that they have put in place and the fact that there will be a consultation process, which I understand will reopen the debate about the 10 per cent. fee that is charged on the sale of park homes. Will he confirm that that is the case and that there will be consultation with both residents and park home owners on the matter?
I am glad that the hon. Gentleman appreciates the work that the Government are doing to improve the situation for park home owners. I have visited a manufacturer of park homes in my constituency and I am aware of the concerns that residents and site owners have. He is right to say that there is still a lack of transparency in the payment regime. Although the Bill addresses some of those problems, I confirm that we will examine the 10 per cent. commission payments further in consultation later this year.
I too welcome the measures in the Bill, because they will protect my constituents from Barton-Upon-Humber who are residents of Barton Broads from the frankly unscrupulous and intimidatory activities of owners such as Avondale Park Homes. We have the consultation ahead of us, but when will the new rules come in? The residents of Barton Broads want to know when they will have the same rights and protections in law as other home owners.
My hon. Friend is right to press for early action. The Bill will help to prevent unscrupulous—as she puts it—site owners from exploiting and harassing park home owners, many of whom are elderly or vulnerable. I am pleased to say that the secondary legislation will come into force next year. There is more to be done and we will consult further on the other recommendations in the working party's report. We want to ensure that the rights of residents on those sites are clearly protected.
I am afraid that I must strike a slightly discordant note. Although what the Government are doing is welcome, it is too little, too late for people such as the residents of—[Interruption.]
Order. Let the hon. Gentleman speak.
Labour Members seem to forget that they have been in power for seven years—some things are actually their fault now.
Will the Government set a timetable for the secondary legislation and the further consultation that they promise, because the lot of park home owners in this country is still desperate?
The hon. Gentleman makes a mistake by suggesting that we have acted insufficiently quickly. The Conservatives were in power for 18 years, but we are amending the Mobile Homes Act 1983. There is consensus throughout the House that all parties involved—owners and residents—should have clear, fair, consistent and proper protection. We see a positive future for park homes, not least because of the way in which they can provide affordable housing throughout the country. However, we want to ensure that site owners are given decent protection in law.
Park home owners from throughout the country write to me about the excellent progress that the Government are making. They know exactly who is responsible for the improvements to the law and who neglected the issue for decades. My hon. Friend the Minister talked about the positive future for park homes. Does he agree that there is a real future for a responsible park home sector, run under proper legislation, that can provide affordable, secure, safe and adaptable accommodation, especially for older people and those with disabilities?
My hon. Friend is right to stress the benefits that park homes bring to people who choose to live in them. It is important for those people to have adequate protection in law, but the previous, Conservative Government failed to give them that. The reform package significantly strengthens the rights of residents of park homes and puts in place a regulatory framework to ensure that park homes may play their part in meeting the growing need for good quality, affordable housing.
There has been a lack of balance so far on the question. Does the Minister accept that the majority of park home operators are decent people who give a good and much needed product to park home residents? Does he accept that there are controversial matters to deal with, such as the retrospective aspect of legislation? Will he take a breath and ensure that he does not destroy the income streams that enable good park owners to reinvest and to maintain park homes to a decent standard for their residents? Will he look again at what he is doing?
We recognise that site owners have concerns about the proposals that are out for consultation. They have not been finalised. We are in consultation and want to know their views. I am aware that the hon. Gentleman has written to my right hon. Friend the Minister for Housing and Planning about the Kings residential park in his constituency. A reply is on its way and he can look forward to the possibility of meeting my right hon. Friend to discuss his concerns. There is cross-party support for the need to get the balance right between the needs and interests of the home owners and the park residents, and that is what the legislation is designed to do.
Housing
What plans he has to encourage co-operative options for housing provision with particular reference to (a) community land trusts and (b) community gateway. [192477]
We have no immediate plans to pursue community land trusts. However, the Housing Partnership, the joint unit of the Housing Corporation and English Partnerships, is holding discussions with proponents of a community land trust model. The community gateway is an approach to housing stock ownership and management that gives tenants, where they want it, more involvement and control over their homes. We are currently supporting the community gateway model in two local authorities.
I thank my right hon. Friend for that answer. I also thank him for coming to Stroud to listen to its tenants. Could he not be a little more enthusiastic, however, because we need to find alternatives to the problem of a lack of affordable housing, especially in rural areas? The co-operative model, and community land trusts and the community gateway in particular, is a way to take that forward. I look forward to working alongside him to ensure that that happens.
I am grateful to my hon. Friend for referring to my visit to Stroud, which was a good visit. During that visit my hon. Friend asked about the possibility of using a community gateway model in the options appraisal process in Stroud. I said that that was a perfectly legitimate approach and I am sure that we will work with the community housing task force to take that further as part of the stock options appraisal.
On community land trusts, the Housing Partnership is holding discussions with CDS Co-operatives to develop proposals for a demonstration project. The aim would be to use the demonstration project to develop good practice for partners and to simplify delivery, using the model for the future.
May I press the Minister on the quality of the schemes, in particular the £60,000 affordable homes? Does he share the view of the experts that the quality might be mediocre and not necessarily what tenants or residents need? If his approach is not predict and provide, does he agree that it is dictate and provide?
That is a curmudgeonly response to the Government's initiative to provide £60,000 homes for first-time buyers who so desperately need them. Of course those properties, on which we have consulted in depth with the industry, will be built to the highest design standards and will certainly meet all the required building regulations.
Rescue Control Centres
What assessment he has made of the effect on (a) job numbers, (b) service standards and (c) response times arising from the proposed transfer of rescue control centres in the south-west to one regional control centre. [192478]
The establishment of nine regional fire and rescue control centres is prompted by the need to ensure more effective and efficient responses to the whole range of local, regional and national incidents, including significant or complex ones, such as a terrorist incident or severe flooding. The new centres will strengthen the capability of the fire and rescue service to deal with exceptional call volumes, will improve resilience, and will provide more effective fall-back arrangements.
The move to nine regional control centres in England will result in a reduction in the number of control room staff, but together with fire and rescue authorities, we will fully explore the opportunities for the redeployment of staff whose skills and experience are transferable.
My right hon. Friend is aware that Gloucestershire has a relatively new rescue control centre in Quedgeley. Much has been invested in it and it works well and efficiently. It has knowledge of the local area and is in the public sector. Why then are all the proposed bidders for the new regional centre in the south-west coming from the private sector?
There have been a number of bids as part of the procurement process from both the public and the private sectors. Our aim is purely and simply to ensure that the premises of the site that is chosen for the regional control centre are the best in terms of resilience, efficiency and effectiveness as a centre for the region.
The estimates of the Gloucestershire fire and rescue authority show that its likely costs per incident of maintaining the current arrangements at Quedgeley, which is a good centre with a good reputation, is £112, which is more than double the estimated cost of dealing with incidents on the regional control basis. The savings that will come from that can be ploughed back into life-saving measures such as fire prevention work, installing smoke alarms and so on. Our approach is all about improving safety and saving lives, which I hope my hon. Friend recognises.
Does the Minister accept, as the Deputy Prime Minister himself knows, that the recent severe flooding in Cornwall was well handled by our local rescue and emergency services? Why, then, is the region being picked on in the extraordinary experimental pilot that was imposed on the area without proper consultation?
The hon. Gentleman is right that the response of the emergency services to the flooding crisis in Boscastle was exemplary. I spoke to the regional resilience forum in Plymouth a few weeks ago, and all the services involved thought that it was an effective and well co-ordinated operation. Indeed, my right hon. Friend the Deputy Prime Minister visited the area very soon after the incident to congratulate everyone involved on the way in which they coped.
Logic therefore points in the direction of a regional control centre, as I suggested in my reply to my hon. Friend the Member for Forest of Dean (Diana Organ). The estimate produced by Cornwall's fire and rescue services for the cost of responding to incidents under existing arrangements is more than double the cost of doing so under a regional control centre. Such savings, which can enable resources to be ploughed back into fire prevention and safety work and saving lives, will surely be welcomed by the hon. Gentleman and his constituents.
My hon. Friend the Member for Forest of Dean (Diana Organ) highlighted her concern about the 21 fire control jobs at Quedgeley control centre. Quedgeley's bid for the south-west region failed, but is it still fair to say that Gloucester still has a good chance of operating the regional fire control room for the south-west?
Restrictions in the EU services directive make it impossible for me to reveal details of the outstanding bidders. However, my hon. Friend is right that the fact that Quedgeley has not been selected for the final shortlist does not mean that there is no possibility of the regional fire control centre being located in Gloucester.
Is the Minister aware of the difficulties that fire and rescue authorities expect to face in recruiting and retaining fire control staff in centres that are certain to close in 2007? In the south-west, those centres are located too far from the regional call centre for commuting to be a practical option. Can he tell the House what practical steps the Government are taking to ensure that the fire control service does not deteriorate, or even collapse, between now and 2007?
I can assure the hon. Gentleman that we are committed not just to maintaining but to improving the quality of the service delivered by fire and rescue authorities throughout the country. He will be aware that when making a change of this nature the issues of staff confidence and recruitment and retention are important. We are paying attention to them, but there are exciting prospects under the new arrangements, and the skills of existing fire control staff are generally transferable, so there will be a premium on ensuring both that people who are not going to find jobs under the new arrangements are helped to relocate and secure other jobs and that the service will continue to operate in the most effective way.
Regional Government (North-East)
What assessment has been made of the potential benefits to Teesside from regional government in the north-east. [192479]
Improving economic performance and the quality of life in Teesside and the north-east would be a key objective of the elected regional assembly, which would have general powers to enable it promote economic and social development and protect and improve the environment. It would also be responsible for developing an economic strategy for the whole region. The regional development agency would play a crucial role in delivering that strategy, as it did in the recent announcement of a £205 million investment in the Huntsman chemical plant in my hon. and learned Friend's constituency.
Does my right hon. Friend agree, after meeting the vice-president of the Huntsman Corporation with me in Redcar this week, that he is clear that the RDA played a key role in getting the world's biggest polyethylene plant to be built in Redcar? Is it not clear that the RDA's arm will be stronger still if there is a boosted regional identity in the north-east brought about by a regional assembly?
Yes, I met the vice-president of Huntsman and he made it clear to me that he was investing in the north-east because he realised that the Government saw the north-east as an important area for economic help and development, and also that the regional development agency played an important part in achieving that. He noted that the Opposition have committed themselves in their manifesto to abolishing the regional development agency, and the Liberals have committed themselves to abolishing the Department responsible for the RDA. Nevertheless, he knows that people in the region want a strong regional voice. That is what the referendum is about.
I agree with the Deputy Prime Minister that a yes vote in the referendum will give more power to the people to Teesside to hold unelected bodies to account, so local taxpayers' money can be better spent on training for jobs, investment in housing and action to cut crime. But does he not find it odd that some people can reject more democracy for the people of Teesside, having called for more political accountability at the Tory party conference just a month ago?
I agree. I find it difficult to understand how the Opposition always demand more accountability but are against any form of democratic accountability. However, I am reassured by the fact that they opposed Scottish devolution, then accepted it, they opposed the Welsh Assembly, then accepted it, and they even opposed the Greater London authority, so there is a chance for them to do yet another U-turn, as I believe they are now saying they have done on the RDAs.
Is my right hon. Friend aware that there is widespread support for the assemblies in the north-east? I am sure he looks forward to an affirmative vote next month. Several times recently I have been in Yorkshire and Humberside, where people also want a referendum on the issue. They are reassured by my right hon. Friend's commitment to hold one in the near future, and will be much reassured by the definition of the powers of the assemblies that he has just outlined, which will give them a real chance to redress the anomalies and imbalances of the northern regions against the prosperous southern English regions.
Yes, I am convinced that across the northern region people like to make their own decision about matters that affect them—economic, social and environmental. Hopefully such opportunities will be provided for them. In the meantime there is a referendum in the north-east, which gives a clear choice between northern people making their own choice about economic development, or relying on central Government—like Lord Hailsham in the 1960s going up with his bell and ringing for the north to have more jobs, or Mrs. Thatcher arriving with her handbag and saying, "I'm going to convert this brownfield site into jobs." Nothing happened, but in seven years of a Labour Government there have been more jobs, more business and more prosperity, and we intend to do more.
We all know the Deputy Prime Minister is beginning to feel a bit desperate about his plans for a regional assembly in the north-east, but why has he resorted to the most astonishing and intemperate attacks on the business community in the north-east in his interview in the Financial Times today? Why does he not listen to business in the north-east, like the Federation of Small Businesses, which said that it would rather the money that he would spend on a toothless talking shop assembly in the north-east were spent on projects such as upgrading the A1? Will he confirm that the North East assembly will not have the power or the money to dual the A1?
I note that the hon. Gentleman has not said that he would abolish the RDAs, but let me come to his question. My dispute with businesses, in response to the chamber of commerce letter sent to me, was to point out that they were the same people who were against regional development agencies. They have now changed their mind and want to keep the development agencies. That is why business is telling the Tories, "You'd better keep the regional development agencies." My dispute was about the fact that they are saying that RDAs would cost more. The administration that will be set up after the referendum will cost the people of the north-east £12 million less than at present, there will be 600 fewer councillors and there will be 10 fewer councils—more efficient, more effective and the people making their own decisions. That is why I am convinced they will vote yes.
Housing
What steps his Department is taking to increase the supply of affordable housing in growth areas. [192480]
Since 1997, we have tripled capital investment in housing and doubled the funding for affordable housing. We have supported the creation of 230,000 new affordable homes and helped more than 9,000 key workers into home ownership in areas of high demand.
In my constituency, Stockton, South, housing demand is defined differently: high demand areas are green and leafy, such as Ingleby Barwick, or they have a low population, such as the area alongside the river Tees, or they are large Victorian settlements, such as Egglescliffe. However, houses in those areas have been demolished and replaced by blocks of flats, which has changed and worsened my constituency's character. What powers do local authorities have? PPG3 is a guide for local authorities; it is not an open invitation for house planning and building. I ask my right hon. Friend to acknowledge that good brownfield sites exist.
PPG3 concerns sequential testing. We require local authorities to examine brownfield sites, which are used in preference to greenfield sites, and that approach has been successful. In 1997, 56 per cent. of housing was built on brownfield sites; the figure is now 66 per cent., and it continues to increase. Large Victorian houses cover an awful lot of ground, and I appreciate that local planning decisions to increase housing density may have caused some changes in the make-up of the areas to which my hon. Friend referred.
I shall ask my Department to give me the exact details, because I am not sure of them, and I will write to my hon. Friend. However, our towns are growing in prosperity. When we stopped the growth in out-of-town shopping, the big retailers returned to building in cities. The same is true of housing, which is a considerable advantage to our cities' development.
Will the Deputy Prime Minister explain—[Interruption.]
Order. The noise level in the Chamber is far too high.
Thank you, Mr. Speaker. Will the Deputy Prime Minister explain why at last week's conference on the vision for eastern England, his own director of sustainable communities announced that he was unable to comment on the eastern corridor because it is too controversial? I suggest that it is too controversial because, as stated by the Government's consultants, Levitt-Therivel, the plan would have serious negative impacts on water resources—
Order. Perhaps the Deputy Prime Minister will try to answer the question, which was far too long.
The question was obviously too sustainable. We need more houses in the east and the south-east. We have laid out our plans, the consultation has started and the consultants have given their report, but we are still in the early stages. Let the talks begin, and we will see the conclusions at the end of the process.
May I congratulate my right hon. Friend on his dedication to increasing the supply of affordable housing? However, will he examine the plans submitted by Cambridge city council and Cambridgeshire county council to relocate Marshall's airport? The relocation may not be feasible or possible, and it is certainly undesirable. Will he ask the councils to examine the alternative of providing housing on land near Cambridge?
My hon. Friend is aware that the matter involves a planning application and, like any other Minister at the Dispatch Box, I cannot comment on it at this stage.
Sustainable Communities Plan
What infrastructure will be provided in the Milton Keynes and south midlands sub-region of the sustainable communities plan in the period to 2016. [192481]
Housing growth in Milton Keynes/south midlands and other growth areas must be accompanied by good quality supporting infrastructure. The Government have already allocated £95 million for projects in Milton Keynes/south midlands, which is in addition to other Departments' growth-related spending in the area—around £1.2 billion in the case of the Department for Transport—and the private investment that that will lever in.
If the Government double the number of houses in south Bedfordshire, as they plan to, will Leighton Buzzard receive a community hospital, as it is one of the largest towns in the country without one? Will the Dunstable and Houghton Regis northern bypass be built before the new houses come, as the level of congestion is already appalling?
As the hon. Gentleman will know, the Department of Health is including growth area adjustments in its future primary care trust revenue allocations, with additional revenue funding of £20 million for next year and the year after. In addition, £20 million of capital funding is in the plan for 2006–07.
The Department for Transport has committed more than £800 million to fund transport infrastructure development. In the hon. Gentleman's area, a new Dunstable northern bypass worth £50 million is in the process of development. The key to sustainable development is delivering key public services and infrastructure in line with housing growth.
Prime Minister
The Prime Minister was asked—
Engagements
If he will list his official engagements for Wednesday 20 October. [192461]
Before listing my engagements, I know that the whole House will join me in sending our thoughts to Margaret Hassan, who has been taken hostage in Iraq. She has dual Iraqi citizenship and has lived in Iraq for 30 years. She is immensely respected, married to an Iraqi and has worked tirelessly to help the country. We are doing what we can to secure her release.
This morning I had meetings with ministerial colleagues and others. In addition to my duties in the House I will have further such meetings later today.
Employment in my constituency and throughout the whole country is at record levels. Britain is working. However, is it not an unexpected consequence of the Government's economic success that we face unprecedented skills shortages?
Does the Prime Minister accept that if we are to encourage a new generation of young people to embark on apprenticeships, they must be guaranteed parity of esteem with those young people who choose instead to go to college or university?
I entirely agree with my hon. Friend on both points. As he rightly points out, there are now 2 million more people in work than in 1997. I am pleased to say that there are record levels of employment in this country today. However, I entirely accept that we need to do more on skills. That is why we have increased the number of apprenticeships from 75,000 in 1997 to 255,000 today. I can tell the House that that will increase further to 300,000 by the end of next year. What is more, we are ensuring that the vocational pathways for 14 to 19-year-olds are put on parity of esteem with the academic route. That is precisely what my hon. Friend wants, and it is right for the country.
May I begin by joining the Prime Minister in the remarks that he made about Margaret Hassan? Our thoughts, and indeed our prayers, are with her and her family.
I make it clear at the outset that I do not regard it as appropriate for deployments in wartime to be subject to a parliamentary vote. The official Opposition will not, therefore, be calling for a vote on the proposed redeployment of the Black Watch battle group.
However, Parliament does need to be given proper and accurate information. On Monday, the Defence Secretary said that no decision had been taken on the redeployment of the Black Watch. Yesterday morning, the Foreign Secretary said that a decision had been taken in principle. Later yesterday, the Prime Minister said that no decision had been made. Will the Prime Minister now be straight with Parliament and the country? Has a decision been taken and, if so, what is it?
No, a decision has not been taken, for the reasons that General McColl explained this morning; I hope that Members of the House heard what he said.
I think that the right hon. and learned Gentleman would understand, and I hope that the House understands, that there is a limit to what I should say, and can say, about where British troops might be deployed on operations in Iraq. We cannot fight terrorists and insurgents in Iraq by advertising our movements or disclosing the nature of operations.
I will, however, say this in answer to his question. We are about to enter a period of increased activity in Iraq. That is nothing to do with the American elections; it has everything, however, to do with the Iraqi elections in January. There has also, as General McColl pointed out this morning, been a spike in activity during Ramadan. We have to create the conditions in which fair elections under UN supervision can take place. To do this, there has been a request from the American military to the British military to fill in a gap as American troops are redeployed. That is being assessed now by our military. It will be assessed in the normal way and subject to a recommendation. As General McColl made clear, it is a military request for operational reasons that will be considered on an operational basis. If we do it, the Black Watch will still be back home by Christmas at the end of their six-month period.
Some 650 troops are involved. I cannot say exactly where in Iraq they are going but I can say that much of the speculation has been wholly ill informed and that, for example, they are not going to Falluja or Baghdad. They will remain under the operational command of UK forces.
I shall make one more thing clear. There has been speculation that the British military, especially the Chief of the Defence Staff, are unhappy that such a request has been made. That is completely untrue.
A request has been made. There is now a military assessment. The military will make a recommendation and a final decision will be made.
Of course we share the objectives that the Prime Minister set out and we support proper action taken in their pursuit. We all have the greatest admiration for the Black Watch, who will perform any duties that they are asked to undertake with the bravery and distinction that has been the regiment's hallmark over many centuries. I welcome—I am sure that they and their families welcome—the Prime Minister's comment that they will, after all, be home for Christmas.
However, the question that everyone in the country and all hon. Members are asking is: given that there are 130,000 American troops in Iraq, why is it necessary to take 650 men from the British forces in southern Iraq and redeploy them further north?
First, not all the 130,000 American troops are fit for that particular purpose. Secondly, the American military have made a request to our military, who are considering it on a purely operational basis. I do not believe that our commanders, as, indeed, General McColl made clear this morning, would want British troops to do that unless they thought it necessary for the achievement of our overall objectives. With the greatest respect to the right hon. and learned Gentleman, General McColl and those on the ground in Iraq are in a better position to make that judgment than me or him.
Does not the Prime Minister believe that the hole that he has dug in respect of Iraq is big enough? Is not it time to listen to the British people and to say no to the Americans, and high time that we stopped digging?
I am afraid that I cannot agree with my hon. Friend. I believe that we are right to be in Iraq and that we can be immensely proud of the contribution that our British troops have made there. I think that we should be thankful that they are engaged wholeheartedly in the operation, and I believe that the stabilisation of Iraq and bringing democracy to that country is in the national interest of this country, never mind the United States. We participated in the operation from the outset because we believed that it was the right thing to do. I believe now that it was the right thing to do. We have to stand firm and see it through, and we will.
I join the Prime Minister in extending all our thoughts and sympathies to the family and the professional colleagues of Margaret Hassan. We all hope for her safe return.
I am sure that the Prime Minister appreciates the great stress and anxiety that the families of Black Watch soldiers are experiencing. An indicative example is a mother who e-mailed Sky News on Monday to say that her son had been back on a training course here in Britain but
"was told yesterday that he was returning today to go and help the Americans. This decision has been made obviously."
Does the Prime Minister recognise that he will have to go further to convince mothers and families in the face of their legitimate concern?
I do not know whether the right hon. Gentleman really thinks that what he has just said will help to relieve the anxiety of people in the Black Watch. The fact is, as I have said, that this has to be decided on an operational basis. The recommendation will come from our military and on the basis of that recommendation, a final decision will be made. I have to say that I think we should be glad that we have soldiers of the capability of those in the Black Watch, who are ready, willing and able to do this job. Irrespective of whether people were for the war, as I was, or against it, as the right hon. Gentleman was, it is surely right that we should now do everything to make sure that the Iraqi elections can take place, the country can progress towards democracy and the terrorists can be defeated.
The whole House has the greatest admiration for the armed services, not least the Black Watch. There is no question about that. However, to return to the exchanges about possible British deployments that the Prime Minister and I had here in May, I said at that time that further deployment should come
"only at the request of the British commanders on the ground",
and should take place
"only for the purposes of enabling them to fulfil more effectively the role that they are currently undertaking".—[Official Report, 12 May 2004; Vol. 421, c. 350.]
I have to say to the Prime Minister that we would oppose the proposed deployment, because it does not meet the requirements that we set out in May. If, in due course, the Prime Minister is confident of the case for acceding to the request that the Americans have made, will he come and test his argument by putting it to the House for a decision?
With the greatest respect, what the right hon. Gentleman just read out suggested that he would not support a further deployment—although this is not an additional increase in the number of troops—unless it were operationally necessary. That is what he has just read out. If, however, it is the advice of our commanders on the ground that it is operationally necessary, is he then going to say that the troops should be deployed or not? What he is actually saying to me—
You are supposed to be answering the question.
I am answering it. I am saying that what I am actually being asked to do by the Liberal Democrats, even if the recommendation comes from our commanders to engage in this operation, is to overrule it politically. [Interruption.] Well, that is what the right hon. Gentleman is saying. I only wish that he had more than two questions to ask me, so that we could carry on this exchange.
Is the Prime Minister aware that the Prison Officers Association membership has voted overwhelmingly to oppose market testing in prisons, in the face of strong rumours that certain civil servants are trying to entice American companies to take over young offenders institutions? Does he agree that this would cause disruption in the service, and would also be politically undesirable?
What we have to do is make sure that the primary consideration is not just cost and efficiency, but the right way for these establishments to be run. It says somewhat optimistically in my briefing that I hope the members of the Prison Officers Association will work with us to rise to these challenges, but I am not entirely sure that that is what will happen. Whatever happens, however, it is important that we ensure that the way in which our prisons are run is the most cost effective, and that we do our best for the juveniles in those establishments. The criteria that will be applied to any contracting process will be cost and the standard of the service.
Yesterday, the Government announced the return of matron to help to deal with methicillin-resistant Staphylococcus aureus—MRSA. They made the same announcement in 2000, 2001, 2003 and 2004. It is what they always say when they do not know what to do. Will the Prime Minister confirm that neither the new chief nursing officer nor any other nurse—nor, indeed, the local infection control teams—has the power to ensure that infected wards are closed?
The number of matrons we have introduced is about 3,000 since we made that announcement, so it is wholly untrue to say that we have not brought in new people. Furthermore, in respect of MRSA, of course the state of infection in a ward is a primary consideration in regard to whether the ward remains open, and they have full powers to make sure that they can do this.
But I am afraid that what the Prime Minister has just said is not the case. The National Audit Office has found cases of managers refusing to close infected wards, even when infection teams have recommended that they be closed, because that would result in their missing Government targets. The Prime Minister should know this, because I have made this point to him before. Does he now agree that that is completely unacceptable?
Of course the state of infection in wards must be taken into account by matrons and managers when they decide whether to keep a ward open. Nothing is more important than the good health of patients in those words. Let us be clear: the only reason that we know about MRSA and the infections in our hospitals is that we collected the data that the Conservatives refused to collect. As for the targets on waiting times, I do not resile in any way from the need to set strong targets for outputs on waiting times and waiting lists because of the extra investment. Let us remember that when the right hon. and learned Gentleman was in office, waiting lists went up by 400,000; they are now down by 300,000, as a result of the investment that he voted against.
The Prime Minister is wrong again. On the day that families of victims of MRSA are lobbying us in Parliament, are we not right to be sceptical of yet another Government initiative, when we have had 21 initiatives, endless re-announcements, and billions of pounds of taxpayers' money spent, yet the number of people dying from MRSA has doubled under this Government? When are the Government going to stop talking and allow doctors and nurses to deliver the cleaner hospitals for which everyone in the country is crying out?
First, let us remember who forced the contracting-out of cleaning services in the national health service—the Tories. Who refused to put better investment in the health service? The Tories. Who came to this House and voted against every single penny of extra investment? The Tories. We accept that MRSA is a problem; of course it is. There is also a problem with dentistry. There are always problems in the health care system. But let us make it clear what are no longer problems, which were problems in the Tory years: we have cut waiting lists, so that the maximum waiting time is now half what it was under the Tories; 97 per cent. of patients are able to see a GP within two days; more than 96 per cent. get decent cancer care within a two-week period; cardiac deaths have fallen by more than 20 per cent.; cancer deaths have fallen by 10 per cent.; and there are an extra 80,000 nurses. I do not doubt that MRSA is a problem. Of course it is. But the national health service today is a service on its way to renewal, whereas when we took over, it was a service in a state of collapse.
The answer that we have just had from the Prime Minister tells us volumes about his attitude to the truth. He suggested—the Health Secretary urged him on—that there was some link between infections in hospitals and contracting-out. [Hon. Members: "Yes, there is."] His Back Benchers say, "Yes, there is." I am surprised that the Health Secretary has not told them about the Department of Health's study, referred to in the 7 October, which says in terms that there is no link between contracting-out and MRSA. When will the Prime Minister stop pulling the wool over people's eyes and start taking action to deal with the problems that the country faces?Health Service Journal on
I am sorry if—[Interruption.] I am sorry if the right hon. and learned Gentleman believes that the standard of cleaning in our hospitals has nothing to do with MRSA, but plainly it has—[Interruption.]
Order. Let the Prime Minister speak.
That is why we are imposing greater controls on cleaning. I have accepted that MRSA is a problem, which is why the Health Secretary announced the programme yesterday to tackle it. As I pointed out a moment or two ago, only under this Government have we had the figures that tell us the true extent of the problem.
If we compare the national health service in 1997 with the national health service now in 2004, we see that it is unquestionably better—better in terms of buildings, better in terms of the numbers of doctors and nurses, better in terms of the quality of care, and better in terms of waiting lists and waiting times. Yes, it is true that there are still more challenges, which we must tackle. But we know the truth—we do not have to speculate—about when the right hon. and learned Gentleman was in office: waiting lists went up, investment was cut and the health service was in despair. That has changed as a result of this Government's measures.
