Hospital Parking Charges (Exemption for Carers) Bill

Jacob Rees-Mogg Excerpts

Friday 30th October 2015 Commons Chamber

[Philip Davies]

My hon. Friend makes a good point. The Bill applies only to car parking charges, and many carers cannot afford a car, let alone car parking charges. They travel faithfully on a probably more tortuous journey to hospital by public transport. If the Bill were to be passed, people who could afford a car would get their parking charges reimbursed but those who cannot afford a car and have to travel by public transport would not get their public transport costs reimbursed. Clearly, there is something not quite right about that. My hon. Friend makes a good point. While we are on that subject—I may come back to this as well—I should have thought that we were trying to deter people from using a car. Some people have to use a car, as he said, and nobody argues with that, but it would be perverse to give people an incentive to use a car rather than using public transport if they could. My hon. Friend has made a good point as to why the Bill would give people a perverse incentive to use a car rather than public transport.

[Mr Jacob Rees-Mogg (North East Somerset) (Con)]

I am rather surprised by my hon. Friend’s burst of socialism and that he should be discouraging the use of the motor car, which should be encouraged in a free society.

[Philip Davies]

I have been accused of many things in my time. A burst of socialism is a first, even for me. I may try and put that out to my left-wing constituents to show them that there is hope for me yet. If I did come out with a burst of socialism, I apologise profusely, not least to my hon. Friend, who always keeps me on the straight and narrow. I apologise for a burst of socialism; it was not intended to be such. I feel chastised.

We should consider why hospital car parks are not already free. There is an argument, I guess, that instead of picking out parking for carers, all hospital car parking should be free. In its 2009 report, “Fair for all, not free-for-all—Principles for sustainable hospital car parking”, the NHS Confederation stated:

“Charging for car parking is often necessary, but needs to be fair – and to be seen to be fair.”

It is important for Opposition Members to recognise that the country and the NHS do not have millions of pounds to spend on covering the cost of parking for a certain section of the population. The Labour Government left this country in a huge financial black hole which we are still struggling to recover from. Policies such as this could severely affect local NHS hospitals and services and their budgets.

There is an analogy that I always give in such situations, which I first heard Lord Tebbit use. I hope that goes some way to restoring my hon. Friend’s faith in me after my earlier lapse. The analogy in this context, which is not necessarily the context in which Lord Tebbit used it, is this: if somebody asked, “Do you think we should have free hospital car parking?”, the chances are that virtually everybody who was asked would say yes. If they were asked, “Should we have free hospital car parking? By the way, that will mean having to get rid of lots of doctors, nurses and essential staff”, people may give a different answer. In the analogy that Lord Tebbit used, the question was, “Would you like a free Rolls-Royce?”, and he suspected that the vast majority of people would say yes. If they were asked, “Would you like a free Rolls-Royce? You’ll have to live in a tent for the rest of your life to pay for it”, people may come up with a different answer.

Of course, in principle, people would love to have free hospital car parking, but we have to think what the consequences would be and whether people would want to face those consequences. When it comes to the crunch, I suspect the answer may be different. If the Government had an additional £180 million to spend, which would be the cost of free hospital car parking, I am sure there would be many other pressures to spend that £180 million on in some part of the NHS. For example, it may pay for another 2,500 doctors or 8,000 nurses for the NHS. If we had a vote on what is the most important thing that we should do with that money, I suspect that the additional doctors and nurses would carry quite a weight of support, not just in this House, but across the country as a whole. It is not just a free-for-all. The harsh reality is that there are consequences of doing these things.

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[Philip Davies]

My hon. Friend is right. There will, as an inevitable consequence of the Bill, be issues about preserving the integrity of the spaces.

I am not sure, but perhaps the hon. Member for Burnley intends to ask hospitals to provide designated spaces for carers to use, in the same way that there are designated spaces in car parks for people with disabilities or for parents with toddlers. If so, how many spaces should the hospital provide? There are rules and guidance on how many spaces there should be for disabled customers. From my memory of working at Asda, I think the rule is that 4% of all the spaces in a car park plus four should be set aside for disabled customers. That was certainly the situation when I was at Asda. Does she envisage a similar system—a number of designated spaces for carers, but when they are full they are full?

Does the hon. Lady expect someone to police the car park at all times to ensure that carers use the right spaces and that no one is charged unfairly? I do not know what system she wants. Perhaps she envisages a system of reimbursement, with carers paying for parking normally, just like everybody else, and then going into the hospital to demonstrate that they are a carer and have their costs reimbursed. That may require 24-hour-a-day, constantly manned reimbursement desks to be open at the hospital. Does she envisage that?

[Mr Rees-Mogg]

I am following my hon. Friend’s speech very closely. Is the heart of what he is saying that the scheme proposed in the Bill would prove so complex to administer that it would in effect be the end of all car parking charges, because to continue to have any charges would make the whole system collapse?

[Philip Davies]

Yes. That is absolutely my fear. Once we start down this route of having a centrally imposed system that has not been worked out locally, there will be all sorts of consequences. Ultimately, hospitals will be forced to turn a blind eye to this person or to that person, because their situation justifies having free parking just as much as a carer’s situation. It would be terrible for someone in the hospital car park to say, “Yes, you are a carer so you can have the free parking,” but, “You have a disability, so no, you can’t have free parking.” I do not see how we can allow hospitals to get into such a situation, because that would be grossly unfair.

From time to time, there will inevitably be disputes about whether somebody is a carer. If the system uses badges, somebody may forget to take their badge. As a carer, they would be entitled to free car parking, but if they had forgotten their badge, the hospital would not have to grant it. I am not entirely sure how such disputes would be policed. Would somebody be on site to adjudicate, or would the hospital do so? What training and qualifications would such people be given? Is this something for the Parliamentary and Health Service Ombudsman to adjudicate on? Is the hon. Member for Burnley suggesting that a new adjudicating body should be created to settle hospital car parking disputes? Those are all practical matters that need to be considered. This is not an easy yes/no question. There will be disputes from time to time, so who will sort them out, how will it be paid for and who will organise it and set it up? Will the hospital be judge and jury on its system of parking charges, or will that be monitored by an independent board?

[Mr Rees-Mogg]

To follow on from that, will the public or the private appeals system for parking offences be used? The two are completely different and have different statutory backings.

[Philip Davies]

My hon. Friend makes a good point. I do not know. The Bill covers not only NHS hospitals but private hospitals, which is another factor that needs to be considered. The hon. Member for Burnley did not say anything about how this would work in practice. In effect, we are being encouraged to vote for a pig in a poke.

The Bill will have unintended consequences. Hospitals may or may not be able to cope with the number of carers who use their car parks. The shadow Minister talked about the figures. According to the Department for Work and Pensions, just short of 721,000 people were claiming carer’s allowance in February, and a further 408,000 were estimated to be entitled to it. In England, 613,000 people actually claim it, and a further 331,000 are entitled to it. The number of people entitled to it varies quite widely from region to region.

I do not know whether this is why the hon. Member for Burnley has introduced the Bill, but she may be interested to know—this will certainly be of interest to my hon. Friend the Member for Bury North (Mr Nuttall) —that the north-west has a very high proportion of people entitled to carer’s allowance and a very high number who receive it compared with any other region in the country. I am not entirely sure of the reasons for that, but that is the fact of the matter, according to the figures from the Department for Work and Pensions. If, just under such a narrow definition, nearly 1 million people are suddenly automatically entitled to free parking in hospitals, how will hospitals cope with any potential increase in demand for car park places? Hospital car parks are bursting at the seams and unable to meet the current demand for car parking.

The principle of supply and demand is obvious in this regard. If the price of something is put up, the demand for it goes down, and vice versa. If we exempt people from car parking charges, an inevitable consequence will be a surge in demand. We all know that, much to the delight of my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), car use is increasing in the UK. Presumably, the demand for hospital car parking places will get more acute as time goes on—something that he will no doubt welcome regally.

[Mr Rees-Mogg]

I do indeed. The more the motor car is used, the better. My hon. Friend is getting to the nub of the matter. One can ration either by price or by queue. There is no other way of determining how supply and demand meet.

[Philip Davies]

I am glad that we have got back to a situation where I am in agreement with my hon. Friend.

The Cumberland infirmary in Carlisle has outlined its concern over its four car parks on its website:

“We are currently experiencing unprecedented levels of cars requiring parking spaces at the Cumberland Infirmary.”

It is already having that problem. How on earth is it expected to find the additional car parking spaces for carers to park free of charge?

In the north-west alone, 102,000 people are receiving carer’s allowance and a further 60,000 people are entitled to it. That is 162,000 people just in the north-west who would be entitled to free car parking under this regime. Where on earth will they all go?

In the 2015 edition of the Department of Health’s health technical memorandum entitled “NHS car-parking management: environment and sustainability”—they always have catchy titles at the Department of Health—Leeds Teaching Hospitals NHS Trust was quoted as saying:

“The car-park occupancy levels often reach and surpass 100%.”

It is not as though there are lots of car parking spaces available to allocate to worthy groups of people who might need to use them.

[Mr Rees-Mogg]

I am momentarily puzzled about how the usage of a car park can exceed 100%. Are the cars crashing into each other or parked on top of each other? Can my hon. Friend explain?

[Philip Davies]

I suspect it means that people are parking in places where they should not be parking within the car park because there are not enough spaces, so they park somewhere where there is not a space.

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[Philip Davies]

I am very grateful, Mr Deputy Speaker.

I will turn to the example that the hon. Member for Burnley used in her remarks, which she encouraged me to reflect on. As she said, at the end of last year, Torbay and South Devon NHS Foundation Trust announced that it would offer free parking to registered carers at Torbay hospital. I should point out that that scheme, unlike the Bill, is offered specifically to unpaid carers, rather than people who receive carer’s allowance. That is not what the Bill proposes, despite the impression the hon. Lady wanted to give. The interim chief executive of Torbay hospital, Dr John Lowes, said in December 2014:

“Family members and friends who provide unpaid care to our patients at home are invaluable, so we wanted to do something to make their hospital visits a little less stressful, and to demonstrate that we really do value what they do.”

He explained that the system was being implemented with the involvement of the established local care providers and that

“if someone is registered with either Devon or Torbay Carers Services, they just need to display their Carers Card on the car dashboard whilst they are parked in the public pay and display areas, and they will not be charged for parking.”

There are two points to make about that. First, the hon. Lady argued that what happens in Torbay shows why we can happily roll out the scheme across the country, but my view is that it is a perfect illustration of why we do not need legislation. Torbay has managed to do it without any legislation in a way that suits its local requirements, which is what I want to see.

Secondly, I know from my own experience that there is a problem with having a card displayed on a dashboard in a pay and display area, which is effectively what happens with blue badges. Anybody who has been involved in that area knows that people hand their badge to someone else to use—a member of their family, or whoever. It is not right—it is a terrible thing—but it happens, and we cannot ignore the fact that it would happen under the system proposed in the Bill.

[Mr Rees-Mogg]

I just want to say that I am sure things like that do not happen in Somerset.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. And I am sure that it is not part of the debate for today.

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[Philip Davies]

I very much agree, which is why I think the Bill is unnecessary. This can be done much better locally than by central Government diktat.

Gloucestershire Hospitals NHS Foundation Trust has also set up a scheme for carers, aiming to support their needs when they visit hospitals. It asks that carers make hospital staff aware of their caring responsibilities, and it also mentions that they may be entitled to a carer’s badge that they can use during a hospital stay. That entitles the carer to exemption from parking fees, but also to reduced meal costs in the hospital restaurants, free drinks on the ward and the use of toilet and washing facilities in the ward area. When we allow local hospitals the freedom to do their own thing, they can give carers an enhanced service that is much better than what the hon. Member for Burnley proposes. I fear that if there were a central Government diktat that was bureaucratic and difficult to implement, areas such as Gloucestershire would scale back the other benefits that they gave carers and instead just meet the requirements of the law.

It is perfectly clear that the Torbay and Gloucestershire schemes have completely different ways of working and of identifying eligible carers. If it works at local level, all is well and good, but that would not be possible under the Bill.

[Mr Rees-Mogg]

Is my hon. Friend saying that carers who currently receive the benefit of free parking would have to be removed from the Torbay scheme if the Bill were brought into law, because they would not qualify and Torbay would have to change the scheme?

[Philip Davies]

That is my reading of the situation. Because the definition of carers in the Bill is different from that used by Torbay—

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[Philip Davies]

In which case we must look at the Bill itself, Mr Deputy Speaker, if that is what you are urging me to do.

The Bill is called the Hospital Parking Charges (Exemptions for Carers) Bill, but it would actually apply to all health service providers, both public and private, and not just hospitals. I do not think many people appreciate its true scope. Clause 1 states that bodies that provide healthcare must

“make arrangements to exempt qualifying carers”

from car parking charges. That applies to

“any National Health Service hospital, walk-in centre, GP practice or other health care facility to which patients are admitted, or which they attend, for diagnosis, testing, treatment or other appointment relating to their health”,

so we are not just talking about hospital car parking charges. It also extends to private hospitals, so not only are we dictating what should happen in the NHS, but we are telling private hospitals what they should do. Many people might argue that those who can afford private healthcare treatment can also pay for car parking. Whether that is a legitimate use of resources is a different matter.

