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Oral Answers to Questions
(5 years, 11 months ago)
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Alex Norris (Nottingham North) (Lab/Co-op)
The Secretary of State for International Development (Penny Mordaunt)
The Department for International Development has supported co-operatives across many sectors and is increasing support to small-scale farmers to help them to commercialise. For example, the ÉLAN programme is working with women’s co-ops in the Democratic Republic of the Congo to increase quality, improve marketing and establish systems for full traceability of product.
Alex Norris
The co-operative model of ownership has distinct advantages for sustainable international development. Regrettably, in 2011 the Government cut the £5 million fund for co-operative development. Will the Secretary of State commit to investigating the desirability of reinstating that fund, and match the ambition of Opposition Members by ensuring that the Department is looking properly at alternative models of ownership?
Penny Mordaunt
I agree with the hon. Gentleman that co-operatives can be a hugely powerful and empowering model for delivering economic development. I do not think we should have just a small £5 million fund. We should be levering all the investment we have from DFID into those organisations. Through a new initiative, “GREAT for Partnership”, we hope to build connections with organisations that can do just that.
James Gray (North Wiltshire) (Con)
The Secretary of State mentioned in passing the role of women in developing countries, particularly in the agricultural context. Does she agree that microfinance is an incredibly important way of developing women in such areas? What more will the Department do to enhance, prolong and enlarge the use of microfinance in agriculture in developing countries?
Penny Mordaunt
DFID has a proud tradition as a leader in initiatives that empower women, including economically. Microfinance is critical to that. In most countries where we have a presence, we are running such a programme specifically for women.
Chris Law (Dundee West) (SNP)
ActionAid has calculated that women in developing countries could be almost £7 trillion better off if their pay and access to paid work were equal to that of men. Will the Secretary of State make a commitment that, when establishing such agreements around the world, the UK will demonstrate its commitment to women’s rights and gender equality by ensuring that new co-operatives go further than they have before in protecting and upholding women’s rights?
Penny Mordaunt
I will commit to do just that. We have a big opportunity with the forthcoming G7 Development Ministers’ meeting next week in Canada. Canada has done a huge amount on this agenda, and the issues of which the hon. Gentleman speaks will feature heavily in our discussions.
Mark Menzies (Fylde) (Con)
Does the Secretary of State agree that women’s co-operatives have an important role to play in tackling poverty? I encourage her Department to do much more in this area.
Penny Mordaunt
I congratulate my hon. Friend on his election to the Select Committee and wish him well in that role. He is absolutely right that unless we enable women to reach their full potential, nations never will.
Luke Hall (Thornbury and Yate) (Con)
The Secretary of State for International Development (Penny Mordaunt)
We have introduced new safeguarding standards for all DFID programmes. I have requested and received assurances from our partners on their safeguarding policies and procedures. Internationally, we are leading the charge to raise standards.
Penny Mordaunt
The conference will be held on 18 October in London and will involve survivors of abuse, aid beneficiaries, multilateral organisations and others. Much work is being done globally to develop vetting procedures and new human resources practices and to harmonise standards and policies across the board. At the conference, we will secure sector-wide action to prevent and respond to sexual exploitation.
Stephen Twigg (Liverpool, West Derby) (Lab/Co-op)
I welcome the Secretary of State’s international leadership on this issue. What conversations has she had with United Nations institutions, where there are serious concerns about potential sexual exploitation both by peacekeepers and by civilian staff?
Penny Mordaunt
The hon. Gentleman will know that we have had extensive discussions with all UN agencies and partners, as well as core UN bodies. They are making progress. The safeguarding conference will be fundamental in consolidating that progress, but we are also talking with our counterparts in the Ministry of Defence to look at what we can do to help to build capacity in peacekeeping troops before they deploy.
Mrs Pauline Latham (Mid Derbyshire) (Con)
The International Development Committee is looking at this very issue. How can my right hon. Friend be absolutely certain that charities are telling her the truth about what has happened within their organisations, and does she believe that an international register of people working in those bodies would be a good idea?
Penny Mordaunt
Absolutely. As well as the assurances we have sought and our oversight of projects and programmes we are contributing to on the ground, there will be other tell-tale signs. For example, if organisations are not reporting incidents or allegations, that is a red light to me that there is something wrong within those organisations. We are still monitoring this situation. We are leading an international donor group that is looking at setting up the precise procedures to which my hon. Friend refers.
Kate Osamor (Edmonton) (Lab/Co-op)
Before agreeing with Oxfam and Save the Children that they would withdraw from Government funding, did the Department carry out an assessment on the impact that that would have? Will the Secretary of State tell the House exactly how many jobs will be affected and how many vulnerable people will lose access to life-saving aid?
Penny Mordaunt
My sole concern in making these decisions is the impact on the beneficiaries. Unlike other nations, I will not take decisions that impact negatively on beneficiaries. We are very conscious that both the organisations to which the hon. Lady refers may have difficulty in maintaining employment contracts—I suspect most of those people will transfer to other organisations—but how they maintain their staffing budgets is not the basis on which I am going to take decisions.
Kate Osamor
I thank the Secretary of State for her answer, but we still do not know what assessments were carried out and whether they will be made public. What steps is she taking to guarantee that the agencies and contractors now bidding for Government funding will have safeguarding protections against sexual exploitation that are robustly stronger, not weaker, than those of Oxfam and Save the Children?
Penny Mordaunt
I would be happy to share with the hon. Lady any information about any of the projects. For example, I looked at everywhere we are working with Oxfam, not just directly but with other partners who work with Oxfam. I will not allow any beneficiary to suffer and that will be key in my decision making. We have to strengthen the system across the board. We are leading the charge and other donors are following our lead. I hope that by the end of the year we will have vetting procedures, benchmarking and the harmonisation of policies to deter predatory individuals from the aid sector.
Carol Monaghan (Glasgow North West) (SNP)
Afzal Khan (Manchester, Gorton) (Lab)
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
The Minister for the Middle East (Alistair Burt)
Up to 200,000 Rohingya are living in areas at risk of flooding and collapse during the rainy season. We are working with the Bangladesh Government and humanitarian partners on preparedness, including improved shelters, water and sanitation, vaccination campaigns and pre-positioning of emergency supplies.
Carol Monaghan
Last August, Myanmar soldiers systematically brutalised and raped young Rohingya women. Nine months on, and in the middle of the monsoon season, many of those young girls are now giving birth to babies conceived as a result of rape. As these girls are often shunned by their communities, what support is the UK Government providing to these vulnerable girls and their babies?
Alistair Burt
The hon. Lady is right to raise this issue. Some 16,000 women may be caught up in this. We have deployed a specialist maternity worker to be there. In addition, we are working with our partners to support Rohingya women who were raped and are pregnant. The deployment includes training of medical specialists, psycho-social support, clinical management of rape and emergency obstetric care. This is all being provided despite the difficulty of the monsoons and other circumstances.
Afzal Khan
Given the greatly increased risk of waterborne diseases facing the Rohingya during the monsoon season, what steps is the Department taking to make sure that as many people as possible are vaccinated?
Alistair Burt
There are two issues here: first, work needs to continue to ensure that latrines and waters are as safe as possible, and secondly, an extensive vaccination campaign is already being undertaken. The United Kingdom is a major contributor to the vaccination programme.
Lloyd Russell-Moyle
When the International Development Committee visited the refugee camps, we were told that non-governmental organisations had identified land that could be made available to them for the safety of the Rohingya refugees. What representations have the Government made to the Government of Bangladesh to ensure that that land is released and that refugees are not put on an unsuitable island?
Alistair Burt
Regular representations are made about this. The hon. Gentleman is right: a certain amount can be done at Cox’s Bazar to strengthen fortifications in relation to the forthcoming cyclones, but the land itself is difficult. Some have already been moved out, but we do make representations as well about the unsuitable nature of the island that is sometimes proposed.
Sir David Evennett (Bexleyheath and Crayford) (Con)
Now that the UK is providing 10.5% of the total budget set out in the humanitarian joint response plan, will my right hon. Friend advise and update the House on what he is doing to get other countries to step up to do their bit?
Alistair Burt
First, may I congratulate my old friend on his recent award, which will please all of us, for his long service and devotion to this House and its duties? We are very proud of our record in relation to being a major donor. My right hon. Friend the Secretary of State announced a further £70 million on 7 May to help with the current crisis, but my right hon. Friend the Member for Bexleyheath and Crayford (Sir David Evennett) is right: we need to make sure that we continue to ask other donors to step up, and it is a regular part of our briefings and contact with other donor nations.
Mr Nigel Evans (Ribble Valley) (Con)
We witnessed the precarious conditions in which many of the refugees are living in Cox’s Bazar; it was quite appalling. If the monsoon is devastating for the region, will my right hon. Friend redouble his efforts to ensure that land is made available, as well as emergency housing? Pushing them on to an island is totally unacceptable.
Alistair Burt
To answer my hon. Friend, our sense is that as far as possible, preparations are being made both by the Bangladesh Government and the international community to meet the anticipated and expected conditions. Bangladesh has an excellent record on dealing with emergency crises caused by weather. No one can say, if something exceptional happens, what the response will be, but all preparations have been made. However, he is right: the nature of the land is extremely difficult and we must continue to try to urge that as many people as possible are moved to the safest possible areas.
Paul Masterton (East Renfrewshire) (Con)
The hon. Member for Glasgow North West (Carol Monaghan) was right to raise the issues of pregnant women, new mothers and small babies, who are particularly vulnerable to issues of hygiene and sanitation, so will the Minister assure me that those will be key priorities for aid spending in this area?
Alistair Burt
I can reassure my hon. Friend that as much as possible is being done in relation to this. UK-supported cholera, measles and diphtheria vaccination campaigns will help to provide protection against some of the most common diseases in the camps, and this is very much on people’s minds at such a vulnerable time.
Henry Smith (Crawley) (Con)
The Secretary of State for International Development (Penny Mordaunt)
DFID’s small charities challenge fund was launched last summer to support small UK-based charities working in international development. The first round of grants will be announced shortly and the second review of applications is under way. We are also looking to improve the scheme.
Henry Smith
Crawley-based Vision Aid Overseas does really effective work in Africa, helping to provide sight health to some of the world’s poorest. Will the Secretary of State endorse such work and congratulate those local UK-based charities, which can make a real difference?
Penny Mordaunt
I thank my hon. Friend for the opportunity to praise the work of Vision Aid Overseas. It is absolutely right that we want to connect more of these small, fantastic UK charities with the developing world. The “GREAT for Partnership” initiative will help us to do that.
Mr Gregory Campbell (East Londonderry) (DUP)
What steps is the Secretary of State taking to ensure that small charities can avail themselves of the fund with a minimum of bureaucracy to maximise the benefit to the countries they operate in?
Penny Mordaunt
I absolutely agree with the issues the hon. Gentleman raises. We are learning from the first wave of applications to the small charities fund. I would like to make it less bureaucratic, more nimble and open to even smaller organisations.
Mr Speaker
Far be it from me to intrude, but I thought that the hon. Member for Bexhill and Battle (Huw Merriman) had an interest in a charity appertaining to soccer. As we might not reach his question, he could take the opportunity to intervene with a flying tackle now.
Huw Merriman (Bexhill and Battle) (Con)
Penny Mordaunt
I thank both you, Mr Speaker, and my hon. Friend for plugging Soccer Aid. Every pound raised by the British public will be matched by UK aid. You and he might also like to know that today Arsenal announced a three-year partnership with Rwanda.
Mr Speaker
Absolutely splendid! I am most grateful to the Secretary of State for announcing that, as I am sure will be both Rwanda and Arsenal.
Julie Cooper (Burnley) (Lab)
Will the Secretary of State join me in paying tribute to the Burnley-based charity Furniture for Education Worldwide, which will next week send its 100th container of furniture and equipment to aid developing schools overseas?
Penny Mordaunt
I thank the hon. Lady for raising that. I will indeed endorse that fantastic organisation. It is a testament to the fact that we have small companies and charities in our constituencies that can make a big difference to many people across the world.
Edward Argar (Charnwood) (Con)
The Secretary of State for International Development (Penny Mordaunt)
The UK’s global disability summit in July will increase action and investment, share best practice and deliver lasting change. It will tackle the stigma faced by people with disabilities and provide educational, learning and economic opportunities and the means to access them through more available assistive devices.
Edward Argar
I welcome that answer. I recently met Sightsavers, a fantastic charity doing great work tackling sight loss and the stigma faced by disabled people around the world, particularly in the developing world. Can my right hon. Friend reassure me that at this important summit she will join with it in pressing for concrete goals for Governments to tackle the stigma faced by disabled people around the world?
Penny Mordaunt
That is absolutely the aim of the summit. It has already galvanised people into action, including multilateral organisations around the world, which will be embedding disability in their programming.
Ann Clwyd (Cynon Valley) (Lab)
Given the new statistics showing that the number of disabled people able to access legal aid here in the UK has fallen by 99% since 2011, what steps will the Secretary of State take with Cabinet colleagues to get the UK’s own house in order before we host a global summit?
Penny Mordaunt
When I speak to my opposite numbers in other nations, they tell me that one barrier to their making further progress is that they are starting from a low base. It is important that the summit is not just about the UK showcasing what it does; we can learn from other organisations, which is why we are co-hosting it with Kenya. My new role as Minister for Women and Equalities affords me the chance to make a difference in both the UK and the developing world.
Mr Jim Cunningham (Coventry South) (Lab)
The Minister of State, Department for International Development (Harriett Baldwin)
The UK is one of the leading humanitarian donors in the Democratic Republic of the Congo. We have acted quickly to support the country and the World Health Organisation in tackling the Ebola outbreak; the Secretary of State today announced an extra £5 million to support the WHO response plan.
Mr Cunningham
What are the Government doing to prevent the outbreak from spreading to places such as Kinshasa?
Harriett Baldwin
The plan announced by the World Health Organisation involves making sure that we use a new, experimental vaccine that the UK has helped to develop. It is being applied to anyone who has come into contact with Ebola. Yesterday, vaccinations began to be offered to health workers and to anyone who has had contact with a contact.
Stephen Crabb (Preseli Pembrokeshire) (Con)
I commend the Department’s response to the outbreak, but what assurance can the Minister give that the capacity and leadership at the WHO are stronger than they were in 2014, when it made so many mistakes in responding to an earlier outbreak?
Harriett Baldwin
I pay tribute to Jane Ellison, who is now very much involved in that. As my right hon. Friend will know, there has been an extensive programme of work to learn lessons from the outbreak in Sierra Leone, and, indeed, this is the ninth outbreak in the Democratic Republic of the Congo. On every occasion lessons are learnt, and we are helping the WHO and the Government to deliver on them.
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
In the light of the DRC Government’s decision to boycott the April humanitarian pledging conference in Geneva and to deny the scale of the displacement crisis in the country, what representations has the Secretary of State made, now that Ebola poses a very real additional threat, to ensure that the same does not happen again and that the DRC Government accept urgent assistance to prevent an international health emergency?
Harriett Baldwin
The hon. Lady is right to highlight the wider humanitarian crisis in the DRC. I was there myself last month to see the fantastic work that UK aid workers are doing on the ground and the extensive way in which we are helping. We are proud to have announced £100 million of support for this year, and we are the second largest donor.
Kevin Foster (Torbay) (Con)
The Secretary of State for International Development (Penny Mordaunt)
UK aid is currently dealing with 10 large-scale humanitarian emergencies and giving humanitarian assistance to 30 countries around the world. It is, for instance, protecting the Rohingya at Cox’s Bazar during the monsoon and cyclone season, providing food and healthcare for those affected by the conflict in Yemen, providing medical training and aid for families in Syria, and tackling Ebola in the DRC, for which I have announced £5 million of UK aid spending. We are also making preparations to provide support, if needed, for the Caribbean during the hurricane season. I am sure that the whole House will join me in commending the work of British scientists, British aid workers and our armed forces, and UK aid, in saving lives.
Kevin Foster
My right hon. Friend will be aware of yesterday’s Westminster Hall debate about the persecution of Christians. Will she update the House on the Government’s efforts to promote freedom of religion and belief worldwide?
Penny Mordaunt
The most stable societies are those that uphold the right to freedom of religion or belief. Through UK Aid Connect, DFID will fund a consortium of organisations to address the key challenges in building freedom of religion and belief. The Foreign and Commonwealth Office is also very focused on that agenda.
Mr Speaker
Order. I understand the sense of anticipation of the session that is to follow, but may I gently remind the House that we are discussing the plight—[Interruption.] Order. I remind the House that we are discussing the plight of some of the most destitute people on the face of the planet. I think that a respectful atmosphere would be appreciated.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
The Minister for the Middle East (Alistair Burt)
Both the Foreign and Commonwealth Office and DFID are acutely aware of the degree of concern about the situation in Yemen, and we are in regular contact with all parties there. The only answer is for the work of the United Nations envoy, Martin Griffiths, to be successful through negotiations, but we have already made clear that we do not see a military solution to the conflict.
Henry Smith (Crawley) (Con)
Penny Mordaunt
DFID scores very highly on the international aid transparency initiative, and we are working with other nations and multilaterals to help them to reach the same standards. We are also leading the charge on combating illicit money flows and capital flight, which is necessary if we are to help developing nations.
Joan Ryan (Enfield North) (Lab)
Alistair Burt
One of the main areas of focus at last week’s United Nations Security Council meeting was to accept special envoy Nikolay Mladenov’s persuasion that Gaza does indeed need more direct assistance and support to ease the circumstances there. Israel will be involved, as will other international donors, working in a very complex situation. The relief of humanitarian issues in Gaza is essential.
Mr Laurence Robertson (Tewkesbury) (Con)
The Minister of State, Department for International Development (Harriett Baldwin)
I pay tribute to my hon. Friend for his work as chair of the all-party group on Ethiopia and Djibouti and I assure him that the UK has provided assistance to more than 13.6 million people in east Africa and allocated £279 million in humanitarian aid to those countries this year.
Alan Brown (Kilmarnock and Loudoun) (SNP)
Alistair Burt
The UK is well aware of the circumstances surrounding the issues in Gaza and calls for a transparent and independent inquiry, but we are providing humanitarian aid through UNRWA to the Palestinian people and looking at further possibilities of providing direct aid to the medical situation in Gaza.
Zac Goldsmith (Richmond Park) (Con)
The horn of Africa has been hit by a devastating tropical cyclone and Somaliland has been particularly hard-hit, with devastation to lives and livelihoods. Somaliland is already a progressive democratic country in an otherwise very troubled part of the world and, as a former British protectorate, it has strong ties to the UK, but because we do not formally recognise Somaliland, any aid we provide must pass through Somalia, which is much less stable. Will my hon. Friend reconsider that policy and consider working directly through Somaliland?
Harriett Baldwin
I invite my hon. Friend to the meeting of the all-party group on Somaliland later today.
Ian C. Lucas (Wrexham) (Lab)
Alistair Burt
The excellent work of the Westminster Foundation for Democracy and those who have taken part through the British Council in encouraging the development of democracy are playing an important part in Tunisia, but the hon. Gentleman is absolutely right to draw attention to a good move forward for Tunisia, which we hope foreshadows other things to come in the region.
Kirstene Hair (Angus) (Con)
My right hon. Friend may be aware of the Dalitso project in my constituency. It involves more than 500 volunteers in Scotland and Malawi, and they have collectively generated funding for over 300 orphans in Malawi and employ 30 people. What is the Department doing to support such small charities that contribute so much to our overseas aid?
Penny Mordaunt
I was recently in Scotland to dish out some UK Aid cheques to many of the wonderful organisations that have raised money and are doing fantastic work to benefit people around the world.
Liz Twist (Blaydon) (Lab)
Penny Mordaunt
That is the only criterion that I look at when making those decisions: no beneficiaries will be harmed in any way as a result of the decisions we take about withdrawing funding or preventing people from bidding for funding.
Kerry McCarthy (Bristol East) (Lab)
The Prime Minister (Mrs Theresa May)
This week has seen the start of the Grenfell Tower inquiry. This was an unimaginable tragedy and justice must be done for the victims, survivors, bereaved and the wider community. It is right that we learn everything we can about what happened and take the necessary steps to make sure nothing like it ever happens again.
Yesterday also allowed the nation to come together, one year on, to remember all the victims of the Manchester terrorist attack. That night saw the worst of humanity, but it also saw the best. The kindness, compassion and fortitude we witnessed that night triumphed, and the great spirit of Manchester continues to inspire us.
This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
Kerry McCarthy
I echo the condolences expressed by the Prime Minister to the victims, friends and families of both Grenfell and the Manchester bombing.
On a happier note, I send congratulations from the Opposition side of the House to the royal couple. Even the fully paid-up cynics among us found it quite charming, and I am very much one of them.
A not so welcome American import is the fact that Britain now has a higher proportion of children classed as obese at the age of 11 than America. Yesterday’s Public Health England report shows the dismal failure of the first-year target on cutting sugar, at only 2%, compared with the 11% drop in sugar following the tax on sugary drinks. Will the Prime Minister admit that the voluntary approach is simply not working, and will not work, and that what we want to see in chapter 2 of the childhood obesity plan are mandatory targets and a ban on junk food discounts?
The Prime Minister
I welcome the hon. Lady’s good wishes for the royal couple. We expressed our good wishes in the House last week, and indeed it was a perfect day and a perfect wedding. Windsor did the couple proud.
We know that childhood obesity is one of the greatest health challenges we face, and we are determined to tackle it. That is why nowhere in the world is setting more stringent sugar reduction targets than the Government have set. We are, as the hon. Lady says, taxing sugary drinks, and we are doing more. It is not just about sugar in food and drink; it is about helping children to exercise more. It is also about the funding we are putting into research on junk food advertising, and it is about cutting sugar and calories in food. We have made good progress on the sugar reduction target. Sugar in drinks has been reduced by 11% and the average calories have been reduced by 6% in response to the soft drinks industry levy. More needs to be done, which is why an updated plan is currently being worked up, and we will be in a position to say more on that shortly.
Nigel Huddleston (Mid Worcestershire) (Con)
The Prime Minister
The deeply moving testimonies we have already heard and will continue to hear this week from survivors and the bereaved leave absolutely no room for doubt. We must learn everything we can about what happened, and we must take the strongest possible action to stop such an unimaginable tragedy from ever happening again.
As my hon. Friend says, Dame Judith Hackitt’s recommendations do not include banning inflammable cladding. We are minded to go further by banning combustible materials in cladding on high-rise buildings. We are meeting our legal duty to consult on these proposals, and we will not delay any necessary action.
Jeremy Corbyn (Islington North) (Lab)
Indeed it is almost a year since the Grenfell tragedy, and sadly justice has not yet been done. Many of those families have still not been rehoused and many are still living in tower blocks. People across the country are worried about the safety of cladding. More needs to be done more quickly.
I agree with what the Prime Minister says about the anniversary of the Manchester bomb. We were there at the service yesterday, and I pay tribute to the people of Manchester for the fantastic event they held last night in Albert Square, which brought all communities across Manchester together. That is the answer to terrorism, that is the answer to threats: bring people together.
In 2010, £4 billion of NHS services were outsourced to private companies. How much is it today?
The Prime Minister
First, I echo the right hon. Gentleman’s comments. Terrorists attacked in Manchester, and we sadly saw a number of other terrorist attacks in this country last year. They were trying to divide us, and I think the response of all communities, whether here in London or in Manchester, has shown that we will not be divided by the terrorists. We will not let the terrorists win. We will defeat them.
The right hon. Gentleman asks about the outsourcing of services within the NHS. Of course, what we do know is that spend on the independent sector nearly doubled in the last four years of a Labour Government.
Jeremy Corbyn
My question was about the amount spent now. NHS budgets have increased by just 1% per year under this Government, but it is jackpot time for the privateers, whose share is up by 100% to over £9 billion per year. We have also learned that Surrey NHS has just paid Virgin Care £1.5 million, not for any service that it has delivered, but because its bid was not chosen—£1.5 million wasted on Virgin Care that should have been spent on healthcare. Is the Prime Minister concerned that the National Audit Office said this week that NHS England’s handling of private contractors had put
“patients at risk of serious harm”?
The Prime Minister
The NAO report said that
“no actual harm has been identified.”
It is also the case that, in relation to the contracts that the NAO was talking about, the savings that have been made have all been reinvested into frontline NHS patient care and have helped to fund the equivalent of an extra 30,000 operations. The right hon. Gentleman talks about the percentage of money that has been spent on the private sector, and I must say that the proportion of spend in the NHS in England that was outsourced to the private sector last year did not go up at all. There was somewhere where it went up by 0.8%. Ah yes—Wales.
Jeremy Corbyn
The NAO criticised NHS England’s Capita contract, saying that it had put
“patients at risk of serious harm”.
Thousands of women were dropped from the national cervical cancer screening programmes. Another element of the contract handed over to Capita was for GP services, which resulted in two thirds of GP practices receiving incorrect medical records, and 500,000 new patient letters were left unsent. Is that not the inevitable consequence of this Government tearing up the founding principles of the NHS and putting private profit before public service?
The Prime Minister
At every general election since the NHS was formed, the Labour party has scaremongered about the Conservative approach to the NHS. At every general election, Labour has made claims about privatisation and about funding cuts. What has every elected Conservative Government done? We have protected the NHS; we have improved NHS services; we have put more funding into the NHS; and we have ensured that we remain true to the founding principle of the NHS: that it is free at the point of delivery.
Jeremy Corbyn
From the party that opposed the NHS in the first place, that is a bit rich. [Interruption.]
Mr Speaker
Order. There is far too much noise on both sides of the House. I have plenty of time, and I am sure that the principals have as well. We will get through the questions, but preferably in an atmosphere of calm.
Jeremy Corbyn
The Royal College of General Practitioners says:
“The long list of failures made by Capita have been incredibly frustrating for GPs and our teams, and we are still dealing with the fallout”.
Public servants are bearing the brunt of private failure. GPs are leaving the profession in despair—4,000 have retired early in the past five years, which is one in 10. In 2015, the Health Secretary said that he would hire another 5,000 GPs. How many more GPs are there than there were in 2015?
The Prime Minister
We now have more than 14,900 more doctors in our NHS than we had in 2010. We are indeed committed to delivering 5,000 more GPs. We have increased the number training to be GPs. The right hon. Gentleman talks about the private sector being used in the national health service, but he might ask the shadow Health Secretary for his view. The shadow Health Secretary has said, “We are still going to buy from the private sector where we haven’t got capacity in the NHS.” The right hon. Gentleman’s shadow Health Secretary is committed to it.
Jeremy Corbyn
The shadow Health Secretary has a very good understanding of the needs of patients and will always put them first. He will not be the one putting the private sector first.
The reality is that there are 1,000 fewer GPs and the number is falling. It is no wonder that more and more people are writing to me every week saying how difficult it is to get a GP appointment. GPs are the bedrock of the NHS. We need more of them.
I had a letter this week from Anne, who is retired. Until recently, she cared for her mother at home. She wrote:
“The NHS pay a private nursing home for mum’s care…day after day we experience a catalogue of disasters. I can’t leave my mum knowing that her needs aren’t catered for, so I spend hours at the nursing home”.
What action are the Government taking to deal with the substandard care that providers give in the private care sector, which is so upsetting for so many people?
The Prime Minister
I say to the right hon. Gentleman and to Anne that I fully understand that people want to have the confidence and reassurance of knowing that the care their loved ones receive is of a good quality. That is why this Government have put in place the various steps to ensure that we are looking into the quality of care provided in those sectors.
The right hon. Gentleman talks about the shadow Health Secretary recognising the needs of patients. I think he was saying that he recognises the needs of patients, which is why the private sector will be used in some cases. The former Health Secretary, now the Mayor of Manchester, said that
“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate”.
Jeremy Corbyn
The shadow Health Secretary is dedicated to the NHS, not to handing it over to private contractors. That is the difference.
The Care Quality Commission said last year that
“there is too much poor care”.
A fifth of care providers require improvement. Year after year, private sector care providers are letting down our elderly.
This year is the 70th birthday of the national health service—I pay tribute to all its staff over all of those 70 years—but the NHS reaches that milestone with the worst A&E waits on record, the worst delays for cancer referrals on record, falling numbers of GPs, falling numbers of nurses and the longest funding squeeze in its history, while this Government open the door to even more profiteering. Why does the Prime Minister not act now to end the siphoning off of billions of pounds from patient care and give the NHS the funding it needs?
The Prime Minister
We do indeed pay tribute to all those who have worked in the NHS over its 70 years and those who work there today. We want to see a bright future for the NHS, which is why we will be coming forward with a long-term plan for it. What we see today is a national health service not only with more funding going into it, but, crucially, with more people being treated and more operations being undertaken. There are people alive today who have suffered from cancer and would not have been alive just eight years ago, because our cancer outcomes have improved. That is the reality of our national health service. What we also see is that this Government can put money into the NHS only because we have a balanced approach to our economy. What did we learn this week that the Labour party and the shadow Chancellor want to do? They want to “overthrow capitalism”. What would that mean? It would mean families paying higher taxes—[Interruption.] It is supported by parts of the Labour party; now we know where the Labour party really stands on this issue. I say to the shadow Chancellor and others: what would this mean? It would mean families paying higher taxes; more debt for our children in future; fewer people in jobs; and less money for our schools and hospitals. A Labour party that would bankrupt our economy would do lasting damage to our national health service.
Steve Double (St Austell and Newquay) (Con)
The Prime Minister
My hon. Friend has put in a good bid and is a good champion for Cornwall on this issue. He is absolutely right to say that our industrial strategy identifies the role of new markets, such as space launch, in driving growth across the UK. That is why we are delivering a programme to ensure that companies can offer small satellite launch and sub-orbital space flight from UK spaceports. On the specific issue relating to Newquay and Cornwall, strong enthusiasm for this new opportunity is being shown by Newquay airport and other locations around the UK, which is why in March the Government brought forward the Space Industry Act 2018 to support them and we have made £50 million available to enable small satellite launch and sub-orbital flight from UK spaceports. The space agency is considering funding to help kick-start promising projects and will be making announcements shortly.
Ian Blackford (Ross, Skye and Lochaber) (SNP)
May I associate myself with the remarks of the Prime Minister on both Manchester and Grenfell?
The Windrush scandal has taught us that the UK Government’s “hostile environment” policy has targeted those who legally live here; young people who have grown up in the UK and know of nothing else face losing their lawful settled status because they simply cannot afford the paperwork. Home Office fees have increased by 148% since 2014. These children have the right to be here; the UK is their home. I am giving the Prime Minister the opportunity today: will she scrap these fees for young people, as she has done for the Windrush generation?
The Prime Minister
A minor who has indefinite leave to remain will have access to benefits and entitlements that put them on an equal footing to their British citizen peers, so a grant of British citizenship is not therefore required. Of course specific exemptions from application fees are provided to several groups with limited means, such as stateless people, victims of modern slavery or domestic abuse, asylum applicants and children who are looked after by a local authority. And the Children Act 1989 imposes a general duty on local authorities to promote the upbringing of children in need by providing a range and level of services appropriate to those children’s needs, regardless of their status.
Ian Blackford
That simply is not good enough. We are talking about up to 120,000 young people in this country. We are talking about young people who live here, who have to wait 10 years and pay up to £10,000 to achieve permanent right to remain. It is shocking. The Government are guilty of creating a generation of undocumented citizens without the rights that many of us take for granted. Will the Prime Minister change her policies that target young people, and will she meet me and my hon. Friend the Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald) to resolve this issue?
The Prime Minister
First, the right hon. Gentleman cites a figure that I certainly do not recognise as the cost that he suggests applies for an application for citizenship here in the United Kingdom. I repeat the point that I have made: a minor who has indefinite leave to remain will have access to the benefits and entitlements that put them on an equal footing to their British citizen peers. A grant of British citizenship is not required in order for someone to access those rights and benefits.
Tom Pursglove (Corby) (Con)
The Prime Minister
The daily mile is an excellent programme. It is simple and inclusive, and as my hon. Friend says, it can successfully engage in physical activity children who would otherwise not undertake that physical activity. This gives me the opportunity to congratulate my hon. Friend on running the London marathon for two of his local charities: Corby Nightlight and Crazy Hats Breast Cancer Appeal. Well done to my hon. Friend for doing that. I certainly agree that we want more schools to adopt the active approach and the daily mile.
Pete Wishart (Perth and North Perthshire) (SNP)
Mr Speaker
Order. The hon. Gentleman’s question must be heard. [Interruption.] It is his question. He has a right to ask his question and he will ask his question. The question will be heard and the answer will be heard. That is the way it has always been and that is the way it will continue.
Pete Wishart
I am grateful to you, Mr Speaker—and I will be heard.
After all these defeats, apparently we need the right type of crony. There are now more than 800 cronies, donors and aristocrats in that circus down the corridor, embarrassing this nation and mocking any notion of democracy. How many more is the Prime Minister going to appoint? When will enough be enough?
The Prime Minister
Actually, the total size of the House of Lords has fallen since I took office in July 2016. From the sound of what he says, I think the hon. Gentleman is making a bid for himself to be put in the House of Lords. He needs to speak to his leader.
Mr John Whittingdale (Maldon) (Con)
The Prime Minister
I thank my right hon. Friend for raising what is a very important issue. I am sure that Members on all sides of this House will join me in offering our deepest sympathies and condolences to Councillor Miriam Lewis and the right hon. Member for Chorley (Sir Lindsay Hoyle). [Hon. Members: “Hear, hear.”] I thank my right hon. Friend for bringing this website in memory of Natalie to my attention. I am happy to offer my full support to the project, which I am sure will provide much-needed help and advice to those who are in the most difficult and painful of circumstances.
We have, of course, changed the law to introduce a new domestic abuse offence of coercion and control in intimate and familial relationships. Since the introduction of that offence, there have been almost 300 successful prosecutions. That shows what a problem this issue is out there. We are always looking for what more can be done, and in our consultation on transforming the law on domestic abuse and violence, we are currently looking for ideas on how the offence can be further strengthened, to ensure that perpetrators are brought to justice.
Mary Glindon (North Tyneside) (Lab)
The Prime Minister
Of course, as we are building more homes—and we need to build more homes for people—we want to ensure that those homes are fit for purpose. There are standards that house builders have to abide by, and also a number of ways in which it is possible to raise these issues, including where there are defects in the homes that are being built.
Julian Sturdy (York Outer) (Con)
The Prime Minister
We now have the highest cancer survival rates ever, as I mentioned earlier. The latest figures show that an estimated 7,000 or more people are surviving cancer after successful NHS cancer treatment compared with three years ago, but there is still more to be done. My hon. Friend is absolutely right that early diagnosis is an important element of that. We are looking at how the development of smart technologies, which allow us to analyse great quantities of data quickly and with a higher degree of accuracy than we have through the intervention of human beings, can be used to ensure that we get that earlier diagnosis. By 2033, we want to see at least 50,000 more people each year being diagnosed at an early stage of prostate, ovarian, lung or bowel cancer.
Mrs Emma Lewell-Buck (South Shields) (Lab)
The Prime Minister
As the hon. Lady will know, it is for the local NHS to make decisions about the future of local health services; these matters are not determined in Whitehall. I understand that the Sunderland and the South Tyneside hospital trusts have formed an alliance to improve the sustainability, quality and performance of hospital services. Local commissioners did consult the public and they agreed a number of service changes in February, which will improve services for patients.
Dr Andrew Murrison (South West Wiltshire) (Con)
The Prime Minister
As my hon. Friend says, on Monday, I did announce that we will use data, artificial intelligence and innovation to transform the prevention, early diagnosis and treatment of chronic diseases by 2030. I have just referenced, in response to my hon. Friend the Member for York Outer (Julian Sturdy), the fact that we want to see at least 50,000 more people each year being diagnosed at an early stage of prostate, ovarian, lung or bowel cancer. That will mean that, every year, around 22,000 fewer people will die within five years of their diagnosis compared with today. We are also committed to the highest possible standards in using data, which is why we brought forward the Data Protection Bill and have announced our intention to create a new centre for data ethics and innovation. Big data gives us a huge opportunity to improve services to patients in the NHS, but, of course, we must use that data very carefully, and patients need to have the confidence that it is being used carefully, and that is what we will do.
Paul Blomfield (Sheffield Central) (Lab)
The Prime Minister
I look forward to meeting the hon. Gentleman, with the young carers, and I am sure that that will be a really interesting meeting. I am pleased that we will have the opportunity to hear directly from them.
On school funding, as the hon. Gentleman knows, the new national funding formula is providing for a cash increase for every school in every region, as well as protected funding for those with additional needs, but it is important that the Department for Education is helping to bear down on costs that schools are experiencing. That is exactly what my right hon. Friend the Secretary of State for Education is doing—ensuring that the Department is giving support to schools where it is needed.
Mark Pawsey (Rugby) (Con)
The Prime Minister
My hon. Friend draws attention to a very important sector in our economy. The motor industry does play a very significant role in our economy.
Our exit from the EU provides us with an opportunity to forge a new role for ourselves, to become that great global trading nation and to have those other trade deals around the world, but we also need to ensure that we provide as much certainty as we can at an early stage. That is why we are working with businesses and other stakeholders, including the motor industry, and looking for as free and frictionless trade as possible between the UK and the EU—because we want to see that trade flowing freely and those integrated supply chains being able to work as well as possible. That is what we are working for in our future partnership.
Jo Platt (Leigh) (Lab/Co-op)
The Prime Minister
I think that I answered comments about the national health service in response to the Leader of the Opposition, but I will just reiterate: this Government are committed. We are putting extra funding into our national health service; we are committed to a long-term plan for our national health service that will give it certainty and sustainability over a longer period of time than through the annual budget-making process; and we are committed to a national health service that remains free at the point of delivery.
Priti Patel (Witham) (Con)
The Prime Minister knows that stem cell transplants are the only lifeline for leukaemia patients. Tragically, children such as five-year-old Kaiya and 11-year-old Rajie, whose families are in Parliament today for a donor awareness event, have only a 21% chance of finding a donor match because there are simply not enough donors registered from an Asian background. Childhood leukaemia affects children of every ethnic group. Will the Prime Minister commit to leading a nationwide donor registration drive to help to save the lives of hundreds of children suffering from leukaemia, like Kaiya and Rajie?