The Prime Minister may well be aware of the suggestion by the Council of Scottish Colonels of a union between the Royal Scots and my local regiment, the King's Own Scottish Borderers. I am delighted that my right hon. Friend the Secretary of State for Defence is to meet me to discuss that, but we are talking about a merger with one of the strongest regiments in terms of recruitment and retention. Does the Prime Minister agree that the Council of Scottish Colonels has really done no more than fudge the issue, and come up with entirely the wrong recommendation?
The important thing is this. Obviously there must be a change in the way in which the armed forces work in today's world, because they perform a different set of tasks now. Today we often need a far more flexible and adaptable force than would have been needed 30 or 40 years ago.
On the other hand, we are currently considering—on the basis of recommendations from the Scottish colonels and others—the best configuration of those battalions. We said that the number would be reduced from 40 to 36, but the precise nature of the arrangement is still under discussion. It is being implemented by the armed forces themselves, and when we have an outcome we will announce it. I assure my hon. Friend, however, that as we have constantly increased spending on our armed forces, their ability to function effectively in the modern world will be the test of what happens.
If the Government are serious about tackling antisocial behaviour, I am sure the Prime Minister will agree that the role of the youth service is vital. Will he agree to meet a group of members of the Youth Parliament and hear their concerns about the Government's agenda of forcing learning outcomes on the youth service? Young people work hard all week, and often at weekends too. What they want is somewhere to go and relax and have fun, rather than being forced to achieve a learning outcome on a Friday or Saturday night. [192462]
I am actually proud of what the Government have done on antisocial behaviour. We have introduced new legislation that is making a big difference in communities up and down the country, as I heard for myself in discussion with police officers yesterday. We are increasing investment in youth services, and it is important that we do so. I might add that the Conservative party voted against that investment.
If by "learning outcomes" the hon. Gentleman actually means results in our schools—[Interruption.] I happen to think that the best learning outcome is learning of the basics in schools. The fact is that the number of pupils passing exams and attaining the right results at 11, 14, 16 and 18 has gone up under this Government, and was down under that represented by the hon. Gentleman's party.
May I take the opportunity to thank the Prime Minister and the Chancellor for their intervention in the proposed closure of Jaguar in Coventry? The labour force appreciates their efforts very much. [192463]
Having said that, may I ask the Prime Minister what progress has been made?
I have actually spoken to both the company and the unions. I have asked them both to ensure that the proposals they have made are subject to proper scrutiny by unions and company jointly, and I understand from the conversations I had the other day that that will shortly take place. I hope that they will be able to give commitments on the long-term future of Jaguar and, indeed, Ford in the country.
The failure of the Government's pension policy is causing widespread alarm in east Devon. Why is the Prime Minister still so obsessed with means-testing pensioners? [192464]
We introduced pension credit in order to help the poorest pensioners, some of whom were on appallingly low incomes a few years ago. Two million pensioners have actually been lifted out of acute hardship as a result of our measures, and I suspect that many of them are in Devon. I think that if the hon. Gentleman goes and asks his constituents who receive pension credit whether they like the Tory proposal to take it off them, he will find that they do not.
Will my right hon. Friend give his support to the measures in my Children's Food Bill? Does he realise that if he does so, he will be in the company of hundreds of MPs from all parts of this Chamber and some 120 organisations, including the Royal College of Physicians, the Royal College of Surgeons, the Royal College of General Practitioners, cancer charities and the Food Commission? Does he further realise that the only people who do not support my proposals are those who are making large sums of money by promoting food that is high in fat, sugar and salt to children?
I congratulate my hon. Friend on her work in this area. As she knows, a Government White Paper on public health will be published in a few weeks, and I think that she will have to await the proposals in it.
The Prime Minister rightly praised the capabilities, strengths and professionalism of the Black Watch, and said that they would be home in time for Christmas. Did he also tell them that they face amalgamation on their return, and does it really make sense, at a time when the British Army is being called on to step in and cover the US army's overstretch, that we should be looking to cut the size of our own? [192465]
It is a question not of cutting the size of our own Army, but of the right configuration of battalions and regiments. That is subject to review by the armed forces, and they will decide the function of the Black Watch in that regard. I again suggest, given that proposals have been made by the Scottish colonels on this issue, that we await the outcome of that review, because it may not be exactly as the hon. Gentleman thinks.
My right hon. Friend has presumably had an explanation from the Americans as to why, given their massive military commitment in Iraq, they need to call on our own overstretched forces. Can he share that explanation with the House?
I will share what I can properly share with the House. As I said a moment or two ago—it is important to understand this—although it is true that there are 130,000 American troops and 9,000 British troops in Iraq, not all are suitable for the particular tasks that they are being called upon to do. It is important that we recognise that there is also an immense amount of cover in Iraq that Americans provide us. We are doing this as a joint operation in Iraq. If a military recommendation is made to us to do this, it will be done for operational reasons—for reasons agreed by our commanders out there. Of course, we have immense pride in the troops and the work that they do, but I hope that my hon. Friend understands that only a certain number of them are capable of doing some of the operations that they will be called upon to do.
Totnes Natural Health Centre
If he will make an official visit to Totnes natural health centre. [192466]
I have no current plans to do so.
Given the success of complementary medicine and the 24 practitioners in the Totnes natural health centre, and given that there are virtually no NHS dentists in the whole of south Devon, can the Prime Minister see a way of using some of the unspent funds committed to NHS dental practices in south Devon to purchase homopathic—[Interruption.]
Order. I am sure that the word is homeopathic.
I just had a slight slip of the tongue there. Can some of the unspent funds be used to purchase homeopathic medicines that relieve toothache, instead of awaiting the promised arrival of busloads of Polish dentists in the south-west?
The more that the hon. Gentleman describes the full range of activities available in Totnes, the more that I think I will have to change my answer of having no current plans to visit there. I am sorry that he does not want the extra dentists that, as my right hon. Friend the Health Secretary announced, are coming to Devon. We have to recruit more dentists in the health service—that is part of trying to expand the service, as we know. There are some 2,500 more dentists than there were in 1997, but there are still not enough, so we have got to recruit more, and they will all be highly qualified people.
I should also tell the hon. Gentleman that the South Hams and West Devon primary care trust has received an increase in its funding, in cash terms, of 9 per cent. It is for PCTs to use this funding locally to commission services, and there is no reason why, if his PCT considered it the most appropriate use of the money, that could not include complementary medicine—although perhaps not exactly as he described. [Laughter.] Or perhaps it could. I hope that that helps him when he gets back to his PCT.
Point of Order
On a point of order, Mr. Speaker. On Monday, the Secretary of State for Defence told us that any deployment of the Black Watch would be announced in the usual way, but there is no usual way to make such announcements and this is a very unusual deployment. It could be announced by written answer, orally or in a debate. There is a debate on defence tomorrow. Can you confirm that it would be in order for the Government to table a business motion to turn it into a substantive vote to test whether the Government's policy retains a majority? Is it not right, if we are to send 600 Scottish soldiers potentially into a valley of death, that we should find out whether the Government command a majority and that Members of Parliament should have the opportunity to stand up and be counted?
The hon. Gentleman asks whether it is possible, but he will know that the Government are entitled to change the business up to the rise of the House today. Of course, that is not a matter for me.
Microtherm
I beg to ask leave to move the Adjournment of the House, under Standing Order No. 24, to debate an important matter that requires specific and urgent consideration, namely,
the closure of the Microtherm factory in Wirral, West.
My constituents in Upton want to express their thanks to you, Mr. Speaker, for allowing me this opportunity. The matter in question is the proposed closure of a factory in my constituency—Microtherm, one of three high-quality manufacturing factories based there. In the firm's own words, it is the world's leading high-temperature insulation material manufacturer. Insulation does not get any better. My constituents are shocked and horrified by the decision taken in Belgium to look into closing the factory with the loss of 96 full-time and well-paid, high-technology manufacturing jobs.
In trying to persuade the House to adjourn today's business to debate this urgent and specific matter, I want to establish a number of facts to help us to take a reasoned decision. The company has been manufacturing in my constituency for 30 years. It has established itself as a world leader in its niche market. The factory is, I am told, highly profitable, and it is against that background that my constituents are wondering why it has been named as a closure target.
The fact is that the company withstood the Tory years, the economic mismanagement of the early 80s—then, later, of the early 90s—going from strength to strength. It has a sister factory in Belgium where it is proposed to transfer these high-quality jobs. The work force are highly trained, highly skilled, highly thought of and highly productive. Many have been with the company since its opening in the early 1970s, when it was opened by the inventor of the process that provides the basis for Microtherm's thermal insulation.
I want to ask the House to consider why the company was being secretive about this matter, news of which it was going to explode before my constituents on 5 November.
As the House knows, under Standing Order No. 24 I have to announce my decision without giving my reasons to the House. I listened carefully to what the hon. Gentleman said. As he knows, I must decide whether his application comes under Standing Order No. 24, and if so, whether a debate on this matter should be given priority over the business already arranged for this evening or tomorrow. In this case, the matter raised does not meet the requirements of the Standing Order. I therefore regret that I am not able to submit the hon. Gentleman's application to the House.
Historic Counties (Traffic Signs and Mapping)
I beg to move,
That leave be given to bring in a Bill to amend the law so as to require traffic authorities to cause traffic signs to be placed near roads for the purpose of indicating the location of historic county boundaries; to require the Ordnance Survey of Great Britain and Northern Ireland to mark the boundaries of the historic counties on its maps; and for connected purposes.
I pay tribute to my hon. Friend the Member for Uxbridge (Mr. Randall) for his help following the presentation of a similar Bill last year that made a strong case for Middlesex to be recognised as an historic county. I also pay tribute to the Association of British Counties for trailblazing the campaign for our historic counties to be given, once again, the full recognition that they rightly deserve.
As an Englishman who is proud to have grown up in the county of Somerset, I strongly believe that recognising and celebrating our past is important. Too much of our past has been jettisoned by those seeking to ignore the lessons from history, but we do that at our peril. It is vital that we are able to look back and celebrate the past, so that we can fathom where we are and make better progress through the uncharted waters ahead of us.
The 39 historic counties of England are a vital part of our heritage and need to be nurtured rather than discouraged. Many people have a strong sense of identity with their own county. The 39 historic counties are older than our medieval churches and cathedrals and complement the beauty of our countryside. The counties form the bedrock of England's local history, with a wealth of historical documents based on the county system. Those documents include parish records and parish registers of baptisms, marriages and deaths, quarter sessions records, and manorial and taxation records.
The importance of the counties is much greater than just local government. Their names and areas are widely used in tourism, sport, business, record keeping, local and family history, and in literature and the arts. They are sources of identity and affection for many people. They are the basis for an unchanging, recognisable and stable geography. It is where many of us live, "come from" and "belong". We may no longer have a Somerset Light Infantry Regiment, as it was subsumed, many re-organisations ago, into the Light Infantry, but the association of former members continues to represent those who served their country by serving in their county regiment.
For us in Somerset, and no doubt for people elsewhere, especially in Middlesex, there is still a constant reminder of the historic county borders—the county cricket club. It has done a sterling job in helping to keep alive the memory of the real county boundary. Somerset may have been broken up when the county of Avon came into being in 1974, but changing the boundaries of the administrative organisation has not deterred the county cricket club. It has continued to play its festival week in June at the Rec in Bath, and until recent years still played at Weston-super-Mare—still in the historic county of Somerset.
When modern local government was created in 1888, the areas of its "administrative counties" were based closely on the historic counties. In that way, the traditional county-based geography of England was tied in with local government, and a sense of the continuity of areas and identities was maintained.
However, the story goes back much further than that. This very House came into being in 1265, when Sir Simon de Montfort called two knights "from each shire" to come to London to be part of the body to represent the interests of the commons. While each county may have originally been set up for some public purpose or other, long before the beginning of the 19th century it was their geographical identity that was paramount. No single administrative function actually defined them. Rather, the counties were territorial divisions of England with names and areas that had been fixed for many centuries. The counties were clearly recognised legal entities. Numerous Acts of Parliament used them as the framework for various administrative functions, such as lords lieutenant, high sheriffs and even parliamentary seats.
The cumulative effect of the local government reforms of 1965, 1974, 1986 and—as far as Somerset was concerned—the failed opportunity of the mid-1990s to right the wrong of Avon has meant that the local government system is now very much changed from what it began as in 1888. Unintentionally or otherwise, the traditional county-based geography of England is in the process of being destroyed. The Bill would protect the historic counties and maintain their identity.
A modern local government map bears little resemblance to the historic counties. Successive Governments have always maintained that local government changes do not affect the counties themselves. Many of us are not convinced by such reassurances: the tendency for the media and of course the map-makers to use local government areas as a basis for geography is obscuring the identities of the counties that so many of us cherish. The first aim of the Bill is to place a duty on the Ordnance Survey to mark the 39 historic counties on the larger scale OS maps.
The second aim of the Bill is to have signs celebrating the boundary of the counties wherever they are crossed by major roads. A set of such signs of a uniform type would help to make clear the distinction between the counties and local government areas. The Association of British Counties suggests that the white-on-brown tourist signs would be suitable. Each one would have the words "Historic County of" followed by the county name—say, Somerset—above the local government area. The use of tourist signs is especially appropriate, since many of the counties, especially Somerset, are major tourist destinations in themselves.
I shall give the House one example of where such a sign would be based. If you, Mr. Speaker, were to travel down the M5, past Bristol and over the Avonmouth bridge you would, according to the sign currently placed there, be in the area administered by the unitary authority of North Somerset. Some 10 miles down the motorway, there is a further sign, which welcomes you to the county of Somerset, but that is the part of Somerset looked after by the county council. In welcoming those who pass the sign the county is being very gracious, but hardly accurate. Somerset, as with every historic county, belongs to us all and not to the councillors and officers of the local authority.
The Bill would force local authorities to mark out the boundary of historic Somerset and other counties so that the millions of drivers who go past those signs every year would be aware of part of my country's history. At the very least, it would remind those drivers that they were in a part of England that is forever Somerset. I commend the Bill to the House.
Question put and agreed to.
Bill ordered to be brought in by Mr. Adrian Flook, Mr. John Randall, Sir Nicholas Winterton, Mr. Ian Liddell-Grainger, Mr. Nigel Evans, Mr. David Wilshire and Mr. David Amess.
Historic Counties (Traffic Signs and Mapping)
Mr. Flook accordingly presented a Bill to amend the law so as to require traffic authorities to cause traffic signs to be placed on or near roads for the purpose of indicating the location of historic county boundaries; to require the Ordnance Survey of Great Britain and Northern Ireland to mark the boundaries of the historic counties on its maps; and for connected purpose: And the same was read the First time; and ordered to be read a Second time on Friday 5 November, and to be printed [Bill 165].
Delegated Legislation
Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation) and Order [12 October],
Section 5 of the European Communities (Amendment) Act 1993
That this House takes note with approval of the Government's assessment as set out in Budget 2004 for the purposes of Section 5 of the European Communities (Amendment) Act 1993.—[Paul Clark.]
Armed Forces (Pensions and Compensation) Bill (Programme) (No. 2)
Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 6 November 2003],
That the following provisions shall apply to the Armed Forces (Pensions and Compensation) Bill for the purpose of supplementing the Order of 22nd January 2004.
Consideration of Lords Amendments
1. Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion three hours after their commencement at this day's sitting.
Subsequent stages
2. Any further Message from the Lords may be considered forthwith without any further Question being put.
3. The proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.—[Paul Clark.]
Orders of the Day
Armed Forces (Pensions and Compensation) Bill
[Relevant documents: First Report from the Defence Committee, Session 2003–04, Armed Forces Pensions and Compensation, HC 96, and the Government's response thereto, Cm 6109.]
Lords amendments considered.
Clause 1 — Pension and compensation schemes: armed and reserve forces
Lords amendment: No. 1.
I beg to move, That this House disagrees with the Lords in the said amendment.
It might benefit the House if I made it clear from the outset that the Government will not accept Lords amendments Nos. 1 and 2, although we will agree to Lords amendments Nos. 3 and 4.
Lords amendment No. 1 relates to the burden of proof in the new pension and compensation schemes. The new schemes for the armed forces will each be broadly cost-neutral. Both Lords amendments Nos. 1 and 2 would lead to major additional public expenditure at a time when the defence budget is hard pressed, so for that reason alone, I must ask the House to reject them. However, there are other compelling reasons to reject the amendments, especially Lords amendment No. 1.
There has also been a suggestion that savings have been taken out of the compensation scheme to finance improvements in the pension scheme. That is not the case. There has certainly been rebalancing within each scheme to improve benefits for some at the expense of others, but that is all.
Lords amendment No. 1 goes to the heart of the new compensation arrangements. There was a full debate on the burden and standard of proof at every stage of the Bill's passage through this House and the Lords. Unfortunately, the House of Lords passed an amendment to introduce provisions that are even more generous than those in the current war pension scheme. Both place the onus on the Secretary of State to show beyond reasonable doubt that service was not the cause of death or injury. The amendment would extend the generous burden and standard of proof requirement so that it covered not just the causation of death or injury, but also eligibility; in other words, was the claimant a member of the armed forces who qualified under the scheme and did the individual suffer from the disablement claimed?
I am listening carefully to the debate, which has a huge audience of service and ex-service personnel. If the amendment is unreasonable, will the Minister consider a compromise because it is certain that his plans will make it much harder for people to get compensation?
I respect the hon. Gentleman's view, but I disagree, for reasons that I shall outline.
Even in the war pension scheme, those latter questions are decided on a balance of probabilities standard of proof. The effect would be to increase significantly the probability of acceptance of claims for compensation that had nothing to do with service in the armed forces and where it was even unlikely that there was a disablement or that the claimant had been a member of the armed forces.
The House is aware that the war pensions scheme burden and standard of proof are quite explicit in allowing claims to succeed even when it can be shown that the death or injury was unlikely to have been due to service. I do not consider it reasonable to allow such arrangements to persist; still less do I regard it as reasonable to extend their scope. Inserting into the new compensation scheme a burden and standard of proof more generous than we have announced would be expensive. Our latest assessment is that the total cost would run to more than £300 million after 10 years, with a continuing annual premium.
There has been a mistaken suggestion that that sum was a saving and that the value of the scheme would be reduced as a result of the change to the burden and standard of proof. That is not the case. There has been no such saving; were we to accept the amendment, substantial additional money would be required over and above our broadly cost-neutral proposals. This is because we have taken the savings from the changed burden and standard of proof and used them to provide bigger payments where the need can be expected to be greatest. The most obvious example of that is the award for the first time of major cash lump sums to a maximum of £280,000 for pain and suffering caused to the more seriously injured. That key group is, frankly, poorly served by the current scheme.
In short, the current war pensions scheme arrangements allow a claim to succeed when there is no evidence that a condition is linked to service. That means that our funds are not focused properly on those whose disablements are greatest and whose conditions are likely to have been caused by service. In effect, by changing the design of our compensation arrangements as we have, we have taken away from a minority of cases for whom death or injury is unlikely to have been caused by service and given to those who are more seriously disabled. We cannot afford to do both, and I have no doubt that our decision is the right one.
Looking at the new compensation scheme as a whole, I am confident that it will deliver fair and reasonable outcomes. The new arrangements invite both claimant and the Ministry of Defence to provide evidence relating to a claim. Both sets of evidence would be subject to the same careful scrutiny and would be given equal weight in the process of evaluation. Only if the evidence were equally balanced or if there were an absence of clear evidence one way or the other would the burden of proof result in a rejection of the claim. The proposals are in line with those for civil courts and follow a pattern widely used in other schemes.
I hope that the House will recognise that the arrangements are, in fact, the same as those used to determine the outcome of claims for attributable benefits under the current armed forces pension scheme. It is worth knowing that it is generally the current armed forces pension, not the war pension, that provides the larger share of the benefits paid in a case of invaliding or death due to service.
However, the Government have not ignored the concerns expressed since the Bill moved to the Lords in July. We have looked carefully at the Royal British Legion's concerns that our proposals do not represent a fair balance of responsibilities between the claimant and the Department. Our approach does not place the whole of the evidential burden on the claimant. The scheme rules will provide that the Secretary of State or, at appeal, the pensions appeal tribunal will decide whether, on the basis of all the relevant evidence before them, it is more likely than not that the injury, illness or death is due to service. That evidence will include any supporting evidence provided by the claimant. It will also include the claimant's service and medical records and any additional evidence obtained by the Secretary of State.
We recognise that it would be unreasonable to ask the claimant to obtain evidence relating to his claim that is held in his official service records. The scheme rules will impose a duty on the Secretary of State to make available to the claimant such evidence on request. Any decision taken by the Secretary of State will be subject to appeal to the pensions appeal tribunal, which in turn will have regard to the entire body of evidence, whether provided by the claimant or the Secretary of State. That will place a responsibility on the Secretary of State to provide a credible response to any substantial evidence submitted by the claimant.
I regret that the Royal British Legion has not been reassured despite the many conversations with it, but I also accept that it has been flexible in recent months in offering alternative formulations of burden and standard of proof, the point made by the hon. Gentleman. However, flexibility has not been one-way. We have made a number of changes to our proposals already to address the concerns of the Royal British Legion, and I shall give just three examples. There will be an extended time limit for claims of five years instead of the three originally proposed; provision for exceptional review where deterioration of someone's condition is substantially greater than would normally be expected; and agreement to report to Parliament annually on the operation of the schemes. I shall take a close personal interest in the working of the schemes and I can assure the House that if the system is found not to be delivering fair results, the design of the arrangements will be reviewed.
I must, however, tell the House that there is no easy option here for Members who support the amendment. They cannot cherry-pick the parts of the current arrangements to which they remain deeply attached and, at the same time, embrace the improvements in the new compensation scheme. I will not allow the new schemes to proceed on that basis. If it comes to it, I would prefer to withdraw the Bill entirely, which would mean that that the benefits of the new pension and compensation schemes, which are keenly sought by many people in the Armed Forces and the ex-service community, will be lost. I hope that the Commons will tell the Lords that they have got it wrong, and reject Lords amendment No. 1.
I am sorry that the Minister has come to the Dispatch Box in a rather pugilistic mood. As my hon. Friend the Member for Canterbury (Mr. Brazier) made clear, a great many ex-servicemen and women are concerned about this issue. It is not just people outside the House who are concerned—many Members on both sides of the House are as well. There cannot be anyone inside or outside the House who fails to understand the difficulties that this Government or, indeed, any Government face in meeting people's aspirations while keeping down the tax burden or, in the case of the Ministry of Defence, remaining within budget. The Opposition, however, and many other people believe that our armed forces are different, and should be treated differently.
The Bill provides us with a great opportunity to look at all pension and compensation arrangements. We should not treat the Bill, as the Minister wants us to do, as a take-it-or-leave-it package. He is in such a belligerent mood that, if we do not like it, he will take his bat away.
Forgive me, that is what he just told the House, and it is also a fair reflection of what he told the Royal British Legion and the Forces Pension Society.
I am grateful to the hon. Gentleman for allowing me to intervene at an early stage, but I have made it clear that we cannot cherry-pick the scheme and expect it to remain coherent. That was the point of the cost-neutrality that I first referred to in September last year and which we debated at length in Committee. The hon. Gentleman talked about the ex-service community and people outside the House, but perhaps he will reflect on the fact that the new compensation arrangements come into effect on 6 April 2005, and do not affect arrangements made prior to that date.
Indeed not, but the hon. Gentleman knows that the ex-service community takes an abiding interest in today's armed forces, and has a close personal attachment to them. He and I have come to the House straight from a service at St. Paul's cathedral—it was extremely kind of him to give me a lift back—in which we celebrated the 60th anniversary of the heroic events on the beaches of Normandy. A large number of veterans, many from the Aldershot branch of the Normandy Veterans Association, attended the service not just to commemorate the heroic events of years gone by but to demonstrate their ongoing interest in the affairs of today's armed forces. The Minister, who has responsibility for veterans' affairs, will have learned of that interest from his discussions with veterans, as I have in my role both as shadow Minister and as the Member of Parliament for Aldershot.
The Opposition believe that the armed forces should be treated differently. I accept that the Bill is cost-neutral, as the Minister said, and that the new arrangements are driven by cost-neutrality. As the hon. Member for Dunfermline, West (Rachel Squire) will confirm, when the Defence Committee was first appraised of these matters by Ministers, the expression "cost-neutrality" was not used, and appeared only late in the day. We should not be driven by the Minister's self-imposed constraint, because that was not the MOD's original position. It was only because it lost out in the battle with the Treasury that it had to impose a cost-restraint straitjacket on the new measures.
Members on both sides of the House will recognise the tremendous work carried out by the Royal British Legion on behalf of the veterans' community in providing representation for people seeking compensation and in campaigning on veterans' welfare issues. I am sure that the Minister is at one with me on that. In constituencies up and down the country, hon. Members recognise the vital role played by the Royal British Legion. Equally, Members on both sides of the House will share my disappointment at the shabby way in which the Government have treated the Legion during the passage of the Bill. What can only be described as open warfare spilled out in exchanges in another place. Everyone in the House would concede that our debates can become frenetic and even rebellious, but the Lords tend to debate contentious issues in a more measured fashion. It is therefore all the more astonishing that Lord Bach, the Minister in the other place, was treated to a severe roasting from Labour peers, including a former Minister, who turned on the Government over their sniping at the Legion. Lord Morris of Manchester was well known in the Commons as a Minister with responsibility for disabled people, and has spent a lifetime, Members on both sides of the House will concede, seeking to look after the interests of the most vulnerable people in society. He is a doughty campaigner in the other place, where he said on 8 September at column 572:
"The Legion's legal adviser has told my noble friend that there has been no meaningful discussion whatever."—[Official Report, House of Lords, 8 September 2004; Vol. 664, c. 572.]
The exchanges in another place on 15 September make interesting reading. Lord Corbett of Castle Vale, formerly the MP Robin Corbett, moved an amendment, and began his contribution by accusing Lord Bach of "misleading" the Lords about the position of the Royal British Legion—his word, not mine. Both here and in the other place, the Government have sought to give the impression that the Royal British Legion has been unwilling to compromise on the burden on proof, and that its stubbornness, along with the alleged stubbornness of the Opposition, have threatened the implementation of the new scheme.
There has been an attempt to blackmail the Royal British Legion and the Forces Pension Society, which the Minister continued today. He suggested that the Government were acting reasonably in making three changes, two of which were requested by the Defence Committee and the Opposition, so should not be regarded as extraordinarily generous dispensations to the Royal British Legion. It has been told that if it and the House do not accept the changes, and if the Lords do not accept the package on offer, that is the end of the deal. Of all the new benefits that will be available, the most significant is the increase in the death in service benefit from 1.5 times salary to 4 times salary. That is one of the biggest benefits that will be brought about by the changes, which are not so much on compensation as on the pensions side, but if the package is not accepted, the Government will withdraw the Bill and that will be the end of the story. That is not grown-up politics.
On a point of order, Mr. Speaker. My hon. Friend has rightly drawn attention to the threat that the Minister made. He said that if we failed to disagree to the amendment, he would withdraw the Bill. For those of us who served on the Standing Committee and can think of any number of good reasons why it would be better to see the back of the Bill, does that bring those reasons into the scope of the amendments, so that we can achieve the very prospect that the Minister has held up in front of us?
These are matters for debate. I call Mr. Howarth.
I think the Minister wanted to intervene.
I am grateful. On the three points, the extended time limit was discussed between the Royal British Legion and the Ministry of Defence in the run-up to the launch of the scheme in September last year. The agreement to report to Parliament annually was an initiative that I took as the Minister for veterans, along with my noble Friend Lord Bach. The second point, concerning exceptional review, was part of various discussions between ourselves and the British Legion. It is rather disingenuous of the hon. Gentleman to suggest that we have not been discussing these matters with the British Legion for some time. I have correspondence going back to 3 December 2003 about the compensation scheme. We are debating only the compensation scheme. I heard what the hon. Gentleman said, but he is confusing compensation and pensions. As I made clear in my opening remarks, we have not transferred money from one to another. Both schemes will be rebalanced within themselves to make good and effective schemes for the future.
I accept what the Minister said about not transferring any savings to be made out of the compensation scheme to the pension scheme, so let us leave that on one side. But I do not want the Minister to get away with the idea that he has been extraordinarily generous to the Royal British Legion in accepting these changes to the compensation scheme. They were argued by hon. Members in all parts of the House and by the Defence Committee. The Minister is trying to say how carefully the Government have listened to the British Legion and responded. Yes, indeed, that was part of the Legion's pitch, but the point was made by many other people as well. The Minister should not claim that he has given the Royal British Legion a thoroughly decent hearing. On the big issue with which the Legion is concerned, the Government have made no shift at all.
I know that hon. Friends of mine and other hon. Members wish to participate, so I shall pursue my remarks. We and the Royal British Legion have attempted to achieve a more equitable balance in the burden of proof. We have been open throughout to the double standard compromise proposed by the Defence Committee, where both parties would have to make their case on the balance of probabilities test, with the onus resting on the Government. The Government would have to prove, on the balance of probabilities, that the claimant's injury or ailment was not attributable to service, and the claimant would have to prove on the same standard that it was. Only when both had gone against the claimant would the claim fail. That seems a reasonable compromise.