[Mr Rees-Mogg]

I wonder whether the Bill’s proponents have considered the human rights implications of taking a revenue source away from a private company without compensation. The Bill makes no provision for compensation.

[Philip Davies]

That is a very good question, and I do not know about that. My understanding is that Bills have to be certified to say that they fulfil obligations under the Human Rights Act and all of that stuff, but I do not know whether that applies to private Members’ Bills. My hon. Friend raises an interesting point, and I am not sure what the answer is.

Clause 2 is an attempt to define who would qualify. It states:

“A qualifying carer under section 1(1) is a person who…receives the Carer’s Allowance, or…has an underlying entitlement to the Carer’s Allowance.”

I have no idea where to begin with that. To claim carer’s allowance, a person must provide at least 35 hours a week of care for a severely disabled person receiving one of the following benefits: the middle or highest rate of disability living allowance; attendance allowance; the daily living component of personal independence payment; constant attendance allowance at or above the normal maximum rate with an industrial injuries disablement benefit, or at the basic rate with a war disablement pension; or armed forces independence payment. The person applying must be at least 16 years old, meet residence and presence conditions, not be subject to immigration control and not be in full-time education or gainfully employed. Anyone entitled to carer’s allowance would automatically receive free parking at hospitals under the Bill, whether they frequently visited hospital or not.

The hon. Member for Burnley has specifically identified that the members of the caring community who should be entitled to free parking are not only those who receive carer’s allowance but those who have an underlying entitlement to that allowance. I do not understand how on earth a hospital is supposed to know whether somebody has an underlying entitlement. The benefits system in this country is incredibly complex, and I would prefer our NHS hospitals to concentrate on the complicated process of providing the appropriate treatment to the right patients rather than have to be bogged down in Department for Work and Pensions rules on who is eligible for a particular benefit. That is what the hon. Lady is asking them to do in clause 2—to understand who is eligible for the benefit, not just who receives it.

As the hon. Member for Worsley and Eccles South made clear in an intervention, many people in this country care for people but are neither recipients of carer’s allowance nor eligible for it, because of the restrictive entitlement definitions. Why would we want to exempt some carers from parking charges but not others? That seems very unfair. I tried to get some information about what defines a carer, and it is not necessarily the same as what qualifies somebody for carer’s allowance. We need some flexibility on that.

I want to move on, because other Members want to speak. Clause 3 sets out provision for the Secretary of State to issue guidance and regulations through statutory instruments about the implementation of the duty to exempt carers from car parking charges. It is an important part of the Bill. It is something that we often see in private Members’ Bills: whether the Bill has merit or not—I am trying to flag up some serious concerns about that—the Member in charge includes a provision that would allow Ministers to extend the Bill’s requirements with the stroke of a pen and with barely a breath being taken. Clause 3 is a dangerous part of the Bill, because a Secretary of State or Minister could come along and say, “Actually, I’ve decided that we’re going to extend this left, right and centre”, and the hospitals will just have to implement it. That is very worrying.

Clause 4 would introduce a

“Duty to establish a scheme for exempting eligible carers from hospital car park charges.”

I think I have sufficiently covered who that would apply to and why it is a dangerous path to go down. Clause 5 states that a person would be eligible for free hospital car parking if they are assessed by a local authority under section 10(5) of the Care Act 2014, and it would change the provisions of that Act. It therefore seems to me—perhaps the hon. Lady will correct me—that under clause 5 eligibility could be granted on an intention to provide care, rather than someone actually being a carer. I am not sure how well that has been thought through.

[Mr Rees-Mogg]

Can my hon. Friend explain whether under clauses 2 and 5 somebody can quality for this allowance but not be eligible, or be eligible but not qualify?

[Mr Deputy Speaker]

If the Bill goes to Committee, such points can be teased out and straightened out there, rather than on the Floor of the House today.

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[Mr Mahmood]

I wholly agree with my hon. Friend. The services that carers provide are really beyond the call of duty and any compensation they might receive would not account for that. They provide huge support to nursing staff pressed by the shortages that currently exist in our hospitals. The huge amount of support and love they provide comes at great financial cost, and that is why I support the Bill. They are making a huge contribution to society, as well as to the people they support.

The hon. Member for Shipley went around the issue of parking about 25 times and back again, but the questions he asked were not substantive. As Mr Deputy Speaker helpfully pointed out, if he and his colleagues are really interested in this subject, they can sit down in Committee and raise the issues there rather than breaking down the issues in the Bill at this stage, which is their intent. Carers in their constituencies should take note of that and hold them to account.

Parking charges are excessive. This is not the first time I have raised this issue. I have raised it a number of times in Birmingham, because it affects the people who are least able to pay. The biggest issue is how to have some sort of discount. Offers are available, but they are hardly ever advertised and people are not aware of them. Many hospitals employ private contractors and it has been claimed that it is very easy to negotiate with them, but it can be very difficult to go through the bureaucracy to get that discount. The hon. Member for North East Somerset (Mr Rees-Mogg), who is no longer in his place, talked about human rights. It is interesting to hear a Conservative Member talk about human rights, but what did he do? He talked about the human rights of the car parking contractors. These are the people who drive around in Porsches with special number plates. That is what Conservatives believe in. The real issue is support for carers. They are the ones who need support.

Comments have been made about the technicalities of sorting out carers’ parking. That is not the problem. Who comes in and who goes out can be verified, and that currently happens. The hon. Member for Solihull (Julian Knight), who is also not in his place, mentioned problems associated with city centre hospitals. There are procedures that deal with that quite easily. The Bill would not make parking free for everybody. Tickets would be validated only within the hospital. People could not park and then go off to the city centre to go shopping. A huge number of red herrings have been raised by those on the Government Benches. The intention of the Bill is clearly to give very vulnerable people more of the support they need. Carers in the north-west are not paid a huge amount. They do the job because they want to support the people they are caring for. That is the main issue. That is the problem.

Contractors make a huge profits. There has been a national campaign in the newspapers and we should back it. I see the hon. Member for North East Somerset is back in his place. He wants the human rights of parking contractors to be considered over the human rights and liberties of carers.

[Mr Rees-Mogg]

Will the hon. Gentleman give way?

[Mr Mahmood]

I am not going to give way to anybody on the Government Benches. They have wasted enough time, so I will not indulge them.

We have to support this important Bill, because it would provide support to the people who pay in a huge amount to society. I was glad to hear Conservative Members talking about using public transport. The problem with public transport is that services do not run as well as they should. They do not run late, so somebody receiving dialysis in the evening may not be able to manage and carers may not be able to get a bus at that time. If no buses are running they will have to pay for a taxi, which is a lot more expensive. People use their own cars because of the equipment they might sometimes need to carry or if they have to drive their children. Some carers bring their children into the unit—the children can sit and do some work while the dialysis take place—because there is no one else to provide childcare.

These are all very significant and important issues and concerns. The Bill is a small measure. People say the NHS will go bankrupt, but the money generated does not go back to the NHS; it is paid to private contractors who hold the car park licences and make a huge amount of money, as has been pointed out in the newspapers and by the national campaign. That is the real issue and we need to deal with it. We need a lot more action, rather than the huge amount of jaw that has, and will, be expended by other Members. We should have a vote and show our support for carers. They care for the most vulnerable and they are sometimes the most vulnerable themselves.

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[Mr Nuttall]

I am grateful for the work carers do in my own constituency, particularly at the carers centre I visited recently, which provides a wide range of activities and support for those who undertake the often unsung job of caring for a loved on. I also pay tribute to the work that Carers UK does, as the principal national charity for carers. Of course, it very much supports the Bill, in this its golden jubilee year.

The aim of the hon. Lady’s Park the Charge campaign, which has resulted in the Bill, is to improve the financial position of carers who have to use hospital car parks by exempting them from car parking charges. Without doubt, the Bill is well intentioned, and no one from across the House would disagree with the proposition that helping those who selflessly care for others is a worthy aim. The first difficulty, however, facing anyone determining the size and nature of a group is that of definition, and that applies to carers as much as to any other. Carers UK says there are 6.5 million carers in the UK, with 5.4 million of them living in England. As I tried to mention earlier, the Bill only applies to England so that is the relevant figure.

Carers UK goes on to state that these people are providing unpaid care for their loved ones, saving the economy an enormous £119 billion each year, yet its research found that 48% of carers were struggling to make ends meet, and 45% said that financial worries were affecting their own health. It is no surprise, therefore, that Carers UK and the Bill seek to alleviate one of the financial pressures on carers—hospital car parking charges. However, I have several concerns, ranging from the Bill’s drafting to its financial implications and potential impact on other groups.

It is not clear to me how we can objectively determine who should and should not be expected to pay for car parking, as we would be doing if we started centrally exempting one particular group as being more deserving than another group. It would seem preferable to allow individual NHS trusts to continue making such decisions locally. Otherwise, on the face of it, we seem to have here a fair and reasonable proposal. Indeed, my initial thought was that it sounded like a good thing to do, and I suspect that most people’s instinct would be to support the Bill simply because of the title.

I know that the hon. Lady has campaigned on this issue with the best intentions, but I want to deal precisely with the exemptions she seeks to introduce. The Bill would exempt two groups of carers. The first is defined in clauses 1 to 3. Clause 2 states that beneficiaries of an exemption would either be in receipt of carer’s allowance or have an underlying entitlement to it. Carer’s allowance is a taxable benefit currently set at £62.10 a week to help a carer look after someone with substantial caring needs, and it is paid to the carer, not the recipient of the care. To qualify, the applicant must be over 16, spend at least 35 hours a week caring for someone, have been in England, Scotland or Wales for at least two of the last three years and not be in full-time education or studying for 21 hours a week or more. The person in receipt of care must receive qualifying benefits, such as the daily living component of the personal independence payment, the middle or highest care rate of the disability living allowance, attendance allowance or the armed forces independence payment.

That is the first group to which we can start to put a number. According to Department for Work and Pensions figures, as of February, 721,000 people were receiving carer’s allowance, so these people would be the first group that would clearly qualify under the criteria. However, the Bill would go further, by also including within the first group all those who have what is referred to as an underlying entitlement to carer’s allowance. The term “underlying entitlement” refers to the fact that a claimant cannot usually receive two income-replacement benefits together—for example, carer’s allowance and the state pension. This is called the overlapping benefit rule. If a person is not entitled to be paid carer’s allowance because of this rule, they are said to have an underlying entitlement to carer’s allowance instead. This might mean they could get the carer’s premium in jobseeker’s allowance and income support, the extra amount for carers in pension credit or the carer’s allowance element of universal credit. The importance of including those people is that the Bill would otherwise exclude carers in receipt of other benefits, such as the state pension, bereavement allowance, contribution-based employment and support allowance, contribution-based jobseeker’s allowance, incapacity benefit, industrial death benefit, maternity allowance, severe disablement allowance, universal credit, war widow’s or widower’s pension or widow’s pension.

Not surprisingly, the inclusion of these people significantly increases the number of those eligible under the Bill. DWP figures, as of February, estimate this group to number 409,000. Taken together, therefore, clauses 1 to 3 could exempt approximately 1.13 million people. These people are either receiving carer’s allowance or have an underlying entitlement to it. As the hon. Lady will be aware, in the north-west, where both our constituencies are located, there are 163,000 such people. To give some idea of the massive increase in the number of carers in recent years, I should add that the figure of 1.13 million is up from 451,000 in February 2000.

If, however, the definition of entitlement is applied in strict accordance with clause 2, the Bill would exclude, a university student caring for a disabled parent, for example. I suspect that the second group of potential beneficiaries was defined for people in such a position. The Bill therefore draws a distinction between a “qualifying carer”—someone caught by clause 2—and an “eligible carer”, as defined in clauses 4 to 6. My hon. Friend the Member for Shipley (Philip Davies) touched on this, and I pointed out in an intervention that the figure of 1.13 million—the figure quoted by Opposition Members as being the total number involved—seemed to ignore completely those included under clauses 4 to 6.

Clause 5(1)(a) defines the eligible carer as someone who

“has been assessed for free hospital parking”

by virtue of an amendment to the Care Act 2014, which this Bill would insert. The Bill proposes to amend section 10 of the 2014 Act, which deals with carer’s assessments. A carer’s assessment is made by a trained person either from the council or another organisation that the council works with. The Bill will make it a mandatory requirement for the assessor to assess

“whether the carer should be eligible for free hospital…parking”.

This is in addition to assessing, as outlined in the rest of section 10—

“(a) whether the carer is able, and is likely to continue to be able, to provide care for the adult needing care,

(b) whether the carer is willing, and is likely to continue to be willing, to do so,

(c) the impact of the carer’s needs for support on the matters specified in section 1(2),

(d) the outcomes that the carer wishes to achieve in day-to-day life, and

(e) whether, and if so to what extent, the provision of support could contribute to the achievement of those outcomes.”

It is not clear at all on what basis the assessor is expected to make this decision. If only eligibility or underlying eligibility to carer’s allowance is going to be checked, this provision is superfluous, as such people would be covered in the first group. If some other criteria are to be applied, there is nothing in the Bill or in any guidance notes—no such notes have been issued—to suggest what that might be.

