House of Commons
Thursday 11 December 2008
The House met at half-past Ten o’clock
Prayers
[Mr. Speaker in the Chair]
Oral Answers to Questions
Business, Enterprise and Regulatory Reform
The Minister of State was asked—
Bank Lending
The credit crunch and the global economic downturn are, of course, having a serious effect on small businesses. As well as the measures to increase the availability of credit that have been set out by the Government in the pre-Budget report, my noble Friend the Secretary of State has established the Small Business Finance Forum, which involves all the major high street banks and the main business organisations. That body has drawn up a revised statement of principles covering business lending and is also monitoring the availability of credit to small business.
Some would say that the banks have been treated more than fairly, yet they have not passed on that largesse to their customers. Will the Minister look into a case where the Royal Bank of Scotland, which is one of the banks that has been bailed out, has increased fivefold the repayments required from one of the businesses in my constituency, despite an existing six-month agreement, and the fact it was a long-standing customer? That could, effectively, put 80 jobs at risk. Does he think that is fair and, given such agreements, what will he do to ensure that customers and businesses are treated fairly by the banks?
Ministers will not seek to place themselves in the shoes of bank managers and judge individual credit applications. However, of course, it is also true that many businesses have raised the difficulties of accessing credit with right hon. and hon. Members from all parties. The hon. Lady mentioned the RBS Group, which, with the NatWest Group, announced on 23 November that it would maintain existing overdraft pricing for small businesses until the end of next year. Some measures have been taken, but we are not saying that there is not an issue. That is why the Small Business Finance Forum has been established, and, indeed, why both the Chancellor and the Secretary of State will meet the high-level lending panel later today to pursue the issue further.
My right hon. Friend’s comments will give some comfort, but I draw his attention to one specific group of small firms that, even in easier times, have traditionally found it difficult to obtain finance: those firms involved in research and development. They are at the cutting edge of technology and are vital businesses in terms of the creation of future manufacturing strength and employment. Will he have a particular look at how such firms can gain access to finance in these difficult times?
In the pre-Budget report, my right hon. Friend the Chancellor of the Exchequer set out a number of measures that should help businesses to gain more access to credit. In addition to the existing small firms loan guarantee scheme, those measures included a small business finance scheme to support up to £1 billion of bank lending, a separate £1 billion guarantee facility to support bank lending to small exporters, and a £50 million loan facility based on swapping debt for equity. That is in addition to the measures announced by regional development agencies for transition loan funds. The Government have taken a number of measures to try to ease the problems of access to finance and credit, which small businesses across the country are raising with us.
The Prime Minister boasted yesterday that help has been given to small business, yet all the small businesses that have contacted me say that the banks are not well informed about the scheme, some are reluctant to promote it and many small firms are unaware of it. The Minister talked about monitoring, from which one assumes he has had some results. Will he tell us what results he has had, because my information is that things simply are not working?
I think the hon. Gentleman is referring to the small firms loan guarantee scheme. The measures that I listed in response to my hon. Friend the Member for Manchester, Central (Tony Lloyd) are in addition to that scheme and are coming on stream precisely because we recognise how important access to credit finance is to small businesses. Without such credit, businesses cannot take investment decisions and they cannot operate in the way that they should. That is why we are so active in this matter.
The measures that the Government have announced to help small business are clearly welcome, but there is a problem with small businesses knowing where to go. A plethora of initiatives has been announced, but the Government should take steps to improve one-stop shop access to make it clear to small businesses what initiatives are available. I would be interested to know what the Minister is going to do to address that problem.
My hon. Friend makes a good point. The Government have recognised a need for the simplification of information in business support schemes. Indeed, prior to the pre-Budget report, we announced a large-scale simplification of advice to businesses, collating all the different support schemes into a much smaller number. I hope that the process of obtaining advice about what help is available and where to go will be easier than it is at present. Business Link is the key place to go for businesses looking for advice on what help is available from the Government. I also think that the banks have a role to play in ensuring that an appropriate level of lending is available, so that the economy can work in the way that we all want it to.
Sharp practice by the banks clearly must be exposed and challenged, but Government interference is often not helpful itself. Why is the much-promised European Investment Bank money yet to reach our small businesses? Czech businesses have reportedly received €100 million, Spanish firms have received €200 million and French firms have received €300 million. Could the Minister tell us how much of the EIB money UK small businesses have received? I am talking about the actual businesses, not their banks.
A number of other countries have traditionally used EIB money, and that is precisely why their businesses are already receiving money. The banks in the UK have accessed up to £1 billion from the EIB, which will be channelled to small businesses.
Car Industry
We are closely engaged in supporting the UK automotive sector, both at a European level, through pressing the European Investment Bank for an €8 billion automotive support fund and domestically, through our investments in low-carbon research and development and training, and our package of support for small and medium-sized enterprises announced in the pre-Budget report.
The Minister will be aware of speculation in the newspapers that secret talks are taking place between the Government—Ministers and perhaps his officials—and the owners of Land Rover and Jaguar about some kind of financial support. I would be grateful if he would tell the House whether that is the case and whether, given the severe situation in America and in its automotive sector—General Motors is in trouble over there—the Government are also having talks with Vauxhall, which is owned by GM.
I do not want to speculate on talks that the Government may or may not have been having with a range of automotive companies. What I want to say clearly to the House is that the automotive sector is extremely important to the UK. Peter Mandelson and I publicly had a meeting with a wide cross-section of the automotive manufacturers, suppliers and retailers on 27 November. We continue to engage closely with the sector, and I am determined that we shall do everything we sensibly can to help viable businesses during these exceptional times.
Clearly these are difficult times for the motor industry. Some of the major manufacturers are going on extended breaks as a result of falling sales. Does my hon. Friend agree that, although understandable, that can cause major problems down the line in the components sector? Does he also agree that we need to take real action to ensure that our technological base in motor sport, components and other parts of motor manufacturing is maintained, not just for the sake of jobs right now, but to secure our prowess in those areas in the future?
My hon. Friend is an expert in these areas, and I agree that the integrated nature of the automotive supply chain brings real challenges for suppliers when the automotive manufacturers decide to take extended breaks. We are acutely aware of the pressures that the situation is causing a number of supply chain companies. As he is aware, the UK has about 200,000 jobs in the supply chain alone, about 500,000 in retail and about 180,000 in direct automotive production. This is a vast and important sector of the UK economy, and we need to examine what more we can do to support companies that are going through very difficult times at the moment.
I heard what the Minister said, and he cited the statistics that I was going to cite about the manufacturing and retail sectors. But continuing to engage closely is not enough; action is urgently needed. I have just come from a meeting with the Retail Motor Industry Federation, which has suggested a range of practical measures that would help it and manufacturers. Such measures include abandoning the Government’s proposals to remove the right of car retailers to claim back vehicle excise duty in respect of unused car discs and ending the Government’s punitive attack on void rates. The pathetic measures introduced by the Chancellor just will not be enough for car dealers, who will have empty premises next year. A range of things, such as introducing 100 per cent. capital allowances for commercial vehicles, could be done now—urgently—to prevent an imminent disaster, not just for manufacturers, but for retailers.
There is a range of things that the Government are already doing, such as the small business finance scheme, the £1 billion in loan guarantees, the schemes to convert business debt into equity and the transition loan fund, of which the hon. Gentleman will be aware, that exists in the west midlands and other places. I have already written to supply chain companies, through the manufacturers, outlining the package of measures that are already available from the Government. However, we need to see whether we can do anything further, because we recognise as a Government that the UK automotive industry is of critical national importance. The Government are taking action. The action that we took on the recapitalisation of the banks and through the £20 billion fiscal stimulus, which the Opposition have opposed, is about responding. We are trying to kick-start the economy and help companies through difficult times, and I hope that the hon. Gentleman appreciates the actions that we are taking.
My hon. Friend is quite right to say that the car industry is of national importance, but so is the steel industry, which provides it with the basic raw materials. He knows that Corus recently had a meeting with the Prime Minister and other Ministers. Corus is making efforts to keep the work force together, which is a welcome break from the past, because losing a skilled work force makes it difficult when things turn around. Will my hon. Friend assure me that the Government will give Corus whatever assistance is appropriate to see it through this difficult period?
As I have said, we want to do all that we sensibly can to help viable businesses. My right hon. Friend will be aware from reports in the newspapers today of the discussions that Corus has been having with the unions about taking a pay cut, and of the other measures being taken to see people through difficult times. Whether we are talking about the steel, automotive or construction industry, the global credit crunch and the recession that we are all facing are bringing enormous challenges to companies, to people who work in them and to Governments. We need to ensure that we are up to the mark and are taking action to support our companies through these difficult times, and that is exactly what we are going to do.
As has already been said, the car manufacturing industry is a major part of British industry, as well as a substantial employer. Given that President-elect Obama has decided that the US car industry is too large to fail, what assessment has the Department made of the potential for a failure in the car industry to give rise to a systemic failure in UK plc? Would the Government consider a similar decision, and if so, what criteria would they use to make the judgment?
I have already quoted figures that demonstrate the importance of the automotive sector to the UK economy, and I do not need to repeat them. The Government are engaging with the automotive industry on a daily basis about the problems that it faces. We have already taken a range of measures to support companies, particularly some of the small and medium-sized companies in the supply chain, with the schemes that we have made available, which we are widely publicising to the industry.
There is a case for saying that we need to do more and we are actively considering that. I can only repeat that the circumstances in which we find ourselves are circumstances that we have not seen for more than a generation. Sales have fallen off a cliff. The November figures show that UK car sales are down by 37 per cent. The situation is the same in the United States and sales are down by 50 per cent. in Spain. Although they have declined less in France, Germany and Italy, the declines are still significant. When companies’ sales disappear, we need to ensure that we bring back confidence to the market as quickly as possible, which is why the fiscal stimulus is so important and why it is irresponsible of the Conservative party to oppose it.
Credit Availability
We understand that credit is a serious issue for business. That is why the Chancellor announced a number of measures in the pre-Budget report to improve access to credit, including the new small business finance scheme, which could make available up to £1 billion of additional credit, the export lending scheme and the transition loan funds that will be available through the regional development agencies in many parts of the country.
I would be interested to learn from the Minister about the methodology involved in the Government being able to get information, other than that provided by the banks, on the provision of credit to small businesses. He might be interested to know that, according to the Croydon Guardian, the chief executive of South London Business reports that many perfectly solvent businesses are being damaged, as many other Members have said, by the speedy removal of credit and the early calling away of debt. Many companies that are cashed out and close to being in default will be at risk if the Government are unable to bring forward measures in a speedy way to ensure that such companies are bailed out.
We are bringing forward measures, as I have said. There is a disjunction between what small businesses are reporting to the hon. Gentleman and many other hon. Members on both sides of the House, and what the banks are saying about the availability of credit. That is precisely why we have brought business and bank representatives together in the Small Business Finance Forum to examine the facts and to find out exactly what is happening in the lending market.
The Minister is a fellow west midlands MP, and he will know that many businesses throughout the region cannot get credit from the banks. Why is it that, within hours of coming to the Government, the banks received a big fat cheque from the taxpayer, when businesses in Shropshire, even after many weeks, cannot get the credit that they need to run on a day-to-day basis?
Had we not taken the action that we took to recapitalise the banks and inject more credit into the system, there would have been a danger of a complete seizure in the banking system, which could have had a catastrophic effect on the wider real economy and on the businesses that the hon. Gentleman is worried about. That is why it was entirely right for the Government to take that action to stabilise the banking system. We now need to ensure that lending at an appropriate level is available to businesses in the wider economy, and that is why we are working with the banks and why we have taken the measures that were announced in the pre-Budget report.
I recently met representatives of the Civil Engineering Contractors Association to discuss the impact of the downturn on its members, which include small businesses and some of my constituents. They broadly welcomed the measures that the Government have introduced to assist them with credit, but said that there were still some issues. They were also concerned about the small firms loan guarantee scheme, and gave me examples of their members being told that it would take four months for the process to go through. That is causing real hardship. Will my hon. Friend look into those delays and see whether anything can be done to speed the process up, so as to avoid the loss of jobs and skills in the sector?
It should not take four months for loans to be processed through the small firms loan guarantee scheme, and I will certainly follow that up for my hon. Friend if she gives me the details. The combination of measures that we have taken, including that scheme and the other measures announced in the PBR, are designed precisely to take action with regard to the problem that we are all concerned about—access to finance for small and medium-sized businesses, which are the lifeblood of our economy and which provide so much employment for our constituents.
As it is clear that, in this recession, the biggest single problem facing most businesses is a lack of credit, does the Minister not see that his small firms loan guarantee scheme is inadequate, and that he should take up our proposal for a national loan guarantee scheme? It would cost a lot more money, but it would be paid for by scrapping the ridiculous reduction in VAT, which has not helped industry at all.
Our proposals are not restricted to the existing small firms loan guarantee scheme because, as I said, the Chancellor announced additional measures. As to the right hon. Gentleman’s party’s proposals, the Conservatives really need to make up their minds. The other day, his party leader attacked us over our level of spending and borrowing; the Conservatives have now announced a new scheme, but we have not yet been told about the balance of risk between the Government and the banks or the exposure of the taxpayer to the scheme. If more action is needed, this Government have said that we will take it, but I can assure the right hon. Gentleman that, unlike what happens in his party, any measures we announce will be properly costed and thought through.
When the Secretary of State appeared before the Business, Enterprise and Regulatory Reform Select Committee, he made the valid point that it was important that bank bosses’ promises on lending got through to banks on the ground. This morning, I received a Christmas card from the Federation of Small Businesses Scotland—[Hon. Members: “Ah.”]—and a very nice one it is, too. It is a letter to Santa, which refers to overdrafts renegotiated, rates trebled and charges of £150 for the privilege. That is the reality on the ground. When the Minister has a summit with bank leaders, what other action will he take to ensure that any promises made to small businesses are actually carried out by bank managers on the ground?
It is important that any statements made by banks about the availability of lending are reflected in the reality on the ground. That is why the Small Business Finance Forum has updated the statement of principles that govern lending by banks to small businesses. I referred to RBS earlier, but Lloyds TSB has announced a charter for small businesses, which commits to maintaining overdraft limits and margins at existing levels, and HSBC has announced a £1 billion business support fund for UK small businesses to fund working capital. Some action has been taken, but we will, of course, continue to work with the banks to ensure that the sort of statements made by the banks and mentioned by the hon. Gentleman actually feed through to the small businesses in his and other constituencies.
The real truth is that businesses are increasingly desperate because their credit lines are drying up, the cost of borrowing has increased dramatically and credit insurers are refusing to underwrite the payment chain. Surely the Minister would agree that the recapitalisation of the banks has not yet filtered adequately, if at all, into the real economy. Why, then, has he chosen to reject our clear policy for a national loan guarantee scheme that would augment and underpin credit lines in a way that no Government policy yet does—or is he really saying that the Government have no ideas of their own and are simply rejecting it because it has on it the label, “Not invented here”?
We announced a loan guarantee scheme in the pre-Budget report, based on a balance of risk sharing between the Government and business. As far as the hon. Gentleman’s proposal is concerned, as I have already said, the Conservatives have not made clear what proportion of the loans would be underwritten or what balance of risk will be shared between the Government and the lenders. It is important that proposals in this area are properly costed. That is what we have done and if further action is needed to help small businesses, we will not hesitate to take it.
But one thing the Government could definitely do to extend credit to businesses is to let them delay their VAT payments. Yesterday the Prime Minister said at Prime Minister’s questions that that was his policy and it should happen, but businesses are saying that, in fact, they are not being allowed to do that because Her Majesty’s Revenue and Customs says, among other things, “Oh no, it would give such a company a competitive advantage.” How can the Minister reconcile what the Prime Minister says one day with what is actually happening on the ground, and what instructions—what clear instructions—have the Government given to HMRC about the deferral of businesses VAT?
The Chancellor announced in the pre-Budget report that HMRC would, on a case-by-case basis, allow businesses to spread their tax and VAT payments over a longer period of time. It is not the case that they have all been refused, as the hon. Gentleman claims that they have. It is judged, as I said, on a case-by-case basis.
In terms of policy—I know that the Conservatives like a leak—perhaps I should draw attention to the hon. Gentleman’s approach. I have an e-mail to him from his colleague, the hon. Member for Hertford and Stortford (Mr. Prisk)—
Order. We will not bother with that.
Car Industry
We have wide-ranging contact at all levels with the automotive industry. The Secretary of State for Business, Enterprise and Regulatory Reform and I met automotive manufacturers, suppliers and retailers on 27 November and we continue to have close dialogue.
Factories such as Nissan in Sunderland, Honda in Swindon and Toyota in south Derbyshire have components supplied by extensive networks of much smaller firms, which, lacking significant cash reserves, suffer disproportionately as car production is scaled back. Does the Minister agree that a possible erosion of jobs in parts suppliers by up to 25 per cent. will reduce the anchorage of car plants in the UK, with remaining firms sourcing much more from abroad? Further to the question asked by my hon. Friend the Member for Birmingham, Northfield (Richard Burden), what steps is the Minister taking to ensure British component firms have the necessary access to credit to enable them to trade through the deepening recession?
My hon. Friend is absolutely right to point to the importance of the supply chain and UK automotive manufacturers sustaining it in the future. Clearly, some of the major difficulties that the automotive industry faces have an impact on the supply chain. We saw Wagon Automotive going into administration in the UK only very recently. Any job losses are regrettable.
As a Government, we need to ensure that we continue to provide measures—the finance that is available—to the sector. As I explained, I have written to automotive suppliers, through the lead manufacturers, outlining a range and package of measures that are on the table and available now or will be available very shortly. Again, we need to see whether there is more that we can do to help some of the companies that are viable but are facing unprecedented shocks to their businesses as a result of the problems that we are seeing internationally.
Will the Minister confirm that it is not just about the manufacturers, or even the component manufacturers, but about the national network of dealerships, which employ dozens, if not hundreds, of people in each of our constituencies? As we know, they are struggling and have had a very bad year. Will he help them by the clarifying precisely which cars will have their vehicle excise duty increased over the next year or two, because people out there are still completely confused by this and it is acting as another deterrent to cars being sold? Will the Government enter into a campaign to demonstrate precisely which cars will have their VED reduced or increased, and clarify the situation for the people at large?
The hon. Gentleman is right to point to the importance of the retail end of the industry and the car dealership networks that exist in the UK. They employ significant numbers of people. While they might not be as geographically concentrated as some of the big automotive plants, the cumulative effect is that something like 500,000 people work in that retail sector. What we said about VED in our pre-Budget report was clear, but I will talk to some of my colleagues and officials in the Treasury to see whether there is more that we might need to do to ensure that that information is widely available. The industry as a whole has welcomed the announcement that we made on VED. We need to ensure that we actively promote it.
My hon. Friend will be aware that many small companies in my constituency are second, third and fourth-tier suppliers to the car industry. If they go under, it will not only be a tragedy for the employees of those companies, but it could undermine our future industrial capacity to meet the upturn when it takes place. Will he undertake to listen to their submissions and work on policies, but above all will he examine the potential role that Government procurement could have in the motor industry to sustain demand at this time when it is most needed?
My hon. Friend has made some key points. Obviously the development of lean production techniques and “just in time” manufacturing has led to a hugely interrelated supply chain. If one part of it suddenly breaks down, major problems can be caused to the process of making cars, so it is right for automotive companies themselves to take a close interest in the financial performance of their supply base. A number of companies have given their suppliers credit to ensure more prompt payment and to help the supply chain through difficult times.
I am not sure that a major Government programme of purchasing new cars would be effective. What we want is for people to start buying cars again because they feel confident about the future, and there are some pretty good car deals around at the moment.
The Government have already introduced a substantial bail-out package for the banks, and there have been calls for them to do the same for the automotive sector. Will the Minister tell us precisely what the policy is on the use of further taxpayers’ funds for future rescue packages, to enable the half million employees in the sector to whom the Minister referred to know exactly what they can and cannot expect from their Government?
We were absolutely right to make the decision to recapitalise the banks. Even the Conservatives have welcomed that decision, although they have cavilled at measures such as our credit guarantee scheme. The scheme is effective, and by the end of the year some £100 billion worth of guarantees will have been issued.
As I have said, it is important for us, as a Government, to see what we can do to help viable businesses through difficult times. We are engaged in a contingency planning exercise and we are considering a number of possibilities, which is the right thing for us to do. We will continue to consider what further sensible measures we can take to support the automotive industry during the current incredibly difficult period.
Topical Questions
Our Department is concentrating fully on working with businesses through what is a difficult economic period, and ensuring that British business can emerge from the downturn in as strong a position as possible.
In the absence of the Secretary of State, I must rely on my right hon. Friend, as his political amanuensis, to interpret Lord Mandelson’s views as reported in The Sunday Times last week. He said that
“it was up to individual companies to sort out their own future if they ran into trouble… ‘We”
—the Government, that is—
“‘are not going to step in when banks and other lenders are capable of doing it themselves.’”
What does my right hon. Friend think Lord Mandelson meant by that, against a backdrop of potentially the worst economic situation for generations?
What that means is that the Government cannot and should not seek to replace the role of the banks as the main lenders to the economy. We have introduced a number of measures—which I have mentioned several times today— to give small businesses access to finance, but the main lenders must be the banks themselves, and that is precisely what my noble Friend Lord Mandelson meant.
The hon. Gentleman did give notice of the question. My understanding is that the company has laid off a number of people and is having difficulty meeting the redundancy payments that may be involved in doing so. There is a scheme: the financial difficulties scheme under the Insolvency Service. It is designed to avoid both stress and delay in employees applying under such a scheme. Under this scheme, the Redundancy Payments Office can pay employees the redundancy payments to which they are entitled against an agreement from the employer to reimburse the national insurance fund over time. I am happy to look further into that matter for the hon. Gentleman.
My noble Friend the Secretary of State yesterday met major businesses and the Institute of Credit Management to agree a code of prompt payment from large businesses through their supply chains. The Government have said they will do their best to be a good and responsible customer during this period, and we understand the importance of prompt payment to small businesses. I entirely agree with my hon. Friend that this is a job not just for Government, but for the many large businesses upon whom countless thousands of small businesses depend for prompt payment and their day-to-day business.
The hon. Gentleman might be aware that the Business and Enterprise Committee is currently looking at the issue. We are closely watching the different strands of evidence that are presented to it, and we will carefully consider any recommendations arising from the Committee’s work. As he alluded to in his question, pubs are crucial small businesses in many communities and, as he will be aware from the answers that my ministerial colleagues have already given, the Government are taking a series of initiatives to help small businesses, and pubs might be able to access them as well.
A written statement was issued this morning extending the compensation given to Icelandic waters fishermen to aggregate service not interrupted by 12-week breaks. That will be warmly welcomed in all the fishing ports, but will my right hon. Friend tell us what estimates he has of the number of fishermen affected? In terms of the unacceptable proposal to extend the conditions to requiring two years of service during the cod wars, will he bear it in mind that there were in fact three, if not four, cod wars, two of them in the 1970s?
I thank my hon. Friend for his welcome for the written ministerial statement tabled today, which is in response to the ombudsman’s recommendations on the Icelandic waters trawlermen’s compensation scheme issued last year. The statement says that we will run a new scheme based on aggregate service and not using the previous breaks rule. We estimate that that will benefit about 1,000 former trawlermen, who should receive additional payments. I pay tribute to my hon. Friend and all Members representing port communities who campaigned so hard and effectively for their constituents on the issue, and I hope he is right that this news will be warmly welcomed in port communities that have been affected over the years.
I hope that the hon. Gentleman will forgive me for not knowing the specific details of what happened to that question, but I will investigate what happened and get back in touch with him by the end of the week.
May I add my warm congratulations to my right hon. Friend the Minister for Employment Relations and Postal Affairs on the statement that he made this morning about opening up the cod war trawlermen’s compensation scheme and on finding an answer to a very difficult problem? He will be aware that many of the people who will qualify under the new scheme are elderly, and some have died and their widows are also elderly. Can he give us some idea of the programme for the introduction of the scheme, because it needs to be done quickly?
My hon. Friend makes a good point and I know that he has campaigned hard and effectively on that issue. We are aware that this has taken a long time. It is a complex scheme because, as my hon. Friend the Member for Great Grimsby (Mr. Mitchell) said, we are often dealing with fishing records going back for some decades. I can assure my hon. Friends and other Members with an interest in this area that we will implement the new scheme as quickly and efficiently as possible.
If I may quote the Secretary of State who, when asked about the timing of that report in the House of Lords a couple of weeks ago, said, “Not before too long.” I echo that. In terms of the USO, I remind the hon. Gentleman that it was this Government who enshrined the USO in primary legislation.
Church Commissioners
The hon. Member for Middlesbrough, representing the Church Commissioners, was asked—
Church Collections
Collections in churches totalled £56 million in 2006, the last year for which figures are available. However, that is only a small part of the regular committed giving of members of the Church of England, most of which is by standing order. Total income from donors was nearly £537 million, including £70 million of reclaimed gift aid.
I congratulate the Church Commissioners on the staggering amount of contributions from the worshipping public. Do the Church Commissioners anticipate a reduction in the amount received because of the credit crunch? If so, will the hon. Gentleman join me in renewing our campaign to obtain a reduced VAT rate on church repairs, now that we have established the principle that the Prime Minister is minded to lower VAT in certain circumstances?
I am grateful to the hon. Lady for making that point. I should point out that the average donation to the Church of England is £8.64 a week, or £450 a year, but that is more than double the amount given by the average adult in the UK to all the other charities they support, so the Church clearly benefits from that dedication. The question of reducing VAT further is a problem throughout the European Union, as we need the consent of all the other member states. We have a reduction in VAT through a method introduced by the Prime Minister when he was Chancellor of the Exchequer. That is still available and it has no time limit.
Public Accounts Commission
The Chairman of the Public Accounts Commission was asked—
NAO Headquarters
We approved extra funding because the initial work identified problems with asbestos, structural defects and, unexpectedly, construction-cost inflation. Those problems could not have been anticipated at the outset.
In view of the extra funding, can we be sure that the project will still deliver its original aims and meet its 2009 deadline? Will the revised budget of £83.24 million be the final figure?
The NAO has given us an absolute assurance on all those points. It will deliver on time next year, and within the new budget.
The right hon. Gentleman will know of the John Tiner report into the governance of the NAO. What does he think that the auditors will say about the refurbishments? Are there any plans to rotate the auditors?
We do rotate the auditors, and I cannot envisage that they will have any problem with these budget increases.
Church Commissioners
The hon. Member for Middlesbrough, representing the Church Commissioners, was asked—
Church Estate (Water Services)
It is estimated that the new annual charge for surface water drainage will cost Church of England churches and cathedrals around £5 million or more. Churches using the public sewers will also be liable for highways drainage contributions at an estimated cost of around £10 million per annum.
By way of a statement, we are deeply concerned about the impact of these charges on the local work of the Church and other faith groups.
Do we not have enough difficulty finding funds to run and maintain our churches without the water companies adding to the burden by adding to their profits? Does my hon. Friend intend to seek meetings with Government and others to rectify the situation?
I am grateful to my hon. Friend for that question. Representations have been and continue to be made to the Government on that issue. We have looked at it carefully and are not convinced that it is all a matter of water company profits. The companies maintain that the change will be cost neutral as it redistributes charges falling on different categories of non-household customers. That includes businesses, churches, charities and community bodies. However, it is having a considerable effect on our churches.
I have been working on this problem with the diocese of Salisbury, and it has been reported to me that Wessex Water believes that the changes to the charging regime would come into operation only on change of ownership of the property involved. On the face of it, that would seem to make it unlikely that a church would be affected, but what would be the impact of a change from freehold to common tenure? I do not expect the hon. Gentleman to know the answer to that question today, but will he please let us know?
I am relieved that the hon. Gentleman does not expect me to answer that off the top of my head, and I would not wish to do so. It is a matter worthy of study, and I shall give him a specific response, and place a copy in the Library.
Is it not absolutely outrageous that the water companies charge churches and other similar bodies for the disposal of surface water? Rain comes from heaven: it does not cost the water companies anything yet they charge us for it. Why the devil are the Government allowing them to charge churches for the disposal of surface water? It is outrageous.
He voted for privatisation.
I am sure that the hon. Gentleman does not wish to answer his own question. I am happy to do that, but he knows that mercy is like the rain, gentle from heaven above. Unfortunately, the water company charges are not from heaven, but are induced and calculated. I support what he says, and agree that this is a Church-wide issue: a Teesside clergyman at St. Luke’s, North Thornaby has reported to me that his church has experienced a rise in its water charge of 1,300 per cent. His church warden created a petition on the No. 10 website, and so far it has attracted 37,000 signatories. Given the hon. Gentleman’s views, perhaps that total will now rise to 37,001.
Public Accounts Commission
The Chairman of the Public Accounts Commission was asked—
NAO Financing
The Public Accounts Commission monitors the financing and cost-effectiveness of the National Audit Office, especially when considering the NAO’s three-year corporate plan and when approving its estimates for the coming year.
I am grateful for that answer. Is it not the case that the NAO has a target of saving the taxpayer £9 for every pound that its operations cost? Would the NAO not be able to do that much more easily if it had a proper grip on the £250,000 million-worth of private finance initiative projects, which are prohibitive in cost, flawed in concept and intolerable in consequence? Alternatively, the NAO could get a grip on Her Majesty’s Revenue and Customs to bridge the tax gap, which at a minimum is at least £25 billion a year, in tax avoidance by the best-off individuals and the 700 largest corporations.
I should like to comfort my hon. Friend, as I know he gets very anguished about the National Audit Office. It has in fact progressively increased its performance. When I first went on to the Public Accounts Committee—I think it was in 1990—the ratio was 5:1 and at the request of the Public Accounts Committee and the Public Accounts Commission, the ratio has gradually increased to 9:1. A nice ballpark figure for my hon. Friend to remember is that as a result of that, in the last 18 months the NAO has saved the taxpayer £1 billion.
Church Commissioners
The hon. Member for Middlesbrough, representing the Church Commissioners, was asked—
Church Restoration
Church of England staff have been meeting officials from the Treasury, the Department for Culture Media and Sport, the Department for Communities and Local Government, the Office of the Third Sector and the Department for Environment, Food and Rural Affairs. The Church Commissioners encourage continued financial support for the English Heritage and Heritage Lottery Fund places of worship grant scheme. The Church’s discussions with the Government are focused on securing equal access to national and local government funding streams, and are ongoing.
I thank the hon. Gentleman for his reply. Does he agree that churches are a vital part of our Christian heritage and that everything possible should be done to protect and restore English churches? Will he accept an invitation to my constituency to visit St. Alban Protomartyr in Princes road, Romford to see the exceptional work of Father Roderick Hingley, who has raised money through public donations? Will he come to see that work, which is an example to others?
I am grateful to the hon. Gentleman for his kind invitation. He has made me an offer I cannot resist. Nearly half the population think that central taxation, local taxation, the national lottery or English Heritage should primarily be responsible for providing money to maintain churches and chapels. It is not something that I would wish to lay entirely at the state’s door but it should not be left entirely to the Church. I should like a better funding partnership. I welcome the hon. Gentleman’s invitation and I shall be happy to take it up.
Chancel repair obligations remain a medieval scandal and a nice little earner for the insurance industry, or a total disaster for the people who find that they are liable for them. There is a terrible degree of uncertainty among the churches where such obligations apply. There have been suggestions that the obligations should end, but the Church Commissioners appear to be running a policy of raising more money through chancel repair obligations, which will mean that more of our constituents become subject to a financial disaster of which they had no knowledge. Will the hon. Gentleman recommend the ending of that obligation?
I am grateful to the hon. Gentleman. He raises a matter of which I have no particular personal knowledge, but I will be glad to look into it, to give him a full report and possibly to put it in the Library.
Public Accounts Commission
The Chairman of the Public Accounts Commission was asked—
Tiner Report
We agree with John Tiner’s recommendation, subject to retaining the requirement that the commission approve the auditors’ appointment. The NAO’s audit committee will recommend a firm to the NAO board, which will appoint the auditors, subject to the approval of the Public Accounts Commission. The NAO already rotates its auditors—something that concerns the Government—in line with best practice.
I am grateful to the right hon. Gentleman for answering the question twice. Would it not have helped if the banks had followed that practice of rotating auditors, as they might not then have got into such a mess?
Certainly, that is best practice at the moment, and it is thoroughly recommended. If the banks have not been doing it, it is about time that they started doing it.
Business of the House
Will the Leader of the House give us the forthcoming business?
The business for next week is as follows:
Monday 15 December—Conclusion of the debate on the Queen’s Speech. The economy, pensions and welfare will be debated.
Tuesday 16 December—Estimates (1st Allotted Day). There will be a debate on energy prices, fuel poverty and Ofgem, followed by a debate on dental services. Details will be given in the Official Report.
[The details are as follows: Energy prices, Fuel poverty and Ofgem (Eleventh Report from the Business and Enterprise Committee, HC 293; Government response— Seventh special Report HC1069; and further Oral Evidence of 24 and 25 November); and Dental services (Fifth Report from the Health Committee, HC 289; and Government response—Cm 7470).]
At 10 pm the House will be asked to agree all outstanding estimates.
Wednesday 17 December—Proceedings on the Consolidated Fund Bill, followed by Third Reading of the Banking Bill, followed by motion to consider the Value Added Tax (Change of Rate) Order 2008, followed by motion to approve a resolution relating to parliamentary pensions. I have tabled that motion today. Copies of the explanatory memorandum and the motion are available from the Vote Office. That will be followed by motions relating to the Electoral Commission.
Thursday 18 December—Motion on the Christmas recess Adjournment.
The provisional business for the week commencing 12 January will include:
Monday 12 January—Second Reading of the Business Rate Supplements Bill.
Tuesday 13 January—Second Reading of the Saving Gateway Accounts Bill.
Wednesday 14 January—Opposition Day (1st Allotted Day). There will be a debate on an Opposition motion. Subject to be announced.
Thursday 15 January—Topical debate: subject to be announced, followed by a general debate on armed forces personnel.
We expect to have an oral statement on Equitable Life in the week commencing Monday 12 January.
I should like to inform the House that the business in Westminster Hall for January will be:
Thursday 15 January—A debate on the report from the Northern Ireland Affairs Committee entitled “Policing and Criminal Justice in Northern Ireland: the Cost of Policing the Past”.
Thursday 22 January—A debate on the Department for Culture, Media and Sport annual report 2008.
Thursday 29 January—A debate on the Inter-Parliamentary Union.
Before I come on to the forthcoming business, as these are the last business questions before Christmas, may I take the opportunity to wish you, Mr. Speaker, all the staff of the House and all right hon. and hon. Members a very merry Christmas and a happy new year? [Hon. Members: “Hear, hear.”]
On the future business, however, I note that the Leader of the House announced a statement on Equitable Life in the first week back after Christmas. Last week, the Prime Minister promised to the House a statement on Equitable Life before Christmas. So will the Prime Minister come to the House to explain why his Chancellor is not doing what the Prime Minister promised the House he would do? Given that the Leader of the House, on numerous occasions, told us that the statement would be given in autumn, perhaps she can explain why this is the first time in living history that autumn has extended into January?
Climate change! [Laughter.]
I will give the hon. Gentleman that one.
Following the disclosure yesterday by the chief executive of Ofsted that three children are killed by abuse every week, the Secretary of State for Children, Schools and Families is today due to announce a major shake-up in social services under the children’s plan. This announcement is in a written statement. Why has the right hon. Gentleman not come to the House to be questioned by Members on this crucial issue?
When the Government announced approval for two new aircraft carriers in July 2007, the Defence Secretary made an oral statement. Today, when it is widely reported that he is to announce a delay in their approval, the Defence Secretary is making only a written statement, which, I understand, was not even available in the Vote Office or the Library at the start of business questions. That written statement will, of course, prevent Members from asking key questions about the impact on the defence budget, on jobs and on national security. Again, why is the Defence Secretary not making an oral statement to the House?
Yesterday, the Secretary of State for Work and Pensions made an oral statement on welfare reform, but will the Leader of the House explain why, the day before, the right hon. Gentleman released an extract from his statement to the press? That was a blatant disregard of his duty to the House. Will the right hon. and learned Lady reassure us that she will speak to her Cabinet colleagues and tell them that this House takes precedence over the media?
Last year, in the final business questions before Christmas, I asked the Leader of the House to
“commit to a debate on the economic slow-down, and the problems in the banking industry and their effects on the housing market”.—[Official Report, 13 December 2007; Vol. 469, c. 465.]
She did not give us a debate in Government time then, and she has not given us that debate a year later; the debates on the economy have been chosen by the Opposition. Given that that the pound has now hit its lowest level against the euro and the German Finance Minister has said that the Government’s switch to “crass Keynesianism is breathtaking”, when will the Government give us a full debate in Government time on the economy?