It is the Government who have proved so resistant to compromise. They dismissed out of hand the Defence Committee's proposal, and refused even to sit down with the Legion and representatives of the veterans community to work out some kind of compromise. The Minister says from a sedentary position—I will save him intervening—that that is not true. The fact is that he has been intransigent on the possibility of compromise. He has simply said that the scheme will cost £200 million—we are now told £300 million—and that's it. No deal. The Minister is about to tell me otherwise.
I cannot accept the hon. Gentleman's assertion about truthfulness. That remark was inappropriate. I have a continuous and high-level series of discussion with members of the Royal British Legion executive. I meet the secretary-general regularly and we discuss many of these issues, which are rightly debated between the British Legion and the Government. That does not mean we agree. We accept in an adult relationship that there are times when we disagree. That does happen— I do not deny it.
The burden of proof that the House of Lords suggested should be adopted for the compensation scheme is costed at £300 million at least, over the next 10 years. I cannot find that in the present defence budget. The House would be interested to know how the hon. Gentleman proposes to find it, if he intends to support the House of Lords on the matter.
I make it clear that we intend to support the House of Lords on the matter.
Of course we understand that the Government have a position and the British Legion has a position. We are trying to find a compromise. It is the Government's intransigence about sitting down with the Legion to find a compromise that exercises not just the Opposition, but Labour Members. Lord Corbett said in another place that
"to imply that the Legion was being unco-operative, as my noble friend did on 8 September"—
that was the Lord Bach—
"was grossly misleading. Neither did he acknowledge the Legion's responsibility for liaising with other ex-service organisations and its duty, as the guardian of the interests, welfare and memory of ex-service people and their dependants, to do all in its power to protect the safeguard currently vouchsafed by a burden of proof based on reasonable doubt. Nor again did my noble friend at any time acknowledge the Legion's offer to compromise on the basis suggested by the House of Commons Defence Select Committee and the MoD's rejection of that offer."—[Official Report, 15 September 2004; Vol. 664, c. 1183.]
There is a compromise on the table, but the Government have shown no willingness to consider it.
If the House rejects the Lords amendment in the name of the former Labour Minister Lord Morris, we will move from a system that protects the rights of those serving and those who have served who are injured or become ill as a result of their service. The current standard of proof gives the benefit of the doubt to the claimant, placing the onus on the MOD to prove beyond reasonable doubt that the injury was not attributable to the individual's military service. A change to the balance of probabilities would see the roles reversed, with a much harsher standard of proof. Those who have become ill or been injured would have to prove, on the balance of probabilities, that their illness or injury was attributable to their military service.
As Lord Bach said in his letter to Brigadier Townsend, the director general of the Royal British Legion, on 14 September,
"It remains our view that the War Pension Scheme burden and standard of proof are no longer required in order to provide the high level of safeguard appropriate to service in the Armed Forces and that the resources freed up from a change in this area are more beneficially used elsewhere".
But the British Legion continues to dispute that position. After all, the Legion is in a position to know something about the matter. It has immense experience of representing hundreds of war pensions claims every year, and it has argued strongly that the safeguard continues to be necessary to protect the rights of our servicemen and women.
The Legion estimates that with the combination of the change in the test and the shift in the onus, which would rest on the claimant, 60 per cent. of the claims that are successful under the present arrangements would fail. Although the Government dispute that figure, they too must estimate a larger number of unsuccessful claims under the new scheme by the very fact that they predict £200 million savings. Where else can that money come from, except from that which would otherwise have gone to those injured in the line of duty? Or is the Minister saying that he thinks there will be so many more frivolous claims because of the compensation culture that the amount will be ratcheted up?
What does the proposal say about the Government's concept of the duty of care? Do they really want to send a message to our armed forces that if they are injured or become ill in the line of duty, the MOD will make them fight for that which should be theirs by right, and that after such a fight, 60 per cent. of claims will fail? Many hon. Members on both sides of the House will regard it as a sad day indeed when the Government treat our armed forces with such disdain and demonstrate such a flagrant disregard for their duty of care for those who serve—I am bound to say that at a time when Her Majesty's armed forces are undertaking such onerous and dangerous responsibilities in Iraq.
As the Minister said, some will win and some will lose as a result of what he describes as "rebalancing", but greater attention must be paid to the duty of care. A moment ago, he said that some of the funds saved would provide better benefits for those who currently fare—he used this word—"poorly". In other words, he acknowledges that some people are not well served by the present arrangements, and he wants to benefit them at the expense of others. Some who fare poorly at the moment would do better; some of those who do reasonably well under the present arrangements would be imperilled.
The hon. Gentleman quoted me correctly. I make no apology because I want those who are most disabled to get the main benefit from the compensation scheme, which is right and proper. Frankly, I hope that all hon. Members share that view. However, events happening today are covered by the current laws, whereas we are discussing events occurring after April 2005.
Hon. Members are obliged to look to the future, because the recent pattern of deployments and military conflicts is likely to form the template for the future. Indeed, the Government currently formulate their defence strategy on the basis that our troops will be deployed more frequently, further afield and in larger numbers than was even envisaged under the strategic defence review. After the cold war, when conflict was expected but none happened—thankfully—we have moved to a position in which there is every expectation that our troops will deploy into conflict zones several times a year, and the risk of injury or illness is therefore likely to increase. It is therefore incumbent on this House to make sure that tomorrow's soldiers get the best possible deal. I submit that a compromise, which would tighten up the existing procedures without increasing the possibility that genuine claims might fail, could be reached, and it seems to me that the Defence Committee's solution provides the answer.
The stick with which we were being beaten was £200 million—the noble Lords were told that the amendment would cost the taxpayer £200 million—but the Minister told us today that the figure has gone up to £300 million. In the other place, Lord Bach promised to provide a detailed breakdown of how the figure is calculated. That is the big stick with which we are being beaten, but no one has come forward from the Ministry of Defence to provide us with an analysis.
The Opposition do not have the resources to undertake such forensic and extensive examinations, but the Minister does—he has all the Ministry of Defence's resources—and he should tell us how the figure was reached. Will the savings be achieved as a one-off or over a period of time? If the Minister expects this House to make an informed decision, he should surely provide some clarification.
I hoped that I had done that today. I said that our latest assessment—these are assessments—is that the total cost would run to more than £300 million after 10 years with a continuing annual premium. We have examined our assessments and the issues arising from the various debates in the House of Lords, and we have made a fresh assessment. I am happy to give the hon. Gentleman more detail if and when I can, but today I have brought the latest assessment of the amendment's cost to the House.
Instead of the Minister's coming to the House to conciliate me, why on earth was his Department not conciliatory with the Royal British Legion, which has asked for the figures for several months? It is not good enough for the Minister to tell us that a figure that was set in stone until half an hour ago has increased by 50 per cent. Realistically, the House cannot accept a 50 per cent. increase off the back of an envelope to the figure that Lord Bach gave down the other end of the Corridor for the scheme's cost if their lordships were to stick to their guns.
Perhaps I can help my hon. Friend. I understand that it would cost £200 million to keep the arrangements as they were and £300 million to fund the amendment. The Minister still refuses to answer my hon. Friend's question on how much the compromise would cost. He keeps quoting the cost of the Lords amendment and criticises its drafting for extending the scope of the scheme. Instead, he should cost the compromise that the Royal British Legion proposed a long time ago.
My hon. Friend's intervention is extremely helpful, because it demonstrates the bind that the Minister has got himself into. Instead of negotiating with the Royal British Legion by saying, "We will go away and cost what the all-party Defence Committee has come up with," the Government have tried to block the Royal British Legion's proposal, which is a great shame. Hon. Members cannot accept the £300 million figure, unless it is justified in a much more expansive way. I am not prepared to take the Minister's word for it—I mean no personal disrespect to him. Today, he said that figure is £300 million, but one week ago it was £200 million.
Will the hon. Gentleman give way?
No. I am sure that the Minister will have a chance to wind up the debate, if he can catch your eye, Mr. Deputy Speaker. Will he catch your eye or should I give way to him now?
Order. It is entirely up to the hon. Gentleman whether he gives way to the Minister. Having attended to part of the debate, I merely observe that so many points have been dealt with in interventions that there may be very little scope for a winding-up speech.
Thank you, Mr. Deputy Speaker.
The issue is important and the Ministry of Defence's resources should be made available to cost the double standard proposed by the Select Committee. The double standard offers the means of realising some savings while protecting those servicemen and women who are injured or who become ill as a result of their service.
We will vote for the amendment because the Government's blatant disregard for their duty of care should not go unchallenged, but their unwillingness to accept any form of compromise means that the amendment will be voted down. However, when the Bill returns to another place, we will encourage their lordships to pursue the compromise measure, and, even at this late stage, we urge the Government to do the same.
As Lord Craig of Radley, a former Chief of the Defence Staff, said in the other place:
"This is a rare opportunity to get the arrangements for Armed Forces pensions and compensation dealt with. They should be dealt with against the concept of best practice and not just cost neutrality."—[Official Report, House of Lords, 8 September 2004; Vol. 664, c. 575.]
The Army has the recruiting slogan, "Be the best"; the people of Britain know that it is the best; it deserves the best; let us give it the best.
I rise to speak on behalf of the Select Committee on Defence. The Chairman sends his apologies as the Committee had a prior commitment to take evidence on another issue this afternoon.
I should declare that I am the honorary vice-president of the Dunfermline branch of the Royal British Legion, Scotland. That means that I take considerable personal interest in pension and compensation arrangements for veterans and for certain members of our armed forces. Personally, I am very disappointed by the Minister's speech and by the Government's refusal to compromise and I find the constant description of the Royal British Legion's concerns about compensation as "cherry-picking" insulting.
Lords amendment No. 1 deals with one of the main changes to the proposed compensation scheme—the method for deciding whether an injury has been caused by service. The Government believe that it is right that service personnel should have to prove for themselves, on the balance of probabilities, that a condition from which they suffer was caused by service. The Lords amendment would maintain the status quo, whereby it is for the Ministry of Defence to prove beyond any reasonable doubt that an injury was not caused by service.
Under the Lords proposal, it is probably true that some people whose condition was not in fact caused by service would win the right to compensation. Under the Government's proposal, however, it is certainly true that some people whose condition was caused by service will not win the right to compensation. The question for the House is, which is the lesser of those two evils?
Sometimes it is not obvious why someone has become ill. As the Defence Committee noted in its report of December last year, armed forces personnel
"are likely to be involved in situations of great uncertainty, with uncertain effects on their health".
That is particularly true at the moment and will apparently be so in the near future. The fact is that we simply do not know how or why servicemen and women become ill, but does that mean that they should not be entitled to compensation?
The Government recognise that they have responsibilities to service personnel who make compensation claims—in particular, that they must keep proper medical records and make them available. That is welcome. However, we on the Defence Committee remain concerned that service people will find it more difficult to claim compensation under the proposed scheme and that, in some cases, personnel will be unable to prove that their condition has been caused by service because of a lack of information, not because their condition was not caused by service.
The armed forces are a special case. The essential difference between them and almost all other employees is that they can be asked to put themselves in harm's way or, indeed, to die for their country. In our December 2003 report, the Defence Committee argued that
"Because of the special risks that Armed Forces personnel are required to run, and because they are likely to be involved in situations of great uncertainty, with uncertain effects on their health, we continue to believe that the onus should remain on the Government to prove that service was not responsible for causing or worsening a condition for which a compensation claim is made."
The Government have explained that they oppose the Lords amendment for several reasons and those deserve proper examination by the House. The first reason is cost. The Government claim that it would be too expensive to maintain the status quo because of the cost of improvements that they have made elsewhere in the schemes. Lord Bach told the Lords:
"Frankly, we cannot afford to improve benefits for the more severely disabled and maintain the current, generous burden of proof."
The Government have always insisted that the new schemes should cost the same overall as the existing schemes. In 2002, the Committee said that the pension review had been
"hamstrung almost from the outset by the decision that the new proposals should be cost-neutral".
The hon. Lady is making a powerful and convincing speech. In fact, the problem goes even further than that, because the Government's definition of cost-neutrality involves taking money out of the scheme to allow for the fact that people are likely to live longer, but adding nothing back in to allow for the fact that there will be fewer of them.
I thank the hon. Gentleman for that intervention. Indeed, we need further detailed consideration of where money is being taken from to benefit other developments.
In the Lords, it was suggested that to maintain the status quo would cost an additional £200 million. According to the Government, as we have just heard, it is more likely that it would cost £300 million over a 10-year period. All these figures can only be estimates based on a best guess of the number of claimants who would qualify for a war pension under the current criteria but who would not be entitled to compensation under a balance of probabilities test. Maintaining the current test would undoubtedly be expensive, although whether as expensive as the Government claim is open to conjecture. But this is a matter of principle—a question of ensuring that when service personnel put their lives on the line for their country, we look after them properly. We should do that even if it is unclear whether their injury was caused by service or not.
The Minister and the Government have claimed that the Lords amendment would upset a balanced package and that Parliament should not cherry-pick. Many of us would question whether that is a democratic approach. After all, what is Parliament here for if not to legislate? And legislation means looking at the detail, not just accepting or rejecting the Government's proposals as a package. In the Defence Committee, many hon. Members have expressed concern that several parts of the Bill remain very vague and general with insufficient detail.
The Defence Committee recommended that some of that detail—the basic principles of the schemes—should be set out in the Bill, including
"the standard and burden of proof for claims under the compensation scheme".
We need to be aware of the effects of what we propose and to decide whether the extra expense of maintaining the current burden of proof would be justified, but that is a judgment that Parliament is fully entitled to make. If the Lords amendment remains in the Bill, the Government may need to break out of their cost-neutral straitjacket to pay for it. Many of us think that that would be the right thing to do.
Finally, the Government argue that the status quo is wrong in principle and encourages a compensation culture. Lord Bach told the Lords that
"under the present arrangements it frankly is too easy for people to claim that they have received an injury or an illness during service, whereas everyone knows that they almost certainly did not. But, because of the burden, and particularly the standard of proof, that person succeeds in their claim. That is what we are trying to stop".—[Official Report, House of Lords, 8 September 2004; Vol. 664, c. 585, 587.]
That is the real debate that we should be having and the only one of the Government's arguments that is worth exploring in depth. If it is indeed true that, under the current scheme, many claims are unfounded yet claimants receive a war pension, a remedy should indeed be sought. However, the Government need to provide hard evidence, in the form of statistics or examples, that people are succeeding in spurious claims for war pensions. Even if they can make a convincing case that the net should be tightened, it is important that that should not penalise those whose claims may be just but who lack the information to prove it.
The Government may also claim that the amendment is poorly drafted and would make claims for compensation even easier than under the current war pensions scheme. However, the amendment's aim is clearly to maintain the status quo and it could be redrafted to achieve some compromise. The Royal British Legion wrote to me on Monday. The letter stated:
"The Legion has carried out research which indicates that, under the proposed scheme, using the amended burden and standard of proof, coupled with its new limitation of only 5 years during which a claim might be submitted, up to 60 per cent. of those claims currently succeeding, would fail. Although the MoD challenged our figures, they have carried out no research of their own and offered no credible alternative, whilst admitting successful claims would reduce. However, the MoD has recently conceded that their proposals, if accepted, would result in savings of £200 million"—
we now hear the figure of £300 million—
"although they do not specify over what period of time. It has additionally confirmed that the burden of proof relating to the claim will transfer from the MoD to the individual claimant."
The Government have threatened to withdraw the Bill if the Lords amendments, especially Lords amendment No. 1, are accepted. The Minister has reiterated that this afternoon. There is particular concern about that, especially in the Forces Pensions Society. Both the Minister and Lord Bach said that, if the Lords insisted on their amendment, we would have no choice but to re-examine the overall package and that there was no guarantee that the schemes could be delivered in such circumstances.
None of us wants the Bill to fail but elements of it need improving. Some of those improvements may cost money. Rather than threatening to throw it all out, the Government would do better to consider calmly how best they could effect Parliament's decisions, seek some acceptable compromise and be seen at such a crucial and dangerous time, which is likely to continue for at least the next five years, to be prepared to reward those who serve and seek to maintain freedom in our country.
It is a privilege and a pleasure to follow the hon. Member for Dunfermline, West (Rachel Squire). May I, through her, thank the Select Committee on Defence for its extremely valuable work? It has benefited all hon. Members in their contributions to defence debates.
I wish to express again my admiration and gratitude for the service of the armed forces. That has been put on record many times and we need to continue to do that. Against that background, we want wholeheartedly to support any amendments that seek to provide the best compensation scheme that this country can realistically afford.
The Royal British Legion has worked tirelessly. I accept that the Minister has held many meetings and, I suspect, hard negotiations, with its representatives. They provide a valuable service in representing the best interests of our armed forces.
We support the Lords amendment, which returns the safeguard of reasonable doubt that the Government removed in clause 1. They propose to substitute a balance of probabilities test of entitlement for claims, thus shifting the burden away from the Ministry of Defence and on to the claimant. As everybody has recognised, it means that a significant number of deserving members of the armed forces will be deterred from even beginning an attempt to take on and challenge the Ministry of Defence.
Amendment No. 1 would result in a reversion to the status quo. I could not understand the Minister's assertion that the position would be better than it was. If the amendment were accepted, the burden would not be on the claimant to prove that injury, illness or death was due to service but on the Secretary of State to disprove the case.
We have all stressed in such debates that it is inappropriate to compare armed forces personnel with other parts of the civil service and other civil pension schemes. They are clearly different and they need to be addressed in a different way. Armed forces personnel run special risks, which often have uncertain effects on their health. That special status means that we should do the very best that we can.
I want to concentrate on three matters, which perhaps have not been explored in depth. First, let us consider the figure of £200 million or £300 million over a 10-year period. In my simple maths, that means approximately £30 million a year on average, although I accept that the figure could increase or decrease. I do not know how it is worked out. I want to contrast that with the announcement in the Ministry of Defence's annual review, which was made last week. It set out the abortive expenditure of £25 million on a project in the River Tamar, adjacent to my constituency.
The project is called RAFT, which stands for remote ammunitioning facility in the Tamar. It was hugely controversial and designed to enable submarines to be rearmed. It was approved against a background of great opposition. After digging hundreds of thousands of tonnes of rock and debris out of the river and dumping them in an adjacent bay, causing all sorts of environmental damage, the project was pulled. In the process, £25 million of public money was spent. I do not suggest that that is an everyday event, but £25 million would pay for at least one year of the additional expenditure. Saving abortive expenditure on one such example every year would render the Ministry's increase in spending almost cost neutral.
Secondly, the Minister said that the provisions start on 6 April next year and that current rules will apply until then. Last night, when I was considering today's debate, I heard that my daughter had given birth to our first granddaughter—a very happy event. That made me consider being a grandfather. Many children are being born to members of our armed forces while their fathers are away in Iraq. In future, the sons and daughters of those now serving in the middle east and, indeed, my granddaughter, might ask, "What did you do in the war, Daddy?" or "Granddad."
What might I reply? Perhaps I would say, "I participated in a Parliament that sent many of our armed forces to war." Perhaps we will have greater perspective when we consider the matter with hindsight in 10 or 12 years. I could say, "I also participated in a Parliament that ensured that the sort of compensation and pension schemes that those members of the armed forces may want to rely on was significantly weaker and much reduced from what they might have expected to get it they received injuries or illnesses through the conflict to which Parliament decided to send them." I would have to say that I sat on the green Benches while that happened.
Exactly what I might say, I have not the foggiest idea, but that is not important. What is important is that questions will be asked. Why did Parliament decide, within the same Parliament, not only to send people into situations of great potential harm but to introduce a compensation scheme which would not provide them with the very best support? The cost of that could well fall on those families rather than on the Government and the country. So, yes, this is about the future. We are looking towards the future and trying to provide the very best for it.
Thirdly, I want to turn to something that I shall call track record. Why is it that so many people in our armed forces, the Royal British Legion and elsewhere do not believe that the MOD is seeking the very best for them? Why do people think that the Ministry is not doing its level best to provide a scheme that will give them all that this country can properly afford and should rightly provide? Perhaps the answer can be found in an ongoing issue. I want to quote extensively from a letter from one of my constituents, Mr. John Connelly. I am sure that, as I read it, hon. Members will understand where he is coming from.
First, I shall provide a bit of context. Mr. Connelly used to work at Devonport. He was in the Royal Navy, and he worked alongside dockyard workers. He worked on ships, hauling out vast quantities of asbestos lagging and he now has an illness that is likely to cause his premature death. He says:
"Asbestos-related illnesses have killed and injured many thousands of Royal Navy veterans over the decades, and still continue to do so. The problem for Royal Navy veterans will not pass until approximately 2025, when the MOD can safely say that due to safer use of insulating materials used on warships and submarines today, and the reduced number of Royal Navy personnel and the huge reduction in the size of the Royal Navy fleet, no more sailors should be killed or made sick by asbestos. This is all very nice for those who are serving today, but our plea is on behalf of those who served Queen and country when no precautions were offered to protect us from the harmful asbestos dust and fibres which were used in massive and unregulated amounts on warships and submarines."
Mr. Connelly writes
"on behalf of the sailors and their families who have 'crossed the bar' or are still suffering today with this dreadful disease caused by the Royal Navy's use of asbestos."
Mr. Connelly continues by saying that the MOD's stance relates to
"the 1947 Crown Proceedings Act, section 10, which the Government changed in May 1987 but did not make retrospective. This has seriously disadvantaged Royal Navy veterans with asbestos diseases because the bulk of us served and left the Royal Navy prior to 1987. This gives the MOD total legal immunity, which they are very happy to exert in any challenge to this Act. This unfair and unjust law puts the Royal Navy veterans with asbestos-related illnesses, and many of their families, below the law which allows dockyard workers, coal miners and civilian workers with asbestos illnesses to claim proper and just recognition and compensation for their illnesses through the courts. It is simply obscene to give compensation for a dockyard worker's life or a coal miner's life to their families, when 'Jolly Jack Tar' is treated less than these. It was good enough to change this law in 1987. Why is it not good enough to change the law and make it retrospective? This would allow a degree of fairness for sufferers and their families.
The MOD will hide behind the war pension theory that, if ill, we can claim a war pension. The payments, if you are successful, from the Veterans Agency, are small in comparison to MOD payouts to dockyard workers and Government payouts to coal miners, etc. If large payments are good enough for these good men, then they are good enough for us. The playing field is not level, and the Royal Navy veterans with asbestos-related illnesses have an uphill struggle for recognition and fairness. It should be the other way round for those who have given their all and are now dying with asbestos diseases."
I could go on, but I think that hon. Members will have got an idea of what I am trying to say. There are many who are extremely sceptical about the real motives for the MOD's changes to the pension and compensation schemes. I recognise that the Minister is going to say that we need to make a decision on this, but this decision will pass into legislation that will affect the lives of hundreds of thousands of people for many years to come.
There is no track record of any decisions to overturn arrangements that go against the MOD's long-term interests. There is huge scepticism among people who have heard what has been done about Gulf war syndrome, about asbestos and about the other illnesses that can be contracted while people are serving; they feel that those issues have not been properly dealt with. We must provide a real Rolls Royce of a compensation scheme. It is sometimes preferable for a few people to exploit a scheme in a minor way in order to ensure that the vast majority of those who are properly owed compensation receive it. If we err in the other direction, by excluding 100 per cent. of those who might be trying to exploit the system, we will undoubtedly significantly reduce the number who should rightly and properly be rewarded.
It seems unlikely that the Government will accept any compromise on this issue, in the light of their threat to pull the whole Bill. There are good things in the Bill, which the Liberal Democrats welcome. However, there are one or two issues on which we disagree. I am sure that figures can be provided in relation to cost neutrality, and that all sorts of good reasons can be given, but the Government now have the opportunity not only to provide a proper compensation scheme for those who are serving Queen and country, but to demonstrate once and for all that the issues that Mr. Connelly raised in his letter have been consigned to the past and are not part of the MOD's current plans, and that, although mistakes may have been made in the past, they will not be repeated in future. In that way, other hon. Members would not have to receive similar letters in 10 or 15 years' time, citing these pension and compensation schemes as the reason why people are not receiving what they should be.
It is a privilege to take part in a debate that has had such high quality contributions. As 11 November approaches, our minds go back to the parades that we have seen over the years. This year, we have also witnessed the D-day commemorations, when we saw the many fine old men and women with their medals. Some of them paid a horrible price, and of course we remember those who paid the ultimate price.
I hope that it is in order, Mr. Deputy Speaker, for me to quote a little story that really put the whole business of war into perspective for me. A very good friend of mine was at the dinner that used to take place at the end of the rather gruelling selection procedure in my regiment. He was sitting next to an elderly, grizzled veteran. My friend, full of enthusiasm for the process that he had just been through, was telling the veteran how tough and demanding the selection had been. He went on at some length before realising that the other chap had hardly said a word. My friend turned to him and asked, "Was there a selection when you joined the regiment?" "Oh, no," said the old boy, "there was no selection. We just signed on." "I see," said my friend. "What is the most demanding thing that you can remember doing?" The old man paused for a moment, then said, "Well, Passchendaele was no picnic."
The truth is that we have a special duty of care to our armed forces. As the previous two speakers and my hon. Friend the Member for Aldershot (Mr. Howarth) have said, it is wrong to draw a parallel with normal civilian practice, as such people are not normal civilians, given the risks that they take and the things that we ask them to do. I know that the Minister cares about the armed forces—I have no doubt about that—but we have an honest difference of opinion about what is in their best interests. As we think of our troops today in Iraq—not just the Black Watch but all the other units there—and as we think of the troops in Afghanistan and other uncomfortable and dangerous places where they are risking their lives, we owe it to them to get this right.
This is a bad Bill and I would be delighted if it failed in its entirety. It comes on top of a number of other extremely unwelcome measures that the armed forces have had to bear—I will not test your patience, Mr. Deputy Speaker, other than to mention in passing the cuts in numbers and the unprecedented risks of legal proceedings against them if they make a mistake in action.
Can we lay to rest what the Minister said about cost neutrality, as we have been round this buoy so often it is becoming tedious? It has been clear from the beginning, from the MOD's evidence to the Defence Committee, that the proposals are cost neutral in a distorted sense of the word. The overall double package—as the Minister rightly says, it is pensions and compensation—is cost neutral if we include in the calculation the fact that people will live longer. Individuals will be penalised for their prospects of living longer, if at the same time we exclude the fact that there will be more of them. The Government will save money overall, because the package will take account of the fact that people are living longer; obviously, the status quo does not do so. For that reason, I think that the Minister is bluffing when he says that he will drop the Bill—but I, for one, would be delighted, as would most members of the armed forces, were it to disappear after another gallant stand by their lordships.
It is a shame that the Minister has not been willing to listen to his gallant, honourable and noble Friend Lord Morris, whose father gave his life for this country in action, and who himself served in Palestine where, coincidentally, my father also had his first military service, with problems that are not very different from the ones being faced by our servicemen in Iraq today.
It might be helpful were we to discuss how the proposals will impinge on individual cases. I will quote three, the first two of which are actual, concrete cases, and the third of which is hypothetical. I am grateful to the Royal British Legion for providing the cases. The House will recall that the standard of proof for the war pension and the attributable pension is currently different, so we can see how the current test and the proposed test would work, because the proposed test is the current test for the attributable side. In the first two cases, there was a victory on one and a defeat on the other, but under the new arrangements there would have been a defeat on both because of the burden of proof.
The first case is that of Mrs. Rita Norman of York, the widow of Flight Lieutenant Roy Norman, RAF, who died of heart disease, which the war pensions scheme, under the old standard of proof, accepted was attributable to service. She got the war pension award, but she did not get the attributable pension on the balance of probabilities. Anyone who has followed the campaign by the hon. Member for Vale of Glamorgan (Mr. Smith) on deep vein thrombosis, for example, will know that heart problems are commonly associated with civilian air travel, so it does not take rocket science to know that one is far more likely to have a heart attack if one is a pilot. I can see why, on the balance of probabilities, that case would be lost. Anyone who marries a pilot in any of the three services knows that the likelihood of dying in service in peacetime is far higher than in most other professions. But proving that a particular death, unless it was in a crash, was attributable to military service can be extremely difficult.
In some ways, the second case is even more worrying. It involved Mrs. Cheryl-Ann Hulme of Anglesey, widow of Sergeant Geoff Hulme, RAF, who died in a climbing accident in 1996. Let us be clear: adventure training has always played an important part in the armed forces. Are we going to have arguments about whether someone who carries out activities involved in adventure training is involved in attributable service? We can argue that someone is on holiday on a particular occasion. A climbing instructor who takes people adventure training may from time to time want to take holidays in the same way, or may want to try out a slope on which he is thinking of taking personnel later. If someone engaged in climbing while in uniform—a recognised form of adventure training—will not be eligible for a war pension, that fills me with doubt.