Returning to my example of the student who is caring for a parent but cannot get carer’s allowance because of their studies, clause 5(1)(b) perhaps comes to the rescue. It says an “eligible carer” is a person who

“provides or intends to provide substantial care on a regular basis, other than by virtue of a contract or as voluntary work and has been certified as such by an appropriate clinician.”

I believe that the meaning is ambiguous. What does “intend to provide” mean? How far into the future is it expected that the care will be delivered—within the next week, the next month, the next year, or what? The Bill does not say. Or is a fixed timescale not required; is consideration of caring enough? What constitutes “substantial care” in this provision? Is it the 35 hours a week required to be eligible for the carer’s allowance, or is it fewer than 35 hours a week? We need to know, because the Bill is asking an assessor to be the ultimate arbiter of whether someone is entitled to free hospital parking charges.

Suddenly, the number of people who might benefit from free hospital parking becomes a lot less certain. The first group gave us 1.13 million people. How many more of the 5.4 million carers estimated by Carers UK to be living in England would be included in the second group? We simply do not know.

[Mr Rees-Mogg]

Does my hon. Friend agree with the further point that clause 5(1)(b) might provide an incentive to increase the total number of carers because people would have a strong need to say that they were carers or had the intention to be carers—even if the reality were completely different, which would mean falsely inflating the figures?

[Mr Nuttall]

There is always a danger with any scheme, as with the blue badge scheme, that some people will try to use it for their own ends. I hope it would be only a minority, but that danger exists. The assessors would need to be aware of that; they would need to be constantly on the lookout for people who were not genuine cases. That is what I think my hon. Friend is getting at—that some people might “try it on” to their own advantage.

Given that there are no explanatory notes and no impact assessment for the Bill, it is worth considering what has been done in the past. Fortunately, under the last Labour Government, an impact assessment was done—the NHS car parking impact assessment, which was published in December 2009. It estimated that there were 46 million in-patient visitors a day. We do not know how many of them are carers, but as we shall see, car parking charges vary significantly around the country. Regardless of the precise number, it is inevitable that one consequence of the Bill would be to divert part of the healthcare budget that could otherwise be used for front-line national health services—potentially life-saving services—to cover car parking maintenance and all the associated costs ranging from maintenance to administration and dispute management.

The Bill places Members here in the unenviable position of being asked to single out one particular group of people as being more deserving of financial assistance than any other. Without an exact number of those eligible for exemption, it is difficult to know how much money we are talking about in each area that the Bill would take out of the healthcare budget.

At the Bill’s heart is the principle of whether it is right to charge for parking at a hospital or other healthcare facility and, if so, which if any group should be exempt from those charges. I appreciate that some of the public—perhaps virtually all the public—take the view that charging to park a car at a hospital is simply an attempt to make a profit for greedy hospitals or, worse still, for nefarious parking companies. If that were the case, I suspect there would be universal condemnation of such a practice, but of course it is not the case.

Hospital car parking charges in our national health service are what are called “an income-generation scheme”. They are not just an extra-revenue scheme for hospital managers to provide comfier chairs or profit for private parking company executives to fund their jollies to the Seychelles. In 2006, the Department of Health issued guidance called “Income Generation: car parking charges —best practice for implementation”, which was subsequently revised in the same year. This guidance clearly states that to qualify as an income-generation scheme, the scheme

“must be profitable and provide a level of income that exceeds total costs. If the scheme ran at a loss it would mean that commercial activities were being subsidised from NHS funds, thereby diverting funds away from NHS patient care. However, each case will need to be assessed individually. For example, if a scheme is making a substantial loss then it should be stopped immediately.”

If a scheme such as car parking charges at an NHS hospital ran at a loss, it would not be acceptable. The Department of Health’s guidance goes on to state that

“the profit made from the scheme, which the NHS body would keep, must be used for improving the health services”.

The current guidance therefore prevents public money that should be used for patient care from being used to subsidise a loss-making scheme.

Clearly, if the Bill became law, it would inevitably affect the amount of income that a scheme would generate, meaning either that there would be knock-on effects for other users of the car park who are paying for it or that the health authority would be faced with the question of whether to start to subsidise it. It cannot do so because of the guidance, thus raising the question of whether the guidance would need to be revised in the regulations anticipated in the Bill. It is a principle that the Bill could reverse or it could open a door to making such a change.

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[Mr Nuttall]

The problem with selecting a group to exempt from parking charges is the necessity of considering other groups, and deciding which groups it is fair to charge and which groups should be exempt. Is it fair to exempt a particular visitor, albeit a carer, but to charge a clinical support worker who parks at the hospital every day? It could be someone with children or other dependants, working and acting as a carer but not in receipt of carer’s allowance.

Fairfield general hospital in my constituency comes under the Pennine Acute Hospitals NHS Trust. According to figures from the northern commissioning region for the latest available year, I understand it is one of the trusts that charges on average 11p per hour for staff to park. I have to say that the trust sets out very clearly what its charges are for hospital car parking, and it provides a range of concessions. I take note of your stricture, Mr Deputy Speaker, so I will not read them out, but it is fair to say that it has obviously looked at this question and considered the various groups that should be entitled to a concession. For example, it has picked out blue badge holders, patients and visitors who need to attend on a frequent or regular basis and those who need to visit because they have suffered the bereavement of a loved one.

Such a scheme would be put in danger, and the trust would have to revisit it, which would undoubtedly have an effect on the viability of that scheme. Is it fair to charge a spouse or partner of a cancer patient who is still working and does not get carer’s allowance if they are too busy to get certified as eligible for hospital parking charge exemption, as required under clause 5 of this Bill? The Bill would require them to be approved in advance, and there will be many other deserving cases not covered by the Bill. The Bill does not seek to exempt people because of their low incomes, which is one a weakness. Some of the carers may well be in straitened circumstances, but there may be others who would be able to pay the charge, whereas some members of other groups would not be in that position.

The conclusion may well be that the fairest answer is not to exempt any groups but to make car parking free for everyone, as has happened in Scotland and Wales. Aligning us with those countries would be a popular idea with many people, but we must not forget that it would mean taking hundreds of millions of pounds out of the healthcare budget. The 2009 impact assessment suggested that the cost then would be between £140 million and £180 million. In six years’ time, it is reasonable to assume that cost would have increased enough to pay for 13,000 band 1 clinical support workers or 9,000 band 5 nurses. We have to ask what we think it is right to spend the healthcare budget on: patient care or free or reduced car parking.

[Mr Rees-Mogg]

Perhaps my hon. Friend intends to mention it, but he is ignoring the reduction in the availability of spaces that would come about without charges—people would be able to park all day, and there would be much less control. It is not going to make it easier for carers to park if all the spaces are taken and they are blocked.

[Mr Nuttall]

My hon. Friend is right. The fact is that in September 2014 the then Health Minister, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), noted in a debate that 40% of hospitals now do not charge for hospital car parking. They are likely to be in rural areas where there is less demand for parking—where it is easier to provide parking and there is less pressure on it. I suspect the reality is that a hospital with a car park in a central location in a busy town or a major city centre has no choice but to have a car parking charge. That is the reality of life. If it were be free, there would just be chaos; essentially, it would mean that those who really needed to get close to the hospital would not be able to do so. There has to be some system in place to protect the spaces that are close to the hospital for those who need them. Whatever system we have, there is no simple answer to that.

What we do know is that the present system of having local decision making is working. Fairfield hospital allows 30 minutes of free parking for everyone; then it costs just £1 for up to one hour. In the constituency of the hon. Member for Burnley, by contrast, people would pay £1.90 for up to three hours’ parking. There is a huge disparity across the country. We heard earlier—in an intervention from the hon. Member for Streatham (Mr Umunna), I think—about the costs in central London, which are understandably very much higher than in the provinces.

While the Bill does explain the generality of what is required, it does not explain how the system would work in practice. In the opening remarks of the hon. Member for Burnley, she mentioned that the system would work by way of having a badge in the car window. I am happy to be corrected if I misheard. That is the first time I had heard that. It would perhaps have helped all of us if that had been in an explanatory note saying this was how the scheme would work. She also mentioned that in some hospitals people have to pay on entry—I think the hon. Lady is nodding. That is all very well, but I am not quite sure how simply having a voucher in the car window would help in that scenario. It must be more complex than that, and some sort of token would be needed in order to get through the barrier.

Cities and Local Government Devolution [Lords] Bill

Jacob Rees-Mogg Excerpts

Wednesday 21st October 2015 Commons Chamber

[Mr Jacob Rees-Mogg (North East Somerset) (Con)]

My hon. Friend makes the important point that rural areas should be protected. Will he give the House an undertaking that rural areas that are close to urban areas will be protected from being swallowed up by those neighbouring cities?

[James Wharton]

My hon. Friend raises a point that I know is close to his heart. He has tabled amendments to the Bill, which we shall discuss later. No area will be compelled to agree a devolution deal. The purpose of the Bill is to enable us to put such a deal on the table for any area that wants one, but it does not give us the power to compel any area to accept it. His comment is in line with the Government’s intentions in the legislation. We want to ensure that devolution and the benefits it can bring are there for everybody, but we will not compel areas to be part of it.

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[James Wharton]

I cannot give way to my hon. Friend, because I must make some progress. I apologise to him, but there will be opportunity throughout today to discuss this matter.

I doubt that it would be right to accept this amendment, but we shall of course listen carefully to the debate, both on this amendment and on the amendments of my hon. Friends the Members for Hazel Grove and for Shipley. We recognise the strength of feeling and we want to find a way to ensure the broadest possible support for this legislation. I have put on record the Government’s views and the concerns that we have to the proposed approach, but we will of course listen to what is said later on today.

Amendment 46, which is in the name of my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), seeks to prevent the ceremonial county of Somerset— the administrative county of Somerset and also the two unitary authorities of Bath and North East Somerset and North Somerset—from adopting arrangements that include a mayor for the area of the combined authority. There are two difficulties with the amendment. I suspect that my hon. Friend will speak to the amendment later, and I will listen intently to the comments that he makes. The first is that it would single out Somerset, Bath and North East Somerset and North Somerset as some kind of special case.

[Mr Rees-Mogg]

They are a special case.

[James Wharton]

Although those places are indeed special, the amendment is completely at odds with the generic, enabling provisions of the Bill. To recognise the unique character of an area is not to seek to exclude it from the enabling provisions. Rather, it is through those enabling provisions that we can recognise the particular character of Somerset along with the particular character of any other area. That is at the heart of the Government’s flexible approach—the bottom-up approach—of delivering devolution that is bespoke to the areas that want it.

Secondly, the amendment would rule out the Somerset authorities from having the option of adopting one of the models for strong and transparent governance that is available. Clause 3 enables an area to adopt the model of a combined authority mayor, but it will be for the councils themselves to decide whether they wish to move to this form of governance. We will not impose devolution on anyone, but it should be possible for everyone. I look to my hon. Friend the Member for North East Somerset to withdraw his amendment, but I will listen with interest to the comments that he makes.

I also want to comment on amendments 53 and 56, which are tabled in the name of the hon. Member for Nottingham North. Amendment 53 seeks to extend the Secretary of State’s powers under the new section 107A, so that in addition to providing by order for there to be a mayor for a combined authority area, provision could be made in certain circumstances, following a proposal from the constituent authorities, for some other governance and accountability structures for the combined authority area. Amendment 56 seeks to provide that, where such other governance structure has been provided, the combined authority would be a major precepting authority, as it would be if there were a mayor for the combined authority area.

In general, I have some sympathy with what might be seen as the underlying idea of those amendments, which is to introduce some greater flexibility, but in this case I am not persuaded that this is the right approach. The amendments risk being seen as an attempt to hold out the possibility of some governance arrangement that does not have that sharp single point of accountability. Although we have been clear that the Government wish to impose that accountability on no one, it will be a requirement for those deals that are similar in their scope and ambition to that with Greater Manchester.

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[Mr Allen]

I do, but I gently suggest that the hon. Lady does not push me too far on that point, because she will push me into talking about what the SNP has done to local government in Scotland. One of my new clauses, which may go some way to meeting her point, would entrench the rights of authorities below local councils—neighbourhood, community and parish councils—so that they too can have clear rights.

The hon. Member for Amber Valley (Nigel Mills) has left the Chamber, but people do get confused if there are lots of different tiers and nobody quite knows who does what. If the parish council looks after grass verges, everybody gets to know that and those who are interested can ask questions at that level. If the electrification of the midlands main line or the refurbishment of the M1 motorway is the responsibility of the combined authority for Nottinghamshire, Derbyshire, Nottingham and Derby, people will get to understand that mechanism. We could spend a lot of time talking about combined authorities. Let us let evolution take place and let us make sure, as part of that evolution, that, if we manage to secure this immense gain and step forward of going from Whitehall to town hall, we also go to the level below the town hall.