The Prime Minister
I thank my right hon. Friend for raising this issue and for highlighting it with the experience of children like Kaiya and Rajie. I know that she is doing a lot of work to raise awareness of the lack of donors from Asian backgrounds, particularly with her event today in Parliament. We support efforts to raise awareness of the need to recruit more stem cell donors from black, Asian and minority ethnic backgrounds. More than £20 million has been provided to NHS Blood and Transplant and Anthony Nolan for stem cell donations since 2015, and that includes very specific stipulations about the numbers of newly registered donors with units stored in the UK cord blood bank who must be from BAME backgrounds, and specific funding to support the recruitment of donors from BAME backgrounds. Of course more needs to be done. I am happy to voice my support for my right hon. Friend’s event, which I think is continuing to raise awareness of this important issue.
Justin Madders (Ellesmere Port and Neston) (Lab)
The Prime Minister
That is a decision for the owners of Wembley. It is a private matter; it is not a matter for the Government.
Jeremy Lefroy (Stafford) (Con)
Just over five years ago, the Francis report was published, at the instigation of my hon. Friend the Member for Stone (Sir William Cash), and since then there have been major improvements in patient safety throughout the NHS. Just in relation to County Hospital in Stafford, will my right hon. Friend congratulate the staff there, who have seen a great improvement over the years, with the result that in A&E we are now seeing more patients a day over 14 hours —I wish it was 24 hours—than we did previously over 24 hours and the 95%-plus target being met on a weekly basis?
The Prime Minister
The Francis report was very important. It highlighted an area of deep concern about what had been happening at the local hospital. I welcome what my hon. Friend says about County Hospital and the work that is being done there. Excellent work is being done to provide safety to patients, to provide more treatments for patients and to provide those services to his constituents and others.
Deidre Brock (Edinburgh North and Leith) (SNP)
Philip Davies (Shipley) (Con)
May I paraphrase our former colleague, the late, great Eric Forth? Prime Minister, I believe in the free market, I believe in individual freedom and individual responsibility, and I am suspicious of the nanny state. Am I still a Conservative?
Sir Vince Cable (Twickenham) (LD)
The Prime Minister and the Labour Leader of the Opposition—[Interruption.]
Mr Speaker
Order. Let us hear the full eloquence of the right hon. Gentleman’s flow and the flow of his eloquence.
Sir Vince Cable
The Prime Minister and the Labour Leader of the Opposition both agree that we should leave the single market and leave the European Union customs union and that the public should not have a final say on the Brexit deal, so will the Prime Minister dispense with our tradition of party political point scoring and, in the spirit that I am setting, publicly thank the leadership of the Labour party for its help and support in making Brexit happen?
The Prime Minister
First of all, I am not sure about the position of the Labour party, because it is talking about a second referendum. Secondly, can I just say to the right hon. Gentleman that there is nobody in this House who knows more about party political point scoring than the Liberal Democrats?
Mr Peter Bone (Wellingborough) (Con)
Thank you for calling me at 12.43 pm, Mr Speaker. Your stewardship in allowing Back Benchers to get in to question the Prime Minister is much appreciated.
Prime Minister, how are the European Union negotiations going?
The Prime Minister
They are going with purpose, and with good intent and good will on both sides. We have negotiators in Brussels this week doing further work on those negotiations, and we are determined to deliver a good Brexit for the United Kingdom.
Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)
Mental health is now the No. 1 public health concern for a third of our country. Its importance has jumped 16 percentage points in the past year alone, yet the joint report published last week by the Health Committee and the Education Committee said that the Government’s strategy for young people’s mental health “lacks any ambition” and will fail a generation. Will the Prime Minister commit to think again and go back to the drawing board to ensure that we afford every young person in our country the best start in life?
The Prime Minister
We have committed to ensure that 70,000 more children and young people have access to high-quality NHS mental health care by 2020-21. We recognise the importance of young people’s mental health because something like half of mental health problems later in life started before the age of 14. That is why one of the initiatives the Government have taken is to ensure that staff in schools are trained to better identify mental health problems and are better able to ensure that young people with mental health problems get the treatment and support that they need.
It is important, as the hon. Lady says, that mental health has risen up the scale of people’s concerns. I would like to think that that is partly because we have ensured that there is greater awareness of the issue of mental health. Everybody in the House has a job to ensure that we remove the stigma attached to mental health so that people feel able to come forward when they have mental health problems.
Luke Graham (Ochil and South Perthshire) (Con)
Does my right hon. Friend share the surprise that I felt, as a former Marks & Spencer employee, at the news that the Scottish National party Administration have bullied Marks & Spencer over the use of the word “British” and the Union flag on British produce? Will she stand with me against that petty bullying and support companies that are proud of Scottish and British produce?
The Prime Minister
I absolutely agree with my hon. Friend. We should all be proud of Scottish and British produce and of produce from any part of our United Kingdom. It is frankly appalling that the Scottish Government did not want to see the Union flag and the word “British” on produce. It is not only appalling; it fails to reflect the vote that took place in Scotland, which showed that people in Scotland want to stay part of the United Kingdom.
Tracy Brabin (Batley and Spen) (Lab/Co-op)
Mid Yorkshire Hospitals NHS Trust is struggling to recruit doctors because of immigration rules. One example is an experienced paediatric doctor who has applied for a visa every month for six months, but has now given up because he has been rejected six times. What can the Prime Minister say to my constituents to reassure them that Home Office delays will not impact on the safety and health of their loved ones at this time of greatest need?
The Prime Minister
We keep the issue of tier 2 visas in relation to the health service under review. We have already taken steps. We took steps a while back to ensure that the numbers could be adjusted to reflect the need for nurses, and we continue to look at the situation in relation to doctors.
Petition
Alexandra Hospital Redditch Urgent Care Centre
Rachel Maclean (Redditch) (Con)
Ever since I was elected last June, the Alex hospital has been—and will continue to be—my top priority. My constituents deserve first-class healthcare, and I am determined to make sure that their hospital is there for them when they need it most.
The people of Redditch are well aware of this hospital’s history, but I am focused on its future—a bright future, with new services being launched and much-needed investment going into our hospital. One service that demonstrates local health bosses’ long-term commitment to the Alex is the urgent care centre. This vital service will work alongside A&E, will treat adults and children with minor and moderate illnesses and injuries and will give parents much-needed peace of mind that their children can be treated at their local hospital.
However, local health bosses promised this service to my constituents before I was elected last June, and it still has not been delivered. That is why I launched my urgent care centre parliamentary petition to demonstrate strong local support for this new service. I want the urgent care centre operational as soon as possible. With more than 1,000 constituents signing my petition, the people of Redditch clearly want this service open now without further delay. I am hugely grateful to every single person who has signed my petition and it is an absolute honour to submit it on their behalf today.
The petition states:
The petition of residents of Redditch County,
Declares that as part of the consultation into Acute services in Worcestershire in 2017 which saw overnight paediatric care centralised at the Worcestershire Royal Hospital, the local Clinical Commissioning Group (CCG) promised to bring forward plans for a GP-led urgent care centre in Redditch; further that was understood to be an essential part of the proposed model for Acute services which was brought before the West Midlands Clinical Senate and the boards of the three local CCGs; however there is still no timetable for delivery of the urgent care centre; further that once the children’s A&E was centralised to Worcester, residents were told there would be an urgent care service for under 16-year-old very sick children provided at the Alexandra Hospital in Redditch; and further that would give parents peace of mind that their loved ones would be assessed, in a place familiar to them, especially for those who have difficulty travelling to Worcester.
The petitioners therefore request that the House of Commons urges the Government to press the local health authorities in Redditch and Worcester to publish their detailed plans for the implementation of the said urgent care centre.
And the petitioners remain, etc.
[P002150]
Points of Order
Wednesday 23rd May 2018
(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text
Barry Gardiner (Brent North) (Lab)
On a point of order, Mr Speaker. You are a redoubtable champion of Members seeking to hold the Government to account. One of the things we sometimes resort to in doing that is the submission of freedom of information requests. On 20 July last year, I submitted a freedom of information request to the Department for International Trade, to which I have not yet had a response, nor indeed any acknowledgment, despite chasing it up in March and April. I submitted a separate FOI request on 14 March this year, which did receive a response, advising me that the Department would be unable to respond within 20 days but that a response would be forthcoming by 14 April at the latest. I have still had no such response, despite it now being May.
On 26 April this year, the Cabinet Office and the Office for National Statistics released the annual FOI statistics by Department. The Department for International Trade was the worst of all Departments, with 27% of requests either not being answered within the time limits or not answered at all. That failure prevents parliamentarians from properly scrutinising the Government’s trade policy at a time of intense public debate on these matters—something we have a duty to Parliament to do. I make no judgment of whether it is by intention or incompetence on the part of Ministers, but I seek your advice as to how we may redress the situation.
Mr Speaker
I am very grateful to the hon. Gentleman. I hope he will not take it amiss if I begin my response to him by saying that, although it is an attempted point of order, in a very real sense it appeared to me to resemble an intellectual dissertation, which of itself is no surprise to those of us familiar with the cerebral quality of the hon. Gentleman. I think it is important to distinguish between parliamentary proceedings on the one hand, in respect of which I may have some modest powers and capacity to assist Members, and freedom of information requests on the other, in relation to which I am literally powerless, as those are not matters for me. However, the hon. Gentleman has raised a concern, and it may well be shared by others. It is on the record, and I hope, consistent both with the letter of obligation to those who submit such requests and with its spirit, that full account will be taken of the situation the hon. Gentleman has painstakingly highlighted. If I may, I suggest we leave it there for today.
Mr Speaker
I will come to the hon. Gentleman, of course, but I call Andrew Bridgen.
Andrew Bridgen
On a point of order, Mr Speaker. Following last Wednesday’s difficult day, will you clarify a point of Chamber etiquette? Is it now acceptable in the Chamber to call a colleague a liar?
Mr Speaker
I am extremely grateful to the hon. Gentleman for his point of order. I would say to him very respectfully and courteously by way of reply that I made a statement on those matters in the Chamber. I think what I said at the time was very clear to people, and I do not feel the need to add to that statement. My position has been very explicit. I thank the hon. Gentleman for inviting me to dilate on the matter, but I do not intend to do so, and we shall leave it there. I am deeply obliged to him.
Mr Kenneth Clarke (Rushcliffe) (Con)
Further to that point of order, Mr Speaker. Do you agree that, if action were taken every time a Member of this House felt moved to say under his breath something rather abusive about another Member, the Chamber would be deserted for considerable lengths of time? Do you not agree that it is better to leave this to the body that is now investigating it and hope that some common sense will be applied to this rather overheated subject?
Mr Speaker
I thank the right hon. and learned Gentleman for what he has said, and Members will make their own assessment of it. I simply appreciate the fact that the right hon. and learned Gentleman says what he says on the strength, next month, of 48 years’ uninterrupted service in this House.
Mr Speaker
I am saving the hon. Gentleman up, as I often say. I do not want to squander him at too early a stage of our proceedings. I call Mr Martin Docherty-Hughes.
Martin Docherty-Hughes
On a point of order, Mr Speaker. Two hundred days have passed since my constituent Jagtar Singh Johal was held in India without charge, with accusations of torture and with trial by media. I am grateful to Ministers who have engaged with me so far in holding the Indian authorities to account. Nevertheless, I have now written to the Prime Minister twice, without formal response other than a holding response from their office. Will you assure me that all Ministers of State take their responsibilities seriously in responding fully to a constituency Member of the House of Commons on a critical matter involving a constituent—a UK citizen, and a true son of the Rock of Dumbarton—who has made accusations of torture against a close ally?
Mr Speaker
I hope that these matters are always treated with the utmost seriousness and that responses to parliamentary colleagues are both timely and substantive. I say to the hon. Gentleman, without fear of contradiction, that that notion of a timely and substantive response should apply both in relation to parliamentary answers to parliamentary questions and in relation to correspondence. I was not familiar with all the details of this matter, although the hon. Gentleman has apprised me of some of them, but it is of course important that these matters are addressed fully.
A moment ago, we heard from the Father of the House—perhaps I may respond on this point because it is quite an important one for all of us. A former Father of the House, Sir Gerald Kaufman, when he did not receive substantive replies to questions or letters, was given to tabling a written question on the matter, inquiring when he would receive a substantive reply. If I remember correctly, Sir Gerald was inclined to say that that was an extremely effective technique. I volunteer that advice gratis to the hon. Gentleman.
Simon Hoare
On a point of order, Mr Speaker. As you are probably aware, there have been problems with the wi-fi connection in the House for remote devices during the past few days, and the authorities have been reasonably good about keeping Members up to speed. May I invite you to provide the House from the Chair—today is a sitting day, but we are coming up to the recess—with both an update on progress and confirmation that those of us on recess next week will be able to access the intranet, our emails and parliamentary sites in the usual way, notwithstanding the problems?
Mr Speaker
I believe the Parliamentary Digital Service is attempting to keep Members updated on this matter. It would perhaps be rash of me to proffer any—[Interruption.] Well, it would certainly be rash of me to proffer any technical advice, as I have no expertise in that matter, as the hon. Member for Lichfield (Michael Fabricant) can perfectly well testify. It is probably unreasonable to think that I can offer any sort of oral statement on the matter tomorrow, which is the last day that we will sit before the Whitsun recess, but I think the Parliamentary Digital Service will seek to keep Members updated. On the back of what the hon. Member for North Dorset (Simon Hoare) has said, if there is a further way in which the House Service can help him and other right hon. and hon. Members, we shall do so.
Mr Speaker
However, this particular subject will not have been exhausted until we have heard the views on it of the right hon. Lady.
Anna Soubry
Further to that point of order, Mr Speaker. I am sorry not to have given you notice of this, but it flows so naturally from what was said by my right hon. Friend; sorry, by my hon. Friend.
Anna Soubry
No doubt in time.
Mr Speaker, it has come to my attention that some constituents are unable to email me. I believe this is a common problem from which all hon. Members are suffering. Obviously, we will not know because the emails do not even get into the spam filters. For some peculiar reason, which I will not trouble you with, I found out that one constituent—she had a very serious concern about a personal independence payment application being refused—had emailed me and included attachments, quite properly, with her email; I found out through another source that she had emailed me. Therefore, I could deal with her inquiry, but I would never have known about it if that other source had not contacted me.
I have contacted the parliamentary authority, PICT, on more occasions than I would care or want to remember, I have to say, to no avail. In short, the spam filters are set too high, and there are certain popular email addresses that simply do not get through even to the spam filters. It is a serious problem, and I simply do not know how we can resolve it. Can you help, Mr Speaker?
Mr Speaker
I rather fear that I am not able to help. I do not want to make too many declarations on the Floor of the House. Suffice it to say that I am not myself technologically sophisticated. I think I owe it to the right hon. Lady to disclose that candidly to her. I am not saying that I have not the slightest idea what she is talking about, but I am not closely familiar with the detail, and when it comes to this filter or that filter, it all seems very confusing to a simple chap like me.
I would say to the right hon. Lady that these are serious matters. PICT of course ceased to exist about three years ago, but the Parliamentary Digital Service—I think that is what she means—does try to assist. I think there are ways of dealing with this outside the Chamber, but knowing the right hon. Lady as I do, I feel sure that if she is not satisfied on this matter ere long, we will all be hearing more about it and I will doubtless be hearing more about it. [Interruption.] Indeed, the right hon. Lady will probably send me an email. It is always a pleasure to hear from her both in the Chamber and outside it, but in all seriousness, people are aware of this and I will try to ensure, as of now, that there is some progress and that Members are satisfied, because they should not be obstructed in the discharge of their parliamentary duties. I thank her for raising what she has raised.
It is a case of patience rewarded for the hon. Member for Na h-Eileanan an Iar (Angus Brendan MacNeil).
Angus Brendan MacNeil
On a point of order, Mr Speaker. That was excellent pronunciation, as ever. In the north-west of Scotland, fishing boats have been sold, processing jobs lost and exports lost because the Home Office will not provide visas for such work in Scotland or Northern Ireland. All of that is happening to keep the Home Office happy, essentially. We need seasonal workers from non-EEA countries urgently, otherwise we will only have European Union fishing boats around our waters. How can I best get this matter on the record and raise awareness of it? I seek your advice and guidance.
Mr Speaker
As the hon. Gentleman knows, he has achieved his objective with immediate effect. His words will have been heard on the Treasury Bench and will be recorded in the Official Report by the dedicated and expert staff of the House. He can therefore go about his business with an additional glint in his eye and spring in his step, which might otherwise have been lacking. If he feels that he has not exhausted his energies on this matter, he can of course seek a debate in the Chamber or in Westminster Hall. Who knows? The hon. Gentleman might be successful.
Bills Presented
Non-Domestic Rating (Nursery Grounds)
Presentation and First Reading (Standing Order No. 57)
Secretary James Brokenshire, supported by the Prime Minister, Mr David Lidington, Secretary Greg Clark, Secretary Michael Gove, Mel Stride and Rishi Sunak, presented a Bill to make provision for buildings used as nursery grounds to be exempt from non-domestic rates in England and Wales.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 214) with explanatory notes (Bill 214-EN).
Ivory
Presentation and First Reading (Standing Order No. 57)
Secretary Michael Gove, supported by the Prime Minister, Mr Chancellor of the Exchequer, Secretary Boris Johnson, Secretary Penny Mordaunt, Secretary Matt Hancock, Andrew Leadsom and Dr Thérèse Coffey, presented a Bill to prohibit dealing in ivory, and for connected purposes.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 215) with explanatory notes (Bill 215-EN).
Terminal Illness (Provision of Palliative Care and Support for Carers)
Wednesday 23rd May 2018
(5 years, 11 months ago)
Commons ChamberRead Full debate Terminal Illness (Provision of Palliative Care and Support for Carers) Bill 2017-19 View all Terminal Illness (Provision of Palliative Care and Support for Carers) Bill 2017-19 Debates Read Hansard Text
A Ten Minute Rule Bill is a First Reading of a Private Members Bill, but with the sponsor permitted to make a ten minute speech outlining the reasons for the proposed legislation.
There is little chance of the Bill proceeding further unless there is unanimous consent for the Bill or the Government elects to support the Bill directly.
For more information see: Ten Minute Bills
This information is provided by Parallel Parliament and does not comprise part of the offical record
Bambos Charalambous (Enfield, Southgate) (Lab)
I beg to move,
That leave be given to bring in a Bill to require the provision of comprehensive palliative care to those with terminal illnesses, including adults over the age of 60; to require certain public bodies to co-operate with hospices in the provision of palliative care; to make provision for support for those caring for individuals with a terminal illness; and for connected purposes.
I was moved to choose the subject of palliative care for my ten-minute rule Bill following a visit to my local health and wellbeing day centre run by North London Hospice, where I heard an inspirational speech by Joy Watkins who is a patient and user of the amazing facilities there. Joy said:
“So what do I get from coming here to the Hospice? My GP and hospital doctors are excellent but they don’t have the extra time to give. What I get here is the space, time and flexibility to talk through things with experts who know about living and living with a good quality of life; help in dealing with the impact of a life threatening or terminal illness; and also the chance to meet others like me and have honest supportive conversations and encourage each other.”
Joy and some of the other patients, carers and staff are in the Gallery today. I welcome Joy and everyone.
As the population grows older and lives longer, many will develop health conditions that could become a terminal illness. Macmillan Cancer Support has estimated that by 2040, older people will account for 77% of people with a cancer diagnosis. The number of people dying of cancer is increasing and is expected to continue doing so. There is a real prospect of unprecedented pressures on the already overstretched NHS.
Palliative care needs to go hand in hand with hospital treatment and should be available for all people with advanced and progressive illnesses and life-shortening conditions. Unfortunately, the provision of palliative care is patchy at best. Even those with a terminal illness are not being identified as in need of referral for palliative care. In some regions, one in four people dying of cancer has never been referred for palliative care and has not been on a care register. For people with motor neurone disease, early access to palliative care is essential, as one third of people with motor neurone disease die within a year of diagnosis. Sufferers should be able to plan ahead for their end-of-life care and ensure that their wishes are known.
Research has shown that early referral for palliative care can improve the quality of life and lengthen it. Early referral also results in fewer admissions to hospital and helps carers by alleviating the stress and pressures they face.
It cannot be right that palliative care funding is dependent on local clinical commissioning groups, whose contributions to local hospices’ costs range as widely as 1% to 50% from region to region. The average contribution of CCGs to the costs of children’s hospices is 10%, compared with 30% for adult hospices. This week is Children’s Hospice Week, and the Rainbow Trust Children’s Charity has identified that hospices save the NHS money by freeing up hospital beds, reducing the number of missed appointments and, in the case of children with terminal illnesses, helping parents stay together by allowing them to manage their feelings better in a supportive environment. I am still staggered by the thought that many hospices survive thanks only to their own fundraising activities or the generosity of donors.
We need to have properly funded nationwide palliative care provision that is integrated with local authorities, community care providers and local NHS providers, so that there is a comprehensive and coherent way of addressing end-of-life care. This Bill will seek to provide that.
There is still a big taboo about talking about end-of-life care and there is limited understanding among the public about what palliative care is and when it is appropriate. This is a challenge for all of us, but doctors and healthcare professionals could also benefit from training and a greater understanding of the work that hospices do and what is available from palliative care. Better communication is needed and more sensitivity and empathy are required from health professionals when discussing an end-of-life diagnosis and options such as palliative care.
One cannot underestimate the value of district nurses in providing care for the terminally ill. They build a trusting and supportive relationship with patients and their families and friends, making the patient’s last few months as comfortable and pain free as possible. Many more district nurses are needed to provide that support.
Palliative care is only part of the picture and we cannot forget the role that carers provide in supporting their loved ones at the end of their lives. We have only one chance to give decent care to each person who is diagnosed as terminally ill. No matter what age someone is when diagnosed, there is likely to be a relative or friend who goes above and beyond to unconditionally care for and support them in the last stages of their life. Hospices like North London Hospice’s health and wellbeing centre in my constituency of Enfield Southgate can play a role in identifying carers who have not realised that they have suddenly become a carer and are entitled to an assessment. Someone focusing on a person who is at the end of their life can find it tough to identify their own needs and to fully appreciate the role they have taken on.
The health and wellbeing centre works for outpatients and carers, recognising the holistic and inclusive approach that is needed. Carers face many physical and emotional challenges as they provide the essential support that their loved ones need—things like dressing them, taking them to the toilet or physically helping them move about, all while trying to preserve their loved one’s dignity. Even where there is palliative care provision, there is virtually none that is out of hours, so carers rarely get breaks at night time or at weekends. Many carers get no support or respite at all and are often stressed to breaking point as they adjust to a time when the sole focus in their life is the care of their loved one.
At a time when there is chronic underfunding in social care, there is a serious lack of high-quality community care and support for carers. Carers UK estimates that as many as one in eight people are providing unpaid care and support to a family member or friend. That unpaid care is worth £132 billion each year, which is equivalent to the entire NHS budget for one year. Under section 10 of the Care Act 2014, councils in England must carry out an assessment of a carer of an adult if they may need support. However, Carers UK research shows that 25% of people who provide palliative or end-of-life care are waiting over six months for an assessment. Even when assessments have been carried out, many carers get no extra support, leading to carers suffering ill health, financial pressures, stressed relationships and feelings of loneliness and isolation. Carers need breaks, an allowance in line with jobseeker’s allowance, a right to paid leave and support from a more carer-friendly NHS, for which Hospice UK has been campaigning for some time.
It is for those reasons that I am seeking a clearer recognition from the Government of the existing contribution of carers and an understanding that without this support, the situation would become unsustainable. In tandem with that is the need for a new right to paid care leave for carers who are in work and an increase in carer’s allowance for those not in work.
Marie Curie Cancer Care has estimated that in the next 25 years an extra 100,000 people will die each year. The need to do something about this problem could not be starker. The Bill seeks to ensure that there is equal access to community palliative care services for anyone who is terminally ill; better co-operation between hospices, agencies and NHS services to join up the currently fragmented provision; and better funding for district and community nursing.
Each person who becomes terminally ill has only one chance to live well until they die, and it is unacceptable that their only chance of living well is dependent on the prioritisation of funding for their hospice from their local CCG. In all probability, when the Bill receives its Second Reading, Joy will no longer be with us, but, in her words,
“the hospice can help us live with a better quality of life. It is about living not just about dying, until we are ready and then it will be a safe place to die.”
We owe it to Joy and all current and future sufferers of terminal illnesses to make sure that we improve the provision of palliative care and make the system better and fairer.
I should mention that my right hon. Friend the Member for Enfield North (Joan Ryan), my hon. Friends the Members for Hornsey and Wood Green (Catherine West), for Weaver Vale (Mike Amesbury), for Canterbury (Rosie Duffield) and for Colne Valley (Thelma Walker), and the hon. Member for Lichfield (Michael Fabricant) also support the Bill. I commend the Bill to the House.
Question put and agreed to.
Ordered,
That Bambos Charalambous, Jo Platt, Emma Hardy, Tonia Antoniazzi, James Frith, Eleanor Smith, Laura Smith, Layla Moran, Dr Philippa Whitford, Dr Lisa Cameron, Jim Shannon and Will Quince present the Bill.
Bambos Charalambous accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 23 November, and to be printed (Bill 216).
Opposition Day
Transport Secretary: East Coast Franchise
(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
16:00 - The House divided: - Ayes: 271 / Noes: 304 - Question accordingly negatived.
Andy McDonald (Middlesbrough) (Lab)
I beg to move,
That this House censures the Secretary of State for Transport, the Rt hon Member for Epsom and Ewell, for his handling of the East Coast franchise and his proposal to re-privatise the route rather than operate it as a public sector operation; and calls on the Government to reduce his ministerial salary by £2,400 per year.
Labour has brought forward today’s motion because of the lack of candour and lack of debate around the future of the east coast franchise, both inside this House and outside. Not for the first time, the Secretary of State for Transport has fallen desperately short in matters of clarity and courtesy in his ministerial conduct. I believe that manners maketh the man and manners also maketh the Minister.
I would like to take this opportunity to advise the House that a week ago today I was denied the usual courtesy of being furnished with a copy of the Minister’s statement at least 45 minutes before the statement was made. I was allowed sight of the statement at 12.15 pm in an ante room on the upper ministerial corridor. I was not permitted to retain a copy and simply had to grab the few minutes afforded to me to make brief handwritten notes. With Prime Minister’s questions scheduled to finish at 12.45 pm and there being no other business before the House, that gave me the briefest sight of the document that I was to respond to.
To add insult to injury, I was not even provided with a hard copy of the statement as it was being delivered at the Dispatch Box. I noted that you, Mr Speaker, did have the benefit of a hard copy of the Secretary of State’s statement as he delivered it, but sadly I did not have that luxury.
Mr Speaker
I say in the most gentle spirit—we do not want to go over all of it in detail—that the copy for me was of limited use. It was very interesting to read, but of limited use. It would have been of greater use to the hon. Gentleman.
Andy McDonald
I am grateful, Mr Speaker.
It seems that certain newspapers had sight of the statement approximately an hour before its delivery. That courtesy ought to have been afforded to Her Majesty’s Opposition. To add further injury to further insult, the Secretary of State told this House, in the course of responding to questions on the statement, that the Opposition had been provided with a copy of the statement. Being given brief sight of the statement, by any reasonable interpretation, is a far cry from being provided with a copy. I trust the House will accept that this is not the way to go about business. Even at this stage, I live in hope that the Secretary of State will accept that his behaviour was not what is expected of a Minister of the Crown.
In my remarks today, I intend to examine how rail operations in the United Kingdom got into such an inexplicable and unsustainable place and consider whether the Government’s policy solutions are the right ones. Before I do so, however, I would like to deal with a preliminary issue. Each time we debate the railway, the Secretary of State argues that the private sector funds investment in the railway that we would not have under public ownership. That is simply untrue and misunderstands where investment comes from. It is the taxpayer and the fare payer, not private companies, who fund investment in the railway. Every bit of new track, every new station or new train is paid for by the public. The private sector only finances investment and it does so at a profit, such as rolling stock companies who finance the purchase of new trains and take home eye-watering profits.
Sir Desmond Swayne (New Forest West) (Con)
Can the hon. Gentleman explain to me the difference between paying for something and financing it?
Andy McDonald
Absolutely. The private sector can organise financing, but the funding has to come from somewhere. It always comes from the same source: it is provided by taxpayers and by fare-paying passengers. It is paid for, so it is wrong for the Secretary of State to repeatedly credit companies with the investment made by taxpayers and passengers who are paying sky-high fares. Public ownership does not mean less investment. Under Labour, it will mean greater investment.
Jonathan Edwards (Carmarthen East and Dinefwr) (PC)
I am not sure whether this is bad timing, but the hon. Gentleman will be aware that today in Wales the Labour Government have awarded the Welsh franchise to a multinational French-Spanish company, KeolisAmey, in a £5 billion 15-year deal, despite a manifesto promise to award it on a not-for-profit basis. Why are his Labour colleagues in Wales directly contradicting what he is proposing today?
Andy McDonald
That is entirely a matter for the Welsh Government.
The east coast saga is littered with incompetence and delusion, alongside a frankly cavalier regard for the public and passenger interest by a succession of Transport Ministers.
Helen Goodman (Bishop Auckland) (Lab)
This is now the sixth change of management for the east coast main line in 11 years. That cannot be good for any organisation. Does my hon. Friend know what is happening to the planned investment programme of new trains being built by Hitachi in the north-east?
Andy McDonald
My hon. Friend is entirely right. There are people now working on the east coast main line who are expecting their sixth change of uniform in 10 years. It is absolutely ludicrous. There has been an appalling record over the past several years.
Jenny Chapman (Darlington) (Lab)
My hon. Friend says something that sums it up. This has been about changing uniforms and livery on trains, while the promised improvements to service, the new routes and the benefits to passengers have never ever materialised.
Andy McDonald
My hon. Friend is entirely right. It is ludicrous that the reported cost of changing the livery yet again on this network is an estimated £13 million.
Huw Merriman (Bexhill and Battle) (Con)
I am very grateful to the hon. Gentleman. He is being very kind in giving way. Does he recognise that since 2015, when the franchise was put back into private hands, there have been an extra 1.74 million seats and an extra 40 services each week from London to Edinburgh? Is it therefore not the case that we have seen not only a 20% increase in money coming in, but an increase in service?
Andy McDonald
If we speak to people who take that train journey regularly, I think they will have their own observations about the quality of service. However, if the hon. Gentleman bears with me, I will deal with his remarks as I develop my speech.
Andy McDonald
I really want to make some progress—I have taken a lot of interventions thus far.
I am concerned that the Government’s unimaginative and ill-thought-out response to the current crisis threatens the taxpayer interest yet further. Following the west coast franchise debacle in 2012, there were numerous reviews and process changes to rail franchising. We were told that nothing like that could ever happen again. In an act of ideological spite, the east coast franchise was forced back out into the private sector by a coalition Government desperate to tie the hands of a possible Labour Government in 2015. Passengers and taxpayers have lived to regret that decision.
Liz Twist (Blaydon) (Lab)
Does my hon. Friend agree that there is huge support in the north-east for a directly operated railway in not just the short term, but the long term? The experience in the north-east proved that this was a viable proposition and one that has tremendous support from the public and passengers.
Andy McDonald
I agree entirely with my hon. Friend. There is great support for a publicly owned railway on the east coast—
Alec Shelbrooke (Elmet and Rothwell) (Con)
Will the hon. Gentleman give way?
Andy McDonald
I’ll tell you what: I will answer one intervention and when I have finished with that one, I’ll see if I should answer another one—how does that go as a deal?
My hon. Friend the Member for Blaydon (Liz Twist) is entirely correct about that, and she is right about the response from the people who work on the railway. The investment in their training and performance reflected that and the benefits of the quality of the railway are because of the hard work and dedication of the people who work within it.
The Secretary of State said more than once that Virgin-Stagecoach got its numbers wrong when its bid for the east coast franchise was accepted in 2014. Why, then, did the Department accept the bid? What due diligence of the bid took place? Two of the Department’s franchise bid advisers told the Transport Committee on Monday that the Virgin-Stagecoach bid got through the DFT’s financial robustness test and financial risk assessment test. If that is the case, the financial robustness test and the financial risk assessment test are wholly ineffective and inadequate. Those same witnesses—the Department’s own advisers—suggested that the east coast franchise was doomed from day one. That is hardly a ringing endorsement from those in the know. In all those circumstances, what faith can we have in the Department’s processes?
This week it emerged that the Secretary of State allowed HS2 to appoint Ernst and Young to investigate Carillion, notwithstanding that EY was advising HS2. Clearly that is a direct, obvious and major conflict of interest. The Business, Energy and Industrial Strategy and the Work and Pensions Committees asked if appropriate diligence took place. It seems that the Secretary of State’s failure to conduct proper due diligence is not isolated. EY, it should be recalled, is one of the Department’s technical advisers on the east coast operator of last resort.
Stagecoach knew that it would not meet its revenue targets weeks after taking over the east coast franchise in March 2015. The company was in constant dialogue with the Department about it. The Secretary of State has been in post since July 2016 and must have known about this for that period of time. Why did he do nothing? Has not this Transport Secretary been asleep at the wheel?
We learned this morning that the Government knew that Carillion was at risk for more than a year before the company went bust. As with the east coast franchise, the Government sat on their hands and did nothing. What about the Department’s managing director for passenger rail services, Peter Wilkinson, who was brought in at such great expense in 2012 to “get rail franchising back on track”? I am not a personnel expert, but I would say that Mr Wilkinson must be in breach of his contract.
Let us get into some of the details. On 14 Feb 2018, DFT OLR Ltd—presumably OLR stood for “operator of last resort”—was renamed London North Eastern Railway Ltd. It is a company limited by shares to a nominal value of just £1. The company has six directors, four of whom are listed with the occupation “civil servant”. They include the DFT’s head of passenger service, Peter Wilkinson; the DFT’s lead on in-franchise change, Richard Cantwell; and the DFT’s head of franchise policy and design, Simon Smith—the other civil servant does not show up on the DFT’s organogram.
Not only was LNER established in February, but the domain name was registered on 29 March. Why has it taken the Secretary of State three months to inform the House of a decision that he took all those months ago? Last year, it emerged that the Government decided to cancel rail electrification projects in March but they did not announce the decisions until after the general election in July. The collapse of the east coast franchise should set alarm bells ringing at the Department for Transport.
Rachel Reeves (Leeds West) (Lab)
Virgin-Stagecoach has let down passengers, as well as the taxpayer. Does my hon. Friend agree that Virgin-Stagecoach should not be allowed to bid for any other train routes? If it were, that would make a mockery of the whole system of privatisation and outsourcing, with absolutely no responsibility or accountability?
Andy McDonald
My hon. Friend makes a very good point: we seem to be in the business of rewarding failure. The smack on the wrist for Virgin-Stagecoach was to give it an extension on the west coast line. How on earth does that relate to a franchise that has failed?
As I said, the collapse of the east coast franchise should set alarm bells ringing at the DFT. The Secretary of State acknowledges that his Department accepted a bid that was too high, yet at the time of the bid, Virgin Trains East Coast was told by the DFT that it was the highest-quality bid that it had ever received. If the highest-quality bid ever received could go so badly wrong so quickly, what does that mean for other franchises?
Mr Speaker
Order. Before the hon. Member for Harrow West (Gareth Thomas) intervenes, the shadow Transport Secretary has been most generous in giving way, and that is perfectly proper, but I just emphasise that 15 Back Benchers want to speak. Therefore, it might be an idea to think in terms of finishing the speeches from Front Benchers by 10 past or quarter past 2 at the latest. If it is possible to do so earlier, so much the better. I call Mr Gareth Thomas.
Gareth Thomas
I am grateful to you, Mr Speaker, and to my hon. Friend the Member for Middlesbrough (Andy McDonald) for accepting this intervention before you got up to make your own. Is my hon. Friend aware of the Centre for Policy Studies—not a natural ally for him, perhaps—and its recent report in which it alluded to fundamental problems with rail competition and the declining market interest in bidding for rail franchises? Would he therefore take this opportunity to commend to the Secretary of State the recent Co-operative party report setting out a new approach to public ownership of the railways?
Andy McDonald
I am grateful to my hon. Friend for his intervention. He makes his point very well. With your guidance in mind, Mr Speaker, I put the House on notice that I do not intend to take any further interventions—I shall crack on.
The franchising model is based on ever-growing passenger numbers. Indeed, other franchise agreements have been agreed with similarly optimistic assumptions about growing passenger numbers and fares revenue. Even in times of growing usage, franchises have proven to be unsustainable, yet we are now seeing a period of falling passenger numbers. In the last two quarters, rail passenger usage fell by 0.4% and 0.9%, driven by respective 8.1% and 9.4% falls in season-ticket journeys. That is a result of above-inflation fare rises; people who have seen fares rise at three times the rate of wages since 2010 are opting for cheaper modes of transport. Passengers are being priced off the railway. This declining usage threatens the integrity and financial sustainability of the railway and the franchising system itself, as other operators find themselves in similar trouble to Virgin-Stagecoach on the east coast.
What, then, is the Secretary of State’s solution? Will he abandon above-inflation fare rises, as Labour has pledged to do, so that passengers can afford to travel by rail and patronage can be boosted? If not, how does he plan to handle problems with franchises down the line? Will he do as he has done with the east coast and allow companies to walk away from their contracts, thereby forfeiting billions of pounds in premium payments owed to the Treasury, before handing services over to other companies that will agree to pay less back to the taxpayer?
The new west coast partnership franchise has a £20 million parent company guarantee. This contrasts with the £200 million guaranteed by Stagecoach on the east coast. Less risk for the private sector means more risk for the public purse. Both options would allow private operators to renege on their contracts, at a cost of billions of pounds, and makes a mockery of rail franchising by telling private operators that the state will intervene if they are in trouble, removing risk and incentivising reckless bids. It would be a case of profits being privatised and losses socialised.
The Public Accounts Committee and the Transport Committee have published reports that are scathing of both the Secretary of State’s handling of franchises and the franchising system more generally, which is clearly failing on its own terms. The Secretary of State is attempting to prop up the franchising model for ideological reasons. Since 2010, there have been more direct awards—companies being gifted services without having to bid—than successful franchising competitions, meaning that the system resembles state-sponsored monopolies rather than a market where franchisees make bids they are expected to honour.
