1. What steps he is taking to ensure that local authorities have sufficient resources to deliver an effective service for voters at elections.
Before I answer the hon. Lady’s question, Mr Speaker, I hope that you will allow me briefly to thank and pay tribute to my predecessors in these roles, in particular my right hon. Friends the Members for Ashford (Damian Green) and for Derbyshire Dales (Sir Patrick McLoughlin). They have done great service for their constituents, this House and their country during their time in office and I want to put my thanks to them on the record. I also thank my hon. Friends the Members for Romsey and Southampton North (Caroline Nokes) and for Kingswood (Chris Skidmore) for the work that they did in the Cabinet Office before moving on to other responsibilities The Electoral Commission’s report shows that, overall, the 2017 general election was successfully delivered by a committed community of electoral administrators. We work with the commission, the Society of Local Authority Chief Executives and the Association of Electoral Administrators to ensure that returning officers are effectively supported to run polls.
I thank the Minister for that response and welcome him to his new role. As well as the snap general election last year, my local authority of Rochdale Borough Council presided over the Greater Manchester Combined Authority mayoral elections, for which it received no central funding, which is surprising considering that one of the Mayor’s functions is to replace the police and crime commissioner’s role, which did receive central funding. What action will the Government take to help local authorities such as mine to deliver well-run elections for these new roles?
The responsibility of the Cabinet Office lies in reimbursing local authority returning officers for the costs incurred in the administration of national elections. The responsibility lies with local authorities for the costs arising out of local elections. Local authority resources will be more than £200 billion over the current spending review period, including real-terms increases for both 2018-19 and 2019-20.
May I be the first Member also from the 1992 intake to offer my right hon. Friend congratulations on his latest appointment? Is he aware of the landmark ruling of the Supreme Court of the United States, which has said that the boundary changes in North Carolina are unconstitutional and gerrymandering? Will he join me in praising the work of the boundary commissions—despite their appalling recommendations for Lichfield—for at least being transparent, quasi-judicial and non-partisan?
It has always been an accepted strength of our constitutional arrangements that we have a parliamentary boundary commission for each part of the United Kingdom that is wholly independent of party politics and party influence. I hope, therefore, that all parties in this House will rally behind the recommendations of the parliamentary boundary commissions.
On behalf of Opposition Front Benchers, I welcome the Minister to his new role The chair of the Electoral Commission has warned that our electoral system is facing a “perfect storm” due to funding pressures, and 43% of local authority election teams have experienced real-terms cuts since 2010. Will the Minister outline why the Government’s democratic engagement plan fails to address these concerns, and will he ensure that a full and comprehensive review of the delivery and funding of electoral services is implemented as a matter of urgency?
I thank the hon. Lady for welcoming me to my new responsibilities. I repeat to her what I said in my initial response: the Electoral Commission concluded that, although there were problems in a number of specified constituencies, overall the 2017 general election was successfully delivered. The Government are committed to strengthening our electoral processes. As part of that, we are planning to run pilot schemes in a number of local authorities later this year to test requirements for voters to present ID before voting. We will look seriously at recommendations to us from the Electoral Commission on these matters.
2. What steps the Government are taking to maintain the security and integrity of the electoral registration process.
Every application to the electoral register is now subject to identity verification checks, making our system more secure than before. In late December, the Government laid draft legislation aimed at further improving the registration process, including addressing recommendations from the Pickles review of electoral fraud.
Last month, a 21-year-old man was convicted of voting twice—first by post, and then by varying his name and voting in person. He then bragged about it on Twitter. I understand that more than 1,000 similar complaints are being dealt with by the Electoral Commission, mostly relating to students. What steps are the Government taking to deal with this distortion of our democracy?
I share my hon. Friend’s concerns and am glad that he has brought those examples to light. I understand that, following the examination of these reports—or perhaps of reports other than those to which he refers—the Electoral Commission has stated that there is “a lack of evidence of widespread abuse.” None the less, we will continue to work with the police and the Electoral Commission to reduce the risk of double voting.
I welcome the hon. Lady to her position. Does she agree that the electoral process, particularly in Northern Ireland, was severely corrupted some eight months ago by thousands upon thousands of proxy vote applications? The previous Member for Foyle, Mr Mark Durkan, lost his seat as a result of thousands of proxy vote applications that were approved without any electoral or photographic identification.
I struggled to hear the hon. Gentleman owing to some noises off. As he knows, and as he knows I know, the electoral system in Northern Ireland is devolved. I am sure that my new ministerial colleagues at the Northern Ireland Office will be taking his concerns very seriously and working with the devolved Administration, where appropriate, to look into them.
I, too, welcome the Front Benchers to their new responsibilities. I am delighted to see the strong team in the Cabinet Office Is the Minister giving any consideration to restricting registration for national elections to one address, which may help with the problem of double voting raised by my hon. Friend the Member for North West Leicestershire (Andrew Bridgen)?
I thank my right hon. Friend for her views. I refer to the breadth of the Pickles review of electoral fraud, which gave us the basis for a number of reforms of our electoral system, all designed to reduce fraud and improve security. In that context, I will look carefully at all its recommendations. As you will know, Mr Speaker, the Government have already accepted and will be moving forward with a number of them. I would be delighted to discuss any issue further with my right hon. Friend.
One of the ways in which the Government could look to give more security to the electoral register is by moving to automatic registration when national insurance numbers are given out. Will the Minister comment on the private Member’s Bill introduced by my hon. Friend the Member for Cardiff Central (Jo Stevens), which would resolve any issues with individual registrations?
I am very well aware of the arguments, although I confess that at this point, 24 hours into my role, I have not yet had a chance to study that particular private Member’s Bill. I shall be happy to do that and take up the conversation from that point.
May I, too, welcome the Minister to her post? She is the fourth I have had the privilege of facing in the past two years The biggest threat to the integrity of the electoral registration process is the fact that millions of our citizens are not on the electoral register. All the Minister’s predecessors promised that they would bring forward proposals to address this problem. We were told that there would be a plan at Easter last year, then in the summer, then in December, but still nothing. When will she bring forward proposals to make sure that we can increase the number of people on the register?
The hon. Gentleman will know that in fact we have near-record levels of participation in our democracy. Voter turnout has risen. The completeness and accuracy of the electoral register have improved. There have been 30 million new registrations to vote since the introduction of IER—individual electoral registration—in 2014. Seventy-five per cent. of those used the “Register to vote” website, which I am sure he will agree is an important reform. The electoral register for the 2017 general election reached a record level of over 46 million electors. I do not agree with his assessment.
3. What steps the Government are taking to ensure that small and medium-sized enterprises can access opportunities to secure Government contracts.
I call Minister Oliver Dowden.
Hear, hear!
Thank you, Mr Speaker, and hon. Members for that very warm welcome Small businesses are the backbone of our economy, and this Government are committed to supporting them in securing Government contracts. To that end, we have already streamlined our procurement processes to assist small businesses. Our small business panel is working to improve accessibility of Government contracts, and we continue to focus on breaking down the barriers that might deter SMEs.
I thank the Minister for that answer and welcome him to his position. He will know that many small businesses are put off trying to get contracts by the amount of information they need to supply and the bureaucracy they have to go through. What more can the Government do to reduce that bureaucracy and amount of information?
My hon. Friend raises a very important point. It really is vital that small businesses can access Government contracts as simply as possible, so to achieve this we have already taken action to ensure that bidding processes are simplified across the public sector, with complex pre-qualification questionnaires abolished for low-value contracts. We will continue to look at ways to reduce burdens for business, particularly small businesses.
Given what the Minister has said, what information does he have that there has actually been an increase in the number of small and medium-sized businesses accessing Government contracts?
I would point to three pieces of information: direct spend with SMEs is up 80% since the Conservatives came to power in the coalition in 2010; more small businesses than ever are bidding for Government business; and the Government now spend about £5.6 billion directly with SMEs.
As a fellow Hertfordshire MP, may I congratulate my hon. Friend on his well-deserved new role? Does he agree that it may be possible for prime contractors with Government contracts to do more to bring in small and medium-sized businesses, particularly in specialist areas, where Hertfordshire is of course so strong?
I thank my right hon. and learned Hertfordshire Friend for his welcome. He raises an important point. There are two aspects of this: there is the direct spend—as I have said, it is about £5.6 billion—but we also need to ensure that we get spend into contracts lower down, with people who have Government contracts then spending with small businesses, which is something we are committed to doing as a Government.
Too often, rather than outsourcing to SMEs, very large companies are employed. In this respect, despite being under investigation by the Financial Conduct Authority and reportedly having debts of £1.5 billion, the massive outsourcing company Carillion remains a major supplier in terms of Government procurement. If it were to collapse, it would risk massive damage to a range of public services. Do the Government have a contingency plan for such an eventuality, and what is the likely cost to the taxpayer?
As the hon. Gentleman would expect, we of course make contingency plans for all eventualities. If I could briefly update the House, Carillion, as Members will know, is a major supplier to the Government, with a number of long-term contracts. We are committed to maintaining a healthy supplier market and working closely with our key suppliers. I can tell the House that Carillion’s operational performance has continued to be positive. For example, it advanced its work on Crossrail over the Christmas period.
The truth is that the Minister has failed to answer the central question. The Government have been outsourcing public services to large outsourcing companies on an industrial scale. When these massive outsourcing companies fail, as too often they do, does the Minister really think it is fair that the costs stay with the taxpayer, while the profits are creamed off by the shareholders?
I do not think there is anything wrong with profit. Profit is a reward for investment made by businesses. Perhaps if the hon. Gentleman had listened to my answer, he would not have had to read a pre-scripted question. I gently suggest to him that this is something the Government take very seriously. We, for the first time, as a Government—this had not been done for 13 years previously—started measuring the number of small and medium-sized enterprises that have Government contracts. We set a target of 25% in the last Parliament, and we have delivered on that, so I think that is a record of success for this Government.