Entrenchment sounds like a very technical, dry constitutional question, but it is what just about every other country has. Just in case we ever got an unpleasant or tyrannical central Government of any political party, a local area would have justiciable rights to say, “I’m sorry. You cannot do that. You cannot impose that on us. We are an independent unit, with just as many rights as central Government.” Those rights might include the right to raise its own money, issue bonds or whatever it may ultimately be during the next five or 10 years as we catch up with the rest of Europe. Such entrenchment cannot be obtained, however, even by a Minister as benign as this one or his colleague the Secretary of State, because it is sometimes required to be in writing and to be defended.

The object of my new clause 1 is to defend the progress that the Minister and the Secretary of State are trying to make so that there cannot be changes unless there is consent. There are many ways of doing that. One way is to have a super-majority in the House. If someone came along and tried to terminate the life of a Parliament, just at the whim of the Executive, it could not now be done because there has to be a super-majority. Perhaps local government is as important as the question of how long the life of a Parliament is. Another way would be to have a check and balance, as it were, perhaps with local government itself—with the LGA, or any other institutional arrangement—being able to say, “No. We’re not yet prepared to relinquish that power, so we stand where we are.” It could also be defended behind the Parliament Act 1911, which says that the second Chamber shall not stick its nose into any affairs other than—this is the only one at the moment—five-year Parliaments. We could add that it shall also defend the rights of local government and its independence from the centre. Putting such constitutional or democratic blocks in the way of an erosion of some of the very good work that the Government are doing in the Bill is very important in my opinion. I hope that that will be addressed, if not only this occasion, then in a future Bill.

[Mr Rees-Mogg]

The whole concept of entrenchment in legislation is very interesting, but it is very difficult without a written constitution. Would the hon. Gentleman like to move to a written constitution to be able to entrench such powers?

[Mr Allen]

I would jump at the possibility of moving to a written constitution, because that would make it knowledge we could share with every schoolboy and schoolgirl, rather than having parliamentary archaeologists, such as the hon. Gentleman, tell us the right interpretation of a particular view. We could, however, have a halfway house; sadly, it does not necessarily require a written constitution. There are the means of a super-majority, a self-denying ordinance, a lock by an external body—in the case of local government, I have suggested it could be the LGA—or the 1911 Act. It is absolutely possible: every other western democracy has done it, and there is nothing in the parliamentary water that robs us of the wit to do something comparable.

I tabled new clause 13 on double devolution. The Minister has been very generous about considering how we can safeguard devolution pressed down below town halls to the localities. The new clause suggests that the Government should make a regular statement to talk through and enable Parliament to debate what happens when powers are given to town halls and to ask whether the powers get down to the people who really need them. There may be many powers that appropriately stop with the town hall or the combined authority. Equally, however, many others would be administered much better at a lower level. It is not about doing that for everything or forcing people into it, but about doing only what is appropriate. That is the way to follow this through and to continue the debate. This is not about trying to prevent the Government from doing what they are doing, but to facilitate the next stage.

My hon. Friend the Member for Sheffield South East (Mr Betts) talked about the need for public consultation and involving the public. It is absolutely imperative to take the public with us on this journey. It should not be seen just as a technical exercise. We should involve them by saying, “Look, we’ve had our devolution for a year or so. Let’s have a little look at what we’ve managed to do so far. What do people outside Government or Parliament think we could do better?” It would be very healthy to have such dialogue, promoted by the Government through a statement to the House or to the general public, and it would help us to move to the next stage of the evolution of devolution, particularly in England.

The Minister referred courteously to my new clause 18, so I will not go over the ground again in relation to parliamentary oversight. Let me, however, mention the other part of the new clause, which is about having an independent body to look at how devolution is going. This is comparable to my point about double devolution. However, they constitute it, the Government could create an arm’s length authority to say, “There are a lot of problems around x, or whatever it may be.” My hon. Friend mentioned cross-border difficulties, where one bit of territory is contested by more than one combined authority or metro mayor. Other colleagues spoke about powers being in one place, but not being relevant to another part of an authority. Many others have spoken about mayoralty.

An independent body—without the vested interests we sometimes have to have in Parliament, sadly—should look at this and say, “Well done, the Government. You’ve got us to first base, but if you want to get to second base, we think you should have a look at these things.” Again, that is not about binding Parliament or telling Ministers what to do, but about allowing ventilation of what is, for us, the very novel concept of devolution and the question of how it can work better.

I have already put a number of other points on the record. Like the Minister, I have spoken to Core Cities, Key Cities, the New Local Government Network and the National Association of Local Councils. They have all raised with me concepts, as well as detailed amendments, about where this ought to go, but I will not go through them. I will not detain the Committee much longer, suffice it to say that as well as getting this Bill through the House, we must look at where we want to be in 2020 and take steps to open a dialogue so that we can get to where we all want to go. We want to ensure that people control much more of their own affairs not only at United Kingdom level, but at national level, at combined authority devolved level and at the grassroots—on the ground in the localities. I hope that the Minister will take my remarks in the spirit in which they are intended and continue such a dialogue over the coming years.

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[James Wharton]

Given that the hon. Member for Nottingham North (Mr Allen) has informed the Committee of the sad news of the death of Michael Meacher, I think it is appropriate for me to put it on the record that the Government’s thoughts are, of course, with those who were close to him and who will be feeling pain at this time. As someone who was in this House for longer than I have been on this earth, he made a very significant contribution to this place and one that we should recognise.

[Mr Rees-Mogg]

May I add to what the Minister has just said? In my dealings with Mr Meacher in this House, he never put his strongly held political views above his fundamental good manners and civilisation. He was always the most decent man to talk to, even though I doubt there was a single subject of any political importance on which we agreed. He is a loss to this Chamber.

I will come on to my amendment 46, which would exempt Somerset, God’s own county, from the provisions on having a mayor. The Minister suggested that Somerset was not exceptional. I think that that was a momentary lapse because he is not only a most honourable gentleman, but somebody of fundamental good nature and wisdom. We will forgive him such a momentary mental lapse on this occasion and put it down to the wet weather or something like that.

The Government are giving fine and good undertakings. I will quote briefly from the Secretary of State on Second Reading:

“It is a fundamental tenet of this Bill, in contrast to other reforms debated over many years, that it does not give me or any of my ministerial colleagues the power to impose any arrangement on any local authority.”—[Official Report, 14 October 2015; Vol. 600, c. 326-327.]

My hon. Friend the Minister has reiterated those undertakings. They are excellent and encouraging, and they provide a solid basis for proceeding. Unfortunately, there is a “but” coming.

Everything I hear from local councillors in North Somerset and Bath and North East Somerset tells me that they are having their arms twisted. We are seeing a velvet glove today—a finely manufactured velvet glove of the highest quality velvet. Behind it, however, is a firm iron fist that expresses the Government’s will that things should go in a certain way. I encourage the Government, through my amendment, to make the background noises—the conversations in smoke-filled rooms—match the fine words that we are hearing in this House.

And so I come to why I want to exempt Somerset. Well, there is history—there is always history! I will start, as always, with Alfred the Great. If we go all the way back to 879, Bristol was in Mercia and Somerset in Wessex. One of those two kingdoms was completely under the Danes—that was obviously the Gloucestershire bit. The borderline between the two has been there for over 1,000 years. There is a strongly embedded history in Somerset and, indeed, in Bristol which means that they see themselves as independent, distinct units.

It is important that the Government go with the grain of communities that have built up over generations, centuries and, in this case, even a millennium, rather than create new administrative regions that mean very little to people. Most people have no interest in the title of their council. They have an interest in where their home is. Their home may relate to a great city, to a great county or to a village, a county and the country. The use of power needs to go with that. Therefore, devolution from the United Kingdom to an administrative body with which people do not have sympathy and about which they do not have a feeling makes things no better. People have a loyalty to the nation and a loyalty to their locality, but if interspersed between them is some random political agglomeration that came about through a sudden burst of enthusiasm by a Government, people have no association with that, no enthusiasm for it and no loyalty for the institution.

Of course, this has been tried before. This is my second and perhaps more important appeal to history in the context of Somerset, particularly in relation to North Somerset and Bath and North East Somerset. We were part of a much disliked, most unsuccessful, high-cost organisation called Avon. It is known to the cognoscenti as CUBA—the county that used to be Avon. The name CUBA was appropriate because it was almost as left-wing as Mr Castro in its approach to government and it was exceptionally expensive. It had one of the highest increases in rates in the 1980s. It was felt by people in the rural areas that it was run for the benefit of Bristol, with the cost being borne by people in rural areas.

We continue to see that in Avon and Somerset police, the cost of which is borne by the rural areas, even though—I am sorry to say this with the hon. Member for Bristol South (Karin Smyth) sitting opposite me—most of the crime is in Bristol. Inevitably, being an inner city, Bristol has more drug dealing, more armed crime and more social disorder than Nempnett Thrubwell and other villages in my constituency, which are bastions of law-abiding civility.

[Karin Smyth]

I was not going to intervene, but the hon. Gentleman is maligning the great city of Bristol, which draws in people from North East Somerset with its great employment and cultural opportunities. Indeed, that causes some great problems in my constituency in respect of travel arrangements and so on, but we are grateful to have his constituents coming to work in the city. Perhaps we can have a more balanced discussion.

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[Mr Rees-Mogg]

I am very grateful for the hon. Lady’s intervention, because it brilliantly encapsulates what I want to say, which is that Bristol is a fantastic city, a noble city, a city of fine history, but it is not Somerset. What I want to do is to protect Somerset from encroachment by Bristol. I want Her Majesty’s Government to ensure that the people of Somerset are not subjected to any pressure, any force or any arm twisting to be ruled from Bristol or to subsidise Bristol. I would rather, and I know the people of Somerset would rather, see our money spent through decisions made in Whitehall than decisions made in Bristol. We see the unity of the nation and we see the history of our county; what we do not see is a random administrative area.

I hope that the Minister can give me one commitment, which is that if we do not sign up to these things and if we retain our independence and freedom of manoeuvre, the Government institutions that spend money, such as Highways England, will continue to spend money—that it will not mean any loss of money, but will merely be about who decides how it is spent. For once, I am trusting the man in Whitehall against the man in red trousers in Bristol.

[Mr Kevan Jones]

The Minister made three startling claims in his opening remarks. He said that mayors will not be imposed, that devolution settlements will not be imposed and that the Government will seek consensus on such settlements. That is just not what the Government are doing.

The hon. Member for North East Somerset (Mr Rees-Mogg) talked of an iron fist in a velvet glove. What we have here is complete doublespeak. The portrayal of the situation by the Minister and others is that these decisions will somehow be taken in local areas. At the same time, the North East combined authority is being told that it will get devolution, but that a non-negotiable condition of that is to have a mayor. When councillors meet the Secretary of State and ask him why they need a mayor, he says that it is because the Chancellor of the Exchequer requires it as a prerequisite of devolution. The Conservative party and its friends in the north-east state that when the North East combined authority’s leaders ask sensible questions about why other areas have devolution without a mayor, or legitimate questions about how the mayor will work in practice, they are somehow being difficult, and that is why amendment 51 is so important. Throughout this entire exercise we are forgetting one important group of people—those who elect us and who are served by local councils and local areas.

Last week on Second Reading the hon. Member for Bromley and Chislehurst (Robert Neill) claimed that the Secretary of State was being a Chamberlain-style reformer. No, he is not, and I agree with my hon. Friend the Member for Sheffield South East (Mr Betts) when he says that we will end up with a complete dog’s breakfast.

There has been no great commission. When the Conservative party restyled local government in the 1970s we had the Redcliffe-Maud report, and in the ’60s—I think it went over into the Heath Government—the Crowther commission considered devolution. At least we are considering the issue and have some consistency to our approach, but that is because this Bill has nothing to do with real devolution and is about the Chancellor’s political control. He is seeking to ensure that the cuts required by his ideal of a small-state Britain can be devolved to local authorities or mayors, so that when people ask, “Why do you have to make these cuts?”, he will stand back and say, “It is nothing to do with me. It is down to your local mayor, and you decide.”

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[James Wharton]

My hon. Friend raises a valid point. An elected mayor provides the focus and accountability; it means there is someone to drive the agenda forward and be accountable for it. However, we would not impose this on any area. It will be delivered only by agreement. That is true of the north-east as it is for the country as a whole, and it is true of the text in this Bill, which does not give us the power to impose. It gives us the power to make deals with the areas that want them. Devolution should be on the table for any area that wants it, but it should be imposed on no one, and that is what the Bill ensures will happen.

[Mr Rees-Mogg]

I am grateful for my hon. Friend’s very clear answer. Is it therefore the case that if an area refuses devolution, the money stays with Whitehall but can still be spent in that area, and that refusing devolution results in no financial loss?

[James Wharton]

Of course. Areas that choose not to be part of devolution—and it is their choice; devolution will not be imposed on anyone—will suffer no disadvantage as a result of that choice. I shall be happy to meet my hon. Friend and his colleagues to discuss any concerns that they may have about what may come to be proposed for the area that my hon. Friend represents, and also about the implications should an area choose not to be part of the process. This is not about imposition; it is about consensus, working together and co-operation.

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[John Stevenson]

I am grateful for the opportunity to say a few words about amendment 50, which I tabled. I will be interested to hear what the Minister says, but it is not my intention to press it to a vote.