Yesterday, I had a meeting with representatives of Derby and Nottingham chamber of commerce, who expressed dismay at the Government’s announcement this week on home information packs. As the housing market continues to plummet, the Housing Minister is cancelling provisions that allowed sellers to put their homes on the market before the HIP was completed. Sellers will now have to wait longer and have a raft of paperwork in place before they can even put their home up for sale, which is hardly the way to stimulate our stagnant property market. Can we have an oral statement from the Housing Minister, so that Members can question her on that ridiculous policy?
The Leader of the House recently asked the women’s institute to put pressure on local newspapers not to carry advertisements for the sex industry. What a pity that she cannot persuade the Secretary of State for Work and Pensions to join her campaign. A new report shows that Jobcentre Plus advertised 351 vacancies in the adult entertainment industry last year, including adverts for
“topless/semi nude bar staff”
and “nude cleaners”. Two jobseekers complained that they were asked to perform sexual services after contacting an employer about a vacancy advertised at Jobcentre Plus. Will the Leader of the House, in her role as Minister for Women, take steps to end this hypocrisy within Government?
Finally, last week at The House Magazine “Year ahead in Parliament” conference, when talking about the economy, the right hon. and learned Lady said
“I know what it’s like for everyone, stuck in a job with an outrageous boss”.
How can she possibly say that about the man who saved the world?
The right hon. Lady mentioned Equitable Life. I acknowledge that we said that the statement would be ready in the autumn, but it is important to note that the issue has its roots in problems that started in the 1980s. In the summer, there was a substantial report from the ombudsman that needed consideration. We are talking about important issues, and if the Treasury needs to dot the i’s and cross the t’s, it should do so. Surely it is more important that the report is properly considered before it is brought to the House than for us to have an artificial timetable. The statement will be made in January.
The Secretary of State for Children, Schools and Families has made a number of statements on the children’s plan. Issues to do with it were set out in the draft legislative programme, and there have been a number of statements, debates and discussions on it.
The right hon. Lady also mentioned aircraft carriers and the armed forces. There will be a debate on that in the week in which we return from the recess. [Interruption.]
The right hon. Lady talked about welfare reform—[Interruption.]
Order. The Minister is replying to questions. [Interruption.] Order. It ill becomes hon. Members—and right hon. Members, for that matter—to barrack a Minister who is giving a reply in good faith. It should not be done.
On welfare reform, we make no apology for constantly considering how we can ensure that people who lose their jobs are helped into work as quickly as possible, and how we can increase the requirement on people not only to look for a job, but to be prepared to receive support that gets them to a position in which they can get a job. I absolutely agree with the right hon. Lady that there is no way that jobcentres should be used as places in which to advertise jobs in sexual services, lap-dancing jobs, and jobs in sex encounter establishments. I raised the issue with the Secretary of State for Work and Pensions, and he is reviewing the situation. We do not want any of those sorts of jobs in our jobcentres.
The right hon. Lady wished the House a merry Christmas. She obviously hoped that there would not be a business statement next week, but I have to disappoint her; there will be a business statement next week, so she can repeat her Christmas greetings then.
The right hon. Lady mentioned the economy. There will, of course, be a debate on the economy next Monday. As far as the German Finance Minister is concerned, Germany went into this world economic crisis with higher levels of unemployment and Government debt than us. However, it, too, has sought to recapitalise its banks; it, too, has benefited from a cut in interest rates; and it, too, has provided fiscal stimulus—in its case of €31 billion. It has taken action on its economy, and we have taken action on ours.
As for the man who saved the world, I would rather have Superman than the leader of the right hon. Lady’s party, who is the Joker. [Interruption.]
The Opposition obviously did not like that. Wonder Woman does it again.
Seriously, I am sure that my right hon. and learned Friend will join me in congratulating Mr. Ron Cox, one of our Doorkeepers. He is nicknamed “the father of the Doorkeepers” because he is the longest-serving of them. He looks an awful lot younger than he is—I did not believe that he was up for retirement. Will my right hon. and learned Friend join me in putting on record the House’s thanks for all his hard work, done in an efficient, professional and pleasant way, and wish him and his family well in his retirement?
I endorse my hon. Friend’s comments, and thank not only Ron Cox, the father of the Doorkeepers, for all his years of service to the House, but all the Doorkeepers and staff who work so hard on behalf of Parliament.
May I first associate myself with the timely request from the hon. Member for East Lothian (Anne Moffat)? We send our best wishes to Ron Cox, his family and his colleagues.
May I join the strong protests from the right hon. Member for Maidenhead (Mrs. May) on two matters that are quite inexcusable? First, every week, my constituents ask me about the Equitable Life statement, and I am sure that that is the case, too, for other hon. Members. We have told them, “Yes, it has taken too long for the Government to respond to the ombudsman’s statement, but there will be a statement before Christmas.” Autumn ends on21 December according to the latest definition, but the statement has now been postponed until the new year. Will the Leader of the House relay to the Prime Minister, the Chancellor and to other colleagues that to promise a statement of such importance to so many people, but then not to deliver it, undermines confidence in their ability to respond?
Secondly, may I make the strongest protest about the fact that yesterday we had a full day’s debate on foreign affairs and defence, but there was no word of an announcement about the aircraft carriers, HMS Queen Elizabeth and HMS Prince of Wales. The Order Paper, however, shows that there is a written statement today, which clearly indicates that there will be a postponement of that aspect of defence procurement. On behalf of many of my right hon. and hon. Friends, and of many people with jobs and job interests in all parts of the country, may I say that it is not acceptable to announce good news on the Floor of the House and bad news later, so we cannot quiz the relevant Minister on the basis of the statement, when it is placed in the Library and the Vote Office?
May I ask the Leader of the House to amend her planning for next week to make sure that the Minister for Trade, Investment and Consumer Affairs appears before the House? On 26 November, there was a credit card summit, at which I gather the Secretary of State for Business, Enterprise and Regulatory Reform and the Minister for Trade, Investment and Consumer Affairs asked credit and store card companies to consider a reduction in the amount of interest that they charge on credit cards. Those charges have gone up in the past 12 months to an average 17.7 per cent., which, for most people who face the prospect of having to buy things at Christmas, is not the right way for them to go—they are far too expensive. There is a meeting today between those companies and the Minister for Trade, Investment and Consumer Affairs, at which the companies will report whether they have heeded the Government’s request to cut profits and help consumers. Will the Leader of the House make sure that the Minister comes to the House to answer questions, so we can see whether the Government have persuaded those companies that they have to help consumers?
Next Thursday’s business for Westminster Hall is a debate on the report by the Foreign Affairs Committee on human rights around the world, which is very welcome. However, before we break for Christmas, may we have a debate on human rights in this country? May we have a statement from the Home Secretary on what she is going to do about the case of S and Marper, in which the European Court decided that DNA samples from innocent people cannot be kept—many of us have been saying that for a long time—so the Government will have to change their policy? May we have an explanation why my noble Friend Lord Lester of Herne Hill has resigned as the Government’s adviser on constitutional affairs, saying that, after a good start, the Government’s recent record was “dismal and deeply disappointing”, and why the Government persist in wanting to go ahead with identity cards, even though all the evidence is that they are going to be ridiculously expensive and inefficient?
Finally, on the business of the House, will the Leader of the House tell us about any follow-up to the debate on Monday, and whether she has had a conversation with you, Mr. Speaker, or your office, about what is going to happen to the Committee that she, with her colleagues, forced on the House against our understanding of your wishes? I am sure that she knows the figures: only one colleague not in the Labour party voted for her position on Monday, and colleagues from the Labour, Conservative and Liberal Democrat parties, Plaid Cymru, the Scottish National party, Respect and the independent groups voted against her. All but a handful of Labour Ministers were present, but the Government majority was four. If she wants to have the confidence of the House, may we have a new proposal for a Committee, as Mr. Speaker recommended, and may we have it soon?
The hon. Gentleman returned to the question raised by the shadow Leader of the House about Equitable Life. During the course of business questions in earlier months, I tried to give a sense of timing with regard to when this important statement would come before the House. If hon. Members think that that raised expectations and was insufficiently specific, I could have said, “This statement will come before the House when it is ready,” but I was trying to be helpful. It is in that spirit that I say that I hope that there will be an oral statement next week, but we are trying to be as helpful as possible, and the House will recognise that this is a big issue. There is a big report to be considered and we cannot be that specific about when it will be available, but we will try to give as much indication as possible.
As far as defence procurement is concerned, work is under way on the aircraft carriers that have been procured, and that work will be carried forward. It is important that Government policy is that public procurement, whether in housing, transport or defence, is brought forward, because many jobs depend on it.
The hon. Gentleman asked about consumer affairs and credit cards. I have said that there will be a debate on Monday on the economy, but we had Business, Enterprise and Regulatory Reform questions just this morning, when he could have put those questions to Ministers. We know that those issues are important, and that they should be kept before the House, which should be given an opportunity to hear from Ministers as regularly as possible.
The hon. Gentleman mentioned human rights and the European court case that dealt with the retention of DNA. I have two things to say about that. First, I find it ironic that other hon. Members—not the hon. Gentleman—protest about the violation of human rights, but would abolish the Human Rights Act. That is inconsistent. The hon. Gentleman does not share that inconsistency, but if one of his constituents were the victim of crime, they would want the police to be able to find the offender and bring them to justice. DNA evidence is vital in ensuring that the police can find people, especially in cases of rape and other sexual offences. It means that offenders who would have escaped justice are brought before the courts and punished. DNA records are very important in the detection and investigation of crime, but we will, of course, consider the implications of the European court judgment for our policy. When we have considered it, if we have anything to say, no doubt we will say it.
On the question of the search of the House in relation to the hon. Member for Ashford (Damian Green), the hon. Member for North Southwark and Bermondsey (Simon Hughes) will know that the Public Administration Committee is looking into the question of leaks, and the Cabinet Secretary has appeared before that Committee. He made it absolutely clear that he will not comment on any issues that are the subject of a police investigation, and that is rightly the case. The Home Affairs Committee will look into the police search of the House, but when I gave evidence to that Committee the day before yesterday, I suggested that it should not put itself in the position—especially as it is the Home Affairs Committee—of carrying out the same investigation as the police. Progress on the Speaker’s Committee, which was the subject of a motion of the House on Monday, is a matter for the Speaker.
Will the Leader of the House join me in welcoming the decision of the England cricket team to return to India for the test series? Could we have some parliamentary time to look at the implications of what happened in Mumbai for the fight against global terrorism? Will she confirm that there will be a ministerial visit to India at the earliest opportunity? So far, no British Minister has visited, and it is important to show solidarity with a country that is so close to ours.
I welcome my right hon. Friend’s welcome of the England cricket team’s visit to India. Ministers in our Foreign Office have been highly active, working with their colleagues in the Indian Government and the Pakistan Government. Everybody shares the huge concern and grief for those who lost their lives and were badly injured in Mumbai, and remembers that Pakistan suffered with the Marriott hotel explosion. Not only have our Ministers been active in supporting the Indian and Pakistan Governments fight against terrorism—we hope that they work together in that endeavour—but they have been working with the Pakistan and Indian community here. We will continue to be active in international work to tackle terrorism.
The Leader of the House will be aware that in the foreign affairs and defence debate yesterday, concern was expressed on both sides of the House about what is happening in Afghanistan. Unfortunately, given the length and breadth of the debate, we were not able to deal with that subject in the depth that it deserves. She will also be aware that a review of future strategy on Afghanistan is taking place in the United States at the moment. Will she arrange for the Prime Minister to come to this House to make a statement on future policy in Afghanistan, and provide a full day for a debate on Afghanistan where the House can fully explore, in depth, the concerns that exist?
I take the points that the right hon. and learned Gentleman has made, and I will raise those with the Prime Minister and the Secretaries of State for Defence and for Foreign Affairs. We recognise that those on both sides of the House want to debate our involvement of Afghanistan and hear from Ministers about it.
The House will be aware that Holocaust memorial day takes place on 27 January next year. The theme for that day is “stand up to hatred”. It is very timely, given the European and local elections held later in the year. This year, my right hon. and learned Friend allowed the House a debate on Holocaust memorial day that was supported by all parties. It was an excellent debate, and it gave us time to give credit to the work of the Holocaust Educational Trust, among other organisations. Will she consider a similar debate to mark 27 January next year?
We had an important and valuable debate on Holocaust memorial day this year, and I thank my hon. Friend for raising that point. We will look for another opportunity to debate it next year; we must never forget these important issues.
May we have an early debate on the written statement made last week by the Financial Secretary to the Treasury on the closure of Her Majesty’s Revenue and Customs offices? As I explained to the House in a point of order yesterday, his statement indicated that the Lerwick office in my constituency would be retained, and that it was not part of the review. At the time when that statement was made, HMRC management were arranging to remove the last of its staff, so we might have an office that is open with nobody working in it. I do not question for a second the good faith of the Financial Secretary, who is a man of integrity who is respected on both sides of the House, but it is clear to me that elements in HMRC management do not feel accountable to anyone. We need to make them accountable, and an early debate in this place would be an important start to that process.
If I may, I will ask the Financial Secretary to the Treasury to write to the hon. Gentleman about the Lerwick HMRC office.
Can we have a debate in Government time to look at the behaviour of the management of the Sunday Herald, The Herald and the Evening Times? Those are quality campaigning newspapers in Scotland, and this time last week, 240 journalists were brought into a room and summarily dismissed. Bizarrely, they were given 90 days’ notice, and then even more bizarrely, they were told to reapply for far fewer jobs. That is totally unacceptable behaviour and shows the need to look at trade union legislation again.
I am sure that the journalists and staff at those newspapers will have the solid support of my hon. Friend and their trade union. Their management will no doubt have heard the points that he has raised and reflect on the fact that there is support on this side of the House for those points.
The autumn has long since gone but
“Now is the winter of our discontent”
because the Prime Minister reneged on a solemn commitment to the House, which was given in the debate on the Queen’s Speech last week, that we would have an Equitable Life statement before Christmas. What are we to say to those of our constituents who are affected, most of whom are elderly and many of whom live on modest means? Indeed, some have already died. When will the Government make a statement to ensure that those people are able to live better in the future, because they have been seriously disadvantaged through no fault of their own?
No one thinks that this is not a serious issue, and it is because it is a serious and important matter that we wanted to ensure that the Treasury has the time necessary to consider it. On the question of what the hon. Lady should tell her constituents, she should say that the statement will be in January.
Many of us have constituents who work for Woolworths. Will the Department for Work and Pensions issue a statement in the near future that gives advice about where those people can go for assistance if they need it, particularly in relation to some of the measures that the Government have recently introduced to help people through these difficult times during the economic downturn? May we have a statement to provide at least some respite to those who have had the worst possible news this side of Christmas?
I share my hon. Friend’s concern for those employed by Woolworths, many of whom have worked there for many years. This has been devastating news for them, and I reassure them that the Government will do everything we possibly can to help them with a difficult situation before Christmas. Jobcentre Plus will be on hand to ensure that they are pointed in the right direction for any training that they might need and towards any vacancies that are available. We will certainly not simply stand by and say that unemployment is a price worth paying and that they can get on their bike. We will give those affected every help possible.
What kind of Government will not even come to the House and make an oral statement about serious defence procurement delays? Journalists outside the House were being invited to a briefing at the Ministry of Defence, while the written statement was not even available to Members. That is totally unacceptable. When can we have a debate in Government time about the complete hash that they are making of defence procurement funding arrangements?
That is not the situation at all; we are pressing forward with important defence procurement. Regarding the enthusiasm for that subject shown by Opposition Members, I say to them that receipts coming into the Treasury are decreasing because of stamp duty and the retail sector is declining, so VAT receipts are decreasing. If defence spending is to be maintained at such a time—we have committed to maintain it—borrowing has to increase. I hope that all of those who want defence procurement to continue will support our decision to allow borrowing to rise.
Will my right hon. and learned Friend either initiate a debate in the House or consult the appropriate House authorities about an important matter? A few weeks ago, Scope had an event in the Terrace Pavilion. Most of the representatives were wheelchair bound and had to go through a designated smoking area to gain access to that part of the Palace. That is disgraceful and totally unacceptable. Will my right hon. and learned Friend have another look at that so that we show the rest of the country that we practise what we preach?
I agree with my hon. Friend that it is a serious issue when people who need wheelchair access have to go through a fog of tobacco smoke. Perhaps the shadow Leader of the House, other members of the House of Commons Commission and I can consider that matter.
What are the right hon. and learned Lady’s plans for the publication of Members’ expenses?
The plans for the publication of Members’ expenses are: to ensure that we comply with the laws passed by the House and that the public have the information that they need to reassure them that public money is being spent properly by Members as we do our work; to ensure that there is a redrafted green book; and to ensure that there is better audit and assurance to reassure the public. However, the amount spent on gathering information for the public must be proportionate, and there has to be a sense of balance. The public have the right to know and we must ensure that they have the information they need, but that has to be done at a reasonable and proportionate cost.
Has my right hon. and learned Friend seen the recent report “Carers in Crisis”, which shows, notwithstanding the improvements the Government have made, that carers continue to struggle and their true worth continues to be undervalued and under-rewarded? May we have a debate soon on the huge contribution that carers make to our country, as that would provide an opportunity for Ministers to spell out what more they intend to do to ensure that carers are supported properly?
I will look at finding time for a debate specifically on carers. The increase in the number of people with disabilities and in the number of people aged over 85 means that the issue will only get bigger. Most people want to ensure that their families can provide care, and that is what most families want. We have already taken action on the right to request flexible working for carers, and important services—the local authority health service, voluntary and respite services—support family carers. Providing cash to those who are unable to work as often as they would have been because they are caring is also important. I will consider the points my hon. Friend has raised and see whether we can find an opportunity to debate the matter.
May we have a statement from the Secretary of State for Culture, Media and Sport early next week on what has gone wrong with the latest Stonehenge project? It is not just a local or regional issue; it is a matter of national and international concern, because the visitor facilities are a national disgrace. Will the right hon. and learned Lady confirm that the Department for Culture, Media and Sport, the Department for Transport and the Treasury are in agreement about the matter, and that the problem lies with one or more of the stakeholder partners in the project who cannot agree a compromise? Alternatively, as the chairman of the National Trust wrote in an article entitled “The neglect of our heritage is shameful” in The Guardian on 12 September, is it the case that
“In Britain, nobody gives a damn”?
It is certainly true that there has been a big focus on Stonehenge, and I know that the hon. Gentleman, as the local Member, has been anxious to be at the forefront of that. He will know that the stakeholders’ group met yesterday. This is a question not of whether Stonehenge will, as a site, be improved, protected and made more accessible, but of where the visitors centre will be, and of knocking heads together to ensure proper agreement. It is not that the Government have been holding back, but that we need to work with all the stakeholders to agree where the visitors centre should be.
May we have a debate on the role and powers of local authority trading standards services, because as trading conditions get more difficult, the likelihood is that there will be more disputes between consumers and retailers? I shall tell the Leader of the House about the long struggle that my constituent, Mr. James McMahon, has had with the major national company, Everest Windows, to get recompense for a faulty product. It took Mr. McMahon two years to fight his case through the county court. He was eventually vindicated and received compensation, but if trading standards services had had the power to intervene more forcefully in civil cases, all of that time, expense and anxiety could have been avoided to the benefit of the consumer and the retailer.
In difficult economic times, people want to ensure that their money is well spent and that they get value for money. I will raise my hon. Friend’s point with my fellow Ministers.
May we have a debate next week on a motion to refer the matter of the search of the offices of my hon. Friend the Member for Ashford (Damian Green) to the Committee on Standards and Privileges? The Leader of the House knows that the vote on Monday was profoundly unsatisfactory and that the result was distorted by the activities of the Labour Whips. It denied Mr. Speaker the purpose of his statement and kicked the matter into the long grass, where I know that the Leader of the House wants it to be. That is a disgrace and ought to be debated by the House on a motion to refer the matter to the remit of the Committee on Standards and Privileges.
If a Member wants something to be referred to the Standards and Privileges Committee, and if a motion is introduced to that effect, the Government make time available as soon as possible thereafter so that the House can express a view on whether it wants something to be referred to that Committee.
Will my right hon. and learned Friend urgently consider the inclusion of small-scale wind devices and air source heat pump devices in the terms of the general permitted development orders? She may be aware that the orders in respect of other microgeneration were laid last spring, that the devices I mention were excluded and that considerable distress is being caused to manufacturers by the fact that the orders have not yet been laid.
I will raise that point with the relevant Ministers and ask them to write to my hon. Friend.
I wonder whether the Leader of the House could find time for the Secretary of State for Transport to come to the House next week to explain the Highways Agency’s extraordinary decision to close the A303 entirely for three months early next year. Aside from the west country, I can think of no region of the country where the main arterial route could be closed for a quarter of the year for the convenience of contractors, rather than being operated in the economic, environmental and social interests of the people whom I represent.
This is just the sort of issue that the hon. Gentleman’s regional Committee will want to address. As we will have that new accountability mechanism, he will not need to raise such an issue in business questions; he and his fellow Members who represent the region will be able to get to grips with it with the Highways Agency directly.
My right hon. and learned Friend will be aware of the strong support across the House for the campaign run by the Federation of Small Businesses to “Keep Trade Local”. Is she aware of my early-day motion 107, which calls on hon. Members to move on from that and to support the campaign by procuring their Christmas dinner from local shops and retailers in their constituency?
[That this House congratulates the Federation of Small Businesses on their Keep Trade Local campaign; notes that local high streets are increasingly under threat with 2,000 local shops closing each year; believes small businesses form an essential part of local communities and economies; and calls on hon. Members to source their Christmas dinners from small independent retailers in their constituencies in order to support local businesses at this time of economic difficulty.]
Only 29 Members have signed it so far, but, ever optimistic about the great generosity of all hon. Members, will she encourage Members to sign it and to procure their Christmas dinner from local suppliers, thus making it a merry Christmas not just in their households, but in those of our small retailers?
There are five more days in which to sign early-day motions before the Christmas recess, and hon. Members will be able to take note of the points my hon. Friend raises.
I am always anxious to give the Leader of the House the benefit of the doubt, so I accept that she was acting in good faith when she told the House in July, when the ombudsman’s report was published, that there would be a statement on Equitable Life in the autumn. I am less able to give the Prime Minister the benefit of the doubt about what he told the House during the debate on the Address:
“There will be a statement before the House rises at Christmas. I can say to the hon. Gentleman that that will be done. There will be a statement”.—[Official Report, 3 December 2008; Vol. 485, c. 38.]
That was only a week ago. What has happened in that week? Has the Prime Minister saved the world but lost his grip here?
What was said then was that there was an expectation—[Interruption.] Well, it stands to reason, does it not, that if the statement had been ready, it would have been made, so what was being talked about was a statement that was under preparation? The preparation has taken a bit longer than anticipated, but I think that Members are going way beyond things if they are asserting that there has somehow been some calculation about the timing and that Ministers are not acting in good faith. All we have been trying to do is give a reasonable estimate of when the statement might be ready, and the latest estimate is that we hope it will be ready in the week of the 15th.
The right hon. and learned Member for Sleaford and North Hykeham (Mr. Hogg) has just asked that the privilege issues relating to the search of the House be referred to the Standards and Privileges Committee. If he moves the motion that the Leader of the House advises, will she ensure that there is an opportunity to amend the motion to ensure that the standards issue inherent in the apparent suborning of a public servant to breach the civil service code is also considered by that Committee?
The Public Administration Committee and the Select Committee on Home Affairs are both looking into aspects of this. I understand that if there was a reference to standards and privileges, the Speaker would decide whether there should be a reference and a debate would then be held on a motion to the House.
On behalf of all colleagues whose constituencies have interests relating to dockyards or shipyards, or substantial defence interests, may I impress upon the Leader of the House that today’s written statement by the Secretary of State for Defence announcing a two-year delay in the procuring of both the aircraft carriers, on which thousands of jobs depend, which appears to fly in the face of Government policy to bring forward major spending projects, is completely unacceptable? Has she any idea of the dismay that this is causing thousands of constituents up and down the country? Will she, even at this late stage, bring the Defence Secretary to the Chamber so that we can quiz him about the implications for the jobs of our constituents?
We are very concerned not only that the right defence equipment should be procured, but that the jobs and skills dependent on it should be secure. The hon. Gentleman may rest assured that with this Government’s support for capital expenditure and for public expenditure, we will sustain the capital investment that we have announced. Obviously, that involves a question of phasing, which will depend on the circumstances and on priorities. Unlike the Conservative party’s policy, our policy is to make sure that we sustain public investment.
Will the Government consider including in the Bill on political party funding that they announced they would introduce this Session measures to make political parties that receive donations that result from the proceeds of crime return the cash to the people from whom it was stolen? Will the Leader of the House examine the issue?
There will be an opportunity to consider that when the Political Parties and Elections Bill comes back to the House in the new year.
I am about to write to the hundreds of Equitable Life policyholders who have written to me about their concerns. Could the right hon. and learned Lady offer me a form of words so that I can explain to them, first, that they will have to spend another Christmas in a state of uncertainty and, secondly, why her promise that there will be a statement in the first week back in January is any better than the Prime Minister’s statement of a week ago or than her statement last July that this would be dealt with in the autumn?
May I also emphasise to the Leader of the House that the treatment of today’s written statement on defence equipment is disgraceful? May I suggest that she take some advice on the difference between personnel and equipment when she suggests that we will debate this next January?
The question of defence spending is a question of prioritisation between different sorts of equipment available for our armed forces personnel. Therefore, I was assuming that if Members were to catch the Speaker’s eye during the debate that will be held in our first week back, the question of what equipment is available for our armed forces would be within the remit of that debate. I was trying to assist hon. Members by saying that there would be an opportunity to debate these concerns. The hon. Gentleman does not need to patronise me and assume that I do not know the difference between a tank and somebody serving in the Army—I do.
On Equitable Life, I can only say what I have already said; I do not want to repeat it too often, but this was an expectation—[Interruption.] There was an expectation of when the statement would be ready, and I tried to assist the House by sharing that expectation with it. Hon. Members should be focused not only on the timing, but on what we are focused on: the substance of ensuring that we get the answer right on Equitable Life.
May we have a debate on the issues in early-day motion 229, which is about mobile termination rates?
[That this House notes that mobile telephones remain a popular gift for Christmas time, with an estimated one million telephones waiting under the tree this year; but regrets that in spite of this popularity, fixed and mobile customers in the UK will be charged in excess of £3 billion in unnecessary call charges in 2009 due to mobile termination rates; and calls on Ofcom to take immediate action to lower these outdated and unnecessary charges so that consumers can get a better deal from their new mobiles this Christmas.]
This Christmas many of our constituents will receive mobile telephones as presents, but £3 billion of unnecessary call charges will also be under the Christmas tree. May we therefore have a debate to explore those costs and expose the companies responsible, either on the Floor of the House or elsewhere with the Minister for Trade, Investment and Consumer Affairs?
My hon. Friends in the Department for Business, Enterprise and Regulatory Reform have been looking into the issue to ensure that there is no unfair charging. One of the things that my hon. Friend and others will welcome is the fact that the VAT reduction of 2½ per cent., which I am afraid Opposition Members have so derided, will help people with their mobile phone bills.
There is a sense of betrayal on the island of St. Helena at the Government’s failure to build an airport, which has been promised for many years. On Monday, there was a written statement, which said that there had been “a pause in negotiations”. For “pause” read: the dead hand of the Treasury cancelling the project. May I refer the Leader of the House to early-day motion 175, which is about the airport for the island of St. Helena, an overseas dependency, and reinstating the airport project?
[That this House agrees with the people and government of the island of St Helena that the construction of an airport is crucial for the island's economic future; notes that the British Government has for many years promised that an airport would be constructed, and that plans had reached an advanced stage where the award of a contract to build an airport was imminent; is therefore appalled at the announcement, by means of a Written Statement on 8 December 2008 by the Secretary of State for International Development, that there is now a pause in negotiations over the St Helena airport project which brings it to a halt; believes that the dead hand of the Treasury is responsible for the betrayal of this loyal overseas dependent territory; and calls on the Government to proceed with the award of a contract for the construction of an airport on the island of St Helena without further delay.]
Getting an airport is the only way in which the island and its people can have an economic future.
The hon. Gentleman will have an opportunity to raise the matter if he seeks to intervene on the relevant Treasury Minister in the debate next Monday.
Will my right hon. and learned Friend assist the Minister for the West Midlands in securing a meeting between the Coventry MPs and Mr. Adam Crozier, with whom we have been trying to arrange a meeting for many months about the relocation of the sorting office in Coventry to Northampton? The proposed relocation has the potential to cause an industrial dispute and, equally, has generated vast public concern in Coventry.
I will draw those points to the attention of my hon. Friends the Ministers concerned and ask them to write to my hon. Friend.
May I ask the Leader of the House, as I asked her colleague the Deputy Leader of the House some time ago, to investigate why the Department for Transport seems to be incapable of meeting deadlines for freedom of information requests? I know of at least two outstanding requests that took several months to receive a substantive answer. Today the Department will breach the 40-day maximum limit on internal reviews, and those answers that I have received have been shoddy. Will she investigate the matter and ask the Department why it seems to feel that it is above all guidelines set by the Information Commissioner?
My hon. Friend the Deputy Leader of the House says that he has been looking into those questions on behalf of the hon. Lady. I will ask that she meet him, so that they can pursue the matter jointly with the Department for Transport.
Just over two hours ago, in the most important lottery in central London, 20 hon. Members were successful in the private Members’ Bills ballot. Assuming that none of them decides to adopt the excellent draft autism Bill, which the hon. Member for Tiverton and Honiton (Angela Browning) introduced on 7 October, may we have what is by now a long-delayed debate on autism and in particular on improving the local planning and commissioning of services for people with autism? Two thirds of adults with autism say that they do not have access to appropriate services and only one in seven is in work. We need to ensure that they do not have to struggle to access the services that they deserve, so let us have a proper debate.
This issue could be raised in the six-hour Christmas Adjournment debate. I am sure that hon. Members will have the opportunity to raise the important issues of support services for those with autism and their families on that occasion.
May I take the Leader of the House back to the plight of the hundreds of small businesses in Britain’s ports and the enormous backdated rating demand, which many of them are quite unable to pay? I understand that since I raised the matter last week some informal guidance has been issued saying that they may not have to declare that on their balance sheets. However, all the legal and accounting advice is that the requirement remains. Those businesses will have to close on 1 January unless the Government improve their offer of simply phasing the payments.
The issue has been raised by a number of hon. Members and is obviously an important one, so I will raise it with Ministers in the Treasury and the Department for Transport.
My hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) asked the Prime Minister for a “concrete date” for when the Equitable Life statement would be made. The Prime Minister said:
“There will be a statement before the House rises at Christmas. I can say to the hon. Gentleman that that will be done.”—[Official Report, 3 December 2008; Vol. 485, c. 38.]
If we cannot believe the Prime Minister’s word, whose can we believe?
The point was that at the time he said that, obviously the statement was not ready; otherwise it would already have been before the House. The statement will be ready, we hope, shortly, but the important thing is not only that it comes forward as soon as it is ready, but that the substance is right.
Is it possible to have an early debate on the “Alice in Wonderland” workings of the Child Support Agency? I have a constituent with four children who is separated from her husband. She made a claim from the father, who built up arrears, but when one of the children went to live with the father temporarily while he was doing an education or training course, the father claimed from the mother, who had to pay him. That is absolutely nonsensical. As BT said, “It’s good to talk.” Is there any chance of the people in the Child Support Agency talking to one another, at least so that the payments that the mother would otherwise have made could be taken out of his arrears?
The hon. Gentleman should not minimise the important work done through the Child Support Agency. If people have children, they should be responsible for their financial upkeep and should not expect the taxpayer to foot the bill. The Child Support Agency has to deal with complex family circumstances, and he has just illustrated that. The more people there are who do not pay up and have to be chased, the more difficult it is for the CSA to devote its time to sorting out those sensitive and difficult cases. I am sure that the hon. Gentleman and other hon. Members will welcome the fact that the Queen’s Speech said that we will introduce a Bill—this was the subject of yesterday’s statement by the Secretary of State for Work and Pensions—so that all child support payments will be disregarded in income-related benefits. That means that when parents—usually fathers—pay up, all the money will go to the children.
I received a letter this week with a postscript in the handwriting of the Minister concerned saying that the Government would make a statement to the House on Equitable Life. If the Minister who sent me that letter, which I received 48 hours ago, cannot be accurate, why has there been such a delay in bringing forward a statement from the appropriate Minister? To my mind, that is unacceptable. I do hope that the Leader of the House will accept that the matter is one of deep concern to hon. Members in all parts of the House. This has gone on long enough. The statement should be delivered to the House before Christmas.
I hear what hon. Members are saying and I know where they are coming from. I understand what the concerns are. We know where we are on this issue, which is that we will hopefully have a statement in the week of 15 January.
Today is the third anniversary of the Buncefield disaster in my constituency and I know that the Leader of the House will not be surprised that I am raising it with her. Today, Lord Newton will conclude his inquiry, which has been conducted behind closed doors. The Department for Work and Pensions has washed its hands of the explosion, yet we still have problems, with people who will never be able to return to their homes and thousands of workers, at this difficult time, with businesses that are just not safe enough to return to. Which Department will take responsibility from today onwards, and may we have a statement from a Minister from whichever Department that happens to be?
As the hon. Gentleman says, the third report—the major incident report—will be concluded today. The first two have already been published and the Government have responded to them. There is no question of the Government washing their hands of that important incident. We will reflect on the report and take the appropriate action.
Next week, will the Leader of the House investigate and make a statement on what seems to be a significant problem relating to the setting up of the regional Select Committees, resulting from the sloppy drafting of an amendment? If she looks at Hansard for 12 November, she will see that amendment (a) to her main motion, tabled by the hon. Member for Thurrock (Andrew Mackinlay), inserted the words:
“except that Chairmen of regional select committees shall not be paid.”—[Official Report, 12 November 2008; Vol. 482, c. 810.]
I understand the intention of that amendment, but because of its sloppy drafting, it means that no hon. Member can be the Chairman of a regional Select Committee—because all hon. Members are paid, as Members of Parliament.
The intention of the amendment was clear. It means that the Chairs should not be paid for their work as the Chair. It does not refer to their being paid in respect of their work as Members. I do not think that the hon. Gentleman is right to say that it will not be possible for Members to chair those Committees because they would then lose their parliamentary salaries as Members; they will not.
Benefits Uprating
With permission, Mr. Deputy Speaker, I wish to make a statement on benefits uprating, particularly in the context of the Government’s commitment to provide real support to people in the current economic climate. I will, as usual, place full details of the uprating in the Vote Office and arrange for the figures to be published in the Official Report.
As in previous years, I can confirm that most national insurance benefits will rise by September’s retail prices index, which is up by 5 per cent. Most income-related benefits will be uprated by September’s Rossi index, which is RPI less housing costs, and is up by 6.3 per cent.
We are not alone in experiencing the shock waves reverberating through the world’s economic systems. Effects emanating from the epicentre of the American banking system are being felt around the globe. We believe that when the economic situation is more difficult, people need all the help they can get to deal with the situation. When things get tougher, people need more help, which is why our response to the current climate is twofold.
We are not only focusing on providing immediate support for those who lose their jobs; we are also determined to continue with our radical programme of welfare reform, to ensure that those further away from the labour market are not forgotten, as they have been in the past. As my right hon. Friend the Secretary of State for Work and Pensions made clear yesterday in his statement to the House, we are not going to repeat the mistakes of the past. During the recessions of the ’80s and ’90s, hundreds of thousands were shuffled on to inactive benefits to keep the unemployment count down. They were trapped there without support, and abandoned. In contrast, we are investing an extra £1.3 billion in helping people to find work now, and we are bringing forward proposals to increase requirements on people the longer they are out of a job, to ensure that they do not fall out of touch with the world of work.
We believe that work is the best welfare, and we are committed to ensuring that everyone has the opportunity to improve their prospects and those of their families. The proposals in our White Paper are based on the simple ideas that no one should be left behind, and that virtually everyone should be required to take up the support that we know works, to help them to prepare for and look for work. But we recognise that, for those who are receiving benefits, we need to uprate the value of this safety net to reflect changes in the cost of living.