That brings me to the third—hypothetical—case, which I want to put to the Minister. Previously, I have made it clear that the Bill offers a rotten deal for the reserve forces by reintroducing the abatement system, which was rightly abolished by the previous Government. That is in another part of the Bill. While the Minister was speaking, I realised to my concern that there is potentially a bad deal for the reserve forces in the Lords amendment. It is common practice in the reserve forces—I imagine it is even more common now, with the cuts in man training days under this Government—for officers in particular, but to some extent for all ranks, to carry out military activities without being paid for them. Indeed, Territorial Army units could not go on if from time to time officers and senior non-commissioned officers were not willing to do recces and carry out other activities outside paid training time, because there are not enough man training days within the annual budget.
Can the Minister give the House an unequivocal assurance that under the arrangements that he proposes, no one will try to argue in an MOD court that a person carrying out activities on behalf of their unit but not being paid, perhaps because the budget has run out, was not "in uniform" at the time? My God, that would be another blow to the reserve forces, on whom an incredible stress is falling at the moment. They are suffering from the same sort of problems of overstretch as the regular forces, and their civilian employers and families are becoming concerned about it.
Those three cases illustrate, I hope, why the Government's proposals are unsatisfactory. Over the years, we have all seen Ministers—it is a characteristic of Ministers in all Governments—faced with an amendment that has been lost in the other place, or in a tight corner with their Back Benchers, using a classic ministerial tactic, which is perfectly legitimate, of hiding behind the wording of the amendment to show how defective it is. The Minister has argued that this amendment would be more expensive than keeping the status quo on the burden of proof, if I have understood him correctly—£300 million against £200 million. That is not what he should be addressing, and he knows it. What he needs to tell the House is what the Government's attitude will be if, as we know is likely to happen, their lordships introduce a compromise amendment. Better still, why does he not tell the House that the Government are willing to introduce their own compromise amendment, which deals with any concerns he may have about enlarging the scope, but which still leaves those people who deserve compensation able to get it?
We owe a special debt to those who risk their lives for us. We owe it not only to those in the discomfort and danger of Iraq and Afghanistan but to future generations, such as people in cadet units—one of which I had the privilege to visit yesterday—who are thinking of joining the armed forces. Those people have received a number of unhappy messages over the past few years. Let us send a message from Parliament that we still recognise that when things go wrong, and when they get injured in military service, the House, Parliament and the system of compensation will continue to give them the benefit of the doubt, as has been the case ever since the first world war.
The Minister, in his opening remarks, provided us with a powerful argument for voting against his motion. He said that if we did not disagree with the Lords, or if subsequently the Lords insisted on their amendments, he would withdraw the Bill. Although I agree with the hon. Member for Dunfermline, West (Rachel Squire) that there are many good things in the Bill, I feel that on balance it is a rip-off—a bad package—and I therefore would not mind if the Minister did withdraw it. The critical argument is that advanced by my hon. Friend the Member for Canterbury (Mr. Brazier): in financial terms, the Bill amounts to a diminution of the present package.
The Minister has said that as a consequence of the change in the balance of probabilities involved in decisions on claims, there will be a reduction in the number of people achieving a settlement. That is also the clear implication of what Lord Bach said in the other place. When I raised that point in Committee, the Minister said what he has said once this afternoon: "No—this will not take effect until April next year." The reality is, though, that we judge what will happen in the future on the basis of what has happened in the past, so Lord Bach is right. There are undoubtedly people who have secured pensions and settlements which, had they brought their cases after April next year, would not be secured. It is right for us to ask whether that is fair, given that the settlements sought were proper.
I know of people who have secured awards on the basis of Gulf war syndrome, which would not be secured according to the new test. A whole category of settlements would fall at the first fence—they would be ruled out for being out of time. As the Minister has already been told, unless he can tell us that all those people have been given awards unfairly and improperly in the past, we should not be prepared to countenance a change that I consider absolutely unacceptable.
Many of my constituents have benefited from the existing test. I have yet to learn of one who should not have received an award, and until such information is produced I cannot countenance any change. I believe that, on the merits of the amendment, we should not disagree with the Lords. As for the new test presented by the Minister today—that if we do not do his will, he will withdraw the Bill—that is itself a powerful reason for disagreeing with the Minister.
I welcome this debate and will try to be brief in my summing up. First, let me congratulate the hon. Member for South-East Cornwall (Mr. Breed) on becoming a grandfather. [Hon. Members: "Hear, hear."] That has prompted agreement throughout the House, of which we have seen little this afternoon.
Let me also pay tribute to all our forces, wherever they are serving today. Both regulars and reservists are doing a job whose difficulty we recognise. On that, too, there is agreement throughout the House. The hon. Member for Canterbury (Mr. Brazier) asked whether a reservist would be compensated for injury or illness. The test is whether the injury or illness is due to service; pay is not a determinant.
I hope that I can reassure my hon. Friend the Member for Dunfermline, West (Rachel Squire). We have calculated the compensation scheme carefully so that more people who are more seriously disabled will receive benefit. I consider that to be social justice, a value shared by members of my party—although I do not exclude other parties; the Liberal Democrats are welcome to share some of our values.
Securing more compensation for those who are more seriously disabled is essential. If we take money out just in connection with the burden of proof—I shall deal shortly with the point about the Select Committee—it is likely that other parts of the compensation package will suffer.
My hon. Friend also made a point about records. Let me repeat what I said at the outset, namely, that we recognise that it would be unreasonable to ask the claimant to obtain evidence relating to his claim held in his official service records—"his" also meaning "her". The scheme rules will therefore impose a duty on the Secretary of State to make available to the claimant such evidence on request. I hope that on the basis of that, along with my commitment to the Select Committee that we would take responsibility for lost or inadequate medical records, my hon. Friend will accept that we have made considerable progress.
As the hon. Member for Dunfermline, West (Rachel Squire) pointed out, this is essentially an enabling Bill. Very little of its content enshrines provisions in law. I hope that, for the benefit of the courts, the Minister will make clear that this constitutes an obiter dicta, and that he may therefore be cited as having given an undertaking to the House today.
This is not the first occasion on which the hon. Gentleman has heard me give such undertakings. I gave them in both the Standing Committee and the Select Committee. The good news for some Members is that we shall revisit many of the issues during the secondary legislation phase, which I hope will begin once the Bill has been given Royal Assent.
Let me reassure my hon. Friend and the House that we gave careful consideration to the alternative formula suggested by the Select Committee. It proposed a change to the standard of proof, but offered no compromise on the key cost driver of burden of proof. Although it appeared at first sight to be offering a compromise overall, on closer study that turned out not to be the case. The claimant would not be required to prove his or her case and the ultimate burden of proof would remain with the Secretary of State. We have no detailed costing, but we are satisfied that the Committee's proposal would not change the position sufficiently to make it affordable. I am not referring to the amendment proposed in the Lords with the support of the Royal British Legion; we have costed that and it, too, is not affordable.
Given that a clear compromise was proposed by the Select Committee, why did the Minister's Department not undertake an examination of the costs? It costed everything except the one compromise that might have secured agreement on the Floor of the House.
I think that the hon. Gentleman is becoming over-excited. I have made clear the difference between the Select Committee's proposal and what we actually looked at. We took it away and studied it, and had we been able to cost it we would have done so. The key point about Lords amendment No. 1 is that it is not the same as the Select Committee's suggestion.
The hon. Member for Aldershot (Mr. Howarth) asked me earlier why I did not share the new figure with the Royal British Legion. Call me old-fashioned, Mr. Deputy Speaker, but I thought that sharing it with the House first was an appropriate act for a parliamentarian. I am very happy to come here today and to share, first, with the House of Commons our calculation of £300 million, which is the right and proper thing to do. I will share the details relating to that figure with the RBL, and I also intend to write to the hon. Members for Aldershot and for South-East Cornwall and to the Select Committee about them.
I have explained why it remains the Government's strongly held view that the "beyond reasonable doubt" standard of proof supported by the Lords is not appropriate to a no fault compensation scheme and is out of line with current good practice, which shows that evidence-based decisions that are based on a "balance of probability" standard of proof are indeed the norm. The important fact is that the new scheme has been designed to admit all reasonable claims, including those that will, for good reasons, fall outside the time limit. The reassuring message that I can give to the House is that the Government are confident that no claim will fail where there is reasonable evidence that injury, ill health or death is due to service.
I want to touch briefly on the RBL's claim, which was widely quoted in the House of Lords in particular, that it expects some 60 per cent. of claims successfully made under current arrangements to fall under the new scheme's rules. Indeed, the hon. Member for Canterbury made a broadly similar point. After some initial doubts as to whether a review of this analysis would help us to resolve the disagreement, I wrote to the RBL about the analysis and asked my officials to follow up the letter. The RBL has now withdrawn its offer to allow the Ministry of Defence to look at how it arrived at this very high failure rate, having concluded, I think, that we are not genuinely open to change. I want to take this opportunity to reassure the RBL that that is not the case, and to reiterate my offer, which I made in my original letter, to consider further its analysis.
Will the Minister give way?
I will not give way because I want to conclude.
For the moment, however, as we have not been given sufficient sight of the RBL's work, we must retain our concern that the study did not provide a sound analysis of how past claims would fare under the new scheme.
Those who argue that it is appropriate to have the war pension scheme arrangements, or something even more generous, in the new compensation scheme, have a duty to explain to the taxpayer why they consider it reasonable to spend an additional £300 million over 10 years. Indeed, the hon. Member for Aldershot should explain that to the right hon. Member for West Dorset (Mr. Letwin), who doubtless does not know what he is up to today in budgetary terms.
Will the Minister give way?
Or would the Conservatives rather take money away from the more severely disabled in particular, to allow awards in cases where service is unlikely to be the cause of a condition?
The compensation scheme—
On a point of order, Mr. Deputy Speaker. Is it acceptable for the Minister to make an assertion that is wholly without foundation about my right hon. Friend the Member for West Dorset (Mr. Letwin), who is fully aware of our position on this matter?
That is not a matter for the Chair; it is a matter of debate.
I am delighted to hear it, Mr. Deputy Speaker.
If one wants to spend that additional £300 million over 10 years, it has to come from somewhere, and I assume, as I said, that the Conservatives are suggesting taking it from the more severely disabled, to allow awards in cases where service was unlikely to be the cause of a condition. That is the Conservatives' position, but I am pleased to say that it is not the position of this Labour Government.
The compensation scheme has the full support of the Chiefs of Staff, the support of many in our armed forces and, indeed, those in the ex-service community. I hope that the Bill will have this House's support today and the Lords' support when it returns to it.
Question put, That this House disagrees with the Lords in the said amendment:—
The House divided: Ayes 269, Noes 181.
Question accordingly agreed to.
Lords amendment disagreed to.
After Clause 6
Lords amendment: No. 2.
I beg to move amendment (a) to the Lords amendment, in line 3, after 'widows' insert 'or'.
With this, it will be convenient to discuss amendments (b) and (c).
I am speaking to the amendments that stand in my name. There are several, but they add up to the same thing, which is to amend the amendment proposed by their lordships in the other place.
On retirement widows, as with the burden of proof, the Government have remained stubbornly resistant throughout, refusing to give an inch in response to calls from the Forces Pension Society, Members of this House and of the other place and the widows themselves.
Currently, those who retired before 6 April 1978 and married for the first or subsequent time after their retirement receive no widow's benefit. Those who retired after 6 April 1978 have a widow's benefit based only on that part of their service that took place after 1978. For example, a serviceman who served a full career with half his service before 1978 would leave his widow from a post-retirement marriage on a pension worth just over 12 per cent. of his final salary. That compares with a pension worth 24.25 per cent. of final salary that would be paid to a pre-retirement marriage widow; that is, a woman who had married her husband while he was serving in the armed forces.
The Government have set out the same arguments repeatedly, and I have no doubt that we will hear them again today. They say that the projected cost of £50 million is too expensive, that such a change would affect the longstanding policy that there should be no retrospection and that there would be a read-across to the rest of the public sector. As the Opposition have said on previous occasions, we remain unconvinced on the two latter points, and I shall turn to them now.
First, I shall deal with the question of cost. Lords amendment No. 2 offers an affordable compromise, and is aimed at helping the oldest and most vulnerable widows. We accept that the one-off, up-front cost of £50 million could be difficult to justify, given the competing pressures on an already overstretched budget, so we are offering a compromise to address the needs of the most vulnerable members of this group. By making provision for those over 70, we would maintain the spirit of the amendment tabled by Lord Freyberg, and would do so at a relatively small cost, which we believe to be entirely justified.
I should like to take this opportunity to pay tribute to Lord Freyberg. From the Cross Benches, he made a very valuable contribution to the debates on these matters in the other place.
The Government Actuary's Department and the Ministry of Defence have refused to release the assumptions on which their costings are based, so it is difficult to make accurate financial projections. However, the Forces Pension Society has estimated that were the Government minded to make a small concession on payments to those who married a member of the armed forces pension scheme before his 60th birthday and who are now widows over the age of 70, the cost would be of the order of £10 million.
We believe that to be affordable and justified. If the Government refuse to relent on this issue, the next Conservative Government will make the provision for the oldest and most vulnerable of the people affected. We are willing to make that commitment. Are the Government willing to do the same?
Furthermore, the stipulation that the marriage should have taken place before the member's 60th birthday would bring the provision into line with the normal retirement age for the vast majority of workers in the public sector. The vast majority of service people leave the armed forces at or before their 40th birthday, so that stipulation would mean only that service personnel would be treated equitably with the rest of the public sector. It would confer on them no special privilege, but would merely bring them into line with the rest of the public sector. The amendment is designed to secure parity, and there would be no read-across to the rest of the public sector.
Since 1973, service personnel have had their pay abated; in other words, a deduction is made from their salary to assist in the provision of pensions for themselves and their dependants. Pension provision is therefore not without cost for members of our armed forces, as they make payments by way of a reduced salary. That principle was conceded in the new scheme, and changes were introduced in 1978, so there can be no justification for this small and disadvantaged group to continue to be penalised by outdated legislation.
The Minister has said that providing the proposed pension provision for widows and widowers of post-retirement marriages would go against the policy adopted by successive Governments that there should be no retrospection. Again, we remain unconvinced. The precedent has already been set for making provision for vulnerable groups adversely affected by changes in legislation. In 1989, for example the then Secretary of State for Defence, my noble Friend Lord King, responded to concerns that help should be given to a "uniquely deserving category" of individuals and stated that pre-1973 widows would, from April 1990, be given an additional, tax-free payment of £40 a week. That payment would come from the Department then known as the Department for Social Security.
In his statement to the House and in the ensuing debate, Lord King made it clear that the change was not retrospective, and that the new payment was designed to boost the income of a group of people who had not benefited from the later improvements made to the armed forces pension scheme because of the policy of non-retrospection. When any new scheme is introduced, there will always be some who are left behind, as happened in 1978. However, the precedent exists to make provision for what Lord King called a "uniquely deserving category" of people.
On the question of read-across to other public sector workers, we have maintained throughout the Bill's passage through Parliament that the armed forces are different from all other public services. As Opposition Members, Liberal Democrat Members and the hon. Member for Dunfermline, West (Rachel Squire) have all said, what we ask of our armed forces is unique. We ask them to place their lives on the line as a matter of routine, in the name of their country.
A former Pensions Minister said:
"I should emphasise that the exemption of the armed forces will not be a precedent for the treatment of any other group. The armed forces are unique in the demands that are placed on them and the diversity of duties that their members may be required to undertake at any time and for any period." —[Official Report, Standing Committee D, 5 February 1998; c. 777.]
That was not said by my noble Friend Lord King, nor even by a member of the Conservative party, although it might have been. It was said by the right hon. Member for Makerfield (Mr. McCartney). We agree. The sacrifice made by the members of our armed forces should be recognised in the way in which we treat them and those whom they leave behind.
As the splendidly feisty organisation No Pension 4 U has observed, many of the spouses of the oldest widows covered by our amendments will have seen service during the second world war. Indeed, some of the very oldest widows may have contributed to that victory themselves, through the Women's Royal Army Corps, the Women's Royal Naval Service, the Auxiliary Territorial Service and the Women's Royal Air Force, or other associated occupations.
Some pretty touching cases have been drawn to my attention. A lady from Devon stated:
"My husband was in Bomber Command during the second world war. He stayed on in the Royal Air Force and served until 1970. He lost his first wife in 1974 and he and I married in 1977. He is now nearly 88 and I am 82—however, not too old to feel very bitter that although now partners of the same sex are entitled to a pension I am not and would have a struggle to maintain standards if he dies first. One really does feel was his sacrifice of his youth worth it when the older service men seem to be forgotten?"
A lady from Essex wrote:
"My husband joined the army in 1946 and left in 1975. His first wife sadly died in 1987. We married at Christmas 1989 and I am dismayed to find that I have less status regarding pensions than an unmarried or same sex relationship partner. My husband is now 75 and still works. Although he enjoys working I know that his main motivation for doing so is to help to provide for my future as he now knows that I shall not receive any part of his pension if he dies first."
Does my hon. Friend remember an earlier debate in which the need to recognise the realities of life were mentioned? It was said then that people facing circumstances that were less favourable than expected should have a reasonable or fair deal. That is an attractive argument. Will my hon. Friend explain why people do not feel the same way about women who have lived as second wives for a long period of time and who then find themselves in reduced circumstances? That was wrong under the previous Conservative Government; surely it is time that the House recognised that it would be sensible to put the matter right?
My right hon. Friend is entirely right. The Minister will say it anyway, so I shall say it first: the legacy issue was not dealt with by the previous Conservative Government, but the number of people involved is declining all the time. It is time to recognise those members of the armed forces pension scheme who served their country and got married later in life.
There is a well recognised precedent in this House that we try to put right unfairnesses and injustices for which the resources previously have remained unavailable. We believe that those resources should be made available, and we are prepared to commit them in this matter.
We see no reason why a gesture to the most vulnerable among the post-retirement widows need have any effect on the wider public services. The Government admit that the armed forces are unique; their members and their families should be treated as such. With so many of those covered by the amendment being widows of second world war veterans, it would be an entirely justified and magnanimous gesture to make in the 60th anniversary year of the end of the war, regaining the Government some of the trust they have lost among the ex-service community.
We accept that there is no particular reason why the post-retirement marriage amendment should appear in the Bill; little else does. We accept that it is essentially a legacy issue and falls outside the auspices of the new armed forces pension and compensation scheme. However, the plight of the most vulnerable post-retirement widows cannot be simply brushed to one side.
The Opposition have made a commitment to seek some kind of provision for those widows. We will, therefore, not seek to take this amendment further if the Minister is prepared to give a commitment now to make provision for the most vulnerable widows, along the lines of the amendment, outside the new scheme. The Minister has already given various commitments to the House today that while not in the form of legislation, are nevertheless binding commitments on the Government. If the Minister wishes to make that commitment now, I shall be happy to give way to him.
Answer came there none. I am sorry about that, because I am trying to find a compromise. If the Government refuse to be magnanimous and make a small cash commitment to some of the most vulnerable who have been overlooked for many years, we shall seek to press the amendment to a vote. The Minister can be assured that the issue will return when it has been considered in the other place. I am sorry that the Minister is unwilling to compromise. I have made what I consider to be an overwhelming case and it is time we took action and acted magnanimously. I hope that the House will support the amendment.
The Defence Committee sees the amendment as contentious, and I understand that it was passed in the other place by only one vote. The amendment would have a retrospective effect. Before 1978, service personnel were unable to accrue pension entitlements for widows or widowers except when marriage occurred before or during service. The amendment would extend the right to a widow's pension to wives, husbands and registered unmarried partners of service personnel, even if the marriage took place after the service person had left the armed forces, as long as it occurred before they reached the age of 60.
The amendment would also increase the rate of post-retirement widow's pension for those widows and widowers who currently receive a post-retirement pension based only on that part of their spouse's service after the changes were made. It would improve the benefits of unmarried partners who presently receive benefits only if the death of their partner is due to service.
I am aware that the Government opposed the amendment in the other place because of the cost of some £50 million and because it is wrong in principle for laws to have a retrospective effect. The Government are also concerned that a change for the armed forces might require similar, and much more expensive, change for the rest of the public sector. I have heard estimates of between £300 million and £500 million. We are all aware of successive Governments' opposition to making improvements to public service pension schemes retrospective, and I have been made aware of possible considerable ill-feeling if the widow of a serviceman received some retrospective benefit and was treated more favourably than the widow of a fireman or a policeman. However, the Defence Committee and many other hon. Members think that our armed forces deserve particular treatment because of the commitment they give, including possibly risking their lives in the service of our country.
Like the hon. Member for Aldershot (Mr. Howarth), I have received strong representation on this issue from the Forces Pension Society. This year we have been remembering the 60th anniversary of the Normandy landings and next year we will remember the 60th anniversary of the end of the second world war, so I hope that the Government will consider a compromise on these issues, especially for the 75-plus age group and those linked to the veterans of that war.
The subject of the amendment is easily made into an emotive issue and, in a sense, is none the worse for that. As the hon. Member for Dunfermline, West (Rachel Squire) said, we are talking about a group of the population whom we have asked to do something very special that is different from anything that we ask of anyone else. Given that we are—in my view, wrongly—at war, it is a good time for us to think about this issue.
Throughout my time in Parliament I have taken up several relevant cases, and I am sorry that previous Conservative Governments were not able to put the matter right. I have always found it unacceptable that widows of service people who marry another service person should lose entitlement to the pension of their first spouse without gaining entitlement to the pension of the second. That is not a generous approach. I commend the concept of generosity to the Minister. I have been frank in saying that it was a pity that previous Governments, of whom I was a member, were not generous enough. If I am willing to say that, perhaps the Minister will be willing to be more generous.
The amendment provides an opportunity to do something that is, frankly speaking, a matter of common decency for those who, in later life, have provided the companionship that has been denied to a serviceman through the death of his original wife. We do not say that those people should receive extra compensation or special treatment, but that they should receive what reasonable people might think was theirs by right.
There is no need for a read-across from this provision to other areas. It never has been true that we have allowed our treatment of the servicemen and women, to whom we owe so much, to be prayed in aid in other cases. The Government have a particular reason for accepting the amendment. At this very moment, they have decided or are about to decide—depending on which version one believes—to ask yet more of service personnel by extending their tour of duty and making them more vulnerable by putting them in the line of fire. It is not unreasonable, therefore, to see what we can do to recognise the special role that the armed forces play.
I understand that there is not much money around. I can think of many examples of the Government's policies and programmes from which they could find some money, but I would incur your wrath, Madam Deputy Speaker, were I to explore that issue. That is why we have not been ambitious in our request that the Government do the right thing.
The official Opposition have done our sums and we calculate that we can provide a 10 per cent. uplift in defence expenditure—a £2.7 billion increase for our armed forces over two years. My right hon. Friend says that we should be able to afford the measure; we will be able to afford it.
My hon. Friend makes an important point, which I put in this context. The Government make the amazing argument that all their expenditure is perfect, inviolable and properly directed and that no other expenditure can possibly be accepted due to the enormous responsibilities they have taken on. That is an incredible position for any Government, but especially for this Government because we can see just how much wastage there is throughout the system. However, we are not dealing with that but with a principle—whether the proposal is right.
I am worried about the amendment, as I think it would be right to go the whole hog. That is the moral demand placed on us by our forces. I have always made that argument, so I do not suggest for a moment that I have changed my mind simply because we are in opposition. I held that view as a Minister and I am only sorry that I was neither in a position, nor had the clout, to insist on it taking place. I am now trying again.
I suggest to those who have been especially dependent on our forces and have put them in a position in Iraq that is wholly unacceptable—I know that my hon. Friend the Member for Aldershot (Mr. Howarth) does not agree, but that is my view—that they really should do something. What could be better than to say to our troops currently fighting in the very questionable circumstances in which the Government have placed them that, in addition to the vast sum of money—unnecessary money in my view—that we are expending, we are spending that small sum on people who served our country in so signal a way? That is the least we can do.
If the Under-Secretary says that we cannot afford to do that, my reply will be that we are able to afford every pound that we spend in Iraq, even though we should not be there. We should not be spending that money and we were misled into that position, so the least he can do is to spend a bit on these proposals. That is where he should spend the money; on those who cannot speak for themselves and who deserve it. I hope that he will do it—[Interruption.] It is all right for the Minister of State to mumble under his breath; he has a very heavy price to pay. Most members of his party know that. Some of us knew at the time, and more and more of us—
Order. I hope that the right hon. Gentleman will confine his remarks to the amendment.
You are perfectly right, Madam Deputy Speaker. I am sure that Ministers will be pleased to get back to the amendment, which they find easier. It is easier not to help the poor than to take the measures that should be taken. Perhaps, however, they will allow me to suggest that this would be a good moment for them to show that they understand that the armed forces do something that no one else does. Accepting the amendment would be a way of recognising that.
There are only a few occasions when primary legislation deals with long-standing grievances that people have waited a long time for us to address. Many people will be watching closely the debates in this and the other place on this legacy matter.
As other speakers have noted, there seem to be three main reasons that the Government feel unable to support the amendment: expense, retrospectivity and read-across. All three have been adequately addressed and if the Government had the will, they could in fact undertake that relatively modest additional expenditure. It has nothing to do with the overall cost, the retrospective principle or the fact that the provision could be read across into other sectors. At the end of the day, the Government are the Government and they can will things to happen if they believe it right.
If the Government do not act, it is because they do not consider it right to do so. Such a rebuff will resound in many homes after this debate and others that succeed it during the passage of the Bill.
The Government are fond of targeting their resources and the amendment would give them a good opportunity to employ that principle by targeting those aged over 70, who may be the most needy in these circumstances. As has been said, many of those people would feel not that they were being given special treatment, but simply that they were being treated equally and with justice. That uniquely disadvantaged group will inevitably grow smaller each year. If the Government feel, at this late stage, unable to support a genuine attempt to reach a reasonable compromise, it is because they do not actually believe that it will affect real people—they are real people, as the examples we have heard demonstrate—and we can come to only one conclusion.
I very much appreciate the debate that we have held on post-retirement marriage. People are affected by the issues, as the hon. Member for South-East Cornwall (Mr. Breed) said and I accept that, at present, the Government have not been able to agree to this particular measure. However, both the hon. Gentleman and the hon. Member for Aldershot (Mr. Howarth) might have reflected on the changes that we have made during the past few months, during our debates on these issues.
In particular, we agreed, in the Lords, to a measure to allow war widows whose husbands' service ended before 1973—when the improved occupational pension schemes were introduced—to retain their pension on remarriage. That was a valuable and important amendment and shows our commitment to an important group of pensioners. It does not breach the retrospective rule. It has a cost, however. The right hon. Member for Suffolk, Coastal (Mr. Gummer) was baiting me a little about cost, but that relatively small amendment will cost the Government £20 million. None the less, I think it is worth doing and my right hon. Friend the Secretary of State and other Ministers accept that. There is always a cost, however, and we cannot exclude such considerations. That provision was especially significant for the War Widows Association and it demonstrates the Government's desire to consider the issues when we can do so.
Perhaps I can just put on the record that we do indeed welcome the change that the Government have made. It is a welcome sign of flexibility. If the Minister would just move a little further forward, we could all agree and go home.
Let us not get too carried away. I want to place on record one or two comments about the Lords amendment No. 2 and the three amendments tabled by the hon. Member for Aldershot. He recognises that this matter does not require primary legislation and has nothing to do with the pension scheme. Hon. Members on both sides of the House accept that, and I accept that particularly the Forces Pension Society has used the Bill to promote the legacy issues. I do not deny that; nor do I disagree with it. It is a perfectly reasonable campaign approach.
If the House were to accept Lords amendment No. 2, pensions would be provided to widows and widowers who married their service spouse in retirement and who did not benefit from the introduction of pensions for post-retirement marriages in the 1970s. That would affect all widows whose husbands had service before 6 April 1978, and all widowers whose service wives had service before 1 October 1987.
In moving his amendment, Lord Freyberg limited his concession to marriages before the age of 60, arguing that members of other public service schemes who were similarly affected before 1978 could, unlike servicemen and women, have expected their careers to last until the age of 60 and so would not, up to that age, have been marrying post retirement. The Government do not accept the thrust of that argument. The basic rules apply equally to all public service schemes, and early retirement is not unique to the armed forces. Other public servants who have had to give up their careers before the age of 60 were equally unable to marry after leaving service and pass on their benefits to their widows for any service before April 1978.
Most people in the public service who give up work before the age of 60 would consider themselves unusual—that is not what happens normally—but the fact is that the nature of service life is such that people do so as a matter of normal activity. Therefore, such a read-across is not fair. Surely, it is possible to make a special arrangement for those in the armed forces because of the nature of their jobs and their prospects after the age of 40. Unless we are to have a large number of people in the infantry at the age of 59, that seems to be a likely continuum.
Perhaps I can come to the point that the right hon. Gentleman makes, but we cannot avoid the read-across to wider Government issues. I certainly want to say a bit about that in a moment, although I do not think that my explanation will satisfy him.