As the Minister is well aware, I fully support the Government’s overall aims and intentions. It is sensible that this is an enabling Bill and that it allows the maximum possible flexibility. I think that it will lead to innovation and fresh thinking not just at the national level, but at the local level. Indeed over the past few years, local authorities have demonstrated that they are innovative and that they can change.

I appreciate that the Government want to reform local government with the support of local government. The Bill gives local government the opportunity to step up to the plate and embrace these opportunities. It gives local authorities the chance to take responsibility, to take on more powers and to achieve an awful lot more for their communities. I understand that the Government do not want to impose things on local authorities, but to discuss and negotiate with them in order to come to a deal that is beneficial for central and local government.

A key part of this change is not only about powers, but about governance and structure. There has been an extensive discussion about elected mayors, of which I am an enthusiastic supporter. Indeed, I believe that elected mayors should be the default position for all councils throughout the country. I will continue to support and encourage that idea. However, I accept that the Government want local areas to come up with their own solutions and ideas for change on both governance and structure. I understand the thinking behind that.

I do, however, have some concerns. If I may take this opportunity to be rather parochial, I would like to talk a little about Cumbria. I suspect that other areas face similar circumstances, but I will just discuss my own county. Cumbria has been described as a county that is over-governed and under-led. We have more than 380 councillors and seven councils, yet we have only half a million people. That system was created in 1974 and is now clearly not fit for purpose. It is recognised by everybody locally, including all the political parties, industry, business, the health service and local people, that it has to change, and that it has to do so soon if it is to be part of the devolutionary changes that are happening and to take the opportunities that are available to local government.

However, there is a potential problem. That is why I tabled amendment 50. I believe that it is wrong in a two-tier area for one authority effectively to have a veto over any change, even if it is a sensible and well-supported proposal made by the rest of the county and all the other districts. That allows one authority to stop popular and vital reforms going ahead. Anyone who understands Cumbrian politics will know that that is a distinct possibility.

Amendment 50 is not about allowing central Government to impose their will over what happens in Cumbria—I want to emphasise that. It is about stopping one authority denying progressive change that is in the interests of people throughout Cumbria. Cumbria is an obvious example of this problem because six of its authorities could be prevented from bringing about badly needed and well-supported reform by one maverick authority.

[Mr Rees-Mogg]

I am very interested in the point that my hon. Friend is making, but concerned that his proposal would undermine one of the principles behind what the Government are doing, which is to ensure that there is consent for the proposals. Does he feel that if what he is describing were to happen, it would be right to have a referendum to ensure that people were not having decisions made for them wrongly by the hierarchy above them?

[John Stevenson]

I do not feel that a referendum would be necessary, because the councillors on the various councils are the elected representatives of the people. My concern is that one authority might dig its heels in and prevent change that is in the beneficial interests of the rest of the council and all the other districts, particularly given that sacrifices will be made by those districts and the county council.

I ask the Minister to give serious consideration to what I consider to be a modest and sensible amendment. I look forward to him accepting it on Report.

--- Later in debate ---

[Mr Rees-Mogg]

I am very grateful to my hon. Friend for his assurances, which are extremely welcome, and for acknowledging that Somerset is an extremely special place. On that basis, I will not press my amendments later.

[James Wharton]

I thank my hon. Friend and note that flattery can get you a long way in this business.

The hon. Member for Harrow West (Mr Thomas) tabled new clause 10, which would provide for the devolution of the Secretary of State’s housing powers to the Mayor of London. Since 2012, the Mayor of London has had overall responsibility for housing policy and delivery in London, taking over from the Homes and Communities Agency. The Mayor has powers to set strategic housing and regeneration policy through the London housing strategy. The Secretary of State has a legitimate role in relation to housing across England and it would be inappropriate to remove that role.

The amendment would weaken the Mayor’s role by requiring the Assembly’s consent. That fundamentally misinterprets the role of the London Assembly, which is a scrutiny not an Executive body. I recognise the hon. Gentleman’s desire to pursue the issue and to put it on the record. I am sure he will want it to be considered further as matters progress and that this is not the last time it will be discussed on the Floor of the House.

A significant number of other amendments relate to finance. Government amendment 9 provides greater flexibility in funding the functions to be devolved. Orders under the Local Democracy, Economic Development and Construction Act 2009 enable a combined authority to levy for transport purposes, and the constituent councils to make financial contributions to that combined authority to fund economic development and regeneration functions. The amendment provides flexibility to enable the constituent councils, if they so wish, to make financial contributions for any function of the combined authority, not just economic development and regeneration.

Opposition amendment 58—which the shadow Minister, the hon. Member for Croydon North (Mr Reed), has said he wishes to pursue further this evening—proposes that the Secretary of State be allowed the power to allow combined authorities to set multi-year finance settlements. For a combined authority to set multi-year budgets, it requires not a power from central Government, but the certainty of knowing what funding it is to get. The deals we have agreed with Greater Manchester and the Sheffield city region show how funding across the years can be agreed. We do not, though, need powers to put in place multi-year settlements for local authorities. We can already do that administratively as part of the wider local government finance settlement.

Amendment 60, tabled by the hon. Member for Sheffield South East (Mr Betts), would delete from clause 5 the exclusion of borrowing powers from the ancillary powers that can be given to a combined authority mayor. I listened very carefully to his contribution and understand his concerns. We agree that in appropriate cases there should be prudential borrowing for funding investment for which the mayor is responsible. The Bill provides for that, and the exclusion that the amendment seeks to remove is not about prohibiting such prudential borrowing.

Clause 10 makes provision for funding combined authorities and, in particular, provides that the Secretary of State may make regulations specifying the functions for which there can be borrowing. The Bill explicitly provides that those functions can include mayoral functions and that the constituent councils must consent to any regulations allowing borrowing.

I assure the hon. Gentleman that there are indeed borrowing powers for mayoral functions. In addition to devolving powers to a mayor, the Bill also allows ancillary powers to be conferred on a mayor to allow him or her to exercise the devolved powers. These ancillary powers could be those needed to ensure that there are no doubts about a mayor being able to run an office or to commission necessary studies, or they could include giving the mayor a general power of competence.

The exclusion, which the amendment seeks to remove, is to make it clear that those ancillary powers cannot include a power to borrow. They cannot be a back door to borrowing. The Bill sets up a proper regime for borrowing to fund mayoral powers, and that should be the route for a mayor being able to borrow.

Health Service Commissioner for England (Complaint Handling) Bill

Jacob Rees-Mogg Excerpts

Friday 27th February 2015 Commons Chamber

[Mr Chope]

With the greatest of respect to the hon. Gentleman, I do not accept that, which is why I tabled the new clause. As he says, the Minister was addressing new clauses 1 and 2, and I would not at this stage anticipate her response to the debate we are now having on new clause 3. If a statutory duty is in place, minds will be concentrated. That means that the ombudsman would, for example, be able to explain to a complainant who it was who was not providing the information that was necessary in a timely fashion and say, “If we don’t get a move on, your complaint will be time-barred because we will dismiss it on the basis that we have a lack of evidence.”

[Jacob Rees-Mogg (North East Somerset) (Con)]

Following on from the point made by the hon. Member for Ealing North (Stephen Pound), may I say that I am not entirely sure that corsets are normally metallic—I believe they are generally made of whalebone? Leaving that aside, I wonder whether my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) ought to be introducing a shorter time limit, because we all know that work expands to fill the time available. [Interruption.] Parkinson’s law, indeed. As soon as a 12-month time limit is introduced, that is the time that will be taken. If 95% of complaints are being dealt with within six months, six months would seem to be quite a good limit.

[Mr Chope]

I agree with my hon. Friend. It is a pity that he did not put down an amendment to my new clause to replace the limit of 12 months with one of six months. We know that the Bills that we debate on Fridays involve an iterative process. If the new clause were accepted today by my right hon. Friend, we would start off with a 12-month limit, which might in due course move to six months. That deadline, which will have the effect of concentrating minds, makes the measure legally meaningful, whereas, at the moment, everything in the Bill is legally meaningless. The Bill is, as someone has said in relation to the draft clauses of the Scotland Bill, “legally vacuous”.

[Mr Chope]

Unlike quite a lot of organisations, the ombudsman is accountable to this House. If the ombudsman were experiencing the difficulty to which my right hon. Friend refers, I would expect the ombudsman, the chief executive or chairman to contact my hon. Friend the Member for Harwich and North Essex (Mr Jenkin) and say that they wished the Public Administration Committee to look into the matter and put pressure on the recalcitrant Department. In a sense, my right hon. Friend is saying that, because we may have customers—if that is the right expression—who are minded to delay things, we should facilitate enabling them to delay things beyond a year. We need to focus on who the real customer is. The customer is the person who has made a complaint, and whose complaint has been accepted for investigation by the ombudsman. In my view, they are entitled to have a decision on that complaint within 12 months, which is why I put in this statutory duty.

[Jacob Rees-Mogg]

It occurs to me that, for once, my right hon. Friend the Member for North East Hampshire (Mr Arbuthnot) is wrong. If a public body failed to respond to the ombudsman, it should be found against and that would be quite a penalty and an incentive not to procrastinate.

[Mr Chope]

Again, my hon. Friend makes a first-class point. I hope that, when the Minister responds to this short debate, she will support the line that is being taken. We need to ensure that there is no scope for statutory bodies to avoid their responsibilities to deliver and that we facilitate the ombudsman to reach a result within 12 months of a complaint being made.

At the moment, the ombudsman is dealing with about 4,000 complaints a year, some 3,000 of which are related to health. The cost of those complaints to the taxpayer is about £4,000 a time. As the taxpayer is investing that amount of money, a reasonable return on that would be to say that those complaints should be dealt with in a maximum period of one year. If we pass new clause 3 and include it in the Bill, we will have a useful piece of legislation, instead of an empty vessel—although even an empty vessel with the name of my right hon. Friend the Member for Haltemprice and Howden on it will be cherished by many people, especially his constituents.

Amendment 3 is more specific. It will require the commissioner, in fulfilling the obligations set out in clause 1, to explain the delay before the end of the 12-month period, rather than after it. At the moment, there is a lacuna here—perhaps it is a deliberate one—to ensure that the minimum pressure is applied, which will show that we are just engaged in gesture politics. I hope that that is not correct. As it stands, clause 1(2) says:

“Where the Commissioner has not concluded an investigation before the end of the 12-month period…the Commissioner must send a statement explaining the reason for the delay to the person who made the complaint.”

But it does not say when the commissioner should send that statement. Unless there is a requirement on the timing of that statement, the measure is completely meaningless. It may be that that statement will be sent at the same time as the ultimate decision is made. In an effort to make the Bill do what my right hon. Friend wants it to do, which is to put pressure on the health service commissioner to deal with complaints in a timely fashion, I am suggesting a modest amendment.

Amendment 4 is on the same theme. When that statement is sent, it would not just explain the reason for the delay, but contain an estimate of the target date for completion of the investigation. I accept that, in itself, that would not be much use, because if there is another target date—it could be in another year—there may still be no remedy for the complainant. At least, though, it would force the ombudsman service to apply its mind to how much longer it thought it was reasonable for the investigation of the complaint to take.

Amendment 5 brings us into a slightly different territory. I suspect that a main reason for the delay in dealing with these complaints is a lack of resource. The amendment would add to clause 1 the words:

“If the reason for the delay specified in Section 2HA is lack of financial resources it shall be the duty of the Commissioner to set out the action which is being taken to remedy that lack of financial resource.”

Again, if the delay is due to financial reasons, it is surely important that the world outside, and particularly the complainant, should know about that so that they can make the necessary complaints. It is also important that the ombudsman is able to say, “Well, because of a lack of financial resources, I am not able to deal with these cases as quickly as I would have wished. Therefore, I am asking Parliament for more money to help us meet our case load.”

There is a £15 million budget for this exercise. Each case currently costs some £4,000 on average. The average compensation payment that was paid out in 628 cases amounts to less than £1,000. I am not sure that anyone coming from another planet and looking at this system would say that it is financially well focused. The average cost of dealing with a complaint is over £4,000. The average amount paid to a successful complainant is just less than £1,000. That shows that there is a potential problem in relation to the funding of the ombudsman service. That may be exacerbated by the ombudsman’s decision to take on more complaints for investigation by “lowering the threshold” for investigating such complaints. As the annual report makes clear, the consequence of that is an increase in the number of complaints being investigated, only a reduced proportion of which is being concluded in favour of the complainant. Expectations among the complainants are being raised, but they are not being delivered on by the ombudsman because a lot more cases are being taken on which probably should not have been taken on in the first place. The report states that because the ombudsman is

“taking on many more investigations than before, the proportion of investigations…upheld or partly upheld has inevitably declined”.

I think that the expression “inevitably declined” is a bit of an underestimate, because it has declined from 86% to 42%, which is a dramatic reduction in one year.

--- Later in debate ---

[Mr Nuttall]

I do not intend to detain the House for long on this group of amendments. Suffice it to say that I think there is merit in new clause 3, to the extent that it concentrates the mind of the ombudsman. At the moment, there is simply a requirement to report and that is the end of it. If nothing seems to be done, it just carries on. My concern is that the whole object of the Bill is to stop the situation that occurred in the case that led to its introduction, in which an investigation carried on for the best part of two and half years. As I read the Bill, it seems to me that there would be nothing to stop that happening again. A case could be reported as being outstanding in the annual report at the end of year one, and at the end of year two it could still be outstanding and nobody other than the complainant and the ombudsman’s staff would know anything about it.