We propose, therefore, that most working-age income-related benefits will increase in line with the Rossi index, at 6.3 per cent. This means, for example, that the personal allowance for a single person over the age of 25 will increase from £60.50 a week to £64.30 a week. The amount for a couple will increase from £94.95 to £100.95. Child-related allowances that may be payable in the income-related benefits will be increased in parallel with child tax credit rates by almost 7 per cent., from £52.59 to £56.11. This is essential to ensure that families receiving these benefits see the full value of any increase in child tax credit. We have already announced in the pre-Budget report that we are bringing forward April’s increase in child benefit to January. This will be worth an additional £22, on average, to families. The standard rate of statutory maternity pay and maternity allowance will increase in line with prices by 5 per cent., from £117.18 to £123.06.
In April 2009, incapacity benefit will be uprated by the same index as the employment and support allowance—the Rossi index, instead of the retail prices index—in order to prevent rate differences widening over time. No incapacity benefit customers with age additions will, as we proposed in the welfare reform Green Paper, have their rates frozen. Instead, the cash increase in their overall benefit will be at least half of Rossi, until they are transferred to the employment and support allowance. The additions will therefore be phased out more gradually than previously planned. Incapacity benefit claimants with an age addition, including those formerly on invalidity benefit, will not receive less than £95.15 a week—the same as someone in the support group on contributory employment and support allowance.
In these difficult times, we must also continue our strategy of providing support for all, and more for those who need it most. This means that for older people, as my right hon. Friend the Chancellor announced recently, from April 2009, the basic state pension will increase to £95.25 per week, which is up by £4.55. For couples, the standard rate will rise to £152.30. These increases, against a backdrop of falling inflation, are in line with the highest level of inflation this year—5 per cent.—and represent a real-terms rise in the state pension of 7 per cent. since 1997. And for pensioners on the lowest incomes, from April 2009 we will see the biggest increase in the pension credit guarantee since its introduction in 2003. The standard minimum guarantee will rise from next April by £5.95 a week for single pensioners and £9.10 for couples. That means that from April next year, no single pensioner need live on less than £130 a week, and no couple on less than £198.45 a week. That is an increase of £31 for a single pensioner and £45 for couples since 1997.
This above-earnings increase in the guarantee credit underlines our ongoing determination to tackle pensioner poverty, with 900,000 pensioners lifted out of relatively low income since 1998, after housing costs, and £13 billion more will be spent on pensioners in 2008-09, compared with what would have been spent if we had continued the policies that we inherited in 1997, over half of which is going on the poorest third of pensioners. Tax and benefit changes will mean that the poorest one third of pensioner households will be on average £2,100 a year, or about £40 per week, better off in 2008-09 than under the 1997 system.
But of course, the Government recognise the difficulties that pensioners face when prices increase. That is why, alongside the winter fuel payment, which is worth £200 for those aged 60 to 79 and £300 for those aged 80 or over, this winter there will be additional payments of £50 for those aged 60 to 79 and £100 for households with someone aged 80 and over. This will take the total direct help with fuel costs for pensioners this year to £250 for those aged between 60 and 79 and £400 for those aged 80 or over.
The pre-Budget report also announced additional direct financial support in the form of a £60 payment that will benefit not just pensioners, but all the estimated 15 million people who receive the Christmas bonus. This will take the total value of the Christmas bonus this year to £70, and is equivalent to bringing forward the uprating of the state pension from April 2009 to January 2009.
All these measures demonstrate the Government’s commitment to supporting pensioners, just as we are also committed to increasing the support on offer for those of working age. Our new proposals for lone parents and disabled people, for partners and for those facing multiple barriers to work, build on the steps that we have taken over the past 10 years to bring the advantages of an active, responsive welfare state to all those who can benefit. Today’s uprating continues our progress towards a fair and inclusive society that offers opportunity and independence for all. It reinforces our commitments to tackle poverty and exclusion and to ensure security in retirement. I commend this statement to the House.
I begin by thanking the Minister for his usual courtesy in letting me have sight of his statement in advance.
The Conservatives support the uprating of benefits. Anything that will help hard-pressed individuals and families at this difficult time is welcome, especially as this Government’s own policies have contributed so much to the economic downturn and to its likely duration and severity. Every day brings new job losses, including the extremely bad news from Woolworths only yesterday. Will the Minister share with the House his projections for unemployment levels over the next 12 months? I also wonder whether he has an up-to-date figure for the amounts paid out by his Department due to fraud and error. On welfare reform, the Minister knows that he will have our support, if the Government are really serious about tackling these hugely important issues.
We welcome the increase in the state pension, which will then be worth, as we have heard, £95.25 a week and £152.30 for a couple. Perhaps the Minister will join me in pointing out to the leader of the Liberal Democrats that it is not £30 a week. Will the Minister tell us exactly when the Government intend to restore the link with earnings for the state pension?
We know that £5 billion of benefits go unclaimed by pensioners every year, so what are the Government doing to increase take-up? About 40 per cent. of those entitled to council tax benefit do not claim it, and 1.8 million are not claiming pension credit. Will the Minister restore the boosting of take-up as a departmental priority? The Government’s decision to reduce the period of backdating from 12 to three months for pension credit claims suggests that they are more interested in saving money than in increasing take-up. Will the Minister confirm that at least 110,000 pensioners will be adversely affected by that change, and that they will tend to be older pensioners?
There are already 2.5 million pensioners living in poverty in this country, so how are the Government going to tackle that disgraceful state of affairs? We naturally welcome the extra £60 and so forth, but does that really tackle the problems faced daily by our older citizens? Help the Aged describes the pre-Budget report as
“a truly skinflint package for the UK’s older citizens. The chilling message from the Chancellor is ‘keep struggling’”.
Age Concern said of the same report that it
“will still leave many of the oldest and poorest pensioners…paying the price for the economic downturn.”
Falling interest rates may be popular with some people—indeed, with many people—but there is one section of the population for whom they are really bad news. Does the Minister recognise that many pensioners are facing real hardship because their hard-won savings are now attracting very low interest? Now there is talk about interest rates reaching even zero. We are talking about people who have done the right thing, and what successive Governments told them to do: they saved during their working lives so that their savings could supplement their income in retirement. To add insult to injury, those with modest savings are assumed to earn 10 per cent. on their savings when it comes to eligibility for pension credit. In these times of falling interest rates, that is surely total nonsense. I am sure that pensioners would love to get 10 per cent. on their savings, but in Brown’s bankrupt Britain, that idea is pure fantasy. Will the Minister please undertake to approach the Treasury as a matter of urgency to right this wrong?
Will the Minister confirm that he is wholly confident that the new personal accounts system will begin on schedule in 2012, and that it will definitely come in at or below a 0.5 per cent. cost base? Is he confident that the crucial issue of the relationship with means-tested benefits will be addressed in good time so that we do not have hundreds of thousands of people who are no better off, or worse off, as a result of being auto-enrolled into personal accounts?
Will the right hon. Gentleman tell the House what the Government intend to do in respect of deregulatory measures to encourage defined-benefit provision? Is there an intention to add any such measures to the welfare reform Bill?
This Government have presided over the closure of more than 70,000 occupational pension schemes since 1997, yet we know such schemes are likely to provide a significantly more comfortable retirement than personal accounts ever will? Why have the Government given up on final salary schemes?
The Prime Minister may think that he is saving the world, but is it not high time he got round to repairing our broken society?
I will ignore the politicking in the hon. Gentleman’s comments, as I usually do—not least his last throwaway point about a broken society, which is, of course, absolute nonsense, but I do not have time to go into that now. I thank the hon. Gentleman for his usual courtesies, and for broadly supporting the uprating. Let me deal in turn with some of the points that he raised.
I have said, until I am—I was going to say “blue in the face”, and I shall stick to that, as I do not know what the Labour equivalent is. I have said until I am blue in the face that I am not Mystic Meg, and that it is not my job to forecast what unemployment may or may not be as the months progress. Rather, it is my job to ensure that Jobcentre Plus and all other aspects of the Department for Work and Pensions’ offer are there for people when they need them—sometimes before and sometimes after they lose their jobs. The hon. Gentleman will know that we look into what we can or cannot do on an almost monthly basis.
I take the hon. Gentleman’s point about Woolworths, but let us be clear that it is not closing down shops and losing jobs at the moment. There has been an apparent lack of success with the administrator. Since Woolworths first went into administration, we are, and have been, talking with Deloitte and we stand ready to help as much as we can on a regional and local basis if the worst prevails—but it has not, yet. As I said some weeks ago when the news was first announced, we should not discount the 27,000 jobs that are currently in the mix.
I also take very seriously the hon. Gentleman’s point about fraud and error. Notwithstanding the fact that losses due to those two have gone down by about £100 million over the last period, some £2.6 billion remains variously attributable to them. About one third is caused by customer error, one third by benefit error on the DWP side, and one third by fraud. I welcome all the help and support that the hon. Gentleman and local agencies of whatever persuasion can make to drive that down.
With the best will in the world, I am not going to get into the issues around the fixation of the right hon. Member for Sheffield, Hallam (Mr. Clegg) with the figure 30. That is not my business at all.
I do not think that the points made by the hon. Member for Eastbourne (Mr. Waterson) about the link between pensions and earnings stand up to much scrutiny. Current rates and increases are significantly better than they would be by simply establishing the link—but I think that the hon. Gentleman would concede that the link was broken by the last Conservative Government rather than by any other.
The hon. Gentleman’s points about take-up were well made. He may not have noticed, but we have made that absolutely central to what I am trying to achieve with colleagues on London child poverty. Take-up is part of that process, and boosting it is one of the quickest ways of dealing with poverty, whether at child or pensioner level: it helps to restore the balance and get people back on the path out of poverty. I welcome the hon. Gentleman’s support in that regard.
I also take seriously the broad point about pensioners and savings, and I will happily raise the issue with my right hon. Friend the Minister for Pensions and the Ageing Society, and report back with her to the Treasury about the House’s concerns. I would also say that pensioners in receipt of pension credit who find that their capital has decreased should report the changes to the Pension Service, which will be able to reassess their claim. That may be a shorter-term point, but the hon. Gentleman cannot get away with the notion that somehow, tariff income rules have only just been imposed by this Government. They have always been linked with income-related benefits, and pension credit disregard of savings of up to £6,000—and £10,000 for those in care homes—are still very real. The vast majority of pensioners who get pension credit—about 80 per cent.—have savings of £6,000 or less and do not have tariff income applied, but I am not belittling the point. I have said clearly that I will take the matter back to my right hon. Friend the Minister for Pensions and the Ageing Society and to the Treasury because we can and should look further into the current circumstances for savers—both for pensioners and more generally.
I, too, thank the Minister for sight of his statement. There are more than 500 people currently employed in the Woolworths office in Rochdale, which I understand from yesterday’s newspapers will be closing. What steps is the Minister’s Department taking to assist those people, with more than 70 losing their jobs last week in Castleton, for example?
We are pleased to see from the welfare reform White Paper that the Government are moving towards our policy of having a single working-age benefit in future. Although the Minister was unable to tell us the amount lost in fraud, we believe that the position will be improved by moving to such a benefit. I understand that more than £6 billion was lost last year.
The right hon. Gentleman mentioned the additional £1.3 billion for next year. How will that be spent by the Department? As he is not sure about rising unemployment, how does he think that that will pan out? If there is a need for additional resources, how will they be found?
We welcome and support increases in pension and benefits. However, we are disappointed that the right hon. Gentleman has again refused to link earnings to pensions. What will happen next year, when there may well be negative inflation, and the value of the pension will continue to be less than it was in 1950? Does he not think that now is the right time to restore that link?
The Minister should be aware that the carers allowance stops completely if anyone earns above £95 a week. Carers have the worst of all worlds. The allowance is not an income replacement, but it is an active barrier to carers being able to work. In the current economic circumstances, why has he not at least introduced a taper—but does he not accept that it would be better to have a meaningful increase of the carers allowance?
With regard to take-up, we remain concerned about the 1.8 million eligible pensioners who do not claim pension credit. The Minister must have some data now. Will he explain what has happened to the number of people claiming pension credit, in the light of the three-month backdating limit? Does he not accept that in the current economic climate, that is making life very difficult for pensioners who fall behind with their rent, for example?
Does the Minister have plans to extend the winter fuel payment to people who claim the higher rate mobility component of the disability living allowance? I am sure he would agree that that reflects the fact that their movement is limited and they have to spend more time indoors. What about people with severely disabled children, and the terminally ill?
On Woolworths, let me be clear that we have a rapid support service located in every region and district. Where there are large redundancies—defined as those involving more than 20 people—the service will engage directly and locally with Woolworths when the jobs are under threat. As I said, we are, and have been, talking to the administrator at a national level. As and when that follows through in each region and locality, the hon. Gentleman can be assured that Jobcentre Plus will work alongside the rapid response service. Where the problem is larger and has a more distinct impact on a region or area, we will grow the service response as well. He will know that we have quadrupled, from £3 million to £12 million, the central co-ordinating costs for the rapid support service.
On the hon. Gentleman’s point about the White Paper, I welcome what he says about the single benefit. We think that it is the right direction to take. However, given his genuine concern for carers, he may know that one thing buried in the White Paper is the fact that we are taking the carers allowance out of the path to a single benefit. There were concerns in the caring community that putting carers on a single benefit akin to jobseeker’s allowance would undermine what they saw as a strong job that well supported the members of their family who needed that care. We are looking at that whole notion again.
I thought that I had made it clear—I am sorry if I did not—that fraud accounts for about one third of the £2.6 billion currently lost through fraud and error. Customer error also accounts for about one third of that, as does DWP jobcentre error. We need to do all we can—I think that this will be a consensual point across the House—to eradicate that fraud and error. Much is being done. We are at least going in the right direction, but quite slowly.
The hon. Gentleman makes a perfectly valid point about the £1.3 billion. We will in due course announce how that is to be broken down, but a central part of it will be for Jobcentre Plus, given the circumstances, and some will be for employment services and intervention. We will make those announcements as soon as we can, and I will ensure that he knows when that happens. The only significant spend from that thus far has been in connection with the 60,000 additional jobs that we committed to Jobcentre Plus in the PBR.
To be fair, I do not think I said that I was not aware that unemployment might rise. Again, that is a point of consensus, whether we like it or not. It is not my job to make forecasts. The hon. Gentleman will know that forecasts are made on a daily basis, with various degrees of legitimacy and cogency, by any number of people, some of whom probably should set up a little tent and call themselves Mystic Meg. However, I shall not do that.
I take cognisance of the hon. Gentleman’s general point about welcoming the uprating. Given the time, I will happily get back to him on the smaller points of detail at another stage.
Perhaps I ought to declare an interest, in that I am a pensioner.
On behalf of my many constituents who are in receipt of benefits, I appreciate my right hon. Friend’s statement. Is he aware that in parts of Yorkshire, certainly in west Yorkshire where I live, we have had an awful winter—although I am not blaming him for that? The winter fuel allowance of £250 for those between 60 and 79 and £400 for those over 80 is much appreciated, but that money will quickly go if the weather of the past week or two continues into the new year. Will there be a supplement later if the severe weather continues in Scotland and the north of England?
The comments of the Secretary of State for Work and Pensions yesterday about single parents are related to those of my right hon. Friend the Minister. Most single parents are not single parents by choice. That situation is visited upon them by a husband—usually—who has left. I am sure that those single parents would prefer to be in work, training, or further or higher education, but especially if they have more than one child, they can do that, only if there is adequate provision of day nurseries. Will the Minister assure me that day nurseries will be provided in every area where they may be needed?
I am grateful to my hon. Friend for not blaming me for the weather. I am grateful, too, that she welcomes the uprating. I can no sooner forecast the weather, or the bitterness or otherwise of the winter in west Yorkshire, than I can the unemployment trends for forthcoming years—but I am sure that all services, not simply on the benefits side, will look at that problem as it affects vulnerable elderly people.
I take my hon. Friend’s point about lone parents. I am not in the business of demonising lone parents in the shameful way in which others have done and continue to do. However, we think it is right that, at the core of the welfare reform White Paper outlined yesterday, we afford them all the support and help they can possibly have. Notwithstanding what she says about barriers such as child care, as my right hon. Friend the Secretary of State for Work and Pensions said, no lone parent will be forced into a job, however appropriate, if child care is not available.
The hon. Member for Rochdale (Paul Rowen) asked about negative inflation. We enshrined a 2.5 per cent. floor in the Pensions Act 2008, so if inflation goes down to zero, as some anticipate, there will always be at least that 2.5 per cent. I am sorry I forgot to say that earlier.
As the Minister knows, I fully support in principle the welfare reforms that his right hon. Friend the Secretary of State announced yesterday to which he himself has referred today, but on the assumption that they would save money rather than cost money. Can he clarify that point? Outside the House, he and his colleagues have suggested that the reforms will, on balance, save the taxpayer money, but in the House yesterday the Secretary of State said that the reckless borrowing in the pre-Budget report—he was quoting a Conservative Member—was necessary because
“it allocated an extra £1 billion and this White Paper allocates still further money.”—[Official Report, 10 December 2008; Vol.485, c. 541.]
The Minister said today that that further money would amount to £1.3 billion. Will he tell us whether the programme will cost money and require extra borrowing, or save money and reduce the borrowing and the cost to the taxpayer?
I know that the right hon. Gentleman has been consistent in his support for welfare reform, albeit, as he has said, in the context of saving rather than otherwise. We believe that not only the welfare reform proposals but all that we are seeking to do will, on balance—his words, not mine—be cost-neutral. We have said, however, that at least during the interim period, when savings can be made we want to work closely with local authorities to come up with flexibilities that will enable them to respond to the requirements of their areas. Not all the savings will be brought into the centre in the first instance.
In the broader context of all that the Department is seeking to do, as I have announced and others have announced previously, there will be an additional £1.3 billion because of the economic downturn—and that is £1.3 billion that could not be counted on as an absolute if the policies of the right hon. Gentleman’s party were pursued. My right hon. Friend the Secretary of State made that point yesterday.
We are indeed experiencing difficult times when even the greatest financial institutions in the land are happy to take Government loans on very acceptable terms. Meanwhile, some of the very poorest people are taking money at the door at annual percentage rates of 100 per cent., or even several thousand per cent. Has the Minister reviewed the operation of the social fund in connection with both the money that is available and the stringent conditions that are applied?
I believe that an informal consultation paper reviewing the operation of the social fund was published yesterday along with the White Paper, but if it was not, it will be published very shortly. As my right hon. Friend the Secretary of State said yesterday, we want it to become much more community-focused and responsive, and, if possible—and eventually, we hope, on a national basis—to have credit unions at its core. I am aware of the hon. Gentleman’s interest in this topic, and I accept the broad sweep of his perspective on it. I invite him to read the consultation paper and present us with his comments.
I welcome the Minister’s statement. Unfortunately, there have been a series of redundancies in my constituency. When I met a group of people who had been made redundant this week, they reported that the local Jobcentre Plus simply could not cope and they were being referred to telephone numbers. While I welcome the uprating, I wonder what advice the Minister can give people who are finding it difficult to obtain benefits in certain parts of the country.
Obviously I do not know the details of the case, or cases, raised by the hon. Gentleman, but I can say that people who have been redundant and want to claim benefits are finding increasingly that the telephone is the first point of contact enabling them to establish their claims and get the process running, so I would not be so dismissive of telephone numbers.
I made it very clear the other week—on the Jeremy Vine show, no less—that if people did wish to complain about the service that they had received, I genuinely wished to know about it. I do not want to go around saying that this is a world-class service, although I believe that to be the case. It is certainly a far better service than that provided in the early 1980s, when I was unemployed; in those days people had to run around four or five different buildings before they knew for certain whether they could make a claim. What I want to do is provide a service at local level, because that is what is required.
As the hon. Gentleman will know, we are increasingly using Train to Gain funds and other interventions to work with companies to try to prevent redundancies from occurring in the first place, and, when that cannot be done, to ensure that people know exactly what support they will be offered long before they are faced with the cliff edge of redundancy. For that purpose we need, and are receiving—for which we are grateful—support and intelligence from, for instance, companies, the insolvency administrator—whatever that is—and trade unions on a region-by-region basis. The earlier the intervention, the earlier we can tailor the appropriate response from Jobcentre Plus.
Can the Minister answer the specific question asked by my hon. Friend the Member for Eastbourne (Mr. Waterson) about the Department’s decision to reduce the time limit for pensioners to backdate their pension credit, housing benefit and council tax benefit from 12 to three months? Does he accept that older pensioners are more likely to be affected by the proposed change, and can he explain why a decision was made which will cause endless extra poverty to people who are in difficult circumstances at this time of year?
I am sorry that I failed to deal with that question when it was first asked. The change is part of a wider package to increase take-up and make claiming simpler, and we believe that it will benefit thousands. It is not about saving money, but about targeting people in the most effective way possible. I do not doubt that the hon. Gentleman’s concerns and those of the hon. Member for Eastbourne (Mr. Waterson) are genuine, and I should be happy to pursue the matter with both of them outside the Chamber, but we genuinely believe that this measure is not about saving for the sake of it. As I have said, it is part of a wider package to increase take-up and make the claiming process simpler.
Points of Order
On a point of order, Mr. Deputy Speaker. I wonder whether you have received any indication that the Prime Minister intends to come to the House to correct the statement that he made on 3 December about the Government’s response to the report on Equitable Life. He was quite specific last week, when he said:
“There will be a statement before the House rises at Christmas. I can say to the hon. Gentleman that that will be done…There will be a statement before the House rises this Christmas.”—[Official Report, 3 December 2008; vol. 485, c. 38.]
We learnt this morning that the statement would not be made until January, but I and other Members have written to constituents telling them that there would be a statement before Christmas, on the back of what the Prime Minister said.
We have been misled by the Prime Minister’s statement, Mr. Deputy Speaker. Will the Prime Minister now come to the House to correct his statement, or ensure that the Chancellor comes to the House before Christmas and makes a statement on Equitable Life as promised?
Further to that point of order, Mr. Deputy Speaker. The right hon. Member for Maidenhead (Mrs. May) and I have raised this matter persistently. If neither the Prime Minister nor the Chancellor feels able to come to the House and respond to the specific question asked by the right hon. Lady, can we at least have an apology and an explanation? We have had neither today. All we have had is an announcement that a statement will not be made by the date by which we were told that one would be made. There may be a good reason for that, although it is difficult to understand how the Prime Minister could be confident last week but cannot be confident this week. However, surely the House and our constituents deserve at least some factual explanation of why a statement made last week has been undermined and contradicted by a ministerial statement made this afternoon.
Further to that point of order, Mr. Deputy Speaker. This is not the first occasion on which the Prime Minister has made a statement in the House which he has subsequently failed to correct. I hope you agree, Mr. Deputy Speaker, that in this Chamber the spoken word is of the utmost importance, and carries enormous integrity in the context of the respect from the outside community that we all command as parliamentarians. Will you advise me what can be done to ensure that the Prime Minister himself makes an effort to correct the record and to avoid such misrepresentations? If the Prime Minister does not do that, Mr. Deputy Speaker, the possibility will arise that other Members on both sides of the political divide will take the view that if the Prime Minister can make a misrepresentation and get away with it, so can they.
Order. I think that hon. Members should choose their words very carefully on this issue. I think that the use of words such as “misrepresentation”—which I ask the hon. Member for North-West Cambridgeshire (Mr. Vara) to withdraw—suggests that an hon. Member, whoever he or she may be, knows what he or she is saying to be wrong when he or she says it. We have no evidence that that is the case in this instance. Perhaps the hon. Gentleman would like to withdraw the word that he used.
I will withdraw it, Mr. Deputy Speaker, and use the word “inaccurate” instead.
I thank the hon. Gentleman.
The Leader of the House gave the House further information today about the proposed statement on Equitable Life. If hon. Members wish the Prime Minister formally to correct the statement that he made last week, I suggest that they table parliamentary questions. Let me add that I have no doubt that Ministers have heard the points of order raised today, and I also have no doubt that the Prime Minister will respond if he feels it appropriate.
On a point of order, Mr. Deputy Speaker. As you might have heard, there is bad news today for our armed forces and defence industry, with delays in major procurement programmes, including our aircraft carriers, the Navy tanker programme and future Army vehicles. There is, therefore, huge uncertainty about jobs at what is a very difficult economic time. When Ministers made previous announcements about these programmes, they were all too happy to do so by oral statement to the House, yet today, when it is bad news, we get a written statement with no opportunity for Members to ask the questions that matter. Have you, Mr. Deputy Speaker, had any requests for an oral statement on these very important and worrying matters? It is in stark contrast to the courage expected of our armed forces that the Ministers who represent them are too afraid to come to the Commons to explain and defend their own incompetence.
Further to that point of order, Mr. Deputy Speaker. At business questions, we witnessed the spectacle of the Leader of the House doing her level best to answer the substance of questions on the statement that was issued in the form of a written statement, but failing dismally to explain to the House why an oral statement was not being made. Can you, Mr. Deputy Speaker, tell us whether there is any reason, from the point of view of Mr. Speaker’s office, as to why that statement could not have been an oral statement?
rose—
Order. I think I understand the point that Members are seeking to make. Mr. Speaker has made it very clear that on all important issues on which the House will have a view, statements must be made to this House. Whether they are oral or written statements is entirely a matter for the Department and Ministers concerned. That is not a matter for the Chair, but I repeat that Government Front Benchers will have heard the comments, which are on the record.
rose—
I will not deal any further with the same point of order.
On a point of order, Mr. Deputy Speaker. I seek your guidance. When a Minister comes before the House to deliver an oral statement relating to a piece of procurement and gives the House an opportunity to question them on the announcement, if there is subsequently a delay in, or cancellation of, that procurement is there not a convention that the Minister should return to the House to give another oral statement? Otherwise, is that not unfair?
. I think we are covering the same ground again.
rose—
Order. I shall take more points of order only if they are about entirely separate matters.
On a point of order, Mr. Deputy Speaker. The defence training review is the largest private finance initiative in British history, worth £11 billion—indeed, the costs have increased in the last six months to £12 billion. I seek your advice, Mr. Deputy Speaker, because in today’s Financial Times it was announced that Land Securities Trillium, one of the major backers of the defence training review package, has pulled out of the project altogether. This has major implications for the future training of our armed forces not only in the short term, but in the medium to long term. Is it not a disgrace that, yet again, the Government have chosen to leak this information to the Financial Times rather than bring it to the Floor of the House?
I can only repeat that Mr. Speaker considers it extremely important that all important matters on which this House should have a view should be brought before the House, but I am sure the hon. Gentleman will find ways to pursue these matters himself, and the points he has made are on the record.
On a point of order, Mr. Deputy Speaker. I was listed to have a question today for the Minister of State, Department for Business, Enterprise and Regulatory Reform. Yesterday, however, my question was removed from the Order Paper. It was very similar to Question 1, which was accepted, because it concerned small businesses and banks. I see no logic in why my question was removed, and I ask for your advice and assistance.
The Chair plays no part in how such questions are dealt with.
On a point of order, Mr. Deputy Speaker. I seek your guidance on the topic of matters that are deemed relevant to particular debates. At this morning’s business questions, the Leader of the House said that on 15 January there will be a debate on defence personnel, and that it will be in order to raise during that debate matters to do with defence procurement; she said she was sure it would be in order. I remember from previous defence debates, however, that when Members tried to raise detailed questions of procurement in personnel debates, the Chair ruled that they were not in order. I seek your guidance, Mr. Deputy Speaker, as to whether what the Leader of the House said this morning was accurate.
The scope of the debate is entirely a matter for the Chair on the day of the debate, and I think that that can probably safely be left until then.
On a point of order, Mr. Deputy Speaker. I seek your guidance on what we are to make of Secretaries of State who attend the House to make a contribution when on the same day we see in the press leaks of a very significant nature that have to do with vital national interests. Further to the point made by my hon. Friend the Member for The Wrekin (Mark Pritchard), is it not a disgrace that such matters should be gleaned from the press without this House having the opportunity to quiz the relevant Minister adequately and fully?
I honestly do not think I can say anything more to the House about that than I have already said.
Debate on the Address
[5th Day]
Debate resumed (Order, 10 December)
Question again proposed,
That an humble Address be presented to Her Majesty, as follows:
Most Gracious Sovereign,
We, Your Majesty’s most dutiful and loyal subjects, the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament
Health and Education
I beg to move,
As an Amendment to the Address, at end add ‘but regret the absence of measures in the Gracious Speech to deliver reforms which would make public services genuinely accountable to patients and parents; believe that the measures proposed offer no prospect of raising long-term productivity or value for money in public services; object to the absence of measures to reduce bureaucracy; regret the failure to abolish centrally-dictated targets and support public services focused on outcomes; note the lack of commitment to improve public health and outcomes to reduce health inequalities; regret the failure to provide patients with meaningful information to improve local accountability; deplore the failure to bring forward proposals on social care; further regret the lack of measures to break the link between poverty and educational achievement and to raise standards in literacy; call for proposals to tackle the United Kingdom’s declining position in international education league tables and to give pupils in state schools the opportunity to sit the best examinations; note the lack of proposals to ensure higher standards of child protection; further regret the absence of measures to reverse the decline of science and to make schools accountable to parents rather than bureaucrats; and seek long-term reform of public services rather than short-term palliatives.’.
I tell the House that Mr. Speaker has selected the amendment in the name of the Leader of the Opposition. Interestingly, in his speech last Wednesday at the commencement of these debates, the Prime Minister sought to upstage the Queen’s Speech itself. It was not hard to do; we knew the Queen’s Speech would be thin, but it turned out to be skeletal. I do not object to having fewer Bills—
I am grateful to the hon. Gentleman for that.
Legislative hyperactivity and lack of delivery are the story of this Government—I am now waiting for another “Hear, hear” from the hon. Gentleman—but if the Government propose legislation, one would at least expect that it might be original, purposeful and substantive. On health, the Government’s approach is none of those. It is certainly not original.
Almost three years ago, my right hon. Friend the Member for Witney (Mr. Cameron) and I called for an NHS constitution to be established in primary legislation, and the Government are now following our lead, but do their plans have the necessary purpose? The Government’s plan is to construct an NHS constitution that, by their own admission, does not extend new legal rights to NHS services. That is astonishing; their consultation states to the public that they are not setting out to create any new legal rights. All the rights or pledges could be provided under existing powers. Even the much-vaunted new legal right to choose can be, and indeed probably will be, established by a direction issued by the Secretary of State under existing legislation. NHS bodies can already be required by direction under existing legislation to comply with any of these rights or pledges, and certainly to have regard to them.
So what does the Government’s proposal—the centrepiece of the Queen’s Speech so far as health is concerned—achieve? It achieves this: the Prime Minister said he wanted a constitution, so he has to have one. I wonder whether Ministers are even aware of how meaningless their response to the prime ministerial commitment has become. However, I think the public and the people who work in the NHS do know. The consultation issued this summer on the NHS constitution resulted in 1,008 replies to the Department of Health, including just 178 from NHS staff. That is not even one response for each NHS hospital; not even one in 5,000 NHS staff could be bothered to reply.
No doubt Ministers think that silence betokens consent. I do not think so; I think silence means contempt—contempt for the Government, where NHS staff feel that responding to the Government is pointless because they do not listen. In a top-down culture, what price consultation? When gimmicks abound, why should NHS staff have given this particular Government proposal any more credence? We will see whether Ministers listen to consultation. Three weeks ago, another consultation on the pharmacy White Paper ended, with 80,000 responses received. If consultation means anything, the Secretary of State will say this afternoon that the Government will make no changes to the existing GP dispensing arrangements because he has listened to the results of that consultation. I challenge him to do so.
I would be grateful if the hon. Gentleman repeated what he has just said. Did he say that the lack of response indicated consent or contempt?
What I said was that Ministers probably think that silence betokens consent, but in my view silence means contempt—[Interruption.] No, I have said it twice, and that is sufficient, even for the purpose of educating the Secretary of State for Children, Schools and Families.
I regret the lack of engagement with the idea of an NHS constitution. My third point is about substance, and there is an opportunity for substance there. We could have had legislation in prospect that would genuinely put the values of the NHS into primary legislation. We could have NHS bodies given greater freedom and autonomy, which the Prime Minister said—before he became Prime Minister—that he favoured. It turns out that he is not remotely interested in giving those freedoms to the NHS.
A constitution could do what constitutions are bound to do—define in statute for NHS bodies, often for the first time, their respective duties and responsibilities, both within the service and towards patients. A constitution could give patients choice, and a voice, after the Government have so disgracefully dismantled any effective statutory voice for patients at a national level. It could also strengthen the link between inspection and complaints. The Government have just legislated—wrongly—to remove from the new Care Quality Commission responsibility for the consideration of second stage complaints and hand it to the Parliamentary and Health Service Ombudsman. How can the new Care Quality Commission acquire and use intelligence about what is happening in the NHS if it does not have a responsibility to investigate unresolved complaints?
The ombudsman will get £4.6 million, which is less than half the amount of money that is currently being spent by the Healthcare Commission—between £10 million and £11 million—on second stage complaints. The Government blithely assume that the number of second stage complaints going to the ombudsman will be about half the number that currently go to the Healthcare Commission, but there is no basis for that belief. It is at best naive and at worst dangerous. The system is at serious risk, and if that carries on, the NHS will not be the learning organisation that it should be. I urge the Government to reconsider.
The opportunity is there for a health Bill in this Session that could make a real difference. Typically, the Government have failed to take that opportunity. The Secretary of State is pursuing a “do nothing” strategy for the Department of Health—least said, soonest mended. We should not be surprised by that, because before he became Secretary of State he described his approach to his responsibilities. He said, “I just drift along.” At least that provides plenty of room for his Under-Secretary, Lord Darzi, to hog the limelight. It is a pity that Lord Darzi has not understood that he is just window dressing for a Government who are chronically incapable of delivering.
I shall give one example. Hon. Members will recall that in October 2007, in anticipation of a general election, Lord Darzi was prevailed on to publish rapidly his interim report. The headline proposal was the Health Innovation Council, which Lord Darzi was to chair. Many people were prevailed on to become members of the council. It was announced that it would spend £100 million on a new health innovation fund—half from the Wellcome Trust and half from the Government. The details of the fund were to be published early in 2008, bids would be sought by the second quarter of 2008 and innovation would, as a consequence, flow throughout the NHS. What happened? The council met, twice, for rather inconclusive discussions; no details of the fund have been published; no bids have been sought; no money has been offered; and nothing has happened. It has all just drifted, again.
On the subject of platitudinous Labour soundbites, perhaps my hon. Friend recollects a vintage example of the genre—the 1999 pledge by the former Prime Minister, Tony Blair, that within the following two years everyone would once again be able to see an NHS dentist just by phoning NHS Direct. Does my hon. Friend share my concern that since then 1.2 million of our fellow countrymen and women have lost access to NHS dentistry, including many thousands in my constituency and his?
I am very concerned about that. The House will have an opportunity next Thursday to debate dentistry, but the Government should be ashamed of the current position. As my hon. Friend rightly says, we were promised in 1999 that everyone would have access, but the consequence of the Government’s contract is that 1.2 million fewer people have access to dentistry.
The Government also promised that the change in charging for dentistry would be neutral, in the sense that the amount raised through charges would not increase as a proportion of dental expenditure. That did not happen either. The latest figures published by the Government suggest a 14 per cent. increase in dental charges in the latest year alone. That is about £65 million extra from dental charge income. Patients are paying more, fewer have access, and the dental contract is not delivering as it should.
Does my hon. Friend share my concerns about orthodontic provision? Children have to travel vast distances for such provision and wait up to two and a half years for those services.
My hon. Friend is right. The great bulk of orthodontic work is provided privately, but work for children whose oral health would otherwise be prejudiced is done through the NHS. That is very difficult to access, and can often lead to the circumstances to which my hon. Friend refers. It is important that we ensure that children get good access. I was in a hospital recently and the staff told me about the rising numbers of children with dental caries presenting to hospitals as a consequence of an inability to access NHS dentistry. That will get worse. I do not know whether Ministers are aware of it, but from the coming year many primary care trusts will tell their dentists that they cannot have children-only contracts. So NHS dentistry will be taken away from children whose parents are not accessing NHS dentistry. That is a scandal, and I hope that Ministers will do something about it.
Does the hon. Gentleman think that it is right and proper that dentists should say to parents, “We’ll look after your children under the NHS if you take out private insurance with us”? Does he agree that those dentists should be ashamed of blackmailing individuals in that way?
The right hon. Gentleman makes a different point. I am not asking dentists to tell parents that they should be private patients. The point that I am making is that dentists who offer NHS services should not take NHS access away from children if they are already registered with them. That is what will happen. If he is suggesting that we should see the number of children accessing NHS dentistry falling, with all the potential consequences for poor oral health, I would be surprised. That seems contrary to many of the things that I have heard him say in the past.