4. What steps he is taking to ensure that democratic processes are protected against foreign influence.
The first duty of the Government is of course to safeguard the nation, and we take the security and integrity of our democratic processes very seriously. Although we have not seen evidence of successful foreign interference, we are not complacent, and we will continue to do what is necessary to protect ourselves.
In order to protect ourselves, the chair of the Electoral Commission has said that we need new rules for online political advertising to combat external influence, particularly via Facebook and Twitter. When will the Government bring forward the legislation we need?
One of the very first things for me to do in my new role is to meet the Electoral Commission, and I look forward to discussing that with it.
I welcome the new Minister. Does she agree that one of the ways of reducing foreign influence in our democratic processes would be for Members of this House not to go on Russia Today and Sputnik, and indeed be paid money for doing so?
Hearing from the right hon. Gentleman reminds me of the heady days during the coalition Government when we served in and around the Cabinet Office together. His question reminds us that there are hon. Members who seem to feel the need to do as he says. I think it would be more helpful if we recalled the words of the Prime Minister in her Mansion House speech, which were that we should be well aware of what Russia seeks to do and should seek to protect to the UK from it.
5. What steps the Government are taking to support people with disabilities to access the electoral registration process.
8. What steps the Government are taking to support people with disabilities to access the electoral registration process.
The Government are considering the responses to our call for evidence on the accessibility of the voter registration system. We have recently released the Government’s plan for democratic engagement, which includes strategies for disabled electors. The Government have also implemented the findings of an accessibility review of the website “Register to vote”.
For those who are disabled physically and visually who want to carry out a normal role in voting like the rest of us, will the Minister confirm that those who have disabilities and are in wheelchairs can gain access to polling stations and that ballot papers in Braille are available for those who are visually disabled?
Notwithstanding the caveat that in Northern Ireland the system is devolved and in some ways different from that in Great Britain, we certainly should not regard people with disabilities as in some way restricted in using the voting system in one way or another. Polling stations are equipped with, for example, tactile voting devices. More broadly, there are arguments around whether Braille brings some opportunity to identify a voter, but I very much welcome the hon. Gentleman’s question and would look forward to any further conversation he would like to have.
I welcome my hon. Friend to her new role. In my constituency of Southport, three excellent schools specialise in teaching children with autism as well as behavioural and learning disabilities. Does she agree that encouraging children with those conditions to learn about our political structure will make them more likely to engage with the electoral systems as adults?
I agree with my hon. Friend and I am glad he has raised those points. My predecessor in this role, my hon. Friend the Member for Kingswood (Chris Skidmore), did excellent work in the Every Voice Matters project where he focused on this as a matter of social justice. Of course, the citizen—any citizen—should be at the heart of voting and able cast their vote as a matter of public service.
6. What recent assessment he has made of the level of Government procurement from small businesses.
In November 2017, we published the 2015-16 figures for central Government Departments. The Government are fully committed to supporting our small businesses, which are the engine room of our economy, so we are continuing to take action to meet our target of a third of procurement being with small businesses by 2022.
It is good to see the Minister looking in a state of high excitement, as well he might.
Those 2015-16 figures show procurement to small and medium-sized enterprises to be falling, from 27% to 24%. The majority goes through indirect procurement, so is not the truth that wholesale changes are needed in a Government procurement system that just delivers crumbs from the table of large contractors to SMEs?
The hon. Gentleman is right to highlight the fact that this is a challenging target, but, as I said previously, we set a challenging target in 2010 and we met it by the end of the Parliament. I am confident that we will meet our target again. In particular, we will be taking further measures in relation to SMEs. We will use transparency to encourage large businesses to employ more SMEs and make prompt payment part of the selection process for larger suppliers, which is the point that he raised. I can tell the House that we will be bringing forward proposals on that very shortly.
7. What steps his Department has taken to co-ordinate the Government’s work on social mobility.
The Cabinet Office is responsible for co-ordinating action to increase socioeconomic diversity in the civil service. We are delivering on all recommendations made by the Bridge Group in its 2016 report.
The recent Social Mobility Commission report found that the worst-performing areas on social mobility are no longer inner-city areas but remote, rural and coastal areas and former industrial areas. What steps will the Government take to redress the funding imbalance that the north faces and to tackle social mobility issues in post-industrial towns such as Leigh?
The Social Mobility Commission report identified action on education, housing and employment as the key steps needing to be taken, and those are the exactly the things to which the Prime Minister and the Government are giving priority. For example, we have 1.9 million more children in good or outstanding schools than we did in 2010.
I am absolutely delighted to see that the right hon. Member for Bexleyheath and Crayford (David Evennett) has been promoted from the Whips Office and can now speak.
Thank you, Mr Speaker Does my right hon. Friend agree that social mobility is essential to maximise the potential of individuals and our country, and that while the Government have achieved a great deal so far, there is still more to be done?
I completely agree with my right hon. Friend. The Government look forward to delivering in full on the social mobility action plan for education that my right hon. Friend the Member for Putney (Justine Greening) announced just before Christmas.
9. What discussions he has had with Cabinet colleagues on ensuring the cyber-security of public and private sector organisations.
Cabinet Office Ministers and officials meet regularly with colleagues across the Government to discuss the cyber-security of public and private sector organisations. We are investing £1.9 billion in that work, as detailed in our national cyber-security strategy.
What resources are available for organisations to better protect themselves against cyber-attacks?
The National Cyber Security Centre gives direct help and advice to public sector organisations and also offers private sector organisations advice, guidance and help in responding to attacks. I encourage all to use its services. [Interruption.]
Order. There is far too much noise in the Chamber, with very loud and persistent private conversations going on. Let us have a bit of order at Topical Questions.
T1. If he will make a statement on his departmental responsibilities.
I intend to continue the work of the Cabinet Office to deliver its purpose: to maintain the integrity of the Union of the United Kingdom, to co-ordinate the security of the realm, to sustain a flourishing democracy, to ensure the delivery of the finest public services, and to help to implement the Government’s policies and the Prime Minister’s priorities.
The Government have withheld a dozen documents relating to the Government’s European policy in the early 1990s. What are they trying to hide? What embarrassment is the Tory party trying to cover up? Will the Minister release those documents?
I am happy to look at the particular case, if the hon. Gentleman would like to write to me, but I can assure him that documents are not withheld lightly. Sometimes individuals are named, or documents contain information that is still diplomatically sensitive. [Interruption.]
Order. Let us have a bit of order for a Dorset knight: Sir Robert Syms.
T2. One of the Minister’s new responsibilities is the important negotiations with the devolved Assemblies and Parliament. When will my right hon. Friend undertake meetings for those important discussions on the future of our country?
It is true that the Prime Minister has asked me to continue with my predecessor’s responsibilities of overall supervision of intergovernmental relations within the United Kingdom. I spoke yesterday evening to the Deputy First Minister of Scotland and the First Minister of Wales and assured them that I hope to visit both Scotland and Wales in the near future. I hope also to visit Northern Ireland.
T3. Earlier, the Minister remarked that the 2017 snap election had been well run, but following that election the Association of Electoral Administrators felt the need to provide its members with a free counselling service. What action will the Government take to address the significant staffing pressures and unsustainable workloads experienced by our election staff?
One of the challenges facing electoral staff this year was an unprecedented number of people taking advantage of the opportunity to register online, and administrators had to sort out duplicate registrations. We are looking at the lessons to be learned from that, but we should not fail to acknowledge the fact that online registration has made it easier for people to register and has been a great boon to many of our citizens.
T5. With over 25% of overseas development money being spent outside the Department for International Development, is there a role for the Cabinet Office in encouraging more cross-departmental spend and better reporting across all Departments?
My hon. Friend, with his expert knowledge of Africa, makes an important point. The national security adviser based in the Cabinet Office is responsible for roughly £3.2 billion of cross-departmental overseas development aid spending. I look forward to discussing with him how that money can best be spent and will certainly take account of my hon. Friend’s views.
T4. Lewisham has over 2,000 residents in temporary accommodation, and three quarters of those who have contacted me are not on the electoral register. I am not happy with this. Are the Government? If not, what will they do about it?
Despite the success of online registration, we accept that there is more to do. It is important that we encourage all our citizens to take advantage of their democratic right to cast a vote, both locally and nationally.
A number of my constituents have suffered terribly as a result of the contaminated blood scandal. Will my right hon. Friend please update the House on the progress towards the appointment of a chair and the timescales for the inquiry?
The contaminated blood scandal was an appalling tragedy from which individuals and their families are still suffering. I regard this as a very high priority for me. We have asked the Lord Chief Justice to nominate a judge to chair the inquiry, and I hope to announce the name of that judge soon.
T6. After the Prime Minister’s painful and protracted reshuffle clearly failed to ensure that the Cabinet reflected diverse and modern Britain, what steps is the Minister taking to increase diversity in the civil service?
We are implementing in full the recommendations in the report to which I alluded earlier and are encouraging all Departments to step up their work in making sure they recruit people and seek to recruit people from groups in society that have been harder to reach than others in the past. It is important that that work continues. The Prime Minister’s commitment to the racial disparity audit, which in 13 years of Labour Government we never saw from the party opposite, is an indication of the Government’s seriousness of purpose on this point.
The Minister will be aware that personal assurances were given to me and colleagues that the Government would bring forward amendments to clause 11 of the repeal Bill, but they have failed to do so. Will he assure me that the Government remain committed to working with the devolved Administrations to find a form of words that will be agreed and will allow a legislative consent motion to be passed?
I can certainly give my hon. Friend that commitment. When I spoke to the Deputy First Minister of Scotland last night, I said that we were disappointed that we had not been able to reach agreement with the devolved Administrations on an acceptable form of words for such an amendment but that I was committed to intensifying our discussions with the devolved Administrations to seek to reach an agreed form of words in time for proceedings in the House of Lords.