I have yet to hear the Secretary of State articulate a solution to these fundamental flaws in rail franchising. So far, he has only proposed to tinker around the edges. The strategic vision for rail announced last November will be a future case study for media students on Government presentational double-speak. Amid reversing the Beeching cuts and announcing the invitation to tender for the next south-eastern franchise, there were two sentences on how the east coast franchise had failed. The strategic vision embodies his approach to his ministerial brief and to announcements in this House: smoke, mirrors, ambiguities, jargon, technicalities, empty aspirations and discourtesy.
Lilian Greenwood (Nottingham South) (Lab)
Can my hon. Friend offer any insight into the Secretary of State’s long-term vision for rail franchising? Did he hear the evidence to the Transport Committee on Monday on the proposed east coast partnership, when Iryna Terlecky, a rail professional with decades of experience, told us that she had
“no idea how it might work”?
She added:
“If I was doing this kind of partnership, I would not do it on the east coast”
because it was
“completely counter-intuitive”.
Can he understand why the Secretary of State is going down this path?
Andy McDonald
I am grateful for my hon. Friend’s intervention. I value the work she does so astutely as Chair of the Transport Committee. It is remarkable that those experts and advisers are making such comments. I will come on to deal with the choice of the east coast for a potential partnership option in my concluding remarks.
Simon Hoare
A moment or so ago, the hon. Gentleman mentioned ideology. I am a Welshman and I thought I understood the Welsh Labour party. What is the difference between the ideologies of Welsh Labour and London Labour on these vital transport issues? Clearly there is a difference, as alluded to by the hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards).
Andy McDonald
The hon. Gentleman will recognise of course that the Government forced through the franchise option, so they had no choice in Wales.
Like his time at the Ministry of Justice, the Secretary of State must hope to be moved on before his wrecking-ball approach to decisions reveals its true horrors. He seems incapable of being direct with Members and the public alike. Given his track record, is it any wonder that no one takes the east coast partnership idea seriously? Where on earth did he come up with it? In the back of a taxi on the way to Parliament to deliver his statement?
As my hon. Friend the Chair of the Select Committee has remarked, the east coast is the last line on the rail network on which a partnership between a train and track operator has been launched. More than 20 passenger, freight and open access operators use the east coast main line. The east coast franchise runs less than 10% of services. Why would anyone put this operator in charge? There is no basis for the Secretary of State’s assurances that the governance of the partnership would be independent.
The Secretary of State knows that Network Rail’s London and north-eastern route covers the east midlands. Putting that route into an east coast partnership will force Network Rail to prioritise the east coast over the east midlands and further damage a region that is losing rail electrification and services because of timetable changes. Will his east coast partnership not undermine the national rail infrastructure manager, Network Rail? His new market-led proposals for rail enhancements also undermine Network Rail’s role and increase the Department’s micro-management of rail. Is there not simply too much political interference in rail?
Andy McDonald
I will give way briefly, but it will be my last intervention.
Mr Campbell
Like many north-east MPs, I travel on the east coast line every week, and I am always being asked this question by passengers and staff: why on earth did the coalition Government get rid of a perfectly good company that put £1 billion over four years into the Treasury and give the franchise to Virgin-Stagecoach? That has never really been explained.
Andy McDonald
I think the explanation is quite simple: it was done out of ideological obsession and to put the franchise outwith the reach of anybody else.
By contrast, the next Labour Government will allow rail professionals to get on with their jobs free from political interference. [Interruption.] They do not seem to understand the difference.
Andy McDonald
No, I am not taking any more interventions. Sit!
Last week, the Secretary of State failed to address my concerns about four other highly vulnerable rail franchises being provided with revenue support by the Department. Is it his intention to take these contracts within the operator of last resort function should they fail?
Kwasi Kwarteng
How does the hon. Gentleman square his statement that there is too much political interference in the rail network with his party’s stated desire to nationalise the entire network? It does not make any sense.
Andy McDonald
Had the hon. Gentleman been here for the entirety of the debate, he might have heard me refer to that; I know he has just walked in. The object of the exercise is to put rail professionals in charge of the railway system.
Is it not the reality that the franchise system is totally broken? It is finished; it’s a dead parrot; it is no more. The one thing the Secretary of State is right about is that track and train should be unified, but that should not be done simply to further his ideological obsession with parcelling up public services for profiteers. I am glad, therefore, that this service has been taken out of the franchising system and placed under public control, although the fact that it is a consortium of private companies brought about during the partial privatisation of the operator of last resort prevents it from being properly described as full public ownership.
A minimum estimate is that £725 million flows out of the railway every year into the pockets of shareholders. In addition, £200 million each year is wasted through a disjointed system. Breaking the railway up into pieces was necessary to sell it off, but it has created an inefficient railway. A few years ago, the McNulty report found our railways to be 40% less efficient than European comparators.
I do not agree with the Members who favour a “halfway house” option—having a degree of public ownership, but retaining the broader franchising model, along with a public sector operator or two—as that would mean failing to realise the full benefits of public ownership. What is needed is a fully integrated railway that is fully in public ownership. A unified railway in public ownership, serving the interests of British citizens, their communities, their jobs and their businesses is what Labour will deliver, and the sooner we can have a general election to bring it about, the better. I commend the motion to the House.
The Secretary of State for Transport (Chris Grayling)
What a lot of incoherence from the Labour party and the hon. Member for Middlesbrough (Andy McDonald)! Who does the hon. Gentleman think runs the railway today except rail professionals? It is a nonsense.
What we also have seen today is a classic example of the definition of the word “hypocrisy”. This morning, the Welsh Labour Government announced their plans for what will be a public-private partnership to develop a new metro service on the Welsh valley lines. This afternoon, the Labour party at Westminster is trying to censure me for announcing a public-private partnership to improve services on the east coast main line. That says a great deal about what the Labour party has become.
Several hon. Members rose—
Chris Grayling
I will give way in a moment; let me make a bit of progress first.
I am not going to go through, line by line, the process that I have been undertaking in the past few months to reach what I believe is the right position for taxpayers, passengers and employees, but I have been struck by how little Labour Members understand about the way in which such a process must be managed, and how little they appear to understand the financial structure of franchising, rail laws, or the fact that the Government have to operate within the legalities of contracts and other laws.
I believe that, when confronting a failing franchise, the Government have three duties. The first is to ensure that any transition to a new arrangement is smooth and trouble-free for passengers. That was why we engaged an operator of last resort team in the autumn, meaning that, if necessary, they would have plenty of time to plan a smooth takeover. The team registered the name and prepared the website so that they would be ready if this situation arose. That is good practice.
The second of the duties is to ensure that the failing company fulfils its contract with the Government. If I had moved to make this decision months ago, the operator of last resort would not have not been ready and, moreover, I would have left taxpayers short-changed—they would have been given back less money than they should have been. When this contract ends, the taxpayer will have recovered all the money that it is possible to recover under the terms of the contract. That is a key duty of the Government in such a situation.
The Government’s third duty is to act according to due process, to be seen to assess all options properly, and to ensure that they have proper legal protection against any challenge to the decisions that I make. In the last few months, the Department has ensured that all those duties have been fulfilled, and I am grateful to all the members of the team who helped me to make that happen.
Mr Stephen Hepburn (Jarrow) (Lab)
The Secretary of State mentioned the Welsh railways, but the motion is not about the Welsh railways; it is about the east coast main line, which has gone bust three times in less than 10 years. The Government are still obsessed with financing the private sector through taxpayers and railway users, whose fares have gone up by more than 32%.
Chris Grayling
I will tell the hon. Gentleman what the motion is about: Labour Members saying one thing in one place and doing something else in another. Why should we take them seriously when they do that?
Alec Shelbrooke (Elmet and Rothwell) (Con)
Is there not a much bigger problem with the Labour party’s policy of nationalisation? Labour Members are trying to keep us in the single market, but the state aid rules within the single market mean that we cannot nationalise.
Chris Grayling
That is absolutely true. The irony is—I shall say more about this later—that it is the rail unions that have been campaigning against the same European laws that the Labour party wants to keep. This is another example of Labour’s nonsensical position.
Sir Greg Knight (East Yorkshire) (Con)
Will my right hon. Friend amplify something that he hinted at earlier? Will he confirm that he sees the Government as an interim operator of last resort and that this is not a permanent renationalisation?
Chris Grayling
I do not intend that the arrangement will be permanent. What I am saying—I have said this all along—is that when we move ahead with the full future shape of the LNER, we will not do everything in exactly the same way. What has been done on this railway in the past has not worked, and I do not intend to do it again. We will do things differently. We will consider giving the staff a stake in the business, and we will look at a different kind of investment from the private sector. However, as I shall make clear, I believe—the Welsh Government clearly believe—that a partnership between the public sector and the private sector is beneficial to the country, and not something to be cast aside as an evil and sinister attempt to do down passengers.
Chris Grayling
I will give way once more, and then I will make some progress.
Ian Mearns
I am very interested by the comments that are coming from behind the Secretary of State. It is clear that he is in favour of state ownership of UK railways; the only problem is that it is German, Italian and French state ownership.
Chris Grayling
It appears that the Welsh Government—the Welsh Labour Government—take the same view, because they have just awarded the contract for the Wales & Borders franchise to a French state business in partnership with a Spanish-owned private business. Again, the Labour party says one thing in one place and does something else in another.
What we have heard from Labour in the last few months has been a litany of misinformation, misunderstanding and inaccuracy. Let us take the bail-out point. Labour Members claim that there has been a £2 billion bail-out. That is just plain nonsense. It is wholly inaccurate to claim that there has been a bail-out now, when the railway will continue to make a healthy profit for the taxpayer. It would equally be inaccurate to claim that Labour had bailed out National Express when it did not push through nearly £1.5 billion of future premium payments after 2009. The railway carried on making a profit then, and it will carry on making a profit now.
Andy McDonald
Had the franchise run its full term, would the Secretary of State have expected Virgin Trains East Coast to pay the full £3.3 billion in premiums?
Chris Grayling
Any franchise that runs its full term is expected to pay the full premiums, but when National Express went under and there was a further £1.5 billion of premiums to pay, that money continued to be paid by the new operator, in the same way that the premiums that we are expecting will continue to be paid by the operator in this instance. This is my point: the hon. Gentleman does not understand how the finances of the railways work, and that is why the Labour party is so unfit to be in opposition, let alone to govern.
Chris Grayling
I will give way first to the hon. Member for Easington (Grahame Morris) and later to the Chairman of the Transport Committee.
Grahame Morris
I am grateful to the Secretary of State. I hope that he will clear up that point about the last Labour Government and National Express. As a member of the Transport Committee, I heard a former Transport Secretary, Lord Adonis, explain that sanctions had been applied and that that particular operator was not permitted to bid for other franchises, which was a significant sanction.
Chris Grayling
If I am not mistaken, Lord Adonis actually accepted before the Select Committee that that did not happen. He thought that standing up in Parliament and saying that there would be a ban meant that there actually was one. I assure the hon. Gentleman that my Department looked very carefully at this and no evidence of any ban has been found. Moreover, a report from the National Audit Office stated that it had found no such evidence.
Huw Merriman
I was at the same Select Committee sitting. Of course, in the year following those events, the Labour party left office. What did happen at the time was that the then Secretary of State said that National Express would be stripped of other franchises, but of course that did not occur—I dare say that that could not happen legally—and the two franchises remained the same.
Chris Grayling
My hon. Friend is right. It is all very well Labour Members posturing, but we do have to operate within the law of the land, which is a fact that they sometimes miss.
Chris Grayling
I will take two more brief interventions, but then I must make some progress.
Lilian Greenwood
I want to deal with the loss of premium payments. According to the Secretary of State’s own “Short-term Intercity East Coast train operator 2018 options report”,
“the business revenues are estimated to reach around £2bn over the period of interim operation and the forecast income or premium for taxpayers is estimated at around a quarter of a billion pounds.”
That is about £420 million less than had been anticipated under the VTEC contract. Who will fund that black hole in the Government’s finances? Will it be taxpayers or will it be passengers? Will the Secretary of State have to cut other departmental budget lines, or has the Chancellor agreed to bail him out?
Chris Grayling
I am grateful to the hon. Lady for confirming that the talk of a £2 billion bail-out that we keep hearing from Labour is absolute nonsense. The reality is that we will drive this business as hard as we can to keep the revenues as high as we can. But if this railway were going to deliver as much money as was forecast, none of this would have happened in the first place.
Julian Knight
I thank my right hon. Friend for giving way; he is being most generous. He is forensically taking apart the Opposition’s case. Was he struck, as I was, by the fact that the hon. Member for Middlesbrough (Andy McDonald) did not even mention the cost of renationalisation? Across the board, the renationalisation of the utilities and the railways would cost more than £170 billion, and that is money that we simply cannot afford to spend.
Chris Grayling
My hon. Friend makes a good point. The Opposition never cost in their renationalisation plans the value of the trains that are currently privately owned, for example. That amount would be billions and billions of pounds, unless they are planning to nationalise the railways but have no trains to run on them, which is also a possibility.
Several hon. Members rose—
Chris Grayling
I am going to make some progress. I will want to talk about a couple of other issues, for the benefit of the House, but first I want to be clear about what the debate is all about.
The Labour party, in its guise here today, unreservedly hates the private sector. Other parts of the party do not, however. Even Lord Adonis, who has been attacking me for months, said yesterday that he thought that the franchising system was working well. I do not necessarily agree with him on that. I think that some serious changes are going to be needed, as I have said in the House before, but the solution is not to go back to where the French are today. President Macron is trying to move things away from the model that the Labour party is advocating, which would be disastrous for this country. Labour’s vision for the future of transport in our country is precisely the opposite of President Macron’s. When a country has a system that is struggling, losing money and closing routes, Labour’s vision is not the way for the future.
Several hon. Members rose—
Chris Grayling
I am not going to give way at the moment.
I will take no lessons from a party that says that it wants to dismantle capitalism and create a socialist society that looks fondly towards the disaster that has been Venezuela. Madam Deputy Speaker, did you hear the shadow Chancellor talking at the weekend about his vision for a socialist Britain? This is a man who does not even believe in private property. That would be disastrous for this country, and we must stand up very firmly against an ideology that would damage this country—[Interruption] Opposition Members talk about where investment comes from, but they do not understand that if the railway is in the public sector, that means it has to compete for precious capital day in, day out, and year in, year out, with other parts of the public sector—the health service and the education system. The reason why right now we have knackered old trains in the north of England—the Pacer trains that were no more than bus bodies bolted on to train wheels in the days of British Rail—is that British Rail, in the public sector, did not get the capital to invest properly, and that would happen all over again.
I am going to keep my remarks brief, because many Members want to speak. However, I do want to say a quick word about this week’s timetable issues on the railways, since the shadow Secretary of State raised them and they are of great concern to Members.
What we have seen in the last few days has not been good enough. No one should underestimate the logistical challenge of introducing a timetable change. The changes have been made for a very good reason: they mean a big expansion of services across the country. A timetable change of such a scale involves reorganising staff rotas, training staff for new routes, and reorganising how we deploy our trains. It needed months of preparation, and I am afraid that a number of things went wrong, but most particularly the fact that for the second time in six months, Network Rail was far too late in finalising planned timetable changes and left the rest of the industry struggling to catch up. I am not happy with that at all and I have told the leadership of Network Rail that it cannot happen again. But it is perhaps an uncomfortable truth for Labour Members, who keep talking about current problems as an excuse for nationalisation, that the problems that have arisen in the last few days are, to a significant extent, the result of failings in the nationalised part of the rail industry.
I know that many passengers have had disrupted journeys; that is not good enough. I am sorry that that was the case, and everyone in my Department and people elsewhere are working hard to get the problem sorted out. But this has been a major teething problem in what will be a step forward for the railways. Even with the unwanted cancellations, at the start of this week far more services were running than before the timetable change happened.
I know that some people have experienced change that they are not happy with. We cannot deliver everything for everyone, but this is going to mean better journeys for thousands of people up and down the country.
Mr Kevan Jones (North Durham) (Lab)
The right hon. Gentleman blames Network Rail for these problems and calls it a nationalised part of the railways, but he must remember that he is the Secretary of State. One of the main problems was the lack of consultation with the wider travelling public, or for that matter with many local Members of Parliament or local authorities.
Chris Grayling
There is a certain irony in Labour Members keeping on saying that they do not think I am competent and they do not think that the Department is competent, yet saying that they want to take a greater role in running a nationalised railway. That does not add up—it is a great contradiction—and the idea that they would be any better at it is for the birds.
The issue has arisen because of late delivery of the finalised timetable. That has created huge logistical problems, and two things have made them worse in the north. One is the fact that the electrification project on the Bolton line has gone wrong, which needs to be learned from very carefully indeed—[Interruption.] I do not electrify the railways personally. Secondly, there is the behaviour of the unions, which are currently, in the midst of a difficult period, going forward with work to rule in a way that is deeply regrettable.
Several hon. Members rose—
Chris Grayling
I will give way, but then I shall wind up my remarks so that others have a chance to speak.
Stephen McPartland (Stevenage) (Con)
I have been experiencing some of these teething problems due to the new timetable in Stevenage. There continue to be issues, but we are looking forward to more seats, more services and more destinations. I was on a train today from Stevenage. I had to get off at King’s Cross, but it went through to Gatwick and then on to Brighton, so we are excited about the prospects.
We are very proud to have the east coast main line stopping at Stevenage. We would like more services, but we cannot forget the passengers. They do not care whether ownership is private, mutual or public—they just want things to work. I am grateful that the Secretary of State has stepped in to try to make that happen.
Chris Grayling
That is the most important thing. It is why we are pushing forward with the integration of track and train to make the railway more reliable, and it is why we have a strategy to bring in digital technology to improve the performance of the railway. It is also why, for the first time in a long time, we are investing in significant extra capacity across the rail network.
We sat in opposition looking at things that needed to be done but just did not get done, but now we are in government, they are happening. Last week the fantastic new London Bridge station opened. In the summer, I will be in the midlands to open the new Kenilworth station. In July, I will be opening the expanded Liverpool Lime Street station. These are big and positive steps forward for the railway.
In total, over the next five years, we will be investing £20 billion on renewing the current infrastructure and another £9 billion on further enhancements, including the flagship trans-Pennine rail network. We are building HS2; we will shortly be opening Crossrail; we are just opening the Thameslink tunnels through central London; and we have done the Ordsall chord in Manchester. [Interruption.] The £2.9 billion trans-Pennine rail upgrade will begin in the spring of next year and make a massive difference to passengers.
The thing that passengers will probably notice the most, however—this is being funded by the private rather than the public sector—is all the new trains that are arriving. Every single train in the north of England is being rebuilt, starting from later this year, with all the Pacer trains going to the scrapyard, and every train in East Anglia. The new trains asked for by Opposition Members are arriving on the east coast main line later this year, and new trains are coming to the south-west, the midlands and the south. There will be new trains across the whole country because this Government are investing in our rail network. This Government want to give a better deal to passengers, and this Government are going to do what works. All we hear from Labour Members is ideology from a party that cannot quite work out what it is actually talking about, and I think we have one big job for this country: make sure they never get anywhere near government.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. Before I call the spokesman for the Scottish National party, let me say to the House that it will be obvious that a great many Members wish to speak. We have limited time, as there is another debate after this one, and I therefore want to warn colleagues that I will be imposing a six-minute limit on Back-Bench speeches. That, of course, does not apply to Mr Alan Brown.
Alan Brown (Kilmarnock and Loudoun) (SNP)
It is a pleasure to follow the Transport Secretary. He made a speech that will certainly appeal to his Back Benchers, but I would not say it was a forensic demolition of the argument for public ownership of the east coast main line. When the Transport Secretary throws out phrases like “Labour just hate the private sector” and “they would turn our economy into a Venezuelan economy” that seems like smoke and mirrors to me, rather than forensic analysis.
This censure motion relates directly to the handling of the east coast main line franchise. I am happy to support it on that basis, but there has been a further catalogue of errors on the Transport Secretary’s watch. I want to touch on some of that as well, as it builds up to where are today.
It is clear from the opening speeches that there are opposing views across the Chamber on the merits of privatisation and franchising, but one thing that I am confident about is that, as the hon. Member for Middlesbrough (Andy McDonald) touched on, the Transport Secretary wrongly connects cause and effect when it comes to privatisation of the railways. He continually plays up the increased investment in the railways since privatisation and the subsequent increase in passenger numbers as if it all just magically happened when British Rail was broken up and sold off. It can be argued that British Rail was struggling—it did have some poor rolling stock and it was outdated—but that is only half the picture because the Government would not allow British Rail to borrow to invest in the railways. The Transport Secretary says British Rail did not have access to capital, but that was because the Government would not allow it to access capital.
There was another restriction on the railways at the time. Substantial investment was needed following the 1988 Clapham rail crash, and further rolling stock upgrades and the channel tunnel were bleeding money elsewhere that British Rail was not allowed to access. Once John Major’s Government sold off British Rail, they allowed private borrowing, so it is correct that additional money was levered in, but that money was levered in on the basis that it could be recovered only through fares or through Government subsidy. If the Transport Secretary cannot acknowledge that money can be borrowed only because it is underpinned by the taxpayer, either it shows a real lack of understanding of where the money comes from, or it shows his ideological blind spot.
That attitude permeates all the way through the failed east coast franchise. The Transport Secretary has previously more or less shrugged his shoulders in the Chamber and said, “Well, you know what? Stuff happens. Some franchises fail, and that is the way the private world operates. Some fail and we move on, but do you know what? Others will come along and they will be successful, so why worry?”
Christine Jardine (Edinburgh West) (LD)
Does the hon. Gentleman agree that one of the flaws in the east coast franchise, and one of the reasons it failed, is that it was so badly set up in the first place, with the backloading of payments? Does he agree that perhaps we should take this opportunity, as we go into a different arrangement, to look at how we set up franchises to make sure we do not doom them to failure?
Alan Brown
I agree with the hon. Lady. I will address a couple of those points because I agree wholeheartedly with what she says about the tender process and the backloading.
The reality is that private investors and companies either make money out of a franchise or they seem to be allowed to walk away. The Transport Secretary stated at the Dispatch Box that what is now happening is not a bail-out of VTEC. But if VTEC owes £2 billion in track premiums and is allowed to walk away without paying anything, that must by definition be a £2 billion bail-out. That is so simple and it cannot be argued against.
Huw Merriman
Surely the definition of a bail-out is when the Government actually have to pay money to the company, which of course they are not doing. If anything, the criticism of the Government is that they have ripped off the private sector and got more money from it than it could deliver.
Alan Brown
Yes, there we see the ideological blind spot yet again. If somebody owes me £2 billion, I would be writing off £2 billion of debt if I said, “Forget about it. It’s okay.” Let us say it is technically not a bail-out, but the Government are writing off £2 billion of debt that that company owes the taxpayer. The company is walking away and getting rid of a £2 billion liability, and I do not understand why Conservative Members are trying to argue different.
The Transport Secretary has previously justified the predicament by saying the franchisee got its sums wrong. That should not be an excuse, but, as I have repeatedly said, and the shadow Minister also touched on this, it means the Department for Transport also got its sums wrong when it thought the tender was suitable for award. It is not just the franchisee that got its sums wrong; the Department for Transport got its sums wrong, too.
The Government failed in their due diligence. What about the supposed parent company guarantees? Those guarantees clearly have not been worth much to the taxpayer. We do not know what the runner-up bids looked like, but do those runners up have a case against the Government, given they clearly failed in their due diligence by awarding this franchise, from which VTEC gets to walk away?
As the hon. Member for Edinburgh West (Christine Jardine) said, we know VTEC backloaded the track premiums. If another consortium’s bid did not backload the track premiums, the taxpayer might already have made more money, but we do not know whether there was such a bid because it is all clouded in commercial confidentiality. It also shows, yet again, that no lessons were learned from the failed 2012 west coast franchise. The Transport Secretary had a duty to ensure that lessons were learned and properly applied in awarding the east coast franchise, and it is clear that not enough analysis was undertaken.
When the story broke, although VTEC got the sums wrong, Richard Branson blamed some of the reduced numbers on Network Rail. Given the Transport Secretary also has responsibility for Network Rail, what is the truth in that statement? If it is true that Network Rail was the problem, VTEC should be compensated because that is the way the franchise model works. If it is not true, why has the Transport Secretary not come out fighting to disprove Richard Branson’s comments, instead of casually defending VTEC at the Dispatch Box? It is more smoke and mirrors from VTEC.
At the Transport Committee, the chief executive of Stagecoach used excuses such as that the Scottish referendum and Brexit hit the numbers. Considering that our referendum was in 2014, before the franchise was awarded, that is clearly patent nonsense.
Despite all that, the Transport Secretary’s new wheeze to prevent a blame game between the track owner and the franchise holder is a combined partnership model. That might improve things, but at this stage we do not know what the set-up will look like or how it will interact with other services outwith the franchise. Given the repeated Back-Bench Tory support for open access on the line, there will clearly be further complications for such a partnership to address. It is absolutely guaranteed that there will be further issues down the line.
Fiona Onasanya (Peterborough) (Lab)
The Public Accounts Committee found last month that the passenger growth forecast by Virgin and Stagecoach was wildly wrong. In the light of what the hon. Gentleman is saying, does that prove the rail franchising model is broken?
Alan Brown
It certainly proves the current model is broken. If a franchisee gets its figures wildly wrong, it goes back to the due diligence by the Department for Transport, which clearly accepted the wildly wrong and inflated figures. Action is needed to remedy that.
Even if we accept the Government’s partnership model, the Transport Secretary has made it clear he believes that the private sector always operates better than the public sector. Surely then, at the very least, he should allow the public sector to bid for franchises: if he is that confident the private sector will win, he does not have to worry about the public sector bidding. Let the public sector bid and let us see which is the most competitive.
Mr Kevan Jones
Is it not the case that what we are seeing here is not a free market situation at all? In a free market situation, a failing franchisee would lose money, too. The current situation is tantamount to going into a casino, putting on a bet, losing and being given back the stake. Surely risk should be shared with the private sector in future arrangements so it takes a hit, as well as the taxpayer.
Alan Brown
I completely agree. Rail franchise holders have been able to walk away. As has been said, the profits are privatised and the losses are underpinned by the taxpayer. That is not a proper free market model because there is absolutely no punitive action against franchise holders when they fail.
Huw Merriman
If that were the case, why did the share prices of the companies involved collapse?
Alan Brown
Funnily enough, Stagecoach’s share price increased when the Transport Secretary gave a statement from the Dispatch Box in February. Share prices go up and down, which is to do with the overall performance of these companies, and they are very big companies. The whole point of these big companies bidding and providing parent company guarantees is that it is supposed to offset the risk, rather than leaving the risk to the taxpayer.
On the question of state-owned companies or public sector organisations running franchises, the Transport Secretary’s logic completely falls apart when we consider that four foreign state-owned rail companies already operate franchises in the UK. Those companies are making a profit here for reinvestment in their domestic set-up, which is proof that state-run railways can work efficiently.
The previous east coast main line services are further proof that public ownership can work. When the previous franchise failed and was taken into public sector operation, it returned £1 billion in track fees to the Treasury and turned an operating profit of £42 million. So, as has been asked before, why move away from that successful model to one where VTEC can come in with inflated sums and then get to walk away? It is clearly not right.
The southern rail franchise shambles also happened on the Transport Secretary’s watch. The main conclusion of the NAO’s report is that it could not be demonstrated that the franchise has delivered value for money. At the time, the operator blamed Network Rail and the unions, and the Government blamed the unions, completely ignoring the Transport Secretary’s role in refusing to engage with them. The fact is that 60% of the cancellations were due to Govia Thameslink Railway and only 40% were caused by Network Rail. The UK Government set up the model supposedly to deal with the complex infrastructure upgrades, but the Government took all the revenue risks, so the strikes actually cost the taxpayer, because the loss of revenue is underwritten. The Government also awarded the franchise based on an even higher roll-out of driver-only operation, which is what caused some of the disputes.
Ian Mearns
This is not just a problem with southern. Southern is a failing franchise, but northern seems to be on the verge of failing, too, with complaints from passengers across the north of England about services regularly not being provided.
Alan Brown
I agree, and I think that the Government are now looking at northern because it is yet another failing franchise—another sign that the current system is just not fit for purpose.
I go back to the problems with the southern franchise. The NAO report makes it clear that the Department for Transport’s responsibility was large, especially for access to the network and timetabling pressures. Such errors led to an additional £60 million being allocated from the Treasury, following a loss in revenue and other costs. Again, all that happened on this Transport Secretary’s watch.
Chris Grayling
I do not want to deflect attention in any way, but may I remind the hon. Gentleman that that franchise was not set up while I was Secretary of State?
Alan Brown
I am happy to accept that, but all the current problems are happening under the Secretary of State’s watch. He has refused to get involved in trying to resolve the disputes to move things forward. I accept the fact about when it was set up, but he could have been stronger in his leadership and his interventions instead of letting things rumble on.
Another issue that I have with the Secretary of State’s overall competence is his dogmatic refusal to devolve Network Rail to Scotland. The organisation is clearly too big, and it has a bad reputation for delays and overspend, so why would he not want to take the opportunity to devolve it, allowing the Scottish Government to take full responsibility? It has been estimated that a unified management structure could save up to £100 million a year, and that alone should appeal to a Tory Secretary of State, so I just do not understand his dogmatic refusal to engage.
Then there is his lack of engagement with the Scottish Government about the funding for control period 6 in Scotland. The allocation is way less than his regulator recommended for track maintenance and growth in Scotland’s railways. Why is he being so obstinate in refusing to meet the Scottish Government or to consider what might be a fair funding settlement? We also had the recent railcard fiasco. The autumn Budget included the announcement of a discounted railcard for 26 to 30-year-olds, except the Treasury did not put any money into the scheme. In answer to a written question, I was told that the rail industry would pay for it itself, but that was done without discussions with the industry so, lo and behold, the scheme is in chaos. Who would have thought it? Again, that happened under this Secretary of State’s watch.
The Transport Secretary’s slash-and-burn attitude to rail electrification projects and the short-sighted selection of hybrid engines will lead to continued diesel pollution. He has also so far refused to fund or consider meaningful upgrades to the west coast main line north of Crewe. The way that high-speed rail will be implemented means that journeys between Scotland and Crewe will take longer on high-speed trains than they take currently with Virgin Trains, so we need further investment north of Crewe.
I will deviate from rail slightly before I finish. The Transport Secretary’s incompetence is summed up by his proclamations that there will be no border checks post Brexit. The suggestion is that lorries will not be stopped—just like on the US-Canada border—but that just shows that he does not have a grasp of his brief. That is why I am more than happy to support the motion.
Stephen Hammond (Wimbledon) (Con)
It is a great honour to speak in this debate, and I am looking forward to making a short contribution—certainly no longer than six minutes. It is a pleasure to follow the hon. Member for Kilmarnock and Loudoun (Alan Brown). I note that he chastised Government Members for saying that the explanation was simple, but it appears that he does not understand the difference between revenue projections and debt, which is fundamental here. At its heart, the motion seems to be about the east coast main line, how it was franchised, how it is now operating, the solution and also the future of the railways. The divide between the two sides of the House is clear: the Opposition believe that everything should be nationalised, and the Government believe that a public-private partnership will work for the benefit of passengers.
I listened to the opening remarks of the shadow Secretary of State, and I understand his frustration, but surely he appreciates a Secretary of State who comes to the House to announce changes, rather than one who, as happened in the case of National Express, made an announcement on the radio at 7.30 am. When this Government had less talent available to them and I was a Minister, I met a number of people from the rail industry and I can say that to think that the railways are not run by professionals is an insult to the many who work on them. They will have been disappointed to hear the shadow Secretary of State say that today.
This is about rail franchising, the principles on which it is based, and then whether the Secretary of State has followed those principles. After the problems with the franchising of the west coast main line, the Brown review set out the principles for franchising and re-franchising. The principles contain clear guidance on the capital that must be put up by franchisees, on the risks and on the Secretary of State’s duties—duties that this Transport Secretary has surely followed. It is his job to ensure that passenger services are not disrupted and that there is a smooth transition if a franchise is failing. By getting the operator of last resort involved last autumn, services were preserved, and the reality on the east coast main line is that more trains are being run, more money will be generated for the taxpayer and more people are being employed. In addition, the most recent passenger satisfaction survey shows that 92% are satisfied with the privatised railway.
Stephen Hammond
I will happily give way to the Chair of the Transport Committee.
Lilian Greenwood
I want to pick up on the hon. Gentleman’s point about the Brown review. One of its recommendations was that franchisees should be responsible only for the risks that they can manage, but that was not implemented. Does he agree that the failure to do so was one reason why this franchise has gone wrong?
Stephen Hammond
If the hon. Lady reads on, she will see that that recommendation states that franchisees
“should not be expected to take external macroeconomic”
risks. Surely this franchise has underestimated the risk to itself by overestimating revenues. Now, whether the Department for Transport took the appropriate advice is for the Transport Committee to dwell on, but the Brown principles are quite clear.
The next duty on the Secretary of State is to ensure that taxpayers are protected, and this private failure has not resulted in public sector liability or taxpayer cost. The Secretary of State is right in what he says about that.
Finally, there are processes that must be followed. Like it or not, whether someone is a Minister or a Member of Parliament, there are many times when frustration with some public or private service can boil over, but due legal process must be followed. Looking at what this Secretary of State has done, I do not think that anyone can argue that he has not followed the process. He came to this House in February, and before that he set in place the operator of last resort. He has ensured continuity of service and that there will be no loss to the taxpayer. He has taken the appropriate legal advice. Against that test, the motion must fail.
Stephen Hammond
On that point, I will give way to my right hon. Friend, a former Minister of State.
Mr Hayes
I was able to work with the Secretary of State, as the House knows, and I can say with absolute surety that he is a diligent Minister who does indeed know the detail and follows procedure in precisely the way my hon. Friend describes. I do not think it is reasonable to blame the Secretary of State for intervening when we all know that he would have got the blame had he not intervened. He has taken the right steps in the public interest and should not be blamed for doing so.
Stephen Hammond
The former Minister of State is a friend of mine from when we were both in the Department for Transport. I wholeheartedly concur, as ever.
The second part of the motion is about the future, which is where the biggest divide is. I enjoy a good reminiscence as much as the next person. I remember my fifth birthday treat—my parents took me on the railways, because I always wanted to do it.
Stephen Hammond
Yes, steam was still around.
For most of the first part of my professional life, I used British Rail to commute. The idea that it was a paragon of virtue and good service is just nonsense. My memory, which I do not think has deserted me, is of old and failing rolling stock, poor maintenance, timetables that were never operated and a lack of investment. That is not the reality now. Since privatisation, the Government have invested billions in railway infrastructure. Over the next five years, they will ensure that there is another £20 billion—actually, there will be much more than that coming directly from the private sector investing in new rolling stock, which will be the biggest benefit for the public.
Stephen Hammond
I am mindful of the six-minute limit. I have taken two interventions, so I will not take one from the hon. Gentleman.
That private investment, which Labour so heavily opposes, is the very investment that will greatly benefit the people who travel on the trains, about whom all hon. Members should be most concerned. Under Labour proposals, that investment would disappear.
I applaud my right hon. Friend the Secretary of State, who has come to the House with a future rail strategy. It is a great start, but he knows I would like him to go further in a few key areas. I went to speak to the managing director of South Western, which runs the trains around my area. The reality is that Network Rail is causing the bulk of the delays. I am delighted to see public-private partnerships, but I urge my right hon. Friend to go further with his plans to devolve sections of Network Rail, which would provide local accountability and responsiveness to local passenger need. Let us not worry ourselves about nationalisation; let us make sure we get this right. It is ironic that the part of the railway that is most criticised is the nationalised part.
My right hon. Friend the Secretary of State made the point about timetable delays and one or two other issues. The projects division inside Network Rail is responsible for many good works, but it is also responsible for a number of delays. I urge him to get the private sector more closely involved in the design and concentration of projects.
Finally, I am pleased to say that this motion fails at the most basic level. It is wrong to censure the Secretary of State, who has followed the right processes. The last thing this country needs is to go back to the 1970s. It needs to look forward to the 2020s, and nationalisation can never be the answer.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
I am pleased to be allowed to speak in this very important debate. I start by thanking the staff on east coast rail who, during the eight years I have been in the House, have been unfailingly helpful on my twice-weekly journeys to and from Newcastle. They have been unfailingly cheerful and unfailingly efficient despite the turmoil that successive Conservative-led Governments have put them through.
Speaking of the workers, I would not normally support singling out one worker—in this case, the Secretary of State for Transport—for criticism and in effect a fine for a collective failure of this Government, but if anyone is responsible for that failure, it has to be him. What is more, it is not only a failure of competence; more importantly, it is a failure driven by ideology—the Secretary of State’s extreme free market ideology. If he wants to play ideology at dinner parties around the country, that is his decision, but here he is playing ideology with the east coast main line, a critical piece of national railway infrastructure serving more than 20 million passengers per year and contributing more than £300 billion annually to the UK economy. Also, independent research shows that investment in it could generate more than £5 billion in additional GDP for our country and our region. The Secretary of State’s ideology is destroying jobs in my constituency, for which he must be held accountable.
Hon. Members may have heard me mention that before entering Parliament I spent 23 years as an engineer. My last job was for Ofcom, the communications regulator. As part of that, I spent a lot of time looking at the economics of networks and the benefit of competition, which is where I shall focus my remarks.
Free markets require competition. Without competition, markets become monopolies. I hope we can all agree that private sector monopolies are bad—there are no interventions, so we agree. On the other hand, public sector monopolies can be run in the interests of the many, not the few. Many believe that rail is a natural monopoly. I agree. Railways were born in my region. The Rocket—the first commercial locomotive—was built in Newcastle by the Stephensons, and will return to Newcastle for the Great Exhibition of the North this summer.
From the very start, it has been impossible to run railways competitively in the private sector. The Office of Fair Trading states:
“Competition is a process of rivalry between firms seeking to win customers’ business over time by offering them a better deal.”