A central and joint responsibility for both Secretaries of State—and also at the centre of our concerns—is children’s health. The Department for Children, Schools and Families is pushing for a child health strategy to be published, but the Department of Health is letting that drift. That will not do. I hope that the Secretary of State for Health will now tell us when he will publish that child health strategy.
Drift will not do either when it comes to the protection of vulnerable children. The Secretary of State for Children, Schools and Families has responded to the latest tragic events in Haringey by announcing a review by Herbert Laming and the establishment of a task force. The Select Committee was told yesterday by Ofsted that three children a week die from abuse or neglect, which is a compelling case for urgent action.
The joint area review of children’s services in Haringey illustrated one of the important points with painful clarity:
“the reliance on national and local performance indicators is too great and does not enable understanding of the quality and effectiveness of service provision on the ground.”
When we respond, as we must, to the tragic baby P case, I hope that Ministers recognise—and perhaps will use this afternoon to say—that constant structural change and a tick-box, top-down attitude will not do for protecting children. We have to move on from that.
Like other hon. Members present this afternoon, I remember when the then Secretary of State, the right hon. Member for Darlington (Mr. Milburn), responded in the House to Lord Laming’s report on the Victoria Climbié inquiry. He announced the creation of children’s trusts, even though Lord Laming had not recommended them. That is an example of the Government offering a structural solution that Lord Laming had not asked for. It did a disservice to Lord Laming’s report from six years ago to offer a structural response to the problem that he identified.
In his report, Lord Laming stated:
“I am convinced that it is not just structures that are the problem but the skills of the staff that work in them…The single most important change in the future must be the drawing of a clear line of accountability from top to bottom without doubt or ambiguity about who is responsible at every level for the welfare of vulnerable children”.
How can it be that, six years later, it took weeks of public pressure in the same borough of Haringey for such accountability to be brought to bear, for the facts to be exposed and for those at the most senior levels to accept responsibility? We must all take responsibility for the fact that things that Lord Laming asked for, and which were understood early in 2003, were clearly not being put into effect culturally in the social work profession and in those services with responsibility for children. It is important that we make sure that that accountability is in place now, and that we recognise the need for improvements in skills.
In 2006, in the absence of Government action in that respect, my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton), set up the Opposition’s own commission to look into how to improve the training, recruitment, status and perception of social workers. Its report was published in 2007, and I urge the Government to look at some of the examples that are available, including work done on this side of the House. Instead of starting again from year zero, with another task force and another report that will take a great deal of time to prepare, they should think about how we can do things.
I shall take one example from our report. It suggests that we should recognise that experienced social workers far too often go into hierarchies of management and are not retained on the front line. The report proposes that we should recognise the need for them to be retained in front-line care and that, to make that happen, we should create a structure of consultant social workers.
I urge the Government not to push every issue off to a new review or task force. We need to think—by all means on a cross-party basis—about the things that need to be done now that we know can make a difference in the short term.
I am grateful to the hon. Gentleman for giving way. For the most part, we have proceeded in this matter in a cross-party way. I am pleased that he recognises the importance of Lord Laming’s original report, and that he welcomes the urgent progress report that I have asked Lord Laming to compile. Does the hon. Gentleman think that Lord Laming is the right man to do the progress report?
I do. The right hon. Gentleman may or may not recall that I was vice-chair of the all-party parliamentary group on child health when Lord Laming produced his original report. I had my own debate on child health at the time and did not share some of the concerns expressed in that report. As I have said, that report concentrated on structures and did not focus enough on the importance of skills, leadership and accountability in the social work profession. It discussed those matters, but it has not been acted on sufficiently. I have no difficulty accepting that Lord Laming is capable of finding out why his earlier recommendations in that regard are not being implemented.
My point is that Lord Laming can produce a report, but that does not mean that the things that need to be done will get done. We have to be aware of what needs to be done, and producing reports is not the sole answer.
I met Lord Laming on Monday to discuss the review that he is to undertake. Does the hon. Gentleman share my concern about the narrowness of its terms of reference?
I confess that I have not read the terms of reference of Lord Laming’s review, so I shall leave that question to my hon. Friend the Member for Surrey Heath (Michael Gove), who may want to refer to it later.
I return now to the Government’s legislative intentions. The Secretary of State for Health announced this week that the Government are going to remove point-of-sale displays for tobacco products. I hold no brief for tobacco—I wish that no one were a smoker—but how can it be legal for a shop to sell cigarettes to adults but illegal for it to put such products on a shelf? What is the point of the Government constantly mandating increasingly alarming labels for cigarette packets—as the Minister of State, the right hon. Member for Bristol, South (Dawn Primarolo), did recently—and then require them to be hidden? How can they say that their proposal is aimed at sales in shops of cigarettes to young people, when we legislated less than two years ago to make it illegal for shops to sell tobacco products to under-18s?
The day before yesterday, the Government claimed that removing displays of cigarettes can reduce smoking prevalence among young people by 10 per cent., but the evidence from other countries shows that similar bans have not had that effect. It is true that smoking prevalence rates among 15 to 19-year-olds in Canada declined after 2002, but that cannot be attributed to the removal of tobacco displays. The provinces that removed tobacco displays achieved a success rate broadly equal to those that did not, so the ban apparently had no great effect. In Iceland, Government statistics show that the display ban had no impact on the number of 15 to 19-year-olds who smoke—in fact, the proportion rose from 14.4 per cent. to 15.2 per cent.
Many small businesses will be hit by the proposal, and it is simply not good enough to say to them that the Government have the best interests of public health at heart when the evidence to back that up is not there. The Norwegian Department of Health and Care Services said last year that
“there is yet no scientific study published that definitely shows the impact that a ban against public display would have on the number of people who smoke”.
Is the hon. Gentleman aware of the recommendations from the World Health Organisation? It set out six priorities for action to tackle smoking, but none of them refers to the removal of tobacco displays in shops.
Yes, I recall that report, which contained no such reference. If international example and guidance are important, we should listen to them.
No doubt we will have this debate when we discuss the health Bill, but Ministers have had an outing this week on the basis of evidence that has been reported in an uncritical fashion. It is rather important that we in this House base our arguments on the evidence.
I am listening carefully to the hon. Gentleman. I have not yet made up my mind about the issue, but it strikes me that if a ban on display does not work, sales will not be adversely affected and corner shops will not suffer. If corner shops were to suffer as a result of a ban, the ban would be working in cutting tobacco sales. Which is it?
No, it would raise the question why the ban does not work, because the percentage of illegal sales is already high. If one removes the point of display, there may be an impact not only on costs but on the proportion of sales going through small retailers rather than the illegal trade. I am surprised that the Government are not more concerned about protecting their income. If they want to do something about the issue, we have suggestions. There are things that can be done on enforcement against the illegal trade, which would at least mean that the price of cigarettes would have an impact on smokers, many of whom do not realise what the real cost of tobacco, including duty, would be if they had to pay it. There is much that we can do on nicotine patches, such as ensuring that the right strength of patch is available to help habitual users of tobacco.
There is a lack of practical action when there are things that ought to and can be done to help people facing the risk of unemployment. The Secretary of State for Health knows that rolling out cognitive behaviour therapies, which the Government are committed to do, can and should be achieved across the country, rather than only in certain areas. In 2004, Lord Layard told the Government that we needed 10,000 more cognitive behaviour therapists. The Government are committed to 3,600 but only over the next three years and only in one in seven primary care trusts. Given the current unemployment risks, it must be right for such therapists to be available throughout the country.
We know that the impact of such therapy can be substantial; it can double the rate at which people who lose their employment get back to work. The evidence suggests that an increase of 1 per cent. in unemployment would lead to a 7 per cent. increase in demand for mental health services. We know where the biggest short-term demand for health services will be, but we do not have a strategy to respond to it.
Does the hon. Gentleman agree with the Liberal Democrat view that there should be an entitlement within a defined period to access treatment such as CBT, which has been approved by the National Institute for Health and Clinical Excellence as an effective treatment, especially as all the evidence suggests that early access to such treatments has a disproportionate impact on individuals suffering from anxiety or depression?
No, I do not propose to go down that path, which involves simply reintroducing more targets. We need to ensure that capacity is available rather than simply setting targets.
The Government have, of course, set plenty of targets, and I shall remind them of one. In 1997, Labour told us that their plan for the NHS was
“rooting out unnecessary administrative cost”.
In 2006, Members will recall—because there was so much argument about it—that the Government proposed to halve the number of primary care trusts from 303 to 152. They told us that it would save the taxpayer £250 million by reducing management costs. What happened? In 2005-06, the management costs of PCTs were £1.09 billion. By 2007-08—only two years later—after reorganisation, the amount rose to £1.178 billion. The costs are not £250 million down, but £88 million up; an extra £333 million has gone into administration, which is not available for the front-line care that Ministers said that it would be used for. It is unbelievable. That is only one example, but there are many others.
Ministers constantly tell us about the importance of the front line, but the resources do not reach it, which is the experience of people right across the NHS. They are constantly told that they have resources, but they do not see the situation in the same way.
Will the hon. Gentleman give way?
No, I gave way to the hon. Gentleman earlier, and I want to finish my speech, because time does not permit me to go on too long.
Two years ago, my right hon. Friend the Member for Witney (Mr. Cameron) and I said that the Government and the NHS should focus on outcomes, not targets. This summer, Lord Darzi’s report endorsed the emphasis on outcomes, but it did not actually get rid of the targets. On Monday, the Secretary of State published the new operating framework and it is still littered with targets. We know what dominates the thinking of NHS managers—the so-called must-do targets, not the outcomes that in reality matter most for patients.
The Conservatives will focus on what we need to achieve the outcomes for the people whom we are here to serve, not on how people in services go about achieving them. Of course, performance management has to follow evidence of effectiveness and benchmarked performance, but objective measures such as standardised mortality rates should be mixed with more subjective ones, such as patient experience and self-reported outcomes. All those things should also be benchmarked against the best in the world.
When evidence was published by the Healthcare Commission of the scale of adverse events and harm resulting to patients, it was entirely typical of the Government that their response was, “Well that’s all right, it’s about the same level as elsewhere in the world.” Ministers seem to be prepared to use international benchmarking only when it justifies the level of error in the NHS. They do not use international benchmarking for infections and admit that our MRSA rates are much higher than best practice or that our rates of clostridium difficile can be four times the average for other hospital systems. They do not use international benchmarks to admit that our cancer survival rate is a quarter worse than the best in Europe, that our stroke mortality is a third worse than Germany’s or that deaths from lung disease in the UK are two thirds worse than the European average. The NHS should be focused on those issues. That is what is most important, not whether every PCT sets up a Darzi centre.
The Government talk about world-class commissioning. We need world-class services, but we will not get them with a one-size, top-down bureaucratic approach. We will get them through innovation, professionalism, responsiveness to patients and the rigorous application of evidence-based care. Treat the staff of the NHS like drones, and they will behave like drones; trust them like professionals, and they will respond.
The Government have de-professionalised the NHS, which is why they have seen declining productivity year on year. That is why, despite their targets, performance has fallen short. Patient choice has diminished—fewer patients say that they have experienced access to choice—and practice-based commissioning has stalled. Patient experience measures have deteriorated, and the foundation trust programme has not met its 2008 targets. Health inequalities have widened—[Interruption.] The Minister of State says that I do not like targets. What is the point of targets if they do not deliver? What was the point of saying that every hospital should be a foundation trust by 2008, when only about half of them are?
The Minister of State may like to recall that back in 2006, Tony Blair described his four drivers for health reform—patient choice, foundation hospitals, independent sector treatment centres and practice-based commissioning. All four have stalled or disappeared from the reform process. The Blairite reforms have gone. What do we have in their place—world-class commissioning? It does not feel world-class yet.
We will not have world-class NHS services unless the Government recognise what is really needed—to trust NHS professionals, to make the service more accountable to patients, with less to top-down bureaucracy, to reinvigorate our public health service and to focus at every level on patient outcomes. We are committed to reforms that would make a real difference to patients and NHS staff. For the Government it is all Darzi or drift; it is about money spent and money wasted; it is all inputs and not enough outputs.
The Queen’s Speech is all short-term gimmicks and does not include the long-term reform that our great public services so badly need. The Government have run out of steam—they are out of ideas and out of time. I agree with my right hon. Friend the Member for Witney: bring on the election. I commend the amendment to the House.
I welcome this opportunity to debate the measures in Her Majesty’s Gracious Speech. The proposals on health set out how we will expand patient choice, enhance quality, protect the health of young people and safeguard the values and principles of the NHS for future generations. The proposals on education will provide new powers to improve standards in schools, provide greater opportunities for young people and improve the local organisation of children’s services to make them more responsive and accountable. The child poverty Bill will enshrine in legislation our intention to eradicate child poverty by 2020.
Eleven years ago, the NHS was on its knees, after nearly two decades of neglect and underinvestment. In schools, only 35 per cent. of pupils achieved five or more good GCSEs, including English and maths, and the Conservative Government were preparing to introduce nursery vouchers for early-years provision that was scant and inadequate. Now, we see improved standards, nursery places for all three and four-year-olds, new schools and hospitals, reductions in mortality rates from the three big killers—heart disease, stroke and cancer—and the best ever A-level and GCSE results.
By far the most damaging legacy of the previous Government was long waiting times, which delayed important surgery for many months and even years. By the end of 2008, no patient will need to wait more than 18 weeks from the time that they are referred by their GP for treatment, and the average wait will be no more than eight weeks. It is worth reflecting on the way that that enormous achievement by NHS staff has changed a mindset that became entrenched in the Conservative years. Only recently, a clinician at St. Thomas’s was telling me about how, in 1994, her chief consultant took his medical team out to dinner to celebrate the fact that they had reduced the waiting times for hip replacements from five years to three years. The chief medical officer tells of elderly patients in the 1980s seeking to bequeath in their wills their places on the waiting lists to family members, having waited years for a cataract operation. That was the reality of life in the NHS under the Conservative party.
I agree that substantial progress has been made on access to treatment, particularly in acute hospitals, but what about mental health? Does the Secretary of State agree that we need to tackle the outrageous waiting times in mental health care as well? People frequently wait more than a year for access to cognitive behaviour therapy. If they have the money, they can pay to go privately. If they have not got the money, they just wait. That must be tackled.
That will be tackled. The hon. Gentleman is right to say that there are unacceptable waiting times in mental health care, but I will come on to mental health in a minute. The leader of the Liberal Democrats described mental health as being in crisis in this country two weeks before the World Health Organisation said that we had the best mental health services in Europe. I will come on to mental health, because I believe that a chunk of time needs to be devoted to it.
Apart from waiting times, there has also been dramatic progress on tackling health care acquired infections. In September, we announced that we had achieved and exceeded our ambitions of reducing MRSA cases by half—achieving a 57 per cent. reduction in three years. In October, we announced that clostridium difficile cases had fallen by 38 per cent. among the over-65s. We have seen dramatic improvements in primary care. GPs see patients for longer—the length of consultations has gone up by 50 per cent.—and the number of consultations per year has risen from around 221 million in 1997 to nearly 300 million this year. Following the agreement reached with the British Medical Association earlier this year, which Opposition Members opposed, 65 per cent. of GP surgeries are now offering additional weekend and evening appointments—again, meeting and then exceeding our ambition, which was to have half of all surgeries opening for longer by the end of the year.
Will the Secretary of State forgive me if I do not make a party political point and refer to the future, rather than the past? I am very proud of the fact that we are doing a lot of work with the National Audit Office in trying to raise up the agenda the Department of Health’s work on dementia, stroke and end-of-life care. I wonder whether he will say a word about his priorities now that he will address that problem. He has mentioned, of course, his efforts on cancer and heart disease, but dementia, stroke and end-of-life care are very important as well.
The hon. Gentleman is, of course, absolutely right. We published our stroke strategy a year ago, in December 2007, and everyone involved, including the non-governmental organisations and the Stroke Association, is very pleased with the progress that has been made. The hon. Gentleman is quite right to mention dementia. It is an important issue, and only a couple of weeks ago, I mentioned in a speech that cancer had a stigma 20 years ago—people did not talk about cancer in polite society—and that that was now the case with dementia. Of course, no one made jokes about cancer, but people make light-hearted references to dementia, which has to stop.
Our dementia strategy, which will be published shortly, will concentrate on raising awareness, removing the stigma and ensuring a better quality of care and much earlier diagnosis. A dementia sufferer usually goes to a GP about seven or eight times before dementia is diagnosed, so a lot needs to be done there as well. We published our strategy on end-of-life care four months ago. Once again, it entails working with the voluntary sector and NGOs to develop the ability to convince people that, if they choose to die at home, support services are available to them and their families to ensure that they will be okay. That is the biggest single reason why families are sometimes reluctant to allow their loved ones to come home.
Following the NAO reports on dementia and stroke, the Government adopted the strategies that the Secretary of State has discussed, and I am very pleased that they did so. When I have visited stroke units, I have found some excellent work going on. However, a physiotherapist told me that, once the person is discharged, so long as they can get around indoors, they then get virtually nothing at all—they go from very good support to nothing. Stroke victims need continuity of care when they go home. Is the right hon. Gentleman making plans to ensure that that support is provided?
The hon. Lady is absolutely right. That is why the strategy focuses on prevention, on what is done immediately someone has a stroke—thrombolysis and so on—and on a better quality of care. As important as all that is, however, as Macmillan has been saying for many years, aftercare back in the community is crucial. It is one of the three central features of the stroke strategy, and we intend to ensure that every aspect of that strategy is implemented.
May I return the Secretary of State to dementia? He said that the national dementia strategy will be published shortly. As he knows, there are three elements to the welcome work that the Government are doing on dementia: first, there is the national strategy; secondly, there is the research summit; and thirdly, there is the review of anti-psychotic medication. The timetable has slipped quite significantly in relation to all those elements, and he will recognise the concern of all those involved that the urgency originally expressed by the former Minister with responsibility for care services, the present Under-Secretary of State for International Development, the hon. Member for Bury, South (Mr. Lewis) does not appear to have been persisted with, which is a matter of extreme concern. Will the Secretary of State assist us by saying exactly when each of those elements will be available?
I believe that the Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope) had a meeting yesterday with the all-party group that the hon. Gentleman chairs. The dementia strategy should be published very shortly—not before Christmas, but very soon in the new year—but getting a day in the grid is the problem. I believe that the review of anti-psychotic treatment will be ready by about the spring—it is on a slightly longer time scale. I am sorry, but I have forgotten the hon. Gentleman’s third point.
The Government indicated that the research summit would be held this summer, but that did not happen. I take the opportunity to thank the current Minister with responsibility for care services for coming to the meeting. He explained that all those things will be available shortly, but I simply wonder whether we could have a little more specificity.
The hon. Gentleman is seeking a definition of “shortly”. The research conference will take place at about the same time as we publish the dementia strategy, so it should take place very early in the new year. I am not trying to be difficult, but the way in which this works is that we have to get our slot in the system, and I hope that we will get a date very soon.
Only two weeks ago, I opened the first GP-led health centre, in Bradford; the second opened on Tuesday, in Corby. We were rather disappointed: we expected the Opposition Front-Bench team to be outside with placards, protesting vigorously, along with the BMA, but there was not a single protest. All we had was the local community, absolutely delighted to have that fabulous facility in their community. The centres provide access to primary care services from 8 am to 8 pm every day of the year, including Christmas day. The next year will see 152 such centres open, many of them offering additional services such as podiatry, physiotherapy or speech and language therapy. In addition, many will be able to perform minor operations and offer specialist services to patients with asthma or diabetes who would otherwise have had to go to hospital for treatment.
We are also funding 112 additional GP practices to provide much needed services for under-doctored areas, which, for the most part, have suffered from a chronic shortage of GPs since the NHS began. That is a vital step in tackling health inequalities. There is a clear correlation between limited access to primary care services and poor health.
On that very point, my right hon. Friend knows that I have invited him to my constituency to open the new Moorgate medical centre. The centre is now open and patients are benefiting from it. It is of enormous value to my constituents, who welcome the investment that paid for it. May I repeat my invitation to him to perform the official opening function in a few weeks’ time?
I am pleased to hear that. I think my hon. Friend is duty bound to inform the local population that the Conservative party opposes GP-led health centres, saying that they will lead to 1,117 GP practices closing. Have any closed or are any likely to close in his constituency? I expect that experience to be repeated throughout the country.
I suggest that the Secretary of State should indeed go to Bury. As well as seeing the centre that the hon. Member for Bury, North (Mr. Chaytor) mentions, the right hon. Gentleman could take the opportunity to go to Fairfield hospital and shut the maternity services there at the same time.
Once again, the Opposition use that tactic. They said in a press release issued in summer 2007 that 29 hospitals were going to close; immediately, 15 of those hospitals pointed out how wrong they were. A hospital that they said was going to lose its accident and emergency department did not even have an A and E department. Then, the Opposition moved to arguing that 1,117 GP practices would close if GP-led health centres opened, because, they said, each centre would have 20 GPs. In fact, the most each centre will have is five. They were wrong on every count.
Will my right hon. Friend give way?
Now, the Opposition are mixing up two separate issues: the reconfiguration of maternity services—which I am sure my hon. Friend will mention when I give way to him—and GP-led health centres.
My recollection of the shadow Secretary of State’s last visit to my constituency is that he was not allowed inside Fairfield hospital to look at the work being done in maternity care—[Interruption.] My recollection is that the photo was taken outside the building. The reorganisation of maternity services in Greater Manchester was necessary—
On a point of order, Mr. Deputy Speaker.
It was necessary because—
Order. That is an extremely long intervention—I think that the hon. Gentleman has more than made his point. I call Mr. Andrew Lansley to make his point of order.
I do not want the hon. Member for Bury, North inadvertently to mislead the House, Mr. Deputy Speaker. I have visited Fairfield hospital twice. On the most recent occasion, I had a full visit all the way round the maternity services and a lengthy meeting with clinical staff.
That is certainly not a point of order for me, but the hon. Gentleman has made his position clear.
What my hon. Friend the Member for Bury, North was about to point out is that we have got off second-stage complaints and the health innovation fund and on to the real meat and gravy of health services. The reconfiguration of maternity services in his constituency should have been carried out 40 years ago. Clinicians in the Manchester area say that they have been trying for 40 years to reconfigure maternity services to save babies’ lives. The Conservatives, in another failed campaign, have said that there should be a moratorium on closures.
The Secretary of State made an important point about dealing with under-doctored areas. It has long been a scandal that the poorest parts of our communities have far fewer doctors than the leafier suburbs—[Interruption.] I support what he is doing. However, will he please say what steps are being taken on the minimum practice income guarantee? I know that steps are being taken to eradicate it, so that payments to GP practices are based on need and population, but how long will it take?
My right hon. Friend the Secretary of State for Children, Schools and Families was saying that it was worth turning up to learn that the Liberal Democrats also oppose GP-led health centres. The hon. Gentleman asks about the MPIG. This year’s deal with the BMA begins the process of eroding the MPIG. We would have liked to have a multi-year deal, but that was not possible; instead, we agreed a one-year deal and we agreed on the principle of eroding the MPIG. If we continue to erode it on the same basis in future years—I see no reason why we would not—the proportion of practices that depend on the guarantee will decrease from about 90 per cent. now to about 20 per cent. in four or five years. That is a very important development and I praise the BMA—I do not praise the hon. Gentleman; that would be a first—for recognising the fact that, as he says, the MPIG militates against tackling health inequalities.
On his journey from his Hull constituency to Bury, my right hon. Friend will pass through Huddersfield, where we would love him to open something. However, may I remind him of the disgraceful campaign the Opposition waged in Huddersfield? The Calderdale and Huddersfield NHS Foundation Trust was angered by the time it took to guide their large party around the hospital and by the misleading press release that they issued afterward.
My hon. Friend should be gentle with the hon. Member for South Cambridgeshire (Mr. Lansley), who has already had to apologise for something he said earlier this week. If he had to apologise for all the mistakes he has made, he would be at the Dispatch Box for hours and I would never make progress on my speech.
Before we leave the topic of the reorganisation of maternity services and the development of much stronger community-based maternity services, is not the great irony for the Opposition that, if they had pursued their policy of listening to the medical profession without any interference from primary care trusts, acute trusts or the Department of Health, the changes would have been made many years ago, to the vast benefit of the overwhelming majority of women?
It took three attempts, but my hon. Friend has made his point well and eloquently.
As I mentioned earlier, significant improvements have been made to mental health services, in particular community-based and preventive treatment. Since 1997, an additional 740 community-based mental health teams have been introduced, providing early intervention and intensive support; the number of consultant psychiatrists has increased by 64 per cent., the number of clinical psychologists by 71 per cent. and the number of mental health nurses by 21 per cent.
Does my right hon. Friend agree that one of this Government’s great successes has been their suicide prevention strategy, which has cut suicides in England to the lowest level since 1863? Unfortunately, the strategy is due to end in 2010. Will he assure me that the focus will not be removed from suicide prevention and that we will continue to put it at the forefront of our mental health strategy?
My hon. Friend makes a good point. I wish that I had not given way, because she has stolen my thunder; that point was in my peroration. I can give her the assurance she seeks. Of course, all these measures take money. Earlier this year, the shadow Secretary of State talked about £28 billion more going into health under the Tories, but we have not heard what will happen. We have not heard whether they would match the spending in 2010-11 that we announced on Monday. I would be interested to hear about that before the end of the debate, because the spending is important, if we are to do all the things that we want to do on mental health and other issues.
Before I gave way, I was going to say, “And the suicide rate has fallen to its lowest level since records began in 1848.” That will teach me. One in four people will experience an episode of mental illness at some point in their life. Mental illnesses such as depression are one of the leading causes of disability in this country, and 42 per cent. of people on incapacity benefit are on it because of a mental health problem. Until recently, access to psychological therapy was limited, even though, as the hon. Member for South Cambridgeshire said, it is widely acknowledged as the most effective way of treating mild to moderate depression.
As recently as seven years ago, only 9 per cent. of people with depression or anxiety were offered psychological therapy by the NHS. In October 2007, I announced that there would be a rapid expansion of access. The 13 new psychological therapy pilots that I launched a year ago have treated 17,500 people. This month, 35 primary care trusts launched their services; that is 15 more than we had anticipated. By 2011, we will have recruited 3,600 therapists, who will have helped to treat 900,000 people. Those are just some of the many developments that led the World Health Organisation in October to describe mental health services in this country as the best in Europe. In schools and children’s services, there has been similarly dramatic progress.
Will my right hon. Friend give way?
I will make some progress, if my hon. Friend does not mind. There has been a significant expansion in child care and early years education, and greater achievement by pupils at all key stages. More young people than ever before are going on to study at university. Far from variable tuition fees discouraging poorer people from going to university, the social class gap in higher education is narrowing; it grew in the 40 years after the Robbins report. I point that out to my hon. Friend the Member for Norwich, North (Dr. Gibson), who, I remember, engaged in the debates on the issue.
One of the defining moments of this Government came when we pledged to eradicate child poverty by 2020. That has been one of the most important catalysts for improving the life chances for children in this country. In October, the OECD reported that there had been faster growth in income equality in the UK than in any other developed country, and that the poverty rate had fallen well below the international average. It described the achievements in this country as “remarkable”. There are now 600,000 fewer children living in relative poverty than when we took office, and the number of children living in absolute poverty has halved, yet we need to do still more. The measures set out in the Gracious Speech will strengthen children’s trust boards, so that they can lead on local improvements to services. There will be a Bill to raise standards in schools and improve education and training for 16 to 19-year-olds and enhance the skills of those already in the workplace. We will also introduce a Bill that will convert our pledge to eradicate child poverty altogether by 2020 into a legislative commitment.
On health, we need to adapt to meet new challenges. An ageing population and the prevalence of lifestyle diseases such as obesity bring different pressures on health and on social care. Smoking, poor diet and lack of exercise account for most of the disease burden in this country. The next stage review, led by my noble Friend Lord Darzi of Denham, set out how we would ensure that the NHS promotes good health and well-being as effectively as it detects and treats illness.
On health, a major cost to the NHS is diabetes, and recent research suggests that there may be a link between diabetes and coeliac disease. I am a member of the all-party group on coeliac disease and dermatitis herpetiformis. Will my right hon. Friend, or one of his Ministers, meet the group to discuss the disease, which, as my right hon. Friend will know, has a prevalence of about one in 1,000? With the right diet, the adverse symptoms of that disease are entirely preventable, but coeliac disease goes undiagnosed in many carriers for years, and costs the NHS dear while those people are undiagnosed. That is aside from the devastation to those people’s lives. Will he agree to meet the group?
My hon. Friend raises an important point about coeliac disease, and of course I, or one of my fellow Ministers, will meet the group. The next stage review set out how the NHS will ensure that it promotes good health and well-being effectively. It also set out how the NHS will further improve quality of care and give patients greater choice.
Will the Secretary of State give way?
One more time.
I thank my right hon. Friend for giving way. One of the big problems for people with Parkinson’s disease is simple to address. When they are required to go to hospital, they should have access to the same medication that they were taking at home, at the same time as they took it at home. All too often, however, their health deteriorates in hospital because they have to fit in with the nurse’s medication rounds, rather than getting medication as and when they need it. Is there any way in which that can be addressed in the current review?
The current review is all about the issue of personalised care. It is about how we move away from a regimented system and look at the needs of individuals, not least for the important reasons that my hon. Friend raised. There are many other ways in which a stay in hospital could be much more beneficial if the routine were changed. We are finding that out in an initiative called “The Productive Ward”, in which we give nurses and clinicians the ability to organise how the ward works, having listened to the patients on their wards. My hon. Friend makes a profound point.
The health Bill will introduce several measures that will support the implementation of the next stage review, including measures to enable the NHS to explore the potential for personal budgets by piloting direct payments to patients with long-term conditions, and provisions requiring all NHS providers to measure the quality of their services and make that information available to the public. The Bill will also propose several measures to support the health of young people and, in particular, to promote health and well-being. We have already set out a groundbreaking strategy to tackle obesity; it is the first of its kind in the world. An essential component is “Change for Life”, the social marketing campaign that brings together community groups, retailers, employers, the media, schools, health services and national and local government to encourage people to lead healthier lives.
We need to do more to tackle smoking, which still accounts for 87,000 premature deaths in England. Two thirds of smokers start before they are 18. I am genuinely perplexed by the approach taken on the issue by both the Conservative and Liberal Democrat Front Benchers—by the “nanny state” allegation from the Liberal Democrats, and by the other criticisms that we have heard today. The hon. Member for South Cambridgeshire started his speech by talking about the importance of consultation. He said that there had been a derisory response on the NHS constitution, but a very big response—86,000 responses—to a consultation on something or other; I forget what it was.
On pharmacy.
Yes, pharmacy, on which there will be a report very soon. The response on the smoking issue is the biggest that we have ever had on any consultation. If the hon. Gentleman believes that one should simply follow the result of consultation—that is a rather dangerous belief, if taken to its obvious conclusion—he will support the measure in question. The overwhelming response from 100,000 people consulted was that we should remove tobacco from display.
The hon. Gentleman talked about a lack of evidence, and having evidence-based measures. We have found that in other countries where such a measure has been introduced, smoking has reduced among young people. The number of young smokers in Canada, for instance, was reduced by 32 per cent. among 15 and 19-year-olds as a result of the implementation of the measure. There was a 26 per cent. fall among 15 to 16-year-olds in Iceland. That is why Australia, New Zealand and many other countries are taking that route, and why we must do so, too. We should recognise that a youngster who starts smoking between the ages of 11 and 15 is three times more likely to suffer a premature death than somebody who begins smoking at 20. Given the efforts over the years to reduce the number of smokers, with the figure down to 22 per cent., and given the recognition of what a huge public health issue smoking is, and the fact that it is the biggest health inequalities issue—in manual occupations, 29 per cent. still smoke, compared with the overall figure of 22 per cent.—I am perplexed why responsible politicians in both Opposition parties should oppose the measure. I believe that they will be on their own, without public support, when the measure is introduced.
We will take measures, too, to ban vending machines, which provide only 1 per cent. of the overall cigarette market, but provide 17 per cent. of the cigarettes sold to 11 to 15-year-olds. We will take steps, first, to restrict access to vending machines, but if that does work, we will ban them. The steps that we will take to promote health and well-being will have a significant impact on the health of our society.
The NHS is the proudest achievement of a Labour Government. Massive investment and greatly improved services mean that in the 60th year of the NHS, the case for a national health service that provides universal health care, free at the point of need, is supported as strongly by the public as it was at its inception. By 2011, investment in the NHS will have trebled. On Monday, I announced an average increase of funding of 5.5 per cent. for primary care trusts over the next two years, representing a £164 billion investment in the NHS over the next two years. That will mean a rise in local spending on health from £426 per person when we came into government in 1997 to the grand total of £1,612 by 2010.
Say that again.
When the Opposition were in government the figure was £426 per person, but under this Government it is £1,612. As a result of extra investment supporting the skills and abilities of its dedicated staff, the NHS has reduced the rate of premature deaths from heart disease by 50 per cent., from stroke by 44 per cent., and from cancer by almost 20 per cent.
If that spending was not matched by other political parties, has the Secretary of State made any estimates of the impact on the health and well-being of my constituents and those of many other hon. Members?
My hon. Friend is absolutely right. Up to now, the Opposition have sought to suggest that they are as dearly attached to the NHS as the Labour party, abandoning their patient passport scheme, on which every single Opposition Member was elected. They have sought to say that they will invest more. The hon. Member for South Cambridgeshire got into trouble in February for saying that his party would put £28 billion into the NHS. Now we know that it is going to spend less overall and less on public services. We know from the hon. Member for Runnymede and Weybridge (Mr. Hammond), the shadow Chief Secretary to the Treasury, that it will spend less on the NHS. We have not heard it from the lips of the hon. Member for South Cambridgeshire, so I would be perfectly willing to accept an intervention from him, as we need to know whether the Opposition will match our spending in 2010-11. [Interruption.] Okay, he does not wish to do so.
The constitution that we published alongside the NHS next stage review set out the key principles and values of the NHS, reaffirming our commitment to a service for all our people, with the finest medical treatment available, based on need, not on wealth. It enshrines the rights and responsibilities of patients and staff, bringing together existing legal rights with pledges and commitments about the standards of service that the NHS will provide. It establishes patients’ legal right to choose where they are treated for certain services, and it sets out a patient’s right to all NICE-recommended drugs and treatments.
The health Bill will place a legal duty on the NHS, its regulators and any independent or voluntary sector bodies that provide NHS services to have regard to the constitution. It will also commit the Government to renewing the constitution every 10 years. I believe that by building on the solid foundation established over the past 11 years, the NHS constitution and the measures that we have set out in the Gracious Speech will accelerate further progress, improve quality and intensify the focus on prevention. That will further enhance the huge progress made in health and education, and I commend the Gracious Speech to the House.
I welcome the opportunity both to reflect on the state of these vital public services and the Government’s intentions, and to explain our alternative vision.
This debate coincides with the Healthcare Commission report on the state of health care in the UK. It is right to acknowledge, first, that that report had lots of positive things to say about progress in the national health service. The Secretary of State mentioned that progress has been made on survival rates for heart disease, stroke, and cancer. Survival rates for those serious diseases have improved, which is something that we should all welcome. We should welcome, too, the substantial improvements in access to care, compared with the position 10 or 11 years ago. There has been a dramatic improvement, and it would be churlish to fail to recognise that—
But the Healthcare Commission drew attention, too, to the fact that there were areas of serious concern. Ian Kennedy, the chair of the Healthcare Commission, focused on patient safety, and I want to concentrate for a few minutes on the area of most significance—child protection, particularly the tragedy involving baby P. Again, it is important again to acknowledge that the Secretary of State for Children, Schools and Families acted commendably fast in recognising the seriousness of the failings and in mapping out a way forward. However, it is also right to say that so far, the emphasis and focus, particularly in the media, have been on the failings of the local authority—and there were many—rather than on the failings of other agencies. I think that there are lessons to be learned, and it is important to reflect on them for a moment, particularly the situation in the local health service, because serious concerns have been raised with me.
I understand that the paediatric service for child protection in the borough was outsourced to Great Ormond Street. I understand that there was a team of four doctors, of whom two have resigned, one has been on special leave for a year, and one is off sick. Given the fundamental importance of that work—I make these comments not in any sense in a partisan way, as we all have a common view of the importance of addressing these issue—that is an alarming situation in itself. Incidentally, if either Secretary of State is unable to respond to these points today, I am happy for them to respond in writing later. What factors have led to this situation? Why has one of the doctors whom I mentioned been on long-term special leave for a year? Is it the case that the primary care trust cut funding for a designated doctor post, and is it the case that the paediatrician who did not recognise the broken back and ribs in the case of baby P was a locum employee?