T7. On new year’s eve, another four young people lost their lives to knife crime. We have failed to tackle this epidemic because we have failed to recognise that the solution—[Interruption.]
Order. There is a lot of noise in the Chamber. The question is about knife crime. This is a matter of the utmost gravity. Please, it is the last question—let us hear it and the answer.
Thank you, Mr Speaker On new year’s eve, another four young people lost their lives to knife crime in London. We have failed to tackle this epidemic because we have failed to recognise that the solutions span health, education, poverty and aspiration. What can the Minister do in his role to get Departments working together to find a long-term solution?
On behalf of myself and, I am sure, the whole House, may I send our unreserved sympathy and condolences to the families of those four young people, who must be going through hell at this time? The hon. Lady will be aware that the Government’s stance on knife crime is tougher than ever—we have increased the punishments for repeat offenders and banned cautions for the most serious offences—and the latest figures show that more people are being sent to prison for knife crime than in the past. I accept that this has to be cross-departmental work. It has to involve local government and the Mayor of London in a big way. My right hon. Friend the Home Secretary is very committed to seeing further action taken to drive down the rates of these appalling crimes. I promise the hon. Lady that I will give what support I can from the Cabinet Office to the Home Secretary’s work.
Q1. If she will list her official engagements for Wednesday 10 January.
I hope that it is not too late to wish all Members and staff in the House a very happy new year This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
I, too, wish members of staff a happy new year At least 1.4 million households across the UK have been victims of unfair practices in the leasehold market, including my constituent Emily Martin. In advance of any intended legislation, what commitment will the Prime Minister make to ensure that Emily and thousands of people tied into this PPI-like scandal are compensated by developers now?
We are concerned when we hear of unfair practices taking place. I am sure that the Housing Minister will be happy to hear of this particular case as an example. We are looking to see what action the Government can take to ensure that people are secure in their homes and are not subject to practices that they should not be subject to.
Q3. In December, when the Brexit Secretary met Michel Barnier, they hugged. In that spirit, would my right hon. Friend the Prime Minister passionately embrace—not me, Mr Speaker; don’t worry—the agenda that she set out last year to build a Britain fit for the future, encourage home ownership, improve education, health and life chances, and leave this country in a better place than we found it?
My hon. Friend talks about passionate embraces; I do not think that he has ever had the kiss that he once asked for. He is absolutely right: we are determined to deliver a Britain that is fit for the future. That means that we need to get Brexit right and do a lot more. He references house building; yes, we are committed to building the homes that this country needs. That is why we have made £15 billion of new financial support available over the next five years, and why we scrapped stamp duty for 80% of first-time buyers. We are also improving school standards—there are 1.9 million more children in good or outstanding schools today—and we are protecting our natural environment. We are building a Britain that can look to the future with optimism and hope.
Mr Speaker, may I wish you, all the House and all our staff a very happy new year? [Hon. Members: “Hear, hear.”] Everybody is agreed? Yes? Thank you. I know it seems a long time ago, but just before Christmas, I asked the Prime Minister about the 12,000 people left waiting more than half an hour in the back of ambulances at A&E departments. She told the House that the NHS was better prepared for winter “than ever before.” What words of comfort does she have for the 17,000 patients who waited in the back of ambulances in the last week of December? Is it that nothing is perfect, by any chance?
I fully accept that the NHS is under pressure over winter. It is regularly under pressure at winter time. I have been very clear: I apologised to those people who have had their operations delayed and to those people who have had their admission to hospital delayed, but it is indeed the case that the NHS was better prepared this winter than ever before. [Interruption.] Yes. It might be helpful if I let the House know some of the things that were done to ensure that preparedness. More people than ever before are having flu vaccines, and 2,700 more acute beds have been made available since November. For the first time ever, urgent GP appointments have been available across the Christmas period across this country, and more doctors are specialising in treating the elderly in accident and emergency The right hon. Gentleman mentioned the last exchange we had in this House. In our last exchange, he said mental health budgets have been cut; that is not right. Simon Stevens from the national health service has made it clear that mental health spending has gone up both in real terms and as a proportion of the overall spending. So will the right hon. Gentleman now apologise for what he previously said?
The Prime Minister knows full well that child and adolescent mental health services budgets have been raided and many people who need help are not getting that help. We saw on “ITV News” the other night that nurses are spending their entire shift treating people in car parks because of backed-up ambulances. We know the Prime Minister recognises there is a crisis in our NHS because she wanted to sack the Health Secretary last week but was too weak to do it, and if the NHS is so well resourced and so well prepared, why was the decision taken last week to cancel the operations of 55,000 patients during the month of January?
I say to the right hon. Gentleman—[Interruption.] Members on the Labour Front Bench say “Apologise”; if they had listened to the answer I gave to their right hon. Friend the Leader of the Opposition, they would have heard me make it clear that I have already apologised to those whose operations have been delayed, and we will make sure they are reinstated as soon as possible. We are putting record funding into the NHS and record funding into mental health, but the right hon. Gentleman keeps on about the preparations for the NHS and I was very pleased last week to be able to go and say in person a thank you to staff at Frimley health trust from both Frimley Park and Wexham Park hospitals for the work they have been doing to deliver for patients across this period of particular pressure across the winter. Our NHS staff—not just doctors and nurses, but support staff such as radiographers, administrative staff, porters: everybody working in our national health service—do a fantastic job day in and day out, and they particularly do that when we have these winter pressures. In terms of being prepared, this is what NHS Providers said only last week: “Preparations for winter in the NHS have been more extensive and meticulous than ever before.”
We all thank all NHS staff for what they do, but the reality is that the 55,000 cancelled operations mean that those 55,000 people join the 4 million already waiting for operations within the NHS Perhaps the Prime Minister could listen to the experience of Vicki. Her 82-year-old mother spent 13 hours on a trolley in a corridor, on top of the three hours between her first calling 999 and arriving at hospital. Vicki says: “A volunteer first responder from Warwickshire heart service whose day job is in the Army kept mum safe until paramedics arrived.” Her mother had suffered a heart attack just a week before. This is not an isolated case. Does the Prime Minister really believe the NHS is better prepared than ever for the crisis it is now going through?
Nobody wants to hear of people having to experience what Vicki and her mother experienced. Of course we need to ensure that we learn from these incidents, and that is exactly what we do in the national health service. I am very happy to ensure that that particular case is looked at, if the right hon. Gentleman would like to provide me with the details. But week in and week out in the run-up to Christmas, and now today, he has been giving the impression of a national health service that is failing everybody who uses it. The reality in our NHS is that we are seeing 2.9 million more people going to accident and emergency, and over 2 million more operations taking place each year. Our national health service is something that we should be proud of. It is a first-class national health service that has been identified as the No. 1 health system in the world. That means that it is a better health system than those of Australia, the Netherlands, New Zealand, Canada, Switzerland, Sweden, France, Germany and the United States of America.
We on this side of the House are all very proud of the principle of the national health service—healthcare as a human right—but the reality is that, in the past year, 565,000 people have spent time on trolleys when they should have been being treated. The number of elderly people being rushed into A&E from care homes has risen by 62% since the Tories took power, and Care Quality Commission figures suggest that nearly a quarter of care homes need improvement. This is not only robbing older people of their dignity, but putting pressure on A&Es and ambulance services. So why, instead of dealing with the social care crisis, has the Prime Minister rewarded the Health Secretary with a promotion and a new job title?
There are many voices across the House, including from the right hon. Gentleman’s party, who have been encouraging me to ensure that we have better integration between health and social care. I am pleased that we have recognised this by making the Department of Health now the Department of Health and Social Care. That has been recognised by Age UK, which has said that this is a “welcome and long overdue recognition of the interdependence of health and social care” I saw for myself last week at Frimley Park the good work that is being done by some hospitals up and down the country, working with GPs, care homes and the voluntary sector, to ensure that elderly people can stay at home safely and do not need to go into hospital, with all the consequences of them coming into hospital beds. That is the way forward, and we want to ensure that we see the integration of health and social care at grassroots level. From the way in which the right hon. Gentleman talks, you would think that the Labour party had all the solutions for the national health service—[Interruption.]
Order.
If the Labour party has all the answers, why is funding being cut and why are targets not being met in Wales, where Labour is responsible?
The Prime Minister leads a Government who are responsible for the funding of national Governments, such as the one in Wales, and she knows full well what has been cut from Wales. She is also directly responsible for the NHS in England, and giving the Health Secretary a new job title will not hide the fact that £6 billion has been cut from social care under the Tories. Part of the problem with our NHS is that its funds are increasingly being siphoned off into private companies, including in the Health Secretary’s area of Surrey—[Interruption.]
Order. Mr Shelbrooke, calm yourself, man! You are supposed to be auditioning to become an elder statesman, but on present evidence, there will be many more auditions to come. Calm yourself; it will be good for your health.
Even more money is being siphoned out of our NHS budgets into private health companies. In the Health Secretary’s area of Surrey, a clinical commissioning group was even forced to pay money to Virgin Care because that company did not win a contract. Will the Prime Minister assure patients that, in 2018, less NHS money intended for patient care will be feathering the nests of shareholders in private health companies?
First, this Government have given more money to the Welsh Government. It is a decision of Labour in Wales to deprioritise funding for the national health service in Wales. On the issue of the private sector and its role in the health service, under which Government was it that private access and the use of the private sector in the health service increased? [Interruption.] No, it wasn’t.
Order. I say to the shadow Secretary of State for Health, the hon. Member for Leicester South (Jonathan Ashworth), that he, too, is supposed to be auditioning for something. He is normally a very amiable fellow, but he is gesticulating in a very eccentric fashion. He must calm himself. It is not necessary and not good for his image.
First of all, we have put more money into Wales, but the Labour Government in Wales have decided to deprioritise funding for the national health service. Secondly, the increase that was seen in private sector companies working in the health service did not happen under a Conservative Government; that was under a Labour Government of whom the Leader of the Opposition was a member.