What better deal was there under Virgin? Were there more trains? No. Were there better trains? No. Were there better services? No. People could argue that the uniforms and the advertising slightly improved, but does that justify the huge costs involved in bailing out the private sector three times in 10 years? Does that justify the huge costs involved in regulating private sector companies to stop them exploiting their monopoly positions? Private sector companies always abuse monopoly positions. They cannot help it. Did it give us the investment in transport in the north-east that we need for our economic development? Transport for the North estimates that we need £27 billion invested in our transport infrastructure. Did it justify the huge costs involved in designing multiple tenders and the exposure to legal challenges? Did it justify the uncertainty that has been so bad for staff and passengers? Absolutely not. The Conservatives are ideologically constipated on free markets to the extent that they cannot see the reality of our rail network and its needs.
Ian Mearns
I am grateful to my hon. Friend and neighbour for giving way. The Government are ideologically wedded to the privatisation model, but they must accept that, once the regular public subsidy for the railways is netted off, the amount of private sector investment is rather small.
Chi Onwurah
My hon. Friend and neighbour is absolutely right, which shows why this idea that this is a competitive market is a travesty. There is really no investment. More importantly, what little investment does take place is not at these companies’ own risk, because they are bailed out. Yet so infatuated are this Government with private sector monopolies that they do not seem to see that. We see the same thing when they deal with the tech giants: this Government are happy for private sector monopolies to walk all over UK citizens and yet the Government continue to stuff these companies’ mouths with gold.
We need a Government who recognise the role that the private sector can play in many industries and many businesses, but also recognise the importance of delivering natural monopolies through the public sector in such a way that citizens, consumers and passengers benefit. We need a Government who are not in hock to the private sector. As this Government are clearly incapable of understanding the very basics of network economics, I hope they will give way for a Labour Government who will do.
Mrs Anne-Marie Trevelyan (Berwick-upon-Tweed) (Con)
It is an honour to follow my near neighbour, the hon. Member for Newcastle upon Tyne Central (Chi Onwurah), who always speaks wisely on all things engineering and technical. I long to be as knowledgeable as she is.
I wish to thank the Secretary of State for taking this difficult decision to bring the east coast main line back into public control while we find a long-term, sustainable solution for the train line that takes me and my constituents up and down the length of our great nation, week in, week out. As he knows well, I am the MP for the northernmost English constituency, which lies some 350 miles north of us here, and so I am well aware of the crucial importance of good transport infrastructure to ensure business investment can flow into my constituency. That will help to grow strong, long-term successful businesses, which create great jobs for my constituents. This is one of the most vital investments the Government can make.
I have talked endlessly, and partially successfully, about why dualling the A1 from Morpeth to the Scottish border—[Laughter.] I heard that! I have talked about why that is so vital for economic growth and inward investment. Indeed, the Department for Transport based its financing decisions on that economic development model, which was so important to justifying why a rural county needed to address 40 years of lack of road investment. The Secretary of State has listened patiently to me over many years and has supported driving forward that investment. Obviously, we wait with bated breath for the sight of diggers, as they get closer in the months ahead. The Department can be assured that my constituents and I will not rest until the whole road is invested in, because that is a crucial way of linking up north Northumberland to Edinburgh, Newcastle and the rest of the UK.
It is not only road investment that is vital; the east coast main line, linking Edinburgh to London, is an efficient and speedy service, and it has two key stopping points at Berwick-upon-Tweed and at Alnmouth, which is Alnwick’s railway station. With recent and continuing improvements in parking provision at both those stations, we have seen substantial increases in usage by my constituents, who travel north and south for business, study and pleasure. It is a crucial rail transport link for my constituents, of all ages, so it is of the utmost importance to me that this train line is run sustainably and that the long-term security of the east coast line’s investment in rolling stock and the management of fares to ensure a competitive and effective train line is assured.
With the Ministers here, it would be remiss of me if I did not highlight the continuing campaign by my constituents to reopen the Belford station, which sits between Berwick-upon-Tweed and Alnwick, to create more opportunities for investment in that 1,000 square miles of rural constituency. Good rail links bring investment and economic growth, and we must continue to be able to invest in the line.
I remember our nationalised railway systems of old; one of my granny’s Sunday afternoons involved seeing whether we could get a train that went somewhere and could get us home in time for tea—it did not always work. The Labour’s party’s vision for train provision, which does not put the customer at the centre—
Mr Kevan Jones
I am sure the hon. Lady remembers British Rail, because we are still travelling on some of the 125 rolling stock first introduced by British Rail.
Mrs Trevelyan
It is not so much the rolling stock that I remember as not necessarily getting back for tea because the train just did not go—that used to cause my grandmother and I some disconcertion. The railway timetables were more an idea than a reality a lot of the time. That is a childhood memory, and the Labour party’s vision for train provision, which does not put the customer at the heart of all policy, will not work. The customer pays the fares and must be at the centre of those decisions. So I believe the Secretary of State has taken the right, difficult decision to use his operator of last resort powers to get the London North Eastern Railway—that lovely brand, which I believe is on a poster in one of our bookshops in Alnwick—up and running to ensure that my constituents and I can rely on it and we invest for Northumberland, knowing that our train service will be sound.
Paula Sherriff (Dewsbury) (Lab)
Thank you for calling me in this important debate, Madam Deputy Speaker. Like my party’s Front Benchers and others, I really am very happy to see this Government, with no hint of irony, realising the virtue of a rail franchise being taken into public hands, operated in the interests of the many, not the few. Let me be absolutely clear: the failure of Virgin East Coast, and this Secretary of State’s handling of it, shows this out-of-touch Government at their self-serving worst, looking after their rich pals in big business while people across the country are left to pick up the pieces. In January, we were offered the ridiculous suggestion from Virgin that the Government’s bail-out of the east coast franchise was somehow the pragmatic solution. Why is it that this Government can always somehow find the money to bail out their friends in the big corporations but refuse to help increasingly frustrated railway passengers, such as the ones who contact my office every day? What is pragmatic about that?
I have long been a supporter—since before I came to this House—of putting our country’s railways back into public hands. Real pragmatism would involve just that: giving power and control to passengers—giving the public ownership of our railways, because the utter failure of the franchise system is there for all to see. I worry about the precedent that the Secretary of State has set with the east coast line to companies such as Virgin, sending out a message loud and clear, “Under this Government, no matter how badly your business is doing, don’t you worry, we’ll be there to make sure the taxpayer looks after you.”
The public are paying these big companies more and more of their hard-earned money in exchange for a shoddier and shoddier service. Even just last week, I and other regular users of Virgin East Coast received a rather odd email. It was Virgin congratulating itself on the service being
“in a really good position thanks to the positive transformation we’ve started”.
Perhaps I missed that. I am sure regular East Coast users, both in this House and outside, will have been happy to see that Virgin was signing off with a good crack at a joke—that is all it could have been.
Our railways are in a significantly worse state than they were in 2010, and it is not just Opposition Members saying it; the public also know that things are now so bad that something has to give. Some 76% of the public and 90% of Virgin East Coast staff agree. What this Government just do not get is that their party’s privatisation of the railways 25 years ago has been such a deep, unmitigated disaster that the public are now willing to try something different. They are, frankly, sick of seeing a Secretary of State who comes to this House time and again to tell me and colleagues that our constituent’s experiences of travelling by train—trains overpriced and late, people packed in like sardines—are not accurate and do not reflect the real picture.
Every week that this Secretary of State remains in his position—I note he is no longer in his place; perhaps he has something better to do—is yet another week in which mistrust of his Department grows deeper and deeper. Grand promises to improve the daily commute for people in my constituency are being made in one breath, only for the Secretary of State to turn his back on passengers in another.
“It is a bit of a cheek for a Member…to lecture and question us about rail investment when the Government have made so many promises that they have failed to deliver.”—[Official Report, 5 December 2006; Vol. 454, c. 221.]
I hope Conservative Members agree, because those are not my words; they are the words of this Secretary of State when he was the Conservative shadow transport spokesman, more than a decade ago. We do not even have to go back 12 years with this flip-flop Transport Secretary. In 2016, he said that nationalisation is “an expensive, reckless idea”, and in 2017 he called it Venezuelan. This January, he said, “We must never forget how badly nationalisation failed key public services.” Now, four months later, he talks of his excitement at bringing back one of Britain’s most “iconic” state-run brands. Well, the chickens really have come home to roost, have they not? If he cares to return to the Chamber, will the Secretary of State tell the House why he suddenly changes his mind on nationalisation and his seemingly long-held principles against it when nationalisation becomes a means of bailing out Richard Branson?
In Yorkshire, what have we had from this Secretary of State? My Labour colleagues and I have come to the House time and again to demand a fairer deal and highlight the concerns of our constituents, only for Transport Ministers to turn their backs callously on northern commuters. We have had the downgrade of Crossrail for the north. Yorkshire has been hit with the biggest fare increases anywhere in the country. We have seen the Secretary of State ducking and diving meetings with me and colleagues when we simply wanted to discuss our constituency concerns. If we continue to say that we will cut the Secretary of State’s pay if he continues with some of these incompetencies, I am worried that he will end up on less than the minimum wage.
Northern passengers have been told that twice as much is spent on them as is spent in the south, although through a rather imaginative calculation, that ignores London. Just this week, we have seen new timetables cause complete meltdown throughout the region, with barely an eyebrow raised in Westminster. And now this: an accidental renationalisation. On behalf of my constituents, who have quite frankly had it with the state of public transport across Yorkshire, I say this: surely the buck has to stop somewhere. The Yorkshire Post recently took the unprecedented step of calling on the Secretary of State to resign; with a record like his, surely the right hon. Gentleman should and must consider his position. The Opposition stand ready to transform our country’s railways for the better, and my constituents are crying out for it. Surely that is not too much to ask for.
Iain Stewart (Milton Keynes South) (Con)
It is a pleasure to speak in this debate. As a member of the Transport Committee, I hope to inject a rational perspective into proceedings. As has been mentioned, the Committee is currently scrutinising this issue. I should add the caveat that our proceedings are still under way and we might receive further evidence later.
The first point I wish to make is that this is not a failing railway in the sense that most passengers would understand it. It operates efficiently; there are high levels of passenger satisfaction; there is growing usage of it; and, yes, there is investment in it. Under Virgin, many of the trains have been refurbished and, although I appreciate that this is not a direct part of the franchise, King’s Cross station has been transformed in recent years, so the passenger experience is being enhanced.
The issue at the heart of this debate is that something went wrong with the revenue projections for the line. That is what we need to scrutinise. It is important to understand the nature of the east coast main line franchise. It has a much larger discretionary element than most other rail franchises, by which I mean that the passengers who use it have many more options for making their journeys. Those options are both on the railways, with other train operating companies running services on large parts of the line—at the southern end of the line, Hull Trains and Grand Central offer alternatives to the Virgin Trains, and further north there is TransPennine Express and ScotRail, meaning that there is a discretionary element to which service passengers use—and, because of the long-distance nature of the network, passengers can choose non-rail alternatives, including flying between Edinburgh and Glasgow or driving between some of the key towns and cities. That makes it much more difficult for anyone in the public or private sector accurately to forecast revenues over a lengthy period. I have had conversations with other train operating companies this week, and they said, “We don’t bid for these long-distance franchises because of that element of uncertainty.”
Chi Onwurah
The hon. Gentleman is saying that the issue with the east coast line is that there is competition and that Virgin could not handle that competition so should be bailed out. Does he realise that he is undermining the entire argument, because he is saying that when there is competition, franchising fails?
Iain Stewart
No, my point is that Virgin is making a profit on the line and is very able to meet the competition, but what is difficult to forecast accurately—[Interruption.] If the hon. Lady stops chuntering and listens to what I have to say, I will answer her point. The revenues have grown, but they have not reached the very ambitious levels that we set. Many factors behind that are completely unrelated to the rail industry. I shall touch on some that are related to the rail industry, but those that are not include fuel costs, which are considerably lower than was envisaged at the time the franchise was let—
Iain Stewart
No; if it is cheaper for people to use motor vehicles, they are more likely to do that than to use the train. There is a question mark over the extent to which Network Rail’s non-delivery of some of the upgrade projects is a factor; that is part of the picture about which I do not yet know and is something that we will scrutinise. There is also something more fundamental happening in the nature of rail usage, relating to different travel-to-work arrangements and work patterns. There is currently no clear idea of what is behind that, but it will affect other franchises, as well as the east coast line.
Kwasi Kwarteng
My hon. Friend and I served together on the Transport Committee for three years, and his speech is compelling and highly knowledgeable. Does he feel that nationalisation should be part of the solution to the problems we face?
Iain Stewart
Absolutely not. I will come to that point and refer to the evidence that the Select Committee heard on Monday from Iryna Terlecky, who has many decades of experience in the rail industry.
The shortfall in projected revenue would have happened irrespective of who owned and ran the railway. The difference is that under a nationalised system, the public purse would have taken an immediate hit from the loss of revenue, whereas under the system we have, the parent company and the bond that it put up has taken the brunt of it.
Iain Stewart
No; forgive me, but I have three minutes left and the hon. Lady’s previous intervention was not really up to scratch.
There are of course lessons to be learned about how we base our revenue projections over a long period. There need to be more cautious forecasts of rail revenues over the long term. Indeed, I think that that has already happened in respect of some of the franchises that have subsequently been let. We need to revisit some of the Brown recommendations on the balance of risk that an operator takes against extraneous factors that are not to do with the direct operation of the railway. In the end, though, the franchise system does work; it does deliver enhanced performance. I, too, remember what British Rail was like when I was a child, and it was not a glorious existence.
Let me conclude on what I hope is a more consensual point. I am a sentimental old railway buff and I cheer the reintroduction of the LNER brand. LNER was one of the big four private companies that transformed this country’s rail system in the first half of the previous century. May I make one little plea? LNER had iconic liveries, from the apple green of the Flying Scotsman to what is called the garter blue of the Mallard and the Gresley class, and the teak colour of the carriages. Please can we have that back and rekindle the romance of the railways of those years? I am absolutely certain that that would help to keep passenger numbers high and ensure that this important railway line has a bright future.
Several hon. Members rose—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I am afraid that I have to reduce the time limit to five minutes.
Daniel Zeichner (Cambridge) (Lab)
It is a pleasure to follow the hon. Member for Milton Keynes South (Iain Stewart) and other expert members of the Transport Committee who have spoken in this debate. I am only sorry that the Secretary of State has left the Chamber—left the dock, effectively—because I was rather hoping that we might discuss what we will do with the £2,400. I was going to suggest that we should perhaps buy him a bus pass, because I am very keen on moving from rail to bus. I was actually going to say something nice about him as well—only one nice thing, I hasten to add—because I was going to thank him for raising the vexed issue of the timetable changes. Many Members will have heard their constituents’ concerns about the way in which the process has been handled. Of course, this is a major set of changes—we understand that—and such change is not easy to implement.
I was on the “Mann in the Morning” programme on wonderful Radio Cambridgeshire this morning, listening to people who have had bad experiences on the rail line from Cambridge. Those experiences were immediately blamed by the Secretary of State on Network Rail. We are now in the process of no longer transferring risk within the system, but transferring blame. It is not all about Network Rail; the train operating companies must bear some responsibility. If we get a chance to look into what happened around this timetable change, we may well find that that is the case, too.
The positive side is that people in the industry want to make it work. The message from passengers that I heard today is that they want the system to be run as a public service, and that is also the ethos that many in the industry want. We should try to focus on that because, despite privatisation over 25 years, most people in the rail industry still have a public sector ethos. If we could celebrate that and make it work, we would do much better.
I do not agree with Members who say that the franchising system works. I am deeply sceptical about it. A number of reasons have been raised for the failure of this particular franchise. Network Rail is, of course, immediately blamed for ideological reasons. In fact, the evidence given to the Transport Committee rather suggested that the relationships were “not very clear” and that there were some “implicit” understandings rather than “contractual” understandings. If we are writing big contracts, we do not do it like that. Network Rail was not to blame for the failure of this particular contract. It was probably down to a decline in the number of season ticket sales because this route, as has been said, is volatile.
If we are to return to the Brown recommendations and say that train operating companies should not be subjected to these big macroeconomic risks, I would ask what kind of risk transfer is really taking place. These are the very risks that we face, and other businesses have to cope with such risks.
Helen Goodman
This discussion about the over-bidding on the franchise reminds me precisely of the discussion that we had with the mobile phone companies, which came along, cap in hand, having overbid for their spectrum. It was clear that the system was just not working because people wildly overbid.
Daniel Zeichner
I am afraid that my hon. Friend is right. That takes us into a much broader philosophical discussion about how we get investment into our key industries, and that applies to a whole range of discussions. Just look at the huge number of consultants, lawyers, contracts and all the rest of it that are involved. We are told that some 300 people are employed just on trying to sort out who is responsible for delays and that hundreds of millions of pounds are lost on this process. Frankly, do we really need all of that? What are the train operating companies actually delivering, apart from the delightful colour changes that have been suggested? If we ask passengers what they want, they say an integrated system. They are talking not about transferring risk or arguing about blame, but about getting the system to work. Let me conclude with a few words about the so-called future partnership model.
Mr John Hayes
The hon. Gentleman is, as ever, making a valuable contribution. One of the most interesting things that has come out of this debate, thanks to him and to my hon. Friend the Member for Milton Keynes South (Iain Stewart), is the business of how we integrate transport policy. We have heard that a competitive element is associated with road and rail and that all kinds of other factors affect projections and estimates. Perhaps the Minister will take that away from the debate. There has always been a call for an integrated transport strategy, and every Government have wrestled with it. Perhaps this event will stimulate and catalyse just that sort of approach.
Daniel Zeichner
Once again, the right hon. Gentleman, an experienced former Minister, speaks very wisely. In the end, this is a slightly false debate. Of course there will always be a role for the private sector in transport; the question is whether we have to build in competitive mechanisms in this kind of way. We could probably repeat the same discussion with regard to buses and other parts of the transport system. We need investment—of course we do. It is a straw-person argument to point to British Rail 30 years ago. Of course we knew that there was underinvestment in British Rail 30 years ago. The question is what the system will look like in the 21st century and how we will unlock the resources that we need.
Let me turn now to the partnership model, which, I am afraid to say, the Secretary of State has hidden behind. The Transport Committee heard pretty clear evidence on Monday evening from experts in the field that that approach does not look like the best one to try out. Apparently, some 20 passenger, freight and open access operators use the line. Once again, this is a recipe for argument and dispute about who gets priority and how the whole thing will work. It seems to me that this was more an excuse for the Secretary of State to hide behind to spare his blushes, because he could not bear to admit the fact that the line was coming back into public ownership.
Finally, let me take this opportunity to disagree with Lord Adonis, who spoke very engagingly to the Transport Committee on Monday in defence of the franchising system. At the end of his evidence, he gave a warning to me and people in Cambridge who use the line into King’s Cross, explaining how difficult it could become because of the various competing priorities within this partnership. I had to tell him that that was already happening. A year or so ago, I had the pleasure of having a cab ride to King’s Cross—one of the best parts of being a Member of Parliament is that I get to ride in the front of the train. It was an extraordinary experience and very different from the mixed experiences as a passenger. I well remember the train halting from Cambridge as it joined the east coast main line, and the drivers pointed out that there are regular disagreements and disputes about priority at that point. These are very real issues.
Let me return to the people who really matter. I am not convinced that the passengers who were fuming on the station platform in Cambridge this morning are that bothered about the intricacies of franchising approaches and who is to blame. They want a railway that works and a railway that is affordable, and that should be the aim of everyone in this House.
Alec Shelbrooke (Elmet and Rothwell) (Con)
The problem this afternoon is that we are just going to fall into the ideological arguments about nationalisation and privatisation, rather than getting down to some of the key causes of why we are in this position today. Quite frankly, the nationalisation argument has been blown out of the water with the single market argument, as I said earlier.
I am pleased to be following the hon. Member for Cambridge (Daniel Zeichner) because he raised the issue of timetabling, which has affected all of us. I have certainly seen the comments from my constituents who use the trains and heard about the struggles that they have had. What is at the heart of the timetabling issue? Well, train companies normally plan their timetable six to nine months ahead, but the delays of Network Rail meant that they had two to four months. It is therefore not exactly surprising that they ended up in a situation in which the timetabling is not exactly working as smoothly and efficiently as we would hope.
Network Rail had a large part to play in where we are today. We have made comparisons with the west coast main line, and talked about Virgin keeping the contract and Stagecoach making the profits and so on, but Network Rail simply has not delivered on the basis that was laid down in the bids that were put forward. Companies made promises about power upgrades in their bids, but they have not occurred. They also promised to eliminate bottlenecks, and that has not occurred.
Several hon. Members rose—
Alec Shelbrooke
Just give me two seconds. When we look at the money that was earned, some £1 billion was returned in three years compared with £1 billion in five years under nationalisation.
Alan Brown
The hon. Gentleman is talking about the problems caused by Network Rail. Will he remind the House who was in charge of Network Rail for the Government?
Alec Shelbrooke
I am delighted that the hon. Gentleman has made that point. Indeed, that is the problem with a nationalised company. Many people have said, “Oh, it’s the Secretary of State’s responsibility in a nationalised company, ” but that is not how it works—it is not how it has ever worked. On the one hand, people are saying that the Secretary of State should take complete control of the railways, and on the other that he should get out. People who are running a nationalised operation do not share the sense of urgency of those in the private sector. There are litanies of delayed or missing projects under Network Rail.
Ian Mearns
The hon. Gentleman should just remember that Railtrack was privatised. It failed, and the Government had to take it back in-house to save the railway network.
Alec Shelbrooke
Railtrack failed due to the vandalism of John Prescott when he was Transport Secretary. He took advantage of the opportunity when British Rail’s failure to keep its system upgraded and safe culminated just three years into privatisation under Railtrack. The track that broke, which caused Railtrack to fail and to be transformed into Network Rail, did not degrade in the three years of privatisation. It broke as a result of a catalogue of rail mismanagement that led up to that point. It is one of the biggest disgraces—
Alec Shelbrooke
I am sorry, but I have taken two interventions and I will not have any more.
It was a disgrace to use that failure as an opportunity to act according to political ideology. I am very clear on that point. One of the fundamental problems with the railway is that we have got to a point where we are looking back through rose-tinted glasses. I recommend to everyone—perhaps some people have seen it—a programme on Channel Five at the moment called “InterCity 125: The Train That Saved Britain’s Railway”. It is fantastic. I really enjoyed the first episode. What was the first part of that episode? The state of the railways in this country when they were under British Rail, and the lack of investment by Governments of all colours during that time.
We talk about the east coast main line. We are going back to a period when, given the resources that were available at the time, with the overhead powering, the gantries were as far apart as they could possibly be, so of course high winds displaced the wires. These were all failures of trying to deal with a nationalised company that has to compete for its money with the health service, benefits and pensions, education and all the other things the Government have to spend money on. They were also due to the fact that whatever those failures were, staff would still come to work the next day and get paid, because they did not have the responsibilities that they would have had in the private sector.
I am being very critical of Network Rail, and one reason why is that I have had it up to here—up to the top of my head, for the benefit of Hansard—with Network Rail. For several years, this Government—under the then Chancellor of the Exchequer, George Osborne—delivered a grant to Network Rail to put in place a bridge at Dartford station in my constituency under the Access for All scheme. I have constantly been in meetings about that with Network Rail, and I have heard excuse after excuse for why it is not happening. Fundamentally, whatever the reasons, it is getting to a stage where it could not manage its way out of a paper bag. I have had enough—my constituents have had enough—of Network Rail staff’s failure to take responsibility and attempts to pass the buck. There is only one reason why we have problems with electrification: the poor management and poor running of Network Rail. I have kept quiet about my criticisms of Network Rail to this point, but not today, because another failure has led to the contents of a rail franchise bid not being delivered.
Like many Members, I have used the east coast main line regularly, and none of us can deny that the carriages have been upgraded. They were refurbished. The experience in those carriages is more pleasant than it was in the recent past, and that shows that there has been investment.
Every single time we talk about an upgrade, Network Rail puts it back. Now we are looking at December 2018 before the latest set of figures come through. It beggars belief that when we see the failure of such a major company at the heart of our railways, which is charged with delivering the infrastructure for the rail operating companies to work on, nothing ever happens.
The motion states that the Secretary of State’s pay should be cut. In my view, we might instead start thinking about censuring the people who are putting together project plans but not delivering them.
Tommy Sheppard (Edinburgh East) (SNP)
I always travel by train when I can, and with respect to colleagues from the north-east of England, I am going to lay claim in this debate to be Virgin Trains East Coast’s best customer. I have made 32 return journeys from Edinburgh to London in the past 12 months. That is the equivalent of circumnavigating the globe in a Virgin train and it gives me quite an insight into the service.
I pay tribute to the staff of that service who have served me over these years—the people who drive the trains, who check the tickets, who serve the drinks, who provide the information—and also the many hundreds of staff who work in the depots, cleaning and engineering these magnificent machines. I think it is a shame, the way in which they have been treated, and that they are constantly being told that their boss and their uniform is changing, rather than being valued for the service that they provide.
We have heard a lot about ideology in this debate. The Government seem convinced that their opponents are motivated only by ideological dogma. Anyone reviewing the text of this debate surely can only conclude that the reverse is the truth—that in fact, it is the Government who are so blinkered by ideological dogma in favour of privatisation that they refuse even to consider the possibility of a contemporary public sector alternative. That seems to me very regrettable, because there are many positive reasons why the public sector alternative should be considered. I just want to name two.
The first reason is that it would allow integration of the management of the service and remove the ridiculous separation between the train and the track that is responsible for many of the problems that we are facing in the operation. What better way to ensure that the track serves the demands of the train service than to place it under the management of the same people who manage the train service? The idea of separating a vehicle from what it is travelling on might make sense with a road network, where there are lots of different avenues to travel, but the train only has one track on which to get from A to B, and the management of those things ought to be integrated. That could happen, in a public sector organisation.
Alan Brown
Clearly, I agree with the points that my hon. Friend is making. Does this not further reinforce the argument that, in Scotland, Network Rail should be devolved to Scotland, to allow the Scottish Government to have that integration he is talking about?
Tommy Sheppard
Indeed, and I will come to that later.
The second big positive of having a public sector operator is that it will allow for much greater investment—we would not have to have investment that was contingent on franchise payments and on levels of use; we could just take a serious decision, as a grown-up country, and say, “We need to rapidly and significantly invest more in our rail network if we are to bring it up to scratch and achieve the type of global service that our competitors can achieve.”
I represent Edinburgh East, including the world-famous Waverley station. I admit there have been some improvements over the past few years—we have seen the market share of the rail journey from Edinburgh to London rise to a peak of 37%—but that still leaves nearly two thirds of the people who make the journey from Edinburgh to London taking the plane. Surely that is a ridiculous situation, and we must take urgent action.
The industry will tell us that, when we get the journey time down to four hours, that is a tipping point and that will take market share to around 40% but, to get the train as the majority means of transport between Scotland and London, we will have to reduce the journey time to three hours, and that can only happen with massive investment in a high-speed network and it can only happen with a new fleet of trains. So I want the Minister to confirm that these changes that are taking place will not in any way affect the delivery in December of the roll-out of the new Azuma fleet on the east coast line and that he will engage seriously and purposefully with the Scottish Government in discussing the investment required for HST in the future.
The Scottish Government, because of devolution, have some responsibility for the rail network in Scotland, yet as with so many other things it is working in a straitjacket that is set by this place. We have repeatedly said, over a long period, that the franchise for rail services in Scotland should be run by a public sector operator. We tried, in a debate on the last Scotland Bill, to get the whole regime transferred to Holyrood, but could not find support from any other parties in this Chamber. There is now a golden opportunity, however, for the Department for Transport to take seriously the Scottish Government’s request. Now we have the ability to put a public sector operator into the tender process, there is an opportunity in Scotland—if they will not do it here—to use this to experiment to see how a contemporary public sector operation takes place. The Thatcher Government began the attacks on British Rail when, as a service, it was still reeling from the attacks of Beeching and the massive line closures. We do not know what a public sector operator would be like now if privatisation had not happened. Maybe—just maybe—we might have had trains as good as people have in France and Germany.
This is a motion of censure, and I find it surprising that the Secretary of State has absented himself from the debate. This is not a normal motion on a matter of policy; it is a motion that questions the capability and commitment of an individual. At the very least, he ought to have the decency and respect to be in attendance in this Chamber to hear the case against him.
Kwasi Kwarteng (Spelthorne) (Con)
I am grateful to you, Mr Deputy Speaker, for calling me to speak in this very important debate.
We have had a to-ing and fro-ing about the merits of nationalisation, the merits of privatisation and all the rest of it, but what has struck me about the debate is the hypocrisy, I think, that I have heard from many Opposition Members. It is a strong word, used by my right hon. Friend the Secretary of State in his opening remarks—
Mr Deputy Speaker (Sir Lindsay Hoyle)
Order. Let me just say that “hypocrisy” is not a word that we would use against fellow Members, as we are all honourable Members. I am sure you would like to withdraw it.
Kwasi Kwarteng
I will withdraw it, although if you were to look at the record, Mr Deputy Speaker, you would see that the word had been used earlier in the debate, so I was just repeating it, but we will leave it there.
Mr Deputy Speaker
If I might help, I was not here earlier, and I can only make a judgment on what happens when I am in the Chair. I am sure you would respect that.
Kwasi Kwarteng
Thank you very much, Sir, for your very mild and modest rebuke.
I find it extraordinary to hear speaker after speaker look to the network in France, in Germany and in other countries and say that things are operating well there, when clearly, if one understands anything about the EU competition policy or the single market, the whole drift of EU regulation in the rail network has been away from the nationalisation that has been lauded by Opposition Members.
Alec Shelbrooke
I am sure that my hon. Friend recognises that President Macron, a centre-left politician, has recognised that the French railway system is completely unsustainable, and that has led all the workers out on strike.
Kwasi Kwarteng
My hon. Friend makes an excellent point that goes to the slight craziness of a lot of our debate. It is clear to me that the partnership with the private sector has put far more investment—billions and billions of pounds of investment—into the network than would have been the case if it had remained under public ownership. We all know the budgetary pressures. We all know the budgetary situation in 2010, when we had a deficit of £160 billion. It does not take a particularly sophisticated mathematician to work out that, if we had had the rail network in public ownership, as well as public ownership of vast swathes of industry, the budgetary position would have been a lot worse than even in 2010.
Mike Amesbury
Surely the way forward in this debate is what works. In the past 14 days alone, Northern Rail has cancelled 1,159 trains—full cancellations. It is complete chaos in my constituency. That demonstrates that the current franchise system is not working. We need public ownership and public control.
Kwasi Kwarteng
Everyone in this Chamber realises that the franchise system is not perfect, and I freely admit that. However, compared with what was operating before under the nationalised system, we have seen massive improvement in terms of investment and a doubling of passenger journeys since 1995. Under the old system, one of the principal jobs of the Government was, in effect, to manage this huge industry. Half the Secretary of State’s time was spent talking to the unions about the wage bill. There were civil servants running the network who were not rail professionals. The shadow Secretary of State said that we need to get more professionals running the system. His proposed solution to that was to nationalise the entire network. That is essentially giving control to the man or woman in Whitehall, who, despite their qualifications and skills, are simply not rail professionals; everyone can see that. It is extraordinary to say that we need more rail professionals to handle the network and operate the system, and then to say that the Government should nationalise the whole thing. There is an inherent contradiction in that.
When I entered this House, I was very lucky to serve on the Transport Committee for three years. We covered a great deal of ground in that time. We went to the EU—to Brussels—a number of times. It is really disappointing, frankly, to see that the debate has regressed since I served on that Committee, under the chairmanship of the hon. Member for Liverpool, Riverside (Mrs Ellman). All parties in this House were broadly in agreement with the franchise system. The debate was about how we were to manage that system and how the franchises should operate. People have mentioned the Brown recommendations, the majority of which, as I remember, were supported by the Committee. We were moving forward. There was political consensus in this House and across the country.
Now, we are faced with a radical Marxist, or whatever you want to call it, party—[Interruption.] I am sure you would not call it that, Mr Deputy Speaker. We can call it lots of things. We are confronted with a party that is openly suggesting that nationalisation is the answer. [Interruption.] The shadow Secretary of State says, “The public are agreeing with us.” The polls on aviation showed that only 18% of the public believed in privatisation at the time, but we privatised it anyway and it was incredibly effective. The reality of British Rail and a nationalised network is not the fantasy described by Opposition Members.
I want to make some specific remarks about the east coast rail franchise. It is absolutely the case that this has been a very difficult franchise. It has had recurring difficulties in terms of revenue projections, as my hon. Friend the Member for Milton Keynes South (Iain Stewart) said. Those projections would have been difficult under any administrator—any form of ownership. There are serious questions to be asked about the nature of the shareholders’ guarantees and the nature of the public sector liability. However, to suggest that the answer is to nationalise the entire network, which I believe was in Labour’s manifesto, is really, I am afraid, a case of throwing the baby out with the bathwater.
Mr Deputy Speaker (Sir Lindsay Hoyle)
Unfortunately I am going to have to drop the limit to four minutes to get all Members in.
Alex Sobel (Leeds North West) (Lab/Co-op)
One of the firmest ideological principles held by Conservative Members, as we have just heard from the hon. Member for Spelthorne (Kwasi Kwarteng), is their insistence on the superiority of the private over the public with regard to the ownership of capital. The continued failure of the rail franchising framework to harness the power of the private sector ought to give them pause for thought on this matter. Much has been said about the £1 billion surplus that was poured back into the Treasury when the east coast main line was run in the public interest prior to Virgin-Stagecoach, but less has been said about how East Coast achieved what private companies could not.
Mike Hill (Hartlepool) (Lab)
Does my hon. Friend agree that improved transport links are vital to the success of the so-called northern powerhouse? As such, does he agree that this east coast fiasco means that we can now show that only a publicly owned company model can deliver that agenda?
Alex Sobel
I thank my hon. Friend for his comments. I often stand at King’s Cross waiting for my train home and see the words “Train cancelled” above me. I look wistfully at platform nine and three quarters, hoping that I may be able to go through the wall and travel home on the Hogwarts Express. Although the Minister for Magic, Cornelius Fudge, was a very inept Minister, he at least managed to run the Hogwarts Express successfully—unlike the Secretary of State. I completely agree with my hon. Friend’s point.
I would like to turn to the remarkable East Coast Rewards loyalty scheme that was made available to customers from 2011 until it was scrapped by Virgin Trains East Coast. I extend my thanks to the individuals behind the “Save East Coast Rewards” campaign, who kindly provided my office with a collection of documents obtained through freedom of information requests, including financial reports and business plans produced while East Coast was under public control. The documents disclose the business thinking behind the creation of East Coast’s generous loyalty scheme. There is a sharp focus on understanding and exploiting the unique market characteristics of the east coast main line, to compete with fierce competition from road and air.
The scheme had the following benefits. Frequent business travellers who spent £1,800 over three months would receive six first-class return tickets, lounge access for them and a guest, 20% off advance fares from the East Coast website and a quarter of a bottle of wine, which I am sure Conservative Members would enjoy. That was a bold and competitive offer, and it brought business back from air travel and road on to the railways. For less frequent business and leisure travellers, a spend of just £255 through the East Coast website entitled them to a free standard-class ticket anywhere on the network, so they could enjoy Yorkshire, the north-east or Scotland completely free.
After Virgin took over the franchise, it decided to roll out the Nectar point scheme. Subsequently, an £1,800 spend over three months would award business travellers £18-worth of Nectar points, instead of six first-class tickets. A £255 spend would get someone £2.50-worth of Nectar points, instead of one standard ticket under the public East Coast. It appears that Virgin Trains simply pushed the Nectar reward scheme on to East Coast, without paying any attention to what was already on offer, demonstrating a lack of understanding of the loyalty market, what East Coast had to offer and competition from air travel.
Financial reports from East Coast show that, in 2013-14, East Coast Rewards had more than 380,000 members, who accounted for 50% of expenditure. In subsequent reports, the reward scheme is shown to be ever growing, with more than 600,000 members, before being folded when Virgin-Stagecoach came in. The reward scheme was increasingly central to the surplus that East Coast provided back to the Treasury.
The remarkable thing is that a not-for-dividend subsidiary rail operator appears to have understood far better than Virgin-Stagecoach how to run a viable rewards scheme that succeeded in exploiting the market characteristics of the east coast main line—its status as an artery route and its discretionary travel base of leisure travellers, with competition from road and business air travel—to successfully run a rail franchise. Virgin’s inability or unwillingness to recognise the viability and popularity of the reward scheme it inherited from East Coast seems at odds with the belief that private interests are best placed to organise business profitably.
East Coast was an example of a rail operator that was not responsible to shareholders or profits and was not contorted into complementing the brand identity of Virgin. We had a well-run and well-liked organisation that understood its market position and its strengths and weaknesses and improved the service while pouring money back into the public purse. We need to return to that situation, not as a last resort but as a default position, using the best ownership model for rail travellers, whether as directly operated rail or a co-operative, which would have strong employee and consumer interest. We on the east coast deserve the best railway, which we have not had under Virgin-Stagecoach but did have under the public East Coast.
Simon Hoare (North Dorset) (Con)
If Members on both sides of the House can agree on only one thing in this debate, it has to be the importance of the railways to our national transport infrastructure, important though they are for business and social purposes and of course for their distinct and clear environmental benefits, as we try to get people on the trains and off the roads. I pray in aid HS2 and Crossrail, which underscore the importance that the Government place on investment in our rail network.
This has in some respects been a slightly confusing debate, but not, I suggest, on the Government Benches. To paraphrase the arguments that have been made on the Government Benches, of course franchising is not prayed in aid as a perfect, foolproof exercise, but it delivers better results than we had under nationalisation, and the Government have behaved in a pragmatic way in facing the problems of the east coast franchise. The Labour party seems to be trying to have its cake and eat it in saying that the Government are solely ideologically driven, have blinkers on and see the private sector as the sole answer, and yet chastising them for finding a temporary, pragmatic, workable solution not designed on the testbed of any form of political ideology but merely trying to provide a seamless service for people who rely on that rail route for either social or commercial purposes. I see no evidence there of any Conservative ideology, but more likely pragmatism.
There was certainly confusion from the shadow Secretary of State for Transport, the hon. Member for Middlesbrough (Andy McDonald) who regionalised the philosophical basis of the Labour family, be it Welsh or English. As we have heard, Carwyn Jones, the First Minister in the Labour Government in Cardiff, has taken an entirely different approach to the railways from that which the hon. Member for Middlesbrough seemed to suggest.