Amendment 3 places a requirement on the commissioner to notify the complainant before the end of the period and again that seems to me to be eminently reasonable. Given that the purpose of the Bill is to try to get things dealt with within 12 months, it seems sensible that if it is apparent to the commissioner that that will not be the case, they should inform the complainant before the end of the period. Otherwise, quite legitimately, the complainant will expect the result at the end of those 12 months if they have not heard anything. It is pretty sensible to expect that. Whether that would happen anyway remains to be seen.

Amendment 4 would require the commissioner to provide at the same time an estimate of the target date for completing the investigation, which seems very sensible. The commissioner would say, “Look, we’ve not quite managed to do it in 12 months, but we certainly will in another three.” I see no reason why that should not be set out in the Bill.

I am pleased that my right hon. Friend the Member for North East Hampshire (Mr Arbuthnot) decided not to proceed with amendment 1, which relates to keeping complainants informed, as we dealt with that in the previous group. Everyone agreed that that was not a matter for legislation but should happen anyway as a matter of good practice.

I am rather less happy that my right hon. Friend has decided not to proceed with amendment 2, which would insert after subsection (4A)(b) the words

“the reasons for each of those delays”.

The general report, as set out in subsection (4)(a), should include details of how long investigations concluded in the year to which the report relates took to be concluded and how many of them took more than 12 months. That means giving a stark figure, for example saying, “We had 30 investigations outstanding at the end of the year.” It seems sensible also to require the reasons to be included. That would allow us to drill down and find out exactly what is causing the delays.

That leads me neatly to amendment 5, which stands in the name of my hon. Friend the Member for Christchurch (Mr Chope). It would insert the following provision:

“If the reason for the delay specified in Section 2HA is lack of financial resources it shall be the duty of the Commissioner to set out the action which is being taken to remedy that lack of financial resource.”

I am reluctant to support that. In my humble opinion, it is almost certain that any public official will reach the conclusion that what they really need to make their job easier and speed up the service they provide to the public is more resources. Unless we expect them to start having jumble sales and raffles—we have all tried using our own resources in that way to raise more funds—really the only thing they can do is come to Parliament and—

[Jacob Rees-Mogg]

My hon. Friend makes an absolutely brilliant and incisive point, because has not the whole lesson of the past five years been that public services have been able to deliver more with less? That should also be true of ombudsmen, and therefore the amendment is otiose.

[Mr Nuttall]

I am grateful to my hon. Friend. That has indeed been the lesson of the past five years, and we have seen some sparkling examples of people in the public sector doing more with less—our police service, for example. The same is true of the ombudsman. They have said that they have lowered the threshold and changed the way they work in order to try to meet demand so that fewer inquiries from the public are turned away.

[Jacob Rees-Mogg]

It occurs to me that that allows me to say that that is all thanks to our long-term economic plan—the first time I have managed to get those words into Hansard.

Human Fertilisation and Embryology

Jacob Rees-Mogg Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Liz McInnes]

I did not say it was just like changing a battery. In fact, I try to avoid using that terminology. The hon. Lady mentions learning disabilities, but as I just said, the organs affected the most by mitochondrial disorders are organs that require a large amount of energy, such as the brain, so that comes as no surprise to me.

Allegations have been made that the techniques are not safe.

[Jacob Rees-Mogg (North East Somerset) (Con)]

Will the hon. Lady give way?

[Liz McInnes]

No, I will not, because I need to make progress and let other people speak.

Last night, it was my privilege to attend the debate on the safety and ethics of this technique and to hear Professor Doug Turnbull, who leads the research team at Newcastle university, talk about the 15 years of work done by his team and the extensive safety checks that have taken place during those years. In the Chinese case to which my hon. Friend the Member for Stoke-on-Trent South (Robert Flello) referred, the treatment was carried out by an American clinician on a single patient in China. The patient became pregnant with triplets, one of whom was aborted and the other two were born prematurely and died. Importantly, the clinician attributed the outcome entirely to multiple pregnancy and obstetric complications, not to the method of conception. I do not accept that that one case represents a proper clinical trial.

What we have to remember is that mitochondrial disease is a life-limiting debilitating disease, causing severe distress to parents and their affected children. We have here a technique with the ability to alleviate their suffering and to allow affected parents the chance to have a healthy child who is genetically related to them in all aspects apart from a tiny proportion of mitochondrial DNA. The spectre of designer babies can be dismissed. There is no possibility of using this technique to select certain characteristics. It will simply allow mitochondria to function normally and for the child to be free of mitochondrial disease.

Health and Social Care (Safety and Quality) Bill

Jacob Rees-Mogg Excerpts

Friday 9th January 2015 Commons Chamber

[Sir William Cash]

I beg to move, That the new clause be read a Second time.

It is terribly important to use opportunities of this kind to discuss matters of such importance properly on the Floor of the House. It does not mean that we always have the right answers—sometimes, we do not even have the right questions—but there are some really important issues that need to be given an airing so that people outside can hear the nature of the discussion, rather than having that discussion held by an agency on its own account or, alternatively, by the civil service and then put forward in a Government brief.

Basically, this is a new proposal that deals with doctors’ language skills. There are many people in this country who believe that this is an important issue. It is pretty obvious that ensuring that doctors have appropriate language skills is rather important, especially given what happened in a particular case. I do not remember the names of the individuals concerned, but I seem to recall that the case involved a father who died after being treated by somebody from Germany. It seemed to be pretty likely, if not certain, that the reasons that happened were to do with a lack of proper language skills and proper experience of the medical practices in this country. The doctor was effectively coming here as a locum without appropriate qualifications or sufficient skills to be able to give the kind of treatment that was needed, and the result was a tragedy. Other Members of Parliament may have other such examples.

This is a very important issue. Indeed in April last year, the Medical Act 1983 was amended to strengthen the arrangements to ensure that all doctors have sufficient knowledge of English before being able to work in the UK. My new clause would help to ensure that all doctors were able to communicate effectively with colleagues and patients, which would sufficiently reduce the risk to patient safety caused by a lack of understanding of the English language that could result in the misdiagnosis and mistreatment of conditions. Many people regard that as common sense.

[Jacob Rees-Mogg (North East Somerset) (Con)]

I thank my hon. Friend for giving way. I am sorry to bring him on to familiar ground, but would this new clause be acceptable under European Union law?

[Sir William Cash]

My hon. Friend quite properly puts that question to me as I am Chairman of the European Scrutiny Committee of which he is a member. We always come across these questions of interpretation. The short answer is that in relation to the issue of having appropriate language skills, the parameters for the communication of information between the patient and the person giving the treatment would be described as being within the framework of public health and the importance of ensuring that the people concerned—the patient—had not only adequate treatment but the opportunity to ensure that they were not put in danger. I think that in those circumstances it would pass muster and that we could legislate on our own account. If there were ever a challenge, I would propose that we introduce a further provision reading “notwithstanding the European Communities Act 1972” and then legislate. If we did that, under sections 2 and 3 of the 1972 Act the notwithstanding formula would enable us to bypass the European Court of Justice and ensure that we could legislate on our own account in this House to ensure that language skills were needed in English to ensure that patients in this country were properly safeguarded. I hope that I have dealt with my hon. Friend’s point.

[Jacob Rees-Mogg]

indicated assent.

[Sir William Cash]

I see him nodding and I am glad that I managed to pass that test. I am always grateful to my hon. Friend, who ensures that we all keep up to the mark.

On this occasion, I think we would have the capacity to make the change in the first place, but, if not, perhaps we can take a belt-and-braces approach in the House of Lords and use the notwithstanding formula. We shall see.

[Jeremy Lefroy]

Again, I am most grateful to my hon. Friend the Member for Stone (Sir William Cash) for tabling this new clause, which covers an important subject—the language skills of doctors—although of course the language skills of all involved in clinical care are vital.

Clear and understandable communication is essential to safety and the quality of care of patients. Language skills are a necessary condition for good communication, but not a sufficient condition. They must be accompanied by good communication skills, with which not all of us are automatically blessed, however good our language skills. Communication skills teaching is now an essential part of training in medical and nursing schools and it is to the credit of the previous Government that they ensured that it was embedded in the curriculum of new medical schools and was taken forward in existing schools. I welcome the Government’s support for that important approach.

I understand that regulations have been in place for a short while to ensure that all doctors, whether from within or from outside the European Union, have appropriate language skills before being granted a licence to practise. I want to hear from the Minister what the effect of those important regulations has been and whether he believes that new clause 4 is necessary. I would also like him to consider whether the assessment of language skills should include communication skills within that language.

[Jacob Rees-Mogg]

I want to speak in support of my hon. Friend the Member for Stone (Sir William Cash). This is an important new clause on a matter that it would be wise to have clearly set forth in primary legislation.

The heart of the matter is, unfortunately, the European Union and the mutual recognition of qualifications within the EU, and there are good reasons for that. The only way to open up service industries generally is if mutual recognition of qualifications takes place, so if we are to have a single market in services that is an important basis for it. However, above and beyond that there must be a fundamental principle of patient safety, which is embodied in this excellent Bill, and a lack of good language skills and of understanding of a language is a danger in both directions. It is a danger for the doctor who is listening to the patient explain his or her symptoms and it is also a danger when the doctor explains to the patient what steps the patient needs to take for better health. If there is confusion, it can have a seriously deleterious effect on the patient’s health.

We must be clear that this is not about restrictive practice or protecting the market for British doctors but about ensuring that there can never be such confusion. As my hon. Friend the Member for Stone says, if this provision runs into trouble with the European Union, we need to state clearly that it is of such fundamental importance that it must override international treaty obligations. It was Disraeli who said in his speech in the Manchester free trade hall in 1872, “Sanitas sanitatum, omnia sanitas”—that the first duty of Minister is the health of his people. That statement has underlined and guided Conservative policy for nearly a century and a half.

[Sir William Cash]

I recall that Disraeli also said, “The Tory party is a national party or it is nothing.”

[Jacob Rees-Mogg]

Indeed, although I am less clear on the relevance of that, and I was not intending to swap Disraeli quotations all morning. I just wanted to make that point about a fundamental principle that has guided our party since the 1870s and its relevance in defending health through ensuring that there is a proper standard of English-speaking—or in Wales, Welsh-speaking—physicians.

[Sir William Cash]

My hon. Friend used the word “ensuring”. That reminds me that insurance is a very important ingredient in the question of health and language skills—and, as my hon. Friend the Member for Stafford (Jeremy Lefroy) said, communication skills as well. If there were to be a failure of language, the consequence of which was to breach the terms on which an insurance contract was devised as between the patient and the national health service, as well as others involved in the contractual relationship, there would be massive financial consequences that could, in certain cases, run into millions of pounds.

[Jacob Rees-Mogg]

My hon. Friend makes an interesting point. It is possible that that is taken care of by other parts of the Bill. Clause 1 contains the fundamental commitment that unreasonable risks should not be taken, and language could be seen to be part of that. The reason I like the new clause is that it makes it absolutely clear that language is fundamental.

It is very hard to think of a circumstance where a lack of communication could possibly be safe. There may be cases where a patient cannot speak, or absolutely dire emergencies where there is no alternative form of treatment, but in the ordinary course of events language skills must be essential for somebody who looks to work in this country for any length of time.

I hope that the Government will think about this new clause very seriously, and perhaps consider whether a “notwithstanding” aspect is necessary, and that if they do not accept it today, they will look at the matter again in another place.

[Philip Davies (Shipley) (Con)]

I apologise for not being here when my hon. Friend the Member for Stone (Sir William Cash) opened the batting on this new clause.

I very strongly support the sentiment behind the new clause. It should go without saying that people who are practising medicine should be able to communicate properly in English. It is a sad state of affairs when we have got to a point where we feel the need to introduce legislation in this regard. Whatever the rights and wrongs of the matter, sufficient examples have been reported around the country to indicate that we do have a problem. It may not be widespread—it may only occur in pockets—but it is perfectly clear that in some areas there is a problem that needs to be addressed. If the Government do not intend to accept the new clause, I would like to know what they intend to do about this genuine problem that people have identified.

My hon. Friend the Member for Stafford (Jeremy Lefroy) made a reasonable point about the measures that were put in place, partly by the previous Government, relating to new doctors and people who are currently going through training. The problem with that, however, is that it does not deal with the people who are already practising.

--- Later in debate ---

[Jacob Rees-Mogg]

I have just checked the territorial extent of the Bill, and parts of it apply to Wales as well, so we should not forget the need perhaps to be able to communicate in Welsh where appropriate.

[Philip Davies]

My hon. Friend makes a good point. That enhances the complication that could arise as an unintended consequence. I agree wholeheartedly with the sentiment of the new clause and the intention behind it, but I wonder whether its wording may lead to unintended consequences in relation to languages other than English that were not foreseen when it was tabled.