My hon. Friend the shadow Health Secretary is auditioning to be Health Secretary, and he shows real passion for our NHS Under this Government, Virgin Care got £200 million-worth of contracts in the past year alone—50% up on the year before. The Prime Minister needs to understand that it is her policies that are pushing our NHS into crisis. Tax cuts for the super-rich and big business are paid for—[Interruption.] Yes, Mr Speaker, they are paid for by longer waiting lists, ambulance delays, staff shortages and cuts to social care. Creeping privatisation is dragging our NHS down. During the Health Secretary’s occupation of the Prime Minister’s office to keep his job, he said that he would not abandon the ship. Is that not an admission that, under his captaincy, the ship is indeed sinking?
This Government are putting more money into the national health service. We see more doctors and nurses in our NHS, more operations taking place in our NHS, and more people being treated in accident and emergency in our NHS, but we can only do that if we have a strong economy. What would we see from the Labour party? We have turned the economy around from the recession that the Labour party left us with. What do we know about the Labour party’s economic policies? Well, we were told all about them in a description from the shadow Secretary of State for Education, the hon. Member for Ashton-under-Lyne (Angela Rayner), who I see is not in her place on the Front Bench today—
She is in hospital.
I do apologise. I did not realise that the shadow Education Secretary was undergoing medical treatment, so I apologise unreservedly for that comment. However, I have to say that she described the economic policies of the Labour party in unparliamentary terms, which included the word “bust”, saying that the Labour party’s economic policy was “high-risk”. That means high risk for taxpayers, high risk for jobs and high risk for our NHS. That is a risk that we will never let Labour take.
Q5. Moving on to a positive note about the NHS, my NHS trust, Morecambe Bay, has turned around from being one of the worst in the country—it was safe to say that five years ago—to one of the best. That happened due to injections of huge amounts of cash, but the staff were amazing and turned the hospital around. Jackie Daniel, the chief—
Order. I gently invite the hon. Gentleman to be sensitive to time. We want not a long spiel, but a short question with a question mark at the end of it.
Jackie Daniel has received a damehood for turning around the Morecambe Bay trust along with the staff, which is very positive. Does my right hon. Friend the Prime Minister look forward to working with Jackie Daniel’s successor to carry on turning the trust around, and will she wish Jackie well?
I am happy to join my hon. Friend in paying tribute to the work of staff at the Morecambe Bay trust. I particularly wish Dame Jackie well, and I recognise and pay tribute to her work in turning that trust around. This is just another example of the huge gratitude we owe to our NHS staff, who work so tirelessly on our behalf.
Mr Speaker, I wish you, all staff and all Members a guid new year The Government’s European Union (Withdrawal) Bill is quite simply “not fit for purpose and must be changed.”—[Official Report, 4 December 2017; Vol. 632, c. 731.] Those are not my words; they are the words of the hon. Member for East Renfrewshire (Paul Masterton). Does the Prime Minister agree with her colleague that we must amend clause 11, which is nothing more than a power grab from Scotland?
The right hon. Gentleman knows full well that we have said we will look to improve clause 11. Indeed, my right hon. Friend the Chancellor of the Duchy of Lancaster made it very clear when he was answering questions earlier that we continue to look to amend clause 11. However, as I discussed with the First Minister before Christmas, we are looking to work with the devolved Administrations to ensure that we put the right frameworks in place so that, when we come to bring forward any amendment, it is done in the best possible way in the interests of all concerned. I thought that had been accepted by the Scottish National party, but we will be looking to bring forward amendments in the Lords.
That is simply not good enough. The Secretary of State for Scotland promised a “powers bonanza” for Scotland and that, crucially, amendments would be tabled ahead of next week’s debate. Yesterday it was revealed that no amendments will be tabled. The Tories always promise Scotland everything and deliver nothing. The Prime Minister has one last chance. Will she assure the House that amendments will be tabled ahead of next week, as promised?
The SNP says it wants to work with us on the future frameworks; we are doing exactly that. It says it wants clause 11 amended; we are doing exactly that. My right hon. Friend the Chancellor of the Duchy of Lancaster is intensifying his discussions with the Scottish Government and, indeed, with the Executive in Wales as part of that. We will be bringing forward amendments. The right hon. Member for Ross, Skye and Lochaber (Ian Blackford) says this is a Government who never deliver for Scotland. An extra £2 billion as a result of the Budget—that is delivering for Scotland.
Q10. Speaking of delivering for Scotland, the Stirling and Clackmannan- shire city region deal is a massive investment in Scotland’s economy and a huge vote of confidence in Scotland by a Conservative and Unionist Government. With projects such as the UK Institute of Aquaculture and the national tartan centre, which will have UK-wide impact and global reach, will the Prime Minister now confirm that the UK Government are ready to sign off the heads of agreement with the Scottish Government and the local councils so that we can get to work?
I am very happy to give that commitment to my hon. Friend. This is another example of how this is a Government who are delivering for Scotland. I know the importance of the Stirling and Clackmannanshire deal, which will be transformative. He has championed this cause since he was elected, and he is doing a great job for his constituents. We are all working to get an agreement as soon as possible.
Q2. I have been contacted by 11 constituents who are frightened, many of them suicidal, because they have been told either by Hull clinical commissioning group or by East Riding of Yorkshire clinical commissioning group that their desperately needed pain infusion treatment will be stopped. This is the cruel reality of the NHS having to ration treatment due to funding cuts. Will the Prime Minister personally intervene to ensure that the Hull and East Riding CCGs review their decisions and guarantee my constituents the additional funding that will allow this treatment to be delivered?
We are putting extra money into the national health service. We are not cutting funding for the national health service. CCGs will be taking individual decisions about how they apportion their funding, but to stand up here and suggest that we are cutting funding for the national health service is plain wrong.
Q11. Telford is a rapidly growing new town where thousands of new houses are built every year. People come to Telford to buy their home on a new-build estate and live their dream, but for far too many the reality is unfinished communal areas, unadopted roads, non-compliance with section 106, developers failing to take responsibility and the local council passing the buck. Colleagues on both sides of the House see similar problems in their constituencies. Will the Prime Minister agree to strengthen the rights of home owners on new-build estates so that people can come to Telford, or to any other new-build area, and buy a new-build home confident that they can live their dream?
I am happy to say to my hon. Friend that of course we recognise the concern she has raised; this is a similar issue to the one raised by the hon. Member for Weaver Vale (Mike Amesbury). I understand that it is Telford’s 50th anniversary, so I congratulate it on that. We are committed to legislating in relation to the unfair practice my hon. Friend has identified, because it is only fair that freeholders should have the same rights as leaseholders to challenge the reasonableness of the service charges they are being submitted to.
Q4. On a scale between one and 10, how does the Prime Minister think her Brexit is going, with 10 meaning everything is going perfectly, we know what we want to achieve and we know how to get it; and one being chaotic cluelessness? I know what I would give the Prime Minister, but what would she give herself?
I think—[Interruption.]
Order. Let me just say to the hon. Member for Perth and North Perthshire (Pete Wishart), whom I have known for a long time, that when he comes to reflect on his conduct, he will know that he can do better than that.
Thank you, Mr Speaker. I say to the hon. Gentleman that anybody who saw the success we had in negotiating phase 1 of Brexit, and getting that sufficient progress, will say that this Government know what they are doing, and that they are getting on with the job and doing well.
Q12. Environmentalists across the UK were delighted with the announcement of co-operation with the Woodland Trust to develop the new northern forest, but will the Prime Minister assure us that plans to create new landscapes will not obscure the need to protect existing areas of outstanding natural beauty? Will she confirm her commitment to protecting the Chilterns AONB as we pursue the Government’s economic and housing development plans?
First, I congratulate my right hon. Friend on becoming a Dame in the recent new year’s honours—it is very, very well deserved. I assure her that we are committed to maintaining the strongest protections for AONBs and other designated landscapes. As regards the Chilterns AONB, I have to say to her that I enjoy walking in the Chilterns. I recognise the value of that particular environment, and we are committed to protecting AONBs.
Q6. I was a teacher and a headteacher for 34 years, so I know that I speak on behalf of thousands of teachers and support staff when I ask the Prime Minister this: in the light of the recent announcement of a fall in teacher training application numbers by a third, will the Government listen to professionals and fully and fairly fund our schools and colleges; end the toxic culture of targets and tests; deliver a broad and balanced curriculum; and, most of all, return the joy of teaching and learning to our classrooms?
We are putting record sums into our schools. More than that, we are ensuring that we are seeing increasing standards in our schools. That is why today there are 1.9 million more children in good or outstanding schools than there were in 2010, and I hope the hon. Lady would welcome that.
Q13. The Prime Minister will be aware that there is great potential in the south-west to increase prosperity and productivity. Will she therefore confirm how her Government will be backing the south-west, in particular on the need to invest in our vital road, rail and digital infrastructure?
My hon. Friend is absolutely right about that, and he is a great champion for the needs of the south-west. We do want to increase prosperity and productivity in the south-west—and indeed right across the country—and we are taking some particular steps. Across the country we are committing significant sums in relation to infrastructure investment and the road investment strategy. We are committed to creating an expressway to the south-west, which will be part of an important development. We are investing more than £400 million into the rail network in the area. I am pleased to say that more than 600,000 homes and businesses in the south-west now have access to superfast broadband as a result of our superfast broadband programme. There is more we can do for the south-west, and I look forward to working with my hon. Friend in doing that.
Q7. The Secretary of State for Health said that the Government wanted the UK to be the best in the world for cancer diagnosis, treatment and care. Today, according to a memo from the head of chemotherapy at Churchill Hospital in Oxford, terminally ill cancer patients will have their chemotherapy cut because of a massive shortfall in specialist nurses. Will the Prime Minister apologise to cancer patients and their families for this appalling situation?