We are also considering the amendments tabled by the hon. Member for Aldershot. I did not respond when he was trying to bait me to rise from my seat because, quite simply, those amendments came across my desk first thing this morning. As the hon. Gentleman knows, I had another engagement this morning, which I was very pleased to carry out, at St. Paul's cathedral. So I have not had time to study the proposals in detail. Last week, however, I had a constructive meeting with Lord Freyberg, and I indicated to him that we may be able to build on that meeting in future, once the Bill has received Royal Assent. I hope that, when that occurs, we can perhaps look at some of the other issues.
I need to deal with the read-across to public service generally, because it is important.
I will not detain the House long. It is extremely encouraging that the Minister has had that meeting, but I suspect that the other place and, indeed, those hon. Members who feel strongly about the issue will need a little more than hearing that there is a willingness to discuss the proposals. Will the Minister give a firmer undertaking that either Lord Freyberg's proposals on post-retirement marriages or my more limited proposals would be acceptable?
I have gone as far as I intend to go today in respect of my conversation with Lord Freyberg, and the hon. Gentleman will have to make his decisions accordingly.
I want to deal with the costs, which have obviously entered our debate—the hon. Member for South-East Cornwall referred to them. The total cost to the Government of retrospective action would be significant, which is why successive Governments have decided that whatever the merits of the case, change was simply unaffordable. As the hon. Member for Aldershot knows, it is estimated that the Ministry of Defence would have to pay a one-off lump sum of £50 million to cover past service costs. The Government Actuary estimates that the cost of the read-across to all public service schemes would be £500 million. The unmarried partner aspect of the Lords amendment would add substantially to that cost, but we have been unable to estimate how much because of the lack of data on unmarried partner numbers in the past.
I understand why Members of both Houses would want to support the Lords amendment, but I do not think that they have given proper regard to the cost implications that the changes would create. The question of affordability is important, and irrespective of the merits of the measure, it would not be viable to implement it without paying any regard to other parts of the public service. We have put together a good package of pension and compensation benefits for our armed forces, so I hope that the question of post-retirement marriages will not prevent the Bill from receiving Royal Assent during this Session so that we can begin the important transition process to the new scheme in time for April 2005.
It might be useful for me to deal with the question of retrospection because it often comes up during our debates on pensions. It is true that successive Governments have maintained the principle that there should be no retrospection in pension policy. I pray in aid the Defence Committee because its report recognised:
"it would hardly be reasonable of the Government to avoid making better provisions for future pensioners so that previous pensioners do not feel aggrieved".
That is the overall point behind our debate on post-retirement marriages, and I hope that the House accepts that I understand the nature of the situation. During my discussions with Lord Freyberg and the Forces Pension Society, I indicated that we are prepared to continue to consider the matter.
I hope that the hon. Member for Aldershot will resist the temptation to press his amendment to a Division because if he does so, my hon. Friends and I will vote against him. I hope that the House will join me in disagreeing with Lords amendment No. 2 because that provision on pension legacy is not needed, as we proved to some extent in the House of Lords when we made a slight change to the system, which will cost £20 million.
Question put, That the amendment to the Lords amendment be made:—
Question accordingly negatived.
Lords amendment: No. 2.
I beg to move, That this House disagrees with the Lords in the said amendment.
The House divided: Ayes 279, Noes 180.
Question accordingly agreed to.
Lords amendment No. 2 disagreed to.|
Lords amendment: No. 3
I beg to move, That this House agrees with the Lords in the said amendment.
With this it will be convenient to discuss Lords amendment No. 4.
I am pleased to tell the House that the Government accept Lords amendments Nos. 3 and 4 from their lordships' House. They are uncontroversial Government amendments. Lords amendment No. 3 is beneficial to the ex-service community as it broadens the definition of "appeal" in the Late Appeals Regulations 2001 to include late interim assessment appeals.
Lords amendment No. 4 corrects a technical defect in the initial drafting of the Bill that was identified by the Delegated Powers and Regulatory Reform Committee when it considered the Bill. It provides that a commencement order under clause 8 is not subject to any parliamentary procedure.
We have no problem in agreeing to the amendments and we are delighted that the Government have accepted at least some amendments from their lordships' House, even if they have been less than gracious in rejecting the other two.
I welcome the Government's move in the direction outlined in amendment No. 3. As the Minister said, we discussed the matter in Committee and it is right and proper to make provision for late appeals against final as well as interim assessments. We therefore welcome amendment No. 3.
I confess that I am not as technically familiar with the substance of Lords amendment No. 4 as perhaps I should be.
My hon. Friend says, "Shame." However, I understand that the amendment would inhibit to some extent some of the amazing powers that the Bill confers on the Government.
It has been an issue for all parties that the Bill is an enabling measure that confers enormous powers on the Secretary of State. I warmly welcome anything that limits the Secretary of State's powers and I therefore welcome amendment Lord No. 4.
We are happy to signal our support for both amendments.
Lords amendment agreed to.
Lords amendment No. 4 agreed to.
Committee appointed to draw up Reasons to be assigned to the Lords for disagreeing to their amendments Nos. 1 and 2 to the Bill: Liz Blackman, Mr. Colin Breed, Mr. Ivor Caplin, Mr. Gerald Howarth and Derek Twigg; Mr. Ivor Caplin to be Chairman of the Committee; Three to be the quorum of the Committee.—[Derek Twigg.]
To withdraw immediately.
Reasons for disagreeing to certain Lords amendments reported, and agreed to; to be communicated to the Lords.
National Service Framework for Children, Young People and Maternity
Motion made, and Question proposed, That this House do now adjourn.—[Dr. Ladyman.]
Children are special and precious but, too often, we do not treat them like that and we have not designed health and social care services to treat them like that. That is why we need the national service framework for children, young people and families.
Even before the national service framework was published, there should have been no doubt about the Government's commitment to putting children and young people at the forefront of our policy agenda. We believe that every child should have the care and opportunities that they need to live healthy, safe and fulfilled lives. That is why the Government created the post of Minister for Children, Young People and Families and I am delighted that my right hon. Friend could join us for the debate.
That belief is also why we set out a comprehensive plan of action in the Green Paper, "Every Child Matters" and followed it with a series of initiatives, including the change for children programme, to begin the task of transforming services for children. It is why we have introduced the Children Bill, set ourselves the target of eliminating child poverty by 2020 and increased spending on our schools to a total of £40 billion by 2008.
That is also why we have set about producing the national service framework for children, which is a key part of our overarching agenda to generate a step change in the quality and consistency of children's services. It initiates an ambitious programme of change. It has, for the first time, set out standards for health and social care, and the interface with education for children, young people and pregnant women. This is the first time that any such thing has been attempted by any Government anywhere in the world. The attempt is so ambitious that its publication has been eagerly awaited around the world and experts have described it as the biggest step forward for children for 50 years.
This framework has not been plucked from the ether and, although politicians have guided its development, it is not exclusively the work of politicians. It is based on a huge body of evidence and best practice that has been collated for us by a dedicated team of experts and practitioners who worked on it for more than two years. It was pulled together by a superb team of officials led by Professor Al Aynsley-Green. I did my best to ensure that they were all acknowledged in the national service framework itself, but let me say again that the Government and all the children who will benefit from this work owe a great debt of thanks to all those people.
Healthy children become healthy adults. Improving the health of children is the right thing to do, but it is also the best insurance policy that we can have. Experience before birth and in early life has a huge impact on the life chances of each individual, not only in childhood but in adult life. And as healthy children start with healthy mothers, so this framework looks back to before birth to include maternity services, as well as looking forward across the transition into adult life.
Of course, there is already a lot of good to be found among the existing services. The majority of children and young people today enjoy better health than any previous generation. Pregnant women have greater choice in their health care than ever before. So before I go any further, let me pay tribute to the staff working across health, social care and education for their enthusiasm and commitment to those in their care. Every day—day in, day out—they help children, care for children, and keep tens of thousands of children out of harm's way.
But we all know that there have been problems. Sir Ian Kennedy's report into the deaths of children undergoing heart surgery at Bristol and Lord Laming's investigation into the death of Victoria Climbié both revealed key failings in the care that we provide to children. Equal care and equal protection are not available for all. Inequalities affect a significant minority of children and young people. Too many face a damaged childhood, disaffection, underachievement and social exclusion. Child poverty, though greatly reduced, still adversely affects the health and opportunities of those from disadvantaged backgrounds. The difference in outcomes between those children and the successful majority is too wide. So, at the heart of this national service framework is a fundamental change in thinking about health and social care services. Its aim is to bring about a cultural shift in services, so that high-quality services are planned and delivered around the needs of children and their families, not around organisational structures or within professional boundaries.
Of course, I welcome the national service framework for children, just as I welcomed "Every Child Matters", but will the Minister assure us that this is not just writing in a book or ideas from civil servants and that it really will be implemented? Will the framework be audited regularly? Will he address the problem that was so obvious in the Victoria Climbié case, namely that we do not have enough well-trained, well-paid social workers, teachers, paediatricians and nurses working in the field with children? What are we doing to address that deficit?
I can give the hon. Lady the assurances that she needs. The framework will be audited thoroughly by the Healthcare Commission, which will not only look to see which parts are being implemented but ensure that all parts of the service have plans in place to complete the implementation during the 10 years of the framework's life. Later in my speech, I shall detail exactly how that will work. She is entirely right about the work force issues. That is why we have a work force strategy being implemented. We have a whole range of initiatives to increase the recruitment of social workers, to improve their status through measures such as protection of title and to improve the training and practice learning opportunities that they receive. There is a huge agenda to deal with exactly the problems that she identified.
Before we move on from the hon. Lady's point, we must recognise that Herbert Laming's report on the tragic death of Victoria Climbié also made it clear that the fundamental issues of poor practice in a range of services relating to the case were not primarily about resources. They were about the fragmentation of services, the failure of the services to deliver the standards of service that were expected and the fact that no one took responsibility for that. It must be part of the national service framework's remit to solve that problem of fragmentation and to require that responsibility as an integral part of the framework.
I entirely agree with the hon. Gentleman. That is why the national service framework is not just a recipe for change or a list of things that must be gone through with boxes to tick, but is about changing the culture of all the services that we provide for children, generating a step change in the quality of those services and, as he says, making sure that people are properly inspected and accountable for failures.
The services that we create will address the needs of the whole child, not just the specific problem or illness with which they present. That will allow services to pick up problems early. The national service framework covers the full range of issues across health and social services, as well as the links with education. Consequently, it is intended for everyone involved in delivering services to children, young people and pregnant women. It is made up of 11 standards. Each standard conveys the central aims of the NSF that all agencies should work actively together to promote high-quality services that are centred around the needs of children, young people and pregnant women; respond to children and young people according to their age, recognising that children are different from adults both physiologically and psychologically; involve children, young people and families in decisions about their care and how services are designed; and are easy for children and young people to access and use.
The challenge that my hon. Friend sets to integrate the various professions working with children to achieve that transformation is one of the most difficult that any Minister could face. Has he given any thought to how the Government could celebrate the good work that takes place, and in particular, celebrate work across the boundaries by people working within integrated children's systems in the future? For instance, we publicly celebrate nurses. Why should we not celebrate integrated child care professionals?
My hon. Friend is right that we need to celebrate successes. Increasingly, we have opportunities to recognise very good people at award ceremonies. At one recent ceremony, which was intended for those who are innovating in training in social care, I reminded people about "The One-Minute Manager". When I was working in the private sector, my director insisted that all his managers read it. The key message in the "The One-Minute Manager" is to catch people doing something right, which will be fundamental to achieving this culture change. That is why the inspection mechanisms that we are putting in place will be largely about identifying best practice, celebrating it, then making sure that it is disseminated so that everybody can work together on the agenda that he has identified.
My hon. Friend has strongly emphasised the need for greater integration in planning and decision making, which is to be welcomed. Can he spell out exactly how the different agencies will be expected to integrate and who will have the key responsibility for planning services? What is the division of responsibility between the new children's trust, the primary care trust, the acute trust and the strategic health authority, for example?
If my hon. Friend will forgive me, I will deal with those matters in some detail later in my speech because they are fundamental.
The first five standards deal with key issues that relate to all children: preventing illness and promoting health; supporting parents and carers; creating children, young person and family-centred services; growing up into adulthood; and keeping children safe. The rest of the standards address more specific issues: children who are ill; children in hospital; disabled children and children with complex health needs; children with mental health problems; and medicines for children. The final standard sets out our commitment to a high-quality, woman-centred maternity service.
As I am sure the Minister knows, I have been concerned for some time about the low level of NHS funding for children's hospices. It is about 5 per cent., compared with between 30 and 35 per cent. for adults' hospices. What will the framework do to increase Government agency funding for children's hospices?
I hope that my hon. Friend will forgive me for saying that he is starting at the wrong end. We should be starting with outcomes rather than funding. The framework describes the range of services needed for children with long-term conditions. The palliative care that we should provide includes care at home and in hospices. It will be for each primary care trust to think strategically about how it can give the population that it serves a sufficiency of each of those options. If it needs to commission services case by case, it can; or, if it wishes, it can put significant extra funds into the development of a local children's hospice.
That answer could be considered complacent by children's hospices that struggle daily to make ends meet and face a real struggle to survive at all. Does the Minister agree that there could be no more deserving cause in our society than dying children?
Of course the hon. Gentleman is right: there is nothing more serious to deal with than children with long-term conditions. Such conditions, however, tend to be different from long-term conditions affecting adults, especially when it comes to hospices and palliative care. Palliative care for children tends to involve helping them to cope with what are often life-limiting illnesses that can last for a long time, whereas palliative care for adults is often related to an end-of-life choice.
Most palliative care for children is delivered not in hospices but at home. What I want, and what the national service framework calls for, is a range of provision in every area that is suitable for all children with long-term conditions who are receiving care. Some, including the hon. Gentleman's party, have argued that a foundation level of NHS funding should go directly to children's hospices. In many areas, that funding would come from services needed to keep children at home. I think it more appropriate to allow each primary care trust responsibility for ensuring that there is a full range of provision. If that makes it necessary for a PCT to support a local hospice directly, it should do so, but it should be a local decision rather than one made by me in my office in Richmond house.
Will the Minister give way?
I will gladly give way in a while, but I need to make progress because many hon. Members want to speak.
Today, I can do no more than scratch the surface of the content of the national service framework, as any Member who has read the document will appreciate. It weighs in at more than 2 kg and consists of several hundred pages—and that excludes the huge body of evidence on which it is based. It even comes with a DVD explaining how to spot a sick child. There is a family version, a version that is accessible to people with learning disabilities and a children's version. I can, however, highlight some of the key components.
The framework sets out a new child health promotion programme to replace the current system of developmental reviews. The programme is a comprehensive system of care including assessment, health promotion involving key public health issues such as obesity, childhood screening, and early intervention to deal with identified needs. It provides a structure to ensure the promotion of health and well-being for individual children and young people.
The framework describes how we should give support to the parents of pre-school children to help such children to develop their full potential. It places particular emphasis on the importance of identifying parents who need extra support, and on our need to ensure that they know how to gain access to the full range of services. It includes a common assessment framework for use throughout agencies to reduce the amount of time spent on repeated assessments of the same child by different practitioners. That will encourage agencies to work and plan together and to share appropriate information.
The framework refers to how we must educate and support young people to help them to make informed choices about their health and well-being. It focuses on five key health issues: nutrition, sexual and reproductive health, mental health, injury and substance misuse. All the standards on child protection issues that apply to the relevant agencies have been compiled into one document, which ensures that safeguarding children is recognised as being everybody's business. The document emphasises the recognition that a higher level of co-operation and information sharing among staff, both within and between agencies, is required for children in special circumstances.
The framework describes the provision of comprehensive and integrated local services through managed local children's networks. They will be responsible for making sure that children and young people who are ill can get the services that they need at the right time. The framework calls for discharge from hospital to be planned in good time and with other agencies. Stays in hospital are to be kept to a minimum through improved co-ordination of community-based care.
The framework requires the extension of the Government's early support programme to all local authorities, which means that families of young disabled children aged between birth and three will receive high-quality early intervention and family support. It highlights the need for full equitable access to child and adolescent mental health services for learning disabled children, young people and 16 and 17-year-olds, who are often excluded from these services.
The framework also explains how we should provide better support for children and young people who take medication at home, in care and in education settings, with health professionals providing information and training for staff working in schools and other institutions to help them manage the use of medicines. It further shows how we should be tackling inequalities in outcomes for mothers, fathers and babies through the flexible planning and delivery of maternity services, and that we should allow women a say in how those services are designed. That will mean that all women, including the vulnerable and the hard to reach, can feel confident about using services throughout their pregnancy and after.
If all that is not enough, we have also used exemplars to show the life journey of children with special needs and indicate where they can look in the national service framework for guidance on what they should be able to expect. The first two exemplars are for autism and asthma, and on a personal note, I am very proud of the fact that as a Back Bencher, I was involved in lobbying for the autism exemplar, and that as a Minister I have had the privilege of delivering it.
The national service framework is broad in scope and far-reaching. We know that some services across the country already meet aspects of the standards, but it will take time to bring about the required cultural change and embed new working practices across the board. That is why the NSF has been developed as a 10-year strategy. Of course, although local services will be required to meet the standards by 2014, implementation during this period will be left to their discretion. They will have the freedom to prioritise those parts of the standards that are most important to their local areas. But let no one be in any doubt: the NSF is mandatory for the national health service by the end of that 10-year period.
If a reconfiguration of services currently under way did not take full account of the new national service framework, would my hon. Friend be inclined to allow that to continue or would he use his Department's influence to encourage local service providers to take account of the new framework? What leeway will local trusts and health authorities have in the period leading up to 2014?
Clearly, a configuration beginning now ought fully to take into account the national service framework. If my hon. Friend is asking whether Ministers will be able to intervene in that process, I should point out that, under the terms of "Shifting the Balance of Power", they have the power to intervene in local configuration issues only if local agreement cannot be reached. I would be very surprised if a reconfiguration that ignored the lessons of the NSF reached the general agreements that would be necessary. Under such circumstances, it is likely that my right hon. Friend the Secretary of State for Health would be asked to intervene in the process. Clearly, I would expect any reconfiguration starting now to take as much account as possible of the national service framework. There would have to be some pretty good local reasons why any part of it was ignored in any such reconfiguration.
The national service framework for hospital services has been available since April last year. If we were conducting a reconfiguration of children's services, it should clearly take account of that framework. It should already have been applied to that extent. Will the Minister explain why Sir Ian Kennedy's report on the Bristol royal infirmary tragedies recommended that service models should be made part of the NSFs—at least, he recommended certain experiments in service models and the Government responded by acknowledging that they would be set out in the NSF—but they do not appear in it? For configuration purposes, there seem to be no alternative or optional service models for acute services in the framework.
The hon. Gentleman is right that we produced the hospital standard early in response to Professor Kennedy's initial concerns. The approach that we have adopted in the NSF is to set out as clearly as we can and in line with all the guidance of the experts—experts not limited to civil servants, but including people from the medical profession, nursing and maternity services, social care and the whole gamut of services—the targets that we believe people should follow in designing the services. If we were to move to the extent that the hon. Gentleman hints that he would like and set out specific models, I would put back to him the problem that it might prove too restrictive and centralist an approach.
I shall return to the key point later. I asked the Minister that question simply because when the Government responded to the Kennedy report in January 2002, they said:
"We will commission an evaluation of alternative models for the management of children's services and publish the findings as part of the NSF."
That relates specifically to the configuration of acute children's hospital services, but it has not happened.
All I can say to reassure the hon. Gentleman is that Professor Kennedy is now chairman of the Healthcare Commission and he has said that the information that we provided in the NSF is sufficient for him to be able to carry out his work and inspect against the framework. In other words, he is content with the approach taken in the NSF.
The approach of devolving responsibility to the NSFs at the front line is deliberately different from most previous NSFs—those for cancer and coronary heart disease, for example, which relied on detailed targets and milestones. As we have transformed, since 1997, the ethos of the NHS and begun to ensure that it has the capacity, skill and motivation to modernise, so it has become less necessary for us to set targets centrally. We know that people working at the front line best understand their local needs, so we are increasingly empowering them to take local decisions locally. That means that the NSF is fully consistent with the Government's wider public sector reform, devolving power and responsibility to local agencies. If any hon. Member feels that 10 years is too long to see the NSF fully implemented everywhere, I would say that the key to implementing the NSF is change in culture. For the implementation of the NSF to be a success, early and sustained action will be required and 10 years is not a long time to achieve what we have asked.
How are we going to pay for this transformation of children's services? The NHS has already received substantial year-on-year increases in general funding, and that is set to increase by an average of 7.2 per cent. in real terms each year until 2007–08. We have also provided £300 million for child and adolescent mental health services to 2006 to meet the CAMHS public service agreement target. That will also support the CAMHS standard in the NSF.
All that funding was provided to drive up the quality of the totality of health services, including children's services. There is no more money to give, and everything that we do has to be done within that spending envelope. However, let no one doubt for a second that it is more than enough to cover the progress that we must make up to 2008.
If any hon. Member says that we should ring-fence part of that money exclusively for children, I say that they have missed the whole point of the NSF. The NSF is about mainstreaming children's services so that PCTs develop those services, not as an afterthought or add-on, but as a key priority in the commissioning of services. PCTs will therefore need to allocate funding according to local priorities and to strike the right balance between children's services and general services, but must retain the development of children's services at the core of their thinking when they do so.
If we do not have traditional targets and old-fashioned ring fences, how will we guarantee delivery? The recently published health and social care standards and the planning and priorities framework both stress the importance of planning for children by health services, local authorities and the voluntary sector. Therefore, over the next three-year planning period, the different inspectorate bodies will start to inspect services against the NSF standards. They will require agencies to demonstrate progress towards the levels of service set out in the NSF. That is why we can be confident about delivery.
Given that integrated working across agencies is so important to successful implementation of the NSF, the key inspectorates must also work together to develop a method for joint inspections. That means that, from 2005, Ofsted, the Healthcare Commission and the Commission for Social Care Inspection will undertake joint area reviews. They will also contribute to thematic inspections of children's services.
With this emphasis on inter-agency working at the front line, it is incredibly important that we send the right messages from the centre, demonstrating joined-up government and integrated policies. That starts at the top, which is why, although the NSF began life in the Department of Health, it is now jointly sponsored by the Department of Health and the Department for Education and Skills. It is also why my right hon. Friend the Minister for Children, Young People and Families and I work so closely together to develop children's policy. The NSF was jointly published, but it is now jointly owned.
On the ground, the Children Bill will provide a spur to action for the joint delivery of the NSF. If the Bill is passed, key local service providers—including PCTs and strategic health authorities—will be placed under a duty to co-operate with local partners to drive up the standard of care for children in their areas.
Equally important will be the duty to safeguard and promote the welfare of children, and the new director of children's services—a post that we are proposing for each area—will be a key player in ensuring that the NSF is delivered locally.
On that point, will the Minister say why the NSF for children is not mentioned in the Children Bill?
It is not mentioned because it does not need to be. The Bill is based on the five outcomes that children told us were important. One of those outcomes was the requirement for health and well-being and the ability to thrive, to which the NSF speaks directly. Therefore, the NSF does not need to be mentioned in the Bill.
My hon. Friend mentioned the importance of consulting the local director of children's services in connection with a proposed reconfiguration. However, if no such director has been appointed, does he agree that that proposed reconfiguration should be suspended until the director has been appointed and can be consulted?
I detect an agenda between the lines of my hon. Friend's question. I do not want to suggest that he does not wholly approve of the reconfiguration going on in his constituency, so I shall not interfere in that. However, any reconfiguration needs to be agreed by all local partners if it is not to come to the Secretary of State. The NSF for children must play an important part in that decision-making process. If a director of children's services is in place in an area, I would expect that director to have a great deal to say about any reconfiguration of health services. I hope that my hon. Friend's local authority moves rapidly to appoint such a person, if that will help him in his campaigning.
I am enormously grateful to my hon. Friend for that clarification of those responsibilities.
Now I am enormously worried.
The work programme that the Government are taking forward on children's issues demonstrates our real commitment to improving the life chances and opportunities for children and young people. The NSF is a key delivery vehicle for the health and social care aspects of this agenda. It will raise standards in hospitals, in general practitioners' surgeries, in schools and nurseries, in maternity units and in Sure Start children's centres. It will focus the attention of service providers on the needs of all children and young people, including those who have traditionally been hard to reach, such as those who have been abused or live in poverty.
In Northern Ireland, we have seen a significant rise in the number of suicides among young people. Has the Minister given any thought to how we can target young people, especially in areas of social deprivation, to show that we value them, to bolster their self-worth and to ensure future prospects for them?
The hon. Lady is right. I suggest that she look at the totality of the changes that we are trying to implement for children, including the work set out by my right hon. Friend the Minister for Children, Young People and Families in "Every Child Matters"; the change for children programme; the measures in the Children Bill to create co-operation; the White Paper on public health that will be published in a few weeks' time; and the range of changes in the NSF. She will see that we are working as hard and as fast as we can to put in place exactly the mechanisms that can provide the assurance that she seeks. If we make children understand that they are precious and important to us, and give every child the opportunity to fulfil their potential, we will drive down the rate of suicide, not only in Northern Ireland but across the whole country.
We all love our children. But all our nation's children are our children. If one child does not fulfil its potential, we are all diminished. If one child anywhere is in poverty, or is suffering, or is failing to thrive, that is not the fault of someone else, it is my fault and it is our fault, and each and everyone of us has failed in the duty we inherited when we came into adulthood.
No other Government have done more for children and we will not be surpassed in our commitment to making change happen. This NSF is a beacon of that commitment and is a testament to our determination to see change for children, to see every child thrive and to see those special and precious people—our children—grow and become the women and men they were meant to be. I commend it to the House and to everyone who works with or for children, and to everyone who has children, will have children or once was a child.
I am grateful to the Minister for bringing this important subject before the House and giving us the opportunity to debate the national service framework for children relatively soon after publication. I wish first to echo two of the comments that he made.
First, like the Minister, I wish to thank Professor Al Aynsley-Green and many other people—by no means all of them civil servants, as was suggested earlier—from children's services across the country who participated in the work leading to the NSF. I know of the volume of work and the thought that went into it, not least because I had occasion to discuss the issue with Professor Aynsley-Green just over two years ago.
Secondly, I echo the Minister's recognition of the enormous contribution that we are already receiving from the people who provide services, including doctors, nurses, other health professionals and social workers in children's services. They are often somewhat under-sung in the health service context, especially social workers. The hon. Member for Lancaster and Wyre (Mr. Dawson) has been a doughty fighter for their cause and I entirely share his view. Just as we celebrate people in the NHS who save lives and people who shape lives in, for example, teaching, so, too, we should celebrate people in the social services who both save and shape lives in their work with children who would otherwise be in despair. There is every reason for us to say, "Thank you very much" to all the services reflected in the national framework.
The Minister inevitably could not elaborate on most of the issues in the vast range on which he touched and I shall not be able to do so either. If I deal with only a few, I hope that the House will understand that that is because otherwise I should consume a high proportion of the available time and I want other Members to have an opportunity to speak about the national service framework.
The Minister made some points about the underlying principles of the framework and I, too, have something to say about them. First, the scope of the national service framework is unprecedented; it covers a wide range of services. It does not, however, extend to all the services that have an impact on children; for example, in many areas, road traffic accidents are a major cause of mortality and morbidity in young children, but that is not addressed in the national service framework. That example illustrates that, through the public functions of the NHS, we need a greater ability to influence the extent to which the private and public sectors address public health needs.
The second good thing about the document is that it understands that children are different. Of course, this is not the first time that children have been considered as more than small adults; people have helpfully illustrated that point in the past, but an underlying principle of the national service framework is that we should never think of children as small adults—they have their own particular needs.
The documents are interesting because they do not talk about children as an homogenous group, but show an understanding of the distinctions required; everything from child as foetus and neonate to the pre-school child, schoolchild, adolescent and the transition to adulthood. Childhood is a range of ages and we need to be able to deal with all of them. The hospital standard accurately understands that sometimes it would be highly inappropriate to admit 16 or 17-year-olds to a children's ward; it is not simply a case of admitting them to separate children's wards. Understanding the nature of adolescence is probably one of the most taxing things; it is certainly extremely difficult in the mental health sphere and in hospital admissions.
Does my hon. Friend agree with the representation from the Teenage Cancer Trust that it is wholly inappropriate to put teenagers in wards with older people? A ward with people who may be 30, 40 or even 50 years older does not provide the right surroundings for treating a child who is battling cancer.
My hon. Friend is right. His point illustrates just how carefully hospital services for children must be planned. Last year, I visited cancer patients in the children's wards at Addenbrooke's hospital and saw the astute use of single rooms adjacent to the ward for adolescents; they could live there for the short period of their hospital admission and feel quite distinct from the very young children elsewhere in the ward, thus avoiding the distress they might experience, and which my hon. Friend described, if they were admitted to a ward where a substantial number of the patients were relatively elderly. We need to take on exactly that sort of thing, using the national service framework, to help in the configuration of hospital services.