I have heard concern expressed that when children are brought into St. Ann’s hospital in Tottenham as possible victims of abuse, there is a tendency for no information to arrive with the child to put the medical team fully in the picture about possible concerns. That relates to the issues of co-ordination and the sharing of information between agencies dealt with in the report released by the Secretary of State for Children, Schools and Families. I understand that when one doctor filled in a critical incident form at that hospital, in relation to another case, he was told not to do so because it would show up poor record keeping. I do not know whether there is any truth in that allegation, but it is a serious matter and it clearly needs to be investigated. What short-term steps have been taken to ensure that there are proper safeguards in place for other vulnerable babies and children in that borough? What are the longer-term lessons for the NHS—as opposed to the local authority, which has had its fair share of attention—particularly with regard to the responsibility and accountability of the clinicians involved?
That takes me to the wider question of child protection. Such tragic cases open up a debate on parenting and on how we can best protect children. The case of baby P is a stark case of failure, but throughout the country, every day, social workers are grappling with the genuinely difficult dilemma of whether to remove a child from their parent or parents and to place them in care. It is massively challenging work, and the last thing we should do is to stigmatise social workers and make that an unattractive profession, thus putting able people off going into it. After such a disaster, there is a risk that policy is shaped in response to it, and that there is a swing of the pendulum into a different approach, which may not itself be right.
I would like to mention the other side of the coin. There are many cases in which there are genuine concerns about the failure of authorities to remove a child who is at risk, but in my constituency I have been dealing with the case of the Webster family, which was covered in the national press last year. They had a little boy who was taken into the Norfolk and Norwich hospital complaining of pain, and it turned out that he had multiple fractures. The child was removed, along with his two siblings, and after a long process the three children were adopted. That family lost their three children. Subsequently, it was proved through further medical evidence that they were innocent, and that there was an innocent explanation for the fractures—a nutrition deficiency. That case is a disaster. It is a disaster in the system and a gross miscarriage of justice for a family to lose their three children when they are innocent. It cannot get much worse than that. My plea is for us to avoid another swing of the pendulum, and to focus instead on ensuring that procedures are exacting, rigorous, thorough and professional, and that we focus on standards of professionalism in social care and in the NHS.
My hon. Friend is well aware that I have been concerned about both false positives and false negatives in the public family law environment. Does he share my concern that it is difficult for parents to get a second, expert opinion because they require the permission of the judge, which is often refused in family court proceedings?
I share that concern, and because it is so fundamentally important that we get such decisions right, the opportunity for a second opinion ought to exist in all cases. Had it been available in the Webster case, we might have avoided the miscarriage of justice that subsequently ensued. If we focus on standards of professionalism in reaching the right judgment, we stand the best chance of avoiding those dreadful miscarriages of justice, and of ensuring that children who are genuinely at risk are protected and withdrawn from their parents, if necessary. There should be no rush to put children into care, but the right decision, based on absolute professionalism, must be made.
Sure Start is one of the Government’s genuine successes. The WAVE Trust is a good organisation, which has been influential in guiding Government policy development—I believe that it has engaged with all parties. It focuses on the first three years of a child’s life, recognising the importance of getting things right in those years. It concentrates on parenting and ensures that children avoid adverse, damaging experiences that can affect their life chances, including their future health. The right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) and the hon. Member for Nottingham, North (Mr. Allen) produced a good pamphlet, which focuses on the importance of investing in the first three years of life.
A recent article in The Lancet on a research report shows that Sure Start has started to make a difference. We should acknowledge that and recognise that it has been a positive policy move. However, an article by Rachel Sylvester in The Times earlier this week warns that there are signs that the approach in children’s centres and in Sure Start is moving away from parenting skills and towards education. I hope that the Secretary of State for Children, Schools and Families, if he is listening, will ensure that the focus on parenting in children’s centres, which has been so valuable and, according to the research, shows success, is maintained and not lost.
I want to deal with the Government’s proposals for a national health service constitution. It is hard to object to the warm words and aspirations in the proposed constitution, but the Government must answer the key question of whether it will make a difference. Ten years down the line, will patients be able to say, “Ah, we’re being treated better because of that NHS constitution”? Does it tackle the key challenges that face a publicly funded health system?
First, the draft constitution specifically precludes discrimination on the basis of race, gender, disability, religion or sexual orientation, but not of age. How can that be right? Secondly, we all agree that the divide between health and social care can be a problem. Should we therefore also consider the possibility of a social care constitution, so as not to entrench that divide further?
I would prefer something that encapsulates both, and acknowledges that there is an artificial divide between health and social care, which is often damaging to the care that an individual experiences.
The equality Bill is to deal with the first point that the hon. Member for Leeds, North-West (Greg Mulholland) made. We do not know until we see the detail, but the Government are well versed in the need to ensure that age is included in anti-discrimination proposals.
I welcome the equality Bill, but one has to ask why age has been left out of the list of discrimination that the NHS constitution seeks to tackle. We all know that age discrimination happens in the NHS. There is clear discrimination in mental health services: for example, elderly people who suffer from depression and anxiety do not have access to cognitive behavioural therapy. My hon. Friend the Member for Leeds, North-West (Greg Mulholland) is right that we should deal with discrimination based on age as well as that based on other matters.
The amendment encapsulates the priorities that we should address, although I do not believe that the Conservative programme tackles them properly or effectively. They include quality of care and outcomes, on which it is right to focus, as well as accountability. Sadly, the Conservative approach—establishing an independent national quango—would reduce rather than increase accountability, but the amendment is right to refer to it. It also mentions the need to tackle bureaucracy, to ensure value for money, to have a renewed focus on public health—the area that has so often suffered when the finances have got tight—and to tackle health inequalities.
Earlier this year, a King’s Fund report said:
“If the NHS constitution did not confer any legally enforceable rights or guarantees it would, similar to the Patients’ Charter”—
that was the thing that the Conservatives came up with—
“before it, be seen as a political device that simply raises expectations, which then cannot be met. Indeed it would hardly be worthy of being called a constitution.”
That identifies the real risk of this document, which is that it will raise expectations. People will assume that it will deliver something to them that is not being delivered, but ultimately it will amount to motherhood and apple pie, and there will be no extra delivery.
Will there be any legally enforceable rights or entitlements within this constitution? It seems that there will not be; the sanctions for breaching the NHS constitution do not appear anywhere. Trusts will have to “have regard to” things—that wonderful legal phraseology means, of course, absolutely nothing, because one can be acting entirely within the legal framework if one has regard to something and then entirely ignores it. [Interruption.] I shall ignore the abuse from the hon. Member for Wolverhampton, South-West (Rob Marris), which is so uncharacteristic. The proposals contain a reference to the responsibilities of patients, but what does it amount to? There is no substance to it.
What about the issue of missed appointments? Missed appointments cause the NHS enormous additional costs, and many are avoidable. We can do a lot to reduce the number of missed appointments, by using technology and sending text messages, emails and so on—but should we not be considering the idea of charging people, where appropriate? We should recognise that some people’s condition means that they may be unreliable—[Interruption.] Well, there was a great intake of breath from the hon. Member for Bury, North (Mr. Chaytor), but if we are talking about responsibilities, where are they set out? They appear to be entirely nebulous. If we are not talking about responsibilities in any meaningful sense, we should not even use the word.
Does the hon. Gentleman not realise that in most general practitioner practices and in most hospitals the normal practice would be, as it is in other areas of our public and commercial life, to overbook the number of appointments in the first place? That happens with aeroplanes, trains, coaches and MPs’ surgeries; that is how one deals with this. Does he not also realise that many people who miss appointments do not do so wilfully? Such people miss appointments because of varied and complex pressures in their personal life, and fining them for missing an appointment would be too extreme.
I made the point that there would be many circumstances in which such an approach would be inappropriate, but we should consider having such a power, and run pilot schemes. The hon. Gentleman raises the point about a system of overbooking, but if he were to talk to any GP or hospital clinician, he would find that there is a massive problem with missed appointments. If we are having to deal with delivering health services in a much tighter financial situation, we must examine ways of saving wasted costs, and this is one area that we should examine. The main point I am making is that if the constitution talks about responsibilities, those must be genuine responsibilities. If they are not, we ought not even to refer to them, because the concept is meaningless.
The King’s Fund also discusses whether the constitution will endure and whether it will be vulnerable to change by successive Governments for political reasons, suggesting that if it is to have any real value, it ought to be a document that does endure, and cannot simply be changed on a whim by successive Governments. However, the constitution appears to contain no mechanism to prevent that from happening, which is also a criticism. It says nothing, either, about continuing health care or the funding of people with complex needs, which is surely a critical aspect of health care. If the constitution fails to address that at all, it is surely weak. The idea of having second opinions in child care cases has been mentioned, but the constitution says nothing about the right to a second opinion either. That, too, should be addressed.
Let me turn to smoking. We all agree that action should be taken to enable people to give up smoking and to warn people, particularly youngsters, of the risks of taking it up. There is clear evidence that a proportion of young people buy their cigarettes from vending machines, so we readily support action to clamp down on the sale of tobacco from vending machines. Indeed, we might need to go further than the Government have proposed, so as to avoid any risk of youngsters below the legal age buying tobacco in that way.
However, the Government’s case on displaying tobacco is not as good. The Conservative spokesman, the hon. Member for South Cambridgeshire (Mr. Lansley), referred to the risks of misinterpreting the statistics, but it was fascinating to read that the real price of cigarettes in Canada increased by 159 per cent. between 1979 and 1991. That led to the teenage smoking rate falling from 42 to 16 per cent., which clearly shows a direct link between price and teenage smoking rates. We know that price has an effect, but there has been no proposal on price. Canada cut the tax in 1994, because of concerns about smuggled cigarettes, and the real price fell by a third. That led to the teenage smoking rate increasing, from 16 to 20 per cent. We know that price is a relevant factor—it was referred to by the World Health Organisation—yet the Government have made no proposals on price.
We advocate other measures. We should establish a criminal offence of supplying tobacco to an under-age smoker. The Government appear to be flunking that one and have not come forward with any proposals. It is a criminal offence to buy alcohol in order to supply it to an under-age drinker, but why is it not a criminal offence to supply tobacco in the same way?
As for smuggled tobacco, the current statistics show that one in six cigarettes purchased in this country has been smuggled, as has 50 per cent. of the rolling tobacco. A recent article in the European Journal of Public Health highlighted the link between smuggled tobacco and deprived communities, saying:
“the people with the highest likelihood of having bought smuggled tobacco…are…heavier smokers with higher levels of addiction, living in socially deprived areas and with low educational attainment.”
People in deprived communities are obtaining their tobacco across the table in the pub or at the front door, yet we are talking about removing displays from shops—a controlled environment, after all—which will do very little to address health inequalities.
The hon. Gentleman and I represent similar rural constituencies. Although I have absolutely no brief for the tobacco industry, what worries me about the proposals is the fate of village shops. Does he think that one way round would be to have the ban, but to exempt small village shops and corner shops?
That is certainly an option. I share the hon. Gentleman’s concern that village shops are under enormous pressure already. Many are teetering on the brink—indeed, many have already closed—and any further loss of income could tip them into closure. That is something that we should all be concerned about.
I understand that it is already the practice in many areas for shops to sell smuggled tobacco under the counter. The hon. Member for Norwich, North (Dr. Gibson) has confirmed that he is aware of the practice, and I have heard of it happening in Haringey. If that is true, then removing the display of legally sold cigarettes in shops will only open the door to a vastly greater risk of smuggled tobacco being sold under the counter. How on earth can that be policed? This is one of those cases in which the law of unintended consequences might well apply.
I also want to mention smoking cessation, because there appears to be little evidence that the steps that the Government are taking having any real effect. At the moment, under the quality and outcomes framework— QOF—system, GPs get paid for mentioning smoking cessation to their patients and for telling them to suggest a date by which they could have given up. That is it; they get the payment just for doing that. There is no requirement to demonstrate success in the strategy of encouraging their patients to give up; they get the payment simply for mentioning it. In California, however, under the Kaiser Permanente insurance scheme, there is a much more intensive focus on counselling, on prevention, on mechanisms to encourage people to give up smoking, on smoking cessation programmes and on nicotine replacement therapy. Within that community of insured people in California, the smoking rate has been reduced from 18 per cent. to 9 per cent. It has been halved, and people benefit much more from that intensive approach.
Rather than taking a nanny state approach, or, as the hon. Member for Gainsborough (Mr. Leigh) has pointed out, taking steps that could push small village shops into closure, we should do things that are effective in helping people, and which will actually facilitate their giving up smoking.
Does the hon. Gentleman agree that it is nonsense that in the European Union—of which the United Kingdom is a member state—there are still subsidies for tobacco producers? That is crazy.
I absolutely agree with that. It is remarkable that that still occurs in this day and age. This is why international action on such issues, and on finding much more effective ways of tackling tobacco smuggling, must be a real priority.
I shall finish by addressing some of the things that the Queen’s Speech does not deal with. It is a massive challenge to make the NHS secure, sustainable and more effective, particularly in tackling the very poor provision of care for elderly people, at a time when we are seeing rapidly rising costs in our health system. Costs are rising because of lifestyle conditions such as obesity and alcohol abuse, and also because of the dramatically ageing population and the availability of new medicines. Costs are also rising at a time when the likelihood of sustained real-terms increases in funding is surely at an end. The Secretary of State mentioned a real-terms increase for the forthcoming year, but that provision is likely to end in 2010-11, after which the position will become much more difficult. The state of the world economy, and the impact that that is having on this country, will surely mean that focusing on ensuring that our health system is sustainable must be our highest priority. Unless we can get better value for money, we will surely be heading for a crash.
The Secretary of State said that the Darzi review pointed to a direction in which prevention became the real priority, but simply stating that it is a priority, without providing any real mechanisms to make it happen, will not result in any meaningful change. Our approach involves dismantling the wasteful, secretive, central bureaucracy and creating real accountability and financial responsibility locally. It also involves getting the finances working—we are talking about spending about £100 billion a year—to achieve the objectives that we all want to see: prevention, better self-care and better health for our citizens. As Derek Wanless said when he made the case for increasing spending on the NHS, our health system will be sustainable in the long term only if we are much more effective at helping people to care for themselves and to improve their health. So far, we have failed to achieve any meaningful change.
There has been a massive increase in funds for the health service, but the increase has been particularly at the acute end—for repair services. Meanwhile, community care and social care have been under intense pressure. Over the years of funding increases, the NHS has had five times the increase in funding that social care has had—without any explanation as to why that should be the case. Yet if we get our preventive services right, we will reduce pressure on acute services.
Thirdly, then, we must surely look at ways of integrating health and social care. The silo approach that we have is crazy: the patient does not understand the difference between health and social care, yet the system divides up care and budgets according to those dividing lines. We must ensure that we get better integrated care. We need to reflect on areas such as Torbay, where health and social care have been brought together at a service level, in order to avoid the crisis admissions to hospital that are so costly for the NHS.
Fourthly, we must ensure that we have more effective use of funds in our acute hospitals. At the moment, without good enough commissioning of care from our primary care trusts, the payment by results tariff is sucking money through the system. With social care under intense pressure, as I have said, many acute hospitals are making surpluses. Surely that is crazy.
The NHS needs to be better at adopting innovation. I want to refer specifically to photodynamic therapy, in which I know the hon. Member for Norwich, North (Dr. Gibson) has shown some interest. Pioneered at University College hospital, London, this is a cancer therapy that avoids invasive surgery and means that the patient may be able to leave hospital within two days of treatment. It has been shown to be effective with many cancers and it has the potential to be effective with many more cancers. It was recommended for further analysis in the cancer strategy a year ago, yet a year later, that further analysis has not even started.
If photodynamic therapy realises its potential, it will be massively cheaper to the NHS than invasive surgery, chemotherapy and radiotherapy. Patients who have the good fortune to end up in UCH—if they have head or neck cancer, for example—will benefit enormously from this therapy. However, one of my constituents contacted me to ask why he was never told about the possible availability of photodynamic therapy. Surely these innovations going on in our hospitals should be spread around the country much more effectively.
Finally, it is important to put more power in the hands of patients, so that they can vote with their feet—empowered with information and support to make the right decisions about their care. The Secretary of State referred to the pilots for developing personal budgets. We support them, but we believe that they should go further, as they have enormous potential to give patients real power and put them in charge of determining what their priorities are, particularly when they are suffering from long-term chronic conditions.
So far, very little of the public debate has been about how to avoid the crash, with massively increasing costs at a time when no more money will be made available. It is always the most vulnerable who are affected if we fall into crisis. That has been the case in the past with long waiting times, and it will be the case in the future unless we get it right. Surely the Government have to start mapping out a way forward to make better use of the available £100 billion to invest in preventive services, to keep people healthy and to ensure that the NHS is sustainable in the future.
It is a pleasure to be called to speak in this important debate.
Sometimes we on the Back Benches wish that there were a curb on Front-Bench speeches. The hon. Member for North Norfolk (Norman Lamb) spoke for 35 minutes. I almost lost the will to live. I say that because half of the debate time today has been taken up by Front-Bench spokesmen. No wonder the Chamber is so sparsely attended on an important debate on education and health, when Back Benchers turn up and have to wait so long to make a short contribution. It is disappointing sometimes to see the way in which those on the Back Benches are treated. I make that as a general point, Madam Deputy Speaker. You know that I can get irritable, because a long time ago you were one of my students and knew that I was an irritable lecturer. However, I will get on with my speech and try to make it reasonably lively.
Twenty years ago, we had the Education Reform Act 1988, which most of us associate with the person who is now Lord Baker. Some important reforms were introduced: testing and assessment, which is taken very seriously, the national curriculum, and the inspection service. The Select Committee on Children, Schools and Families, which I have the privilege to chair, is going through them. We have conducted a major inquiry on testing and assessment, have come to the end of an inquiry into the national curriculum, and are going to take a thorough look at inspection. In a sense, I always try to use the Queen’s Speech debate to say what is happening in terms of the progress that we have made over the past 20 years. Too often in the Chamber, we make party political points against one another, but if we took a more historical view, we would see that we agree on quite a lot of issues—but not all of them. We fundamentally disagree on some of them, and I shall come back to that.
It is part of a Select Committee’s job to attempt to establish the value for taxpayers’ money and the progress that is made over a longer period. It is with great interest that we look at this Queen’s Speech. It is quite thin, but it does include a portmanteau education Bill. There is an awful lot in it to do with education: from training and apprenticeships to the reform of the Qualifications and Curriculum Authority; measures to promote equality; the introduction of primary legislation to enshrine the child poverty targets for 2020; and the general aim to help families and businesses. I make no apology for concentrating on families and children in my remarks.
The newish Select Committee that I chair is different. Being Chairman of a Select Committee was a simpler task in the past because the Chairman called one Department to account. The responsibility is much more complex with children, schools and families, which I am told span 10 different Departments, if we follow families and children across those arbitrary divisions. The needs of families and children do not pay any respect to those artificial divisions between, for example, health and education.
It would be wrong if, at this time, with the enormous public interest in the welfare of children—particularly the most vulnerable children in our society—I did not spend a little time talking about them. It happens that one of the Select Committee’s decisions was to show that we were taking our responsibility for children seriously, and for the past few months we have been looking intensively at the whole area of children in care—looked-after children. We have been taking that very seriously and have learned a great deal. As soon as one gets into this territory, the vocabulary and acronyms are different, and there is a tremendous learning curve, which members of the Committee have enjoyed.
As we approached the end of the inquiry, we were hit by the awful tragedy of baby P. As we studied the ramifications of the baby P case, we learnt very quickly not just how many children become vulnerable each year, but how many children’s lives are ended when they are murdered by their parents or carers. The figures given to the Committee only yesterday by the chief inspector of schools were chilling indeed. During the early part of the debate about baby P, we were given figures from the National Society for the Prevention of Cruelty to Children stating that a child was murdered between once a week and once every 10 days; the chief inspector suggested that the figure was nearer to three children each week.
The issue is very serious, but it must be dealt with in a balanced way. When a tragedy such as this occurs, we need to establish what happened, and whether it is a one-off case or whether there are systemic problems to be addressed. The Secretary of State has moved very quickly in facing up to that responsibility. Unfortunately, we have seen yet another regrettable attempt by the British media to conduct a trial by television and newspapers even before the facts are known. I believe that we have a heavy responsibility to introduce some balance to that knee-jerk attitude to every crisis, and put it into perspective.
What went on in Haringey was not good. I have been given privileged access to some of the documents involved, and they are very disturbing indeed. What do we learn from this case? We certainly learn that the role of Ofsted needs to be re-evaluated. The evidence that we took yesterday caused me to worry about just how often inspectors enter local authority children’s departments, how close they get to those departments, how often they go to meetings, meet real people and discuss the issues across the table, and to what extent inspections are paper-based.
As I listened to the chief inspector’s evidence yesterday, I had the impression that Ofsted’s system, which is not bad for the purpose of evaluating schools, has been transported to child welfare, where it is less appropriate. I told the children’s commissioner that I found it surprising that, given that there are only 150 local authorities, there was not a member of the inspectorate in every one. It would not have to be a long-term arrangement, I said, but there should be a presence. A member of the inspectorate should regularly accompany social workers on difficult visits, and should sit in on case conferences.
Of course, we now live in the world of the e-mail. We all know organisations in which colleagues who are just across the corridor from each other do not knock on the door and speak, but e-mail instead. That disease exists in health and social services organisations in both the private and the public sector. I believe in the good old-fashioned presence of a person at a table, looking others in the eye and talking about a case—perhaps asking “When did you last see this family?”, “When did you last discuss the child?”, ”When did you last talk to the child on his or her own?” or, “When did you last ask whether there was a man in the house? Did you ask a neighbour whether there might be a man living in the house whom you had not known about?” That last question is a common theme in many difficult cases of this kind. In the context of the baby P case, I issue a plea for us to look very seriously at the systems.
As the hon. Gentleman probably knows, I have been studying the systemic aspects, and trying to establish how many serious case reviews following a child’s death have occurred nationally. Ofsted has only been able to look at the figures since 1 April 2007, but the Government have instructed local authorities not to provide me with lists of serious case reviews prior to that date. Would the hon. Gentleman consider using the authority of his Committee to investigate the number of cases over the past few years since serious case reviews became more common, so that we can identify the systemic trends?
I know of and respect the hon. Gentleman’s work, and I will be as helpful as possible in my role as Chairman of the Committee.
We are looking for systemic problems, and we picked up on one yesterday that caused great shock: the records of the Ofsted investigations of children’s departments were not kept for longer than three months. Apparently, a lot of the original information about what went on in the inspection, such as who was met, what was said and who attended what meetings, disappears after three months. I ask the Secretary of State to look into that.
Did the hon. Gentleman’s Committee discover why there was such a practice?
The answer we got yesterday was that the volume of material would have been too great. I can understand that in terms of school inspections as there are thousands of schools, but I find it more difficult to accept in respect of 150 local authorities and children’s departments. Our role in this House must be to get the answers right, and we await with great interest the findings of the Laming inquiry, which is being carried out at the request of the Secretary of State.
I want Members to bear in mind that the social workers in this country do a wonderful job. They are underpaid, and in many ways they are under-trained. Before the baby P case, a chief executive of a London authority gave evidence to the Committee and said that he no longer trusts the training of social workers in our country and would prefer, as far as possible, only to hire social workers from Australia, South Africa and Canada. That was a remarkable comment, but the Secretary of State intends to look at the training of social workers, and also how they are used and managed. Earlier, a Member talked about accountability, and I agree that accountability is important, but so is good management. The management of a large children’s department is a very challenging job, and all of us know that merging social services with education has been difficult. There is a great tension in that. Some of us represent constituencies whose local authorities have an expert director of children’s services who came from social services; others have someone who came from education.
We must look at these matters very carefully. Although there have been criticisms of the director of Haringey social services, we should look a little more carefully at, and a little more kindly on, the stress of that job. We should sometimes be a little more objective and thoughtful about the comments we make about people before we know the full facts.
Does my hon. Friend agree that the occasionally poor reputation that social workers have is rooted in their unfair treatment in the media, and would it not be a good idea if those in the broadcast and print media commenting on social issues of this kind were required to get some detailed knowledge of the pressures faced by people on the front line, because they are too quick to judge, condemn and excoriate the work of social workers, who are at arm’s length from us in doing a job we need to have done?
I entirely agree with my hon. Friend on that point. Social workers do a great job. Yes, we should look to see if we can improve their training and we should look at their management, but it is one of the hardest jobs in the world. If there is a tendency to take people off the front line quickly, and to promote them into the management and administration of the children’s department, we must find out how to combat that by encouraging people, and by giving them time away from the front line to rest them and then bringing them back. It is a very hard job and we must respect that. We must also respect the complexity of the management task faced by the 150 directors of children’s services, who have very large empires to manage. A little more humility is called for.
My hon. Friend is right about the media. For example, last week a study was published in The Lancet which said that 5 per cent. of children in developed countries were subject to abuse, either sexual or physical. When one looked at the full reports, it became apparent that the figure of 5 per cent. was never mentioned—it was only in the press reports. The media treatment of that report gave people in this country the wrong idea. For a start, hardly any of the original research was carried out in this country.
How many times do we hear on the BBC the words, “Research carried out by this programme”? We know what that consists of. Indeed, we had an example this weekend when it was claimed that research carried out by the BBC had found that a tiny number of MPs— 20 or 23—were unhappy with some aspects of the Speaker’s performance. That was not research. It was some kid in the office who had pestered MPs over the weekend. Too often, the media, especially the BBC, do such things; the “Today” programme loves to do it. Many members will have been rung up as part of that alleged research. I know what real research is, and that is not real research.
The amendment expresses the Opposition’s concern about international tables. We do not stress the good news enough, and the trends in international mathematics and science study, or TIMSS report, shows how extraordinarily well our children have done in mathematics. The performance of the 10 to 14 age group has improved dramatically, and those on both sides of the House should welcome that. The investment in early years education, children’s centres and Sure Start takes a long time to show results, and we are always in danger of making those issues a purely party political contest, with the Opposition saying that whatever the Government have done is wrong. Actually, as Chairman of the Select Committee, I see an enormous amount of good.
However, before the Secretary of State for Children, Schools and Families gets too happy about that, let me say that the Committee’s most recent report, which will be published in the new year, points to some concern. I totally disagree with the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith), the former Leader of the Opposition, and his talk of the broken society and an underclass. Such language gets us nowhere. I hate the terminology and I think that it gets in the way of evaluating what is happening in our society. It is true that some people suffer from social deprivation and a long-standing lack of good employment prospects, but the situation is dynamic and people move in and out of it. There are problems and challenges, and all parties have to find ways to ensure that every child gets a chance to fulfil their real potential. Sometimes that will be through the academic route, and sometimes through an apprenticeship, training and skills route. Thank goodness, we are achieving provision, especially for 14 to 19-year-olds, that is beginning to address all the talents.
We should also give talented people the chance to move easily between disciplines. In a sense, what was wrong with the Education Act 1944 was that people stayed on one track; if they were academic, they went to grammar school—that was their future. People who went to secondary modern school had little chance of getting requisite skills, while those who lived in areas with technical colleges went down a different route again. The apprenticeship provisions in the Bill that we will consider later this Session will ensure that 14 to 19-year-olds have access to a range of potentials.
Finally, I want to say something about child development. One of the great things about a Select Committee is that we can take a cross-party look at very difficult subjects. We can take conventional wisdoms and the sort of street knowledge that people pass on without much research and gather evidence to see whether they are right. Most of us will have been troubled by the oft-repeated research that asserts that a child’s potential is more or less decided by the level of stimulation that it receives up to the age of 22 months. If that is true, it poses a great challenge to everyone interested in the future of this country’s children.
I remind the House that 22 months is about the age of little baby P when he died. If that stimulation is so important, are we making the right decisions to ensure that the right environment is provided for all children? Of course, we have come a long way already with early years provision. We have children’s centres and Sure Start, and children aged three now get 15 hours of free nursery care. All of that is good, but you will know, Madam Deputy Speaker, that child care is still expensive in this country. The challenge is to provide good, stimulating environments for children as early as possible. Income levels should present no bar to that, but at present they do limit what is provided for very young children aged between nought and three. We are not doing a bad job and I do not want to castigate the Secretary of State or the Government, but we must do even better because that is the crucial age.
I advise the House that my Committee will call evidence on levels of stimulation and the development of a child’s brain. We want to establish how accurate the research to which I referred earlier and the conclusions based on it are.
The hon. Gentleman is right that the evidence shows that the investment has to be made in the early stages of a child’s life, so does he agree that the Government should abandon their gimmick of the child trust funds? Billions of pounds are tied up in them, although 18-year-olds get a payment of only a few hundred. Should we not spend that money on early-years education, because that will make a difference to people’s life chances?
I am sorry, but I rather like the child trust funds. Earlier, the Liberal Democrat spokesman, the hon. Member for North Norfolk, spoke about tobacco. Along with other hon. Members, I campaigned for many years on the smoking and tobacco issue. We were trying to change the culture associated with tobacco use and smoking, and that meant that we had to tackle advertising, education and every aspect of trying to get people to stop smoking so as to improve their health and development. The same is true with child development. We must try everything, but the Queen’s Speech is absolutely right that we have to eradicate child poverty.
For that reason, the child trust fund is one of the essential ways in which we will change children’s life chances. No approach can work immediately, and the child trust funds are a long-term investment. Over five or 10 years, we shall be able to see whether they work. Many of the policies that we have embedded over the past 11 years will take a long time to evaluate. Over time, I think we shall see that child trust funds are very useful indeed.
This will be my last point, because after criticising a previous speaker, I am going on for far too long—[Hon. Members: “Yes”.] I am sorry, but normally Back Benchers, even Select Committee Chairmen, have to listen the Front-Bench lot and are then restricted to 10 or 12 minutes, so I am speaking up for Back Benchers. There is no limit today, so I am taking a little longer than usual—[Interruption.] I shall go on for even longer now.
I shall end on the point about culture. We are trying to change cultures and it is difficult. It has to be done in terms of tackling child poverty and in a variety of ways. Some of the things we do will not work—surprisingly enough. We are human beings so sometimes our responses to problems will not work or will not work as well as they should, but then we learn the lessons. Over the past few years, one of the things I have liked is that often when the Government recognise that something is not working too well they change it. Sure Start is a good example. Some of the Sure Start schemes were not very good when they started. I have to tell Members who like localism that it was often because the impetus was too localist—everybody came up with their own ideas and some of them did not work, so Sure Start had to be changed. As long as the Government continue to make pragmatic judgments—seeing whether things work and recognising that sometimes there are mistakes—they will have my support. On the other hand, when they do things in a bone-headed way and carry on regardless, they will not have my support or that of members of our Committee.
Much in the Queen’s Speech will give us plenty of work over the coming months. There are some interesting interventions and innovations for the qualifications framework. The Secretary of State must make sure that the framework is independent and seen to be independent so that it can speak fearlessly about the qualifications system. People will approve of that.
The very last thing I want to say—[Laughter.] In that case, the penultimate—or rather pre-penultimate—thing I want to say is about apprenticeships. Only last Saturday, our Committee produced a report on apprenticeships. It was a good experiment, because the Select Committee on Innovation, Universities, Science and Skills was producing a pre-legislative report on the draft Apprenticeships Bill at the same time. We did not collude, but we came to similar conclusions. We are positive about the apprenticeship route and about the expansion of apprenticeships. We are concerned that the targets will not be met, because as the economy is going through a slight hiccup—I shall not use the other word—and the tough times mean that the private sector will be challenged to produce enough apprenticeships, the real challenge will be to introduce them in the public sector.
The largest employer in my constituency is the university—there are not many apprenticeships there. Health and the local authority are among the biggest employers—there are not many apprenticeships there either. The sooner we can have apprenticeships in every part of our public sector system, the better. If we can achieve that, the Secretary of State and the Government will have my support.
It is always a pleasure to listen to the hon. Member for Huddersfield (Mr. Sheerman) for half an hour. I know that he is irritable, because the last time that I questioned in the Liaison Committee the saviour of the world, otherwise known as the Prime Minister, the hon. Gentleman shouted across the Committee Room, “Who does he think he is?” I do not think that he was referring to the Prime Minister at the time. So I will try not to irritate him, and he might agree with quite a lot of the early part of my speech, because I want to talk about efficiency.
As the parties get less ideologically divided—[Hon. Members: “Ho, ho!”] It is true, actually—efficiency becomes more and more important. We heard a bit of banter between Front Benchers earlier about their public spending plans. The truth is that, if there is a Conservative Government, they will not want to do less in health and education, but they will want to do it more efficiently. I give credit to the Government, who want to do things more efficiently as well, but whether they succeed is, of course, a matter for debate.
Efficiency figured very large in the pre-Budget report and in the spending review. The Government claim that they want to deliver efficiency savings of a massive £35 billion. As Chairman of the Public Accounts Committee, I have often questioned whether they will actually achieve that, but I have never disagreed with the objective, which is even more important in health. We heard the Secretary of State for Health mention that he is increasing spending by what sounds like a very healthy 5 per cent., but given an ageing population and the increasing costs of health technology, unless we can achieve efficiency gains of 3 per cent. every year, that is just a standstill budget, so efficiency is absolutely central to what we are talking about.
I want to go further than in the past, and I believe that we could achieve more efficiency. True efficiency is about achieving the same outcomes for a lot less spending. That is about the absolute, resolute and obsessive pursuit of efficiency, line by line, programme by programme. It may be a rather boring subject—it is not often at the forefront of political debate—but it is absolutely essential. Let us make no mistake: if we do not achieve massive efficiency savings, we will face armageddon in our public services.
The hon. Gentleman says that efficiency is a boring topic. Certainly to an accountant such as myself, it is meat and drink and not boring for a moment. He says that efficiency is all about getting the same outcome for less input—I paraphrase him slightly—but does he not agree that there are circumstances in which to spend more is, first, to get a better quality of service and, secondly, therefore to have a lower cost per unit of production? Earlier today, I pointed out to my right hon. Friend the Member for Swansea, West (Mr. Williams), who is Chairman of the Public Accounts Commission, that Her Majesty’s Revenue and Customs reorganisation, which with the hon. Gentleman is very familiar, risks losing people who might have bridged the enormous gap between the tax that should be collected and the tax that is collected after tax avoidance. That is the case, is it not?
It is true that, at certain times, people make policy decisions and have to spend more, which may indeed achieve their policy objective. Of course I accept that, which is why I do not want to talk about policy differences in a lot of my speech. I want to try to bring the Government and, indeed, Conservative Front Benchers with me as far as possible. I do not believe that it is the duty of an Opposition—certainly not an Opposition Back Bencher—to oppose everything and propose nothing. So I hope to make some practical suggestions about how we can improve efficiency.
The Chancellor recently raised the bar on efficiency savings by another £5 billion, which is quite a difficult task. My call might not be strictly within the rules of poker, but I see his £5 billion and want to try to help him raise another £5 billion. Let me give some ideas, not for cutting services, but for encouraging all the major Departments to match the greatest progress made by their most efficient colleagues in five core categories of efficiency. Let us look at all the Departments and at who does things most efficiently, to try to bring the rest up to that level of efficiency.
Item 1 on that five-point agenda for efficiency is the civil service pay bill. It is true that the Government have made some progress in reducing numbers in some Departments, but not in reducing staff costs. A reduction in numbers running to tens of thousands—I agree that it has been achieved—has been accompanied by a real-terms increase in the pay bill of more than £1 billion. If all Departments matched the greatest staff reductions achieved in Whitehall, the saving to the public purse could be a massive £1.7 billion. Of course—I will mention this now—the new contract for general practitioners is an example of a Department implementing new arrangements that have increased, rather than reduced, inefficiency. Partners in GP practices are now putting in less time and their productivity has decreased; only their pay is burgeoning, having increased on average by 58 per cent. since 2003. I think that we all recognise that major mistakes were made in that contract, which we never want to see made again.
On the subject of staff costs, are the tasks of Whitehall Departments really so different that, apparently—what the NAO tells me is extraordinary—the average civil servant in one Department can cost almost 60 per cent. more than the average employee in another? I know that Departments perform different tasks, but it seems extraordinary to me that we have such a range. If we could bring the most costly and the least efficient up to the level of the least costly and the most efficient, we could save another, staggering, £800 million.
Outsourcing and consultancy form my second item. Consultancy is often discussed. It seems to me scarcely credible that any part of Government could have consultancy expenditure equivalent to even half its staff costs, let alone the 87 per cent. of staff costs spent by one Department, but that is apparent by analysing last year’s accounts. The average central Government body spends five times more on consultants per employee than the private sector—a whopping £10,000 for every civil servant employed. Is that necessary? Do we need all those consultants? We have very good civil servants—they are there in the Box. Although we are not allowed even to refer to them, they are fantastic people doing a great job.