That trust has made it clear that there are absolutely no plans to delay the start of chemotherapy treatment, or to reduce the number of cycles of treatment given to cancer patients. Simon Stevens has said that over the past three years the NHS has had the highest cancer survival rates ever. The latest survival figures show that over 7,000 more people are estimated to be surviving cancer after successful NHS treatment, compared with three years prior. There are 3,200 more diagnostic and therapeutic radiographers than in May 2010. We will continue to look at this issue and we are continuing to put in the funding that is enabling us to improve treatment for cancer patients.
Q14. With record funding, our NHS is doing more than ever, but when the UK is in the bottom third of countries for heart-attack deaths, when we have significantly worse survival rates for stroke than France and Germany, and when our closest matches for cancer survival are Chile and Poland, is it not time to act on calls from all parts of the House, backed this week by the Centre for Policy Studies, to establish a royal commission on health and social care in this, the 70th anniversary year of our most cherished national institution?
My hon. Friend is right that we need to continue to look at the national health service and ensure that we continue to improve its performance in a variety of areas. The independent Commonwealth Fund has been clear that the national health service is the best healthcare system in the world, and that it is better than systems such as those in Germany, France and the other countries I listed earlier, but of course we need to look at what more we can do. That is why we are putting more funding into and looking at the better integration of health and social care on the ground. It is about making sure that we are making a change and doing that integration now, because that is when it is going to make a difference to people.
Q8. The Prime Minister said that she had reshuffled her Ministers so that they look more like the country they seek to represent. I am not sure about that, but in that spirit, will she acknowledge the massive problems in the private rented sector with absentee private landlords? Will she commit to come to visit Easington to gain her own appreciation of the scale of the problems that face many working-class communities? In the spirit of good will, will she support and give free passage to the Bill on homes fit for habitation that my hon. Friend the Member for Westminster North (Ms Buck) is promoting?
I have many fond memories of the time I spent in the north-east when I was a candidate up there. We do need to ensure that we have a good private rented sector in this country, but the one set of policies that would damage the private rented sector are the policies put forward by the Leader of the Opposition.
I was delighted last week to hear the Secretary of State for Environment, Food and Rural Affairs confirm the Government’s commitment to supporting farmers after we leave the European Union. Will my right hon. Friend assure me that the unique needs of Scottish farmers and, indeed, crofters will be taken into account in the design of any new system?
My hon. Friend is right that as we leave the European Union, we will of course be able to put in place our own policy of support for farmers. We want that policy to recognise the particular needs of farmers in all parts of the United Kingdom, and that will of course include the particular needs of farmers in Scotland.
Q9. My constituency office and local citizens advice bureau are receiving ever-increasing complaints about personal independence payment claims. Assessments are being refused and 65% of decisions are currently overturned on appeal at tribunal. The growing number of appeals means that the tribunal process is taking longer—anything from four to seven months. Does the Prime Minister agree that the PIP assessment process is fundamentally flawed? What action can she take to avoid the unnecessary expense of going to court and, more importantly, the undue stress and hardship being caused to my constituents and others throughout the country?
I understand the hon. Gentleman’s point about ensuring, as we want to, that these assessments are being conducted as well as they can be, and that people are getting the awards that they should be getting and that they are entitled to. Since we introduced the personal independence payment, we have carried out around 2.9 million assessments, 8% of which have been appealed, but only 4% of those decisions are changed following an appeal. In the majority of cases, that is because new evidence is presented at the appeal, which was not presented when the original case was put forward. The Department for Work and Pensions continues to look at ensuring that, when these assessments are made, they are done properly and that people get the right results.
My constituent, Justin Bartholomew, was just 25 when he committed suicide late last year. His family is convinced that his intake of high-energy drinks—more than 15 cans a day—increased his anxiety and contributed to his death. Given the increased safety concern around the high-energy drink market and the actions of people such as Jamie Oliver and Waitrose, will the Prime Minister consider introducing a national ban on the sale of these energy drinks for the under-16s?
My hon. Friend has raised a tragic case, and I know that the thoughts and the sympathies of the whole House will be with the family and friends of Justin Bartholomew. We have introduced the soft drinks industry levy. We recognise that there are issues around drinks that are high in sugar and we know that energy drinks high in sugar can be damaging to children’s health. We are supporting schools and parents to make healthier choices and to be able to identify those through clearer labelling and campaigns. Of course this is an issue that the Department of Health and Social Care will continue to look at, and it will continue to look at the scientific evidence in relation to these drinks.
Q15. I have a constituent who escaped an abusive relationship and has been passed from pillar to post between the old Child Support Agency and the new child maintenance service. After four and a half years of that, she has now been told by the CMS that she has to start the whole process all over again. On top of that, it is insisting that she passes on her personal and her bank details directly to her ex-partner to receive payment. Will the Prime Minister agree to help to resolve this problem and to look at the system that has allowed this abuse to continue?
The hon. Lady raises what is obviously a distressing case; I recognise that. Arrangements are in place that ensure, as I understand it, that an individual does not have to pass on their bank details directly. The fact that her constituent has been asked to do so is something that should be looked into. I am sure that if she passes those details to the appropriate Department, it will look into the matter.
Does the Prime Minister welcome the findings of the Social Research survey that the majority of Scots believe that the rules on trade and immigration should be the same in Scotland as in the rest of the UK? It looks like they agree that we are better together.
My hon. Friend has raised a very important point. People across the UK want to see controlled immigration—that is people in Scotland as well as people in the rest of the United Kingdom. As we leave the European Union, we will be able to introduce our own immigration rules and to control that immigration to Britain from Europe. The only point of differentiation is that, of course, we do have a Scotland-only shortage occupation list to recognise the particular labour market needs in Scotland. For the most part, that actually matches the UK-wide shortage occupation list, which shows that this is an issue for the whole of the UK, and that we need the same policy approach.
In a March 2005 interview, the Prime Minister said: “Not getting things done; and seeing people’s lives hurt by government bureaucracy” makes her depressed. In the light of that comment, can the Prime Minister tell me whether she considers it reasonable and acceptable for the Driver and Vehicle Licensing Agency to withhold the licence of my constituent, Mr Coleman, for more than 18 months despite evidence showing that he was fit and able to drive, as she has not responded to my letter of 5 December?
I will ensure that the hon. Lady receives a response to her letter. She has raised a particular case in this House. I will need to look at the details of that case and I will respond to her letter.
Last week, Cleveland Potash announced 230 job losses at Boulby mine in my constituency, which is devastating for Loftus and the wider east Cleveland community, where the mine is by far and away the largest employer. Tees Valley Mayor Ben Houchen, the hon. Member for Redcar (Anna Turley) and I all agree that it would be incredibly helpful if some of the funds remaining from the 2015 SSI rescue package could be repurposed to support people leaving Boulby. Will the Prime Minister agree to look into that with the Business Secretary, and will she make a commitment that Government agencies will do everything they can to support people affected by this dreadful news?
My hon. Friend is right to raise this case. It is obviously a worrying time for the workers who are affected by the announcement by Cleveland Potash. We will help people to find other work, and support those affected through the rapid response service of the Department for Work and Pensions. We will co-ordinate with the Tees Valley combined authority to ensure that we work together to make the best possible support available and ensure that it is aligned. The Department for Business, Energy and Industrial Strategy will look at the situation and the specific issue that my hon. Friend has raised.
Ava has been a foster-carer for years. When her privately rented home failed the inspection for an electrical certificate, which she needed to continue fostering, her landlord evicted her because he did not want to do the repairs. Now Ava and the kids are living in temporary council accommodation in a converted warehouse in the middle of a working industrial estate in Mitcham. The council that placed her there is going to withdraw her right to foster because her accommodation is not good enough. Can the Prime Minister tell Ava, kids in care who need foster-carers and the overworked British taxpayer how that makes sense?
As the hon. Lady has set it out, that does not appear to make sense: as a result of what has happened, we will lose someone who has been a foster-carer. I would like to pay tribute to the work that her constituent has done in foster-caring. We owe a tremendous debt of gratitude to those who care for people as foster-parents. As the hon. Lady has raised this in the House, I am sure that the local council will want to look at it again.
Finally, Richard Grosvenor Plunkett-Ernle-Erle-Drax.
Thank you very much, Mr Speaker. While most of us were celebrating on new year’s eve, the crews of the Poole-based tug, Kingston, and the Swanage and Weymouth lifeboats were battling mountainous seas and 70 mph winds off the coast of Dorset to prevent a cargo ship from being blown on to the rocks. Thanks to the skill of the tug’s crew the tow was fixed and a disaster prevented. Will my right hon. Friend join me in praising the professionalism, courage and determination of all those involved, not least the volunteers of the RNLI?
I am very happy to do that, and to praise all those involved in averting a disaster—both the tug crew and the RNLI. Indeed, I would like to go further. RNLI volunteers do a fantastic job around our coastline day in, day out, and we owe them a huge debt of gratitude.
Order. It would not be a full day without a point of order from the hon. Member for Na h-Eileanan an Iar (Angus Brendan MacNeil).
Thank you very much, Mr Speaker. May I congratulate you once again on your pronunciation of “Na h-Eileanan an Iar”, which was absolutely perfect On a point of order, Mr Speaker. Both the Leader of the Opposition and the Prime Minister talked about “the NHS” today, seemingly unaware that in fact there are four NHS services in the UK. I seek your guidance on what can be done to insist on knowledge and accuracy from the most senior parliamentarians in the Chamber, or is the Chamber indeed just the English Parliament?
If I did not know the hon. Gentleman as well as I do, I would think that he was being mischievous, but I cannot imagine that he would behave in that way. However, I am on the one hand flattered by his exhortation, and on the other hand at least a tad intimidated, for the idea that the Chair can be expected to insist upon knowledge and accuracy on the part of any Member or among any group of Members is an unrealistic ambition on the part of the hon. Gentleman. That is not a matter for the Chair. Members take responsibility for their statements in this House, but in so far as the hon. Gentleman was seeking to draw attention to what he regards as the singularity of the Scottish health service, I think he has accomplished his objective.