--- Later in debate ---

[Jacob Rees-Mogg]

I follow my hon. Friend the Member for Stone (Sir William Cash) in congratulating my hon. Friend the Member for Stafford (Jeremy Lefroy) on piloting the Bill so safely through the House. It is not necessarily easy to get private Members’ Bills through—and nor should it be—given the Scylla of the Back-Bench Tories who are not keen on new Bills coming through and the Charybdis of the Opposition, who sometimes suck Bills down to the bottom of the sea. I therefore congratulate him warmly on having achieved it.

My hon. Friend has done something that rather surprisingly was not done in the first place. The explanatory notes state that clause 1

“has the effect of removing the Secretary of State’s discretion around whether the requirements for registration with CQC should cover safety of care.”

It is amazing that the Secretary of State had that discretion. Why on earth would anyone want the Secretary of State to be able to think, “It doesn’t really matter if the safety of care is implemented or not. I think on this occasion I won’t bother with it.”? How reassuring it is that somebody has had the sense and wisdom to bring forward a Bill to close that extraordinary loophole, drawing on the experiences that are well known, particularly to the Members of Parliament from Staffordshire.

I take great comfort from what my hon. Friend said about the identifiers not being—to carry on with my Greek mythology—a Trojan horse to bring in an identity card system. It really would have set trouble alight if he had been trying to do that, but it seems perfectly reasonable to have a system that sees efficiently who people are within it and has a consistent form of identifying them. Having a notional go at an identity card system does not seem reasonable, so I am glad that he has stated so clearly that the Bill is not intended to do that. I am sure that their lordships will take careful note of that.

It is a tremendously important Bill that is being passed today, and one that I am sure that the other place will want to expedite because there is little time left between now and the end of the Session. The Bill will ensure that the primary duty of not doing harm to patients is established in law. As I said, it is extraordinary that it was not there before. I commend my hon. Friend for his discovery of that lacuna and his closing thereof.

Mitochondrial Replacement (Public Safety)

Jacob Rees-Mogg Excerpts

Monday 1st September 2014 Commons Chamber

[Fiona Bruce]

That is very interesting but the point I am making is that at the moment such clinical trials would involve children. Two peer-reviewed articles in Nature have suggested that mitochondrial transfer is inherently risky, one of them citing a figure of 52% of embryos created through MST having chromosomal abnormalities.

[Jacob Rees-Mogg (North East Somerset) (Con)]

There has been reference to the curing of disease but is that not a misleading way of putting it? What is happening is the creation of different people from those who would have been born suffering from the disease. Therefore, this is not curing an existing condition. It is stopping someone being born who would otherwise have been born.

[Fiona Bruce]

That is absolutely right. This technique will not provide a cure of mitochondrial disorders at all. Indeed, concern has been expressed that even where a female child born through the process appears not to suffer from the disease she could still be a carrier.

--- Later in debate ---

[Mr Willetts]

I confirm that my understanding is also that Lord Winston supports the advances in this area.

The evidence is pretty clear that this could alleviate human suffering, but I am not a simple-minded believer that the consequences justify whatever we do. Looking at my hon. Friends assembled in the Chamber today, many may say, “All right, this alleviates mitochondrial disease, but the price—the threat to human dignity or integrity—is too great.” I should like briefly to touch on those types of objection.

First, I do not agree with my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) that this somehow creates different people. We are not talking about the nuclear DNA that makes us who we are—the characteristics of our character or appearance. This is about a very distinctive part of DNA that has been called, for us laymen, a battery part of the cell, not the nuclear DNA, so it does not affect identity.

[Jacob Rees-Mogg]

Will my right hon. Friend give way?

[Mr Willetts]

I believe I can give way a second time.

[Jacob Rees-Mogg]

It changes 0.1%. If 0.1% is not a change, what percentage does my right hon. Friend think is a change?

[Mr Willetts]

It is a difference between quality and quantity. It is a change of 0% of the nuclear DNA that gives us our characteristics. It is a change in the membrane of the cell so that the battery function continues, but it does not affect human identity even by 0.1%. That is why I do not believe that there is an issue of dignity or integrity of the individual.

There is an argument that this is an engagement with people’s ability to produce children that is reminiscent of some of the worst features of eugenics. In fact, in many respects it is the opposite of eugenics. Eugenics was about forced sterilisation. It was about saying to people who were thought to carry some disease, “We’re not going to allow you to have children.” This is the opposite. It is about saying to people, “We want you to be able to have children and to be able to do so free from the anxiety that they will be bearing some disease.” It is exactly the opposite of the parallel with eugenics that is sometimes claimed.

That leads me on to the next objection. We are sometimes told, “Life is a vale of tears. There are sorrows and burdens that people have to bear, they should bear them with dignity, and this disease is part of that.” I have two responses to that argument. First, we have not run out of human frailties and problems yet. The problem facing our society is not yet that we have all started to lead lives of bland satisfaction.

It is also important to recognise that these scientific advances create a new problem. For the first time, a parent—a mother—could know that she could transmit this disease to her child. We have learned something that we did not know before. If we allow people to have this knowledge but do not permit a medical intervention that will tackle the problem, we have created a new source of human suffering that did not exist before this scientific understanding came about. Now that this knowledge is available, failing to permit families to act on it would be an unacceptable addition of a new cruelty to what is already a very distressing condition. Therefore, in terms of our respect for human integrity and dignity, it is right to intervene.

Then there is the argument that we are on a slippery slope. However, the framework set out in the Human Fertilisation and Embryology Act 2008 is very clear that we are not allowed to intervene in the nuclear DNA that shapes a child’s identity. That is recognised specifically as an exemption in the 2008 legislation.

This is a scientific advance that does not affect human identity, that is the opposite of eugenics, that enables people to escape a potential new cruelty if we do not act on this knowledge, and that is not a slippery slope. This is not just my view. We conducted a structured dialogue to consult members of the public on what they thought. When they understand that this is not to do with hereditary characteristics being affected by an arrogant intervention to create a designer baby, they support these interventions. If they support them, then so should we, in all parts of the House.

Tobacco Products (Standardised Packaging)

Jacob Rees-Mogg Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

Once the Government have made a final decision—and in the event that that decision is to proceed and it is approved in this Parliament—there will be a transition period, as there always is with any tobacco regulations. Because we have not yet made a final decision, we have not decided what that period will be, but there would always be a sell-through period—that has been the precedent set in the past. We are not able to be absolutely definite at this point because of that sell-through period, but I am happy to talk to the hon. Lady about previous sell-through periods for similar legislation.

[Jacob Rees-Mogg (North East Somerset) (Con)]

I thank the Minister for making it possible for Back-Bench MPs to go to the Ministry to read the report this morning. That was a great courtesy and was helpful to parliamentary scrutiny. I bring to her attention two points from that report. First, Sir Cyril Chantler notes that it is

“too early to draw definitive conclusions”

from what has happened in Australia. Secondly, in paragraph 4.21, he says that the research that has been done has been based on “stated intentions” and that those are known to be ones that have to be used with care. He says:

“This caution is justified, and to that extent the findings are essentially indirect and ‘speculative’.”

As the Government may be taking away a freedom from the British people, ought they not to be more certain of their ground than they can be of the ground they currently have from Sir Cyril Chantler?

[Jane Ellison]

The Government are not proposing to take away anyone’s freedom. Our tobacco control measures aim to prevent children from taking up smoking in the first place, which is quite a different thing. On my hon. Friend’s detailed point, Members of Parliament will, like anyone else, be able to make submissions to the final consultation. Once Members have had the chance to read the report thoroughly, any submissions they may wish to make will, of course, be most welcome and they will be considered.

Mitochondrial Transfer (Three-Parent Children)

Jacob Rees-Mogg Excerpts

Wednesday 12th March 2014 Westminster Hall

[Jacob Rees-Mogg (North East Somerset) (Con)]

I am grateful that the debate has been granted and for the opportunity to serve under your chairmanship, Mr Pritchard. I am delighted that the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison) will reply, because she is one of the most highly regarded Ministers in Her Majesty’s Government. I would also like to thank my hon. Friend the Member for Congleton (Fiona Bruce) for all her help in preparing for the debate, as well as Dan Boucher, Helen Watt and Luke Gormally.

It is important to begin the discussion by explaining what is at stake with three-parent babies and mitochondria. Mitochondria are the organelles within every cell responsible for the generation of cellular adenosine triphosphate energy. That passes entirely in the maternal line and can carry serious diseases.

There are two means of replacing the mitochondria. Maternal spindle transfer, or MST, takes place before in vitro fertilisation. The spindle, which carries the genes in the nucleus of the egg, is removed from the healthy donor egg and replaced by a spindle taken from the egg of the commissioning mother—that is, the woman at risk of passing on mitochondrial disease. All other parts of the donor egg, including the healthy mitochondria, are left in place. The combined egg is then fertilised by the father’s sperm, and the embryo has three parents: the spindle mother, the egg donor mother and the father. Genetic parenthood is complete in the case of the father but fragmented in the case of the two mothers.

In pronuclear transfer, or PNT, two embryos are created by IVF. One, the embryo of the commissioning women, will have its mother’s affected mitochondrial genes. The other is the healthy embryo of an egg donor. The embryos are combined using a technique somewhat similar to that in the cloning of Dolly the sheep. Interestingly, the licence for the experiment was adapted from the licence originally given for Dolly-style cloning.

[Sir Edward Leigh (Gainsborough) (Con)]

Given that this is obviously an incredibly important matter, akin to cloning, with a child having several parents—I know of no other country in the world that has done this—does my hon. Friend think it should be the subject of a full debate on the Floor of the House?

[Jacob Rees-Mogg]

I certainly think that this matter ought to come to the Floor of the House. I understand from an earlier debate that the Government are committed to full parliamentary scrutiny, but no doubt the Minister will confirm that.

To continue on PNT, at the one-cell stage the donor embryo pronuclei containing the nuclear genes are removed, killing that embryo. The partially gutted donor embryo with its healthy mitochondria is then used to form a new embryo when the pronuclei harvested from the commissioning woman’s embryo are inserted. Harvesting the pronuclei from the commissioning woman’s embryo kills that embryo.

It is important to understand that the techniques are non-therapeutic. They are in no sense a cure for children who are already born, nor do they pretend to be. Rather, the techniques create new people with altered genetic composition—genetically designed individuals who will not inherit mitochondrial disease. Although the mitochondrial DNA is around only 0.1% of a person’s total DNA, a little leaven leavens all the bread, and a different person is thereby created.

The proposed techniques all promote germ-line genetic modification. That is an infinite change that will lead to all the descendants of someone treated in this way being changed, the consequence of which cannot be known.

[Fiona Bruce (Congleton) (Con)]

I thank my hon. Friend for raising this critical subject. Techniques for mitochondrial transfer deliberately create a child who has three genetic ancestors, or, in the case of PNT, four. Is that not extremely concerning, raising as it does serious issues of personal identity for those born through the technique, particularly since Government guidelines propose that such individuals will not be allowed to know the identity of their third or forth parent? Will that not then transfer into future generations, too?

[Jacob Rees-Mogg]

I was going to come on to that. As an aside, the reason we were able to determine that Richard III’s body was his was through the female line, and because we could establish the continuity of the DNA. I do not believe Government promises of secrecy. They promised that to sperm donors historically. Governments cannot be relied upon, because society becomes more open and so demands greater openness. I have no doubt that if the technique is ultimately used the donors will be identified and people with three or potentially four parents will find out.

[Bob Stewart (Beckenham) (Con)]

On that point, the worry that occurs immediately to me as I listen to my hon. Friend is that if someone does not know who the third or fourth person who created them is, through sheer chance they may well find themselves marrying their brother or sister.

[Jacob Rees-Mogg]

That is a risk, and there are others. Already in the United States a different price is charged depending on the educational qualifications of the donor. There are worries about eugenics, a point I was going to come on to.

[Jim Dobbin (Heywood and Middleton) (Lab/Co- op)]

The head of the United States Food and Drug Administration advisory committee on this matter, Evan Snyder, has said that there are not enough clinical data to suggest that mitochondrial transfer is safe. Does the hon. Gentleman agree that the present UK regulator and the UK Government should be cautious in approaching this technique?

[Jacob Rees-Mogg]

I am grateful to the hon. Gentleman for that point. That is at the heart of the issue.

[Robert Flello (Stoke-on-Trent South) (Lab)]

Another issue occurs to me with regard to knowing who the third or, indeed, fourth parent is or was. Let us suppose that, in subsequent generations, further scientific research finds that another fault is being passed down generations. Without knowing whether the third or fourth parent several generations back carried some other gene that has come to the fore only after 150 years, someone would not know whether they were affected. There is a Pandora’s box of problems.

[Jacob Rees-Mogg]

That must be right. It ends up being a multi-generational experiment with the lives of people.

To return to the PNT technique, it is effectively cloning. As I said, it is telling that the licence for the experiment was adapted from the licence given to create Dolly the sheep. Cloning is widely regarded as a dangerous technique. Essentially what is being done is eugenic.

[Glyn Davies (Montgomeryshire) (Con)]

The company that developed Dolly the sheep received funding from an organisation of which I was chairman. I remember visiting it and expressing a concern that it was one step from cloning sheep to cloning humans. I was reassured that no such thing could possibly ever happen, as the human race was far too sensible. This issue challenges that, big time.