When the NAO reported on the use of consultants, it concluded that efficiency gains of up to 30 per cent. could be achieved without reducing the underlying value of the work purchased. The NHS spent £600 million on consultants last year, when the public sector as a whole spent £2.8 billion, so the saving could be as much as £800 million a year.
Let us take a long look at other running costs, such as the costs of accommodation, leases and IT, which provide the third item on the agenda. I offer the Government and the Opposition a further £900 million saving. I hope that my hon. Friend the shadow Chief Secretary to the Treasury reads my remarks today—I am happy to help anybody, Government or Opposition, with these ideas.
The startling variation in accommodation costs for each individual civil servant provides clear scope for improvement. When the NAO examined this matter in 2006, it found that the Department of Health—I mention that Department, because we are talking about it today—spent nearly three times as much per person as the then Department for Education and Skills. Today, the Secretaries of State for Children, Schools and Families and for Health have been sitting side by side in the Chamber, so perhaps we should ask them to explain the difference between their Departments’ spending. I do not understand it.
Perhaps the Government should consider extending their shared ownership schemes to their Departments, so that they learn lessons from each other. London property prices may not be what they were, but all of us here represent provincial constituencies, do we not? Are we sure that every civil servant currently based in the capital would not be better employed at less cost in our own communities—in Huddersfield, Gainsborough or, indeed, North Norfolk? Why are so many still based in the capital?
The House may need to bear with me as I go through the next item on my list—comparisons of asset values. As an accountant, the hon. Member for North-West Leicestershire (David Taylor) will be interested in this subject, but the eyes of other Members present may glaze over, but it is a fantastically important subject. The Government aim to dispose of £30 billion of assets, but even though last year their main Departments got rid of approximately £1.5 billion of assets—well done—they managed to add a hefty £10 billion of assets. That so often happens in public debate: we hear the good news, but not the bad. I salute the Ministry of Defence, which achieved the highest level of disposals in Whitehall, and the Department of Health did pretty well, too. If others had marched forwards as far, another £850 million would have been captured by all of us.
According to my rough calculations, so far we have identified savings of £4.8 billion and counting. In search of the final big push that would enable me to keep my promise to try to save the Chancellor £5 billion—no small sum—I considered those Departments that make grants. The Departments that are the subject of today’s debate figure heavily among them. A recent National Audit Office report made recommendations to help grant makers better manage the demand and flow of applications, and streamline their processes. A saving of 10 per cent. as a result of greater efficiency in grant administration across the public sector could plough £220 million back to the Treasury. I have now achieved, just in one short speech, savings of £5 billion.
I freely accept that efficiencies are not certain; there are problems with information, challenges in delivery, and variations in circumstances, so we could undershoot, or indeed overshoot, on all those five items. However, surely that is not an argument for the abandonment of the agenda; it is an argument for adding to it. To try but fail is honourable; to fail to try would be criminal. That is why I think that efficiency should be a central part of what we try to do. My challenge to the Government is to take inspiration from Mr. Micawber. It may not be fashionable in these “Buy now, pay later” times, but the Government’s accounts book should be reviewed, entry by entry, in a concerted effort to alleviate the misery of spiralling borrowing.
In debate after debate on the work of the Public Accounts Committee, I have emphasised three broad themes of which the Government should take note in their forensic self-analysis. I start with unnecessary administration. The private sector has long focused on minimising the proportion of resources that it invests in administrative functions, so that it can focus on what delivers value for the customer. It is essential that the public sector take that approach. That can be achieved both by cutting down the complexity of administration and by sharing the management of administrative services. We hear a great deal about that problem in the NHS. Every time that we talk to our doctors and consultants, and people whom we know in the NHS, they harp on at us about the cost of administration—a vital point. We should listen to them all the time.
My second theme is commercial skills and astuteness. The role of the Government is changing from one in which they delivered most public services themselves to one in which they manage other organisations that deliver services on their behalf. No matter who wins the next general election, the process will go on and on. The Government will withdraw more and more from the front line and will use other people to manage their services. Government will become ever more commercial.
In those circumstances, the delivery of services is underpinned by commercial arrangements, so the Government need to improve their ability to manage contracts. We have to employ the best people and pay them the right price. We should bring them in from the City and the merchant banks to work for us. When it comes to private finance initiatives, new contracts or hospital running costs, we have to get the best people working for us and pay them the best price, which pays in the long run.
Frankly, the public sector still lacks the commercial nous to derive maximum benefits from its suppliers. Take one well-known example in the education field. The interest of celebrity chefs in school dinners has helped to draw attention to one small specific area of procurement. We looked at the issue and showed that there was scope to realise over £200 million of efficiency savings in food procurement in just one year, by 2010-11. More than half of those savings could be achieved in schools and hospitals without affecting quality. Ultimately, actions such as joint purchasing could help to avoid situations such as those that we found at the time of our investigations. For instance, we found that one public body pays 32p and another £1.10 for the same loaf of bread.
I come to my final theme: making better use of resources. The Government do not always manage the vast array of resources in their control, including office buildings, service delivery and agents, as efficiently as they should. Earlier this year, the National Audit Office published a report on managing financial resources. It found that since 2003 Departments have indeed improved their management of finances, but, incredibly, that 40 per cent. of them invariably provided decision makers with a full analysis of the financial implications of policy proposals. It is amazing that in only 40 per cent. of cases in which Ministers make difficult policy decisions they were told about the financial implications of those decisions. The message must be driven home that the management of financial resources is the responsibility of everyone in the Department, from the Secretary of State down, and not just the central finance team.
The Government need to know what is being spent, where and on what, and I hope that there is a central emphasis on everything that Ministers and their top civil servants do. They need to know whether one Department pays more for the same service than another, and they must embrace, not avoid, comparisons of cost and performance across the public sector. Departments must benchmark all the time with other Departments, and they must look at what is going on abroad. They must always seek to do the most efficient thing, and pay people to work for the public sector and Ministers to get the best results.
All those disciplines should apply to the Government’s proposed programme. The aim of government is not to legislate at any cost—the Government are clearly not doing so, as we are not overloaded with legislation, and I congratulate them on that—but when the costs and benefits are totted up, how many of the proposed Bills would help the fastidious Mr. Micawber to obtain happiness by balancing his affairs? We should look at all those Bills and ask how they will achieve happiness by balancing our financial affairs.
If the House will allow me, I shall propose one final test to be applied to all the Government’s proposed legislation. It is simple: does the proposal reduce the overall burden on the public purse, and is it efficient? That legislative impact assessment should be policed, perhaps by the House, with more rigour than the Government have put into their own regulatory impact assessments. If the answer to the question is yes, the Bill should be allowed to proceed to further debate. If the answer is no, it should be allowed to go forward only if accompanied by an equal saving elsewhere. Now is not the time for either the cost or the burden of government to grow, because we simply cannot afford it. I urge all public bodies to keep at the forefront of their thoughts the fact that taxpayers and all those who use public services rely on them to get this right. Given the storm-tossed state of the public finances, the success or failure of programmes to achieve true efficiency in the public services will have a major impact on all our lives.
If the House will forgive me, before I conclude may I make one or two policy points? In everything that I have said so far, I have spoken as Chairman of the Public Accounts Committee. I hope that what I have said is not politically sensitive and that Members on both sides of the House agree with it. However, from my own personal perspective as a Back Bencher, may I make one or two points? This is where I fear that I may lose Government Members, but the debate offers an opportunity to express one’s point of view, so why should I not do so?
Yesterday, the Prime Minister, without telling me in advance—fair enough; all is fair in the House—attacked me on the Floor of the House, so I could not pop up and put the record straight. May I now make clear my point of view that the Government have made a major error in seeking to solve our economic problems by cutting VAT at a time at which prices in the shops are falling through the floor? The point that I made, not as Chairman of the PAC but from my own personal perspective, was that the best way to help the poor is by raising tax thresholds to get people out of paying tax altogether and to attack the poverty and unemployment trap.
The hon. Gentleman is supporting Liberal Democrat policy.
It may be Liberal Democrat policy—what do I care? If I see a good policy, I will embrace it—but it is also the policy of many Conservative Members of Parliament. There is nothing original about this, as there are many people on the left who believe that the best way to help the poor is not by cutting VAT, because a much higher proportion of poorer people’s budget is spent on items that do not attract VAT in the first place. That is the point that I made, but I was quoted out of context by the Prime Minister. However, it is much better to be attacked by the Prime Minister than not to be mentioned at all, so I do not mind very much.
May I make two brief points about education and health? The report by Sir Jim Rose was published this week—another report on education—and seeing that my hon. Friend the Member for Surrey Heath (Michael Gove), the shadow Secretary of State, has just walked into the Chamber, I shall make an appeal to him. Often, we on the right are accused of being too obsessed by the structures of education, and it is said that while we have been obsessed in that way, the left has been more concerned about the minutiae, and that it has won the debate. Let me say straight away that I am not the slightest bit interested in returning to the 1950s, in having more grammar schools or in any of that. All I say to Sir Jim Rose and to all those on the Government and the Opposition Front Benches who think that they can micro-manage the thousands of schools in this country is that they are deluding themselves. We have to trust our professionals; we have to trust head teachers.
I know a bit about education—after all, I have educated a few children in my time. I believe that head teachers want to have the freedom to set their own curriculum as much as possible, to hire and fire their staff, to interview potential pupils and to select their own pupils. I know that I start to lose everybody in the Chamber when I say this, but if they were given the same freedoms that independent schools have, there would not be a rush back to grammar schools. Most schools would hardly change at all. My son went to a comprehensive school; I have never sent a child to a grammar school. I am not interested in that, but I am interested in allowing the head teacher of my son’s comprehensive school the ability to manage the school in the way he wants. He should not be micro-managed all the time by the Department, and he should be able to interview and select, if he wants. If we did that, it would revolutionise schools.
I know that I do not take everyone with me on that, and I shall go one step further and lose virtually everyone in the Chamber. I believe passionately that we have to end the totally rigid divide that we alone have in this country between the private and public sector. It does not happen elsewhere. We have to encourage people to shift between the public and private sector. We have to have people who are setting up new private schools. We can bring that process in slowly, starting with reception classes, or start the process in some postcode areas. We should do what the French do. The French pay staff salaries in private schools, so fees in private schools are minuscule in France compared with—
Will the hon. Gentleman give way?
I was hoping that I would incite the hon. Gentleman to intervene.
Surely in France the vast majority of private schools are state schools under any other name, because they are Catholic schools that are financed by the state. The idea that the French definition of a private school is analogous to the British definition is absurd.
I am not saying that the system is exactly comparable, and I know that many parents in France use private schools because they want their children to have a Catholic education—that may be the same here. I am not arguing for a sudden revolution, but a gradual change.
I know that my hon. Friend the Member for Surrey Heath, the shadow Secretary of State, agrees with that. He has been very innovative. He has looked at what is happening in Sweden, and he will come up with ideas to make it easier for people to set up private schools. All I am asking is why it is considered to be so wrong and reactionary to break down the rigid divide between the state and the private sector in education. I have never understood that, and if we can find ways of being innovative and of helping people to break down that divide, we should. If I cannot take the hon. Member for Bury, North (Mr. Chaytor) with me on that, can I at least take him this far—please do not go on with this process of trying to micro-manage our schools on the curriculum? The people involved are professionals and they know what is best. Rely on parent power: if head teachers do not deliver what people want locally, people will not want to send their children to those schools.
I say the same thing about health, and again, I know that I will lose people on this issue. Why do we have a rigid divide between the public and private sector in health? My family and I rely completely on the national health service. I have no private health insurance, but if a retired person, after paying tax all their life, wants private health insurance, I do not see why they should not be given tax relief on it. The last Conservative Government did that, and it is simply fair. If people are denied a particular medication because it is too expensive and they want to top up the cost from their own resources, why should they not be allowed to do so?
As with education, I believe that we should not try to micro-manage the national health service. We should rely on professionals and on their good judgment. Increasingly, we should step back and set budgets—the Government are doing that through foundation hospitals—and proceed apace, relying on the professionals to run hospitals in the way they think best. However, I will not take the House with me on many of those things.
I have considerable sympathy with the earlier remarks that the hon. Gentleman made in his capacity as Chair of the Public Accounts Committee. However, I am slightly confused about one thing. The earlier part of his speech was about the Secretary of the State and others in Departments ensuring that we get cost-effectiveness and efficiency in public services, which is right. Yet, in the second part of his speech, he has argued that the Government should not micro-manage education and health. Surely, there is an inherent contradiction between the two: if we are going to get real value for money, it has to be led from the centre, and it follows that we cannot allow complete independence and freedom from Government control of health and education.
I do not think that that follows. Let us remember that much of what I said was, for instance, about the efficient use of asset management and the roll-out of computer systems. What is increasingly happening in relation to health, for instance, is that the Government say to hospitals, “We will pay you through the primary care trust so much per hip and then you can get on with it. If you do it efficiently and learn good practice, you can keep more of your money.” I pay tribute to the Government on that.
There is not a dichotomy between me and the hon. Gentleman on this. A grant-making body can pay so much per pupil in schools, and we can say that we will pay so much for a secondary or primary school pupil if a child needs a statement or if a body is prepared to give him a statement. I know a lot about that from my personal experience. After the school has received the money per child, it is free to manage that child in the way that it thinks is best. The same also applies to foundation hospitals. Once the money has been disbursed per hip, per cancer treatment, or however it is done, real scope is given to the professionals to run the budget in the most efficient way.
I see foundation hospitals in exactly the opposite way. Out of the 107 foundation hospitals that have been set up, there are more than 1 million members. It seems that we are getting more public involvement from outside than the more mainstream trusts, rather than simply letting the professionals have their way in foundation hospitals.
That may be a good point. Perhaps the principle behind foundation hospitals is right, but we have not implemented it in the right way. The Minister has heard the hon. Lady’s intervention, so perhaps we will learn from that practical experience.
Whatever the House might think about those ideological differences, I hope that we all agree that we have to be much more commercially astute in the way in which we operate our public services. Whatever side of the argument we support, we must ensure that we are committed to our public services and that we make them as commercially efficient as the private sector. There is no reason why that should not be done, and if we do it, we will achieve much more for our constituents.
I am delighted to be able to speak in the debate on education and health in response to the Gracious Speech. I spoke in the debate on the same subject last year and much has happened since. I am not only a member of the Select Committee on Children, Schools and Families, but parliamentary private secretary to the public health Minister. I will not be able to talk in detail on health matters because tradition dictates that my new role prevents me from expressing my strong support for steps to remove point of sale displays for tobacco products. It also prevents me from welcoming steps to help cut the cost of having cancer by making prescriptions free for cancer patients. It most certainly means that I am not in a position to say how welcome it is that the Department of Health has shown a clear commitment to the health of our children by putting forward joint funding for pilots of extended and universal free school meals. As I have always said, I came here to break the mould.
Health issues are pertinent to my constituency. For example, in the Sunderland metropolitan area, life expectancy is 18 months below the national average and death rates from smoking, heart disease, strokes and cancer are all above the national average. I am enjoying my new role, but I want to make it clear that I am acutely aware of the priorities for health care in my patch and that although my public voice on such matters may be diminished—
Order. I gave the hon. Lady some leeway, but she must now confine her remarks to those subjects about which she is allowed to talk.
I shall follow your advice, Madam Deputy Speaker, and I am grateful for your patience.
My focus today will be on education. Last year, I called for pilot schemes on universal free school meals, and in September they were announced. I also called for better provision for children with dyslexia, and I am pleased to say that we are well on the way to securing that, too. It was an honour to play my part in highlighting the need to improve provision, not just for children with dyslexia, but for all children with special educational needs. I had a privileged opportunity to steer my Special Educational Needs (Information) Bill successfully through the House, and I am grateful for the help and support that I received from Members on both sides of the House. The Special Educational Needs (Information) Act 2008 should lead to improved information on the types of needs these children have, and it is my fervent hope that this improved information will raise outcomes in years to come. I cannot let this chance go by without reminding Ministers of the need to spell out how the new powers in the Act will be implemented.
I spend so much time talking to charities and stakeholders with an interest in SEN, but a number of interests that still need attention have come to the fore. I hope that the education and skills Bill can be a vehicle for addressing some of those problems. Last year, I focused on two issues in depth and I achieved some success, so this year I shall cover more matters, although perhaps in less detail, and hope for a similar outcome. Recent answers to written parliamentary questions have said that the Government are considering the specific remit of Ofsted’s report on SEN in our schools. The sooner we know what that remit will be, the better.
It is good to see that an interim report has been published today by Brian Lamb as part of his ongoing review of parental confidence in the statementing process. As a parent of a child with a statement of SEN, I know all too well the feelings of “fighting” or “battling” the system that this report recognises. Better information for parents, better outcomes for children and a place in mainstream policy for SEN and disability issues are all vital. I know for a fact that the report is not falling on deaf ears as far as the Secretary of State is concerned.
There is a consensus among the charitable sector that we need to define types of need more clearly when we record SEN, so let us hope that the Ofsted report will examine in detail whether the current categories of recording need are efficient. There is consensus, too, that parents deserve better information about SEN provision, so let us hope that Ofsted will consider the need to empower parents to make well-informed decisions. We also know that there are similarities in the difficulties that children with medical conditions such as epilepsy or diabetes face in our schools, and it may be a smart move to ask inspectors to examine how a joined-up approach to delivering support to those whose unique physical or mental abilities create barriers to learning could be achieved.
I realise that I am digressing somewhat from the substance of the proposed education Bill, and I wish to return more tightly to it, while keeping a focus on SEN issues. It is extremely welcome to see that the Bill will provide teachers with the right to request time for training. Not only does that reflect the Government’s wider focus on upskilling our work force, but it allows scope for teachers to develop specialist skills in support of those with SEN. Last year, the Government announced £18 million of funding for a masters qualification in teaching and learning. If they are to match their words with action, it is imperative that the qualification be required to contain work on supporting pupils with dyslexia and other SEN. I know that is something that Dyslexia Action is keen to secure, and it has my full support in that.
We must also examine measures to improve the skills of those who work with our children without requiring huge time commitments from teachers over and above their already heavy work load. When the Government publish the children’s work force strategy, I hope that they will have considered the possibility of using rights for teachers to request training to deliver further training on SEN. I am considering a campaign calling for one in five INSET days—in-service training days—to be given over to our SEN children, who, as some hon. Members may know, make up one in five of our school population. I understand that there are potential barriers to making that a reality, but I cannot help thinking that “One in five for one in five” is a catchy campaign slogan.
Why not give teachers the right to undertake training in different special educational needs, when they are already required to teach pupils with such needs in schools every day? In the case of deaf children, there are things that teachers could learn in a matter of hours that would benefit children for a lifetime. Awareness of acoustics and the aural environment can make an immediate difference. I will continue to work with the National Deaf Children’s Society on the proposal. I hope not only that it will benefit deaf children, but that it can be adapted to help a range of children with special educational needs.
I congratulate the hon. Lady on the points she has made so far. Does she agree that one major problem is that teaching assistants are not necessarily trained in sign language to a level sufficient for interpretation, which is important for maths and science? I therefore hope that she will call for those higher levels of sign language qualifications in her campaign.
I thank the hon. Lady for her intervention. We have worked together a lot in the course of my private Member’s Bill and on the Children, Schools and Families Committee, and I know how keenly we agree on a lot of SEN issues. I certainly do hope that teaching assistants and learning support assistants will be included in any SEN training, because they spend a lot of time with our children in schools. One-to-one time is often spent with the teaching assistant or a learning support assistant, so it is vital that they should receive such training.
The ultimate aim, which we all share, is to lift the level of support received by pupils in schools. I note from the information published on the Department’s website that the Bill will look at changes to learning in juvenile detention centres and prisons. It is an established fact that the prevalence of special educational needs among the prison population is far higher than it is in wider society. I hope that any eventual changes will look at the difficulties with learning that those in prison face and that any attempt to tackle the stagnant educational development of our young prison population will ensure that those unique challenges are addressed.
Does the hon. Lady agree that one of the problems in enabling young prisoners to continue their education or training is that when they move prisons, it is difficult for them to continue the course they were studying? Does she think that the Government should look into that as a matter of urgency?
I do not have great expertise in the subject, but I take the hon. Gentleman’s word that what he describes is the case and urge the Government to look into that, too.
In addition, there will be measures to review school transport for those in post-16 education. There is already a feeling that a wider review of school transport is needed across all age ranges to plug holes in budgets through which money can often leak—I am thinking of the use of taxis, for example. The recent outrage felt by the public at the case of baby P was shared by all hon. Members. It is a cliché to say that lessons must be learned following such tragedies, but I want to make a couple of points about that. It has already been noted that we cannot allow such cases to lead to all child care workers being tarred with the same brush, but at the same time we cannot miss the opportunity to lift the level of professionalism among child care services. Whatever the whys and wherefores of today’s UNCIEF report, we are clearly lagging behind much of Europe. That cannot be allowed to continue. The report notes that provision here is hampered by a lack of well-trained staff.
I mentioned in the House recently that the Danish system uses pedagogues as professionally trained workers who form an extra layer in the protection and development of vulnerable children. It is so often the case that those of us in the House with a progressive viewpoint hold up the Scandinavian system as an example in the hope that it can be mirrored here. I was pleased when the Secretary of State said that there were already plans to look at trials of such workers, because such trials could reveal very interesting results. There need not be a presumption that we must put more children into care, but we should strive to ensure that the level of care that those already in the care system receive is world class.
Another Bill in the Gracious Speech that will put us on a stronger footing for the future is the welfare reform Bill. Those proposals caused a bulge in my postbag when they were first announced. Some constituents were worried that their benefits would be withdrawn, but the majority were happy at the prospect of ending a something-for-nothing culture. We all know the value of work, and it is not just about bringing home a wage; it offers much more. It is important for children to grow up with work as the norm, for adults to feel as though they are contributing to the community around them, and for the country to make the most of all its talents. That might sound idealistic, but I believe that that is the kind of future that we need to aspire to, and more so now, in these times of difficulty, than ever before. We need to get parents into work, to set an example to their children. We need to support those parents in equipping their children to take on a job that comes with rights, including the right to a decent living wage, the right to equal pay and conditions, the right to flexible working, the right to gain further skills and, above all, the most important right, which will now be enshrined in law: the right not to live in poverty any more.
My hon. Friend mentioned the right to training. Soon, millions of workers in Britain who did not fail themselves but who were failed by the education system in past generations will have the opportunity to demand and expect extra training. Does she agree that it is essential that education does not stop at 18 or 21, and that the millions of people out there who did not have the benefits of the system will now be able to enjoy the benefits of training? That is one of the key points in the Bill.
My hon. Friend has made a valid point, which I was not going to cover in my speech, so I thank him for that. As he knows, I am a huge supporter of union learning representatives, who do amazing work in encouraging people back into education when, for whatever reason, they did not have adequate chances at school.
I definitely did not come into the House to quote literature, but there has been much talk of the hard times that we are now facing. As my learned and highly intelligent colleagues will know, “Hard Times” is also the title of a book by Charles Dickens that marked him out as an early supporter of the rights of the working class—something that I certainly did come into the House to be. Dickens used that book to call on people to strike the heaviest blow in their power. With the measures set out in the Gracious Speech, the Government seem to be striking their own blow. Some have said that it contains only a small number of Bills, but that does not worry me or my constituents as long as it has a big impact. I hope that it will do so, especially for children with special educational needs, as well as for those living in poverty. If it does, this year’s legislation will be not only about impact but about legacy, and I very much welcome the measures in it.
I should like to start by making it clear that I pay tribute to members of the NHS—doctors, nurses and any other staff working in the service—and that none of my words imply any impact on them or criticism of them. I am sure that Members on both sides of the House will see what I am alluding to. I particularly want to pay tribute to John Goulston, the chief executive of Barking, Havering and Redbridge Hospitals NHS Trust, for the work that he is doing in trying to turn the trust round, following its previous abysmal administration, about which I shall say more in a moment.
First, I want to talk about the amount being paid out in claims for negligence in the NHS. In my own trust, in the past four years, £33,534,380 has been paid out. That represents 179 claims. There are still 180 claims outstanding, so the final amount could be tens of millions of pounds more. My distress is compounded when I think that across London, £250 million has been paid out in the past three years. I thank the Secretary of State for meeting me to discuss the problem, and for his awareness of how to address it.
I shall refer to two cases, which I will simply call A and B, in order to leave the people anonymous. One lady went for a kneecap replacement, but it was put in the wrong way round, as she realised when she was unable to walk. Not only did she receive compensation, but the operation—with all its associated costs—had to be redone. More tragically, case B concerns a lady in perfect health who went into hospital to have a baby, but something went wrong and she was left paralysed, brain-damaged and in a very distressing state—with multi-payouts of moneys following on. My point is not to apportion blame, but to say that we must look more deeply into how such events are happening and why. Perhaps retraining through the General Medical Council is necessary, but we must stop this happening in the future. For example, my own area’s NHS trust has a deficit of some £90 million—and the vast bulk of it is due to cases such as those two.
The General Medical Council investigates the doctors involved in such cases. The problem is that that is not happening quickly enough: many of these cases drag on and on for years, yet while they are being investigated the doctors continue to operate on patients. I hope that the Secretary of State agrees—in fact, I know from the words he kindly exchanged with me the other day that he does—that patients have the right to know if a doctor who is operating on them is being investigated as a result of a serious complaint connected with another case. I hope that some measures in the Queen’s Speech will provide some assistance with such problems.
I mentioned earlier the previous administration of my area’s trust, which brings me to another point that I have previously raised with Ministers and the Secretary of State. A former chief executive—in this case I will provide the name: Mark Reece, whom I have named here before—left the trust in a bad position, with vast debts, yet received quite a sum of money as a payoff, and, indeed, for his pension. Once such payments have been made by the NHS, we must ensure that the people concerned cannot be re-employed as consultants elsewhere in the country and earn even more money from the NHS. That is simply rewarding failure, and it has to be stopped. I say that because this gentleman—together with his partner, a former chief executive of Maidstone and West Kent NHS Trust, who also had a pay-off—has indeed formed a consultancy with the hope of advising the NHS on how to run trusts up and down the country. I would say that those two people are not the right ones to be advising the NHS on anything anywhere in our country.
Together with my colleague the hon. Member for Ilford, South (Mike Gapes), I recently visited the maternity wing of the Queen’s hospital, Romford, and I can only pay tribute to the work being done there. I say this in a completely non-political way, but I think that the Government have a facility there that they have done proud, as the services that constituents receive there are first class. But—I am sorry that there has to be a but—it can take up to one and a half hours for my constituents in Ilford, North to get there by two bus journeys. Today I received a complaint from a constituent about how long it can take to get there. Although that is a great facility, we must also enhance and improve the King George hospital, which also services my constituency, to ensure that my constituents can receive services as close to their own doorsteps as possible.
We heard earlier from the Secretary of State about the services of polyclinics, and I believe that the hon. Member for Bury, North (Mr. Chaytor) paid tribute to one that opened recently in his constituency. One is opening in my neighbouring constituency, and I welcome anything that enhances services to patients. However, it will not help my constituents, so I very much hope that all GP services are protected, with no closures whatever, so that people can get the service they deserve as close as is humanly possible to their own doorsteps.
My hon. Friend makes a point that resonates in Bromley and my area—which is not dissimilar to his, although mine is in south London and his is in north London—about the threat to our area of polyclinics. I think that the Secretary of State for Health said that polyclinics were mainly for areas that did not have many GPs, but in areas such as Bromley and Ilford, where there are enough GPs—even though too many of them probably work single-handedly—they are not a relevant solution, because they mean concentrating services in one area, which causes lots of transport problems. Polyclinics are not appropriate for our areas.
I thank my hon. Friend for that observation. Of course, there is a problem attached to polyclinics. I have said openly that although I am not against them, I do not want services in any constituency diminished because of them. People need contact with their own doctor, who knows them, has dealt with them for a number of years and can give them the services that they need and deserve.
On the subject of education, the hon. Member for Gateshead, East and Washington, West (Mrs. Hodgson) referred to special educational needs, and I want to concentrate on one aspect of that: the teaching of our teachers. In a recent report by the National Autistic Society, a large number of teachers said that they were ill prepared to understand the needs of autistic children. Training is vital. I hope that that will be covered in the proposed Bills.
I recognise that the Secretary of State for Children, Schools and Families, who was at a meeting that I attended not so long ago, has said that the needs of the most vulnerable children in our society will be addressed, and I believe that he honestly wants to do that. However, relief teachers come into schools and do not know the pupils. I want a system the same as the one used in hospitals, whereby a new team that relieves a shift is given the notes of the patients whom it is servicing. In a recent case, a relief teacher took away from the child of one of my constituents the bar of chocolate that was needed because the child suffered from diabetes; the chocolate was medication. The child had a bottle of Lucozade and a bar of chocolate, and was not being naughty or eating in class. Those things were necessary because of the child’s medical condition, but the relief teacher was not aware of that. Again, that is a matter of training, but also a matter of information being passed on by schools to relief teachers.
The hon. Member for Huddersfield (Mr. Sheerman) said that Back Benchers could not speak for as long as Front-Bench spokesmen, and then went on to speak for longer than the Front Benchers. I do not intend to do that, but I do want to put across my final few points.
I am fortunate. The education system in the London borough of Redbridge is first class. Many people try to get into our schools and our education system, and I commend the borough for that. However, I want better provision of education for special needs children. We have two good schools, in Hatton and Little Heath, which are doing a fantastic job. I want to ensure that they get the resources that they need. I apologise—possibly to those on my Front Bench—for what I am about to say, but this is me saying it; I am not saying it on behalf of my party. I want resources ring-fenced for special needs children so that there is not a postcode lottery. We know about the burdens on local authorities, whatever the political persuasion of those running that authority, and there is a finite amount of money. However, I want the right sums of money to be put into the education of special needs children, and I want to ensure that they get it—and that will be possible only if we have ring-fenced funding. I ask the Secretary of State to consider that. As I said, it is my personal view.
If we do not help the most vulnerable children in our society, we should hang our heads in shame. We were all elected to this House to do that job and ensure that we protect those individuals and young people. I, for one, will do everything in my power to make sure that it is done.
I want to focus on the proposed Bill to give the NHS a constitution. Unlike the hon. Member for Gainsborough (Mr. Leigh), I think that our public services need more public involvement rather than less, and on the basis of my constituency experience, I am sceptical about the suggestion that we should leave professionals to their own devices. I feel that that has led to a slightly unrepresentative NHS that sometimes makes decisions in its own favour as an institution rather than considering the needs of individuals.
In 1996, during the last days of the last Conservative Government, the authorities at St. Helier hospital, which serves half my constituency, made a private, closed decision that the hospital should close and move further into Surrey, further away from those with the greatest health needs living in my constituency. A process was set in motion by NHS officers, who concluded that the hospital should be moved to Belmont, in the Surrey suburbs—one of the areas with the highest incomes and the lowest health needs and, indeed, an area that did not want a big hospital.
How could such a decision be made? I wonder whether it was anything to do with the fact that not one of the 18 board members of Merton and Sutton primary care trust comes from, or lives in, my constituency. They all live in much more affluent areas, and know my area less well. What is more, in an area that is hugely ethnically diverse, all but one of the board members are white. I believe that such boards are set up as they are because people choose other people in their own image and likeness. Potential board members are judged on the basis of whether they are members of other quango boards and whether they have similar experience. The difficult people who tend to challenge the status quo are not included in the selection process.
The NHS later set up a public consultation on where the hospital should go. To no one’s surprise, St. Helier was the favourite choice and Belmont the least favourite, but the NHS wanted to stick to its decision. At that point, all the local boards rowed in behind the official NHS view that the hospital should move further into Surrey, despite the opposition of thousands of residents. Depending on whether or not one is charitable, one can believe either that the health service appointed consultants to re-examine the evidence or that it appointed them to manipulate the consultation results in order to suggest that people had voted for Belmont when they clearly had not. Because most people had answered the question “Would you like a hospital near to where you live?” in the affirmative, it was suggested that that constituted evidence that Belmont was near to where they lived, and that that justified the move. Even people living in the Belmont area did not want the hospital there. A staggering number of people wrote to me saying “We do not want our nice residential area to be bulldozed to pieces, we do not want ambulances with blue flashing lights, and we do not want more bus services.” No one wanted Belmont, except, of course, the NHS.
Over the years, we had more and more arguments about the issue. Members who have been involved in arguments about hospital reconfigurations, or in any similar campaigns, will know how daunting it is to be faced with a wall of experts and professionals, given the limited resources possessed by many of our communities and, in many instances, by Members of Parliament. My local residents, however, had one thing in their favour. In 2004, the London borough of Merton had a Labour council, which, after being consulted by residents, used its powers to have the decision to close the hospital called in to the Secretary of State. The decision was reconsidered by my right hon. Friend the Member for Airdrie and Shotts (John Reid) and subsequently by my right hon. Friend the Member for Leicester, West (Ms Hewitt): they had listened to the people.
Late in 2005 the then Secretary of State, my right hon. Friend the Member for Leicester, West, instructed the NHS to rebuild the hospital at St. Helier. She agreed with residents that it was better for it to be there, because that was most likely to reduce health inequalities. After all, the life expectancy of people in my constituency is 10 years shorter than that of those living in the Belmont area.
One would have thought that that was the end of the matter, because the Secretary of State had made her decision. However, the local NHS did not give up that easily. There is nobody from our area on its boards, and there is no constitution to say this was unreasonable, so although Ministers told it to build a hospital at St. Helier and to stop working on Belmont, it continued to make progress with its initial plans. It held meetings with Transport for London where it made it clear that Belmont was still the favoured option. It then announced that—lo and behold—planning issues meant that the hospital simply could not be built at St. Helier. It asked the Secretary of State to reverse the Government’s decision, and to build the hospital in leafy Belmont as it had originally hoped would happen.
Again, local residents were up in arms. After all this time, why would the local NHS not listen to us? How could it be that there was nobody in the NHS establishment who would represent us? The Government had represented us; the local council had represented us; even the former Mayor of London, Ken Livingstone, had supported us. He told the local NHS, “Look, I’m in charge of London’s planning policy, and St. Helier is the right place to have this hospital.” The local NHS just would not listen to us, however, so we campaigned, fought and lobbied, and eventually, after years and years, it looks as if we have won.
I have to say that I think we now have an excellent deal. Not only has St. Helier been saved, but it is going to be rebuilt and refurbished. There will be new wards with single rooms, to cut down on infections and improve patient privacy, a new local care centre, and a new 24/7 GP service. There will also be four care centres, including one at the Wilson, the hospital the Tories closed down in the early 1990s. These care centres will have diagnostics and treatments, and dentists and GPs, open when people want them. Moreover, the Wilson is not just getting a care centre. It will reopen as a hospital, performing minor operations, and with more than 50 intermediate care beds for people recuperating from operations or needing care they cannot get at home.
My constituents have seen a stark contrast between how their views are treated by local and national Government on the one hand and by the NHS on the other. That is because democratically elected organisations are far more likely to represent the views of those who are least able to express their own views. Sometimes it has seemed as if our achievements were in spite of, rather than because of, the NHS. As I reflect on our 11 years in power, I think it would have been much better if there had been a constitution for our NHS earlier, and in particular a constitution that forced the local NHS to listen to patients and staff, and which obliged it to be representative of the communities in which it is situated.
Why, after all these years, have we not had even one local person on one of our NHS boards? Why, too, should the local NHS professional bodies be packed with people who have little connection with my constituency? I am particularly concerned about the composition of my primary care trust’s professional executive committee. It is dominated by a practice far away from Mitcham and Morden. The medical committee comprises eight clinicians. The last GP from Mitcham to serve on this board was taken off it more than a year ago. Now all its members are white, even though the majority of the GPs in the PCT are not, and they represent an area that has the best health in the PCT area, rather than the worst. Six of the eight PEC members are from the same commissioning group, the Nelson, even though this group covers possibly the most affluent neighbourhood in the PCT. I should have thought that allowing a single commissioning group to dominate such an important committee was extremely dangerous. Indeed, I have received complaints that this very powerful practice-based commissioning group is at an advantage. It certainly appears to have a disproportionate influence.
I am especially anxious because this extremely unrepresentative committee is taking decisions about health care in my area. Both locally and nationally, we have been told to demonstrate that there is equal access to health services. Even the Conservatives who run Merton council say that bridging the gap between my constituency in the east and the far more affluent west of the borough is the top priority. As I have said, the Government have instructed the local NHS to take more account of health inequalities, but I am not convinced that the PCT can eradicate inequality in the local NHS, because it is not representative of either the local NHS or local people.