Clearly this is a bit of a death knell for that debate. We all remember the phase in British politics when people said, “You’re all the same; there’s no difference between you.” If any ideology underpins this debate, it is the vindictiveness of some pettifogging deduction of a ministerial salary and an ideology that British Rail was marvellous, nationalised is best and the private sector does not know what it is doing. That is going backwards, and we all know that trains going backwards is not the ideal way of making progress in transport terms, unless of course you are shunting into the sidings—a direction of travel in which I hope the Labour party continues.
Grahame Morris (Easington) (Lab)
It is a privilege to speak in this important debate. I would like to recognise the expertise of many members of the Transport Committee, on which I have the honour of serving.
Listening to the debate, I cannot help feeling a sense of déjà vu. The shortcomings of privatisation and the franchising process are demonstrated by the private operators running the east coast main line. I was slightly amused when the former Rail Minister, the hon. Member for Wimbledon (Stephen Hammond), who is very affable, talked about the golden age of privatisation and how wonderful the new rolling stock was. I just checked the age of some of the rolling stock on the east coast main line. The InterCity 125 diesel-powered high-speed trains were introduced in 1976; the 225s, which were the mainstay, were introduced in 1989; and the Pacer trains on the Northern Rail franchise were introduced in 1984, so let us have a sense of realism.
This is the third occasion in a decade that the Government have had to accept back the keys to a failed east coast franchise. A failure once we can excuse and twice is unfortunate, but the third time is a cause for censure and for reflection. It demonstrates that the Government’s desire to privatise the east coast main line is nothing more than adherence to blind political ideology.
It is ironic that the Transport Secretary, as a leading Brexiteer and staunch privateer, now allows our railways to be run by any state-owned company except one owned by the British state. The right hon. Gentleman might like to dust off an old phrase to use in this context: “Take back control”. He would be in good company, as numerous surveys show that 70% of the public support calls for the railways to be publicly owned—run in the public interest, not as a cash cow for private operators.
I remind the House that, when in public ownership, the east coast main line returned over £1 billion to the Treasury to be used either to upgrade the rail service or for vital public services. In 2015, we were told that re-privatising the east coast main line represented “best value” for commuters and taxpayers, and I do not believe the Secretary of State has adequately explained how that can be reconciled with the decision to bail out Virgin-Stagecoach to the tune of £2 billion.
Why do the Government not hold such companies to their contractual commitments? The noble Lord Adonis, with whom I do not always see eye to eye, gave some interesting evidence to the Transport Committee. He questioned why it is acceptable for corporate entities to walk away from their commitment to us—the taxpayers—to my constituents and to the Government. We really should take a harder line with the private train operating companies. We should block companies that have corporate structures and base themselves in tax havens from bidding for public contracts. A decision to overbid on such a contract is simply corporate irresponsibility, and the taxpayer is being fleeced time and again.
Huw Merriman (Bexhill and Battle) (Con)
It is a great pleasure to follow my Transport Committee colleague, the hon. Member for Easington (Grahame Morris), who always speaks well on this subject.
I am very interested in why this franchise has been brought in-house yet again, and the Transport Committee is keen to get under the skin of whether there is a particular issue with this franchise that causes it to be more problematic than others. We were very fortunate to have two respected industry professionals come and speak to the Committee, Iryna Terlecky and Nicola Wood, who both act independently to verify whether a franchise should be passed. Quite simply, their point about why this franchise failed is that the bidders overbid. Why did they overbid? Because they took the view that this network is the jewel in the crown of the UK rail network, and if a private company has the jewel in the crown, that sets it up well for the remainder of its franchises.
The House may welcome my taking a step back. The Government can of course be looked at—they should, rightly, be looked at—for allowing this to happen on their watch, but it would be slightly negligent of a Government not to try to take the maximum amount of money they could for the taxpayer. That money ultimately allows the Government to continue with the financing of the entire rail network, and in that regard I think that such strong criticism is based a lot on ideology in relation to who should run the railways. In my view, although I will always regard the private sector as the better operator, where the private sector cannot operate, the state will of course step back in, as has indeed been the case.
Network Rail has taken a bit a battering in this debate. It was quite clear to us from the evidence—indeed, VTEC has acknowledged this—that, in terms of the works Network Rail has delivered, it is not responsible for the issues on this line. It may be that Network Rail became a problem, but it delivered during control period 5. We should acknowledge that, rather than use it as a scapegoat, as it often is. [Interruption.] Quite frankly, I am not particularly bothered what Richard Branson has to say. That actually tends to be the case, but I think he looks more to Brexit and other reasons to explain why this has failed, when we have in fact seen more of an inflow of people staying in this country, rather than leaving.
This point has already been raised, but I want to mention the noble Lord Adonis. I was particularly impressed by the evidence he gave to the Select Committee, and he was very balanced. He made the point that, in his view, all the franchise systems work well, but this line is an exception and has been one previously, and there is no reason to change a model that he still believes works well. He is worth listening to, but I take issue with his claim that, on his watch, a bidder such as Virgin-Stagecoach would not have been allowed to bid again and would have lost its other franchises. Of course, when National Express suffered the same fate, the legal advice was that the cross-default mechanism did not allow it to be stripped of the other two franchises, and it was not stripped of them. It is all well and good for Lord Adonis to say that a future Labour Government would have stopped such bids coming through, but he knows full well that between 2009 and 2010 there was no option to do so, so we will never know whether that would have been the case.
In the 30 seconds I have left, I want to talk up our rail network. In my view it works well. Within the EU, we have the largest investment in the railways; the utilisation of our railways is 60% greater than the EU average; and the European Commission has found that there are £11 billion of efficiency savings for the other 27 members to deliver, but zero for the UK. We have the second safest railway and the second highest passenger satisfaction ratings. That is hardly surprising, given that we have doubled the number of passengers since privatisation. I want to talk up rail because it still has more to offer us in private hands.
Mary Robinson (Cheadle) (Con)
It is a pleasure to follow my hon. Friend the Member for Bexhill and Battle (Huw Merriman). I am pleased to have the opportunity to speak in this important debate about franchising and the operation of our railways.
The Government have undertaken the biggest programme of railway modernisation since the birth of the industrial revolution. Northern Powerhouse Rail, HS2 and the northern hub are among the most ambitious initiatives to fuel the engine of the north and fulfil our aim to create a fully integrated transport network right across the north of England. Greater Manchester is a major beneficiary of the historic transport devolution, and I hope that the powers that are being given to Transport for Greater Manchester will allow those of us in the north to emulate the successful independence of Transport for London.
As this is a censure debate, I want to put on the record my view that a large part of the success of our rail in the north has been down to my right hon. Friend the Secretary of State. I know from working with him over the past few years that he is as committed as I am to ensuring that we improve our rail services and revitalise the whole northern economy.
I emphasise from the outset the importance of the train lines that serve my constituents. Stockport is an important regional hub, with 3.8 million journeys a year made from Stockport station. Rail travel plays a critical role in connecting district centres such as Heald Green, Gatley, Cheadle Hulme, Hazel Grove and Bramhall in my constituency with Manchester and towns across the borough.
However, the new revised timetable from the rail operator, Northern, offers a diminished service for my constituents in Heald Green, Gatley, Davenport and Woodsmoor—stations that account for 2.3 million journeys a year. Of most concern for passengers using Woodsmoor and Davenport stations will be the uneven service pattern, particularly the gap in the morning peak between 7.38 and 8.23. Having no service for almost an hour at peak time is clearly unacceptable. The situation is made worse by cancellations and only this morning, a Gatley commuter told me that both the 7.05 and the 7.47 were cancelled, describing it as simply a disaster for the residents of Gatley. My constituents will be appalled by the actions of unions, which promise strikes and working to rule to exacerbate the problems further.
It is not just passengers travelling to work who are affected by the timetable changes, but students going to school, who have been left high and dry. Parents and headteachers have expressed their concern to me that children as young as 11 may have to make a choice between travelling on a later train and therefore arriving at school late, and catching a train earlier in the morning and facing the prospect of waiting on a busy main road at the school gates until they open.
Northern was awarded the franchise under its parent company, Arriva Rail North, which inherited the rolling stock units from the old Northern Rail in 2016. The franchise agreement stipulated that the outdated Pacer trains, which my right hon. Friend the Secretary of State mentioned, would be phased out by 2019 and that improvements would be made, with more than 2,000 extra services a week along the network. However, we have not reached that situation yet. It is clear that Network Rail failed to complete the Bolton works on time and was late in setting timetable information for Northern.
We need a more integrated rail system across our northern cities and for local connectivity to run side by side with it. There has been a lack of accountability. The Mayor of Greater Manchester mentioned accountability as being important a year ago. I urge him not to make political capital out of this issue, but to work with the Government, the Secretary of State and Transport for the North, to attend meetings and to ensure that we in the north are properly represented by him.
Rachael Maskell (York Central) (Lab/Co-op)
Let us get things straight. Who runs the Department for Transport? Who makes the decision about who runs our railways? Is it the private operators? Is the Secretary of State completely under their control? Is it the officials? Has the Secretary of State completely abdicated his responsibilities and placed them in the hands of civil servants? Perhaps it is the Secretary of State. Of course the buck stops with the Secretary of State. He has the final say. It is his stroke of the pen that decides what happens. The fact is that the Secretary of State has more centralised control than we have witnessed for many, many years. He interferes with work programmes according to his political preferences and he certainly has the final say on all that happens in his Department.
It was, therefore, the Secretary of State who set out the franchising process for the east coast main line. It was the Secretary of State who had responsibility for the content of the franchise. It was the Secretary of State who had the ultimate responsibility to review the east coast main line bids. It was the Secretary of State who would have carried out the due diligence over the bids. It was the Secretary of State who would have determined whether a bid could be delivered. It was the Secretary of State who would have awarded the franchise. It was, of course, the Secretary of State who had the responsibility for managing the franchise ever since.
There is no point passing the buck to some rail operator. There is no point blaming officials. The Secretary of State is 100% responsible for every failed franchise. The Secretary of State therefore bears responsibility for the £2 billion black hole in his accounts created through the termination of the contract with Stagecoach-Virgin. It is now this Secretary of State who is responsible for nationalising the east coast main line. The hon. Member for Elmet and Rothwell (Alec Shelbrooke) mentioned Access for All funding; it is the Secretary of State who has cut £50 million out of the Access for All funding.
Labour is delighted that our desire to nationalise the railway is making so much sense to the Secretary of State. Before we come back into power, he has taken our policy to put rail back under public control, such was its success when Labour did that in 2009 on the east coast, putting £1 billion back into the hands of the Treasury. Unfortunately, the east coast main line will still not be under public ownership: private companies Ernst and Young, Arup and SNC-Lavalin will be taking over its operation.
I have to say to the Secretary of State that passengers up and down the east coast are saying no more franchising, and no more privatisation or privatisation dressed up as some obscure partnership. No. They are saying: keep it in public hands. As my hon. Friend the Member for Easington (Grahame Morris) said, 70% of the public are demanding that rail be put under public ownership. Labour will honour that demand. My hon. Friend the Member for Cambridge (Daniel Zeichner) highlighted how it was not just his but his constituents’ desire to see rail taken back in the interests of the public.
Rachael Maskell
I will make some progress now and see how the time goes.
I thank my hon. Friends for their contributions in holding the Secretary of State to account: my hon. Friends the Members for Bishop Auckland (Helen Goodman), for Darlington (Jenny Chapman), for Blaydon (Liz Twist), for Leeds West (Rachel Reeves), for Nottingham South (Lilian Greenwood), for North Durham (Mr Jones), for Gateshead (Ian Mearns), for Jarrow (Mr Hepburn), for Blyth Valley (Mr Campbell) and for Weaver Vale (Mike Amesbury). My hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) used her business experience and expertise to analyse the reality of the Secretary of State’s failed franchising model and found him wanting. My hon. Friend the Member for Dewsbury (Paula Sherriff) was right about the Secretary of State’s readiness to, as she put it, bail out their rich pals no matter how badly their business is doing. My hon. Friend the Member for Leeds North West (Alex Sobel) provided a reality check to the Government’s approach, saying that it was more likely to be found on platform nine and three quarters. He was absolutely spot on when he highlighted the loss of the east coast reward scheme.
Rachael Maskell
As I say, I am going to see how time progresses.
I question why the Secretary of State has waited so long. Having registered the LNER name back in March this year, it is clear that nearly two months have passed with him withholding information from the public about the level of failure and his intention to nationalise the line. Perhaps he could not say, “Nationalisation”.
I do not want Stagecoach or Virgin to feel that they are off the hook either. While fully exploiting the Tory privatisation of the Railways Act 1993, let us be clear that the track record of companies such as Virgin is to drive profit out of the public purse—out of the pockets of taxpayers. Virgin has been particularly astute in the way that it has used litigation to sue the state over contract failure. It is the financial model of Virgin to do so, no matter the line of business, and look at how it has used that to win the lucrative contract on the west coast.
Can the Secretary of State guarantee that there are no mechanisms that Virgin or Stagecoach can use to take out litigation against him or his Department in the light of this abject failure, and can he further guarantee that he will disqualify them from applying for any future transport contracts? Further, can the Secretary of State report to the House how much this abject failure on the east coast main line has cost the taxpayer? Just three years after the east coast line was ripped out of public hands, time and resources have been spent—public money—on this failed, ideologically driven project.
From my discussions with Network Rail and Virgin—
Rachael Maskell
I said I would give way if there is time at the end. From my discussions with Network Rail and Virgin Trains East Coast, it is evident that the Secretary of State’s Department, and therefore the Secretary of State, failed in the process of drawing up the franchise—failed to discuss the infrastructure upgrade, scheduling and deliverability with Network Rail when its budgets were evidently under strain. So we had one part of his Department cutting back while the other part of the Department was signing agreements to the contrary, agreeing things that would never be delivered. How did the Government let this happen? I have heard that from both Network Rail and the rail operator, so I know it to be true.
We know that there are around another four franchises that are on the brink of collapse. Will the Secretary of State therefore come to this House and make a statement on each of these contracts and bring these immediately back under public control? He has a responsibility to militate against the future failure of our vital public services, so will he take action now to avoid failure and to ensure that our rail is safely and smoothly transferred into his operator of last resort?
Alec Shelbrooke
I am most grateful to the hon. Lady for giving way. Will she now clarify from the Dispatch Box that in order to nationalise the railways, it is Labour’s specific policy not to be a member of the single market?
Rachael Maskell
I can make it absolutely clear to the hon. Gentleman that the French railway system and the German railway system have trains in national ownership, not only in their country, but in our country, too.
Right across the country, it is crystal clear that this Government’s transport policies daily fail the public. They charge more and more for the public to use the trains while signing dodgy deals to enable private companies and even foreign Governments to suck money out of our railways; and they waste money on livery and uniforms, as we have heard in today’s debate. I must put on record that it is the staff who are at the heart of the constant change, and we thank them for their endurance through this process.
Labour would put that money back into our trains, back into upgrades, back into building our public services and therefore back into our economy. Today’s debate has clearly demonstrated that the Secretary of State has completely failed this nation and has completely failed our railways. It is time for a new Secretary of State, and my hon. Friend the Member for Middlesbrough (Andy McDonald) is ready to take our rail back and get our nation back on track. Labour will rescue and generate our rail service once again.
The Minister of State, Department for Transport (Joseph Johnson)
As we have heard from right hon. and hon. Members, the railways always stimulate passionate debate, even if some of the arguments made by Labour Members do not seem to have moved on much since the 1970s.
Leaving aside Labour’s unwarranted, ad hominem, vindictive attacks on the Secretary of State, which only serve to underline how thin its substantive arguments are, it would have us believe that our future lies in returning to the bad old days of British Rail. However, scores of Conservative Members have used this debate to restate the merits of what has been achieved since privatisation, and they are entirely right to recall its considerable successes.
As my hon. Friends the Members for Spelthorne (Kwasi Kwarteng) and for Milton Keynes South (Iain Stewart) made clear, privatisation has transformed the railway. Passenger numbers have doubled, with 1.72 billion journeys in 2016-17. Passenger satisfaction has increased—ours has the second-highest satisfaction levels of any railway in Europe—and we have unprecedented levels of safety, meaning that the British railway is one of the safest in Europe. The public and private sector, working together, have responded to demand by delivering more services to more stations across a busier network. Some 71 more stations are open today than in 1994-95, and more than 7.3 million passengers services were planned on the Great Britain rail network in 2016-17, which represents an increase of 29% from 1997-98.
Paula Sherriff
The Minister seems to be referring to some utopian paradise with his talk of all the great things about the current rail system. Has he looked at Twitter this week and seen the complaints of many thousands of people, including many of my constituents, who are experiencing a living hell just commuting to work and college?
Joseph Johnson
We are of course dealing with the challenges of managing a busy, successful and growing network. The hon. Lady will acknowledge that we have just introduced one of the biggest—if not the biggest—timetable changes in the history of the railways to reflect the surge in demand for rail services. We recognise that there are problems, of course, and we are focusing on them so that we minimise disruption, but we should acknowledge that we are dealing with the challenges of success, rather than failure.
Let us not forget about freight either—it is one of the great success stories of privatisation. The private rail freight operators that took over from British Rail in the 1990s brought a new spirit of commercial enterprise and customer focus, and an innovative approach, to operations. That transformed a sector that had been in steady decline into one that, over 20 years, has doubled its share of the land-based freight market.
Privatisation has driven innovation, new private investment and customer service excellence, drawing in more than £4 billion of private investment in our railways since 2010 to deliver faster, more convenient and more comfortable journeys. Thanks to private investment, 7,000 new carriages are to be introduced on the rail network between now and 2021.
Lilian Greenwood
By talking about freight, the Minister is avoiding the main subject of the debate. He will know, however, that the rail freight sector is in some difficulty following the loss of important business.
Virgin Trains has identified one reason for its underperformance as people switching from rail to road due to rising rail fares and falling petrol prices. Given the Government’s supposed commitment to tackling air quality and climate change and to a modal shift from road to rail, why did he not anticipate that and do something about it?
Joseph Johnson
The hon. Lady mentions climate change, which is of course relevant to freight, as one reason for the freight sector’s difficulties in recent years has been the withdrawal of coal from use in power stations and the declining coal tonnage in freight. And, of course, the Government are committed to our climate change targets, and we are on track with our various carbon budgets.
I will turn now to the main subject of the debate: last week’s decision on the east coast. Our decision ensures that the taxpayer will recover all the money possible under the terms of the contract, and Virgin and Stagecoach have lost nearly £200 million in the process.
Throughout all this we need to remember that, fundamentally, the Intercity East Coast rail operation, as a train service business, continues to be a successful enterprise that returns good value to taxpayers now and will do so in the future. VTEC could not meet the agreed costs of its contract with the Department but, as an operating business, Intercity East Coast services are in good shape, and commercial revenues more than cover the direct costs of the train business. In fact, VTEC paid back more money to the taxpayer than when the line was in public sector ownership.
Alex Sobel
Does the Minister see in any merit at all in the public sector running of the east coast line between 2009 and 2015?
Joseph Johnson
We are putting together the new east coast partnership, which will constitute a new approach to how we run the railways. It will bring together the best of the public sector and the best of the private sector, ending the blame game that has seen train companies blame the track operator and vice versa.
Let us not forget that, as a passenger service, this was a well-run railway. The dedication of the staff responsible for the delivery of railway services has maintained high levels of passenger satisfaction—more than nine out of 10 passengers are happy with their journeys.
Opposition Members have suggested that we have nationalised the railway. That is, of course, not the case; rather, this is a temporary return to public control. Indeed, that was envisaged in the original design of privatisation in the early 1990s. The use of the operator of last resort—our public sector operator—is an integral part of the franchising system, not an alternative to it. It is used on a routine basis when we negotiate with private companies to provide a genuine alternative in negotiations, ensuring that we secure real benefits for passengers and taxpayers, and keep people moving. They are given a better deal because they know that the Government have this option in their back pocket.
As was emphasised in the 2013 Brown review, passengers remain protected through the Department’s ability to handle default with an operator of last resort on hand to take over. In this situation, the OLR will do what it is supposed to do: work with the Department on the next competition for a commercial train operator. It will help us to shape the new partnership railway on the east coast, preparing the ground for the line to be transformed into a public-private partnership that will deliver the best of both worlds.
Alec Shelbrooke
The hon. Member for York Central (Rachael Maskell) commented on the French nationalised railways. Does my hon. Friend agree that they are in terrible straits and that the President has recognised that the present system cannot continue because it is haemorrhaging billions of euros every year?
Joseph Johnson
Indeed. Advocates of the full renationalisation of our railways should heed what President Macron is saying about the sustainability of the French model. It is a warning indeed.
The east coast provides an opportunity for the first of a new generation of long-term regional partnerships, bringing together the operation of track and train under a single leader and a unified brand and delivering more effectively for rail users.
Joseph Johnson
Not at the moment.
That brand is the London and North Eastern Railway, LNER. This will evolve into a partnership between the public sector and a private partner, procured through a competitive process.
Of course, we are always seeking to improve the way in which we deliver. We continually refine the franchise model and monitor the performance of all franchises closely. We know that passengers have had enough of the blame game between train operators and Network Rail. We have also improved bid assessments since 2014 by introducing a new process to ensure that bids are more financially robust, such as when there is a lower level of growth in passenger numbers than was anticipated. We have developed new approaches to sharing risk with train operators, which means that they do not take on risks that they are not able to control, including impacts due to wider economic changes. Let me be clear: this means that the Government will continue to run a system that requires train operators to face financial penalties if they do not meet their commitments and ensures that we get the best deal for passengers and taxpayers.
Some Members have raised concerns about other franchises. I can reassure the House that the Department closely monitors the performance of our franchises, assessing a range of measures such as levels of bonding and parent company support, as well as assessing liquidity ratios to establish their health.
Colleagues have commented that this week has seen the launch of the biggest change to rail timetables in a generation. This timetable change will deliver improved passenger services across the country, including the delivery of substantial passenger benefits from the Thameslink programme and the great north rail project. By 2020 there will be over 2,000 extra services a week, with room for 40,000 extra passengers. There will be faster and more comfortable journeys, and new and direct services across the north and beyond.
This vindictive motion diminishes those Opposition Members who support it. I reinforce the Secretary of State’s message that we put passengers at the heart of the railway by making the best use of expertise from the public and private sectors, just as the Labour Government in Wales have done this morning.
Question put.
Rachel Reeves (Leeds West) (Lab)
On a point of order, Mr Deputy Speaker. At 10 minutes past 3 this afternoon, just after the Secretary of State for Transport left the Chamber, he issued a press release on plans to tackle poor performance at Northern Rail. I wonder whether the Secretary of State, who is almost back in his place, has indicated any intention to make a statement to the House allowing right hon. and hon. Members to question the Government on those plans, which are of huge significance to many of our constituents.
Mr Deputy Speaker (Sir Lindsay Hoyle)
I have certainly not been given any notification that the Secretary of State wants to come back at this moment, but there is a good chance tomorrow morning at business questions, when I have no doubt you will be able to raise this again.
Royal Assent
Mr Deputy Speaker (Sir Lindsay Hoyle)
I have to notify the House in accordance with the Royal Assent Act 1967 that Her Majesty has signified her Royal Assent to the following Acts:
Data Protection Act 2018
Sanctions and Anti-Money Laundering Act 2018
Smart Meters Act 2018.
I should also like to announce to the House the deferred Divisions result in respect of the Question relating to the Somerset West and Taunton (Modification of Boundary Change Enactments) Regulations 2018. The Ayes were 298 and the Noes were 17. Of the English Members voting on that Question, the Ayes were 270 and the Noes were 14, so the Question was agreed to.
In respect of the Question relating to the Somerset West and Taunton (Local Government Changes) Order 2018, the Ayes were 298 and the Noes were 17. Of the English Members voting on that Question, the Ayes were 270 and the Noes were 14, so the Question was agreed to.
In respect of the Question relating to the Bournemouth, Dorset and Poole (Structural Changes) Order 2018, the Ayes were 293 and the Noes were 19. Of the English Members voting on that Question, the Ayes were 265 and the Noes were 16, so the Question was agreed to.
In respect of the Question relating to the draft Dorset (Structural Changes) (Modification of the Local Government and Public Involvement in Health Act 2007) Regulations 2018, the Ayes were 294 and the Noes were 19. Of the English Members voting on that Question, the Ayes were 266 and the Noes were 16, so the Question was agreed to.
NHS Outsourcing and Privatisation
(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
18:59 - The House divided: - Ayes: 230 / Noes: 295 - Question accordingly negatived.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I beg to move,
That an humble Address be presented to Her Majesty, that she will be graciously pleased to give directions that the following papers be provided to the Health and Social Care Committee: written submissions received by Ministers since 8 June 2017 on proposals for reform of the Health and Social Care Act 2012, on the creation of accountable care organisations in the NHS, and on the effect of outsourcing and privatisation in the NHS including the creation of wholly-owned subsidiary companies; and minutes of all discussions on those subjects between Ministers, civil servants and special advisers at the Department of Health and Social Care, HM Treasury and the Prime Minister’s Office.
In six weeks’ time, we will celebrate the 70th anniversary of the national health service, a great civilising moment for the nation, which the Secretary of State’s predecessor, Nye Bevan, described in the House on Second Reading of the National Health Service Bill. He said of the creation of the NHS that
“it will lift the shadow from millions of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering. It will produce higher standards for the medical profession. It will be a great contribution towards the wellbeing of the common people of Great Britain.”—[Official Report, 30 April 1946; Vol. 422, c. 63.]
They are certainly stirring and inspirational words, but as we approach the celebrations and the 70th anniversary of the NHS, we see a service in crisis, underfunded and understaffed, and patient care is suffering.
After eight years of the biggest financial squeeze in its history, and at a time when England’s population has increased by 4 million, when the falling real value of tariff payments for hospital care means that trusts now lose 5% of costs for every treatment, and when the Government have refused time and again to give the NHS the funding required, we see patients suffering every day in our constituencies. That is why we have just suffered the worst winter in the history of the NHS, when our hospitals were overcrowded and our A&E departments were logjammed. The number of hospitals operating at the highest emergency alert level—the OPEL 4 level—was nearly double what it was the year before, which itself was branded a humanitarian crisis.
In the first week of January 2018, there was a point when 133 out of 137 hospital trusts in England had an unsafe number of patients on their wards. Sixty-eight senior accident and emergency doctors wrote in January to the Prime Minister raising
“the very serious concerns we have for the safety of our patients.”
In response, we had a blanket cancellation of elective operations and cancellations of more than 1,000 emergency operations, causing misery for patients and financial difficulties for trusts already in deficit.
Gareth Thomas (Harrow West) (Lab/Co-op)
My hon. Friend should also be aware that many walk-in centres have closed. In my constituency, the superb Alexandra Avenue centre has had a 20,000 cap imposed on the number of patients it can see. This service is run by popular GPs, but it faces the risk of being outsourced, to a Virgin healthcare or someone else. It originally served 40,000 patients, and many of my constituents are genuinely worried for its future.
Jonathan Ashworth
My hon. Friend makes the point well. I believe about 50 walk-in centres have closed and there are another 50 whose future has been reviewed.
Karen Lee (Lincoln) (Lab)
Lincoln’s walk-in centre was closed. A consultation was undertaken by the clinical commissioning group and 94% of those who responded did not want the centre to close. So what did the CCG do? It closed it.
Jonathan Ashworth
I thank my hon. Friend for her contribution. I know that she, as the relatively new Member for Lincoln, will be campaigning for the future of health provision in her constituency.
The response of the Prime Minister to those cancelled operations this winter was to shrug her shoulders and say, “Nothing is perfect,” but by the end of the winter reporting 185,000 patients, often elderly, vulnerable and in distress, had been left waiting in the back of an ambulance or treated in a corridor for more than 40 minutes. We do not have a crisis in our NHS just in winter; we have a crisis all year round. Since 2010, we have seen a reduction of about 16,000 beds, including more than 5,000 acute beds and nearly 6,000 mental health beds—that is almost 20% of them. Among equivalent wealthy countries, only Canada and Poland have fewer doctors per head, and only two countries have fewer beds per head.
A report today in The Guardian details how old and out of date the equipment is in hospitals because infrastructure budgets have been raided. According to the OECD, we are bottom of the league for the provision of CT and MRI scanners. Meanwhile, as my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) has pointed out, eight years of multi-billion cuts to social care provision have decimated the sector and have denied 400,000 people, often the elderly and the vulnerable, the support they would otherwise get.
Years of pay freeze, and failure to invest in and plan properly for the workforce, have meant vacancies for 100,000 staff, including vacancies for 40,000 nurses, 3,500 midwives and 11,000 doctors. In the past two years, we have lost more than 1,000 GPs. In our communities, we have seen district nurses cut by 45%. We have lost more than 2,000 health visitors in two years. We have lost nearly 700 school nurses. There are 5,862 fewer psychiatric nurses and 4,803 fewer community health nurses than in 2010, and the Prime Minister’s hostile environment has meant the Home Office has turned down visas for at least 400 staff.
Conor McGinn (St Helens North) (Lab)
In the St Helens and Knowsley Teaching Hospitals NHS Trust, the spending on agency nurses has quadrupled since 2011. Is it not a fact that under this Tory Government we have a retention, recruitment and resources crisis in our NHS?
Jonathan Ashworth
My hon. Friend has, with great eloquence, explained why failing to plan properly on the workforce is such a false economy. It means that trusts are spending more and more on locums and expensive agencies.
I trust that no Conservative Member will try to pretend in this debate that it is possible to reduce beds, reduce staff, cut social care and fail to invest while patient numbers are increasing without the quality of care suffering. If any Conservative Member does try to tell us the opposite, they should look at the latest performance standards. The lack of hospital capacity and staffing means that the waiting list has risen to more than 4 million. Simon Stevens, of NHS England, has warned that
“on the current funding outlook, the NHS waiting list will grow to five million people by 2021. That’s an extra million people on the waiting list. One in 10 of us waiting for an operation—the highest number ever.”
The blanket cancellation of elective operations has seen waiting lists rise by nearly 5% compared with last year, and we have waiting times up and performance against targets down. In overcrowded A&Es, in the past year, 2.5 million have waited more than four hours. Just 76.4% of patients needing urgent care were treated within four hours at hospital A&E units in England in March—that is the lowest proportion since records began in 2010.
Wes Streeting (Ilford North) (Lab)
Of course, A&E waiting times would not be as long if the Government were investing properly in primary care. In my borough, we have the ludicrous situation of private companies advertising in London underground stations, saying:
“Fed up waiting? Our private GPs can see you now…ONLY £80”.
Does my hon. Friend agree that people should not be forced to pay £80 to see a GP, and they should not be waiting unnecessarily long in A&E because of the Government’s failure properly to fund and deliver the workforce that primary care needs?
Jonathan Ashworth
My hon. Friend has hit the nail on the head. The problem is that, when the Government allow our national health service to deteriorate by such a scale and push it into this level of crisis, they are essentially forcing people, often reluctant refugees from a public NHS, into self-pay options. That is what happened last time the Conservatives were in government and it is happening again.
Anna Soubry
Will the hon. Gentleman confirm that five GP surgeries in Broxtowe have been rated outstanding and that we yet again have a 2% increase in CCG spending? Why is he always talking down the NHS?
Jonathan Ashworth
I am delighted that GPs in Broxtowe have been rated outstanding, but patients in Broxtowe will be concerned that bed occupancy rates at Nottingham University Hospitals Trust are at 94.9%. That is what people in Broxtowe and across the east midlands are concerned about.
Anna Soubry
Would the hon. Gentleman like to speak to Nottingham City Council, which is run by Labour? It has repeatedly refused to unblock beds at NUHT, unlike Conservative-run Nottinghamshire County Council, which always ensures that it has social care available so that there is no bed-blocking in Nottinghamshire. The problem is Labour in the city—
Jonathan Ashworth
I know that Councillor Jon Collins of Nottingham City Council is a talented man, but he does not run Nottingham University Hospitals Trust. The people running the health trusts are the chief executives, who have to rely on the budget settlements that the right hon. Lady and her party have been denying—
Jonathan Ashworth
No, I am not giving way again. The right hon. Lady has had two chances; she can contribute to the debate later.
We have overcrowded A&Es and—perhaps the right hon. Lady can listen to this—patients are not even able to get a bed, often lying confused on trollies in corridors. In the last year of the previous Labour Government, 60,000 people were designated as trolley waits—
Anna Soubry
On a point of order, Mr Deputy Speaker. Could the record please record that indeed the leader of Nottingham City Council does not run NUHT, but he is responsible for social care in the city? That was the point I was making.
Jonathan Ashworth
I am grateful to the right hon. Lady for that. I invite her to make another point of order, because Nottinghamshire County Council is closing five care homes.
Anna Soubry
I am happy to take that up. My understanding is that Nottinghamshire County Council is looking responsibly at the provision of—[Interruption.] Well, the hon. Gentleman invites me to give him information; I am trying to assist him. In my constituency, the county council is making sure that the money that it spends on social care goes to the very many care homes in my constituency that are rated as good or outstanding—
Mr Deputy Speaker
Order. May I just help a little? We have 25 speakers to come in after the Front Benchers, so I appeal to the Front Benchers to leave time for Back Benchers to contribute.
Jonathan Ashworth
I shall take your guidance, Mr Deputy Speaker. It is always a pleasure to indulge the right hon. Lady, but I have to point out to her that Councillor Cutts of Nottinghamshire County Council is cutting care homes across Nottinghamshire. The record will show that.
Jonathan Ashworth
Given that Mr Deputy Speaker has just castigated me, let me make a little progress. Hopefully, I will be able to take more interventions towards the end of my remarks.
Underfunding and lack of capacity have driven more and more—
Jonathan Ashworth
Mr Deputy Speaker has asked me to make a bit of progress, so let me do so.
Underfunding and lack of capacity have driven more and more NHS purchasing from the private sector. We have seen beds lost in NHS hospitals, which are then increasingly forced to use the private sector. Spending on elective treatments outsourced to the private sector rose from £241 million in 2015-16 to £381 million in 2016-17. In many instances—from mental health provision and detox services for those suffering from substance misuse, to routine elective operations—we often see a poor quality of service in the private sector. The House does not have to take my word for it; the Secretary of State himself intervened recently to demand that the private sector gets its house in order. These risks have been known for years, since the Paterson scandal, and I note that the Government are not proposing to legislate.
Several hon. Members rose—
Jonathan Ashworth
I will make a bit of progress because Mr Deputy Speaker has asked me to do so.
I say to the Secretary of State that, if he is prepared to legislate, we will support him because we know that, when things go wrong in the private sector—often these hospitals have no intensive care units—it is the NHS that has to step in and act as a safety net, with patients often being transferred from a private hospital to an NHS hospital. That risk has been estimated to cost the NHS £60 million.
Several hon. Members rose—
Jonathan Ashworth
Let me make a bit of progress and then I will try to let others in.
If the Secretary of State brings forward legislation, we will work constructively with him.
The latest and perhaps most pernicious consequence of underfunding is the move to so-called wholly owned subsidiaries. Many are saying that this is a VAT scam. Hospital trusts feel that, because of underfunding, they have no option but to transfer staff to these so-called subsidiaries, set up at arm’s length but still owned by the trust. We have trusts paying management consultants a total of £3 million, according to freedom of information requests, for advice on setting up these new arrangements. That is money that should be going on patient care. It will mean a two-tier workforce as new joiners no longer need to be on “Agenda for Change” terms and conditions. That looks to many like forcing staff to pay for the Government-imposed financial crisis in the NHS.
Mr Philip Dunne (Ludlow) (Con)
I thank the hon. Gentleman for giving way. He is under a lot of pressure, rightly, in this debate. When he selected the motion for the Opposition debate today, was he aware, given the liturgy of supposed privatisation that he has alleged has taken place under this Government, that the proportion of spend on the independent sector under the Conservative Government in the last year was zero and that the proportion of spend on the independent sector in Wales, run by the Labour Administration, went up?
Jonathan Ashworth
I am grateful to the former Minister of State. We do miss him during our exchanges at the Dispatch Box. The figures that he has quoted are different from those provided by the Library. The Library says that the percentage of the total budget spent on private providers has gone up to 1% in Wales, but it has gone up by 2% in England in the past year. The Department of Health and Social Care may have different figures, but those are the figures from the Library.
Yvonne Fovargue (Makerfield) (Lab)
Will my hon. Friend send his support to the staff from Wigan hospitals who are today striking in protest at the creation of Wrightington, Wigan and Leigh Solutions? Does he agree that that is just privatisation by the backdoor?
Jonathan Ashworth
I do agree. May I reassure my hon. Friend that those Unite and Unison members who are taking industrial action at Wrightington, Wigan and Leigh have our support? We stand with them in solidarity. I congratulate her and my hon. Friends the Members for Leigh (Jo Platt) and for Wigan (Lisa Nandy) on the campaign that they have been running. These jobs should not be outsourced to wholly owned subsidiaries; they should be in-house.
Sir Nicholas Soames (Mid Sussex) (Con)
I am very grateful to the hon. Gentleman for giving way. I know him to be a good man. May I put this to him? None of these figures or statistics means anything to people wanting treatment on the NHS. May I assure him that my constituents, like his, are not over-concerned where their treatment comes from? What they are concerned about is that they should be competently, effectively and caringly treated under the national health service.
Jonathan Ashworth
I say to the right hon. Gentleman, of whom I am tremendously fond, as he knows, that I agree broadly with the point that he is making. If my memory serves me correctly, he sits for a Sussex constituency and, of course, in Sussex, we had the shambles of a patient transport contract that went to a firm, Coperforma, which did not even own any ambulances and which was leaving patients stranded on their doorstep waiting for transport to dialysis appointments and to chemotherapy appointments. It often could not then pick up the patients from the hospital and take them home. That contract had to come back in-house. It is these types of privatisation that we believe are doing great damage to the health service.
Jonathan Ashworth
My hon. Friend has been very patient, so I will give way to him.
Mr Cunningham
My hon. Friend has been generous in giving way. Does he agree that private companies are also increasing car parking charges, which is a tax on patients, and that, more importantly, because of the lack of social workers we have bed-blocking in the national health service, too?
Several hon. Members rose—
Jonathan Ashworth
The hon. Member for East Worthing and Shoreham (Tim Loughton) seems so desperately keen that I will take his intervention and then I will hear from Ashfield and make some progress.