[Jacob Rees-Mogg]

As so often, my hon. Friend is right.

The dictionary definition of “eugenic” is:

“Of or bringing about the improvement of the type of offspring produced”.

The 1922 Eugenics Congress called it

“the self direction of human evolution”.

There is grave question mark about eugenics. It frightens almost every sensible person. It is not only people who share my views who think that. In a letter to The Guardian dated 15 March 2013, that fear was made explicit by a number of medical experts. It is interesting that they chose The Guardian, which is not a bastion of right-wing reaction, to make that point. In a country nervous about genetically modified crops we are making the foolhardy move to genetically modified babies.

There are three categories of risks and dangers that have not been fully considered. The first is the category raised by the hon. Member for Stoke-on-Trent South (Robert Flello), namely practical risks relating to the long-term efficacy of the therapy. An article published in Nature in October 2012 said:

“Pioneering work in nonhuman primates is critical for the development, and safety and efficacy evaluations, of new treatments.”

That view has been discounted by the Human Fertilisation and Embryology Authority without any good reason being given. Current research using PNT in macaques has yet to be shown to be successful. Macaque zygotes do not survive the PNT process well, even though their oocytes are less prone to abnormal activation and fertilisation than human ones. If that is the case, surely we should continue with such experiments first, rather than relying on the fact that four monkeys have reached the age of three.

[Robert Flello]

On that point, the research that has been done talks about generations of mice or of monkeys, but that does not address the fact that until there have been three, four, five or 10 generations, we will not know what the long-term effects are.

--- Later in debate ---

[Jacob Rees-Mogg]

I agree with the hon. Gentleman. I also think that mankind is of a different order of magnitude from other animals. I do not view myself merely as a senior ape—nor indeed do I view Opposition Members as merely being senior apes or monkeys. I think much more highly of them than that. [Interruption.] I will gloss over that point. In their article in Nature, Mitalipov et al showed that they had discovered that 52% of human embryos created through MST had chromosomal abnormalities. If there is a high failure rate early on, how can we be certain that there will not be a similar failure rate later, potentially when people are in their 30s or 40s? It is a life-long, generational experiment.

There are also difficulties with the experiments on fruit flies.

An article in Science on 20 September 2013 states:

“MR in fruit flies had little effect on nuclear gene expression in females but changed the expression of roughly 10% of genes in adult males. The mitochondrial haplotypes responsible for these male-specific effects were naturally occurring, putatively healthy variants. Hundreds of mitochondrial-sensitive nuclear genes identified in that study had a core role in male fertility. For example, one of the five combinations in which mitochondrial-nucleus interactions were disrupted by mismatching was completely male-sterile but female-fertile. In other fly studies MR resulted in male-biased modifications to components of ageing”—

that is very important because we do not know what the effects will be as people get older—

“and affected the outcomes of in vivo male fertility. Together, these results suggest that core components of male health depend on fine-tuned coordination between mitochondrial and nuclear gene complexes and thus the HFEA conclusion that ‘there is no evidence for any mismatch between the nucleus and any mtDNA haplogroup at least within a species’ is incomplete and unsubstantiated.”

It has also been discovered from research in mice and invertebrates that deleterious effects on mitochondrial replacement would not be discovered until adulthood, which goes back to the point that we would have to wait decades.

The second category of risk is moral and ethical. I make no bones about the fact that my thinking on this matter is strongly influenced by the Catholic Church concerning the dignity of the human person. Equally, the Minister and the Government should respond to non-theological, non-religious concerns. I will set out briefly the religious concerns.

Thomas Aquinas wrote in his “Summa Theologica” that

“the soul is in the embryo”.

I certainly believe that to be the case. It means that tampering with embryos is tampering with human souls—tampering with what sets us apart from animals. As Benedict XVI in the Instruction “Dignitas Personae” said,

“the body of a human being, from the very first stages of its existence, can never be reduced merely to a group of cells. The embryonic human body develops progressively according to a well defined programme with its proper finality, as is apparent in the birth of every baby.”

That, too, is absolutely correct. No human, whatever their stage of development, is merely a group of cells.

We must be concerned about the unknown consequences of tampering with the genes of an embryo, and for the unreligious there will be mental issues to be faced by those who find out later life that they have three or even four parents. The gravity of the change is such that it should not be made without the most careful thought and properly tested research. [Interruption.]

[Mark Pritchard (in the Chair)]

Order. I am sorry to interrupt the hon. Gentleman. Will whoever has their phone on please turn it off, or put it on silent or vibrate? This is an important debate and it needs to be heard with respect.

[Jacob Rees-Mogg]

Thank you, Mr Prichard. Silence is golden.

The third risk is legal, and I am slightly reluctant to raise it because it concerns the European Union charter of fundamental rights. It is not a document I often quote in support of an argument, but there is a question about its applicability in the United Kingdom. It is not directly applicable in UK law except when it coincides with EU law. There is considerable debate about how far the overlap between UK and EU law goes. Article 3(2) refers to the

“prohibition of eugenic practices, in particular those aiming at the selection of persons”.

I have established that this is eugenics, so it would be in contravention of the Charter of Fundamental Rights. I do not believe that the Government would want to contravene that accidentally.

Essentially, the Government have started too early and are putting the cart before the horse, which makes travel difficult, by consulting on regulatory approval before sufficient research has been done into the safety of the therapy.

[Jim Shannon (Strangford) (DUP)]

I apologise for not being here earlier. The Northern Ireland (Miscellaneous Provisions) Bill was being discussed in the House and I had to be there.

Does the hon. Gentleman accept my concerns on behalf of the people of Northern Ireland who are very worried by what was suggested the other day—that the Department of Health is pressing forward with regulations without full consultation and without the impact being fully known? I hope that the Minister will assure us that that will not happen.

[Jacob Rees-Mogg]

It is essential with such a fundamental change in our understanding of humanity that it is made with the fullest consultation and parliamentary approval. I believe that the Government are sympathetic to that.

[John Glen (Salisbury) (Con)]

Will my hon. Friend explain what evidence he has seen of any preparatory work on the ethical considerations that would be necessary? Is it not the case that many of the regulatory approval processes have commenced, but no proper work has been done with respect to public opinion on the ethics involved?

[Jacob Rees-Mogg]

There is consultation, but it worries me that it has been done before the prior research has been completed, so we cannot be certain about safety.

I am glad that my hon. Friend raises the issue of public opinion, which is unpersuaded. A ComRes poll for Care will be released tomorrow, and I can exclusively reveal some of the results to the House. It found that 34% are opposed and 35% are in support, so there is no strong balance of support but, crucially, 44% agree that as it is currently illegal to grow most genetically modified crops for commercial purposes on the ground of safety, it ought to be illegal to create genetically modified children.

I return to the point that change of even 0.1% leads to genetically modified children. It is not sufficient to say that that is a tiny modification so it does not matter. It is the essence of the line of inheritance that we all have from our mothers through successive generations and centuries.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

Does my hon. Friend agree that it is worrying that the assumption is that this will happen and that the consultation is more about how it will happen? Would it not be better for the Minister to say today that the Government will stop the consultation and continue with the research until they are satisfied that the procedure is safe?

[Jacob Rees-Mogg]

My hon. Friend makes a very good point. If the Minister would say that, her standing in North East Somerset would rise even higher, although it is hard to believe that is possible.

The Government’s own consultation—this is crucial—says:

“It is estimated that 1 in 200 children born every year in the UK have some kind of mitochondrial DNA disorder.”

The number of serious disorders is much lower, but one in 200 has some kind of mitochondrial disorder. It is worrying that that is in the consultation because the premise is that 0.5% of the population are born imperfect and that in future only perfect people should be born. Many of us have imperfections, but they make up humanity, and the mixed variety of interest, thoughtfulness and development that is humanity often comes from our faults, as well as our abilities. It is a fundamentally dangerous road to start down because, although the technique cannot at this stage affect eye colour, some clever scientist will eventually work out how to ensure that babies have blue eyes and blonde hair, or whatever people want. Every time something like this happens, we go to the next stage and the argument becomes, “Well, we’ve done this, so it is logical to continue.” When that line has been crossed, the argument against going further is merely a matter of degree; it is not absolute.

[Robert Flello]

I fear that we have already had the push to having perfect babies. Abortion on ground E of disability means that babies with even slight imperfections do not see the light of day.

[Jacob Rees-Mogg]

One aspect of political correctness that I like is calling disabled people “differently able”. People with disabilities have different abilities and skills, and contribute to the benefit of society in a different way from those of us who have the use of all our limbs, and so on.

Although the current aim is small, 10 children every year, who might have been born, will be replaced by 10 different babies. That is not a major problem crying out for an urgent solution, but the solution that is being proposed is a fundamental change in our understanding of our own humanity.

Care Bill [Lords]

Jacob Rees-Mogg Excerpts

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

I agree with the hon. Gentleman, which is why I am not opportunistically opposing the Bill. I have tabled a reasoned amendment to put on the record the very serious concerns people have about funding for local authority care in England, the way the new cap will work and, in particular, the proposed clause on hospital reconfiguration—the Lewisham clause. I cannot let those concerns pass without making clear our position on them from the Dispatch Box. That is why we have taken that stand. That is why I am seeking to introduce my remarks in a non-partisan way.

[Jacob Rees-Mogg (North East Somerset) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No, I want to make some progress.

I described the care system we have in England. Surely we can do better. In the last Parliament, the previous Government began a serious attempt at reform. I give this Government credit for continuing some of that work. The Bill contains many proposals originally put forward in my White Paper “Building the National Care Service”, published in February 2010. What most people will remember from the pre-election period was the clash between the parties on funding solutions, but what they might not have realised is that beneath the rhetoric there was much common ground on other matters. I hope that people will welcome that, just as we welcome some of the measures that are carried forward into the Bill.

First, stronger legal rights and recognition for carers are well overdue. For far too long, informal and family carers have been invisible to the system and taken for granted. That simply cannot go on. If statutory services are to be sustainable in the 21st century, they must learn to value informal care and carers and help them do more to help their loved ones. Secondly, we welcome efforts to simplify the social care system. Better information and advice will make a difference to some people. Unifying social care legislation in line with the recommendations of the Law Commission review initiated under the previous Government is sensible and overdue. Thirdly, the idea of a cap on the overall costs of care that individuals can face establishes the important principle that people should not lose everything they have worked for because of their vulnerability in later life.

I am happy to say that those are all important steps forward that we would not seek to oppose. However, let me be clear—this answers the points raised by Government Members—that this Bill is not equal to the scale and the urgency of the care crisis in England. It fails to implement the Dilnot report and does not provide a lasting solution. It does little or nothing to improve care services now or to reduce the costs of care for most people; in fact, it is likely to make things even worse. That is why we have tabled a reasoned amendment to draw the House’s attention to two major problems with the Government’s approach. First, prioritising funding a cap over and above protecting existing council budgets means that the care system will continue to go backwards and get worse, not better. In short, the Government are promising future help instead of helping people right now. Secondly, the proposed £72,000 cap is not what it seems; it is a care con.

On funding priorities, the Government are failing to face up to the scale of the funding crisis facing councils right now. In the cross-party talks on the Dilnot report, Labour stated a clear principle that the cap and the council baseline must be considered together as equal priorities. That was supported by Andrew Dilnot himself, as the right hon. Member for Sutton and Cheam (Paul Burstow) may remember, because he was also party to those talks. As a first step, we called on the Government to use some of last year’s NHS underspend to tackle the care crisis—and, by extension, to ease pressure on A and E—instead of handing the money back to the Treasury. The Government have not listened to that, and this Bill makes matters worse for local authorities by placing new, unfunded and uncosted burdens on them. The fact that it restricts the eligibility of those in substantial or critical need of support is, in itself, a clear admission on the Government’s part that the support system overall is being scaled back.

Tobacco Packaging

Jacob Rees-Mogg Excerpts

Friday 12th July 2013 Commons Chamber

[Anna Soubry]

I do not give in to pressure from anybody, and neither does anybody else in my Department or indeed in my Government. We have taken a decision to wait for the emerging evidence from Australia, and that is the right thing to do.

[Jacob Rees-Mogg (North East Somerset) (Con)]

May I welcome the wise statement made by my hon. Friend today, and remind her that it is often the case that parties in opposition are all in favour of freedom, and when they get into government they are suddenly in favour of the nanny state?

[Stephen Pound (Ealing North) (Lab)]

You had a nanny.

[Jacob Rees-Mogg]

I did indeed; I was very fortunate. [Laughter.] It is a pity some Opposition Members did not, but never mind.

When liberties are removed, it should always be done, as my hon. Friend says, on the basis of evidence, because freedom is very precious, and the state does not have the right to interfere willy-nilly.

[Anna Soubry]

I agree that the state does not have a right to interfere willy-nilly, but of course standardised packaging does not prevent anybody from buying cigarettes or inhibit their right to smoke cigarettes if that is their choice, so with respect to my hon. Friend, this is not a nanny state argument at all. The packaging would be affected, but people would remain free, as ever, to buy cigarettes and to smoke them.