Plurality.
Or even the plurality of services, as he witters from a sedentary position. I think he has accomplished his objective.
On a point of order, Mr Speaker. I seek your advice on how best I can raise the urgent issue of cancer treatment in Oxford with the Minister responsible. Seriously and terminally ill patients at the Churchill Hospital now face delays and cuts to rounds of chemotherapy due to a chronic shortage of specialist staff. The next Health questions are not until 6 February and the people of Oxfordshire need answers now. After all, cancer does not wait.
I will make a number of observations to the hon. Lady. First, the matter was at least raised at Prime Minister’s questions today with considerable force and alacrity, albeit not by the hon. Lady on this occasion. Secondly, I know that she will not take offence when I say this, but I was looking meaningfully at her and was very keen to call her to ask a question of the Prime Minister—admittedly not of the cancer services Minister, but of the Prime Minister—and the hon. Lady, in an uncharacteristic display of reticence, did not respond to my exhortations. She did not seem to wish to rise to her feet at that time. Thirdly, notwithstanding that Health questions are a considerable distance away, business questions are tomorrow, and if she wishes to leap from her seat with alacrity to put a question on this matter to the Leader of the House, she can. Finally, if she applies for an Adjournment debate, she might be successful.
On a point of order, Mr Speaker.
I am saving the hon. Lady up.
On a point of order, Mr Speaker. I hope you might be able to advise me on how I can ascertain Government policy and action on an urgent matter that affects my constituency in Norwich. As you will know, hundreds of jobs could be lost with the closure of the Colman’s mustard factory and the Britvic factory in my constituency. I have repeatedly asked the Business Secretary to come to Norwich to meet the highly productive workers there and see the highly profitable factories. So far, he has not got back to me. Although I understand that he is still in his place at the Department, there are several new junior Ministers whose positions and responsibilities we do not know. May I ask for your guidance on how we might get clarification on that point and answers from the responsible Ministers very urgently, given the hundreds of my constituents who face losing their jobs?
I can and will respond to the hon. Gentleman. I preface my response by thanking him for his courtesy in giving me advance notice of his point of order. I say with great seriousness that I appreciate the importance of this matter to him and his constituents. I have two points to make. First, on the specific question that he raised—which member of the new ministerial team has responsibility for the matter—it is customary for the Government to publish from time to time a list of ministerial responsibilities. It would certainly be helpful to Members on both sides of the House if the division of ministerial responsibilities within Departments could be publicly clarified as soon as possible. Meanwhile, the hon. Gentleman has put his concern on the record and I am sure that it will have been noted on the Treasury Bench Secondly, on the back of my experience as a Member before I became Speaker, my advice to him about seeking a visit is: persist, man, persist. Make what I would call a polite nuisance of yourself. Keep going, keep asking, keep requesting, keep putting the matter in the minds of Ministers. On the whole, I tended to find when I was a Back Bencher that by making a nuisance of myself in that way, more often than not, I got at least a significant share of what I was seeking for my constituents.
On a point of order, Mr Speaker. This point of order is pursuant to the one I raised last night, on which you made good, clear suggestions. I now understand that the Secretary of State for Exiting the European Union has issued a statement, but not an official statement. Given the words that were spoken on 6 December, have you heard from the Secretary of State whether he intends to come to the House to rectify the record?
The short answer is that I have received no indication of any intention on the part of a Minister to make an oral statement on this matter. However, I think that the Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office referred to the matter during his Question Time session, so I think there is an indication to the hon. Gentleman of how the Government intend to proceed on the matter. It may not satisfy him, but it is what we have got at present Moreover, it will not be beyond the wit and sagacity of the hon. Gentleman and some of his colleagues who are similarly exercised about the matter to highlight their concerns during the Report stage of the European Union (Withdrawal) Bill. I look forward with bated breath, eager anticipation and beads of sweat upon my brow to hearing him express his concern, for the simple reason that I intend to chair the bulk of those sessions on 16 and 17 January. Much excitement awaits me.
On a point of order, Mr Speaker. In answer to my question on behalf of my homeless constituent, Ava, who is also a foster-carer, the Prime Minister appeared to suggest that there was some doubt that she would be deregistered as a foster-carer because of her poor homeless accommodation. I confirm that she has been deregistered for that reason. How will I put that on the record?
The hon. Lady has achieved her objective. It will appear in the Official Report and if she wishes to send a personalised and signed copy of said Official Report to the Prime Minister, it is open to her to do so.
I beg to move, That leave be given to bring in a Bill to require specified planning controls in relation to developments likely to be affected by existing noise sources; and for connected purposes This Bill is designed to protect existing music venues from closure or crippling cost arising from the development of new residential properties in their vicinity, especially over questions of noise Why is that a problem? The Music Venue Trust and UK Music have been campaigning on the matter for some time and estimate that more than a third of music venues have closed over the past decade. Many Members of Parliament have examples of much-loved venues in their area that have been closed or are under threat. That is why there has been such widespread cross-party support for this Bill, as shown by the number of Members who have already pledged their support and the turnout at this morning’s photocall. This important issue was also raised on 3 November in an Adjournment debate by my hon. Friend the Member for St Helens North (Conor McGinn). There has also been welcome support from some of the music greats. Sir Paul McCartney said today: “Without the grassroots clubs, pubs and music venues my career could have been very different. If we don’t support music at this level, then the future of music in general is in danger.” I accept that there is a variety of reasons for the decline in venues, but many relate to changes in the neighbourhood, increasingly when redundant commercial or industrial premises are converted to residential, or are knocked down and rebuilt, or as empty sites are developed. Of course, much of that is very welcome. It is part of the regeneration of our inner cities, restoring their historic vibrancy and creating much-needed homes. However, it can sometimes lead to the loss of what makes parts of those areas attractive in the first place, especially to younger residents. Incidentally, that applies not just to music venues but to the wider fabric of inner-city life, and there are important questions as to how we preserve the vibrancy and diversity of city life more generally across our main conurbations My short Bill is a modest and focused measure that would adopt the principle of agent of change into planning law. That basically means that when buildings are converted to residential use or a new development is put up, the onus is on the developer—not the venue—to ensure that the new dwellings are protected from factors, particularly noise, that could be held to affect their general amenity and enjoyment Moves are already being made around the country to address these concerns. Many grassroots campaigns are being mounted to save local venues. For example, among my Bill’s sponsors are my hon. Friends the Members for Bristol East (Kerry McCarthy) and for Bristol West (Thangam Debbonaire), who have been campaigning with the Music Venue Trust in support of The Fleece in Bristol—a city, incidentally, that I am informed has more office-to-residential conversions than anywhere outside London. Two other sponsors, my hon. Friends the Members for Cardiff West (Kevin Brennan) and for Cardiff Central (Jo Stevens), have been supporting the “Save Womanby Street” campaign, along with my hon. Friends the Members for Cardiff North (Anna McMorrin) and for Cardiff South and Penarth (Stephen Doughty). That has led directly to the Welsh Labour Government’s welcome adoption of the agent of change principle across Wales. Another sponsor, the hon. Member for Somerton and Frome (David Warburton), is concerned to protect the rapidly growing Cheese and Grain—a much valued venue in Frome—which shows that this is not just about the inner cities. The Mayor of London, with “London’s Grassroots Music Venues: Rescue Plan”, has that he will be introducing an agent of change rule into the next London plan. As I mentioned, the Welsh Government have announced a similar move, and this is also already under consideration by the Scottish Parliament and Government My Bill will provide the legislative reinforcement for that. It aims to give much greater clarity and greater power for local councils and planning inspectors to incorporate the principle into planning decisions. Why do it? Why was I so receptive to this idea, and why is there such strong public support? Because it matters. Of course it matters to those who enjoy the entertainment and for whom it opens new horizons. Obviously, it also matters for the staff and owners of the venues. But it matters a lot more than that—and not just for the nearby late-night kebab shops For a start, there is the impact on musicians, which is why the Bill is being supported by the Musicians’ Union. Less venues means less work and less opportunity to develop talent—or even for musicians to find out that they are not going to make it in the industry. It also means less opportunity to move up from amateur to part-time to full-time professional, and to national or even international stardom. I was talking today to Billy Bragg, who mentioned that he tried three times to move from having an ordinary job and working part-time to being a full-time musician. It was the existence of the clubs, pubs and venues that enabled him finally to make it on to the national stage We are in danger of taking away the ladder that has served both individual musicians and the music industry so well for so long. And what an industry—not only are domestic sales rising again, but we are second only to the United States in international reach and sales. It is a huge boost to Britain’s standing around the world and our soft power—not to mention millions in overseas sales last year—let alone being a significant part of our tourism offer. But there is a real concern that the industry is now depending on a great past, with a lot of grey hair around. Now, I declare an interest, as I am in favour of good representation of grey hair, but I also support refreshing the pipeline with new talent. That is no comment on yesterday’s Government reshuffle. There is a danger of mining, rather than farming, our musical heritage. Losing music venues also narrows a route of opportunity for working-class youngsters, many from our deprived inner cities and left-behind industrial towns. As a west midlands MP, I am of course proud to represent part of the area that gave birth to heavy metal, and I am particularly focused on the cities and conurbations. However, I also recognise how damaging the loss of venues can be to the life and attraction of smaller towns, and to retaining youngsters and slowing the drift to the cities. All those factors are important, but there is another factor that makes this provision imperative, and it is why the matter requires urgent action either from Parliament or the Government—given the wide level of cross-party support from ex-Ministers, as well as members of the MP4 band, I hope that the Government will adopt this measure and help to push it through. That factor is Brexit As Brexit is happening and we face an uncertain future, it is vital that Britain is made more efficient and effective across the board and that we maximise every possible advantage that Britain has. One of these is clearly our cultural and entertainment offer, not only in London but in our other great centres around the country, many of which, including Birmingham and Manchester, are attracting increasing foreign investment and work—although, of course, Birmingham is the best venue for Channel 4 Companies clearly locate initially for a range of hard-headed, financial, economic and communication reasons, but quality of life is also significant. It is partly about personal safety, environmental quality and a pleasant streetscape, but it is also about the answer to the basic question, “Would I want to live there?” That is a question not only for companies, but for the staff they are seeking to attract, especially the highly mobile, technically skilled and talented international and multinational workforce, not least in our huge creative sector. The cultural and living environment is important to them. That means art galleries, theatres, concert halls, opera, ballet, football clubs, rugby clubs and other sporting environments, but it also means music venues and the street scene. It poses a question to those companies that are being enticed to move abroad after Brexit: “Would you and your family—especially your children and, equally importantly, your employees—prefer to live in London, Birmingham or Manchester, or in Frankfurt?” I hope that this measure will provide some small but useful assistance and relief to a valued industry. I commend the Bill to the House Question put and agreed to. Ordered, That John Spellar, Kevin Brennan, Sir Greg Knight, Pete Wishart, Jo Stevens, Mr Edward Vaizey, Kerry McCarthy, David Warburton, Conor McGinn, Mr Nigel Evans and Thangam Debbonaire present the Bill John Spellar accordingly presented the Bill Bill read the First time; to be read a Second time on Friday 19 January, and to be printed (Bill 149).