I hope that a new constitution will offer us an opportunity to achieve that. I want the NHS to listen to local people and to come from local people. I want it to reflect the people whom it serves and the people who work in it. I support the Government’s plan to introduce a new constitution for the NHS, but I want it to ensure that local residents are represented. I want my local NHS to reflect the area that it serves. Over the last four years, foundation hospitals have shown that communities want to be involved in their NHS as a whole, not as a particular interest group or with a particular agenda. The 108 foundation hospitals have more than 1 million members, with turnouts in elections that often exceed local election numbers. If we can get far more people involved and having their say in an institution that unites this country, we will have a much better chance of having a service that reflects the needs and demands of local residents.
I am pleased to see that the Secretary of State for Children, Schools and Families is back in his place, because, as hon. Members will not be surprised to hear, I intend to talk about the child protection system. For some years, I have been concerned that the system makes the wrong decisions, including both false positives, when it intervenes when it should not, and false negatives, when it fails to intervene when it should.
For some time, I have been trying to identify how many serious case reviews have taken place following the death of a child, because that would provide a threshold from which we could track trends. The Department has been singularly unhelpful. In fact, when I gave up trying to get information out of it and went to all the local children’s services authorities, the Department kindly instructed them not to give me their lists of serious case reviews. I am pleased to say, however, that the Chairman of the Select Committee has agreed that the Committee will work to try to find out that information. Ofsted has given us all the figures—including the 210 figure from yesterday—but it has only been tracking the figures from 1 April 2007. The serious case review process has been going on for some time, but it was strongly emphasised by the Laming report. It is a good process and it gives us a mechanism for tracking what is going on.
We should not focus only on one case: we must look at the system and where it is going wrong. We also have to consider the wider aspects, such as the Laming review. Lord Laming is obviously the ideal person to review the extent to which his proposals have been implemented, but he is not the ideal person to review to what extent other proposals should be implemented. The Government have gradually moved towards the idea, which I proposed, that we need to look at the whole system of public family law. That starts with the initial references, moves on to the assessment processes and the integrated children’s system, and—if there is a reference—it moves into the family courts, and we have not yet decided to look at how those work. I am still hoping that in January the Committee on Legal Affairs and Human Rights of the Council of Europe will agree to investigate the family division of the High Court. I shall go into some of the reasons why the family division is part of the problem.
In the initial process, the local authorities initiate proceedings. They often start with child protection conferences, which are often organised to prevent extended family members from attending. I had such a case today. One of my members of staff agreed to go to a child protection conference in Birmingham with a constituent—I do not know what has happened because I have been in the Chamber—and the time was changed at the last minute. We could say, “Well, that happens sometimes,” except that it also happened previously with another constituent. We arranged to accompany that constituent to the child protection conference and act as an advocate, but the authority—this was Solihull rather than Birmingham—changed the time of the conference. We were told, “You’ve missed it, it’s already happened.” That is an abuse of process and it should not be tolerated. In a sense, though, it is a symptom of the attempt to drive out the extended family.
We need to be straight about the fact that such things do not always happen. I work with many social workers, and there was a conference in Stafford—also attended, not surprisingly, by the hon. Member for Stafford (Mr. Kidney)—arranged by Rachel Bramble that looked at why things are going wrong in social work. The fact that people are being driven out of the profession is evidenced by all the vacancies that exist, but why do people not want to work in the sector?
The existing process is almost designed to exclude people, but then cases go into a court environment that is frightening and bewildering for people who have never been there before. Indeed, it has taken me some time to understand the processes involved. The House will be aware that I co-ordinate the Justice for Families campaign, and we are approached by people from across the country who are facing care proceedings. We refer matters to local constituency MPs, try to find volunteer McKenzie friends and so on, because there are great difficulties with the legal processes in the courts.
In an earlier intervention, I said that the single-expert system meant that people could not get a second opinion without the judge’s permission. Judges tend to refuse that permission, and they pride themselves on the efficiency of the system under which an expert is appointed jointly by the local authority and the parents involved. The problem is that the system is a machine for miscarriages of justice. A number of social workers have complained to me, and last year one explained how he used to collude with parents’ solicitors to ensure that the parents would lose their case. That is a criminal offence, but it is very difficult for me to take the matter further, as that would mean the social worker involved having to give evidence against himself.
A case in Oldham would serve well for a review of the single-expert system. The parents were refused a second opinion in both the county court and the Court of Appeal. When they applied again to the Court of Appeal, they were told that they could have a second opinion, which confirmed that the baby had not and could not have been hurt by them. Not only were the parents not guilty; they were provably innocent.
In one sense, the failure to allow a second opinion is based on practice on the continent, where the parties involved have their own experts as well as the one appointed by the court. The idea is that the court-appointed expert can make a decision about the truth of the other expert evidence. In this country, what happens with experts meetings is a move in that direction.
I see a great many cases, of which the Webster case is a good example. Once initiated, a case like that will trundle through the system. Everything happens and the children are adopted, but then all of a sudden it becomes apparent that once again the court has got it wrong. Such problems are driven by the single-expert system.
I proposed an amendment to the Children and Young Persons Bill that would have enabled people to get expert evidence. At present, when the court has gathered all the expert evidence, it is illegal for a parent’s solicitor to telephone a doctor and ask whether he or she knows anything about a case. That would be a contempt of court, and it is another example of how the single-expert system is a machine for generating miscarriages of justice. Given that some solicitors also conspire against parents in such cases, the House will see that the situation can be very difficult.
I received a letter from the eastern region of the Legal Services Commission, dated 31 October 2008, that refers to legal aid for a case involving a Mrs. M. It states that
“funding will continue on the basis that Mrs. M should accept that her case is being publicly funded, and that contesting Interim Care Orders, where there is no change of circumstances, is not an issue on which she would expect to be legally represented.”
Basically, that means that Mrs. M is allowed non-means-tested funding as long as she does not say no to the interim care order. In other words, she can have a solicitor at the hearing, but she has to agree to the order. That is not the way towards a proper judicial process, and, as I have said, such an approach drives everything else. The Department for Children, Schools and Families has done some good statistical work. Earlier this year, it analysed about 400 cases, and table A2.42 of its report shows what a low proportion of cases are chucked out of court.
There is a problem with the single-expert system. Sometimes, people cannot get legal aid when they want to contest a case; they simply have to accept it and work with it. We need to look at the criteria used to determine when a child is taken into care. The phrase in the section 31 threshold is “risk of significant harm”, but that could mean many different things. Obviously, everyone accepts that baby P and Kyra Ishaq should have been in care, and there are many similar situations, but should we put a 16-year-old in care because his parents have split up and he will not talk to one of them? I do not think so, but some judge does.
Domestic violence is a difficult area, and it is challenging for kids. If parents split up and do not see each other because Mum was a victim of domestic violence, should we still be trying to take her children away from her? I do not think so. We learn from women’s refuges that women are so frightened of losing their children that they do not actually report domestic violence. Margaret Halliday of the Salisbury women’s refuge will provide that information, and I, too, can provide lots of evidence.
Another criterion is secure care for welfare reasons. In some of those cases, children should not be in secure care. There is no evidence that it does anything for them, and they are, in effect, suffering imprisonment without having committed an offence—much like the boy who will not talk to his mum. Not co-operating with professionals is another reason that does not seem sensible. The mere fact that somebody does not immediately snap to and do exactly what they are told should not be good cause to remove their children and have those children adopted. That does not mean that if the children are missing medical attention because the parents never take medical attention seriously, there is not a grave issue. Another reason is “comments eroding children’s self-esteem”; so if the parent tells the kids they are stupid, the children need to be taken into care. I do not think so. Then there is missing school. Obviously kids should be going to school, but we have a one-trick pony—a system whereby at a certain point the child is taken into care. We need much better scrutiny of the operation of the section 31 threshold.
There are important reasons why the system correlates with the false negative environment. It is in part caused by the way the integrated children’s system pressurises practitioners into making an early decision about the truth of the case and not changing it thereafter. That is the basis of an article that I have written with Sue White, who is professor of social work at Lancaster university, and Allan Norman, who is a social worker and lawyer based in Birmingham, where he runs his own practice—Celtic Knot. The article has been published on the Community Care and Family Law websites and in The Birmingham Post, and I have also sent a copy to the Minister, so there is no sense in my re-reading out what is available on the internet.
Haringey, like many authorities, has a target, for the number of children in care, which is kept for budgetary purposes. The target for March 2007 was 365, and the target for March 2008 was 352. In part, the objective of reducing numbers in care is laudable. That is also true of trying to reduce the weekly costs, which have run at higher than £800 per child per week. On 3 October 2006 it was noted that the deficit forecast for Haringey council was £4.6 million, which included a forecast overspend for children’s services of £2.3 million, including a figure of £500,000 for looked-after children. The executive member for finance said, “I will be working closely with the services concerned, and I will be looking to them to identify ways to bring the budget back on target.” It was recognised at that time that the placements budget was running at 381 children and was very tight, and the figure had crept up to 392 by November 2006.
By 31 March 2007, the financial situation had improved, although there was still an overspend of £500,000 on legal fees. The number of children in care had reduced and a new target was set of 352. At the end of the 2007-08 financial year, however, the number of children in care had increased back up to 373, which was 21 more than budget. It appears that controls on the number of care proceedings were tightened up in November 2006, with the 12-month rolling number from November 2006 going below 40 for the first time when they were released in August 2007. The number then went back up above 50, its historical level in recent years. Sadly, baby P died in August 2007.
Given the inherent constraints on the number of children in care, if children are put into care who should not be in care—one of my examples was from Haringey—it pushes resources in the wrong direction, so we have difficulties with that. That is a bit of a run through; I could go on for a long time about other aspects, but two other Members want to speak, and if I can do another five minutes that would be quite reasonable. [Interruption.] They are both smiling.
I want to raise mental capacity and the RP case. It is not sub judice, simply because it has been through all the domestic courts and has got to the first stage in the European Court of Human Rights. That case is absolutely appalling in my view. An expert was appointed who said, “Mum’s too stupid to instruct a solicitor and therefore isn’t allowed to operate her own proceedings.” The Official Solicitor was brought in and said, “Sorry, we’re going to concede this case. That’s it. You’ve had it.” So there was no trial. There was a 10-minute hearing, at which everything said by the local authority was accepted as gospel, and that was it, except for the fact that we have taken it up and said that audi alteram partem—hearing the other side—is a key part of a trial process. Interestingly, although the expert at the time said, “Mum didn’t have the capacity to instruct a solicitor,” another expert has said more recently, “Well, she’s obviously got the capacity to instruct a solicitor.” In fact, she has done quite well at presenting her own case in the Court of Appeal. I have the transcripts of those hearings if anyone wants to read them, and the case is now in the European Court.
Good news from my point of view is that the Equality and Human Rights Commission is showing some interest in mental capacity and what is happening in the Official Solicitor’s office. We have about 180 cases a year where parents are basically excluded from judicial proceedings. They have no locus—something that is not allowed in criminal proceedings, which people have been able to contest since a case in the 1800s. In family court proceedings, it is seen as perfectly acceptable to put parents in a situation where they cannot contest the proceedings.
I have another case, which I call the HP case, in which a lady who does not speak English was given an IQ test in English, did rather badly—whoops—and contacted the Official Solicitor. We went to the Court of Appeal, which said, “Tough.” So that quite appalling case is going to Europe as well.
We have international cases where it is thought more important to ensure that no one escapes the family courts in Britain than to look after the children better. I know of two such cases: the one that is well known from The Times, and another one that is not so well known, where the court’s objective is to get an eight-year-old back to England, away from his or her mother and leave the mother with another baby in situ. When I suggested to the Government that it would be better to put the child first and to transfer the case to the local jurisdiction, the response was, “Oh, no, we can’t do that; the courts have to win,” even though it is better for the child for the case to be transferred to the foreign jurisdiction.
I want to make a few points about Ofsted, which has been very good in this area. It has started to reveal in its reports some of the truth about how the Children and Family Court Advisory and Support Service operated. It has also revealed the truth about the serious case review. Baby P died in August 2007, and Ofsted started taking responsibility for the sector in April 2007. I do not think that those two things can be correlated. It is a ray of light in an area that has involved people covering up for one another for years.
The problem is that secrecy tends to prevent accountability. In fact, secrecy is often used to prevent Members of Parliament from finding out about such cases. Generally, what the Government say should happen is the right thing. I do not think that the Government’s objectives are wrong. The problem is that something quite different actually happens. What is needed is a much wider inquiry, which is independent of people who make money out of the area. Perhaps the departmental Committee can look at that—perhaps the Justice Committee should do so as well—but we need people to look at it who are not interested in sweeping things under the carpet and saying that everything is perfect and that everyone is doing a brilliant job. Some people are doing a brilliant job. Another whistleblower came to me who had faced disciplinary action for telling the truth, which I thought was not very clever. I do not know what has since happened in that case. There are some very good people doing a very good job in difficult circumstances; the problem is that the secrecy has allowed bad practice to develop in an unaccountable way.
I will be happy to meet the relevant Minister and the departmental Select Committee to go through all the details. I met Lord Laming on Monday, although I think the terms of reference of his inquiry are far too narrow. What we need is a wider inquiry, because this matter cannot be kicked into the long grass. Problems arise every day across the country, particularly in England and Wales. Scotland generally has fewer problems, for reasons that I could go into at length, were it not five minutes to the hour—I have said that I will speak for only so long. This is an important issue and both sides of the coin matter. I ask the Government to consider instituting a wider inquiry.
I rise to speak briefly in support of the new proposals on health and education in the Queen’s Speech and to make a few remarks about the general direction of schools policy.
I endorse almost all the comments that the Chairman of the Children, Schools and Families Committee made on policy, especially his comments on the structure of the debate. I have been a Member of Parliament for 11 years and I have attended every Queen’s Speech debate in that time. I may be wrong, but my perception is that each year fewer Back Benchers wish to contribute, or wish to spend time sitting in the Chamber, because of the length of time allocated to Front Benchers. If we are serious about involving more Back Benchers and younger MPs in these debates, we have to take a careful look at the dominance of the Front Benchers.
As a member of the Procedure Committee, let me say that the Committee is considering such issues. If any Member were to refer such a matter to the Committee, I presume that it would be viewed favourably.
I am pleased to hear that. It is an important matter that should be pursued.
Although I do not want to discuss the Haringey case at length, in the context of the comments made by the Chairman of the Children, Schools and Families Committee, it is striking that in the past few months the important subject of children in care and the position of vulnerable children has moved inexorably up the agenda. It does the Government credit that they have prioritised vulnerable children to a far greater degree than has ever been the case before in our country. Let me say this, however: it is easy to discuss such matters when there is a high-profile case in which the whole country is interested; it is less easy to maintain a high political profile for children in care and vulnerable children in the absence of that high level of media attention. I hope that all hon. Members and the Government will sustain their present interest in policy to improve the position of children in care, even when the media interest dies down.
It is an absolute scandal that children in care perform so poorly in our schools, are so neglected and are so overlooked. In the past few months, we have reached a turning point. I hope that we can maintain a high level of interest in those unfortunate children.
Does the hon. Gentleman agree that it is a perverse intellectual dichotomy that, every month of the year, detailed information relating to the actions of social workers in children’s services is routinely disposed of under the auspices of Ofsted, yet, at the same time, thousands of DNA records of completely innocent people are kept? Do we not have our priorities completely wrong in that respect?
The hon. Gentleman makes an important point. At yesterday’s meeting of the Children, Schools and Families Committee, I was startled to hear the admission by Ofsted’s chief inspector that records were routinely destroyed after three months. The defence offered was that it would be difficult to store such a large number of records, but it seems to me that the widespread use of electronic information storage completely invalidates that argument.
I talked to the head of children’s services in my local authority, and a key point that they wanted to communicate to me is that in some high-profile cases, but not in the case of baby P, those who cause abuse deliberately travel around and move to different areas so that it is hard for the record system to follow them. Does my hon. Friend agree that we need to consider the issue of people who deliberately move around? There are proposals for a tracking system, and we need to speed that up quickly.
That is an extremely important point, and it highlights the crucial significance of greater co-operation and communication between police, local authorities, and the national health service. Whenever there is a tragic case such as that of baby P, the media routinely decide to target social workers, but they are less aggressive about the inadequacies in some of our policing systems, and certainly about those in some of our health care arrangements.
Finally on children in care, the reluctance of some local authorities to increase the number of children in care is certainly partly a financial matter, but we have to accept that the quality of institutionalised care that our country has provided over many decades has been appalling. That partly explains the reluctance to put more children into care. If we learned the lessons of some of the Scandinavian countries and provided a higher quality of residential care, and could be assured that the quality of parenting that children would receive in a residential setting was without question better than that which they had received at home, perhaps we would be less reluctant to put children into care, temporarily or permanently.
On schools policy, in my constituency, since 1997 every primary school, secondary school and GP surgery has had its roof fixed. My local hospital has not only had its roof fixed but has been totally rebuilt. That is to the enormous credit of my party’s Government. In addition, there is the welcome prospect of seven new local health centres being built in the very near future. My local authority is on the verge of being able to rebuild or refurbish all its secondary schools, where necessary.
The chief executive and the director of children’s services in Bury are keen to support the bid that they submitted on 20 November to the revised Building Schools for the Future programme. The Secretary of State for Children, Schools and Family is likely to be in north-west England in early January, and it would be extremely useful if he could find time to visit Bury and talk to the chief executive of the local authority and the director of children’s services about the very good plan that the local authority has submitted to the BSF programme. My constituents could then look forward to the most dramatic schools rebuilding programme that they have ever seen. That is enormously to the Government’s credit.
Also enormously to the Government’s credit is the inexorable rise of standards in schools over the past 10 years. It is unfortunate that each year, when the GCSE, A-level and key stage test results come out, parts of the community, and Members in parts of this House, routinely want to rubbish the improving standards and achievements of our children.
It is unfortunate that the Chairman of the Public Accounts Committee has left the Chamber, because he raised a number of interesting issues, on many of which I could agree with him; there is a good deal of common ground between us. He raised a number of issues to do with micro-managing our schools system. That is astonishing coming from someone of the party that introduced the Education Reform Act 1988, which imposed on a generation of young people the most micro-managed system imaginable, and which resulted in the hugely prescriptive national curriculum, Stalinist forms of testing and assessment, and the unbelievably inaccurate league tables that are routinely published, and which drive the behaviour of head teachers in our schools. It is beyond belief that anyone who supported that legislation could accuse this Government of wishing to micro-manage our school system. One of the most interesting developments of the past 12 months is the recognition, not just by the Government but in all parts of the House, that the era of the ERA—the Education Reform Act—has probably come to an end. We have exhausted the advantages gained from the 1988 Act—and there have been some—and we have to build on that and move on. The shift of direction to a more comprehensive approach to children’s services, with a greater emphasis on children’s well-being and a new focus on the remaining inequalities in our school system and on the importance of social mobility, is welcome, and I look forward to the proposed legislation in the Queen’s Speech significantly advancing that new agenda.
Like the hon. Gentleman, I applaud the movement towards looking at important objectives such as social well-being. However, does he agree that the Government do not appear to have taken on board the fact that there is a great deal of teaching to the test, particularly at key stage 2, which has narrowed the curriculum unnecessarily for many children?
That is an important point, but I do not agree with the hon. Lady, because the statement by the Secretary of State some weeks ago—in fact, it was made in the week in which she and I were on a Select Committee visit to Canada—made the biggest change to the testing and assessment system since 1988, and fully recognised the damaging effect of teaching to the test. In fact, I was going to go on to praise the Secretary of State for making that statement and changing our testing and assessment system, and essentially getting rid of the increasingly redundant key stage 3 test, and for leaving the door open to future reforms to the key stage 2 test. The progress that we have made in the past few months on testing and assessment is hugely welcome. The progress on curriculum reform, with the publication of the Rose review and the new freedoms for individual schools to be more flexible about the curriculum so that they can tailor it more to children’s individual needs and develop a more personalised approach to the curriculum, is hugely welcome.
A consultation was launched this week, and the notion of a school report card replacing the bog-standard league table is hugely welcome. I hope that there will be adequate time for all hon. Members to consider what ought to go into the new school report card, which I hope will abandon once and for all the idea that raw scores are the only measure of a school’s success. I look forward to the far more sophisticated but easy-to-understand form of a report card that will give full recognition to the complete range of a school’s achievements.
There are two points on which I want to focus in a little more detail, beginning with my annual comment on school admissions. The Secretary of State will know of my interest in the subject, and that the Education and Inspections Act 2006 made significant improvements to the admissions system with the new code. Only this week, the Government published the revised code on school admissions, which will take effect early next year. I welcome it as another step towards a fairer admissions system that is likely to lead us a little further down the road to a better-balanced school intake. As all the international research indicates, countries that have balanced school intakes and that have the least inequalities and the flattest hierarchies between schools by and large perform better on all educational criteria. I welcome the new duty on the admissions authorities to meet the needs of the local area, and I welcome the improvements to admissions forums so that they, too, are more representative, and have to consider the fairness of admissions policies for that area.
There is one element in the new revised code that I hope the Secretary of State will speak about in his closing remarks: the school’s ethos. The Department’s press release says that schools will be allowed to advise parents of their ethos during the application process and ask that children respect that ethos. Will the Secretary of State assure the House that the issue of ethos will not become a criterion for the selection of children? If that does happen, and if children, or parents on their behalf, have to sign up to a particular ethos as an admission criterion, it will be a hugely retrograde step. I would be grateful if the Secretary of State commented on the question of ethos in his winding-up speech.
Would I be right to infer from the hon. Gentleman’s comments that the Labour party is against schools having an ethos of, say, excellence for all pupils in a community? I wonder what the rationale behind his comments is. Is he against excellence? Is he against schools moving forward throughout the community?
With respect, that is a pretty fatuous question, because obviously I am not. My point is that there is an important distinction between requiring parents to say that their children will accept the ethos of the school and allowing schools to select which children they wish to admit. That is the fundamental distinction I am trying to make.
Allowing time for the final speakers in the debate, I would like briefly to make one other point, which concerns the 14-to-19 phase of education. The Government have made enormous progress in the past two or three years on that issue. They have done so 10 years later than they should have done; we should have been grappling with the 14-to-19 sector as soon as we were elected in 1997. Nevertheless, I welcome the progress that we have made. Two issues emerge, however, from the establishment of this as a distinct sector, and from the development of diplomas as the central part of the curriculum in that sector. The first is the question of funding. My right hon. Friend the Secretary of State will know that for many years there has been an enormous discrepancy—as much as 15 per cent.—between the per capita funding of students in the 16-to-19 phase of education and the rest. I welcome the fact that that discrepancy has recently been reduced; I understand that it is now down to 9 per cent. Given the structural changes in 16-to-19 education and the handing back to local authorities of the funding responsibility, is it not self-evident that we must have a uniform funding system, not only for the 16-to-19 phase, but for the 14-to-19 phase? I would be grateful if the Secretary of State commented on equality of funding between institutions in the 14-to-19 sector.
My final point on that sector, and of my contribution, concerns the structures of 14-to-19 education. One of the issues that I found controversial in the 2006 Act was the power of presumption that schools currently without a sixth form could open one. I have raised that point with the Secretary of State before, and I raised it with the Secretary of State for Innovation, Universities and Skills. As we move to an era beyond 2011 where the annual rise in public investment will be far less than it has been during the past 10 years, the last thing we want is an enormous explosion in the number of new, small sixth forms. All that will mean is that the cost of educating each student will be disproportionately higher, and we will not get the economies of scale increasingly necessary beyond 2011. It has been a concern to many of us that the academies programme, of which I am a strong supporter in most respects, although not every detail, was originally built on the assumption that every academy would have its own sixth form. So, hey presto, there were 400 new sixth forms at a stroke—even though there were not enough young people to fill them. I welcome the fact that that is no longer a requirement of academies and that they can be founded without a sixth form. The majority of our sixth-form colleges perform outstandingly and there has been a rapid improvement in the performance of the overwhelming majority of our further education and tertiary colleges. I am fortunate in having two of the most outstanding colleges in the country in my constituency—the Holy Cross sixth form college and Bury college. I realise that that does not apply to every part of the country, but it must be increasingly self-evident that the most economically effective and educationally advantageous way in which to deliver the new 14-to-19 phase of education is through the college sector, not through the proliferation of small sixth forms.
I confidently predict that if the Government do not take this issue far more seriously than any previous Government, perhaps not by the end of the next Parliament, but certainly by the one after, we will have to close large numbers of sixth forms because the budget will simply not stretch to cover those costs. Again, I would be grateful if the Secretary of State took this on board and perhaps opened up a dialogue with our right hon. Friend the Secretary of State for Innovation, Universities and Skills, because it is an issue that obviously covers both Departments. If we are to make the 14-to-19 sector a success and implement our plan to increase the education and training participation age, it is crucial to recognise that it can only be done by strengthening the college sector and increasing the role of colleges in the delivery of that phase. I am afraid that that means a reduction in the number of independent sixth forms.
I shall focus on just one aspect of today’s discussion about the Government’s programme of activity for the forthcoming legislative Session: the national dementia strategy, to which the Secretary of State for Health referred in his opening speech. At the outset, I should say that I fully welcome the concept of a national dementia strategy, as, I suspect, do most Members. It is immensely important, and has been for a significant time.
In August 2007, the former care services Minister, the hon. Member for Bury, South (Mr. Lewis)—not the other Bury Member, the hon. Member for Bury, North (Mr. Chaytor)—said that we should work to bring dementia out of the shadows. He was entirely right to say that and I applaud the Government for acting on that impulse and arranging for a national dementia strategy to be brought forward. I hope that the House will forgive me if I cover the reasons why a national dementia strategy is so necessary and why dementia is such an important subject.
The figures may be well known to hon. Members, but I will repeat them. Some 700,000 people in the UK now have dementia. That figure will probably double in the next 30 years, and the cost to the UK economy will treble during that period. That is a significant figure, because the current estimated cost to the UK economy is £17 billion a year, which is more than the cost of heart disease, stroke and cancer combined. Those are very significant figures, which is why the strategy is, as I said, extremely welcome.
The strategy is welcome, at least in part, because a problem of that scale should never be ignored. That fits into the context of what other hon. Members said earlier about mental health issues more generally. It is true, and worth recognising, that people do not like to talk about mental health issues in the same way as they like to talk about physical health issues. Some stigma is attached—and that is true of dementia.
It is not just recognition of the scale of the problem that we require. We also need people to have the courage to come forward and explain that it is happening to them, and how they are coping with it. In the context of dementia, one of those people is the author Terry Pratchett, who the House will know has recently revealed that he has a form of dementia. Since then, he has actively campaigned on the subject, talked a great deal about research, and described what has happened to him in terms of a tsunami that will hit the United Kingdom. He is right to talk in those terms.
Two aspects of a tsunami are important, and someone who is about to be hit by one will want to know two things. First, they will want to know how big the wave that is about to hit them is; I have said a little about that. Secondly, they will want to know when it will hit. How urgent is the problem? It is with regard to the urgency of the problem that I have some difficulties with the Government’s position. I have no doubt that the Government have done entirely the right thing in arranging to introduce a strategy, but I am becoming a little concerned, as I know others in the field are, that the Government’s sense of urgency has started to slip.
When the former care services Minister spoke about his intention to introduce a strategy, he said that he hoped that it would be available by the summer of 2008. However, the Department of Health issued a press release on 19 July that said:
“The full Strategy, to be launched in the Autumn, will have three main aims”.
I shall return to those aims in a moment, but it became clear at that point that the Government wished to introduce the strategy in the autumn. We know that the Government have a very flexible concept of autumn, but we are clearly no longer in the autumn now. We then asked the current care services Minister when exactly we might expect the strategy. I asked the Secretary of State that question today, too. The Minister has said that it will be introduced shortly and, under further cross-examination, that that might mean early in the new year.
I understand that things are difficult in government. Other priorities arise, and the Government sometimes find that time scales slip a little. However, an issue of such importance and urgency must be dealt with expeditiously. Those involved with dementia—those who have it, those who care for them, and the professionals working in the sector—regard the situation as urgent. They feel that they have persuaded the Government of that—indeed, the Government have made it clear that they regard dementia as a priority. With that must come a sense of urgency, but if time scales continue to slip, that urgency must fall into doubt, which would be extraordinarily regrettable.
The one aspect of the strategy that I urge the Government to regard as especially important is training. Training applies to various different aspects of dementia, and in various ways to those involved with it. The draft consultation document on the dementia strategy says that it will have three main aims. The first aim will be
“to increase awareness of dementia and remove the stigma associated with it,”
the second to
“ensure early diagnosis and intervention,”
and the third to
“improve the quality of care that people with dementia receive”
There can be no argument about any of those aims, and training is key to delivering the second two.
I want to talk about two aspects of training, the first of which is training for general practitioners. They are, as the name suggests, practitioners of general medicine. No one expects them to be experts in every medical condition. However, one of the problems that we face in dealing with dementia is that general practitioners are extraordinarily reluctant to make diagnoses. I suspect that the failure to make such diagnoses is in many cases down to reluctance rather than inability.
It is often said—rightly, in my view—that where we are with dementia now is roughly where we were with cancer 30 or 40 years ago. There is sometimes a sense in the medical profession that it is not worth diagnosing dementia because nothing can be done. One of the problems is that that is largely true. There is currently no cure for dementia, and there are no effective treatments. However, it is not true that absolutely nothing can be done. Any support for or understanding of those with dementia is of such immense value to them and those who care for them that it is worth making any diagnosis as early as possible. If we expect general practitioners to make diagnoses, as we want them to, we will need to give them the training to allow them at the very least to recognise the signs, and to refer patients to a specialist medical practitioner who can then make a diagnosis.
I pay tribute to my hon. Friend’s work on the all-party group on dementia. Does he agree that it is imperative that the review in the new year, if it arrives, should raise the disparity between government and other funds going into research into dementia, and those going into research into other conditions? We need a public debate, to ameliorate the problems that he has raised.
My hon. Friend is absolutely right about that. The timetable for research is also slipping. The Government have quite rightly suggested that there should be a research summit, and when the Department of Health’s press release was issued, it said that that summit would be held over the summer—in other words, over this past summer. That clearly did not happen either; the timetables are slipping. My hon. Friend is also right to say that the level of funding for dementia research is minimal compared with the funding for so many other conditions. It becomes all the more important to invest in research when we have no cure and no effective treatments, because we are not going to find either unless a substantial amount of research is done.
The hon. Gentleman is making a well-informed and thoughtful speech. A moment ago, he referred to training. Does he agree that some general practitioners need training in Alzheimer’s, for example, to make them aware that it can strike young people in their late 20s? As with other forms of dementia, it is often thought to be solely an older person’s disease but, sadly, that is not the case.
I entirely agree. The problem with dementia is that they have got you coming and going. A doctor will often be unwilling to accept that young-onset dementia could possibly be the explanation, and in cases of older-onset dementia they might well say that there are plenty of other explanations for the symptoms, and that this is simply what happens when people get older. The hon. Gentleman is absolutely right to draw our attention to young-onset dementia, and we also need to persuade the medical profession to have the courage—as well as the knowledge—to make these diagnoses in cases of older-onset dementia.
Training is also important in another respect—training for those who care for people with dementia, either in a residential care home setting or as visiting social workers for people with dementia who live at home. It is crucial that such people have an understanding of what dementia is, how it affects people and what can be done to ameliorate its symptoms. It is remarkable that anyone who works in a care home has to receive training in lifting, handling, fire regulations and many other things, yet they do not have to undergo even one single hour of training in dementia. That is even more ridiculous when we consider that a substantial proportion of the care home population—perhaps some two thirds of them—have dementia, and that that proportion is likely to increase.
The policy of this Government is—as, I am sure, the policy of any future Government would be—that people should be cared for in their own homes for as long as possible, and for as long as they wish. That means that those who have to be cared for in a residential environment will, generally speaking, be those who cannot be cared for at home, and substantial numbers of those people will be in that position because they have an advanced form of dementia. It is therefore becoming more important than ever that those who work in a care home environment understand dementia and receive training in it. The Government’s dementia strategy states that training is important and that the strategy will cover it. I very much hope that when they put the final touches to the strategy, they will recognise how important that subject is, and that it should run through all the aspects of dementia that the strategy rightly seeks to address.
In my last point, I want to link what I have been saying to the theme that has rightly emerged in many hon. Members’ speeches today, by saying something about the tragedy of baby P and all that surrounds it. The argument for training for the broader social work profession is also relevant here. We need a better-trained social work profession. We know that numerous substantial mistakes were made in the case of baby P, and in other cases that we have heard about, and it seems to me that training is part of the answer. However, training can be of real value only if we can retain the staff who have been trained. One of the problems in the social work profession generally, and in the care home sector in particular, is that it is very difficult to keep members of staff in position for long. There is a huge amount of churn in the profession. People do not stay in one job for long, and the training that they have received may go to waste if they move on to another job or occupation.
We need to examine ways of keeping people in their jobs for longer, and one of the ways of doing that is to recognise that the caring professions are just that. First, they are made up of people who wish to care. Secondly, they are made up of people who wish to be treated as professionals. We have to allow them to achieve both those aims. One of the counter-intuitive aspects of the baby P incident, it seems to me, is that when we hear about those terrible failures in the social work profession, we put down social workers as a result. As I say, however, counter-intuitively, the right answer may instead be to raise up the social work profession and say how important it is, if we expect people to act as qualified professionals with good judgment, and to give them the training and then the space to exercise it. That is a hugely important lesson to draw from this episode: it is not an easy lesson, but it is an extremely necessary one.
Let me finish where I began—on the dementia strategy—and say to the Government simply this: I welcome the strategy, as I think most sensible people would, but the Government have raised many hopes in bringing it forward, so they must not disappoint. The strategy must deliver not just the detail but the urgency that the Government promised. We must see it brought forward soon, because it seems to me that there are few more important things that any Government can do.
I thank you, Mr. Deputy Speaker, and the Government Front-Bench team for their understanding in allowing me to leave the Chamber briefly earlier in order to see my daughter’s nativity play. Even though we all face tough economic circumstances, I know that all hon. Members will want to find time in their schedules for seasonal festivities.
I was particularly pleased to read about the great fun had by all at the Christmas party held by the Secretary of State at the Department for Children, Schools and Families. I understand that, as well as wine and canapés, the Secretary of State also laid on for members of the press a Scalextric demonstration, a Nintendo Wii and some Star Wars light sabres. Those were not products acquired during the seasonal sale that Woolworths has just launched to celebrate the life-saving effects of the recent VAT cut; nor were they the toys that the Prime Minister threw out of his pram on hearing what the German Finance Minister thought of his policies. They were, in fact, there to help members of the press celebrate the first anniversary of the children’s plan.
I also understand that the climax of the party was a light sabre duel between the Secretary of State and Mr. Michael White of The Guardian, modelled on the epic duel between Darth Vader and Obi-Wan Kenobi in Star Wars—these are serious times and we need serious people. I also understand that the Secretary of State won, and I am sure that, as he triumphed, he uttered the words that the Home Secretary spoke to my hon. Friend the Member for Ashford (Damian Green) just the other week—“May the force be with you”. But whether or not we believe in the force, and the power of the dark side, I am sure that we can forgive light-heartedness at this time.
Of course, some hon. Members may have been in good spirits yesterday for reasons other than the formal anniversary of the children’s plan. They may have been listening to the Prime Minister taking pride in his global rescue plan. Well, we now know what the man in charge of Europe’s biggest economy thinks of that. The Prime Minister may believe, in his more modest moments, that he is Franklin D. Roosevelt, but the truth is that he is closer to a political Max Mosley: he thinks he is king of the world and he has clearly got money to burn, but all people remember is that he got a terrific spanking in German. [Interruption.] Thank you.
We have had a good debate this afternoon. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) brought his customary authority and gravitas to discussion of the NHS, underlining his reputation as a stalwart friend of health professionals everywhere. The Secretary of State for Health made the traditional partisan points with his customary lightness of touch and discussed forthcoming Bills in a way that reminded us why he is such a valued member of this Government.
The hon. Member for North Norfolk (Norman Lamb) brought his considerable intellect and passion to bear, and I welcome the increasingly reformist focus of Liberal Democrat health and education policy. The hon. Member for Huddersfield (Mr. Sheerman), the Chairman of the Select Committee on Children, Schools and Families, spoke comprehensively and well, and with particular authority on the need to improve child protection. My hon. Friend the Member for Gainsborough (Mr. Leigh), Chairman of the Public Accounts Committee, combined a proper regard for efficiency in the public sector with pungent prescriptions for reform, not all of which I necessarily share.