Tim Loughton (East Worthing and Shoreham) (Con)
I am really grateful to the shadow Minister. Under the last Labour Government, before Worthing became the outstanding hospital it is now, there was a long list of patients requiring hip and knee replacements. To speed up the list, the hospital contracted with a local private hospital. Those patients were treated much more speedily, at least to the same quality, and actually at a lower cost per patient than if it had been done in-house— and, of course, the patients did not have to pay a penny themselves. Is that the sort of privatisation the hon. Gentleman so opposes?
Jonathan Ashworth
I can reassure the hon. Gentleman that no, it is not. I agree with the Secretary of State that the
“use of the independent sector to bring waiting times down and raise standards is not privatisation.”
They were the words of the Secretary of State when he spoke at his own party conference the other year. The Labour Government did spot-purchase from the private sector to bring down the huge waiting lists that we inherited in 1997; but our concern is about contracts for delivery of healthcare services being handed out to private sector providers who not only provide poor quality to patients but give the taxpayer a poor deal. It is a different situation.
Gloria De Piero (Ashfield) (Lab)
Thirty-five pounds a week to watch the basic TV channels from a hospital bed; 60p a minute for a relative to call a patient on a hospital phone; a minimum of £1.80 for the car park for a short visit: these charges are happening at my hospital and at hospitals across the land. They are a tax on sickness and a particular tax on long-term sickness. They have to stop.
Jonathan Ashworth
My hon. Friend has hit upon a brilliant new campaign, which I am sure she will be running. The charges for watching television in wards are absolutely extortionate. It is a scandal; it is a tax on sickness; but it happens because the hospitals, and the health service in general, are so desperately underfunded.
Several hon. Members rose—
Jonathan Ashworth
I will take an intervention from Chesterfield and then I will make some progress.
Toby Perkins (Chesterfield) (Lab)
Chesterfield Royal Hospital is consulting on setting up a subsidiary company. Does it not seem madness that, to save £3 million that the hospital is paying the Government, it is creating this new organisation, which is being funded by the Government anyway? It is the emperor’s new clothes. The money is going round in circles without doing any good.
Jonathan Ashworth
In addition, hospitals have wasted millions in consultancy fees in setting up these organisations. They create a two-tier workforce because new joiners will not necessarily be on “Agenda for Change” terms and conditions, and they could at some point be completely sold off to the private sector. It is a back-door privatisation.
Several hon. Members rose—
Jonathan Ashworth
If Members will forgive me, I will make a little bit of progress, and then hopefully we will get a chance for more to come in later.
Labour has been calling for a long-term economic plan for the NHS. We are led to believe that the Secretary of State agrees with us, because according to The Guardian, in an article headed “Hammond and Hunt in battle over NHS funding boost”, the Secretary of State and Chancellor are reported to be “at loggerheads”, with the Secretary of State calling for £5.3 billion extra, but the Chancellor only wanting to offer £3.25 billion. Of course, neither is quite as generous as the extra £45 billion for the NHS and social care across the Parliament that Labour was offering, but we will watch carefully.
Our plans would have been funded from increasing taxation on the top 5% of the wealthiest in society. Perhaps the Secretary of State can tell us how he proposes to fund his extra £5 billion. Will it be an increase in national insurance for pensioners, as has been floated? Or will other Departments be cut? Will the defence budget be cut to fund the extra £5 billion increase in the NHS? Will it be a move towards co-payment and charges? Or will it be another conjuring trick from the Secretary of State, whereby he claims to be increasing the funds going into the health service, only for us to subsequently find out that public health budgets, training budgets and infrastructure budgets have been cut and the settlement is not quite as generous as we have been led to believe? According to tomorrow’s Spectator, there will be a Tory splurge on the NHS, so he should honour the House today with his confidence and tell us where he thinks this splurge will come from—tax rises, cuts elsewhere, or charges and co-payments.
I remind the right hon. Gentleman: it was a Labour Government with Gordon Brown who increased taxation to pay for the NHS and helped us treble funding in cash terms, and it will be the next Labour Government who will increase taxation for the very wealthiest in society to fund a long-term, sustainable plan for the NHS. When we face the demographic challenges of an ageing population, with people living longer, the disease burden shifting and people living with co-morbidities, and when we are on the cusp of great advances and innovations from artificial intelligence and genomics, is it not clear that the current fragmented structures of the NHS are wasting energy, wasting time and wasting resources?
We are now led to believe that, according to the BBC, the Prime Minister and the Secretary of State, despite both having sat in a Cabinet that agreed the Health and Social Care Act 2012, have realised that the structures produced by that Act have been a dismal failure. I do not like to say, “We told you so,” but we did actually tell you so. The Act has created a fragmented mess, with healthcare leaders trying to work around it. I say to the Secretary of State that it does not need amending—it simply needs consigning to the dustbin of history to be included in the next edition of “The Blunders of Our Governments”.
We will test any new legislation that the Secretary of State brings forward to see if it moves towards greater collaboration—away from a purchaser-provider split model in favour of partnership and planning. Any new legislation should bring an end to the creeping, toxic privatisation of the NHS and instead restore and reinstate a public universal national health service. The Health and Social Care Act has contributed to the reality today where, according to the Department of Health’s own figures, £9 billion is spent on private providers—a doubling in cash terms since 2010. Indeed, we have seen about £25 billion of contracts awarded through the market since the Act came into force.
Of course, there has always been a role for the private sector in providing services, as I said to the hon. Member for East Worthing and Shoreham (Tim Loughton), who is no longer in his place, as indeed there has always been a role for the voluntary and co-operative sector. But the combination of years of underfunding alongside the constant tendering of contracts via the any qualified provider arrangements has led to creeping privatisation. Before Government Members tell us that this is just 8% of the total budget—in fact, the Secretary of State told the House in January that it is “not huge”—let me point out that the problem is that that 8% is located almost exclusively in areas like elective care, community services and patient transport, meaning that the private sector is disproportionately influential in those areas. Moreover, the way in which the funding mechanism works restricts NHS income from those areas and leaves NHS providers picking up the more complex, costly cases—emergencies and the chronic sick. In other words, outsourcing and privatisation is increasingly a false economy where supposed savings are easily outweighed by the costs.
But more importantly than that, privatisation has first and foremost a detrimental impact on patient care.
Maria Caulfield
Does the hon. Gentleman not agree that the any qualified provider system was brought in under the previous Labour Government in 2009?
Jonathan Ashworth
I remind the hon. Lady, whom I greatly respect in this House because of her work in the NHS, that we moved away from that system to a preferred provider mechanism because we knew that the any qualified provider mechanism did not work and was not in the interests of patient care or the interests of the taxpayer.
Let me give some examples. On support services, GPs have warned repeatedly of the dangers of NHS England outsourcing primary care services to Capita, in a contract designed to save £40 million. Those fears proved well founded, as the National Audit Office found that there was a real risk of “serious patient harm” stemming from Capita’s handling of the contract, with major problems around the secure transfer of patient notes, with notes going missing or delivered to the wrong surgery. Capita’s work in providing back-office services such as payment administration, cervical screening tests, medical records and supplies orders had fallen
“well below an acceptable standard.”
On patient transport contracts, I mentioned to the right hon. Member for Mid Sussex (Sir Nicholas Soames) what happened with Coperforma. This was a contract worth £63.5 million.
Jonathan Ashworth
And the CCGs are still paying out to Coperforma—is that not correct?
Maria Caulfield
With regard to Sussex—I am sure that my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) would agree with me—the last time Labour was in government it proposed to close the Princess Royal Hospital in Haywards Heath.
Jonathan Ashworth
I am sure that the hon. Lady accepts that it is a scandal that the CCGs—her local health economy—are still paying out to Coperforma. She should be getting up and complaining about that.
What about support services? Interserve was brought in to provide facilities management across 550 NHS buildings across Leicestershire, with a seven-year, £300 million contract. The contract was scrapped four years early because of reports of patients receiving meals up to three hours late, bloodstains in the corridors and bins not emptied. How about Carillion, which won a £200 million, five-year estates and facilities management contract with Nottingham University Hospitals NHS Trust? It failed to clean the hospitals properly, with reports that infectious waste was seen overflowing in the children’s ward.
Vernon Coaker (Gedling) (Lab)
The concerns that my hon. Friend is raising are the same as those raised by the Chair of the Health Committee in a letter to Sir Simon Stevens, chief executive of NHS England, in which she said:
“My central concern is that contracted services can seemingly fail to meet the basic clinical requirements without being held to account or compelled to acknowledge and remedy their failings. This risks undermining the effective commissioning of services and could, ultimately, compromise patient care and safety.”
Jonathan Ashworth
My hon. Friend, who is extremely experienced, shows with great eloquence the dangers of this relentless outsourcing of services. It damages patient care and is not in the interests of the taxpayer.
Helen Whately (Faversham and Mid Kent) (Con)
I thank the hon. Gentleman for giving way. I remember well when I worked in the NHS under a Labour Government, before I was a Member of Parliament. All around me was talk of independent sector treatment centres, offering more choice through bringing in more private sector provision to the NHS, and PFI contracts. That was under the previous Labour Government, who I believe were trying to make the NHS give better patient care, but Labour has changed its tune. I am concerned that this seems to be all about ideology. I care—
Mr Deputy Speaker (Sir Lindsay Hoyle)
Order. Members cannot make speeches in interventions.
Jonathan Ashworth
I greatly respect the hon. Lady, and I greatly enjoyed her Red Box blog on mental health provision last week. I know she thinks carefully about these matters, but this is not about ideology. It is about what works. Let us take the example of the East Kent contract for integrated NHS 111 and GP out-of-hours services, which began in January 2017. After only seven months of Primecare running it, the service was placed in special measures after it was rated inadequate. That is happening in her own backyard. This is not working, and that is the point we are making.
The history of PFI is that when we came into government, a third of hospitals were more than 50 years old. That is why we carried on with the John Major PFI scheme, which was the creation of that Government. Current Cabinet Ministers such as the shadow Health Secretary at the time, now the Secretary of State for International Trade, stood at the Dispatch Box and congratulated the Labour Government on taking up the private finance initiative developed under the previous Government. He said he would not object to the use of PFI
“exclusively to fund private capital projects”—[Official Report, 8 January 2003; Vol. 397, c. 181.]
In this House, the current Chancellor of the Duchy of Lancaster gave a “warm welcome” to a PFI in his own constituency. The Brexit Secretary said in this House:
“The PFI has many virtues—after all, it was a Conservative policy in the first instance.”—[Official Report, 10 March 1999; Vol. 327, c. 429.]
The Business Secretary said:
“PFI was initiated by the previous Conservative Government”—[Official Report, 12 February 2013; Vol. 558, c. 787.]
The Scottish Secretary has said that PFI is a “successful basis for funding”. The Welsh Secretary said:
“I am a fan of PFI in general.”—[Official Report, 4 November 2010; Vol. 517, c. 1124.]
We will take no lessons from the Tories when it comes to PFI.
We have not only seen facilities management contracts having to be brought back in-house in Leicestershire and Nottingham; we have also seen them deliver a poor quality of service across Lewisham and Greenwich. Those contracts at Lewisham Hospital should come back in-house. I know that the Labour candidate in Lewisham East will be campaigning to bring them back in-house, and I hope the Tory candidate will do the same.
Jonathan Ashworth
I will give way to my hon. Friend from Lewisham, and then I will make progress.
Vicky Foxcroft
I thank my hon. Friend. He is right: the candidate in Lewisham East will absolutely be campaigning on that, because it is out of order and outrageous that many of the people working under that contract are not receiving pay for one week because Interserve is not paying them.
Jonathan Ashworth
Absolutely. I wish the Labour candidate in Lewisham East well and will be campaigning with them. We will be sending a firm message to the Tories that privatisation of the NHS will end. The NHS is not for sale.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
Will the hon. Gentleman give way?
Jonathan Ashworth
I will give way to my hon. Friend and then to the hon. Member for Dwyfor Meirionnydd.
Rachael Maskell
I am grateful to my hon. Friend for giving way. Is not the biggest scandal of privatisation in facilities management the sharp rise in infectious diseases, which really compromised patient care?
Jonathan Ashworth
My hon. Friend, who is an authority on these matters and campaigned on them for many years before entering this place, speaks well and she is absolutely right.
I will take an intervention from the hon. Lady from Wales, but then I will not take any more because I fear I am really testing your patience, Mr Deputy Speaker.
Mr Deputy Speaker (Sir Lindsay Hoyle)
It is not about my patience, but about Back Benchers.
Liz Saville Roberts
I have only one question: will the hon. Gentleman explain why the Welsh Labour Government have outsourced dialysis services at Wrexham?
Jonathan Ashworth
We have always said that there is a small role for the private sector. This is what I said earlier—[Interruption.]
Mr Deputy Speaker
Order. I want to hear Members on both sides, and I certainly want to hear the answer, but I cannot do so if everybody is shouting.
Jonathan Ashworth
We have always said that, and I do not know why Government Members are so surprised about it. Indeed, the Prime Minister, thinking she had a humdinger, quoted me at Prime Minister’s questions, but I was decidedly nonplussed by her response to my right hon. Friend the Leader of the Opposition.
Perhaps the biggest area in which private contracts have gone out is in community services, where the private sector has taken over 39% of contracts compared with the 21% in the NHS. NHS Providers said last week:
“The fragmentation of the community sector is…due to the private provider share of the community…service market being much larger than in other sectors”.
It also said:
“it is almost always a legal requirement for commissioners to go out to tender competitively for community services. Tendering for contracts is therefore much more competitive in the community sector than in the acute sector, and contracts are sometimes won on cost savings, rather than improvements in the quality of care.”
We have seen this time and again. For example, Serco was awarded a £140 million contract in Suffolk, but could not meet key response times, such as the four-hour response time for nurses and therapists to reach patients at home 95% of the time. Before Serco took over the contract, the target was achieved 97% of the time.
Jonathan Ashworth
I did say that I would not take any more interventions. I apologise to my hon. Friend; I know her intervention would have been excellent.
How about the seven-year contract worth £70 million per annum to Virgin Care that was awarded in November 2016 across Bath and Somerset, with services including health visitors, district nurses, speech and language therapists, occupational therapists, physiotherapists and social workers? The first few months were beset with IT problems, and there were problems with payroll transfers and delays in paying staff. How about the dermatology contract in Wakefield, which again went to Virgin Care? The IT systems did not work, and it was not consultant-led. Satisfaction fell by so much that GPs refused to refer, and again the contract had to come back in-house.
In fact, Virgin Care is now picking up over £1 billion of NHS contracts, and when it does not win a contract and believes something is wrong with the tendering process, it becomes increasingly aggressive in the courts. Most recently, and disgracefully, it sued the NHS in the Secretary of State’s own backyard and forced it to pay out £1.5 million. That money should be spent on patients in Surrey, not go into the coffers of Virgin Care.
The legal action by Virgin Care reveals a bigger truth. Not only does the Health and Social Care Act lead to many community health contracts going to the private sector, but the regulations underpinning the Act are dysfunctional, which results in millions being wasted on increasing numbers of failed privatisation projects. Perhaps the most prominent example is the 10-year contract worth £687 million for end-of-life and cancer care in Staffordshire that has had to be abandoned, costing CCGs over £840,000—money that should have been spent on patients.
That is why we are raising concerns about the proposed accountable care organisation model, which is currently subject to judicial review. We favour integration and accountability, and we agree that services should be planned around populations and, indeed, that funding should be allocated by means other than an internal market. We favour a strategic hand in the delivery of services and greater local collaboration, and our vision is one of planning and partnerships.
However, the existence of piecemeal contracts and the contracting out of services is a major barrier preventing the real integration of health and social care. The enforcement of competition obstructs collaboration and the proper, efficient organisation of services. A model in which billions of pounds of NHS and local authority funds can be bundled up and go through a commercial contract for 10 years is not accountable and neither, depending on the level of funding, will it deliver the level of care we expect, while it could also go to the private sector. What sense does it make to offer binding long-term contracts for delivering a vast range of services over 10 years? Surely the lesson of PFI is not to guess the future, not to write healthcare contracts for services 10 years hence and not to get locked into a deal when so much will change in the delivery of healthcare over the next 10 years.
This is a tired, outdated, failing approach. Quite simply, privatisation has failed. Almost every day in the NHS, we hear of a further investigation, a further failure, a contract handed back or a problem uncovered—from scandalous failures in patient transport, to poor standards in private hospitals, to millions wasted on huge tendering exercises that go nowhere, to Circle failing to manage Hinchingbrooke, to Capita failing to manage vital patient records, to Interserve failing to clean hospitals and deliver meals, to Virgin Care suing the NHS for £1.5 million.
I challenge the Tories to point in this debate to a significant success in outsourcing to offset that total mess. No Tory can tell us that the competition and markets in the Health and Social Care Act have led to shorter waits, innovations in care or better services. The reality is that the NHS and the provision of healthcare are too important to be left to the chasing of market forces. The principles on which our NHS was founded seven decades ago are being betrayed by this Government, and the staff and patients of the NHS are being betrayed with it. There are longer waiting times, intolerable pressures on staff, daily stories of human heartbreak and operations cancelled.
On the 70th anniversary of the NHS, the staff can hold their heads up high, but the Government should bow their heads in shame. In this anniversary year, it will fall again to this party—the party that founded the NHS and that believes in the NHS—to rebuild and restore a public universal national health service.
Several hon. Members rose—
Mr Deputy Speaker (Sir Lindsay Hoyle)
Hopefully we will get some Back Benchers in, but I warn them that they will get no more than four minutes each. That may have to come down and some Members may not get in.
The Secretary of State for Health and Social Care (Mr Jeremy Hunt)
I welcome the opportunity of this debate to dispel some particularly pernicious myths.
May I say how much I enjoyed the shadow Health Secretary’s speech? If they had listened to his denunciation of privatisation and outsourcing, I think my children would have said that Alice in Wonderland has nothing on the Labour party when it comes to taking totally contradictory positions on an identical issue. My favourite thing was the stirring way in which he said, “What concerns me most is contracts handed out that are poor value for taxpayers,” after his Government left £80 billion-worth of PFI contracts for the NHS to pick up the pieces. That costs the NHS £2 billion every year—money that cannot be used for good patient care. He had lots of other gems and we will return to them during the course of this speech.
I want to start with the motion. I am afraid that it is a transparent attempt to set hares running about NHS privatisation that is not happening. He used the phrase “creeping toxic privatisation”, but the truth is that we know it is not happening and the Opposition know it is not happening. With all the pressures facing the NHS today, to scare staff and the public with fake news is breathtakingly irresponsible.
In the motion, the Opposition use the Humble Address mechanism to ask for the release of documents, knowing full well that it will fuel wild conspiracy theories if we refuse to release those documents, as we must for reasons that are nothing to do with the NHS, but to do with good governance. However, there is a flaw in their Machiavellian logic. When I asked officials for advice on what submissions we as Ministers hold on privatisation—this great swathe of secret plans that the Opposition constantly allege—this is the written advice that I got back: “Officials have, since the Humble Address was received, sought to find submissions about the privatisation of clinical or patient services within the period specified, but to this point none have been identified. Her Majesty’s Government has no plans to privatise the NHS.” That was the official advice, but don’t take it from me. The respected King’s Fund said in 2015 that
“claims of widespread privatisation are exaggerated.”
Another way in which the Labour party loves to try to scare the public is to deliberately muddle up privatisation and outsourcing, which of course are quite separate. I think the shadow Health Secretary knows that, going by some of his comments. What are the facts on outsourcing? The Prime Minister did indeed wax lyrical about the possibility of 40% of acute operations in the private sector being done under the NHS banner—not this Prime Minister, but Tony Blair in 2006. Had we followed Tony Blair’s advice, we would be spending nearly £2 billion more on outsourcing than we currently spend. The Secretary of State from that period also said quite openly, “We intend to use the private sector when it can bring expertise or resources to help improve services.” That is not me, but Alan Milburn in 2002.
And boy, did team Labour set about that outsourcing with enthusiasm: not just increasing the PFIs we have talked about and not just giving the first contract for an NHS acute hospital to the private sector in 2009—that was Andy Burnham—but increasing the amount spent on outsourcing by 50% in the last four years of that Government. [Interruption.] Fifty per cent. These are the facts. I know the hon. Member for Dewsbury (Paula Sherriff) wants to do the fake news and the scare stories, but let us just listen to the facts. Let us talk about what has been happening under this Government. In my first year as Health Secretary, the proportion going to the independent sector went up by 0.6%. In the second year it was 1.2%, in the third year it was 0.4% and last year it was 0%.
I need to correct the record. During Prime Minister’s questions, I hurriedly passed the Prime Minister a note about the increase in Wales in the use of the independent sector. She said at the Dispatch Box that in Wales it had gone up last year by 0.8%. I need to correct that, because in fact it went up by 1.2%—50% more than I thought. Wales, where Labour is in government, is racing ahead. In fact, in pounds spent, the use of the independent sector last year in Wales went up by a third. What that shows is not just that these allegations are nonsense, but that Labour knows they are nonsense. If there was any truth to them they would not be increasing outsourcing in Wales by one third at the same time as branding it as verging on the criminal in England. With the huge pressures facing the NHS and immense efforts by frontline staff to cope with flu, winter and an ageing population, can the Labour party really be trusted with the NHS when it spends its time putting out fake news?
Unlike Labour, we do not believe that the NHS should close its ears to innovation in other sectors or other countries. We want the NHS to be the best in the world and there are things to learn from others that will help patients and help the NHS. Sometimes those innovations will even come—dare I say it?—from America. But to copy global best practice from one small part of what is happening in America does not mean that we want to copy its system itself, which I think, and I think most people in this House think, is an affront to that great country, with poor outcomes, lack of coverage and high cost.
To stop ideology trumping the needs of patients, the Conservative-led Government in 2012 legislated to stop politicians choosing whether to boost the private or the public sector, formally and legally giving that decision to clinicians who run clinical commissioning groups. I will tell the House why we did that. What would happen if we followed what the shadow Chancellor advocated last year, when he said
“we will reverse Tory privatisation by renationalising the NHS”
is that 120,000 people would have to wait longer for operations on their hips, knees and for other elective surgery. The price of Labour ideology, putting ideology before patients, would be nearly 200 people waiting longer in every constituency in this House.
Julian Knight (Solihull) (Con)
The Secretary of State touches on a point that is very pertinent in my constituency. I met a former police officer who had an NHS operation on his hip. The operation went wrong, so the local NHS trust paid privately for the officer to have the operation done correctly. Does that not show that at times it can be a very good thing to involve the private sector? The key is that the NHS is free at the point of need.
Karin Smyth (Bristol South) (Lab)
I am listening carefully to the Secretary of State’s comments on ideology and the Health and Social Care Act 2012. He will remember that I, in a CCG, was implementing the 2012 Act. Is he saying that he is proud of the Act and that it has worked out as intended?
Mr Hunt
As Chinese Premier Zhou Enlai said about the French revolution, it is too early to tell.
As my hon. Friend the Member for Solihull (Julian Knight) alluded to, there is one ideology that we will not compromise on: our belief that the NHS should be free at the point of use and available to all. And why will we not compromise on this? It is because, contrary to Labour’s creation myth about the NHS, it was a Conservative Health Minister, Sir Henry Willink, who first proposed it in 1944. Here are his words from 1944 announcing the setting up of the NHS:
“Whatever your income, if you want to use the service…there’ll be no charge for treatment. The National Health Service will include”—
[Interruption.] I know this is difficult for Labour Members, but let me tell them what the Conservatives said when we were setting up the NHS:
“The National Health Service will include family doctors”
and will
“cover any medicines you may need, specialist advice, and of course hospital treatment whatever the illness”.
Nye Bevan deserves great credit for delivering that Conservative dream, but let us be clear today that no party has a monopoly on compassion, and no party has a monopoly on our NHS. There are some other myths—
Jonathan Ashworth
I really do think the Secretary of State has some brass neck. The Tory party voted against the creation of the NHS 20-odd times. That is the reality of what happened in 1948, including on Third Reading in this House. It is a Labour creation.
Mr Hunt
As the shadow Health Secretary knows perfectly well, the way that this House works is that Oppositions often vote against the Government when they disagree with elements of a Bill, but that does not mean that they disagree with the principles of the Bill. I remember the hon. Gentleman’s party voting against the Care Act 2014. That does not mean that they disagreed with the principles behind it.
Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)
The circumstances around the recent collapse of Carillion have left Liverpool with an unfinished hospital. Negotiations with a potential new contractor are under way but may require ministerial involvement because of the involvement of other Departments. Will the Secretary of State give me an absolute assurance that he will do whatever he can within his power to ensure that that new hospital is completed as soon as possible?
Mr Hunt
I can give the hon. Lady that assurance. I am most grateful to her for raising that issue and reassure her that my hon. Friend the Minister of State responsible for hospitals was at the hospital on Friday, going into detail about how we make sure that there are no delays on that issue.
Jamie Stone
I thank the Secretary of State for giving way. On the issue of freedom of access and equality of access, would he at least concede that where there are issues of distance, rurality and remoteness of location, that is a challenge—although health is devolved to the Scottish Parliament—which means that it is not quite as free for some of my constituents as it is for people who live in Glasgow, Edinburgh or London?
Mr Hunt
The hon. Gentleman makes a fair point, which would be echoed by many Government Members who represent rural constituencies. There is a balance to be struck between the benefits of specialist surgery, where greater volumes of a particular procedure are done, leading to better outcomes for patients, and the trade-off that we make with travel times. I know that that is something that the local NHS, in all parts of the UK, thinks through very carefully.
There is another myth we always get from the Labour party that I think it is very important to dispel: the narrative about the NHS being in total decline. Let us be clear about the pressures facing the NHS. We had to deal with the financial crisis of 2008, which left this country’s coffers empty. We have had to deal with the fact that over the last seven years, we have had half a million more over-75s. We had to deal with a crisis of care at Mid Staffs, which turned out to be a problem affecting many other parts of the NHS.
Yes, it is true that we are missing some important targets at the moment, but let us not forget the extraordinary things that have been achieved despite that pressure, such as for cancer. We inherited some of the lowest cancer survival rates in western Europe. In 2010, only 10% of patients got intensity-modulated radiotherapy; that figure is now 44%. We have two new proton beam therapy machines—at the Christie and University College London Hospitals—and there are 7,000 people alive today who would not be had we stayed with the cancer survival rates of 2010. Every day, 168 more people start cancer treatment than did in 2010. This is a huge step forward.
On mental health, previously we had no national talking therapy service for people with anxiety and depression; today, 1,500 more people are starting or benefiting from talking therapy services every single day, and we have huge plans to extend mental health provision to 1 million more people.
Mr Hunt
No, I do not think it acceptable at all, but I would ask the hon. Lady to bear it in mind that we have 2,000 more paramedics than we did in 2010 and that we have invested in a huge amount of capital equipment for the ambulance services. Of course we need to do more, but, when she talks about A&E, she should recognise the achievements of many hospitals, including her own. Every day across the NHS—even over this difficult winter—2,500 more people are seen within four hours than were in 2010.
Labour seems to think that quality problems in the NHS started in 2010. I should point out that because of what we have done to deal with the problems of Mid Staffs, which happened on Labour’s watch, including through the new Care Quality Commission regime, 2.1 million more patients every year benefit from good or outstanding hospitals than did five years ago. A couple of weeks ago for the first time the majority of hospitals in the NHS were good or outstanding, which is a huge step forward and a huge tribute to NHS staff. That might be just one reason the Commonwealth Fund last year said that the NHS was the best healthcare system in the world. When Labour was in office, it was not even the best in Europe.
There is another reason to oppose the motion. It has nothing to do with health policy, but is a much bigger point of principle. After more than five years in this role, the one thing I have learned is that good policy can be made only through frank and open discussion between Ministers and officials. It will not surprise the House to know that Ministers are human, we make multiple mistakes—not me of course—and it is critical that the Secretary of State in charge of the largest health system in the world can get honest, high-quality advice, but the motion would fundamentally undermine that.
This is not a party political point. Many Labour Members have benefitted from such advice, and all of us would want Ministers of any party in power to benefit from such advice, regardless of whether we support the Government, yet the motion asks us to release not just that written advice from officials, which would have an enormous chilling effect, but notes of confidential discussions between Ministers and officials. In short, as my right hon. Friend the Member for Aylesbury (Mr Lidington) said only last week, it would undermine the safe space within which Ministers and civil servants consider all the options and weigh up the best approach. Officials must be able to give advice to Ministers in confidence. The candour of all involved would be seriously affected if there were any fear of those discussions being disclosed.
No Government of any party have ever operated in an environment where advice is sought one week and made public the next. Let us look back to what Andy Burnham said in 2007 when he as a Minister was asked to release information. His words were:
“Putting the risk register in the public domain would be likely to reduce the detail and utility of its contents. This would inhibit the free and frank exchange of views about significant risks and their management, and inhibit the provision of advice to Ministers.”—[Official Report, 23 March 2007; Vol. 458, c. 1191.]
Far from increasing the accountability of the Executive to the legislature, releasing such information would risk weakening it, as more and more discussions would end up taking place informally with no minutes taken at all.
Alex Chalk (Cheltenham) (Con)
Does my right hon. Friend agree that it would be completely inconsistent with the Freedom of Information Act—passed, by the way, by a Labour Government—which deliberately carved out an exemption for precisely these sorts of communications? It would be very odd—in fact, completely counterproductive—to turn that on its head.
Mr Hunt
My hon. Friend speaks extremely wisely. He is right: it would fundamentally weaken the ability of the Executive—which the Freedom of Information Act tried to protect—to make considered, thoughtful and wise decisions. Ultimately, that would put at risk the credibility of our democracy itself.
I think it fair to say that, despite my many faults as Health Secretary, I have pursued transparency in the NHS with greater vigour than has been the case previously. I passionately believe that in this House we must be accountable for the outcomes of all the decisions that we make, but all of us are mortal—all of us make mistakes—so if accountability is the watchword after a decision is made, thoughtfulness must be the watchword before it is made. Any measures that affect the honesty and frankness of the advice that Ministers receive would fundamentally reduce that thoughtfulness and reduce the effectiveness of our Government for the people whom they serve.
For those reasons—as well as because of all the ridiculous myths about the millions and privatisation—I have absolutely no hesitation in asking my right hon. and hon. Friends to vigorously and thoroughly oppose the motion.
Several hon. Members rose—
Madam Deputy Speaker (Dame Rosie Winterton)
Order. As colleagues will see, a vast number of Members want to speak in the debate. I will impose a four-minute limit after we have heard from the spokesman for the Scottish National party.
Chris Stephens (Glasgow South West) (SNP)
I will be as brief as I can, Madam Deputy Speaker, to accommodate Members with clear constituency interests who I know will want to contribute to the debate. It was interesting to watch the Secretary of State being the pantomime villain of the day and trolling us about the Conservatives’ record on the national health service.
I want to make some observations about privatisation and outsourcing in particular. I think that I should start off with the World Health Organisation’s definition of privatisation:
“a process in which non-government actors become increasingly involved in the financing and provision of health care, and/or a process in which market forces are introduced in the public sector”.
Patients who attend health service centres throughout these islands will receive amazing care, but that is predominantly due to the dedication of the people who work in the NHS, some of whom—as we need to recognise—are working under much greater pressures than others.
Some have argued that outsourcing such services as cleaning or car parking is a good thing, but there is evidence that the outsourcing of cleaning, and poor-quality cleaning, led to the rise of hospital-acquired infections. The Conservatives created the internal market in 1990, and that led to an “us and them” mentality in many local areas because it introduced competition between hospitals. In 2010, they promised “no top-down reorganisation”, but then introduced the Health and Social Care Act 2012, section 75 of which pushed commissioning groups into putting contracts out to tender.
We have seen the rise of the independent treatment sector, which won approximately 34% of contracts in 2015-16. That figure rose to 43% in 2016-17, and it now stands at approximately 60%. It cannot be denied that private companies are more involved in healthcare in England.
John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)
Will the hon. Gentleman give way?
Chris Stephens
I am sorry, but I will not take any interventions because many Members with constituency interests wish to speak.
We often hear about the costs of service redesign. The new organisations, the external consultants and the change managers are all described as one-offs. However, the experience of NHS workers over the past 30 years is that the process has led to a huge amount of waste.
Chris Stephens
The hon. Gentleman is right: many Members representing English constituencies want to talk about their constituents’ experience, and I think it only fair to allow them to do so—[Interruption.] The hon. Gentleman can try all he likes, but I will not be shouted down by anyone in this Chamber.
What about running costs due to market forces themselves? What about the contracting design, the tendering, the bid teams, the corporate lawyers, the billing and the profits? The Government appear to have moved from an internal market to the external market that is now in England. [Interruption.] Members keep trying to shout me down, but I will continue talking. It is disrespectful to shout Members down in this Chamber. I will continue my speech, but I want to accommodate other Members. I do not think that they should be subject to a four-minute time limit, and I want to give them time to talk about their constituents.
A petition that received 237,095 signatures was debated in Parliament in April. The signatories are very concerned about outsourcing in the NHS, and they have every right to be concerned about the approach of this Administration. Others have warned of the threat of English health privatisation as it applies to devolved services. The trade union Unison has warned:
“The Tories might not run NHS Scotland, but that doesn’t mean they aren’t attacking it. We must fight to save it.”
It also says:
“Devolution means they can’t run down and privatise our NHS directly, the way they are doing in England”,
but what the Tories can do is starve it of resources. The NHS is under threat from privatisation and cuts. The Tories’ health Act pushed the profit motive to the heart of the English national health service.
I hope that the Minister will address a number of things mentioned by the hon. Member for Leicester South (Jonathan Ashworth) when he responds to the debate because I find what has been happening astonishing. I opposed outsourcing and privatisation before I was in this place, as a trade union activist for 20 years. The issue of West Sussex has been mentioned, but we have heard no response. We have also heard about Carillion—I was on the joint inquiry into Carillion—and the effects of what happened on Liverpool. We heard about the collapse of the £800 million contract in Cambridgeshire and Peterborough for older people’s services.
Those issues are all serious, and people across the UK who are watching our proceedings will be concerned about the outsourcing and privatisation of the NHS in England—[Interruption.] I will not be shouted down. The Scottish Tories think that they can shout people down, but that will not happen with me. I am reaching the conclusion of my remarks, so the hon. Members for Berwickshire, Roxburgh and Selkirk (John Lamont) and for East Renfrewshire (Paul Masterton) will have to be patient until another day.
Those who are watching these proceedings will be very concerned about the outsourcing and privatisation of the national health services in England. People want to see a publicly owned national health service across these islands.
David T. C. Davies (Monmouth) (Con)
I am sure that my hon. Friends the Members for Berwickshire, Roxburgh and Selkirk (John Lamont) and for East Renfrewshire (Paul Masterton) were simply trying to find out why the hon. Member for Glasgow South West (Chris Stephens) did not want to talk about the £70 million-odd a year that the SNP Government in Scotland are spending on outsourcing, but we will leave that for another day.
I was delighted that my right hon. Friend the Secretary of State mentioned Henry Willink, the former Member of Parliament for Croydon North and war hero, who was one of many people who helped to form the national health service, along with the great Liberal Beveridge, of course. It is disappointing that Labour have tried to make the NHS something that they alone feel they have the right to talk about. It is not their NHS; it is our national health service. It does not belong to any one political party; it belongs to all of us. There was opposition from a number of Conservatives to the Bill that set up the NHS, but some Labour peers, such as Lord Latham, and Herbert Morrison were concerned about that Bill, although of course all that is written out of history.
We know that whenever the Labour party is in trouble, it starts to generate scare stories about privatisation. We have been thinking about the celebrations for the anniversary of the national health service, but I was rather sad last year about another NHS anniversary: 30 years since Labour started making up mythological stories about the Conservative party wanting to privatise the NHS. It was 30 years since 1987, when Labour said that they would end “privatisation in the NHS”. They did the same thing at the ’92 election, saying:
“Labour will stop the privatisation of the NHS.”
And so it went on at one election after another: Labour trying to conjure up the idea that the Conservatives wanted to privatise the NHS. Despite that, we won numerous elections after 1987—we have been winning them since 2010—and we have absolutely no intention of privatising the national health service and never will.
It was interesting that Labour’s 2005 and 2010 manifestos said that a Labour Government would start using the private sector. The 2005 manifesto talked about using the “independent and voluntary sector”, and that approach continued in the 2010 manifesto.
As a result, between the financial years 2006-07 and 2013-14, we saw a gentle increase in the amount spent on the private sector within the national health service to deliver operations free at the point of use to those who need them by occasionally using private contractors, as the SNP is doing in Scotland. The figure went up from 2.8% to something like 6.1%. To put those figures in perspective, Cuba—a country I love, but not one known for its wild capitalist economy—has about 18% of its production in the private sector. Figures from an obscure website, thediplomat.com, suggest that 7.5% of North Korea’s economy is in the private sector. In other words, North Korea makes greater use of the private sector than the NHS—a figure of 6.1% does not represent privatisation.
From my experience, I can truthfully say that I have a complaint about the NHS in England, and so do my constituents: we cannot access it, because we are forced to use the national health service in Wales. The result of our having to use a health service that has been under 18 years of Labour government is that we have longer waits for our ambulances. I recently dealt with a case of a lady who had to wait two hours for an ambulance after a suspected heart attack. We have longer waits for accident and emergency. We do not have access to cancer drugs such as Avastin in the way patients do in England. And, of course, we wait much, much longer for hospital treatment and operations. The target in Wales is 26 weeks, as opposed to 18 weeks, but that target is all too often missed.
I wish that I had more time to talk about Labour’s failings in the national health service. I have suggested a few things in my time, but neither I nor any Conservative MP will ever privatise the NHS. It is about time the Labour party stopped telling those fibs.
Rosie Duffield (Canterbury) (Lab)
A few weeks ago, my local NHS trust in east Kent announced that more than 1,000 employees—more than 800 Serco employees and more than 200 NHS employees—working in cleaning, catering, estates and facilities will now be employed by an arm’s length management organisation.
Most of us in this House will be familiar with ALMOs, but for those watching, listening and reading about them for the first time, although ALMOs may sound a bit like that well-known cuddly Muppets character, they are nowhere near as fun. This is not “Toy Story” but Tory story, a story of endless austerity and endless cuts to our vital and much-loved health and public services.