Friday 19 January is a very good day; it is my birthday.
I beg to move, That this House expresses concern at the effect on patient care of the closure of 14,000 hospital beds since 2010; records its alarm at there being vacancies for 100,000 posts across the NHS; regrets the decision of the Government to reduce social care funding since 2010; notes that hospital trusts have been compelled by NHS England to delay elective operations because of the Government’s failure to allocate adequate resources to the NHS; condemns the privatisation of community health services; and calls on the Government to increase cash limits for the current year to enable hospitals to resume a full service to the public, including rescheduling elective operations, and to report to the House by Oral Statement and written report before 1 February 2018 on what steps it is taking to comply with this resolution I begin by paying tribute to the extraordinary efforts of our NHS and social care staff for all their work this Christmas and new year, and this winter. They continue to do all of us in this House proud It is almost a year since the House debated the national health service in the first Opposition day debate following the Christmas and new year break. A year ago, we debated winter pressures with a backdrop that was characterised by the Red Cross as a “humanitarian crisis”. Here we are again, a year later, debating a winter crisis worse than last year’s. This winter crisis was described by Taj Hassan, president of the Royal College of Emergency Medicine, as “even worse” than last year’s. He also said: “In some cases, I’ve heard of 50 patients in an emergency department waiting for a bed. We have to try to manage them…as best we can, in cold, draughty corridors, while dealing with new emergency patients.” His words are backed up by the realities on the ground, revealed in the weekly reports of what is happening. Since the start of this winter, more than 75,000 patients waited for over 30 minutes in the back of an ambulance. Almost 17,000 patients waited for over 60 minutes. This is despite the NHS Improvement directive last year that emergency departments should accept handover of patients within 15 minutes of an ambulance arriving.
Does my hon. Friend recognise the pressure across the system? At Arrowe Park on the Wirral, staff made 48 extra beds available for the winter crisis and over Christmas, and in the event they had to make 40 more extra beds available by cancelling all elective surgery. Does he believe that this is the way to plan for the winter, and does he believe that the Department of Health made robust and appropriate plans?
My hon. Friend speaks eloquently about the pressures on her local hospital. She will also be aware of how foolhardy it would have been to close the Eastham walk-in centre on the Wirral, as was proposed because there were not enough staff at Arrowe Park Hospital. Fortunately, because of her campaigns and those of my hon. Friends the Members for Wirral South (Alison McGovern) and for Wirral West (Margaret Greenwood), the Eastham walk-in centre has been saved. That is because of Labour MPs working in their constituencies.
King’s College Hospital NHS Foundation Trust in my constituency, one of the largest trusts in the country, has recently been taken into financial special measures. Does my hon. Friend agree that the failure of King’s is a canary in a coalmine for the NHS, and must be a wake-up call for the Government on the level of resource that our outstanding NHS staff need so that they can deliver for patients? Will he join me in calling on the Health Secretary to ensure that King’s emerges from financial special measures with the additional funding it needs to deliver safe, effective, world-leading care for patients?
I am grateful to my hon. Friend for raising this issue. She has been a passionate defender of King’s, speaking out in this House on numerous occasions. Before Christmas, we saw the resignation of Lord Kerslake as the chair of King’s, when he spoke out about the real pressures facing our NHS, which were dismissed at the Dispatch Box by the then Minister when we had a debate in this House.
Does the hon. Gentleman acknowledge that it was under a Labour Government that a walk-in centre in Broxtowe closed? However, I do not seek to blame that Labour Government, because it was a local decision made by local practitioners. Would he not at least accept, in a spirit of trying to build some sort of sensible debate about our NHS instead of always weaponising it, that this Government have put in an extra £437 million specifically for the winter period? Would he not at least give the Government credit for that planning, which we have never seen before?
The right hon. Lady is a former Health Minister, so she will know that in her local hospital trust 771 patients have waited longer than four hours on trolleys, unable to get a bed. She talks about the winter money. We were calling for winter emergency money back at the general election, and we repeated those calls in September. That money did not come through until the November Budget, and hospital trusts were not told their allocations until a few days before Christmas. That is no way to prepare for the winter. I suspect that when she was a Health Minister, she would have been saying that to the officials in her Department.
The point is that for the first time a Government have done everything they possibly could—[Hon. Members: “No.”] They have, because no Government can predict what the weather may be like, or the uptake of flu vaccinations. It is wrong to suggest that this is the fault of the Government in England when there has a problem across the whole United Kingdom, including in Scotland and Labour-run Wales.
The right hon. Lady will know that we have had eight years of sustained underfunding of our national health service because of decisions by this Government, of which she was a member until very recently.
I refer to the comments made to the Health Committee by Jim Mackey, the head of NHS Improvement back at the start of October, three months ago: “It is true that we are running tighter than any of us would really want to and we have not had the impact from the social care investment this year that we had hoped for; so, it will be difficult—it will be very tight—over winter.” This Government knew what was coming, yet they have let the whole country down.
My hon. Friend, who is an excellent member of the Health Committee, speaks with great eloquence, pointing out the hubristic response of Tory Members in saying that this was not predictable or preventable. This winter crisis was entirely predictable and entirely preventable.
Two hundred and thirty-three patients were left in ambulances for more than 30 minutes outside King’s Mill Hospital in the week of 25 to 31 December. That is more than 40% of those arriving by ambulance in that week. Does my hon. Friend agree that those patients and their families deserve an apology and a promise that that will never happen again?
Absolutely. I have absolute praise for the staff at King’s Mill—it is where my first daughter was born, in fact. The way in which patients have had to wait for ambulances outside King’s Mill is entirely unacceptable, and this Government need to do something about it.
Let me make a little progress, if I may. I will try to take as many interventions as possible, but this is only a half-day debate and I know that many people want to speak We have heard the stories of ambulances backed up outside hospitals. Ambulances have been diverted from gridlocked A&E departments 150 times. Our hospitals are overcrowded and our bed occupancy levels are running at unsafe levels. In the run-up to Christmas eve, over one third of England’s children’s care units were 100% full, with not a single spare bed. We have had reports of whole children’s wards being used for adults. In fact, we do not know the full scale of the crisis because this year NHS England is not reporting which hospital trusts have issued the OPEL—operational pressures escalation levels—alerts revealing hospital pressures. I hope that, given the Secretary of State’s keenness on a duty of candour, he will explain why the OPEL data is not being collected and published nationally for England, as it has been in recent years But of course behind every single one of these statistics is a real human story. We have heard stories of elderly, fragile patients treated in the backs of ambulances in the freezing January weather, or elderly patients, sometimes confused, languishing on trolleys in corridors, such as the 80-year-old epileptic man with severe dementia who was stuck on a trolley for 36 hours waiting to be treated at the Royal Stoke. His daughter, Jackie Weaver, said: “it was absolutely horrendous. You couldn’t get past for all the trolleys”.
rose—
Given that this is about Stoke, I will give way.
We had 67 people sitting on trolleys. We ran out of corridor space. Two hundred people medically fit for discharge had nowhere to go. The pressure on my constituents and those of my hon. Friends in north Staffordshire was appalling, but so was the pressure on the staff who had to cope with looking after those patients. My constituents deserve better and the staff deserve better. We need money for social care—and we needed it last year.
My hon. Friend makes a moving contribution to the debate. Those people in Stoke whose relatives have been waiting so long on corridors will see the Prime Minister saying, “Nothing is perfect,” but the truth is that we do not want perfection—we just want a bit of dignity and humanity in our health service.
rose—
I give way to my hon. Friend, who has been working in her constituency over Christmas.
This time last week, I went out with an East Midlands Ambulance Service crew for a shift, and they told me that over the Christmas period they were waiting two hours and more outside A&E at Lincoln Hospital. They also said that they were not even just sitting in the ambulance—one of them, a paramedic, was going inside and cannulating patients, working in resuscitation, and clerking patients. Will my hon. Friend comment on that and on what we will do about it in government?
My hon. Friend makes a powerful, and indeed raw, contribution to our proceedings, because she was working over the Christmas holiday on the frontline in Lincoln. I pay tribute to her and all her colleagues there. I hope that the Secretary of State reflects on her contribution and responds to it in his remarks.
The stories are indeed heartbreaking, and no one wants that for their constituents or their relatives. Will the shadow Secretary of State therefore recognise and welcome the investment that the Government have made in units for elderly and frail people? As I have seen in my hospital, the Alex, that investment has made a massive difference. It is too early to tell whether that will solve all the problems, and we of course want to do more, but it is making a real difference on the ground, as is the additional Government funding of nearly £4 million, which was put in place in time. The hospital has been in special measures, but its leadership is turning it around. Does he welcome such real examples of good practice that are helping our constituents?