The hon. Member for Gateshead, East and Washington, West (Mrs. Hodgson) made a series of telling points on the need to improve support for children with special educational needs. My hon. Friend the Member for Ilford, North (Mr. Scott) spoke with great passion about the need to improve the service that his constituents get from the NHS. He also made a powerful plea on behalf of children with special educational needs.
The hon. Member for Mitcham and Morden (Siobhain McDonagh) spoke persuasively in favour of the NHS constitution, using her constituency experience to powerful effect. The hon. Member for Birmingham, Yardley (John Hemming) spoke, as he has done so often and with such passion, on child protection. In an intervention, he asked specifically whether we agreed with the terms of Lord Laming’s inquiry. We do not, as we made clear in a letter to Lord Laming. We fear that they are too narrow. We want Lord Laming to ask not just whether his 2003 recommendations are being followed, but whether we need to do more to reform the child protection system.
Lord Laming has said that the foundation of current children’s services is robust, but we are not persuaded of that assertion. He also argues that serious case reviews, including the serious case review in connection with baby P, should remain confidential. We disagree. We have nothing against Lord Laming as an individual—indeed, he was patron of the commission on social workers, chaired by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) just the other year, which produced many recommendations that the Secretary of State now appears to be implementing—but we think that it is important, as I am sure the whole House would agree, for there to be no bar on serious questions being asked on raising the bar in child protection.
The hon. Member for Bury, North (Mr. Chaytor) made a characteristically thoughtful contribution on child protection and schools policy, and my hon. Friend the Member for Rugby and Kenilworth (Jeremy Wright) spoke movingly and effectively about what we can do to help those living with dementia.
I can freely praise one or two speeches that I was not able to hear in full, because the notes taken by my colleagues on the Front Bench have been so generous. I can also praise the Secretary of State’s speech, which I have not yet heard, because I know what is in it—not because it has been leaked to me by the Department for Children, Schools and Families, but because he displays an admirable consistency in the political message he propagates. Whatever the occasion, wherever the platform, whoever the opponent, he repeats the same line: we on the Government side are saints who are investing in stronger motherhood and much more apple pie, and the other guys—it can be Scottish nationalists, Liberal Democrats or even German Social Democrats—are monsters from the Jurassic era who will cut, cut and cut again.
Psychologists have a term for people who repeat the same behaviour over and over again, whatever the circumstances and whatever the efficacy. They call it obsessive-compulsive behaviour. But any such diagnosis of the Secretary of State’s approach would be mistaken. Another psychological term captures his approach much more accurately. It is called transference. Transference occurs when people accuse others of behaviour which they themselves exhibit. If Jeffrey Archer accuses someone of embroidering the truth, that is transference. If Simon Cowell accuses someone of arrogance, that is transference. If Peter Mandelson accuses someone of irresponsible leaking, that is transference. When the Secretary of State accuses others of wanting to inflict cuts, that is actually what he has been doing.
Before the last election, the Secretary of State told us that a Tory Government would reduce future spending by £35 billion, but now his Government are reducing spending by £37 billion. His own Department is not immune. Let us look at some of his budgets, such as the budget for Building Schools for the Future. On school building, he has failed so far. We were promised 200 new schools by the end of this year. We have had fewer than 20. Now local authorities have had to go cap in hand to the European Investment Bank for money for school building because none is available in Britain. The pre-Budget report says, ominously:
“DCSF is assessing the value for money of Building Schools for the Future”.
A senior Treasury source was quoted as saying of the school building programme that
“it’s clear we’re going to have to scale it back and scrap some considerable parts of the programme.”
On child care, the Secretary of State has failed so far. We were promised by the Prime Minister that we would have for every three and four-year-old an entitlement to 20 hours of free child care, and we were promised an extension of that entitlement to all two-year-olds. But again, in the pre-Budget report we are told that that entitlement will not be extended to 20 hours for three and four-year-olds, and the entitlement for two-year-olds will not be extended to all—so cuts again.
On diplomas, the Secretary of State has failed so far. We were promised that 50,000 students would take these new qualifications—then 40,000, then 30,000, then 20,000. Now the number is 12,000 and falling. In a parliamentary answer that I received today, we discover that funding for diplomas is going down as well. It is being cut from £117 million in 2008-09 to £78 million in 2010-11. That is a 34 per cent. drop in funding. So there are cuts in that programme too.
I feel sorry for the Secretary of State having to make these cuts. It is not his Department’s fault. He should really take the matter up with the team who have been responsible for economic management over the last 10 years and who have landed us in this mess. Perhaps he should have a word with the man who has been principal economic adviser at the Treasury for the last decade: the chap who designed the regulatory regime that allowed the banks to behave as they did.
I commend to the Secretary of State an article in today’s Daily Telegraph by Dr. Irwin Stelzer, who says:
“It is beyond question that Britain’s problems stem in part from its fractured regulatory system, with responsibility split between the Bank of England, the Financial Services Authority, and the Treasury. A close study of the relevant documents fails to reveal that this system was forced”
upon us by the United States, says Stelzer, adding that
“it sprang full blown from the brains of Chancellor Gordon Brown and his sidekick, Ed Balls.”
The guilty men are there in front of us.
The Secretary of State will have an opportunity to respond in due course. I must make progress if I am to finish my speech within the allotted time.
The Secretary of State is an intelligent man with many decent instincts—
The Secretary of State will have an opportunity in a second.
I am afraid, however, that like many talented young people the Secretary of State has fallen in with a bad crowd—in his case, the Brownites. Since getting in with this gang, the Secretary of State has been determined to live according to its members’ aggressive rituals, the most important of which is the drawing of dividing lines. He has tried to draw dividing lines on all the issues that I have mentioned, although in doing so he merely exposes his own weakness. He is just like a gang member who wields a weapon but only harms himself.
The Secretary of State will have an opportunity in a second.
The Secretary of State should appreciate the limits of aggression and try a different path.
In just a few minutes’ time, the Secretary of State will have an opportunity to speak for 15 minutes, and I look forward to hearing from him then.
The real story of the Queen’s Speech, and the biggest dividing line in British politics, is the divergence between the path trodden by the Secretary of State and the road taken by the Secretary of State for Work and Pensions.
Oh, all right then.
Can the hon. Gentleman guarantee that he and his party will match the DCSF’s public spending on education this year, next year and the year after that? Can he give that commitment?
I shall wait to see what the Secretary of State actually pledges to commit to education spending. Until we know the details of what he is spending, we cannot know what to match and what to increase. We know, for example, that diploma funding has been cut, but we found that out only today. As the pre-Budget report unravels and as we discover the reality of what is going on, we will come up with the answers that the Secretary of State himself has so far failed to give.
I was talking about the divergence between the path trodden by this Secretary of State and the road taken by the Secretary of State for Work and Pensions. While the Secretary of State for Work and Pensions is pressing ahead with reform, taking on vested interests and challenging the left of his party—creating, indeed, a radical new centre-ground consensus—the Secretary of State for Children, Schools and Families is opting for none of the above. While welfare reform, and the spirit of Blairism, live on in the heart of the right hon. Member for Stalybridge and Hyde (James Purnell), the cause of schools reform, which was championed by Mr. Blair at the start of this Parliament, has now been put to sleep by the right hon. Member for Normanton (Ed Balls). Academies have had their freedoms curtailed; Lord Adonis has been shunted into a siding at the Department for Transport; Bruce Liddington, the schools commissioner responsible for diversity in schools, has been dismissed and not replaced; and Sir Cyril Taylor, the guardian of the independence of academies at the Specialist Schools and Academies Trust, has been dispensed with as well.
In his education Bill, the Secretary of State plans to introduce more powers for bureaucrats, more new bureaucracies and more bureaucratic burdens on teachers. That represents a tremendous missed opportunity. It is sad that in this Queen’s Speech there was so little of conspicuous merit, apart from those welfare proposals which the right hon. Member for Stalybridge and Hyde largely copied from the recommendations of my hon. Friend the Member for Epsom and Ewell (Chris Grayling). In that sense, the Gracious Speech was mostly old, with very little new; most of that was borrowed, and all of it was blue. Members will perceive an irony there. When Opposition Members are given Government papers and publish them, they get arrested. When Government Members get Opposition papers and publish them, they get a fresh White Paper and rave reviews. It is a course that I recommend to the Secretary of State.
What this country needs is a Government committed to reform, ready to tackle vested interests, determined to extend parental choice and convinced of the benefits of diversity. What this country needs is a Government who, instead of searching for dividing lines, seek unity around reform, instead of generating bureaucracy for those on the front line, believe in freedom for professionals, and instead of presiding over economic turmoil and falling living standards, offer change, optimism and hope. That is why we desperately need a Conservative Government, and that is why I commend the amendment to the House.
I am grateful to the hon. Member for Surrey Heath (Michael Gove) for giving me advance notice of something this afternoon, and I think that I probably owe him an apology. He wrote to give me advance notice that he would be absent from the Chamber for his daughter’s nativity play, which was very courteous of him, but I, unfortunately, did not give him advance notice of my intention to intervene on him. If I had done so, he might have had the chance to write into the script of his speech the answer to my intervention, because I have to say once again that, as has been the case time and again in the past year, what we have had from the hon. Gentleman is a well-written, erudite, humorous and insubstantial speech.
I shall now move on to the substance. I want to do so by, without patronising Members, thanking them for their contributions to this excellent debate, with the exception of the speech that we have just heard. We might have some disagreements about methods, but there is common agreement that we want to do the best by the children of this country for their safety, education, well-being and happiness. There has been clear commitment to that in speeches made from all parts of the House, some of which I shall now mention.
My hon. Friend the Member for Gateshead, East and Washington, West (Mrs. Hodgson), whose Bill on information for children with special educational needs will be very important indeed, made an important speech in which she talked about training for teachers with SEN specialities. The hon. Member for Ilford, North (Mr. Scott) also talked about the importance of making sure that there is proper training in SEN for those teachers, and I thank him for his contribution.
My hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) made an important speech on health, and on the fact that we need to involve local communities in the management of health services.
Although I do not agree with everything the hon. Member for Birmingham, Yardley (John Hemming) has said, I know he is committed to the cause for which he campaigns, and I can say to him today that, following the Ofsted reports of recent weeks, we will be able to give him the detailed information that he wants on serious case review numbers.
The hon. Member for Rugby and Kenilworth (Jeremy Wright) made a speech on dementia, which is not an area in which I have expertise. I know that he wants a Government strategy to be implemented sooner rather than later, but when that strategy is published, I am sure that he will contribute to the debates that follow on the important subject of how we make sure we take forward care for people with that disease.
This Queen’s Speech takes forward the commitments that we made in our children’s plan and, one year to the day after its publication, our progress report, “One Year On”—to make sure every child can succeed, to tackle all the barriers to children’s progress in and out of school and to work together, and intervene early, to make sure children are safe and properly protected and that their well-being is promoted. In the Queen’s Speech, we committed to set out in law the responsibility of all of us to do the following: to keep children safe through children’s trusts; to establish the legal basis for our new standards regulator, Ofqual; to strengthen our intervention powers to ensure that all schools can be good schools and all local authorities can tackle underperforming schools; to give schools more power to tackle bad behaviour; and to reform the provision and funding of 16-to-19 education. Opposition Members claim that there is nothing in the Queen’s Speech, but nothing could be further from the truth.
One of the failures identified in Haringey was the insufficient challenge by the local safeguarding children board to its members and front-line staff. Often the chairs of these boards are also the chairs of children’s services. Has the Secretary of State given any further consideration to the conflicts of interest that arise in that situation, and to having independent chairs?
I have done, and I have made it clear that no serious case review should be chaired by anyone other than an independent person. In those areas that have had an inadequate serious case review, we are now asking an independent person to review the case and to report to us as soon as possible.
Haringey has been the subject of debate for hon. Members on both sides of the House. We and our constituents have all been shocked and appalled both by the terrible suffering that that little boy endured and by the failure of services to act and intervene early to ensure that he was properly protected. We have acted, with cross-party support, for which I am grateful, to make changes in Haringey. We have also established, through Lord Laming, a process to produce an urgent progress report on the implementation of the Every Child Matters reforms. With Ofsted, we are also taking forward reforms to the serious case review regime. I have also announced today a new national task force to investigate how we can further enhance training and support for social workers. I hope that my work with my right hon. Friend the Secretary of State for Health on the reform of social work will also have cross-party support.
As the Secretary of State will be aware, the chief inspector of Ofsted told the Select Committee yesterday that three children a week were dying as a result of abuse, whereas the Department suggested that the true figure was a third of that. Can he explain that discrepancy?
I can—I explained it this morning, but I will set it out in further detail. Ofsted’s figures use a wider definition of harm. In the case of the children in the Department’s figures, a serious case review had been done because of a direct act of harm that led to the child’s death at the hand of a parent or other family member. The Ofsted figures include, for example, the death of a young person in which there is a suspicion of neglect, but the cause of death, such as anorexia nervosa or suicide, is not direct murder or manslaughter by a parent. That explains the difference.
I would like clarification on one point from the hon. Member for Surrey Heath. Earlier, the hon. Member for South Cambridgeshire (Mr. Lansley) made it clear that he supported Lord Laming’s work to ensure that his reforms are being properly implemented. At the weekend, according to The Sunday Times, the hon. Member for Surrey Heath said that he had issued a declaration of no confidence in Lord Laming, the former chief inspector of social services who is conducting an independent review. It would be helpful to clarify that the hon. Gentleman has confidence in Lord Laming and that he is happy for Lord Laming to carry on with that work.
I explained in my speech, when I referred to the remarks by the hon. Member for Birmingham, Yardley, that I have nothing against Lord Laming—[Interruption.] If the Minister of State, Department of Health, the hon. Member for Corby (Phil Hope) had been listening, he would know that I said that I had concerns about the terms of reference, but nothing against Lord Laming.
That is a helpful clarification that The Sunday Times was wrong on that point.
The hon. Member for North Norfolk (Norman Lamb) made some important points about the particular practices of health services in the Haringey case. I assure him that the re-running of the independent serious case review and the wider work being done on the Haringey case by the Healthcare Commission will ensure that the points that he raised are properly addressed. It would be wrong for me to prejudge that review now, as it is ongoing. The points made by the hon. Gentleman, and by the Chairman of the Select Committee, about ensuring that we have the best on-the-ground inspection, are absolutely right. I know that Ofsted is also committed to ensuring that the inspection regime is robust in safeguarding cases. I will ensure that that happens.
He who pays the piper calls the tune. Who will appoint the independent chair of a serious case review? Will it still be the director of children’s services, or will it be Ofsted?
The appointment will be made by the local safeguarding board. In Haringey, that board is now independently chaired by Graham Badman, the former director of children’s services in Kent. That will be a matter for each area to decide.
Some wider issues to do with health were raised, and it was a learning experience for me to listen to the debate. I was pleased to hear the Liberal Democrats acknowledge the dramatic improvements in the NHS over the past 10 years. With my right hon. Friend the Secretary of State for Health, I visited the brand new hospital currently being built in my constituency. I was able to see how the investment is being put to good use, but I was surprised to discover today that not only do the Conservatives oppose the new GP centres that are being opened around the country—a Conservative Government would close them—but they oppose the action being taken on tobacco advertising in shops.
We want to make sure that our children and young people are safe and properly protected, but it is no great surprise that Conservatives and some Liberal Democrats oppose those important reforms. After all, the Conservatives also opposed the rise in national insurance contributions that has funded the NHS improvements, and they also voted against the improvements in maternity and paternity leave that we have introduced. When we debate these matters in future, it is important that we remember the Opposition’s track record.
My hon. Friend the Member for Bury, North (Mr. Chaytor) made some important points about the funding of education for 16 to 19-year-olds. He said that we must treat properly the role of ethos in the admissions code and talked about how we plan 16-to-19 education. He asked me to confirm that we would continue with the important investments that we are making as part of the Building Schools for the Future programme, and he invited me to Bury to visit one of those schools.
I am pleased to say that I am very happy to go to Bury and see how our investment is being put to good use, but I cannot give my hon. Friend the assurance that he seeks because I am afraid that the Opposition remain committed to cutting £4.5 billion from the Building Schools for the Future programme. Fourteen secondary schools in the Bury area are set to be rebuilt, but two would be cancelled under Conservative plans. Moreover, we cannot avoid the embarrassment of visiting one of the schools that the Conservatives would cancel, because they have not told us yet which they are.
Might it not be extremely useful if I made a point of inviting my right hon. Friend to the school most likely to be cancelled were there a Conservative Government?
If the Opposition told us where the axe would fall, we would know which school to visit, but it is revealing to look at the list of speakers in today’s debate. There are 27 schools in the constituency of South Cambridgeshire, and four would be closed under Conservative plans. Two of the 17 schools in the constituency of Ilford, North are set to be closed, and the same is true of five of the 36 schools in the constituency of Rugby and Kenilworth.
My right hon. Friend will be pleased to hear that Stockport, an authority in the later stages of Building Schools for the Future, is preparing a bid for capital that includes £30 million for Reddish Vale technology college, which he has visited. Can he guarantee that it will not be scrapped on his watch?
I am afraid that I can give no such guarantee. We are doing the right thing—bringing forward our capital programme to invest in our schools and support our economy. In the case of Stockport, in Denton and Reddish, of 13 schools, two are set to be closed if the Conservatives have their way, and 360 schools are set to be closed—
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Question put accordingly, That the amendment be made.
The debate stood adjourned (Standing Order No. 9(3)).
Ordered, That the debate be resumed on Monday 15 December.
Out-patient Facilities (Rushden)
Motion made, and Question proposed, That this House do now adjourn.—(Claire Ward.)
I should like to thank the Speaker for granting me the opportunity to debate one of the most controversial matters to affect my constituency since I became a Member of Parliament. I would also like to thank the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw) for his attendance, and I look forward to his response. He is a highly regarded Minister and has a reputation for listening to fair arguments. However, I assumed that the Minister replying to my debate would be the hon. Member for Corby (Phil Hope), as he is the Minister for the East Midlands, a Health Minister and, more importantly, the local Member of Parliament who directly benefits from the closure of Rushden out-patient facilities. We could have had a real debate, with proper questioning, between two hon. Members who know in great detail the issues that will be discussed this evening.
I would like to give a little background detail about my constituency that I think will help. My constituency comprises the two major towns of Wellingborough and Rushden, and a large number of outlying villages and towns. It does not have a general hospital, a community hospital or a minor injuries unit. When my constituents need to go to hospital, they have to travel long distances to either Kettering or Northampton. The Wellingborough constituency is a second-class relation to the other constituencies in Northamptonshire when it comes to health care provision. Kettering and Northampton have general hospitals; Corby has a minor injuries unit and is soon to get a community hospital; and Daventry has a community hospital. Wellingborough has nothing, except very limited out-patient facilities at the Rushden Memorial clinic and at the Isebrook facility in Wellingborough.
Our out-patient facilities are now under threat. Kettering General Hospital NHS Foundation Trust wants to close the Rushden Memorial clinic and move all out-patient services out of the town of Rushden and into a small town in the Corby constituency. Naturally, I am outraged at the proposal to cut even more public services for the people of Rushden. This is a cut too far, and the move cannot be allowed to happen, especially given that the Rushden Memorial clinic was originally paid for by Rushden people for the benefit of Rushden people.
The Rushden Memorial clinic, which provided out-patient services for the people of Rushden, was opened in 1950. It was paid for by the people of Rushden and workers in the local shoe and boot industry. The memorial clinic was dedicated to the memory of the 138 men, women and children from Rushden who lost their lives during the second world war. It is immoral to move those services—the only ones we have—out of Rushden. The proposal is an insult to the town and the people who live there. It is not just me who is outraged. As I said at the beginning of my speech, this is the single biggest issue to affect the constituency since I became a Member of Parliament in 2005. I have been inundated with letters, e-mails and telephone calls from worried and upset constituents. As yet, I have not received any representations in support of the proposal.
I would like to read just a few of the many e-mails and letters that I have received; they show the strength of opposition to scrapping out-patient facilities in Rushden.
A lady writes:
“My opinion is that we desperately need these facilities in Rushden as Rushden is much bigger than Irthlingborough. We do lack quite a few facilities in Rushden, and considering our nearest hospital is 9 to 10 miles away, people will find Irthlingborough difficult to get to if they do not drive. I strongly support you that this should go ahead in Rushden.”
Another constituent writes:
“I would like to put forward my extreme disgust at the way this was released to the public. This has not been discussed in any way and completely without patient consultation. I attend the Outpatient Department at least 8 times a year…I am in almost constant pain in my joints and I am now experiencing giddy spells when I move my head. This makes it virtually impossible to drive myself to the clinic and my husband would have to take time off from work to take me to my appointments and, as he works over an hour’s drive from Rushden, this means that if I have an early afternoon appointment, he has to take the whole afternoon off. If the clinic were to be left in Rushden I can get there either by walking or a friend can take me if school hours permit. I can drive short distances but four miles away is pushing it a little. I gave up work recently for this reason.”
A couple write:
“We now read they are to move the outpatient facilities to Irthlingborough. What utter nonsense, the population in Rushden is increasing at an alarming rate so why are they considering this move? Is it to get even more money for the land? We were told that the land was being sold to get the money to build a new outpatients so what the hell has happened to this plan? The whole thing is ridiculous.
We need an A&E. Having to go to Kettering is mad. Most of Rushden feels this is needed and no one seems to care about the needs for Rushden. We are fed up with the attitude towards this town”.
A lady writes to me:
“The people who are making these changes…should let the people of Rushden have their say. After all, it is our town, our lovely town, that is why we chose to live here.”
As these comments, and hundreds like them that I have received, clearly show, it is not just a question of retaining the existing health provision in Wellingborough and Rushden—we need more health provision. We need our fair share of health provision, which has been denied to us for so long. The Government now favour an approach for community hospitals in which a hub-and-spoke system feeds into the main hospital—in this case, either Kettering or Northampton. It would therefore be common sense to put the first community hospital in an area with no hospital provision, but unfortunately common sense does not prevail in this case. There is no valid reason, despite the many excuses one hears from Kettering General Hospital NHS Foundation Trust, why outpatient facilities should be closed in Rushden and moved to Irthlingborough.
Rushden is the largest town in east Northamptonshire, and it is growing rapidly. There are good transport links from Rushden to other parts of east Northamptonshire.
Irthlingborough is a small town that is virtually unreachable by public transport. Let us look at the comparative size of both areas. If one looks at the historic population census for 2001, bearing in mind the fact that my constituency has grown considerably since then, one sees that Rushden and its hinterland has a population of over 38,000. Irthlingborough has a population of just 8,000. The main acute hospital serving Rushden, Corby and the rest of east Northamptonshire is Kettering general hospital. The distance from Corby to that hospital is 9.3 miles; the distance from Rushden to the hospital is 14 miles. Corby already has a minor injuries unit, and is first in line in Northamptonshire to get a new community hospital, as recently announced in the local media.
We have not been given one single decent reason by the foundation trust why it wants to close Rushden’s facilities and move them into the Corby area.
I would like to point out that it is not just my constituents who oppose the plan. I have received many representations from Corby constituents pleading that the out-patient facilities be kept in Rushden because it is much easier for them to get there than to Irthlingborough. An excerpt from just one e-mail that I have received makes the point:
“I live in Raunds and use public transport to access the outpatients department in Rushden. There is a fairly decent bus service between Raunds and Rushden which is half-hourly. If the outpatients moved to Irthlingborough, I would have to take two buses to get there as there is no service between Raunds and Irthlingborough. The alternative would be to travel all the way to Kettering which is a very long bus journey away and the buses only run two-hourly. Therefore the move would not benefit the patients living in my part of East Northants who rely on buses.”
However, the proposed site in Irthlingborough is not only inconvenient for people who use public transport. If my constituents from Rushden and Higham Ferrers had to travel by car to the proposed Irthlingborough site, they would have to go across the infamous Chowns Mill roundabout on the A45. That roundabout is widely recognised by the authorities as a danger to pedestrians and motorists. Only recently, unfortunately, a pedestrian was killed while trying to cross it. At rush hour, Chowns Mill roundabout is so busy that there are extensive queues leading up to all approaches. The district council, the county council, the highways authority and the Government have all stated that the roundabout needs a grade-separated junction and a safe passage for pedestrians to cross. But once again, the Wellingborough and Rushden constituency is way down the line when it comes to public funding and the grade-separation scheme is not even in the regional assembly’s forward programme for capital schemes.
I now want to talk about the Rushden project: “The Rushden what?” you may ask. You would be forgiven if you had not heard of it because health authorities in Northamptonshire have been working hard to brush it under the carpet and pretend it never existed. The Rushden project was formed many years ago. Many local people have been involved in the Rushden project, myself included, before and after I became an MP. It was always the purpose of the project to bring the three NHS facilities in Rushden together on one site. The project was to have an enhanced and comprehensive health facility to serve the people of Rushden and its surrounds, and it had always been planned that the site would be the Rushden hospital site. The logic behind that was that the site already hosts one of the NHS facilities and there is extensive land on which to build, with the additional advantage that the land was owned by the NHS.
The Rushden hospital site is huge. It has good transport links and there is plenty of land to build an all-embracing health facility. But the NHS is proposing to sell off the land on the Rushden hospital site. What for? It is for more housing, so we will get more people and less health service. Where is the sense in that? The Government and the health service have to sit up and realise that that cut to health facilities in the Wellingborough and Rushden constituency has to stop. My constituents live in the worst part of the worst-funded primary care trust in the country. That is a fact and even the Secretary of State for Health has admitted it. Recently, he said:
“Every other PCT has moved to within about 3.5 per cent. of their target through this pace of change process…I think Northampton were the only ones that were more than 3.5 per cent.”.
There we have it from the Health Secretary himself. In other words, my area, in the last three years, was underfunded by £101,746,000. The Government admit that Northamptonshire is the worst funded PCT in the country and yet we are not being given the funding and provision that the Government themselves say that we should get.
I want to consider Kettering General Hospital NHS Foundation Trust’s proposals to close Rushden out-patient facilities and move them out of the town. The foundation trust will claim that it engaged in a public consultation exercise to gauge local opinion. What utter rot. The consultation was completely flawed. It was one of those consultations whereby one asks questions that are not relevant and then claims that a consensus has been reached.
First, the consultation was sent out to a limited number of people. Secondly, it did not mention the proposal to move out-patient services out of Rushden. There was no reference to the proposal to move out-patient facilities to Irthlingborough. If the consultation had been genuine, it would have said, in a straightforward manner, that the proposal was to put the out-patient facilities in Irthlingborough. Had it said that, the consultation would have had a completely different result. Indeed, the consultation document intimated that out-patient facilities would stay in the town. The public, the local council and I were not given the facts. The information came to me only through a leak, and I put it into the public domain.
All I have been able to establish is that there is an issue relating to finance. The foundation trust claims that it has a developer who is willing to build the facilities and lease them back to it at a reasonable rate. Who are the developers? When were they appointed? When did the plan go out to competitive tender? Why has the decision been made in such an unorthodox, cloak-and-dagger way? The foundation trust claims that it examined possible sites in Rushden and found them unsuitable. How can the Rushden hospital site, which the NHS owns, with plenty of land on which to build, great transport links, and in the biggest town in east Northamptonshire, not be suitable? Local councils are providing the foundation trust with a list of alternative sites in Rushden. I do not believe that the sites in Rushden have been properly investigated.
Let me read what one of my constituents has written to me about Kettering general hospital’s supposed public consultation:
“We believe the recent public exercise regarding the extension of the Wymington Road hospital site to provide mental health facilities for the area, was just an expensive ploy to divert the public’s attention away from the fact that the ‘Hayway’ clinics, and the Rectory Road practice are in the pipeline to be moved to Irthlingborough. The proposed site there we believe will be difficult to be reached by any means except by private car or taxi; not a viable means for elderly people.”
I agree. I have here a copy of Northamptonshire Healthcare NHS Trust’s consultation document. It is very nice and glossy, with lots of pictures and, in the middle, there is a map. I do not know if you can see it, Mr. Deputy Speaker, but in the middle of the map, it states in bold letters: “Future Health Facilities”. My constituents were outrageously misled.
I run the “Listening to Wellingborough and Rushden” campaign. I believe that, as a Member of Parliament, it is important to listen to the views and concerns of the people whom one represents. There has been the most extraordinary explosion of outrage about the hospital’s proposal. As part of my campaign, I am writing to every person in Rushden to make them aware of the trust’s proposals and to ask for their opinions now that they have the full facts. I will publish the results of that survey at the end of January. I have also organised a public meeting on 23 January so that local residents can come along and voice their concerns.
I am grateful to the Minister for listening to my speech. I appreciate that he does not have direct power, given the new status of the foundation trust hospital. However, I would appreciate any comments he might have on the situation and any answers to the specific questions I have raised. If he cannot answer those questions now, I would be most grateful if he wrote to me.
I congratulate the hon. Member for Wellingborough (Mr. Bone) on securing this debate. As is usual when there is a potential constituency interest for the Minister who is directly responsible, I am replying instead of my hon. Friend the Member for Corby (Phil Hope), as I am sure the hon. Gentleman understands.
I begin by paying tribute to the NHS staff across the hon. Gentleman’s constituency and in the whole of Northamptonshire for their hard work and dedication, which is delivering a better-quality health service than ever, benefiting not only his constituents, but constituents in England as a whole. Before addressing his concerns about Rushden Memorial clinic, I would like briefly to explain the context. During these first 60 years of the NHS, society, technology and medicine have changed beyond all recognition. Today, patients with more and more conditions can be and are treated and cared for closer to their homes, or even in them.
As part of this year’s major long-term review of the NHS, each strategic health authority in England published a vision for further improving health and health care in its region, based on the work of a number of consultation groups in each area. A key finding of those local reviews was that for planned care, more could and should be provided closer to people’s homes. The changes in health care in Northamptonshire are taking place in that context. The other thing that needs to be made clear is that decisions on how local health services are organised are no longer made by Ministers in Whitehall, but by autonomous NHS professionals on the ground.
I am advised that when Kettering general hospital applied to become a foundation trust in 2006, it consulted the population of north Northamptonshire about its application and the services that it proposed to offer. Those proposals included the trust’s plan to deliver more services from local out-patient units. I am advised that 92 per cent. of respondents said that they supported the trust’s plans. When it developed its plans to establish a new out-patient facility in Irthlingborough, the trust contacted the health overview and scrutiny committee of Northamptonshire county council to establish whether a formal consultation period would be required.
As I am sure the hon. Gentleman will know, overview and scrutiny committees are made up of elected councillors from the local authority and can insist that proposals be consulted on, and if they are still unhappy about them, refer them to the independent national reconfiguration panel. I am further advised that the chair and deputy chair of the Northamptonshire overview and scrutiny committee, which has a Conservative majority, advised that the proposals were “not significant enough” to warrant a formal consultation. However, it is always open to the overview and scrutiny committee to revisit the issue if it wishes.
During the public engagement period, the trust set out a number of criteria against which it would select its preferred site. The first was accessibility. The new facility had to be accessible to the people living across East Northamptonshire. The second criterion was affordability. The development had to be affordable within the trust’s finances. The third criterion was future flexibility. The population in the hon. Gentleman’s constituency and in wider Northamptonshire will continue to grow significantly over the next 20 years. Any building will need to be flexible enough to accommodate that growth. The fourth and final criterion was deliverability. The current premises, to which he referred, are Victorian and are not considered suitable for the range of out-patient clinics that the trust wants to provide. Any new facility must therefore be available quickly. In that context, Kettering general hospital looked at the clinics that it currently provides on the main Kettering site and found that many could be safely moved from the main hospital into a brand new local facility in East Northamptonshire.
The population of Northamptonshire is currently around 680,000 people, but that is predicted to rise to 715,000 over the next five years. The current out-patient unit at Rushden Memorial clinic can accommodate only 8,000 clinic appointments each year. The trust estimates that any new facility would need to be able to accommodate approximately 40,000 out-patient attendances, together with a further 70,000 diagnostic tests, which represents an almost tenfold increase in the number of procedures undertaken at the clinic. The majority of those out-patients will come from East Northamptonshire. The proposed on-site provision of diagnostic services, such as X-ray, ultrasound and blood testing, would mean that local people in the hon. Gentleman’s constituency would be able to access a one-stop service. Otherwise, they would need to attend an out-patient clinic and then have to travel to Kettering general hospital for follow-up tests.
The trust considered four options for its proposals. The first was to relocate the out-patient facility to the planned redevelopment in Rushden town centre. I am advised that that would be unlikely to take place until 2011 at the earliest. The second option was to relocate the out-patient facility to the Rushden hospital site. As I have already said, Kettering general hospital’s plans encompass approximately 40,000 out-patient attendances and a further 30,000 diagnostic tests annually. The trust believes that that would require a larger space than the 1.5 acres allocated by the Northamptonshire health care trust for other health provision. It is therefore unlikely that that option would deliver a new facility in the required time frame.
Furthermore, the trust intends its redevelopment to provide a calm therapeutic environment for people with mental health problems and learning disabilities. Kettering general hospital considers that the volume of traffic associated with the level of its planned out-patient activity would not only be difficult for the Rushden hospital site to accommodate, but would compromise the delivery of the trust’s planned mental health services.
I am grateful to the Minister for this helpful response. I hope that he will not misunderstand the situation, however. What he has just said relates to the little piece of yellow that I attempted to show on the map. The Rushden hospital site is enormous—there is plenty of room to build these facilities there—and it has a direct link to the Rushden by-pass, so I am not sure why there would be transport problems involved.
I am grateful to the hon. Gentleman for his advice, and I urge him to take up those detailed concerns with the primary care trust and the acute trust. I know that he has already had discussions with them, and that they would be happy to continue those discussions.
The third option considered was to extend the existing provision at Rushden Memorial clinic. I am advised, however, that the present site could not accommodate the increase in the numbers of patients that the trust plans for the area. Even if extension of the building were possible, it would be very difficult to continue delivering the present range of clinics on site during the building work.
The fourth proposal involves the new site at Irthlingborough, which is 2.7 miles from the present clinic. The proposed new facility there would serve the whole population of East Northamptonshire, not just Rushden. Of course, any development must be easily accessible to everybody who needs to access its services, including those travelling from outside the town. Kettering general hospital and Northamptonshire PCT advise me that Irthlingborough is their preferred option because it would provide a brand new building built to the trust’s requirements. The alternatives would have meant the trust converting an existing building, with poorer results. As the hon. Gentleman said, a third-party developer, who will assume the planning and development risks, is providing the building. The trust will be able to rent the building from the developer, meaning that the trust can afford the scheme. Otherwise, the trust believes that it would need to raise about £4 million to purchase the land and build its own facility. It also says that the new site could be available for the public to use from January or February 2010.
The trust believes that the new facility, being directly off the A6 and supported by regular public transport links, will be accessible to people from across East Northamptonshire. The site also has the potential to be expanded in the future, which would enable the trust to develop additional services for the area, such as a minor injuries unit and a fracture clinic. The trust estimates that these proposals mean the hon. Gentleman’s constituents would save almost 130,000 travel miles a year, through being able to be treated closer to home, rather than having to travel to Kettering or further afield.
The hon. Gentleman made some other, more general points about health care in his constituency. He has often raised the issue of health care funding and facilities in Northamptonshire. I am sure that he will have noticed that the 2009-10 and 2010-11 revenue allocations to primary care trusts were announced by the Government this Monday. I am also sure that he will welcome the fact that over the next two years, funding for Northamptonshire Teaching PCT will increase by 11.9 per cent. to £983.4 million. This is one of the highest funding increases in the country; only 15 PCTs in England will receive a greater percentage increase. I am afraid that I have to tell him, however, that the primary care trust no longer has the accolade of being the furthest from its target. By 2011, Northamptonshire will be only 1.4 per cent. away from its target, and many other PCTs will be a great deal further away from theirs, so that is good news for his local area on the funding front.
The increase in funding has been matched with a growth in facilities in the hon. Gentleman’s constituency. I am sure that he will have been delighted by the opening of the new GP practice in Higham Ferrers last year. He will also know that Kettering general hospital provides for out-patients at Isebrook hospital in Wellingborough. I am sure that he is also aware of the proposals for a new primary care development there—it is due to open in 2010—and the plans for a brand new community hospital.
That last point was interesting news. Can the Minister tell me when the new community hospital is going to open in Wellingborough?
I cannot give the hon. Gentleman an exact date, but the primary care trust and Kettering general hospital are quite clear that it is something that they are interested in looking at. He will have to ask them about the actual time frame.
Northamptonshire PCT also has ambitious plans for four new GP-led health centres in the county, including one in Wellingborough, which are planned to open in the next two to three years—
House adjourned without Question put (Standing Order No. 9(7)).