ALMOs have become a mechanism by which primarily local authorities, but now it seems NHS trusts too, can avoid responsibility by keeping things such as housing departments and cleaning facilities at arm’s length—away from too much scrutiny, and away from the managers and councillors whose jobs might depend on keeping themselves as far away as possible from that scrutiny.
Judith Cummins (Bradford South) (Lab)
My hon. Friend is making an excellent speech. Staff in Bradford have real concern about the plans to create a wholly owned company that could see 300 members of staff at Bradford Teaching Hospitals NHS Foundation Trust transferred out of the NHS, creating a two-tier workforce. Does she agree that we need to keep our health service, in the words of Unison’s campaign, 100% NHS?
Rosie Duffield
Absolutely. I was just about to speak about Unison, which is my union.
Leading unions have called the move in my local NHS trust—the East Kent Hospitals University NHS Foundation Trust—a “wolf in sheep’s clothing” and fear, with good reason, that workers’ conditions, including pay, will be eroded. I know many of those workers personally and they include some of my friends. The unions are right: workers’ conditions will be eroded, and it is already happening in other public services across Kent.
The Conservative-run Kent County Council, for instance, has introduced another ALMO called the Education People. Educational psychologists currently working directly for the council are being transferred to be employed by the Education People. The terms and conditions being offered by the ALMO to new educational psychologists are significantly worse than existing terms and conditions for those employed by the county, so no new educational psychologists have been recruited for Kent. We already have a serious shortage.
Of course, Kent County Council is doing that because central Government have starved it of funds and, perhaps because it is the same shade of blue, it is too timid to make that big a noise about things, so I will do it instead: Conservative central Government cuts are reducing our ability to care for people properly. In my constituency, the local NHS is potentially doing the same by setting up an ALMO to make yet more cuts by stealth. More money, less responsibility.
My union, Unison, represents nearly half a million healthcare staff employed in the NHS. That is one in every 60 or so working adults in one sector in the UK represented by one union standing up with one voice against injustice.
In Canterbury, rooms at the once thriving city hospital can now be found stacked with old equipment, and staff tell me that whole wings of old, neglected hospitals, such as the Buckland in Dover, lie abandoned, underused and under-occupied while waiting rooms in our not-so-local accident and emergency departments remain rammed. In Canterbury, services that were removed “temporarily” in 2017 look likely never to return to those old buildings. Proposals are afoot for a new hospital, but it simply will not be built if the central Government funding is not there to fill it. I am the only Labour MP in Kent and, as such, I am proud to make a loud noise about and stand up against the Conservative cuts that have caused vital hospital services to disappear in my county in recent years.
Things need to change drastically, and the new university medical school in Canterbury will be part of that much-needed change. If someone in my constituency is sick, they currently have to travel a long way to Ashford or Margate to get the emergency care they need.
Combine an underfunded NHS with a South East Coast Ambulance Service in special measures, and we have the ingredients for chaos. Chaos and a lot of sadness are apparent in all the letters I receive from constituents about the NHS week in, week out. Members will get the idea. The funding is not there, so the services have gone.
Helen Whately
I have a question about what the hon. Lady said regarding the loss of services at Canterbury Hospital. She and I both oppose that. Does she acknowledge that services were lost under a Labour Government?
Rosie Duffield
I agree that services started to be cut under a Labour Government, but they have got so much worse that our hospital is now underused, unusable and unrecognisable.
Madam Deputy Speaker, you will hear the same thing repeatedly from my concerned Labour colleagues this afternoon. The impact of austerity on our health service has been truly dreadful. Trusts are beginning to look to PFIs to keep walls from crumbling, and the desire for a short-term fix has meant that private companies, such as Virgin, Serco and Spire, have stepped in, especially near me in Kent, to profit from sickness, which is fundamentally abhorrent.
So much must change. The privatisation of the NHS and supporting services must be stopped and funding must be fully restored to the levels it was at under the last Labour Government. If Conservative Members continue to erode our health service and encourage private companies to step in to fill in the gaps, there will be little left when they finally realise what they have done. With so many pieces given away, the NHS jigsaw will certainly never look the same again.
Labour Members are constantly accused of running down, criticising and putting down our health service. The fact is that we are telling the truth about the urgent state of our broken NHS, which is staffed by amazing, dedicated and selfless people who deserve so much better from this Government.
Tom Pursglove (Corby) (Con)
It is a pleasure to follow the hon. Member for Canterbury (Rosie Duffield), but I come at this debate with a real sense of frustration, because the NHS is once again right at the heart of political knockabout, which does absolutely nothing to advance the cause or to pursue better patient care. I am frustrated that the word “privatisation” is so readily bandied around for cynical ends to scare the public and to try to give a misleading picture of what is happening for dogmatic reasons.
Nobody is seeking to privatise the NHS, but it was Labour that introduced competition into the NHS. What does that mean? It means that there is often greater capacity to treat people more quickly based on demand. What could possibly be wrong with buying in 100 hip operations, for example, if people get treated more quickly, if they are getting the best possible care and if they are fit and well sooner? Who could possibly argue with that? Not a single constituent of mine would argue that there is anything wrong with that. Surely they matter most in all this.
Labour Members hark on about money and not about outcomes—we do not hear anything about outcomes; we hear just about money, often in crude terms. A more effective debate today would have been about moving the agenda forward. We could have talked about things such as prevention. I am all for discussing prevention—at Prime Minister’s questions today, I talked about prevention through the daily mile, which would be a welcome step. In a time of increasing demand, prevention means that we are able to provide better care and that people do not get into desperate situations. It is often more effective for the taxpayer. Prevention means that people will be fitter and healthier for longer, which we should focus on.
The Government have consistently increased health spending year on year since 2010. I would be happy for a Labour Member to intervene and answer this question. Why have they not supported this Government’s increases in health spending? Could they say which services would have less money if we had taken their advice, given that we would be starting from a lower base? Back in 2010, the former shadow Health Secretary, who is now metro Mayor of Manchester, said:
“I am putting the ball right back in…Osborne’s…court. It is irresponsible to increase NHS spending in real terms within the overall financial envelope that he, as chancellor, is setting.”
On the prevalence of private providers in the health service, currently less than 8% of the NHS budget is spent via private providers. The rate at which that has increased since 2010 has been slower than the rate under the Labour party, under whose Administration the NHS spent around 5% on private providers. The motion is a bit churlish. It does not focus on what we should focus on, which is patients, better care and moving the agenda towards the direction of prevention.
It frustrates me enormously that we use terms such as privatisation so readily, while knowing full well that they give a misleading picture to the public. We hear a lot of complaining from Labour Members, but, as with police and local government funding, and stamp duty for first-time buyers, when the Government find solutions, Labour Members vote against them. People will make their own minds up.
Liz Twist (Blaydon) (Lab)
On 6 March, I had the good fortune to secure a debate in Westminster Hall on wholly owned subsidiaries in the NHS and was shocked to find how many hon. Members—they were not just Labour Members—had experience of local NHS trusts setting them up. The NHS trust that covers my constituency, the Gateshead NHS Foundation Trust, has set up a wholly owned subsidiary company. It is also advising other trusts on how to do the same.
The Gateshead NHS Foundation Trust is a very good trust, but I am concerned that it has transferred staff who provide the maintenance, cleanliness and operation of the hospital to a wholly owned subsidiary company. There are two ways in which trusts can save money by setting up a subco: through savings on VAT thanks to a loophole—the Treasury appears to be willing to look the other way—and through future savings in staffing as new staff are employed outside “Agenda for Change” pay, terms and conditions. Importantly, there are also savings on pensions because those staff are denied access to the NHS pension scheme.
The savings are coming off the backs of staff, many of whom—porters, cleaners and catering staff—are already on the lowest scales. “Agenda for Change” was introduced to provide a fair and equality-proofed pay system for all NHS staff. It is bad enough that staff working for contractors in the NHS, such as those formerly employed by Carillion and now employed by companies such as Serco, which took over some of Carillion’s contracts, are not on that pay system, but the fact that NHS trusts voluntarily and even eagerly take measures to get around the system is simply outrageous.
Let us be clear: we know the problem is underfunding of our essential NHS services. This Government have failed to provide adequate funding right across the NHS and some trusts have taken the decision to set up these subcos in an effort to make that money go further. We understand that on the Labour Benches. But it is beyond the pale to ask lower-paid staff to make the savings from their own pay packets. All of us, on both sides of the House, say how much we value the NHS workforce, but that means not only nurses and doctors, but the staff who make the hospital work. They are an essential part of the NHS team, and the Government must ensure that they are treated fairly, now and in the future.
There is another concern about these subcos. There is a real concern that they are being set up ripe and ready for privatisation: a neatly packaged organisation, vulnerable to the vagaries of the market. This is not the NHS we want. We want an NHS that recognises the value all of its staff, from cleaners and porters to allied health professionals such as occupational therapists and radiographers, from maintenance staff to nurses and, yes, doctors. We need an NHS that does that so that we can provide the best possible care for patients. We need to ensure that we maintain these services in the public sector, and I know that there is huge support from my constituents for ensuring that our NHS services are directly provided by NHS staff.
Earlier today we heard that staff at Wrightington, Wigan and Leigh NHS Foundation Trust are taking industrial action against a proposal to transfer them to a subco. More than that, they are striking against the privatisation of NHS services. I wish them, and staff in other trusts standing up for our NHS, every success.
Alex Chalk (Cheltenham) (Con)
The allegation of privatisation of the NHS is wholly misconceived. It is a reheated and debunked myth that irresponsible elements have been trotting out for decades, and repeating it does not make it any more true. NHS outsourcing to private providers is being weaponised in a way that involves dressing it up as a threat to the NHS’s guiding principle that treatment should be provided free at the point of use and regardless of ability to pay. That is what people understand when the expression “privatisation” is used, but the reality is that nothing could be further from the truth.
That principle is fundamental, inviolable and enduring. It is all those things because it reflects so much about the kind of country we are and want to continue to be. It is the principle that says that when a member of the public is rushed into hospital needing emergency care, we take pride in the fact that the ability to pay is irrelevant. NHS staff are interested in vital signs, not pound signs. There is no appetite in this country for the Americanisation of British healthcare. Even if there were, I could never support it, my colleagues could never support it and the Government could never support it. That is why it is so important that we make that position crystal clear.
On the issue of outsourcing, we must not rewrite history. As moderate members of the Opposition concede, certain services have been provided independently since the NHS’s inception 70 years ago. Most GP practices are private partnerships; the GPs are not NHS employees. The same goes for dentists and pharmacists. Equally, the NHS has long-established partnerships for the delivery of clinical services such as radiology and pathology, and for non-clinical services such as car parking and the management of buildings and the estate. To give an everyday example, the NHS sources some of its bandages from Elastoplast. That is common sense; it would be daft if public money was diverted from frontline patient care in order to research and reinvent something that was already widely available.
That is why certain members of the Labour party have slammed this kind of argument as scaremongering. Lord Darzi, a former Health Minister, has been highly critical. In 2017, the shadow Secretary of State said on the “Today” programme that there may well be examples
“where in order to increase capacity you need to use the private sector”,
so this argument is completely misconceived. In 2009, Andy Burnham admitted that the private sector could benefit the NHS. As Labour’s Health Secretary, he said:
“the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”—[Official Report, 15 May 2007; Vol. 460, c. 250WH.]
Helen Whately
My hon. Friend is making the point extremely well that there is complete inconsistency in Labour’s argument on this point. Which of the various parts of NHS services that are provided by independent sector providers is Labour against?
Alex Chalk
My hon. Friend is absolutely right. I shall give three brief examples from my own constituency. First, Cobalt is a Cheltenham-based medical charity that is leading the way in diagnostic imaging. It provides funding for research, assists with training for healthcare professionals and provided the UK’s first high-field open MRI scanner. Is the Labour party now suggesting that that should be ditched—that we should axe that fantastic facility in my constituency?
Secondly, the Sue Ryder hospice at Leckhampton Court is part-funded by the NHS and part-funded by charitable donations; again, is that for the axe under Labour? Thirdly, what about Macmillan and its nurses? It is a fantastic organisation, yet we have the extraordinary situation in which the Labour party says, “Macmillan is all right, but another provider is not.” What is the logic of the Labour position? What about Mencap? The list goes on and on.
Let me deal briefly with the second part of Labour’s motion, whereby it wants to ensure that all communications between Ministers and their officials are revealed. The reason why that is so bogus was explained clearly by the former senior Labour Secretary of State Jack Straw in a statement that was quoted with approval in the Chilcot committee’s report. He said that meetings in Cabinet
“must be fearless. Ministers must have the confidence to challenge each other in private. They must ensure that decisions have been properly thought through, sounding out all possibilities before committing themselves to a course of action…They must not be deflected from expressing dissent”.
What about advice given by officials in the form of memorandums and so on? What would Labour Members say to those officials about a motion that might result in the making public of the advice of professional civil servants—people who, of course, can never answer back themselves—that they thought was given to Ministers in confidence? As I have already indicated, it would also be completely inconsistent with the Freedom of Information Act 2000, which was introduced by a Labour Government. On both bases, the motion is misconceived, and I shall have no hesitation in voting against it.
Dr Paul Williams (Stockton South) (Lab)
I refer the House to my entry in the Register of Members’ Financial Interests: I work as a GP.
There may be people listening to this debate who work for private or voluntary sector organisations, providing services to patients or to the NHS. Most of them do a fantastic job. They are not employed by the NHS, but they do help our NHS, and I thank them for the work that they do.
When local people and local commissioners agree that it is in the best interests of local patients to use non-NHS services to deliver NHS care, that should sometimes be enabled. In the fields of medical technology and devices, pharmaceuticals, information management and many others, good private sector companies are working to support the NHS. But private sector involvement can also lead to a race to the bottom. When subsidiary companies reduce terms and conditions for workers, that is bad for us all; when privatised community services ignore the hardest-to-reach patients, that can widen health inequalities; and when private sector treatment centres cherry-pick the least-risky patients, do not contribute to training, and then expect the NHS to pick up the pieces when complications arise, the NHS loses.
All that is without mentioning the private Primary Care Support England contract, run by Capita. It is total disaster. The main function of support services is to enable clinicians to get on with the job of looking after patients, but GP registrars are not being paid on time, GPs are not added to performers lists, and one practice manager told me that it took four months and 16 emails to transfer a GP from being salaried to being a partner. This work needs to be taken back by the NHS; Capita has failed.
What vision do I think we should have for our NHS? I endorse the Government’s goal of integrated health and care services built around patients’ needs. That is the only way to meet the health challenges of this century. The Health and Social Care Committee, on which I serve, has looked in detail at moves towards the integration of care through sustainability and transformation plans, accountable care organisations and integrated care systems. We have seen real potential to improve the quality of care for patients, to make the strategic shift away from reactive care to proactive care and to transfer more NHS resources into keeping people well rather than just fixing them when they get sick. The need to bring together primary care, community care and social care has widespread support in the NHS, but we should do that within a health and care service, run by the NHS, owned by the NHS, and led by the NHS.
There are understandable concerns about the integration agenda being used to encourage more private sector involvement. The Government and NHS England say that that is not their intention, but speculation could easily be dispelled by legislating to make accountable care organisations—if they happen—NHS bodies. I am talking about NHS-owned and NHS-led organisations running health, and even care services, for whole populations. What a great legacy that would be, with procurement not being forced on commissioners, with the private sector being used only when it enhances the ability of the NHS to help patients and with no cherry-picking and no dilution of hard-won employment rights for any staff providing services to and for the NHS.
The Government should bring forward legislation to repeal section 75 of the Health and Social Care Act 2012; accountable care organisations should be cemented in primary legislation that makes them NHS bodies; and the Primary Care Support England contract should be brought back into the NHS.
Matt Warman (Boston and Skegness) (Con)
It is a privilege to follow the hon. Member for Stockton South (Dr Williams) who made a laudable and moderate speech. I dare to suggest that when people have serious frontline experience of our health service, as many in my own family do, they are less hyperbolic than those we heard from the shadow Front Bench. We should be clear that hyperbole harms our health service.
I do not for a moment think that we should pretend that there is no politics in the health service, but we should be clear that there are many things that unite us on this. I say that in large part because the situation in my own constituency of Boston and Skegness, where we have a serious and ongoing problem recruiting paediatric consultants and paediatric staff, has led to a number of public meetings, which have been both fascinating and somewhat disconcerting. I say that largely because the rhetoric of privatisation, of outsourcing, is something that I have confronted at first hand.
People genuinely believe that there is a long-term suggestion that an American model is coming to the UK. The effect of that is not simply to scare people, but when the vulnerable older person in Skegness, who often does not have access to a car and often does not have the deep-seated knowledge that the hon. Member for Stockton South has of the NHS, thinks, “You know, I shouldn’t go to my GP. The NHS is under huge strain. I shouldn’t cause a fuss. I shouldn’t make that appointment.” Later down the line, when he or she find themselves in a less healthy position, it is the fault of those of us who have used the NHS has a hyperbolic football. All of us in this place should be responsible when we talk about the health service. As we always say, and as those on the Front Bench have said, it is about patients, not politics.
I have been in those public meetings saying to my constituents that I believe that the trust in my own constituency is passionately committed to providing healthcare services for desperately ill children as close to home as possible. When I say that that trust is struggling to recruit, it is because it is struggling to recruit; it is because it is being honest. It is not because of some conspiracy theory at the top of the previous Government or of this Government, but because there are deep-seated problems that this Government are tackling with, for instance, the expansion of medical schools and the expansion of nurse training places. We should not, I gently suggest, be ideological about this stuff, and we should be responsible.
The shadow Secretary of State said that this is not about ideology, but about what works. The hon. Member for Stockton South also said that where private sector involvement enhances what can be provided by the public sector, we should be brave about saying that what makes patients healthier is in the taxpayers’ interests, it is in their interests and it is in our interests. So, while it is sometimes hard, in this adversarial Chamber, to calm down and look at the interests of our constituents, and although parliamentary theatre may be fascinating for Prime Minister’s questions and may be fascinating to us, I would like to hear an acknowledgment that the present Government are investing more than ever in the health service, are seeking to tackle the challenges of an ageing population and are seeking fundamentally to put patients first.
Tracy Brabin (Batley and Spen) (Lab/Co-op)
I am pleased to be called to speak in this important debate.
In my constituency, local NHS services have been an issue of concern for some time. It seems that services are forever under threat and that our local trusts are always struggling. Dewsbury Hospital, which is in my constituency and serves my constituents, has seen a number of its functions move to Pinderfields Hospital. Its A&E has been downgraded, so that seriously ill patients are more likely to be taken elsewhere, and in recent weeks the Secretary of State for Health stepped in to prevent any potential closure of the A&E at Huddersfield Royal Infirmary. That was a welcome step, but our NHS services should not be in a position where such drastic changes to provision are suggested.
I, like so many colleagues in the House, am in awe of our hard-working NHS staff, and I know that, in the Mid Yorkshire Hospitals NHS Trust, they continue to go above and beyond in ever more testing conditions. I pay tribute to them, and also say to Ministers that in my constituency we want our NHS staff to remain NHS.
Just last week, the Mid Yorkshire Hospitals NHS Trust announced plans to move staff into a wholly owned subsidiary company—something that, as we have heard from my hon. Friend the Member for Blaydon (Liz Twist) and others, is part of a national roll-out. That subsidiary will run a considerable range of local NHS services and will be responsible for an enormous number of local staff. The announcement came with very little warning and no public engagement about the plans.
Once again, I reiterate that I appreciate and understand the pressures that are being put on NHS trusts by the Government, and Mid Yorkshire is no different; but for me, the decision to move to a wholly owned subsidiary company simply is not the right one. Opposition has already been growing. The trade union Unison has called the trust’s plans an “insult” to workers, and will be balloting its members next month over potential strike action—something that will leave my constituents concerned, but also frustrated, as this problem is avoidable. They will understand that to take people off NHS contracts, and thereby put them at the risk of a future where the terms and conditions of their employment are inferior to those of their colleagues, can only worsen the situation.
The good news is—I hope it is good news—that the decisions on whether the trust can go ahead with its proposals are not a done deal. The Secretary of State for Health and Social Care still has to approve the plans. I say to him and his colleagues that these staff, including cleaners, IT specialists, maintenance workers, help keep our hospitals safe and functioning. They have stuck by the NHS in extremely testing circumstances, throughout years of pay stagnation. I, staff and the unions know that it is not the right decision to go down this path—a path that could lead to a two-tier workforce, where two colleagues working side by side, doing the same hours, the same job, could end up taking home a different wage.
Let us do the right thing by NHS staff and local people, and consign this wholly owned subsidiary to the bin where it belongs.
Chris Green (Bolton West) (Con)
It is a pleasure to follow the hon. Member for Batley and Spen (Tracy Brabin) and so many other colleagues who have made excellent speeches from both sides of the House.
I should recognise at the start of my comments that this Government have, over the past eight years, been increasing spending on the NHS and have ambitions, and a determination, to continue spending on our national health service. I look forward to the Government’s introducing a new substantial multi-year funding plan, which will provide more certainty for the future and better enable the NHS to plan and invest.
Locally, only last year we saw the building of a new £40 million mental health hospital—Atherleigh Park. That demonstrates this Government’s commitment to supporting people with mental health concerns. I was really pleased to see that local investment recently. In Horwich, we have plans for investment in GP services, with a new centre costing £6.8 million. It is going to be delivered in the near future, and it will provide a far better service and far better accessibility for people living in Horwich. That commitment to spending—to the NHS—is there.
As the Secretary of State highlighted, during the second world war the Conservative party, along with other parties in Parliament, was committed to delivering a national health service to ensure that we got that improvement in people’s health right across the United Kingdom. It is worth noting that since the second world war the Conservatives have run the NHS more than Labour. That rather undermines these arguments about privatisation, because why has it not yet been privatised if we have run it more than Labour? As my hon. Friend the Member for Corby (Tom Pursglove) said, the rate of increase in privatisation was actually far higher under the previous Labour Government. Labour ought to reflect on its own record in government of the increasing rate of privatisation through PFI deals.
Ultimately, this is about what works: that is what patients want to see. I am concerned about the scaremongering being pursued by Labour Members. Most MPs, when they hear the talk about privatisation, would recognise that care will still be free at the point of use, with a different mechanism to deliver the same high standard of care through the NHS or a private provider. What many people at home would hear, though, is that they will have to pay for that care—that they will need to have their credit card with them and if anything happens they will have to pay extra money, in addition to paying their taxes and everything else. During last year’s general election, I had conversations with constituents who had been terrified by people on the doorstep telling them that they would have to get their credit card to pay for their healthcare. This scaremongering has to come to an end.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I rise to speak as a former public health consultant and the chair of a primary care trust.
I want to start by recalling a conversation I had with Brenda Rustidge, a constituent of mine. She was born in the 1930s, and she described to me what it was like living in a pre-NHS world. Her father, who had just been demobbed after the war, was unemployed. She had a number of brothers and sisters, and they used to have to hide under the window when the doctor’s secretary called round on a Friday night to collect the money. She described the real fear and shame that she felt as a result. Of course, all that changed nearly 70 years ago when the NHS was created. Brenda and her family have thrived because of that.
This debate is not about scaremongering. It is about raising awareness of the real concerns not just of political parties but of clinicians, academics and experts across the country and across the world about what privatisation means. Okay, it is on a small scale, but in terms of spending it has increased from about 2.8% in 2006 to over 7.5%—over 10% if we include not just private providers but all non-NHS providers.
I want to reflect on a point made by my hon. Friend the Member for Stockton South (Dr Williams): we have within the NHS a system that provides universal, comprehensive and free healthcare. That is something we should be very, very proud of. We are seeing that being eroded. For example, private providers of knee and hip replacements exclude certain people. They do not want the complex cases because they are too time-consuming and costly. I take issue with the point that the right hon. Member for Mid Sussex (Sir Nicholas Soames) made, because it does entirely matter who provides the care that we get. There is a slow and steady erosion of the NHS as the sole provider.
In 2014, I conducted an inquiry into the international evidence on the effect of privatisation, marketisation and competition across different health systems. We commissioned a review of reviews, which is the strongest type of evidence, on the impact on health services, particularly looking at equity and quality. It was submitted to peer reviews and accepted in peer-reviewed journals subsequently, and it showed clearly and conclusively that health equity worsens in terms of not only access to healthcare but health outcomes.
It also revealed that there is no compelling evidence that competition, privatisation or marketisation improves healthcare quality. In fact, there is some evidence that it actually impedes quality, increasing hospitalisation rates and mortality rates. Of course, that was the key argument and the sole reason that the Government put forward for the Health and Social Care Act 2012.
The report found a whole host of other issues. I am sure that Members will go to my website to read about that. The transactional cost was one example—
Huw Merriman (Bexhill and Battle) (Con)
It is a pleasure to contribute to the debate. I want to start by recognising the achievements of the Tony Blair Government in taking the ideology out of private-public, which was good, and fast-tracking a number of patients who had been waiting too long for knee or hip replacements by allowing those operations to take place using the private sector. My own family were able to benefit from that. That was a good example of looking at what was best for the patient. It was still free at the point of delivery and ultimately within the health system.
I find it deeply depressing to hear those on the Labour Front Bench this afternoon talking in a manner that completely unwinds that, putting the NHS as a political football first and what is best for patients second. The shadow Health Secretary was so excited about the concept that I thought he was going to spontaneously combust. It is a stain on the Labour party that it would go back in time in that manner.
Far from the exaggerations that we heard, the reality is that the proportion of private spend has gone up from 5% when Labour left office—not, as the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) said, 2.5%—to 8%. Since the NHS has been born, as GPs refuse to work within the NHS system, we have had private sector partnering. We have pharmacies. We have the pharmaceutical industry. The public and private have always worked together to make sure the patient gets the best outcome. I hope that somewhere along the line, the Labour party goes back to the formula that quite frankly got it into government and remembers that the public are not concerned about the politics. They just want to make sure that the NHS will be there for them in the fastest possible time, with the best care and free at the point of delivery—and that is what goes on at the moment.
We are seeing record levels of funding within the NHS, as we did under the Blair Government; I hope Members see that I am being fair and trying to make a cross-party point. I would like to see more funding in the NHS. While I do not like to see taxes go up—I would be the last person on the Government Benches to argue for that—I think the point has come when we need to look at our income tax rates and face facts. People are living longer, and they need better care. We need more money in our social care system as well.
As well as more money, we need reform. Reform only works when more money is put into the system. As well as seeing an extra 1p on income tax, I would like to see another penny effectively suspended. We can then go back to the public and ask whether they think it is acceptable that people abuse the A&E system and the people within it, and whether people should be charged if they turn up wrecked and take advantage. Is it acceptable that people mess around their GP surgeries, wasting time and money for GPs? If that does not work, perhaps we should put a second penny on income tax, because we need to take tough decisions to make this work.
Another point I want to make comes back to political footballs. Reference has been made to Sussex patient transport, and I chaired the group on that. It was a good example of a cross-party group that with other MPs—including my hon. Friend the Member for Lewes (Maria Caulfield), and the hon. Member for Hove (Peter Kyle) from the Opposition—worked with the CCG to try to find a solution. The reality was that the contract was not stripped out of the public sector. The South East Coast Ambulance Service NHS Foundation Trust refused to carry on the service: it said it was not interested, did not tender and gave it back. There was only one bidder in town—Coperforma. The system did not work well, which is why I was glad that another bidder, not present at the time, eventually came forward. Facts matter!
Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)
As we have heard, this year marks the 70th anniversary of the creation of our national health service. The NHS is the jewel in our nation’s crown and represents the very best attributes that we as a society hold dear. I truly believe the creation of the NHS, which was born of a yearning desire for things to change following the death and destruction of the second world war, to be the greatest achievement of the Labour party and, indeed, any Government.
It is because both I and my party hold the NHS so dear that Labour Members are concerned by the parlous state in which it finds itself. Pushed to the brink by the biggest financial squeeze in NHS history and reeling from the worst winter crisis on record, the NHS is at breaking point. People are waiting far too long for operations, and performance targets are so far from being met that they are now about as realistic as the Government’s infamous immigration targets.
Official data show that patient waiting times, bed shortages and ambulance queues have hit record levels. The chair of the British Medical Association succinctly summed up the situation when he said:
“the ‘winter crisis’ has truly been replaced by a year-round crisis. Doctors and patients have just endured one of the worst winters on record…We cannot accept that this is the new normal for the NHS.”
Let us be clear that this is not an unavoidable situation or the result of some unforeseen circumstances; the situation has come to pass as a direct result of this Government’s policies. By stark contrast to the policies of the Conservative party, in our 2017 manifesto Labour promised immediate investment in our NHS and, just as importantly, explained how we would pay for it.
The issue of privatisation within the NHS is both an important and an emotive one. I believe in a publicly owned NHS, free at the point of delivery, but the creeping privatisation of services poses a very real threat to that most essential of principles. The figures are irrefutable. Since 2010, NHS expenditure on private health providers has doubled from £4.1 billion in 2009-10 to £9 billion in 2016-17, while the percentage of funding allocated to private sector providers has grown from 4.4% in 2009-10 to 7.7% in 2016-17. Spending on elective treatments outsourced to the private sector rose significantly from £241 million in 2015-16 to £381 million in 2016-17.
Since the Government’s disastrous Health and Social Care Act, one third of contracts have been awarded to private providers, some of which have resulted in failure and the waste of millions of pounds of taxpayers’ money. We have seen the grotesque spectacle of Virgin Care successfully suing our NHS for £1.5 million after losing out on an £82 million contract for children’s health services in Surrey. This has to stop. Labour is committed to reversing privatisation, repealing the Health and Social Care Act and reinstating the powers of the Secretary of State for Health to have overall responsibility for the NHS.
The creation of wholly owned subsidiary companies represents another concern. These new arm’s length private companies appeal to NHS trusts because they can reduce their VAT payments and cut the pay and pensions for any new staff. They result in millions of pounds being wasted on consultancy fees, with the Clatterbridge Cancer Centre in Birkenhead alone spending more than £660,000. That money could have paid for new staff to work in such hospitals.
I am fortunate to have the amazing Queen Elizabeth Hospital in my constituency. Among many other things, it cares for our brave men and women who are injured while serving their country in our armed forces. I want that hospital to continue to flourish and serve the people of Edgbaston and further afield, but I consider privatisation to be a threat to that happening.
Maria Caulfield (Lewes) (Con)
I, too, want to use this opportunity to debunk the myth that the Conservative party wants to, or ever has wanted to, privatise the NHS. That is an image that the Labour party wants to portray, but the facts tell a different story. In the 70 years of the NHS, 43 of those years have been under a Conservative Government, so if privatising the NHS were the sole aim of the Conservative party, it would have been done by now. The NHS remains based on the three founding principles of meeting the needs of everyone, being free at the point of use, and being based on clinical need, not ability to pay. However, facts do not often matter to the Labour party.
I was at a meeting at the weekend of more than 200 GPs who were desperate for the politics to be taken out of the NHS. They welcome the Government’s talk of a long-term settlement and of taking the NHS out of the political cycle. That puts fear into the heart of Labour because it would mean that the NHS would come first, not the motives of the Labour party.
If Labour Members were honest with themselves, they would recall the history of the last Labour Government, who did more for privatisation in the NHS than anyone before or since. In 1999, within two years of coming to power, the Labour Government set up market structures in the NHS to create choice and competition, with hospitals starting to charge by price per episode to compete with the private sector. That is Labour’s record on privatisation in the NHS. In 2003, they set up foundation trusts so that hospitals could be free from the constraints of the NHS and run like a business. That is Labour’s record of privatisation in the NHS. Also in 2003, they introduced independent sector treatment centres—private companies set up to provide wholly NHS elective procedures. That is Labour’s record of privatisation in the NHS.
Some 84% of PFI projects were started under Labour. Although they built £11.8 billion-worth of hospitals, the cost to the NHS is £79 billion over 31 years. In 2009, the Labour Government introduced “any qualified provider”, which we have heard about this afternoon, allowing the private sector to undertake NHS work. That is Labour’s true record of privatising the NHS. The King’s Fund analysis on the Labour Government found that by the time they left office, the NHS in England was operating more like a market, with half of elective patients being offered a choice of the private sector. The culture of the NHS had changed from one of collaboration to one of competition.
I am not against the involvement of the private sector in the NHS. As a research nurse, I worked with many multinational pharma companies setting up joint research studies that gave NHS patients access to drugs long before they were available on the NHS and access to equipment that was paid for by pharma companies and left in perpetuity to the NHS.
Labour Members lecture us on privatisation in the NHS, but the last time they were in government, they wanted to close the Princess Royal in Haywards Heath to patients in my constituency. When we were missing Government targets and breast cancer patients were not getting their treatment under the last Labour Government, did they listen to the breast surgeons in my unit who said, “Give us an extra theatre and we can deliver it.”? No, they spent hundreds of thousands of pounds on performance management consultants, time and motion studies, brainstorming sessions and patient pathway mapping. At the end of that six-month process, they told us that the solution was to have more theatre sessions, which the surgeons had told them in the first place.
This is not just my experience; the British public know that the NHS is safe in Conservative hands. That is why, for 43 of the last 70 years, they have put the Conservative party in charge of the NHS, and long may that continue.
Karen Lee (Lincoln) (Lab)
After eight years of the Government’s austerity agenda, the NHS is on its knees. People in Lincoln commonly wait hours for an ambulance, including those having a heart attack. If a Health Minister happens to be in Lincoln any time soon, they might want to ask about that, because call-to-balloon times for PCI have increased. I am not scaremongering—that is the truth. I am sorry, but I will not pretend that—pardon the pun—everything is rosy.
Although the austerity experiment has been discredited by various economists, we have not seen a halt or a reversal of the underfunding and privatisation of our NHS. With the NHS approaching its 70th birthday, the Government are not providing it with the funding and resourcing it desperately needs. Despite the Government telling us that they are putting record amounts of money into the NHS, compared with countries such as Germany and France, we spend a considerably smaller percentage of our GDP on healthcare.
The latest King’s Fund research confirmed the bleak picture of the policies of the past eight years. The NHS has among the lowest levels of doctors, nurses and beds in the western world. This is not scaremongering; it is the reality of the past eight years’ effect on the health service. I am sorry if people do not like hearing it, but it is the truth. The question should not be why the NHS does not perform better compared with other countries, but rather how the NHS copes under immense pressure when it is so under-resourced. Remember, this is at a time when the Government are prioritising tax cuts for the wealthy and for large corporations.
Deregulation under the Health and Social Care Act 2012 is a stain on this country’s long respect and support for our NHS. There is no role for the private sector if the NHS is fully resourced. Outsourcing has led to nearly two thirds of clinical contracts being won by non-NHS providers. The NHS should not be a cash cow available to the highest bidder. The financial pressures on the NHS have forced some firms to leave the market, while others search for short-term cheap fixes to deliver contracts, which ultimately impacts on patient care.
It is clear that the Government have a not very well hidden agenda: slash, trash and privatise. Underfunding, with little sign of change over the past eight years, only raises the question: do the Government actually want a nationally run service that provides free healthcare to all, free at the point of service? My constituents, after the closure of our walk-in centre—against the wishes of 94% of people who said they wanted it to stay open—are not convinced. The sustainability and transformation partnerships, wholly owned subsidiaries and accountable care organisations are all a ploy for their ideological goal: the backdoor privatisation of our service.
I have seen that at first hand from the hospital floor as a nurse. Instead of just words of praise for those working in the health service—praising nurses sounds really cheap, you know, as if Conservative Members can take some sort of credit for it; it is their hard work, not yours—why not provide them with the resources to do their job properly? Rewards come with actions, not just words.
Kevin Foster (Torbay) (Con)
It is quite interesting to be following the speech we just heard. I will not dwell too much on it, but the hon. Member for Lincoln (Karen Lee) mentioned accountable care organisations. Supposedly, they will have “multiple benefits” and
“contrary to what some of the demonstrators suggest will make it easier for the NHS not to go down the private contracting route”.
Those are not my words, but the words of the right hon. Member for Exeter (Mr Bradshaw), a former Labour Health Minister.
I always welcome the chance to discuss the NHS on the Floor of the House and to consider some of the challenges in my constituency, in particular for social care, given that 9% of the entire population of one of my wards is aged over 85. That brings not only challenges around social care, but questions of how those with chronic conditions are cared for by the NHS.
I had hoped this afternoon’s debate would be constructive. To be fair, the hon. Member for Stockton South (Dr Williams), who is not in the Chamber, gave quite a constructive and thoughtful speech based on his own experience and his time serving on the Health and Social Care Committee. The debate, however, started off with what can best be described as a 40-minute partisan rant. It did include one positive and constructive offer of working with the Government on potential legislation but, other than that, it was quite bizarre to hear the Opposition spokesman running down every private contract given, except for those given by Labour Administrations. We heard an intervention by the leader of Plaid Cymru in Westminster about outsourcing in Wales, which is apparently okay because it is not wholesale, but just bringing in the private sector when it is the right thing to do. The Labour Front-Bench speech was a bizarre spectacle, although not surprising from a Member of the party responsible for 118 out of the 125 NHS PFI contracts.
People think PFI contracts are just about building hospitals, but they are not. I was deputy leader of Coventry City Council when University Hospital opened. The private sector did not just build the hospital; virtually all the facilities and services were privatised as a part of the PFI contract, which raised interesting issues with regard to amending it. Again, the idea that this was some sort of spot purchasing is absolute nonsense. This was a 25-year contract that even included guarantees about income from the car park, which ratcheted up the prices.
It is disappointing that the debate has not been more positive, with a consideration of some issues around health and social care. The other bizarre thing is that I have not yet heard one Labour Member talk about the motion or tell us why giving these papers to the Health and Social Care Committee would make much difference. What do they think the Committee would do with them? The terms of the Humble Address have not been talked about at all. It would be interesting to hear—I will be happy to take an intervention from a shadow Front Bencher—what discussions, if any, there were with the Chair of the Committee, my hon. Friend the Member for Totnes (Dr Wollaston), before the Labour party tabled the motion. It strikes me as bizarre that we have a motion stating that the papers are really crucial and should be given to the Committee, yet no one has talked once about why doing so would be sensible.
