EU Working Time Directive (NHS)

Debate between Charlotte Leslie and Chris Skidmore

Thursday 26th April 2012 Westminster Hall

[Chris Skidmore (Kingswood) (Con)]

As a member of the Select Committee on Health, I am very interested in this debate. I have learned a lot from the engaging contributions of all hon. Members who have spoken.

I want first to acknowledge the hard work of my hon. Friend the Member for Bristol North West (Charlotte Leslie), and not only for this debate. I want to put on the record the fact that she has campaigned on the matter for nearly two years. She has brought it up in recess Adjournment debates, Health questions, Prime Minister’s questions, and a ten-minute rule Bill—the NHS Acute Medical and Surgical Services (Working Time Directive) Bill. She has not let the issue go, and I think it is important to put that on the record because, without all her work over the past two years, we would not have achieved this Back-Bench debate today, which is extremely important, and the final Backbench Business Committee debate of the Session—and very apt it is too.

Following my hon. Friend’s two-year campaign, the exact financial cost and burden on the NHS caused by the directive is becoming clear. On 18 March, The Sunday Telegraph published a freedom of information request about the cost, and some of the figures have been read out, but I want to read out a few more to place them on the record. Of the hospital trusts that provided figures, 80% admitted spending more than £1,000 per shift on medical cover as a result of the EU working time directive. In total, £2 billion has been spent on that since 2009, which is roughly equivalent to the wages of 48,000 nurses or 33,000 junior doctors.

We have talked about inequalities. It is worrying that some trusts are clearly suffering more than others, and some are in extreme financial difficulties. Yet North Cumbria University Hospitals Trust spent £20,000 on hiring a surgeon for one single week. Mid Staffordshire NHS Foundation Trust—my hon. Friend the Member for Stafford (Jeremy Lefroy) referred to this—spent £5,667 for a doctor for just one 24-hour shift in a casualty unit. The Christie NHS Foundation Trust in Manchester spent £11,000 on six days’ cover for a haematology consultant. Scunthorpe general hospital offered £100 an hour for one month’s work in a temporary post. Princess Alexandra Hospital NHS Trust in Essex paid more than £2,000 for a locum doctor to work a 12.5 hour shift last October.

I could go on, but I want to come back to that £2 billion in two years, and to relate it to the Nicholson challenge, which is a cross-party issue, of saving £20 billion to reinvest back into front-line services. The challenge was set in 2009 by the previous Government to take place over three years. As a result of the comprehensive spending review, that has now been extended to four years. No MP can claim that that is a cut by one Government or another, although some MPs have tried to. It is a cross-party approach, and we in the Chamber are responsible and understand that if the NHS is to remain free at the point of use, regardless of ability to pay, we need to make savings and to reinvest them into front-line care.

The coalition Government have already done a fantastic job in making savings of about £7.5 billion on the way to the £20 billion figure. But the reality is that, if this £1 billion a year cost to the EU working time directive remains, that will be a £4 billion cost over the period of the comprehensive spending review. Therefore an extra £4 billion will need to be found in efficiency savings. We are moving from a 20% efficiency gain, therefore, to almost a 25% one. [Interruption.] It appears that the Minister disagrees, but it is just a back-of-an-envelope calculation.

[Charlotte Leslie]

My hon. Friend is contextualising this debate in an important way, in respect of wider finances and the Nicholson review. Reverting to the question of evidence, does he agree that simple figures, such as these, on the cost of a directive that has been introduced are also evidence? The first-hand reports of clinicians on the ground are perhaps more reliable than the evidence gathered from sources that might not always be willing to tell the truth about the situation, for fear of not meeting compliance targets.

[Chris Skidmore]

Absolutely. On the figures I mentioned, only 34 hospital trusts responded to the requests for information, so the data were incomplete. Only 83 out of 164 responded with any data at all.

Local Rail Services (Bristol)

Debate between Charlotte Leslie and Chris Skidmore

Wednesday 29th June 2011 Westminster Hall

[Charlotte Leslie]

My hon. Friend makes an extremely good point, which anticipates what I was going to say. He has done a lot of work lobbying for electrification, and I thank him for that.

The electrification is fantastic and, as I said, long-term thinking is massively important, not that the current smaller schemes for improvement are not welcome. However, unless we also think long term, and think big, those improvements will merely scratch the surface and we will not have the available infrastructure to maximise the effects of the small schemes. I am tempted to draw an analogy with Joseph Bazalgette’s building of the great London sewer system. There is no more time for devising more effective ways of throwing waste out of the window. For transport in Bristol, we need to devise a structural system that completely changes the way we do things.

When we come to the solution, there is good news: the bare bones of that new structure for transport in Bristol already exist. Disused and used freight lines lace the city, in particular in and around my constituency of Bristol North West, in the north of the city, and there are disused stations such as Henbury. The city of Bristol is sitting on a dormant giant of rail travel.