As I mentioned previously, one of the things that the frameworks do well is to recognise the need to escape from fragmentation and the lack of responsibility for services that has been highlighted in the past. The Minister did not say explicitly that the framework is intended to build on Herbert Laming's report or Sir Ian Kennedy's report, but we know that it is. In particular, Herbert Laming's report certainly showed that fragmented services produce tragic results, as did the lack of responsibility and proper standards in respect of the Bristol royal infirmary. One of the things that I found very useful in reading the national service framework was the theme of treating not only children but their families as being integral to the development of a service that is centred on the needs of children and in which they must be listened to and respected. I welcome all that.
The Minister suggested in introducing the debate that things were going in the right direction and that we just had to push them further along, but it is not quite like that. Many indicators of children's health are not necessarily moving in the right direction. One of the child's journeys reflected in the framework relates to asthma. We now have very high and rising levels of childhood asthma. We have rising levels of childhood diabetes. Children with adult-onset diabetes are starting to present themselves for treatment in their teenage years. We have other public health problems associated particularly with teenagers, which reflect the use of alcohol and drugs and poor sexual health. The Minister referred to some of those issues, but they are serious and things are moving in the wrong direction.
Although the national service frameworks are very important, I want to make it clear that, within weeks, we will be engaged in another debate about how to achieve a stronger public health strategy. I will not begin that debate now, but it is our contention that the problems of fragmentation are at least as great in relation to public health performance and delivery in recent years. It is important to use the public health mechanisms, such as primary care trusts and others, far more effectively than we have until now, to have an impact on those serious children's health issues. The standards will not be enough in themselves; an interventionist approach to public health—including awareness strategies, national campaigns and local action—is needed to deliver them.
The Minister said that this is the first time that there have been such standards. Of course, strictly speaking, that is true only in the sense that these are a complete, co-ordinated set of standards that stretch over a wide canvas. However, one of the reasons why we must be extraordinarily careful about ensuring that the best aspects of the frameworks are delivered is that, frequently in the past, documents have been produced that have not necessarily delivered the intended standards.
In 1991, the Department of Health published "The Welfare of Children and Young People in Hospital", which included guidance on care standards and seven cardinal principles. I shall not go through them now, but they bear examination by comparison with some of the eleven standards to which the Minister referred. In 1993, the Audit Commission produced "Children First: A Study of Hospital Services", which also set out a number—six, from my recollection—of clear principles. In April 1996, the Department published "The Patients Charter: Services for Children and Young People", which was partly a reflection of the fact that, five years on, some of the previous cardinal principles set out in guidance were not necessarily being delivered. The Kennedy report referred to a much wider list of reports on children's services that contained standards that were intended to be met, but have not been met. When all is said and done, all 2-plus kg of the NSF is made up of guidance on good practice. The Minister tells us that it will be implemented in 2014, but that relatively few milestones will be encountered between now and then.
Let me develop my point for a moment.
I am not saying that every national service framework should be set out as a series of milestones and targets because the Minister would say that that was inconsistent with the way in which we wish to reform the national health service. However, we must be clear about what constitutes evidence-based clinical standards that represent cost-effective interventions for the NHS that could be achieved quickly—not necessarily in 2014—because that would be in the interests of children, patients and the service. The problem with the NSF is that it does not differentiate between clinical standards for the NHS that must be achieved and developmental or aspirational objectives and service standards, which would properly be the preserve of performance management, and thus objectives to which individual institutions and health bodies would respond depending on the commissioning decisions that were taken.
I just wanted to correct the hon. Gentleman. He said that I said that the framework would be implemented in 2014, but I said that it would be implemented by 2014.
I am sure that the record will show that the Minister indeed said "by 2014", but he did that in the context of saying that the framework did not contain milestones and targets. If the implementation has not occurred by 2014, that will happen in 2014—that is effectively the structure about which we are talking.
I was trying to make the point that we are not prescribing a specific pattern of implementation for the NSF because that will be decided locally. However, when the Healthcare Commission carries out inspections now, I would expect it to inspect service against the NSF standard. If it finds services that do not meet the standard, it should at least ensure that there is an understanding of when that will happen. Every area should have a plan in place that shows a clear progression from its current position to where it will need to be by 2014.
I understand that because the Minister is reflecting accurately what is set out in the Government's health and social care standards and planning framework, which says that NSFs will be a basis on which the NHS and local authorities will need to demonstrate that they are making process. However, it does not specify the extent to which progress must be made on specific areas. There is an important difference between the elements of the NSF on services that should be subject to local discretion and developed in response to patient choice, general practitioners exercising their commissioning role, commissioning bodies or the commissioning functions of children's trusts as they become established, and those elements that should be part of a system of clinical standards. If an evidence base exists to support such clinical standards, they should be set out clearly in such a way that the NHS responds to them directly.
Let me give the Minister an example. The maternity services section of the NSF refers to caesarean sections requiring a consultant's clinical judgment. It says that they should be approved only if there would be clinical benefit for either the child or the mother. That recommendation resulted from a National Institute for Clinical Excellence investigation into when caesarean sections should occur that took account of an evidence base and cost-effectiveness. The fact that NICE undertook such an investigation means that there is a finding to which the NHS should respond now. There is not a sense that we should be doing that in 10 years' time. The distinction I am trying to make is that we should not disparage the job of NSFs, because they encompass the whole service, but identify within them clinical standards that should be the subject of action within the NHS to deliver better services now. There will be specific instances of improved quality, of understanding where the NHS's proper limits of service lie and of understanding where efficiencies can be gained and services can be reconfigured for the benefit of patients. I hope that the Minister accepts my case, at least in theory.
Questions need to be asked about implementation. Hon. Members will know that it is not simply a matter of resources, although they are important. Resources often mean human resources, such as the number of consultant specialists. To illustrate the case, Professor Aynsley-Green has said more than once that there is only one consultant specialist in adolescent medicine. What does that tell us about the availability of service? I do not know how many consultant specialists there are in adolescent medicine now; perhaps the Minister can tell us. How many trainees are in paediatric orthopaedics? Someone told me the other day that there is only one, although I cannot say whether he was right. We need to deal with those human resource implications.
As for maternity services, it is entirely right to offer mothers a choice. That can be in the form of midwife-led units. I know, however, that Addenbrooke's cannot because it is unable to recruit enough midwives. There should also be a home-birth service. I met staff in Brecon who were offering one of the leading home-birth services in the country. Peterborough, however, did not have the midwives available to provide a home-birth service. The maternity service framework highlights the desirability—I think it is virtually a must do—of 100 per cent. midwife attention to a mother during the course of her labour. The shortage of midwives means that in some places they have to look after two mothers at the same time, so they are not getting 100 per cent. attention. The increase in the number of midwives over the past seven years in wholetime equivalent numbers is fractional and in three regions there has been a reduction.
It is right to want to know the standards for which we are aiming, and maternity services allow us to see what we want to achieve, and what quality we want to have, in a straightforward way. For years the focus of public and political debate has been on specific deficiencies—in particular the length of time that people are on waiting lists—in hospital services and the NHS in particular. By and large, that has not been the issue for children's services. Instead of remedying specific deficiencies of that kind, we need to raise the general quality of services for children. That is a more diffuse but arguably more logical way of approaching the development of NHS services.
The shape of services needs to be decided in a number of ways, but different bodies will take responsibility for that. The Minister did not touch on that, but I would be interested to hear his views, and those of other hon. Members, on it. We have managed local children's clinical networks, which are reflected in the framework, and I am attracted to a model in which those clinical frameworks emerge from combinations of clinicians and professionals, but how will that interconnect with children's trusts? They were at the core of the Government's response to Herbert Laming's report. However, they are still in the pilot stage, and most of those differ substantially from each other.
The process of trying to establish a model from the pilots is clearly not under way. It may be entirely proper to allow local authorities, health service bodies and others to work together to establish the responsibilities of a children's trust. However, the health service must ensure that clinical networks are not squeezed out by the statutory formation of children's trusts. How will trusts interact with the Government extension of Sure Start and Sure Start plus? Initially, there will be 800 children's centres, but how will they relate to children's trusts? Those organisational matters are not necessarily reconciled in the national service framework. Organisational change of this kind often has an adverse impact on efforts to establish a clear framework of standards, for which someone is directly responsible.
Does the hon. Gentleman not agree that the success of networks and liaison between different groups and trusts comes down to resources? I have worked in this field, and unless there are enough people who can spare the time outside their normal duties to undertake liaison and other necessary tasks a proper service is never established. The hon. Gentleman said that it was not just about resources, but in the end it is about having enough well-trained and well-paid staff with the time to do all the things that we want them to do.
I am not sure that I agree with the hon. Lady. Of course, it is difficult to construct clinical networks in services that are so hard-pressed that people have no spare time at all. One can hardly say that staff working in coronary disease and cancer services are free of pressure. None the less, in my experience, they think it worth while to get together and create clinical networks in their specialisms.
They are the glamorous ones.
I do not think that they got together to create clinical networks because they thought that it was a glamorous thing to do. They did so, because they thought that they would be able to influence a process for which, I accept, additional resources are available. They would be frustrated if they tried to develop services and assign bottom-up rather than top-down priorities in circumstances where there was no room for growth. We are committed to increase health service expenditure, as well as the number of people who work in the NHS and the resources that they deploy. Children's services should certainly receive their share of those increases, so people who work in them have an incentive to develop clinical networks, and we hope that they will do so.
Finally, as the Minister may have learned from my intervention following that of the hon. Member for Bury, North (Mr. Chaytor), I am concerned about the implementation of recommendations in Sir Ian Kennedy's report on Bristol royal infirmary. I have said in previous debates, including my Adjournment debate on children's health and social services in Westminster Hall on 10 June—the last time that we debated these matters—that I was concerned that various recommendations on the configuration of acute services have not been followed up. Sir Ian says in recommendation 178:
"Children's acute hospital services should ideally be located in a children's hospitals, which should be physically as close as possible to an acute general hospital. This should be the preferred model for the future."
He went on to recommend piloting a system in which children's hospitals took over the running of children's acute and community services through a specific geographical area, which is effectively an outreach service based on the example of the Philadelphia children's hospital, and that specialist services should be organised so as to provide best available staff and facilities. That obviously has serious implications—with which some areas are wrestling—for the continuation of paediatric services in some hospitals.
From what the Minister said it seems, as I feared when we had a debate back in June, that the Government have abandoned the recommendations made by Sir Ian Kennedy in his report. They do not intend to address the issue of whether specialist services for children should be concentrated to ensure that there are all the necessary support facilities, and that the throughput of activity is sufficiently great to ensure that the specialisation is sound and continues to meet high standards.
The particular illustration of that was the subsequent review of paediatric congenital cardiac services, which reported to Ministers. The Minister suggested today that in these matters the Government are guided by external advice. The advice of that review was straightforward: that there should be a process whereby the number of hospitals providing paediatric congenital cardiac services should be reduced over time. Ministers said there was no evidence that current services were delivering poor clinical practice, so they did not propose to do anything about them.
That was an "It's all right at the moment" approach, as opposed to adopting an approach recommended after the Bristol royal infirmary tragedies, to try and ensure that in the future we concentrate services, if necessary, in a way that provides the maximum opportunity to raise or validate standards.
Had I recommended to the Secretary of State that we follow the advice of the working party to which the hon. Gentleman refers and close down all the paediatric cardiology units that performed less than a certain number of operations, we would, among other things, have closed down one of the only two facilities that can provide heart transplants for children, and we would probably have closed down half of the units that have the lowest mortality rate. There was no expert evidence to support that figure. It was an arbitrary figure produced by the working party on the basis of their judgment. Far from not looking to the future, we said that that advice should be set as a direction of travel for all future reconfigurations to take into account. So I would not be surprised if, over a period of time, all units were configured in accordance with the numbers mentioned. We are just not going to do it immediately and close down half of the best units in the country at a stroke.
The Minister and I have had this exchange before, so I shall not detain the House by repeating it, although my recollection of the working party report was that it did not recommend that those steps should be taken now and that it contained a staged programme. One can argue about the design and the timetable for implementing the recommendations. If the Minister disagreed with the review, it would have been better for him to ask the working party to re-examine the process, rather than to put the review back on the shelf.
In the context of this part of Sir Ian Kennedy's report, one of the central issues was the lack of throughput of activity to justify the maintenance of specialist services on which there could be sufficient peer review and validation. The Government put those elements of his recommendations to one side and said they would be reconsidered in the context of the national service framework. There is nothing in the national service framework that says how those recommendations can be picked up for the future. To my surprise, the hon. Member for Bury, North raised the point that the NSF provides no guidance.
The configuration of children's services has caused serious concern in areas such as Manchester, an issue that the hon. Member for Manchester, Blackley (Mr. Stringer) has raised before, but it is better in other places. In areas such as Yorkshire and my area, East Anglia, a powerful case exists for the reconfiguration of children's services and for the establishment of a children's hospital. Such a children's hospital could become the base for expanded activity within the region promoted from within the acute sector, and it could reach out into community paediatrics, like the Queen's medical centre, Nottingham. The national service framework contains no guidance, not even in the form of alternative service models, on how one might go about that. Although it contains guidance on good practice, in that respect it does not follow up the reports from which it was derived.
I had a much better speech, but my daughter, who is only 18 months old, wrote all over it this morning. In years to come, she will appreciate that we have debated children's services, which is something that we should do regularly. I hope that we return to the matter in five years' time, halfway through the life of the national service framework, and on other occasions.
An incoming Conservative Government will point to the actions that flow from the NSF. I hope that it will be our responsibility and privilege to turn the NSF into standards that make it clear what the NHS should provide and when it should provide it. By 2014, I hope that not only will those standards have been met, but we will have gone beyond them to look to a new and constantly improving quality of service for children, who are indeed our future.
I am pleased to have the opportunity to speak in this important debate. I fully endorse the standards that have been set out, but I want to detain the House for a few moments on maternity services, which the hon. Member for South Cambridgeshire (Mr. Lansley) mentioned earlier.
Standard 11 states:
"Women have easy access to supportive, high quality maternity services designed around their individual needs and those of their babies",
and the accompanying narrative mentions:
"Informed choices . . . Women able to choose the most appropriate place to give birth . . . range of local options including home birth and delivery in midwife led units".
I want to discuss choice. I have raised the matter before on the Floor of the House—I make no apology for that—in the context of maternity-led services in my parliamentary division, Braintree, at the William Julian Courtauld hospital.
The concept of choice in maternity services is not new and has been an issue for the past 15 years. A Select Committee report—the Committee is chaired by the hon. Member for Macclesfield (Sir Nicholas Winterton)—dwelled upon choice and not disadvantaging those who live in small towns or rural areas, and Baroness Cumberlege also chaired a report. The chain of events has led to a situation in which women should choose where their children are born and should not be disadvantaged in making that choice if they live in country areas. Politicians and members of all political parties have happily endorsed that concept for many years, but it does not always come to pass. The William Julian Courtauld hospital was founded by a member of the Courtauld family after the first world war and has continued to be held in great affection by the people of Braintree and the surrounding districts ever since. It was threatened with complete closure in 1997, but enormous public protests secured it a longer lifetime.
Then, as in the film "Jaws"—"Just when you thought it was safe to relax"—along came another threat to the hospital. Last autumn, the local health trust advised me that the maternity unit was closing—but only temporarily, because so many of the midwives were either unwell or giving birth themselves that there were not enough staff. I may have been a little naive, but I took that at face value. However, when the unit reopened—as it did; I was not completely misled—its opening hours were somewhat different. It now opens from 9 in the morning to 5 at night and not at weekends. However, as those who have had children will be aware, they do not always arrive between those prescribed hours.
The trust made arrangements to address that problem. A woman who thought she was going to give birth outside those hours could telephone the midwife, who would go and get the key to let her in and attend upon her. I have not made this up, although it sounds like it. As one might imagine, the system has not always worked successfully, with the result that at least one baby has been born in the car park of the William Julian Courtauld hospital because the key, the midwife and the mother did not come together at the same time.
If we are to make real the concept behind the standard on maternity—standard 11—people must have real choices, not the sort offered by Henry Ford. They must have a choice other than that of a large general maternity unit. I fully understand that if a mother has complications, as she may do for a range of reasons—it is much better that she goes to a fully equipped major maternity centre to give birth, but where it is presumed that the birth will be relatively straightforward—that may be the conceit of a man; I am sure that it is never straightforward, but in so far as it can be—she should have the choice of having her baby delivered locally.
I am fortunate that the Under-Secretary of State for Health, my hon. Friend the Member for South Thanet (Dr. Ladyman), is present to hear me, because previously I had to make do with an Adjournment debate. I am speaking on behalf of the mothers of Braintree, who are very worried about the situation. The trust is now saying that if the number of babies reaches a certain level it will think about opening the unit seven days a week, 24 hours a day.
Does the hon. Gentleman agree that the success of maternity-led units very much depends on GPs promoting them, believing in them and selling them to young mums in uncomplicated circumstances?
The hon. Gentleman is absolutely right. The standards say that mothers must have information made available to them on an even-handed basis so that they can choose between home delivery, a maternity-led unit or a general maternity centre. In my experience, and perhaps that of the hon. Gentleman, GPs do not always promote the midwife-led maternity unit. Indeed, the unit that I mentioned was formerly GP-led, but became midwife-led—very successfully—because an increasing lack of enthusiasm among GPs meant that there were too few of them to staff it. GPs need some propaganda to encourage them to offer mothers a real choice. I am pleased that the standards promote that; we need to aim to achieve it.
I hope that my hon. Friend the Minister will take on board what I have said about my local hospital with a view to some advice being given to those who presently have power over it.
The national service framework has been widely welcomed and it would be churlish of me not to welcome it too, especially given that most of those who welcomed it will have to implement it and were probably involved in shaping it. However, I would be remiss in my duty if I did not ask some questions.
I am especially delighted that maternity is included in the NSF and it is therefore perhaps appropriate to describe it as motherhood and apple pie. That is not to decry it; most of us believe that motherhood and apple pie are very good things. Who can argue with standards such as:
"Women have easy access to supportive, high quality maternity services, designed around their individual needs and those of their babies"?
Clearly, everybody wants and aspires to that. I believe that there is no political difference between parties' perception of that. However, I shall comment on some of the specifics of the standard later. I want to begin with some points about national service frameworks generally.
For once, we are not considering a matter that politicians dispute. I believe that all politicians support the choice agenda. However, as my hon. Friend the Member for Braintree (Mr. Hurst) and the hon. Member for Southport (Dr. Pugh) pointed out, doctors, practitioners or those responsible for designing services often do not realise the need to provide choice. The national service framework states that choice is a right for people and that it needs to be implemented in the next 10 years.
I am delighted to hear that statement from the Under-Secretary because before I came into politics, I was involved with maternity services and worked with the National Childbirth Trust. We did much to try to empower women to ask for choice. In some ways, maternity services are ahead of the game. In parts of the country they have some way to go, but they have come a long way in 20 years. However, their attitudes have not always been transferred to other parts of the health service.
The choice agenda is welcome and we are gradually seeing the back of the consultant-as-God, doctor-knows-best mentality. Doctors are more welcoming of patients having a say and accept that there are well-informed patients and parents who want a choice in their services. However, some parents are not so well informed and they should not simply be told what to do. They have the right to have choices discussed with them, whether in the community or with their health visitor. Sometimes, hard-pressed staff do not have the time for what they regard as the luxury of going through the options with people. If we can change hearts and minds, and staff realise that it is a necessity, not a luxury, that will be welcome.
I want to make some general points about the national service frameworks. The early NSFs, such as coronary heart disease, attracted match funding to help achieve the aims and objectives. The Under-Secretary mentioned that earlier and said that anyone who talked about it missed the point, which is to change attitudes. Although I accept that, he should accept that when I visit my primary care trust in Hampshire, I find that it struggles with the "must dos" and the waiting list targets and to make the books balance. The Under-Secretary will claim that the Government have put in more money than ever. However, it does not seem like that to some of the chairs of primary care trusts, who worry about the future of their jobs.
Genuine pressures exist and anybody who faces them might be tempted to concentrate on the "must dos" and view a national service framework that has standards but no targets as something that can wait because there are 10 years in which to effect it. I am therefore worried that there is no political imperative to achieve the standards.
I take on board the fact that the Minister says that it will be down to local primary care trusts to develop the services in the way in which they see fit. However, they will have quite a lot of leeway over a 10-year period. I would have liked to see the onus placed on the PCTs—it might be written somewhere in the framework document; I have not seen it yet—at least to have their own individual plan for implementation within a year or two as a set piece of work.
Monitoring is obviously important, but if the examples of other national service frameworks are anything to go by, the Government tend to take a step back and pass the buck to other bodies. They say, "It's nothing to do with us. The PCTs are monitoring this, and that is the strategic health authority's responsibility." This relates to NSFs in which targets have been set. I am concerned, therefore, that if there is yet another reorganisation of the statutory bodies within the national health service, the monitoring will fall through the gaps. It is clear in the case of the older people's NSF that the vast majority of targets have not been met. Perhaps I am being cynical, but have the Government given up setting targets simply because they know that they will come back to haunt them two or three years down the line? That is one interpretation; I know that the Minister has another. Time will tell on how this pans out.
I am not sure how certain other things will be achieved. For example, much is being made of having better speech and language therapy services, and I know that many interested parents will be saying, "Hurrah! This is welcome news." However, the stark reality is that even statemented children do not necessarily have access to a therapist for whom a need has already been clearly identified. I should declare an interest in this issue, because my son needed speech therapy. However, he was lucky enough to need it 15 years ago when the provision seemed to be greater, or perhaps the demand was not so great.
That was under a Conservative Government.
I do not think that it was down to the Conservative Government.
I will develop my point, which is that this issue relates not only to young children. Other people needing speech therapy services include older people or people who have suffered a stroke. Could a conflict build up here, in which the NSF for children says that they need greater access to such services, but the NSF for older people is less clear on access to rehabilitation services? Will the resources be switched to young children, depriving older people? That is a tension to which the Minister, in his other role, should give some attention, to ensure that all people have access to these services, which are clearly deficient at the moment.
As I said earlier, the framework has gained wide acceptance, and that is a good thing. Dr. Simon Lenton, vice-president of the Royal College of Paediatrics and Child Health, was generally very welcoming, but he made a telling point when he said:
"The real challenge will be engaging all the people who are involved in children's services".
I know that the children's trusts are being set up, but some local authorities are expressing concern that, amid all the focus on children, there seems to be a lack of focus on the fact that children have parents who have needs that are sometimes not so easily met. I am delighted that there seems to be more involvement with parents in this NSF, but a close eye needs to be kept on that matter.
Beverley Malone, general secretary of the Royal College of Nursing, said:
"We do worry that, as implementation is left entirely to local discretion, some areas may have difficulty in making sure the standards become a reality".
I know that that will be monitored, but I should be interested to hear from the Minister what sanctions will be imposed if, four or five years down the line, the primary care trusts are not implementing the services fast enough.
Enthusiastic individuals will use the NSF as a tool to develop the services that they want locally, which will be good. However, some of my research into the older people's NSF has shown that, while it is great if there is a local enthusiast, if there is no local champion to drive the framework forward, implementation happens much more slowly. Professor Aynsley-Green has commented that children's leads in primary care trusts may be too junior or may have some other portfolio to deal with as well. Therefore, what impression will be made on the primary care trust that this is important, that it should not just be a junior lead, and that it should be higher up the political agenda? It is all very well having it written down, but further impetus is needed.
On an initial reading, the NSF seemed a little weak in a few areas, such as poverty, housing, bullying and community safety. As one reads on, one finds that those issues are not necessarily dealt with in the parts of the NSF where one might expect them to be, but it was pleasing that some of those issues were included.
My other concern, on which I have touched already, is that the NSF focuses on children exclusively, apart from in the maternity section. Children are usually part of the family network, so a little more attention needs to be given to improving services for those carers as a route to improving services for children.
Much of what is in the NSF seems very community based. We have focused quite a lot on hospitals today, and have not said much about district nurses, health visitors, school nurses and so on. Such people come into closer contact with children, perhaps in more informal settings, but their roles have been stretched recently and numbers have not increased as much as they might have liked. There is an opportunity in that area to address some problems as they emerge, rather than dealing with them when they hit primary care, in the doctor's surgery, or when they hit the hospital. In that respect, I would like a little more emphasis on the community.
The hon. Lady cannot get away with the suggestion that somehow parents and carers have been downplayed. Standard 2 supports parents or carers, and includes chapters on information and education for parenting, on supporting the parenting of pre-school children, on parents of school age children, on parents of teenage children, on helping parents to promote resilience, on supporting parents who have specific needs, on supporting adoptive parents, on supporting adults caring for looked-after children and on listening to parents. It goes on and on. She must have missed that bit of the document.
I will not let the Minister go on and on. I take his point. I was making a point that has been made by others, and that I had picked up on. If he assures me that standard 2 will be as highly focused on as the other standards, I shall withdraw that comment.
I want to focus particularly on the standard for maternity, as there are some issues surrounding it. The support for normal childbirth is very welcome, and the National Institute for Clinical Excellence has done a lot of good work in debunking some of the myths that some of the interventions that happened years ago were negative rather than positive. The emphasis on women from disadvantaged communities is particularly welcome, as that was picked up on in the Health Committee report. I do not know whether that emphasis is a result of the report—if so, I would like to thank the Minister as I worked on that Committee—but it is good to see.
The mention of domestic violence, which often starts for the first time during pregnancy, was also useful. What I did not see—I only had the chance for a quick read, and I could get only half the document from the Department of Health, and could not print it off, so it may be there—was a mention of the fact that often children are aware of domestic violence and are a route to finding out when it may be a problem.
One thing that the NSF is less clear about is the problem of pregnant women with mental health problems, or pregnant women who develop mental health problems. We are told that
"all NHS maternity care providers are expected to put in place policies and protocols for identifying and supporting women who are at risk of developing a serious post partum mental illness."
That is all very well, but in many parts of the country women develop mental illnesses so serious that they have to be hospitalised, and often there are not enough places for them to go to with their babies. As I am sure the Minister realises, if a woman is separated from her baby at that stage it may prove detrimental later. It is all very well to have policies and protocols, but what is being done to ensure that treatment is available in such cases?
Moreover, all the policies and protocols in the world cannot identify every woman. There is no way of predicting which women will experience, for the first time, an illness that may be prompted by a hormonal factor. Women get together after having babies, and the talk is all about how wonderful it is: "My baby is doing such and such." A woman who is, in fact, having a hell of a time is in no position to say that, for her, things are not so good. We women want to project a superwoman image, and we feel that we are failing if we do not love our babies. I have encountered many women who have struggled to admit that there is a problem.
The proposal for choice in regard to the place of birth is extremely welcome and I was pleased by the emphasis on midwife-led units and home births. However, as was pointed out by the hon. Member for South Cambridgeshire (Mr. Lansley), there is a shortage of midwives. Between 1997 and 2003—the latest period for which figures are available—the number of midwives increased, but the whole-time equivalent was up by only 391. A 50 per cent. increase in NHS spending has increased the whole-time midwifery work force by a mere 2 per cent., and despite the national increase midwife numbers have fallen in the north-east, the north-west and Yorkshire and Humberside. The most recent annual staffing survey by the Royal College of Midwives revealed that 83 per cent. of midwifery units had vacancies, 56 per cent. of which had been unfilled for more than three months.
I think it was in the national plan that the Government identified a need for 10,000 extra midwives, and there is clearly a great potential for them to be used. Given that only 391 have been provided in six years, however, I estimate that that target will not be met until 2150. If the Minister disagrees with my estimate, will he please tell us what he will do to ensure that the necessary number of midwives are provided?
As the hon. Member for Braintree (Mr. Hurst) demonstrated, choice of the place of birth will not be achieved unless that important issue is tackled. The shortage of midwives has led to closure of some midwifery-led units. In other cases, women have been told almost at the eleventh hour that they cannot have the home births that they were promised. Although much in the NSF is good, if the Government cannot crack the problem of midwife numbers an opportunity will have been missed.
I welcome the support for breastfeeding, but I do not think that the NSF goes far enough in that regard either. The benefits of breastfeeding are clear. Formula-fed babies are five times more likely to be hospitalised with stomach infections in the first year of their lives, twice as likely to develop eczema and ear infections, and five times more likely to develop urinary-tract infections. They have higher blood pressure and are at greater risk of obesity and childhood diabetes. The list goes on, and that is before we even consider the various benefits of breastfeeding to the mother. So there are some positive recommendations, but a comprehensive breastfeeding strategy is missing. Is the Minister content with the fact that the breastfeeding rate in England—28 per cent. of babies have some access to breast milk at the age of four months—is among the lowest in Europe?
Social inclusion is supposedly high on the Government's agenda, but breastfeeding is a perfect example of the stark way in which the statistics break down according to social class. At the age of four months, 56 per cent. of babies in social class I are breast fed, compared with just 13 per cent. in class V. If the Government are serious about tackling health inequalities, what better place to start than at the very beginning of life, and by making a particular effort to tackle women in disadvantaged groups? We often do what our peers do, and such women might not have had much social contact with women who breastfeed; as a result, they do not regard it as the norm. Much work could be done in that regard.