I will conclude by talking about the positives in my community. The recent announcement of investment in urgent care services in Torbay has been very welcome, and it will certainly make a difference to patients. This will be the first new A&E department for Torbay since the 1970s. It was also really satisfying this week to see the local trust rated as good in its latest CQC assessment. That is a real tribute to all those who work in the NHS locally, and it deserves to be recognised here in this House.
Karin Smyth (Bristol South) (Lab)
The biggest issue facing the NHS is the money and the workforce, and going into that mix, we have these wholly owned companies. They are a wheeze to gain income, but the consequences are deeply troubling. They drive further fragmentation of the NHS and, when collaboration should be growing, we instead see each trust going its own way.
If these changes for wholly owned companies were driven by service improvement and the appetite of staff for change, the managers and boards of the trusts would be doing their jobs, which is to identify the need for improvement in these services and to speak to their staff about how to achieve it. However, in almost every case, the changes have been progressed in secret, with little or no staff engagement or consultation and with no documents being made public. It is very hard to get the documents from these trusts. Worse still, we are now in an uncontrollable hiving off of NHS assets to these new companies, with no discernible safeguards to prevent the assets, or indeed the whole company, from being sold off to anyone else. They are one step away from being taken outside the NHS to any other provider.
In response to some of my written questions, I have discerned a bit of change in the Government on the NHS. I asked how many trusts have had to change the terms of their authorisation, which was a requirement in the Health and Social Care (Community Health and Standards) Act 2003, to protect the transferred assets. On 11 May, the Government said:
“There is no requirement to change the terms of authorisation when setting up a wholly owned subsidiary and therefore, the Department does not hold the information requested. If trusts hold community interest assets then these are considered public assets and cannot be sold unless subject to a Departmental/Secretary of State approval, however this is only a limited number of assets.
For other assets trusts should consider whether transactions are ‘reportable’ under the transactions guidance and therefore would be subject to a review if above the thresholds outlined.
NHS Improvement has committed to:
The proposed creation of subsidiary companies becoming a reportable transaction to NHS Improvement under the Transactions Guidance, irrespective of size; and”
NHS Improvement will be looking at “subsequent changes”.
While a tick-box exercise and oversight by NHS Improvement is welcome, that is closing the door after the horse has bolted. In answer to another question about continued onward sale, I was told that there would be restrictions where disposal would affect commissioner-requested services. The 2003 Act does not say that. Section 16 talks about NHS foundation trusts not disposing of protected property
“without the approval of the regulator”
and says that protected property is the
“property of the trust designated as protected in its authorisation.”
I think there has been a change in that period and I would like to understand why. If the Minister cannot answer that today, I am happy to write to him.
We have essentially no assurance as to how the transfer of these wholly owned companies to any private bidder, one step on, can be stopped. How would local people ever know? How would the staff now? We cannot get any information from most of these trusts. They are not answering FOI requests and that is why this is essentially of such continued concern.
The first step to remedying this shambles would be to close the VAT loophole, which I do not have time to talk about today. Meanwhile, NHS Improvement should not be encouraging the recreation of a two-tier workforce, especially at a time of such overwhelming concern about the availability of a skilled workforce. This is ever more important with Brexit looming. NHSI is a Government body funded by the taxpayer and accountable through the Secretary of State to Parliament. That it is encouraging and permitting these deals, and doing so in secret, is a disgrace. It should not be allowed. As NHSI is subject to ministerial oversight, the Secretary of State needs to tell it to stop it.
Helen Whately (Faversham and Mid Kent) (Con)
A constituent wrote to me last year to say that, against the backdrop of negativity around healthcare in this country, he personally had had a really good experience of treatment on the NHS at his nearest hospital. It happened to be KIMS Hospital, an independent sector provider, but it had given him what he really wanted: timely, high-quality and caring treatment free at the point he needed it.
The shadow Secretary of State recognised earlier that there was a place for private providers in the NHS. As in the example I have just given, that place might be enabling somebody to get timely treatment at a time of huge pressure on NHS resources, but, from what we have seen, it seems Labour considers the place for private treatment to be whenever Labour is in power. As we heard, in the years running up to 2010, when Labour was in power, there was an increase in the use of private sector providers in the NHS, as I saw when I worked with the NHS, and there was an increase in their use last year in Wales, where Labour is in power.
I do not want to make an ideological argument—I do not particularly want to talk about who provides the care, because what matters to me and my constituents is that they get good care when they need it—but, as Labour is picking this fight, it is only fair to put some truths on the table, and as far as I can see, the place for private providers, from Labour’s point of view, is whenever it is in government.
What matters to me is great care, and I have observed some ways of getting it. In some parts of healthcare, one way is by offering choice. Giving mothers-to-be the choice of where to have their baby makes maternity teams say, “Hold on. We want to be the best place in the area to have a baby.” Choice works, so long as it is accompanied by transparency, and the Government have done much to improve transparency in healthcare, meaning that people can know where to get good treatment and where there are problems, which has driven up quality.
Innovation and new technology can also transform healthcare. Whether the introduction of keyhole surgery, which has hugely shortened stays in hospital, or the exciting things happening with genomics and personalised medicine, innovation is making a huge difference, and it should not matter where that innovation comes from. If it comes from the private sector, we should welcome it. The workforce also matter. We have skilled, capable and committed people providing great care day after day, but I would argue the Government need to place an even greater emphasis on the workforce to make sure that those who work in the NHS or train to be doctors, nurses or other healthcare professionals are valued and nurtured and have rewarding careers that make the most of their talents.
I will conclude with some facts, given the many myths peddled this afternoon: it is clear the NHS is not being privatised—there has been a zero increase in the last year in the use of the independent sector; the NHS is getting more money—£8 billion more this Parliament; and the NHS is treating thousands more people. Times are difficult, but the NHS is rising to the challenge. We should get away from these ideological arguments and put our energies into making sure we have the best possible NHS.
Anneliese Dodds (Oxford East) (Lab/Co-op)
It is a pleasure to follow the hon. Member for Faversham and Mid Kent (Helen Whately). She spoke with characteristic gusto, even if—I am sorry to say it—I did not agree with a single word she said.
I want to underline how privatisation is sapping resources from our NHS, in Oxford East and elsewhere in the country, at the very time it needs them more than ever, because of demographic change and the knock-on impact of cuts elsewhere in our public services. Oxford has particular problems with staff recruitment and retention because of the very high cost of living and the historically high number of EU staff in our local NHS, who are under threat from the Government’s shambolic approach to Brexit. Too few staff for high demand has led to clear reductions—that is right: reductions—in patient care in my local area.
Between January and March this year, 273 non-urgent surgical operations were postponed in my city. Rather than the response being additional resources for the local trust that was working so hard in trying to provide a decent service, in the topsy-turvy world of this Government, my trust lost £1 million because of what happened during that period. Meanwhile, Virgin Care has taken £1.5 million away from our NHS through court action against it. That is an absolute disgrace.
The hon. Member for Cheltenham (Alex Chalk), who, sadly, is no longer in the Chamber, wilfully misconstrued the impact of privatisation. The clue is in the word: it means privatising—making private—something that was public before. We are not talking about the great British biomedical industry, which has always been private. In fact, my hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Health Secretary, came to my constituency to see an operation this very week. In fact, the innovation that is promoted by that industry would be aided by an end to inappropriate privatisation. If we stopped sucking out resources and putting them into the pockets of profiteers, they could be spent on the high-quality healthcare and technologies of the future that would actually benefit patients.
The delays in operations in Oxford have become substantially worse over time. Between the end of February 2017 and February 2018, the acute hospital trust had to postpone 952 non-urgent operations; 536 were postponed in the previous year. As the situation has worsened, it has become harder and harder to establish whose responsibility it is. It is no longer the Health Secretary’s responsibility, because, following the Lansley reforms, he has no overall responsibility for the NHS. Oxfordshire’s joint health overview and scrutiny committee, which is meant to oversee services, has just decided to hold many of its meetings in secret, so the public do not even know what is going on at that level.
There are constant arguments about who is responsible for the provision of various essential services. As we all know, breastfeeding support is incredibly important to both babies and mums, but my local clinical commissioning group and my local council cannot agree whose responsibility it is to pay for it, so it is not being delivered properly. That is happening throughout the country. Of course, those services used to be available in children’s centres, but we do not have them any more in Oxfordshire since they were got rid of.
The crisis in Oxford’s NHS has been intensified by all the cuts in social care. Even with all those pressures, however, local NHS staff are working incredibly hard. We are not scaremongering when those staff are coming to our surgeries in tears. When they are telling us how much pressure they are under, it is our duty as parliamentarians to stand up and say “Enough is enough: an end to privatisation and an end to cuts.”
Several hon. Members rose—
Mr Speaker
I am very sorry, but in order to accommodate the remaining speakers—I thought that there were four, but there seem to be five—I must impose a three-minute limit, as I advised the Whip. I want to get everyone in.
Rachael Maskell (York Central) (Lab/Co-op)
It is a pleasure to follow my hon. Friend the Member for Oxford East (Anneliese Dodds). I could not agree more with her astute analysis, which also—yet again—applied to what is happening in York.
I want to begin by thanking Pat Crowley, the chief executive of York Teaching Hospital NHS Trust, who has just announced his retirement. He has steered our hospital through unprecedented challenges. I have met the Minister to discuss so many of those challenges—the failed funding formula, the perverse financial incentives, the failed budget integration and the placing of the private profit motive at the heart of our NHS—but I am still waiting for his response to that meeting.
Let me turn to the issue of how money flows. We have talked about private finance in the NHS, but we should also bear in mind that money is not going into primary care and GP services. That is forcing people to use accident and emergency departments, which are the most expensive part of the NHS. Let us follow through the money that people are drawing down. People cannot get in through the front door of the NHS because people are not being cleared out of the back door as a result of the bed-blocking that has resulted from the Government’s cuts in local authority budgets. Those cuts have also caused public health services to be slashed so severely that a massive health crisis is being created. The shocking statistics relating to drug deaths in York are now the worst in the country. We desperately need more resources there. If we invest in people’s health, the health service will save money in the long term. Our teaching hospital is over £20 million in debt—it is the same with the clinical commissioning group—because of the failed funding formula set out under Lansley’s plans for the NHS and the ideology behind that.
I want to take on the argument that the private sector is helping the NHS. The private sector is offloading the low-risk, high-volume work from the NHS—that which under the tariff produces money and profit for the private sector. Formerly that money was invested in the most expensive parts of the NHS to stop the deficits in the NHS; the money went to the ITU, the A&E and the renal units which have a high demand for expensive drugs. The private sector sucking out resources from the NHS in this way is causing the financial failure of the NHS today. Therefore, it is incumbent upon the Minister to withdraw that failed model under the Health and Social Care Act 2012 and to ensure that instead we see real investment in the NHS, which will make a vast improvement to the health service as we move to its 70th anniversary.
Mohammad Yasin (Bedford) (Lab)
I remember when I first heard the term STP; I was portfolio holder for adult services at the time, and while I supported the need for a better integrated health and social care system, there were no details of what this might mean in the future. Within a few months, NHS bosses started talking about accountable care systems and accountable care organisations. Bedford, Luton and Milton Keynes would become a “first wave” accountable care system and this was good, they told us. The decision to become a “first wave ACS” had to be taken within 24 to 48 hours to secure additional funding, so there was no time for consultation with other councillors, let alone the public.
The same approach was taken with the STPs: no or little consultation with a take-it-or-leave-it funding deal, with no time given to us to analyse or debate the pros and cons. Recently we learned that the three CCGs in our STP area have agreed to merge their executive functions, which was “nothing to do with MPs and councillors,” they said, and nothing to do with the public. But they cannot tell us who will be accountable under this new structure, and it is likely that it will not be the people making decisions about our health and social care system.
The term ACO emerged in the US in 2006. ACOs were designed to improve patient experience and control federal expenditure within the US healthcare system, which is dominated by private health and insurance companies. But so far the evidence of the effect of ACOs on quality is not convincing and in fact spending has increased.
There is an inherent risk that if we invite tenders from providers to run health and social care systems across the country, and we do so without proper consultation with patients and service users, we will end up with the sort of mess that we saw at Hinchingbrooke Hospital and hospitals suing the NHS, as Virgin Care did, but on a much larger scale.
The Government’s healthcare reforms of 2012 have created chaos in our health service. We now have a system that allows private providers to escape necessary scrutiny when they get things wrong and to walk away from unprofitable contracts without reproach. Billions of pounds have been wasted that could and should have been invested in frontline care.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
I will use this opportunity to focus on continuing the great work of my predecessor the right hon. Alan Johnson and his campaign to ensure that Hull has the much needed child and adolescent mental health unit in our constituency.
We all accept that mental health is a huge problem, and I was proud to play a part in the Education Committee’s joint report on failing a generation, which rightly criticised the Government’s Green Paper on this issue. But we have been waiting for this change for such a long time.
Alan became involved in the campaign for this unit after meeting a young mum and campaigner called Sally Burke. Her daughter, Maisie, had significant mental health problems, so significant that she was sent 140 miles away for treatment. My constituent was not able to see her daughter as much as she would have liked, which highlights the lack of provision in my constituency and the desperate need for it.
The people of Hull came together with the local newspaper, the Hull Daily Mail, and 3,500 people petitioned the Government to say that we desperately need this child and adolescent mental health services unit in our constituency. Members could imagine our joy and celebration when, in September 2017, we were told that the money had been found and that we were going to get the unit we had been desperately waiting and campaigning for.
The trust has got all the planning permissions ready, everything is organised and the land is there, waiting to go. We were told the building would start in October 2017 and that it would be finished and the unit would be opening in October 2018, and finally the people of my constituency would have access to the support they need.
Members could imagine my disappointment when I heard that the trust is unable to draw down the money that has been promised and that there are further delays. I raised this with the Chancellor on 17 April to ask why the money is stuck in the Treasury, and he asked me to write to him. So I wrote to him about it, and then I had to wait for a really long time, until I tabled a written question asking when he would reply to my letter. He eventually replied with the confusing response that the trust needs to submit more information on the business case for the unit. That deeply concerns me because the unit was promised back in September 2017 and we are still waiting.
The people of Kingston upon Hull West and Hessle are not fools, and they will not accept any more delays. They have been campaigning for this unit for years, and I will not let down my predecessor, the wonderful Alan Johnson, by not making sure I deliver on his legacy and getting the CAMHS unit we desperately need. I call on the Minister to take immediate action: stop faffing about and give us the money for our CAMHS unit, which was promised months ago. I promise I will not stop going on about it until he does.
Alex Cunningham (Stockton North) (Lab)
For now, NHS trusts remain the sole shareholder in their wholly owned subsidiary companies—yes, just for now—but those subsidiary companies will be easier to sell in future. The trusts have established those subsidiaries with long contracts under the misguided impression that such contracts protect the trust and the employees. What the trusts do not acknowledge is that the current Government, or a future Government, could order them to sell off a subsidiary company, contracts and all, and, if necessary, could change the law to make it happen.
We have already seen how these new subsidiary companies make their margins off the backs of now former NHS staff who face the prospect of less favourable contracts with no access to the NHS pension scheme, yet some trust executives claim they are transferring employees to protect them. That is absolute rubbish. We all know that when staff are transferred by TUPE, the receiving employer can have a reorganisation. It can create new roles and axe old ones, and it can require people to apply again for what looks like their old job with some subtle changes, with the terms and conditions varied, putting an end to the protections they once enjoyed. This creates the two-tier workforce many others have spoken about today. It means that some people are being treated better than others, with more rights, better pay and better working conditions.
I have even heard that some of these executives believe the changes could be in the best interest of the workforce. None of these executives faces the prospect of being reorganised out of their job or out of their final salary pension scheme with a 15% employer contribution. The executives will continue to get that pension, yet the people they have shifted into new organisations will get a 3% employer contribution to their pension.
In a few years’ time, it will be interesting to see just how many of the original staff are still in these organisations and how many of them are on the same terms and conditions enjoyed by NHS staff who are still employed directly.
I am proud that, just a week ago, one of the teams at the North Tees and Hartlepool NHS Foundation Trust in my Stockton North constituency was shortlisted for the NHS 70th awards, but a few months ago even this trust succumbed to temptation and set up one of these wholly owned subsidiary companies, despite the accounts for an existing subsidiary company showing it needed a bail-out from the trust to survive.
Wholly owned subsidiary companies are not working. They are a mechanism to rid employees of their NHS pension and of collective bargaining. The companies are damaging to employees, and they are damaging to the service in the longer run. What they are really doing is severely damaging the morale of our staff.
Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)
I thank the NHS’s public service workers for all that they do for us. They have stood against cuts under Tory austerity and a decade of SNP cuts in Scotland. Scotland’s NHS workers are underpaid, undervalued and under-resourced while millions of pounds are spent on agency staff. As Richard Leonard, the Scottish Labour leader, said recently, private companies are
“sucking money out of the NHS”,
but Labour in Scotland is ready to stand up to Tory austerity and SNP cuts.
Justin Madders (Ellesmere Port and Neston) (Lab)
This has been an interesting, passionate debate with many knowledgeable contributions. My hon. Friend the Member for Canterbury (Rosie Duffield) raised concerns about a new ALMO in her constituency and the impact on NHS staff working conditions, and I am sure that she will shine a light on that issue relentlessly. Like many Members, my hon. Friend the Member for Blaydon (Liz Twist) mentioned wholly owned subsidiaries, rightly highlighting the fact that the Treasury is turning a blind eye despite the fact that their creation represents a VAT loophole. That tells us everything we need to know about where the Government’s priorities lie. She mentioned NHS staff striking at the Wrightington, Wigan and Leigh NHS Foundation Trust because of their concerns about the impact that subsidiaries will have on their terms and conditions, and Labour Members send our solidarity and support. Government Members need to start listening to the staff.
My hon. Friend the Member for Stockton South (Dr Williams) gave a typically cerebral contribution. He was right that elements of privatisation encourage cherry-picking and a race to the bottom, and I look forward to hearing more from him on that. My hon. Friend the Member for Lincoln (Karen Lee) gave her frontline view of the problems in her constituency, speaking with real passion, and it would be wrong to characterise that first-hand experience as scaremongering. My hon. Friends the Members for Batley and Spen (Tracy Brabin) and for Bristol South (Karin Smyth) mentioned wholly owned companies. Both talked about the secrecy surrounding the plans—and Members sometimes wonder where conspiracy theories come from.
We also heard from my hon. Friends the Members for Kingston upon Hull West and Hessle (Emma Hardy), for York Central (Rachael Maskell), for Oxford East (Anneliese Dodds), for Birmingham, Edgbaston (Preet Kaur Gill), for Oldham East and Saddleworth (Debbie Abrahams), for Stockton North (Alex Cunningham) and for Coatbridge, Chryston and Bellshill (Hugh Gaffney). In fact, we heard from more than 20 Back Benchers today, so I do not have time to refer to every contribution, but some Members seem to have been in denial about the basic facts. Performance targets are being missed month after month, with A&E targets not forecast to be met until next year at the earliest and the 18-week treatment target seemingly dropped altogether. We have among the lowest number per head of doctors, nurses and hospital beds in the western world. We have a recruitment and retention crisis, with more than 100,000 vacancies across the NHS.
The biggest fact of all is that the NHS faces the harshest and most sustained financial squeeze in its 70-year history. Despite the squeeze, the amount of money being directed to the private sector has more than doubled. That is the NHS under the Tories: patients worse off while private companies cash in. We have heard countless examples of what is happening on the ground today and clear evidence about the damage caused by the wasteful, top-down reorganisation of the NHS created by the Health and Social Care Act 2012—damage predicted by just about everyone other than Conservative Members.
Conservative Members have known for years that the 2012 Act is not working, and even the Secretary of State was uncharacteristically coy today when he was given the opportunity to give his own opinion on it. After six years of disaster, we finally hear reports that parts of the Act will be overturned, but there has been no detail of what is proposed. Why are the media being informed of these plans instead of this House? If there is nothing to worry about, why will the Government not come clean? If Ministers are still formulating their proposals, let me offer them some advice: if they propose anything less than a properly funded, comprehensive, reintegrated public NHS that is free at the point of use, we will not support it and the public will not support it, either. If they will not give the NHS the funding it needs and end the toxic privatisation of the health service, we will. I commend the motion to the House.
The Minister for Health (Stephen Barclay)
The Government oppose the motion. There is no complaint from the Chair of the Health and Social Care Committee, my hon. Friend the Member for Totnes (Dr Wollaston), about papers sought and not provided. Indeed, there are no papers, according to the evidence that the Secretary of State read out at the start of the debate, which was provided to him by officials. There is no logic to the motion when, as several Members pointed out, there has been no increase in the share of NHS spending on the private sector over the past year. As my hon. Friend the Member for Corby (Tom Pursglove) in particular highlighted, the rate of increase has been slower under this Government than it was under previous Governments.
As my hon. Friend the Member for Torbay (Kevin Foster) pointed out, that is perhaps why so few Labour Members wanted to address the motion. As my hon. Friend the Member for Cheltenham (Alex Chalk) said, the motion contradicts both legislation passed by the Labour Government in the form of the Freedom of Information Act, and numerous statements made by senior Labour politicians such as the former Foreign Secretary and Member for Blackburn in his evidence to the Chilcot inquiry.
Instead, there was a mix of confusion and division among Opposition Members. The hon. Member for Lincoln (Karen Lee), who is not in her place and did not stay for the speech of the hon. Member for Bristol South (Karin Smyth), said that there is no logic to the use of the private sector, but in a well-informed and measured speech the hon. Member for Stockton South (Dr Williams) said that sometimes it should be enabled. That point was conceded in the Chamber today by Labour Front Benchers, and in numerous media interviews, including on the “Victoria Derbyshire” show. They seem confused about whether they welcome the use of the private sector.
The confusion extended to the remarks of the hon. Member for Blaydon (Liz Twist). She said that Gateshead trust is very good, yet she seems to ignore the fact that the legislation on subsidiaries was passed under a Labour Government. The staff survey for that trust shows that the subsidiary has a satisfaction rate that is 15% higher than it was in the NHS as a whole. Because of her ideology, she seemed to suggest that her constituents working within that trust, which is 100% owned by the NHS, are wrong.
As my hon. Friends the Members for Lewes (Maria Caulfield) and for Faversham and Mid Kent (Helen Whately) pointed out, there was a rewriting of history. The Labour Government before 2010 embraced the private sector. As illustrated in Wrexham, contracts in Wales are given to the private sector when Labour is in office. Labour Members say one thing in opposition and do something else in office. We have seen the contradiction today. Labour Members say that they dislike accountable care organisations and that they are a form of privatisation. It might surprise colleagues to learn that the Mayor of Greater Manchester, the former Labour Secretary of State for Health, is seeking to pilot an ACO because he recognises the benefits of integration.
The House heard misleading statements today. We were told by the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) that there has been a slow and steady erosion of the NHS as a provider, even though the facts show a zero increase in the private sector share of NHS spending. My hon. Friend the Member for Bexhill and Battle (Huw Merriman) highlighted the fact that private sector involvement was embraced, sought and progressed by the Blair Government.
That rewriting of history was further underlined by the Labour Members’ PFI amnesia. As my right hon. Friend the Secretary of State pointed out, the NHS has £80 billion of PFI contracts and a £200 billion a year spend on PFI. Labour Members mentioned Carillion—12 of the 13 Carillion contracts for service management were entered into under the Labour Government.[Official Report, 11 June 2018, Vol. 642, c. 4MC.]
The reality is that this Government are investing more in our NHS and delivering more outcomes for patients. Some 2,500 more patients a day are seen within the four-hour A&E target. We are training more dentists. The hon. Members for Lincoln and for Canterbury (Rosie Duffield) failed to mention the extra medical training places offered in their constituencies as part of the Government’s investment.
The Conservatives have run the NHS for the majority of its 70 years. This Government are investing in our NHS and treating more people in it. This Government will ensure that the NHS remains fit for the future.
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Main Question put accordingly.
Business without Debate
Accrington Victoria Walk-in Centre
(5 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Graham P. Jones (Hyndburn) (Lab)
I should like to raise the not-so-small matter of the closure of Accrington Victoria walk-in centre, a valuable community health asset and a huge support to those in and around my constituency. The people of the area have, with great affinity, taken to their local healthcare services over many decades, and in years gone by, through paying a penny a week, they have funded the local hospital. Yet every decade unelected bodies, supported by the Government, seek to reduce healthcare provision in the area—with the exception of the last Labour Government, who invested in three new health centres, among other things, and rebuilt the local hospital at Blackburn.
“I am grateful for the opportunity to raise the subject of the future of Victoria hospital, Accrington.”
Those are not my words, but those of former Hyndburn MP the hon. Ken Hargreaves, who like his successor, Greg Pope MP—my predecessor—and me, have fought for better healthcare facilities in Hyndburn, particularly the retention of vital NHS services at Accrington Victoria, and in this case today, the GP walk-in centre at that hospital.
On 28 November 1989, under the previous Conservative Government, the honourable and much liked Mr Hargreaves spoke in this Chamber from the Government Benches, stating:
“Thousands of people have signed the petitions and written to their Members of Parliament and to the Secretary of State…we are fighting the same battle now that we fought 11 years”
previously.
“It is equally clear that the people of Hyndburn wish to unite and fight.”—[Official Report, 28 November 1989; Vol. 162, c. 685.]
On the second of this month, I too presented a petition to this place, like my predecessor, with some 24,000 names on it. I can update the House: the petition now stands at 26,000 petitioners. The truth is, the public are not listened to by Governments and unelected bodies, and the people of Hyndburn are, as the former hon. Member Ken Hargreaves described, uniting and fighting once again.
This popular walk-in centre has already survived five attempts to close it. On 16 June, the health authorities—I do not exonerate the Government from this dreadful decision—are going to try to close the Accrington walk-in centre once again. We have a decision that makes little sense and a consultation that was a sham.
My own story sums up why this is the wrong decision. I contracted acute bronchitis—a serious enough illness. I was unaware of it other than feeling very ill. I struggled on until I eventually realised that it was a little more serious than a chesty cough and walked into my local GP surgery. The very helpful staff told me that there was a considerable wait to get a doctors’ appointment—a situation repeated nationally. The average wait to see a GP in the region is 13 days, I am told. If someone needs GP healthcare but cannot get an appointment, what do they do? My constituents widely share my frustration at the lack of GP access. Ringing up the GP first thing in the morning, the person is probably told that they are No. 8 in the queue, and they finally get through to a receptionist only to be told that all the appointments for that day are gone, with the next available slot being at the end of the next week.
The receptionist at my GP surgery helpfully rang through to the new extended-hours GP service to get me an urgent appointment. She told me that unfortunately all the appointments had been filled that weekend. Coughing badly, I had two choices: A&E or the walk-in centre. I went to the walk-in centre, where, following a two-hour wait, my condition was diagnosed. Notes were then sent to my GP and added to my health records. Without the assistance of GPs at the walk-in centre, my health could have deteriorated. I certainly would not have waited 10 days for a GP appointment; I would have gone to A&E.
The value and scale of the service provided by the Accrington Victoria walk-in centre cannot be overestimated. It has received an incredible 42,000 patient visits in the past 12 months. They were people like me who could not get an urgent GP appointment. If it closes, many of those patients will simply go to A&E. This was clearly my next option had the walk-in centre not been open. In fact, figures from the Bury walk-in centre reveal that about 22% of patients will head to A&E—in our case, the A&E at Royal Blackburn Hospital, one of the busiest in the country. This will add considerably to the problems that the A&E already faces, adding some 9,000 extra patient visits at a time when it is overstretched, with ambulances parked outside waiting to refer patients for care. There are financial implications to this, too. An average patient visit to A&E costs about £124 compared with an average patient visit to the walk-in centre that costs about £60.
Mine is not the only story. In fact, the campaign has received hundreds of similar stories through its “SAVE Accrington Walk-in centre” Facebook page. Some of those real-life stories from the people who have benefited from the walk-in centre are incredible. They include people who had to be rushed immediately from the walk-in centre to the Royal Blackburn for life-saving interventions. I must thank the local people for backing this campaign in such huge numbers. I must also thank the three leading campaigners—Chris Reid, Shahed Mahmood and Kimberley Whitehead—for pursuing a more consultative and informative debate than that offered by the clinical commissioning group. I would also like to place on record my thanks to the two local papers: the Accrington Observer, which has been at the forefront of the campaign; and the Lancashire Telegraph. This walk-in centre service means an awful lot to local people. The campaign has included petitions, walks, polls and articles, and has gathered huge support. It has also included letters to GPs.
Since the phased closure started in April, it has been revealed that only 658 people responded to the East Lancashire clinical commissioning group’s consultation—1.6% of the 42,000 patients who have visited. Members should compare that with the 26,000 local residents who signed the petition against the closure.
Jim Shannon (Strangford) (DUP)
I thank the hon. Gentleman for giving way; I spoke to him beforehand about this. We cannot ignore his fantastic work on this issue, and I congratulate him on his 26,000-strong petition, which far outstrips the 658 responses that the consultation on this closure garnered. Does he agree that more weight should be given to those opposing the closure, who are 60 times greater in number than those who responded to the consultation, and that the Government should listen to those 26,000 people and not ignore them?
Graham P. Jones
The hon. Gentleman makes a valuable contribution. I have yet to meet anyone who filled in the CCG’s consultation, and I will return to the issue of guidelines on NHS consultations and listening to the people.
I want to reflect on the CCG’s consultation. I have grave doubts over its credibility and reliability. To my mind, consulting just 658 invisible people with dubious questions is not a consultation. The CCG asked the public whether they wanted extra GP hours. Just to compare, the walk-in centre provides 88 hours per week. The CCG says that the walk-in centre will be replaced by the new extended-hours GP service, which provides just 19 extra hours’ GP access. That is an 80% reduction in GP access.
In the CCG’s foggy consultation, it said that 61% of people were “in support of” its plans for more GP hours. Which resident is not going to say yes to more GP hours? That is not the same as 61% of people saying, “Yes, and also please close my walk-in centre.” This was a devious consultation. The results of it are grossly misleading, and it is important that the Minister takes that point on board.
In response, I ran my own Facebook poll, reaching out to the four corners of my constituency, and an amazing 6,200 people voted. Unlike the CCG’s consultation question, mine was simple: “Do you want the walk-in centre to remain open?” with an explanation about the 19 extended hours of GP access. Of the 6,200 people who voted, 98% voted to keep the walk-in centre open. That poll reflects the true extent of public opinion in my constituency—98%.
The Minister must stop this closure and ask for a new consultation. She knows that consultation and the views of the public are key to the provision of NHS services. She will know that in national surveys, over 40% of the public say they want to be more involved in decisions about their care. I remind the Minister of the 26,000 people who have signed this local petition to keep the walk-in centre open.
The question is: how has this proposed closure put patients first? Under the Health and Social Care Act 2012, CCGs and NHS England have a duty to promote the involvement of patients in their own health and care. The Minister knows that the guidance is statutory and that CCGs must have regard to it. NHS England’s statutory guidance emphasises to CCGs in the NHS England document “Involving people in their own health and care” that patients must be central to decision making. Clearly they have not been in this case.
The Minister will also know that her Government’s health and social care NHS White Paper included a section entitled “Putting patients and the public first” and promised an NHS that is
“genuinely centred on patients and carers”
and
“gives citizens a greater say in how the NHS is run”.
It embraces the principle of shared-decision making, under which patients make joint decisions about their care with their clinicians. That is clearly not the case with the Accrington Victoria walk-in centre. Notably, the statutory guidance is clear in its description of shared decision making, saying:
“shared decision making is a conversation, or series of conversations, that should include evidence-based information about all reasonable options”,
such as a loss of GP hours. The loss of hours and the walk-in centre were never mentioned.
As pertinent is the recent publication of long-awaited guidance by NHS England, which lays out the future of urgent care services and expectations for local NHS commissioners. The guidance, which the NHS has released early, contains a clear expectation and commitment to retain walk-in centres as part of local integrated health services. I note the reassurances given in it that walk-in centres will remain a vital component of health service provision. The new guidance commits to the establishment of GP-led urgent treatment centres, open at least 12 hours a day, with nurses and other clinicians also available, along with a range of simple diagnostic facilities—a walk-in centre by another name, offering the same services currently offered by Accrington Victoria walk-in centre.
In conclusion—I just want to make a final point, Mr Speaker—patients will be able to book appointments in the new urgent care units using the NHS 111 service, through their GP or, crucially, as at the walk-in centre, simply walk in. NHS England wants these new centres to be co-located where possible alongside other health services, such as Accrington Victoria Hospital. If the Minister wants to put patients first, have a meaningful consultation and roll out the urgent care units, she will see that this closure meets none of those or her Government’s ambitions. I hope the Minister has listened, and will not just defend the decision or simply defer it to the powers of East Lancashire CCG, but accept that this closure runs counter to the NHS England guidance.
Finally, I very gently remind the Minister that thousands of Conservative voters backed the hon. Ken Hargreaves’s campaign to save Accrington Victoria services and today thousands of Conservative voters are backing this campaign once again to save one of the most vital services at Accrington Victoria. I hope she recognises that, were he here today, this cross-party campaign would certainly have been led by my honourable predecessor, Ken Hargreaves. He would want the walk-in centre to stay open, and we would be united in that ambition. I look forward to the Minister’s reply.
The Minister for Care (Caroline Dinenage)
I congratulate the hon. Member for Hyndburn (Graham P. Jones) on securing the debate. He made a very powerful case on behalf of his constituents and very carefully set out the enormous strength of feeling in his constituency, as of course he should as the local Member of Parliament. I am grateful to him for articulating his case so powerfully.
Following a three-month public consultation, the East Lancashire clinical commissioning group made the decision to close Accrington walk-in centre from Sunday 17 June. Other services provided from the Accrington Victoria Community Hospital, such as the minor injuries unit, and X-ray and in-patient and out-patient services, are not affected by the changes and will of course remain available. I understand that there has in fact been a delay in the closure taking place, as the walk-in centre was due to close in the spring. However, following consultation, the CCG has decided to close Accrington walk-in centre on Sunday 17 June. This extension to the originally planned closure date was made to ensure that there is a smooth transition to the new models of care, once the walk-in centre closes.
East Lancashire CCG has implemented an extended access service in Hyndburn as a new model of service provision. This service is being provided under contract by a local GP provider organisation, the East Lancashire Union of GPs. The contract is for 12 months from 11 December 2017, and the extended access GP scheme in Hyndburn has been operating since December. It is important to note that while the extended access service in Hyndburn is a new model of service provision, it is not meant directly to replace the walk-in centre per se.
GP services are accessible to patients through their own GP practice from 8 am until 6.30 pm, Monday to Friday, as usual. Pre-bookable appointments will also be available in the new extended GP service after 6.30 pm on weekdays and at the weekend. These appointments will be booked through the patient’s own GP practice. This new model of extended GP access meets the principles that were tested and supported by local people through a formal consultation process. In addition, the NHS 111 service can signpost patients to the most appropriate services, including an appointment with an out-of-hours GP, if required. We understand and appreciate that this is a real change for patients who are used to being able to walk in and see a GP, rather than phoning up for an appointment.
Graham P. Jones
Does the Minister accept that the consultation had flaws, and will she look at that? Does she accept that replacing 88 hours in a walk-in centre with 18 and a half or 19 hours of extended GP opening hours is a reduction in GP access, which goes counter to what was said in the consultations run by me and the CCG?
Caroline Dinenage
I take on board what the hon. Gentleman says about the consultation and also the consultation that he ran on Facebook. I know how worrying it must be for local people when a service closes, but it is the responsibility of the local NHS to follow the Government’s guidelines. The Government’s four tests for any service change are that it should have support from GP commissioners, be based on clinical evidence, demonstrate public and patient engagement, and consider patient choice. The Lancashire overview and scrutiny committee alone has the power to refer the decision to the Secretary of State or the Independent Reconfiguration Panel, and it was minded not to. That is the unfortunate situation.
Alongside improving and extending GP access, East Lancashire CCG has invested significant sums in social prescribing and care navigation. Those additional services are helping to guide patients and co-ordinate their journey through the health and care system to get the right help and support quickly.
There are benefits from the Hyndburn extended access service, including the provision of seven-day access to GP care, the addition of a minimum of 49 additional delivery hours per week, and 162 additional appointments per week. The facilities are linked to the out-of-hours service, with the ability to secure urgent GP appointments at weekends. I understand that that provision is for Hyndburn patients only until the walk-in centre closes in June, but it will then be expanded to cover patients from the wider east Lancashire area.
The extended access service run by the East Lancashire Union of GPs already has robust information-sharing arrangements in place with Hyndburn practices to ensure continuity of care for patients utilising an electronic record. That level of record sharing has not been available to patients attending the walk-in centre. The patient and public involvement network in Hyndburn has been fully consulted, and has assisted in the production of communication materials to ensure that local patients have been informed of the changes and have the information they need to direct them to the most appropriate service for their health needs.
The extended access service will have the ability to generate electronic referrals that core GP practices can review and progress. The service will collate monthly data, including patient profiles and the reasons why people access the service, to shape service redesign and help to build a clear picture of patient health needs locally. That service will be delivered from an existing modern LIFT—local improvement finance trust—building, which is on a local bus route and easily accessible to the public. Use of the service has been building progressively and is being closely monitored by the CCG.
I thank the hon. Gentleman again for bringing this debate to the House and for his ongoing support for his constituents in Hyndburn.
Question put and agreed to.
Deferred Divisions
That the draft Somerset West and Taunton (Modification of Boundary Change Enactments) Regulations 2018, which were laid before this House on 29 March, be approved.
The House divided: - Ayes: 298 / Noes: 17 - Question accordingly agreed to.
That the draft Somerset West and Taunton (Local Government Changes) Order 2018, which was laid before this House on 29 March, be approved.
The House divided: - Ayes: 298 / Noes: 17 - Question accordingly agreed to.
That the draft Bournemouth, Dorset and Poole (Structural Changes) Order 2018, which was laid before this House on 29 March, be approved.
The House divided: - Ayes: 293 / Noes: 19 - Question accordingly agreed to.
That the draft Dorset (Structural Changes) (Modification of the Local Government and Public Involvement in Health Act 2007) Regulations 2018, which were laid before this House on 29 March, be approved.
The House divided: - Ayes: 294 / Noes: 19 - Question accordingly agreed to.