I have campaigned with the Friends of Suburban Bristol Railways and others for a Henbury station and a Henbury loop line. The solution is a no-brainer: the resurrection of our local lines in Bristol, to complete the circle line around the city that we partially enjoy already with the Severn Beach line. A Henbury loop circle line could link with the major stations of Bristol Temple Meads and Bristol Parkway, and could provide a reference point for shuttle transport to major visitor destinations such as the Mall at Cribbs Causeway, in the constituency of my hon. Friend the Member for Filton and Bradley Stoke. He cannot be here today because he is opening the new St Peter’s school in Pilning, but he has rightly said that, given the likely commercial and residential development if the sale of Filton airfield goes ahead, the case for examining existing rail provision and the possibility of resurrecting mothballed stations such as Filton would be really strong. With section 106 moneys coming from the significant housing development in the area, investment for such infrastructure does not seem out of the question.

In Bristol, which in the past I have talked about in terms of “A Tale of Two Cities” because of the deep socio-economic divides running through it, a circle line could open access and economic regeneration to some of the more deprived pockets of our great city, but the economic benefits do not end there. I understand that some Ministers have already travelled on the Severn Beach line, which runs from Temple Meads station up the west side of the city. That suburban line provides a demonstration of the untapped need and desire for local railway infrastructure, and the benefits of pump-priming investment. Since welcome investment by Bristol city council in 2008, which my hon. Friend the Member for Bristol West (Stephen Williams) was active in campaigning for, introducing more frequent services on the Severn Beach line, passenger numbers have rocketed by about 60%, enabling a long-term subsidy decrease as the service becomes economically more successful. Were the circle line circuit complete around the city, that percentage of passenger increase and revenue would likely be an awful lot higher—but what we need is joined-up thinking.

Among parliamentarians, I am delighted there is broad and energetic consensus on the need to work together for the future of rail in our region. Sadly, in the past, however, a certain lack of co-ordination has led to our region missing out on some major transport investment opportunities. That is why I take this opportunity to back strongly the creation of an integrated transport authority for the region. Other areas, such as West Yorkshire and Merseyside, have seen a major resurrection of their local suburban rail services and they have something significant in common: an ITA. So I congratulate our local paper, the Evening Post, and a one-man campaigning army, Dave Wood, on making the case for an ITA so energetically.

An integrated transport vision is as central to the beating heart of our city as a circulation system of veins, arteries and capillaries. With a strong, united voice, bids for projects such as the reopening of the Portishead line and the Henbury loop line can be more effective. If other regions can do it, why cannot we? The strong progress of our local enterprise partnership gives further hope and might provide a great basis for more joined-up thinking. So the big vision is a circulation system of rail around Bristol, linking with cycling and bus routes, and park and ride, to make all the schemes more effective.

More specifically, a major structural concern is to secure quadruple tracking up the Filton bank to Parson Street station, to alleviate the significant bottleneck which limits services locally. Failing to secure that now is a false economy, holding us back for the future, in particular given the existing demonstrable demand for more services. The electrification of the Bristol to London route is incredibly welcome, not only in itself but for the further opportunities it will provide, but any update from the Minister on how far the electrification will extend—for example, to Yate or Weston—would be most appreciated. Such an extension would open enormous opportunities for the suburban lines, with greater flexibility in rolling stock, new routes and diversionary routes for electric trains when needed. A 30-minute service from and to all stations in the former Avon area would be transformational, although it is quite a modest vision when compared with other major cities around the country.

As I said, the reopening of the Henbury loop and Portishead lines are particularly important specific proposals. An issue worked on and frequently raised by the hon. Member for Bristol East (Kerry McCarthy) is the safeguarding of Plot 6 at Temple Meads for a bus and train interchange. In the more immediate term, I seek clarification from the Minister about additional carriages for crowding relief in Bristol; more rolling stock is badly needed, which is an indication of the appetite for rail travel and the enormous unmet demand. I ask him to consider that seriously.

A Henbury loop line circuit is big thinking indeed, but rail gets to the core of tackling the underlying problems of Bristol’s transport system. Rail infrastructure for Bristol would be an absolute game changer for all the other methods of transport that we need to improve, freeing up the roads for buses and cyclists and transforming the park-and-ride potential. The idea has backing—indeed, the scheme is recommended in Network Rail’s route utilisation strategy—and I ask the Minister to look specifically at backing the scheme with practical financial support. Yes, the thinking is ambitious and long term, but I argue strongly that long-term strategic thinking and infrastructure investment is exactly what is needed if the entire Bristol region is to meet the real, pressing and ever-increasing transport challenges of the future. I called for the debate today because the future comes sooner than we think.

[Chris Skidmore (Kingswood) (Con)]

rose—