I cannot argue with most of the national service framework. It is very well meaning and if it works, it will dramatically influence the way that we deliver services to children, but there are various points that one can pick up on. Although no one would argue with the promotion of good oral health, is the Minister happy that in many parts of the country children have access to an NHS dentist only if their parents agree to sign up privately with that dentist? That is morally wrong, yet it seems to go unchallenged.
As a former pharmacist, I particularly welcome the introduction of standards on medicines. I have seen some of the problems that the use of unlicensed and off-label medicines can cause, and some influence needs to be brought to bear on the pharmaceutical industry to ensure that it develops formulations for children. Most of the accidents that occur result from doctors and other health professionals using diluted adult formulations for children. Occasionally, the calculations go wrong because the adult formulations are completely unsuitable. If the Minister has any power to persuade the pharmaceutical industry to develop more children's formulations—[Interruption.] He looks doubtful, but I wish him all power to his elbow.
The initiatives on mental health problems are also very welcome. On talking to teenagers, I was surprised to discover how high up their agenda such problems are, and they do often develop during teenage years. But there is another issue that needs to be picked up on, and I hope that the Minister can reassure me that it will be. A local teacher pointed out to me that teachers often have to deal with the problems associated with children whose parents have mental health problems. Such children often cope for some time, albeit with difficulty. They are probably more at risk of developing such problems themselves, and they encounter specific difficulties as a result of living in such an environment. This issue could in part be tackled through the greater use of school nurses and health visitors. Such visits often stop at the age of five, and there is very little formal contact after that age; one does not see a health visitor or a district nurse in the same way. I hope that the Minister can reassure me that the needs of children who fall into this category will be dealt with.
I am not sure whether specific money is available for children's mental health services. The Minister will be aware that, traditionally, such services are underfunded in many parts of the country and they struggle to meet the demands placed on them. If there is a way of redressing the balance somewhat, that would be welcome news.
There is much that is good in the framework, but it would help if we had a clearer timetable for implementation, even where such initiatives are implemented at local level. We cannot afford to put this issue on the back burner for a few years; we need primary care trusts and other authorities to get on with it now.
I am delighted to follow the hon. Member for Romsey (Sandra Gidley), with whom I have sat on many Committees discussing issues relating to maternity services. I welcome the children's national service framework. There certainly is a need for joined-up government when it comes to children's services. I know of cases in my own constituency—I am sure it is shared by Members across the House—of children with severe learning difficulties or challenging behavioural problems, and it is often with those groups that agencies find it hardest to come to some agreement about how services should be set up. That can sometimes lead to delays, resulting in lack of services for the children and parents who most need them. I greatly appreciate the work being done to solve that problem.
I also greatly welcome the emphasis on parenting. It is always a surprise to me that our society creates and provides antenatal classes for parents-to-be and that there is so much intensive work focused on the birth of the child, yet when the baby pops out—I hope with the minimum amount of pain and difficulty—suddenly we have apparently created two wonderful parents, even though they may have no knowledge or experience of looking after children. We need a whole new emphasis to focus on the fact that it is not the easiest thing in the world to become a natural parent. Parents need all the support that they can get to help them with all the difficulties that they face.
The hon. Lady is making an important point. In my surgery, I often see families that are struggling, particularly with problems relating to controlling their children, and when I talk to them it is apparent that the problem has gone on from generation to generation. There is no good parenting model exhibited down the family tree, as it were. How does the hon. Lady envisage these services developing? Does she agree that schools should provide more and teach parenting skills rather than French, for example?
I would not say "rather than French", but I certainly agree that schools should do more, acknowledge the problems and provide support. Let us face it: some schools have pupils who are parents themselves or who act as parents. I particularly commend the Government on the Sure Start schemes up and down the country. It is easy to see that they help to change generational patterns by providing intensive and very supportive help to parents. I would like to see them spread throughout all our communities.
I chair the all-party maternity group, which was set up about three years ago to campaign for a national service framework for maternity services. With that hat on, I particularly welcome the fact that the maternity module was incorporated into the children's NSF. I would like to thank colleagues in the House—the hon. Member for Romsey is one—and in the other place for helping me with that work. I would also like to thank the National Childbirth Trust, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists, all of which helped us in many of our meetings along the way.
I also chair the Health Sub-Committee on Maternity Services, which has produced three reports over the last year or so, covering issues such as information on maternity services, staffing problems, choice for women and inequalities in services. We looked particularly at the differences in caesarean rates between units across the country. We tried to establish why those rates were so different when we have pretty similar women across the country and we found that it came down to the leadership within units. With leaders determined to reduce or maintain a low caesarean rate, it led to people challenging whether a caesarean was necessary in certain circumstances and minimising those major operations that would otherwise have happened.
Because of all that work, I particularly welcome aspects of the NSF that deal with maternity and I should like to make a few points about the subject. The maternity framework represents the biggest opportunity to secure a major step forward in maternity services since the publication of the Changing Childbirth report. A number of people told the Health Select Committee that they really appreciated that report, but they felt that not enough had happened. The problem centred on the difficulty of putting theories and Government policies into practice on the ground.
The NSF rightly promotes normal birth, and states that medical interventions should happen only when needed. I am pleased that it goes into detail on this matter, and that it talks about better birth environments and the need for birth pools. It was frustrating to hear midwives tell the Select Committee that there was a time when lack of training meant that no one was able to use the birth pools that they had. It is hard to imagine the frustration felt by parents who had decided to give birth in that way when they found that no one was trained to use the pools available in the hospitals. I am sure that the fact that the NSF even mentions birth pools will convince PCTs that they must ensure that the skills are present to support their existing facilities.
Mention has been made already of the need for choice when it comes to the place of birth. This issue continues to come up because of the real problems encountered around the country in implementing the policy but, where possible, parents should be able to choose between midwife-led units and home births. The NSF goes so far as to state that that capacity needs to be developed to meet the needs of parents, and I hope that my hon. Friend the Minister will take action on this matter now. My hon. Friend the Member for Braintree (Mr. Hurst) has told the House about instances in which that would make a real difference for women who are soon to give birth.
Some time ago, the Select Committee on Health, under the chairmanship of the hon. Member for Macclesfield (Sir Nicholas Winterton), compiled a report that stated that there should be a presumption against the closure of midwife-led units. We looked at the matter again, and endorsed that presumption absolutely. The midwife-led unit at Malmesbury, which is used by some of my constituents, has been proposed for closure, even though it is the only one available for use by women in Swindon. It is the jewel in the crown of my neighbouring PCT, and people visit it from across the nation and even from other countries.
I have seen no serious costings about the long-term benefits of midwife-led units, although, as the hon. Member for Romsey noted, their high breastfeeding rates mean that children born in them are less likely to be admitted to hospital. However, there have been no serious attempts to look at alternatives to closure. Although many women and parents use the midwife-led unit at Malmesbury in my patch, I know that many others do not even know that it is an option because it is not mentioned by the midwife or GP who is looking after them. Clearly, however, such units would become more viable economically, according to the crude measure of cost per birth, if more people used them.
The decision about closing midwife-led units is in the hands of my right hon. Friend the Secretary of State. I know that the wish in Government is always to resist interfering in local decisions, but I hope that the launch of the NSF will promote a shift in policy towards re-emphasising the need for midwife-led units, and that there will be a willingness to intervene to save those units.
I am pleased that, after discussions, my own PCT is considering establishing a midwife-led unit in Swindon. I very much support that, so that women throughout the area can have access to such a unit. Swindon is a big and growing place, and there is no doubt that we can support a unit there as well as one in Malmesbury.
In many parts of the country, people also face problems securing home births. As chair of the parliamentary maternity group, I have received some very distressing letters from women. They may be in their 36th week of pregnancy and they may have planned to have a home birth all along, but they discover suddenly that that option is not available—most often because of a shortage of midwives. I have to say that when we write to chief executives I am never quite convinced from their responses that they have done everything possible to try to give women the choice of a home birth. Midwifes would be asked whether they would be willing to do extra hours. Midwifery assistants or bank staff could be used. There are also independent midwives who could be used to give women a real choice.
The underlying worry appears to be that home births use up too much staff time. Everybody now seems to be committed to one-to-one support during labour, but does it make any difference whether that support is given at home or in hospital? After all, because women are more relaxed in their own environment—they are often so comfortable that they do not call on services until later in labour—home births tend to take much less time. Analysis shows that, on average, home births take up less midwife time than those in hospital.
It is important that we do more to support those women who want home births. I hope that Ministers take action when trusts think about suspending home birth services to ensure that every option is considered.
I share the view of the hon. Member for Romsey that the NSF is a missed opportunity to provide even more support for breastfeeding by creating a strategy for England. Wales and Northern Ireland have strategies, as do many health boards in Scotland. The hon. Lady pointed out the great benefits of breastfeeding for babies, and she also mentioned the benefits for mothers, who reduce their chances of breast cancer and some forms of ovarian cancer, and of developing osteoporosis. I acknowledge that the NSF contains some very good recommendations on breastfeeding, especially on the extra support that women need in the form of access to breastfeeding counsellors. That support does not have to be provided by midwives. For example, the National Childbirth Trust provides support for breastfeeding for many women.
I know from talking to many women in my constituency that they would have liked to breastfeed, but they did not always have the support to do so. Breastfeeding is not always easy to start with, and we must acknowledge that and provide the necessary support. Nine out of 10 women who stopped breastfeeding in the first six weeks would have liked to continue for longer but were not able to do so. That demonstrates a lack of skilled support, which we need to develop.
A breastfeeding strategy could cover such issues as providing proper content for training for midwives, nurses and other professionals. It could also provide for training to update such skills. A breastfeeding strategy could also cover the implementation of the international code of marketing on breastmilk substitutes, which might require some changes in the law. We should also promote legislation to protect breastfeeding mothers from discrimination and harassment, with some supportive employment and guidelines for employers on breastfeeding mothers. Some companies say that women can breastfeed or express milk at work, but the only place provided is the toilet. I do not like that and I am glad to say that I know of only one example of such provision in my constituency. More appropriate and comfortable rooms could be used, for the sake of both the women and the babies.
Of course, we could do more in the House to promote breastfeeding. We have made progress and we now have some breastfeeding rooms, but we still say to Members, staff and visitors that if they want to breastfeed they must go and hide somewhere.
Breastfeeding is not dirty or unpleasant; it is natural and if we could all be more relaxed about it we would help to promote its great benefits to both babies and mums. It seems strange that, for example, the public are not allowed to breastfeed up there, behind that glass barrier. Would it really be a problem? I hope that even in the House we can do more to support breastfeeding.
As we are talking about joined-up thinking, does the hon. Lady agree that more could be done in education through child care syllabuses? I was promised a change in a child care syllabus, but because of the recent 14-to-19 proposals, everything is on hold. In the interim, should not we encourage the Government to ensure that the real facts are put before young people?
I should like more to be done in schools. Sometimes, it seems that schools feel that breastfeeding is embarrassing and do not talk about it, yet it is the most natural and wonderful thing and we should promote it. I should like to see more children's books promote breastfeeding. Often, we see pictures of a baby's bottle in children's books, but only rarely do we see a picture of a breastfeeding baby. I appeal to the publishers of children's books to do their bit to promote breastfeeding as the norm.
Breastfeeding rates in England are among the lowest in Europe; by the age of four months, only about 28 per cent. of babies are breastfed. We certainly need to do more and, through the strategy, I look forward to that.
I am pleased that the NSF focuses on a major issue that we considered in the Health Committee: women who are disadvantaged, whether because they are from ethnic minorities or because they have mental health problems or disabilities, or for other reasons. The Committee heard from a wheelchair-using mum, who had had to argue strongly simply to obtain a height-variable cot. That makes obvious sense, not only for wheelchair users but for everybody. Women are not all the same height.
Such cases often arise when we adapt for people with disabilities. Low-floor buses were introduced so that people in wheelchairs could get on to buses. Then we found that not only those people but everybody—people with buggies, people without buggies—could get on or off buses more quickly and easily, and the buses ran more efficiently. When we adapt services for people with disabilities, it is better not only for them but for everyone. Things such as height-variable cots are better for everyone.
The woman to whom I referred succeeded in her case with the health authority, but it was frustrating to realise that people in neighbouring health authorities would have to undertake similar campaigns and engage in the same debates to obtain height-variable cots because the service was not country-wide. Because the NSF emphasises the needs of disabled women, I hope that such arguments will no longer have to be made, that there will be no more going through the hoops and that change will be implemented quickly.
The Health Committee considered issues relating to translators, who are key to meeting the needs of some people in maternity services. There is sometimes a tendency to rely on the partners of people for whom English is not their first language, which can be a bad idea, especially if domestic violence is involved. I hope that point will be highlighted under the framework. I am pleased that the NSF covered domestic violence, as it can start at pregnancy, so the more that we can address those needs, the better.
The hon. Member for Romsey referred to mental illness. We must ensure that we have enough mother and baby units as soon as possible. We should not separate mentally ill women from their babies; they should not have to choose between taking up mental health services and being separated from their babies and risking not having those services so that they can stay with their babies. That is not acceptable. We must provide those services for people throughout the country when they need them.
I want to emphasise my welcome for antenatal support, the importance of appropriate antenatal visits—the two visits that are required before the 12th week of pregnancy—and, in particular, the options for care. The hon. Member for Braintree drew attention to the fact that GPs were recognised as critical to decisions about where mothers give birth, but midwives are often involved in those decisions as well. I hope that we can ensure that all midwives have not just knowledge of all the different choices that women might have in giving birth locally, but experience of working, and continuing to work, in those different birth environments.
Does the hon. Lady agree that, very often, doctors have not had a positive experience of childbirth? During their training, they are dragged into all the interesting births that are going slightly wrong. They rarely stay with a woman who is having a normal labour and delivery from beginning to end. They do not gain experience of that, whereas midwives are much more familiar with the concept of normal birth. Does she think that it would be a good idea to adapt medical training so that doctors have more idea about normality, rather than abnormality?
Yes, I do. That is a key issue. There is an underlying feeling in the minds of many people who work in maternity services that a birth is best delivered in the most high-tech unit possible. The logic behind that is, if anything goes wrong, everything is available so that staff can dive in and help the woman and baby, yet the evidence does not support that view. Why? The reason is that, unlike almost all of what happens in the rest of the health service, giving birth is perfectly normal and healthy, so virtually no intervention is needed in most births. Psychology is important: if a woman is feeling more relaxed and in control, she is more likely to have a successful birth.
People talk about a cascade of interventions in maternity services. Women are in the main hospital and lots of things could happen, so an intervention is made because the means to do so are available. That intervention necessitates another intervention and so on, until someone ends up with a caesarean—a major operation. I am not suggesting that caesareans are not needed. They are absolutely necessary for many women and their babies, and they produce the best results for them. However, on average, too many caesareans take place in this country, so too many people are experiencing interventions. That is why I hope that the national service framework, which tries to emphasise normality and support women in their choices, will help lead to a reduction in such interventions. I would love all GPs to gain experience of home births, so that they can see how normal births work fine without interventions. As the hon. Lady suggests, if doctors gained such experience, it could help in developing maternity care.
I want to finish by referring to antenatal services. It is important that midwives give impartial advice and that they do not work for just one unit. Given that payment by results is being introduced, it could be very dangerous if the midwife who gives the advice works only for the unit that will receive a payment if the birth takes place there. Midwives should either work in all the units in an area or be separate from any unit that will receive money if women decide to give birth there.
I hope that midwives will be trained to give some legal advice, for example, about rights at work. The Union of Shop, Distributive and Allied Workers recently conducted a large survey of 1,200 pregnant women working in retail outlets, which found that 62 per cent. of mums-to-be reported experiencing a negative attitude towards them when they had reported that they were pregnant. I am delighted that 38 per cent. of women felt that their employers were helpful and supportive—well done those employers—but one in four women told USDAW that they felt marginalised and ignored and more than 22 per cent. did not receive paid time off to attend antenatal appointments. Clearly, that is a worry. One of USDAW's members said:
"I was lifting boxes weighing 20kgs. Being at work nine hours without a break. Going home at 9pm and starting work at 7am the next day. I had no risk assessment"—
that should have been done—
"My manager never asked how I was coping. I collapsed at work and was admitted to hospital twice."
Clearly, with things like that going on in this country, we need to give women the advice and support that they need when they are going through their pregnancies.
The hon. Lady mentioned the legal profession. What is the extent to which many women's preference against natural birth is related to the medical establishment's fear of litigation? Has she discovered any evidence that people are more prone than before to avoid natural birth, or that doctors are less prone to offer it?
When the Health Committee examined the matter, we found that there was a lot of anecdotal evidence—but no concrete evidence—to suggest that that might be the case. The more that we can counter the worry of litigation with evidence showing what is best for women, the better.
I welcome the national service framework and ask the Minister to intervene to ensure that the good aims of the policy are implemented on the ground. We need support through funds such as the modernisation fund so that units can change when possible. They should be released from their day-to-day activities so that they can find out how they can change for the benefit of women, babies and children throughout the country.
I, too, welcome the publication of the national service framework. I do not claim to have read every word of it, but I have read a fair number. It reads well as a clear aspirational statement of a joined-up service—to use the modern idiom—that is built around the needs of individual patients. It gives patients and service users in the social care system a clear framework within which the service will be delivered. The NSF is an entirely welcome and overdue statement of our aspirations for the service that we all want delivering, and nothing that I go on to say should be interpreted as resiling from or qualifying that in any way. I genuinely buy into the description of the service set out in the framework.
Having read several documents produced by the Department of Health over the past few years, I wonder what linking or delivery mechanism will connect the clear and attractive description of the service that we want with the actual service on the ground. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) also made that point. I agree with the Minister that we do not want a snowstorm of micro-targets to define every single output. However, there is a difference between a snowstorm of targets and, to use the Minister's words, a statement of aspiration under which occasional audits will be conducted, but with the eventual target of delivering an up-and-running service in its entirety some 10 years from now.
The hon. Member for South Swindon (Ms Drown) described the kind of maternity service that she wanted, which is one of the subsets of the services defined in the framework. I agreed with virtually everything that she said, but I have heard similar views expressed in the House since the day on which I was first appointed as a Health Minister—I am sorry to admit that that was 14 years ago. It was not the case that our ambitions for the services lacked clarity, but something more urgent always tended to squeeze out important aspirations such as those about which she spoke.
If we really want to depress ourselves for a moment, I can remind the House of the history of mental health service delivery over the past 40 years. During that period, the vision of how our mental health services should develop has been debated, but if hon. Members read Enoch Powell's speeches as Health Minister in the early 1960s, they will find something that is recognisably the same definition of the mental health service that we want to see and which has been redefined and redefined over in official documents—I was responsible for some, as both a junior Health Minister and as Secretary of State—for 40 years. The difficulty is not defining the aspiration, which the national service framework does admirably, but getting the connection mechanism between the aspiration and the delivery.
My hon. Friend the Member for South Cambridgeshire was right to emphasise the danger of defining something that is important because it is in today's headlines or is a life-and-death matter in the short term. That always puts it ahead of the delivery of long-term objectives, whether it is maternity care, mental health services, which are part of the national service framework, or the other longer term aspects of health care delivery.
I say to the Minister in all seriousness that the document is good, but it is not good enough to say that we will look back in 10 years' time to see how we got on. I know that he is not saying that, but the danger of doing that is inherent in what he says. How many documents issued in 1994 has he checked to see whether their aspirations were delivered in the intervening 10 years? That is, perhaps, the test because many of the aspirations have not changed much over the years. It is, of course, an easy escape to say that a Tory Government were in office at the time, but if he reads the definitions of service ambition in terms of service delivery that were issued by the Department under Tory Ministers, and not even those issued by the professionals under Tory Ministers, he will find that they have not changed much, any more than the definition of maternity services has changed. The description of maternity services by the hon. Member for South Swindon was, I am sure she would agree, identical to the one that was issued in my time as a Health Minister when Julia Cumberlege was responsible for changing childbirth. That story repeats itself throughout health care.
The real challenge for Health Ministers is to find a connection mechanism. When my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) was Health Secretary, he used to say that it was a wonderful job with a good office. The officials presented him with an enormous array of impressive levers and he had to decide their positions and which one he wanted to pull, but he always doubted whether the levers he was invited to pull were connected to anything. That test needs to be applied to the national service framework.
Against that background of a degree of scepticism born of disappointment—that is, I think, the best way to put it—I offer a couple of thoughts on how we might improve our chances of delivering this noble ambition, which I think is a shared objective. The first is to consider the concept set out in the NSF of children's trusts. I read the wording of that with interest and there is a kernel of a good idea, but the problem with children's trusts, as with so much else in the document, is that they rely on improving co-operation between agencies.
We can all agree that most of the difficult problems to do with children's services rely on social services, the NHS, the education service and often the probation service and the law-enforcement agencies all working together, which requires them to understand each other's agenda in the case of a particular child or group of children. Many of the reports to which I have referred have relied on the assertion that this Government, with this new set of Ministers and this new political will, will crack inter-agency co-operation. With respect to the Minister, the NSF relies on the same analysis. It does not propose that we change the institutions but aims to ensure that, at last, we achieve genuine co-operation between the agencies. Children's trusts, if they are to add value and not just be barnacles on existing institutions, must do more than send missives that say "Wouldn't it be good if such-and-such happened for this child?". They must be able to break down the statutory distinctions between local authority social services and education departments, and they must have the capacity to tie in with the NHS.
The right hon. Gentleman has made some excellent points. For what it is worth, the Children Bill places a statutory duty on those organisations to co-operate, which is a new factor in the equation. There will be a director of children's services with a wide remit who will make sure that they honour their statutory obligation.
I welcome the statutory obligation to co-operate, but it is like saying, "This time, we are really going to make it happen." I do not remember a Minister coming to the Dispatch Box to say that they are in favour of agencies not co-operating. Ministers always say that they are in favour of co-operation and if they are to deliver it effectively, the agencies must respond.
I should like to offer the Minister some thoughts on the way in which children's trusts could develop. Local authority children's services and the department in the local education authority that deals with difficult children are, in effect, dealing with exactly the same group of individuals, and have far more in common than the LEA department has with other LEA employees who administer a normal school system for children who do not have special needs. I have always thought that there is a case for looking at the structure of local authorities. Instead of separating social services and education along functional lines, we should draw a line between the delivery of a normal education service to normal children—I use shorthand—and the more intensive specialist services required for individuals who rely both on children's social services and on the low achievers' services of the local education authority. If children's trusts developed in that way, instead of merely aspiring to better inter-agency co-operation, we would establish a machinery for delivering it, and children's trusts would be responsible for procuring services from the NHS, social services departments and LEAs to tackle the needs of particular children. I urge the Minister not to be seduced into believing that he has a wholly exceptional political will that can achieve the inter-agency co-operation that all his predecessors failed to deliver.
I should like to detain the House a little longer on a tiny matter arising from inter-agency co-operation. I declare a personal interest in the inspection regime for independent schools, as I am a trustee of Uppingham school, an independent school that serves the needs of people at the opposite end of the advantage scale. I am wholly in favour of inspection for such schools and I am not arguing that they should not have an inspection regime. However, as we are talking about the importance of joined-up government and inter-agency co-operation, I should point out that schools that parents pay in excess of £20,000 for their children to attend are inspected by the independent schools inspectorate as educational establishments. They are also subject to a wholly separate inspection regime run by the social services inspectorate, which has almost no track record in this field. It seems a rather obvious question to ask the Department of Health why it is not possible to have a joined-up inspection regime for independent schools. That is a very particular subject, but I ask the Minister to reflect on it. If he could write to me and let me know his views, I should be grateful.
Nothing that I have said will detract, I hope, from my initial enthusiasm for the service framework. It is a genuinely good document. It reads well, like a new beginning—a new opportunity to improve the services available. We must look beyond the aspiration to the delivery. That is the area where the real challenge, as always, lies for Ministers. They have done the easy bit. Now we must hold them to deliver it month by month, year by year, so that when the Minister is sitting on the Opposition Benches and I am sitting on the Government Benches in 10 years' time, he will remind the future Minister of the aspirations set out, and the mechanism that he put in place will have made delivery of the aspirations inescapable.
It is a pleasure to get in right at the end of an excellent debate about an outstanding document delivering a superb vision of what is, after all, the best work in the world. I have only a short time but it would be remiss of me not to commend Professor Al Aynsley-Green, who as well as doing all his work on the national service framework, came to my constituency and led us in a discussion of what life is like for children and young people in Lancaster. He exemplified the principles of work with children that he set out in the document.The NSF sets out a long-term programme of change. We must plan now to meet the standards of the next 10 years. What we have is a manual for the transformation of children's services and children's lives.
I do not usually regard myself as curmudgeonly or cantankerous—an honest sceptic at times, perhaps—but I sometimes wonder what my right hon. Friend the Minister for Children, Young People and Families and my hon. Friend the Minister know that I do not know. Sometimes they seem to approach the future with a blithe optimism that, from my experience in the work, is not justified.
I find myself in a strange position, because I agreed with almost everything that the right hon. Member for Charnwood (Mr. Dorrell) said. As someone who was working with and in some of the services for which he was trying to pull the levers about 14 years ago, I recognise the dilemmas and difficulties that he identified.
I think that we are missing something here. We have a vision for services. If, at the general election in 1997, I had been told to stand on a platform of supporting the services envisaged in the document, I would have had difficulty believing that we would have a Government who would fundamentally address inequalities and set out to attack and end child poverty. I would have found it difficult to believe the extent to which the Government would create high-quality public services centred on the needs of children and families, imbued with the participation of children and young people, integrated across professions, organisations and institutions, based on a new pedagogy—a common core of knowledge and development—and incorporating innovation and exciting new models.
What I believe is missing, and it is missing from the Children Bill, is a resounding statement of principles. We have had some good discussions on that Bill, but the Government must inspire people on the ground with principles and effectively disseminate this document and others across the country to children, parents and the professionals working in these services to make sure that the NSF is used.
The Government should not try to lever the NSF into certain situations: they are trying to challenge some of the most stuck services in the world; they are trying to change the way in which organisations and professions work; and they are trying to challenge specialised and self-interested institutions and professions. They need to engage the power of children, young people, parents and people who work in those services, and get them to demand that organisations stick to both the principles set out in the NSF and important documents such as the UN convention on the rights of the child and the letter of the Children Bill, when it is enacted. If we work together properly, we can transform the lives of children in this country.
In the short time left, I shall try to make a coherent response to the debate—if my response is not coherent, I cannot blame my daughter for having scribbled on my speech, as my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) did earlier.
I start by reiterating our welcome for the NSF, which is beautifully presented—it is a collector's item, with different slots for the files—and promises great things. The Minister and his colleagues also promise great things. The Secretary of State for Health said:
"These new national standards will ensure that children and young people are not just seen as mini-adults, but have access to services that are tailored to meet their individual needs."
The Secretary of State for Education and Skills said:
"Children and their families will receive integrated health, social care and education services that are prompt, convenient, and responsive."
I gather that the Minister will reply to the debate—we seem to have a new trend in single-handed Ministers, whose colleagues spend time out of the Chamber rather than responding to important debates such as this— and earlier he made ambitious claims about how the NSF is a first. He said, "There is no doubt over the Government's commitment to children," but the trouble is that there was an awful lot of doubt—it has taken them seven and a half years to produce this NSF. That this is the first debate in Government time in this Parliament on children's health and protection issues is significant and speaks volumes, and we have been allocated less than three hours. I hope that the NSF is not, as the hon. Member for Lancaster and Wyre (Mr. Dawson), who is not curmudgeonly, said, blind optimism.
The debate has been good, and we have heard interesting contributions from both sides of the House. We all know that children's services have been treated as add-ons to adult services in the past. Children have been treated as mini-adults for too long, rather than having services based on children's specific needs. We all know that that is a false economy, because it builds up problems, such as obesity, for the future. The looming obesity epidemic will lead to much higher rates of diabetes among ever-younger children—some 15 per cent. of our children are obese. The Minister said that we have the healthiest children ever, but life expectancy rates are declining for the first time in a century, which is a trend that we must address.
One in 10 of our young people suffer from mental health problems, which is a matter that I shall return to in a moment, suicide rates among schoolchildren are three times what they were 20 years ago and alcohol and substance misuse are also causing problems. All those problems should have been addressed sooner. Given the appointment of a Minister for Children, Young People and Families, which we welcomed, we need more joined-up approaches, which is a point mentioned by many hon. Members. I hope that the NSF presents such approaches and that the documents' thickness is not quantity over quality.
The hospital standards section of the NSF, which we saw back in April 2004, dealt with the provision of separate facilities for young children and adolescents, dedicated children's units in accident and emergency departments, children's menus, and play specialists to help children cope with the stress of being in hospital. Will the Minister comment on what progress has been made? It remains the case, for example, that considerations that apply to adults in terms of mixed wards do not apply to adolescents, who are placed side by side with members of the opposite sex up to the age of 17 because they do not fall within the Government's requirements.
We still have the worst perinatal mortality rates in the whole of Europe apart from Greece, with just under eight deaths per 1,000 live births out of the 550,000 births in England every year.
Concerns have been expressed about the new-style NSF. My right hon. Friend the Member for Charnwood (Mr. Dorrell) made some telling comments. We do not want a snowstorm of targets, as he put it, but greater guarantees about the delivery and achievement of the aims of the NSF. We hope that the levers are connected and will drive the cogs that produce the results, which are what matter.
No targets are involved here. Although that is good in itself, the problem is that there are still far too many targets in other areas of the Government's health strategy, which means that areas without targets are de-prioritised. Moreover, as they have no specific funding they become less of a medical priority than those that are specifically funded and subject to targets. Barbara Peacock, the health spokeswoman of NCH, says:
"The fact that there is no specific funding attached to the NSF is a real issue. We believe that there should be a pot of money, which is ring-fenced, to make plans set out in the framework a reality. Without this, the framework will have a limited impact."
The Minister claimed that that is because there has been mainstream funding, but how is that to be monitored? There is no guidance on the speed at which that should be achieved over the 10 years until 2014.
Many hon. Members expressed great concern about work force capacity, as has Al Aynsley-Green, who said:
"We have very serious issues around workforce capacity. We don't have the numbers of nurses, doctors and therapists we would like".
We hear all the time about doctors and nurses in hospitals, but we hear very little about all the ancillary services, particularly those concerned with children. There is a great shortage of consultant paediatricians. Many women are training as consultant paediatricians. That is welcome, but because they are less likely to become full-time equivalents later on there will be further shortages.
According to the Royal College of Midwives, the situation is worse than the hon. Member for Romsey (Sandra Gidley) suggested. Between 2002 and 2003, the number of NHS-registered midwives fell by 6 per cent. and the number of whole-time equivalents between 1997 and 2002—the last year for which figures are available—fell, rather than rose.
Will the hon. Gentleman give way?
I should like to make some progress, because we have very little time left. The hon. Gentleman and I will have plenty of opportunity to discuss other matters tomorrow in Committee on the Children Bill, as we have, with great enjoyment, for the past two weeks.
Earlier this year, the Royal College of Midwives estimated that there is a shortage of 10,000 midwives. I am afraid that the Government are trying to disguise the seriousness of that by grouping midwife vacancy rates with those for nurses and health visitors and using head counts instead of whole-time equivalents.
The problems in midwifery were mentioned by the hon. Member for Braintree (Mr. Hurst), who talked about the lack of choice for mothers in his constituency, and by the hon. Member for South Swindon (Ms Drown), whose great expertise in this area will be missed.
The 10-year plan may be comprehensive and thick, but we need urgent delivery—well before 2014, not merely by 2014.
I want to single out two specific areas of children's health, the first of which is mental health. My right hon. Friend the Member for Charnwood majored on that. It is fascinating that, given what happened 40 years ago, we are merely reinventing the wheel. We must redefine our aspirations and confront the difficulties involved in connecting them to delivery.
Some 24,000 teenagers a year seek professional help for self-harm, but that is the tip of the iceberg, as many more do not seek it. That is indicative of all the extra pressures on young people today. Suicide rates show that those pressures are not being addressed early enough. Mental health services still really work only when crisis point is reached. Last year, 50,000 antidepressant prescriptions were issued, some to children as young as six. Recently, there have been worries over suicidal tendencies linked to certain drugs. There is a lack of clinical data on the suitability of adult drugs for children, dosage rates and so on. There are 1.2 million children with mental health problems in this country. However, the scandal is the lack of in-patient beds nationally. There are only 628 in-patient beds nationally for children—that is six beds per 100,000 children. Only one third of trusts make special provision for mental illness in children with learning disabilities.
A report by the Royal College of Psychiatrists for the Department of Health stated that 60 per cent. of child and adolescent admissions to wards was deemed to be inappropriate. The Mental Health Act Commission pointed out that, between 1999 and 2001, 1,082 children were admitted to hospital under the Mental Health Act 1983, and that 62 per cent. of total admissions of children and young people were to adult wards. One of the Under-Secretary's predecessors admitted to me in a written answer that there were 64,920 occupied bed days for patients under the age of 18 on adult psychiatric wards in only one year.
The state of mental health facilities for children and young people is a national disgrace. The new draft Mental Health Bill makes no statutory requirement to improve the position, aside from the capacity problems. How quickly will the NSF deal with that?
Diabetes and the higher incidence of type 2, adult onset diabetes—now recorded in teenagers—is the second matter that I want to raise in the short time available. The great difficulty is that the Government are not aware of the extent of the problem. The Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton), who has responsibility for diabetes, told me in a written answer that the information is not collected centrally for the number of children who develop type 2 diabetes. Will the NSF quantify the extent of the problem before we can start to tackle it properly?
The Government have prevaricated on the obesity challenge for too long. Our obesity problem among young people is second only to that of the United States. One third of British children are overweight. One in 10 four-year-olds are classified as obese. Dietary problems continue to exist. For every 25g of green vegetables that children eat, they consume 100g of sweets and chocolates. After seven and a half years, we are still waiting for a public health strategy that starts to tackle the problem, which is getting chronically worse.
There are many other chronic conditions and I was pleased that asthma is one of the special exemplars. It is the most chronic disease in the United Kingdom. Thirty-five per cent. of childhood GP visits are for respiratory infection and 132 boys per 1,000 five to 15-year-olds are treated for asthma.
We need to tackle many other preventive priorities now. It should have happened earlier. The Under-Secretary said that healthy children become healthy adults. We should have done much more to tackle the explosion in sexually-transmitted diseases and the 23 per cent. of 15-year-olds who smoke.
Several hon. Members, especially the hon. Member for Barnsley, East and Mexborough (Jeff Ennis), mentioned hospices. There is no excuse for poorer funding of children's hospices when compared with adult hospices. The Under-Secretary is wrong when he claims that giving more money to children's hospices would mean taking money away from PCTs for palliative care. The problem is that the money that PCTs should use for palliative care is being spent elsewhere. They rely on the good will of voluntary contributions to charitable hospices, especially children's hospices, to provide that service. As a patron of one of my local hospices, I know that that happens.
The inclusion of a section on incontinence noted that at least 500,000 children suffer from nocturnal enuresis and a significant number from daytime wetting. I welcome the section's inclusion for which many of us lobbied. Some of us took part in one of the most humiliating photo opportunities last week in the launch of the Bog Standard campaign. The hon. Members for Richmond Park (Dr. Tonge) and for Kingswood (Mr. Berry) and I had to pose for photographs through a cardboard loo seat. The point was that we need to improve standards of school loos.
If the NSF is to work, it must be joined up. We need to have regard to the 750,000 children who live in poor housing and the 30 per cent. of looked-after children who are not immunised. We need to do much more with carers—I am glad that that has been acknowledged, but child carers, too, need to have far greater help. We must do far more for children's nurses who currently perform the role of glorified social workers and do not do nearly as much of the preventative stuff as they formerly did.
We welcome the NSF but it will be judged on outcomes and the urgency of the action, not the thickness of the documents and the number of tsars that are created. We need a greater sense of urgency than the Government have displayed to date.
We have had a good debate which has hinged on a number of key themes. The hon. Member for East Worthing and Shoreham (Tim Loughton) and the previous two speakers, my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson) and the right hon. Member for Charnwood (Mr. Dorrell), have focused on many of them and asked perfectly valid questions. No one has dissented from the fact that the national service framework document is an excellent statement of our aspirations for the national health service and for health and social services for our children. The question is: is it going to work? Can we make it happen?
My hon. Friend the Member for Lancaster and Wyre paints himself as a curmudgeon. I would not describe him as such, although he can sometimes be a bit of a miserable old beggar. Is he missing something that my right hon. Friend the Minister for Children, Young People and Families and I are seeing? We are not blindly optimistic about our ability to get people to co-operate and to work together on this, but we have to be optimistic. Leadership has to come from the top, and if our heads are down and we do not believe that this can happen, believe me, it will not happen. We therefore have to set about this task believing that we can bring it about.
We are not blindly optimistic, however. We know, because we talk to the people who are providing these services all the time, that we have to overcome barriers such as turf wars, self-interest and inertia. Such barriers are found not just in one of the organisations that we are talking about; they can be found in every single one. Perhaps the right hon. Member for Charnwood is right, however, to put this task into the category of "This time we're going to make it happen".
This time, there are differences. In the Children Bill, there is a statutory obligation on all these organisations to co-operate. The director of children's services will have a strategic role in producing a plan for the improvement in services. The mandatory commitment of the national service framework is in place. Several hon. Members, including the hon. Members for South Cambridgeshire (Mr. Lansley) and for Romsey (Sandra Gidley), talked about the inspection process. We have a clear strategy for ensuring that we inspect the national service framework on a regular basis and try to deliver it.
The fact that we have a Healthcare Commission that operates at arm's length from the Government gives us a new tool to work with that we previously did not have. The commission is now putting in place a strategy for inspecting the progress of the national service framework and for monitoring how the framework is further to be delivered, so that we shall end up with it being delivered everywhere within the 10-year period. The hon. Member for South Cambridgeshire asked for a time line to be applied everywhere, but instead we ought to have local time lines everywhere that we can follow and use to judge progress. That will be different in different places because there are different demands in different places. If I were the Member of Parliament for an inner-city constituency with a high ethnic minority population, I would want the initial thrust of the work to be done on inequalities, and on ensuring that we are reaching the minority ethnic communities. However, I have a different kind of constituency, so I would expect to see the priorities there reflecting my community. Each Member of Parliament will have the same opportunity.
Does the Minister not accept my point that what is missing is the empowerment of the users—the children, the parents and the people who work at the coal face of the system?
I am absolutely in agreement with my hon. Friend that empowering those people is vital. If he has listened to me making speeches not only on this agenda but on the other part of my portfolio, which involves responsibility for older people, he will have heard me saying time and again that we shall achieve real progress on improving these issues only when they are made into matters for local discussion, when they become local priorities at local elections and when people ask their local MP, their local councillors and others in positions of responsibility locally, including the primary care trusts, "What are you doing in my area?", rather than always looking to central Government to provide some grand answer that simply will not solve the problem.
The Minister said that these are matters for local discussion. He did not say that they were matters for local decision. Is there any reason why not?
It was a simple slip of the tongue. These are matters for local discussion and local decision.
The other suggestion made by the right hon. Member for Charnwood was that children's trusts should have commissioning responsibility. Indeed, they will have commissioning responsibility. Therefore, we are embarking on the direction of travel that he has identified as one way of delivery. In addition, we will have the joint area reviews, in which Ofsted, the Healthcare Commission and the Commission for Social Care Inspection come together, to make sure that progress is being made. Public service agreements and the policy and planning framework will underpin all that.
Nothing is guaranteed in this life. Possibly, when I am sitting on this side of the Chamber in 2014, listening to one of my hon. Friends speaking from the Front Bench, we will not have seen the progress for which I hope. But I believe that with this national service framework, and the underpinning foundation of inspection processes and the measures put in place, we have a better opportunity to do that than we have ever had previously. Given the good will that came from all parts of the House today, perhaps this time we will get somewhere.
Another theme that ran through this debate was maternity services. My hon. Friend the Member for Braintree (Mr. Hurst) mentioned it, and my hon. Friend the Member for South Swindon (Ms Drown) spoke at great length on it. I agreed with much of what was said. I also agreed with the point made by the hon. Member for Romsey and others that the work force will be critical to delivering our agenda in respect of maternity services. We must start to examine why we are not making better progress on recruiting midwives. There is no question about that and we have put plans in place to try to address the problem.
The numbers are not as bleak as the hon. Lady suggested—we have recruited 1,500 midwives since 1997—but we need to put that in context, which is that we have managed to recruit 67,000 more nurses. Therefore, one of the questions that we must ask ourselves is: why is it proving far easier to recruit nurses than midwives? Why are many of those registered midwives to whom she referred choosing to come back as nurses rather than as midwives? Many issues are related to that: morale, leadership and flexibility of working practices. We must make sure that midwives have flexibility in their lives if they are to come back and work in maternity services. We must make sure that there is the leadership in the units in which they work to ensure that they have the morale that they seek.
Interestingly, when I ask midwives what is reducing their quality of life, I am told about half the time that it is having to work with doctors, and about half the time that it is having to work with other midwives. I am afraid that bullying and some slightly old-fashioned management practices within maternity services are among the reasons that many midwives find it difficult to continue to work in those services. We must address that. We have a range of strategies in place to make sure that we provide leadership training and try to adjust management practices.
There is not a simple solution, however, and I cannot wave a magic wand and suddenly produce another few thousand midwives. Until we have those midwives, we will not be able fully to deliver the range of choice that my hon. Friends the Members for Braintree and for South Swindon were advocating. That choice is important. We are committed to making sure that women have a real choice of birth environments. I want to see birth centres everywhere. Strangely enough, my hon. Friend the Member for Braintree mentioned Baroness Cumberlege, who was in my office today talking about this very issue. We are determined to see that range of choices everywhere.
This national service framework provides a real opportunity to put an end to what I have called, in many speeches, the bag ladies—the ladies who come into our constituency offices with packing cases full of letters that they have had to write to get the services that their children need. When services are properly joined up, when they are delivered to a high standard and quality and when we have implemented the step change in improvement of services that this national service framework demands, we will have put an end to the bag ladies, and we will have got real quality of care for all children in our society—
It being Seven o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Gaelic Broadcasting
Motion made, and Question proposed, That this House do now adjourn.—[Gillian Merron.]
Broadcasting includes both television and radio, and I want to begin by paying tribute to all who work in Gaelic radio. The importance of radio is often overlooked: it is not as high-profile, and perhaps not as open to controversy, as television, but there is no doubt that radio has been the backbone of Gaelic broadcasting for many decades and that continues to this day. Radio goes into every home like no other medium, and all who work in Gaelic radio should be very proud of the role that they play in the life of the language.
Despite the importance of radio, however, I shall concentrate on Gaelic television. Television today is a window on the world and it is the mirror we hold up to ourselves in any and every language. That is why it is so critical for the Gaelic community—as with the other two indigenous language communities of Britain—to secure its own television service in the digital age.
The announcement three weeks ago by the Scottish Executive, made in Scotland, that the Gaelic Media Service would have yet another budget standstill next year and a mere £200,000 increase the following year—and, I think, something similar the year after that—falls far sort of the Gaelic community's aspiration; and, in the context of people's aspirations for an independent channel, it is seen and felt to be an insult to the language and, indeed, to the whole Gaelic community.
Announcing such a small and, for all practical purposes, useless increase was almost worse than announcing no increase at all. It is unbelievable that this is the end product of years of consultation, discussion and debate within Government, going all the way back to 1998 and the appointment of Alasdair Milne—the former director-general of the BBC—to chair the Gaelic broadcasting taskforce. I was involved in that appointment when I was responsible for Gaelic in the Scottish Office under the late Donald Dewar, when he was Secretary of State for Scotland. It is sad for me to have to admit that following the subsequent six years of consultation and deliberation, Gaelic television is not simply no nearer meeting that aspiration for a television service, but instead in the worst funding position it has known since the Gaelic television fund was created in 1990.
To understand how bad the position is we need to compare the current funding with where it ought to be in order to meet the community's aspirations, and also with where it has been in the past. Where Gaelic television ought to be, of course, is where Welsh television has been for many years now—providing a dedicated channel with a balanced mix of entertainment, documentary, news and children's programmes, transmitted at times when it is convenient for people to watch.
We now have an opportunity to deliver that dedicated channel at a reasonable cost, thanks to the advent of digital technology. The Milne report calculated that it would cost more than £40 million a year to deliver a Gaelic channel, but new work by the Gaelic Media Service—taking advantage of developments in technology—has shown that the channel could be delivered for much less: about £30 million. I pay tribute to the work of the service, which has demonstrated beyond doubt that a Gaelic channel is both affordable and deliverable.
There is now a unique opportunity, one that the Government have recognised and, I believe, signed up to in sections 208 and 210 of the Communications Act 2003. The Government have acknowledged that Gaelic needs to move on and that there is a need to create a new channel that is organised, shaped and broadcast by, and for, the Gaelic community. Unfortunately, having willed the end through the 2003 Act, the Government now appear incapable of willing the means. Substantial new funding is required if they are to breathe life into their own legislation. Despite the Gaelic community showing a great deal of patience, there is still no sign of the Government getting to grips with what they need to do. Hence there was the 1998 Fraser report, which was followed by the Milne taskforce in 1999. Our discussions in Committee on the Communications Bill in 2002 were likewise followed by 2003's joint working group, which involved the Scottish Executive, the Scotland Office and the Department for Culture, Media and Sport. So there were lots of warm words and reports full of good intentions, but still no cash on the table to make things happen.
The hon. Gentleman is making a very impressive case for a Gaelic digital television channel. Having attended and chaired some of the events at this year's Perth mod, I feel that I have done my bit for the language in the past few weeks; indeed, I thoroughly enjoyed the experience. Does the hon. Gentleman agree that this is about more than just television programmes—it is also about the skills, expertise and experience that can be built up if we secure a digital channel? If we do not, if we have to rely instead on a terrestrial television channel, it will simply wither on a funding vine.
The hon. Gentleman has made an important and relevant point. I am afraid that I missed this year's mod, but we can jointly pay tribute to its organisers for what was a very successful event indeed.
As I said, the Government have produced lots of reports, but there is still no financial backing to underwrite the aspirations contained in them. To the Gaelic community, this is beginning to look like tokenism. What is the point in the new Scottish Parliament opening with a Gaelic psalm if there is no delivery for Gaelic in the decisions being made by that Parliament? What is the point of my constituency in this place being rebranded by the boundary commission with a new Gaelic name if there is no new funding for the Gaelic Media Service from this Government?
The contrast between the current funding position for Gaelic television and what is needed in order that its aspirations be met is bad enough, but the contrast with past funding is even more embarrassing. I admit this through gritted teeth, and it is a pity that the official Opposition's spokesperson is not present to hear me say this—perhaps that indicates a slackening of their commitment to, and support for, Gaelic under their new leadership—but the fact is that the previous Tory Government spent more money on Gaelic television than either this Labour Government or the Scottish Executive are managing to do between them. When the Gaelic television fund was created, the then Conservative Government found £9.5 million of brand new money to back it. Adjusted for inflation, the equivalent sum today would be almost £13 million. Yet the actual allocation of funding for Gaelic broadcasting in this financial year is only £8.5 million. That is a funding shortfall of more than 30 per cent. compared with what the Tories were able to spend.
Funding for Gaelic broadcasting has not increased—not even in nominal terms—since 1997. Yet during that time, total Government expenditure has increased by 41 per cent., and the Scottish Executive's budget has increased by a similar amount. By way of contrast, funding for Welsh broadcasting has increased by £16 million in just the past three years. During the same period, there have been real-terms cuts for Gaelic. These are indefensible statistics, and the Scottish Executive, this Government and those of us who support them should feel deeply embarrassed about them.
It is no wonder that the Government were criticised by the Council of Europe's committee of experts when it reported in March of this year. It pointed out just how poorly the Government are doing in respect of their broadcasting obligations under the terms of the European charter for regional or minority languages. I was delighted when we signed up to that charter. It was something that I helped set in motion when I was in the Scottish Office, working with Donald Dewar. It saddens me that the progress that we made then has now ground to a halt.
Part of the problem, I acknowledge, is that the constitutional arrangements have obviously changed since I was in the Scottish Office. Responsibility for Gaelic broadcasting is now shared between Whitehall, through the Minister's Department, and the Scottish Executive, which is accountable to the Scottish Parliament. Co-ordination between the two tiers of government is consequently a bit more complicated, but that is no excuse for the failure of either tier to live up to its responsibilities to Gaelic broadcasting.
Gaelic television has become, I fear, a devolution orphan, kept on a starvation diet and forced in consequence to reduce its output each and every year. Not only is the Gaelic broadcasting fund too small to deliver the digital channel that was provided for in the Communications Act 2003; it cannot even deliver the basic 200 hours of annual programme output that was anticipated in the Broadcasting Act 1990. Those 200 hours, which we had in the early 1990s, have been cut down to just 137 hours today. Again, that reduction is indefensible and unacceptable.
The hon. Gentleman has drawn, quite rightly, on experiences in Wales and he will also know about the experience of TG4 in Ireland, which runs an Irish language service with the sort of money that he suggested could run a Gaelic language service. It happens there in practice. As to declining hours, we have seen S4C in Wales become digital and greatly expand its hours. The hon. Gentleman might like to reflect on the fact that over the 20 years that Wales has had S4C, the number of Welsh speakers, once in decline, was first halted and then increased at the last census, whereas the number of Gaelic speakers has, unfortunately, been on an inexorable decline. Perhaps a Gaelic service would help to protect the language in its heartland in Scotland.
The success of S4C in stabilising the language is something that we should take careful note of, and draw some hope from. The parallel that the hon. Gentleman drew with the Irish position is also interesting because the new channel in Ireland runs on a similar budget to what is spoken about for the Gaelic service. There are actually more native Gaelic speakers in Scotland than there are native Irish speakers in Ireland. That is a fact that not many people are aware of. Irish is widely used in Ireland. It is learned at school, but when it comes to native speakers—where people learn the language in their own homes—there are more Gaelic speakers in Scotland, as I said.
The game of pass-the-parcel between the Government here and the Scottish Executive in Edinburgh has been going on since devolution. The result has been the deadlock that I described, which is failing the Gaelic community and, indeed, making a mockery of the spirit of devolution. Both Governments, in Westminster and Edinburgh, are to blame for the impasse, but it is the Government here who have reserved to themselves—quite rightly, I believe—the responsibility to legislate for broadcasting. This Government passed the Communications Act last year, so they have a special responsibility to deliver the promises implicit in that Act for the Gaelic Media Service to provide a Gaelic channel.
I note that the Minister for Sport and Tourism, who is replying to the debate, has proved himself a good friend of Scotland—and the highlands and islands in particular—in the past, when he authorised a large increase in the Scottish land fund, which I can tell him is doing good work in the highlands and islands. I look forward to hearing his response tonight.
I congratulate the hon. Gentleman on securing tonight's debate on this important subject and on the excellent way in which he has presented his case. Before he concludes, I want to let him know that I fully support what he said. Television is an integral part of the modern world and if we want the Gaelic language to flourish, we need a Gaelic television channel. I hope that the Minister will take heed of what the hon. Gentleman has said.
I am grateful to the hon. Gentleman and, indeed, to all hon. Members with Scottish constituencies who have spoken on behalf of their political parties tonight and offered me their support for a Gaelic television service.
I conclude by saying something that echoes what the hon. Member for Argyll and Bute (Mr. Reid) has just said. The Government and all of us must accept that a dedicated Gaelic television service is not a luxury in the context of today's expectations in the 21st century. Indeed, it is the minimum acceptable provision for an indigenous British language that has been spoken in these islands for at least one and a half millennia.
The British economy is the fourth biggest in the world. Let us have no more pretence that we cannot afford a television channel for our Gaelic speaking community. If the Government want to boast that modern Britain is a vibrant, multinational and multicultural society—indeed, a multilingual one—and that they cherish that diversity, they cannot afford not to deliver a Gaelic television service.
I want to begin by congratulating my hon. Friend the Member for Western Isles (Mr. MacDonald) on securing this debate. The House will be well aware of his enthusiasm for and interest in the Gaelic language, and also of his background in the Scottish Office. I welcome this opportunity to say a few words in this debate. The rather specific nature of the debate and the informative interventions that we have just heard from hon. Members mean that I can be brief in my response, although I hope that it will be helpful.
Funding for Gaelic broadcasting came to prominence in September 2000, when the Milne committee—to which my hon. Friend the Member for Western Isles referred—produced its report recommending the establishment of a Gaelic Broadcasting Authority to run a dedicated Gaelic television channel, at a cost of £44 million. We reached the view that the Milne report's core recommendations could not be justified, but we accepted that there was a need for change better to meet the aspirations of Gaelic viewers. Building on the findings of the report, we introduced important legislative changes by means of the Communications Act 2003, and I shall say more about that later. However, Gaelic broadcasting has been high on the political agenda for a number of years.
The current funding for Gaelic broadcasting, the Gaelic broadcasting fund, is made to the Gaelic Media Service—the SMG, to use its Gaelic acronym—via Ofcom, the communications regulator, and amounts to £8.5 million. That is the amount included in the devolution settlement of 1999. The funding is set to rise to £8.7 million in the financial year 2005–06, and to £8.9 million in the financial year 2006–07. As my hon. Friend the Member for Western Isles said, this fund comes from the Scottish Executive's block vote allocation.
It is true that budgetary cuts in 1998 reduced the fund from its original level of £9.5 million to its current level of £8.5 million. My hon. Friend the Member for Western Isles said that Britain's economy was the fourth largest in the world, but he will know the reality of the budgetary pressures on public expenditure that we inherited in 1997. That sum formed part of the devolution settlement and responsibility for setting the level of grant is for the Scottish Executive to decide, in accordance with its own spending priorities for Scotland.
However, £8.5 million is still a considerable sum of money, and the Gaelic Media Service continues to use it to produce high-quality Gaelic programming. That programming makes an important cultural and economic contribution, especially to the highlands and islands of Scotland.
I agree that Gaelic broadcasting has been constrained, and I believe there are two key reasons for that. The first reason is the limited role that the Gaelic Television Committee and, later, the Gaelic Broadcasting Committee—the CCG—were given by the Broadcasting Acts of 1990 and 1996. The inability of those committees to take a more proactive role in commissioning programmes was an area of difficulty, as was their rather awkward arm's length relationship with the broadcasters that ultimately transmitted these programmes to the public. The CCG could fund programmes, but depended wholly on the BBC and the Gaelic Media Service to broadcast them.
Secondly, Gaelic broadcasting is under pressure because the Scottish Executive has seen education policy and funding as the most effective way of supporting and promoting the Gaelic language. Their ultimate goal—one that we shared when Westminster was responsible for those matters—is to ensure that the Gaelic language continues as a healthy, living indigenous language of the UK.
I am pleased that the first of those obstacles was removed, as my hon. Friend said, by the Communications Act 2003, which not only gave the Gaelic Media Service broader powers to ensure that a wide and diverse range of Gaelic programmes are broadcast and strengthened the committee with a broader representative base, but also allowed the GMS to hold a broadcasting licence, which it was not previously able to do.
However, Gaelic broadcasting remains disparate and its future uncertain. It was for that reason that in June this year the Secretary of State for Culture, Media and Sport reconfirmed her strong commitment to Gaelic and Gaelic broadcasting. She made a commitment to seek to break the current impasse and ensure a better deal for Gaelic broadcasting for the longer term. She did not hold out the prospect of Department or additional Exchequer funding for Gaelic broadcasting, and I wish to make that message quite clear, as it has been misinterpreted by some people involved in the issue. However, she is committed to looking at the future of Gaelic broadcasting within the context of the BBC charter review and the wider future of digital broadcasting.
To help to resolve some of the problems facing Gaelic broadcasting, Ofcom was asked to draft a policy options paper. Ofcom is currently finalising its "Looking to the Future of Gaelic Broadcasting" paper and we hope to use that document as a means of moving the issue forward.
Does the Minister think that it is helpful that the funding for Gaelic broadcasting has been devolved to the Scottish Parliament but that overall control of it lies here in Westminster?
The House took the decision that control over broadcasting would remain with this Parliament, but the expenditure was devolved to the Scottish Executive—a decision that was supported fully at the time. The situation is the same for Welsh language broadcasting. That is not the issue. We are discussing how the budgets have been used, and those were decisions for the Scottish Executive.
An officials' meeting is being planned for next month with the goal of refining the options in the Ofcom paper. The Secretary of State has offered to chair a meeting of all stakeholders, if necessary. We hope that that meeting will identify a clear framework for action and give firm direction for the future of Gaelic broadcasting.
I take on board what my right hon. Friend has said about trying to use the BBC charter review to break the impasse. At present, the BBC produces some 25 to 30 hours of original programming in Gaelic. If the BBC were really to step up its output to deliver to the Gaelic Media Service, it would require a huge increase. That would be welcome, but will my right hon. Friend clarify whether it forms part of the Government's thinking?
We want to have a debate with my hon. Friend and with the stakeholders with an interest in the issue. That is why my right hon. Friend the Secretary of State and the Department have made a commitment, and that is why my right hon. Friend made the statement about the BBC charter review and requested the report on the options. It is now for the officials to work through that report and, as I indicated to the House, the Secretary of State is ready to chair a meeting of all the stakeholders, if necessary, and such issues could be on the agenda. That will, we hope, determine the framework and the direction for the future of Gaelic broadcasting in the medium and long term.
The debate has been an interesting and welcome opportunity to discuss an important matter and I thank my hon. Friend the Member for Western Isles for initiating it. Although the steps we are taking are probably not wholly satisfactory to him in the financial sense, I hope that they will create a framework and give a clear direction for the future of Gaelic broadcasting. We are laying the foundations, so if and when the Secretary of State chairs the meeting, I hope that the stakeholders will respond.
Question put and agreed to.
Adjourned accordingly at twenty-five minutes past Seven o'clock.