I do welcome examples of good practice, but I share the hon. Lady’s frustration, which she has put up on her website, about the money taking so long to reach the frontline: “while the money has been approved, the current frustration is the time it is taking for the Trust to gain access to the money.” I agree with her: this money should have been announced sooner for our national health service.
Will the hon. Gentleman give way?
If I may, I will make a little progress. I have been generous, but I will try to take as many other interventions as possible We have heard about Stoke, but what about the story of 87-year-old Yvonne Beer, who suffers from dementia? She was at Worcestershire Royal when, forced to wait 10 hours in hospital to see a doctor, she had to be tied into a wheelchair with a scarf after her bed was taken away. We learn that Southmead Hospital in Bristol has had a capacity of 104%. Yesterday, a leaked memo revealed: “Acute Medical Unit physicians have been on their knees with workload pressure”, and that the “biggest risk remains patients in corridors in the Emergency Department with no allocated doctor, no allocated bed and no treatment—some of these are very sick indeed”.
In my local hospital in Barnsley, general and acute bed occupancy reached 100% on 31 December, despite the incredible effort of the staff. Does my hon. Friend agree that safety targets are simply not being met, and that that is not good enough?
Absolutely. Bed occupancy rates at such a level are unsafe. I know the Secretary of State is committed to patient safety—he has made it one of his signature issues—yet he is presiding over a health service in which bed occupancy in acute hospitals is routinely well over 85% We have heard about the pressures in South Yorkshire, but what about the pressures in West Yorkshire? Of the hospital ward in Pinderfields where people were left lying on the floor, a witness said: “The man who was lying on the floor at the bottom of my husband’s bed was being sick. He was asking for a trolley to lie on but there wasn’t one to give him.” Of course, their plight was dismissed in the House on Monday by the then Minister, the hon. Member for Ludlow (Mr Dunne), who told us there were enough chairs to sit on.
Will my hon. Friend give way?
I will give way to the local MP, and I will then try to make some progress.
I am sure my hon. Friend will join me in thanking the staff for their gargantuan efforts this winter and over the festive period. Just this week, I spoke to a nurse at the very same hospital, who advised me that staff had had to clear out the cleaning cupboard to put in a bed for a patient to receive an infusion. Does he share my horror at that? What on earth is our NHS coming to under this Government?
Beds in broom cupboards—the Tory NHS: isn’t it a disgrace?
I will make a little bit of progress.
rose—
I give way to the former Minister.
In relation to the incident at Pinderfields Hospital, it is completely unacceptable that people should be lying in corridors, but the hospital informed me before I made the statement on Monday that the patients who were photographed had been asked whether they wanted to sit down on a seat and had decided not to do so.
I am grateful to the hon. Gentleman for taking the opportunity to clarify the situation for the House. Perhaps he should have done so on Monday. I do not know, but he may well still have been in place as a Health Minister if he had said that on Monday There have been huge pressures on the North East Ambulance Service, because of which it has been asking some patients, where appropriate, if they have alternative transport options, such as a family member. The East of England Ambulance Service has said that some patients were being sent taxis to get them to hospital, with paramedics stuck in ambulances queuing at hospitals for more than 500 hours in the past four days. Of course, clinicians have spoken out. Richard Fawcett of the University Hospitals of North Midlands warned that his hospital had “run out of corridor space” He also felt compelled to apologise for, in his words, the “third world conditions”.
Let me make a little progress, if I may, because I have been generous in giving way What is the response of the Prime Minister and the Secretary of State? A perfunctory apology, and the unprecedented blanket cancellation of elective operations.
The hon. Gentleman mentioned the East of England Ambulance Service. He will be aware of the case of the elderly lady who lost her life while waiting four hours for an ambulance to arrive. That is often a result of having ambulances stacked up outside hospital, as he has described. Does he agree that it is now time to end these intolerable incidents—such failures of care are apparently widespread across the country—and to have a mature national conversation about how to increase the funding for our NHS and our care system to ensure that people get care when they need it?
I agree entirely. I am entirely happy to have a conversation about how to increase funding in the national health service, but I have huge scepticism about whether this Government—having overseen eight years of desperately tight funding allocations for the NHS, with cuts to community health services—are prepared to engage constructively in such a conversation On the specific case that the right hon. Gentleman mentioned, the hon. Member for Clacton (Giles Watling), whom I cannot see in his place—I apologise if he is in the Chamber and I have not spotted him—has called for an inquiry. He has actually warned that if that incident was a result of underfunding, we need to put more funding into ambulance services, and I share his concerns.
If I may make a little progress, because I have been generous, I will then try to take more interventions. I am conscious, however, that this is only a half-day debate The consequences of this crisis are not only for those in urgent need, but for everyone using the NHS. Let us be clear that this panic cancelling of elective operations means that patients will suffer. Not only will patients suffer longer waits for operations while in pain and distress, but they will wait for appointments with the uncertainty of not knowing what is wrong with them, and the knock-on effects on NHS services and the wider society are huge. Already, patients are facing a waiting times crisis with 4 million on the waiting list.
Will my hon. Friend give way?
Let me make a bit of progress A lost month will mean that thousands of patients across the country are stuck with their lives on hold. To call this “routine care” misses the fact that these are big issues for the individual patients affected. The young man awaiting heart valve surgery, who will have arranged time off work and for his family to be around to care for him, now has to cancel it all and does not know when his operation will happen. He also runs the risk of a deterioration in his heart function, which could lead to further hospitalisation in an emergency, adding to the pressures on our emergency services.
rose—
I give way to the hon. Lady, who has been very persistent.
Will the hon. Gentleman at least recognise that the NHS is doing more operations than ever before? In my area of Mid Essex, an incredible 72,000 operations were carried out last year, which is over 9,000 more than back in 2010. Will he join me in thanking the incredible NHS staff for the many better outcomes they are delivering?
Yes, I will. I of course thank the NHS staff. Of course, if the hon. Lady wanted to thank the NHS staff, she could have supported us when we brought in motions to give them a fair pay rise, but I do not think she did so.
rose—
I give way to the hon. Gentleman, who I know always wants to contribute to such debates, but then I will make some progress.
The hon. Gentleman is extremely generous, and I always follow his remarks with a great deal of interest. Any cancellation is appallingly bad, but does he understand that the worst possible cancellation is one on the day of surgery, which is clinically unacceptable? Will he give the system credit for at least trying to introduce some sort of planning this year, for the first time that I can remember since 1984?
The hon. Gentleman will know that the system is in such a state because of years of sustained underfunding. His answer would be a cross-party commission, a sort of royal commission, and I have huge respect for his contributions to these debates, but let us be clear that for eight years the NHS has not been getting the level of funding it should be getting in historical terms.
My hon. Friend is being very generous in giving way. Down in Sussex, patient transport was privatised and given to a company called Coperforma. Seven months after the contract was awarded, the company was stripped of it for its appalling practices and for completely underperforming in every way, shape and form. It now transpires that Coperforma has been given more money for seven months than it would have received if it had performed properly for a full year. Is that not indicative of the way in which the NHS is being run?
Order. May I appeal for brief interventions? I would just point out to the House that no fewer than 38 Back Benchers wish to speak, and even if the debate is allowed to run on beyond 4 o’clock, which is in the hands of the usual channels, probably half of them will not be able to do so. I say now that they will just have to sit, wait and hope—I am not publishing a list; we do not do so—but long interventions do not help.
I will take that as my second telling off from you today, Mr Speaker. Given your guidance, I will try not to take any more interventions, but on the particular point raised by my hon. Friend the Member for Hove (Peter Kyle), the privatisation of patient transport services to Coperforma in his area of Sussex was an absolute disaster for patients and for the ambulance drivers, who I met—they went for eight weeks, as I recall, without pay. He has been campaigning on the issue, as has the GMB trade union, which I congratulate on the campaign it has run. We now learn that, having ended the contract, money is still going to that firm, which is an absolute scandal. I hope there can be a full inquiry into what has gone on, and I praise my hon. Friend for leading the campaign I have talked about the real impact of cancelled operations—for example, on someone waiting for a hip replacement who is forced to stay at home, unable to walk properly, and who, due to the pain, will no doubt at some point need to see a GP again in an emergency, which again adds to the pressures on the service. Perhaps someone in need of a cataract operation has had that operation cancelled and is now at risk of falls because they cannot see. Such a person could well end up in A&E, again needing a hospital bed. These are real people who rely on the NHS and whom the Government are letting down. The domino effect of not providing proper, timely care increases the crisis and pressures on the wider NHS.
Will the hon. Gentleman give way?
rose—
I did say that I would try to make progress. It is clear that a lot of Members want to speak, so I will continue if I may. I have been generous in giving way Now we are beginning to hear that it is not just routine non-urgent operations being cancelled. Today, The Times reports of a hospital in Oxford considering delaying the start for chemotherapy due to staff shortages and lack of capacity—a four-week delay on all new patients needing chemotherapy—and there are proposals for those on the first cycle to have full chemo, but then discriminate against those on cycles 2, 3 and 4—second, third and fourth-line chemo—giving those patients a reduced number of cycles, which is a two-tier chemotherapy system.
Will the hon. Gentleman give way?
Let me make some progress In The Guardian today, we read the story of Carly O’Neill, who went into hospital for her cancer operation and who was waiting in her gown with wristbands on in the hospital, only to be told her operation would have to be cancelled because there was no bed available.
Will the hon. Gentleman give way?
Let me finish the point How about my constituent Mr Geoff Brooker, who was diagnosed with cancer of the bladder? He has had his planned operation cancelled twice this winter. When Mr Brooker was asked about the Secretary of State’s apology, he said: “He may have apologised for postponements but it was as if he was apologising for the cancellation of a jumble sale.” My constituent went on to say that Ministers were “uncaring” and he blamed “poor planning”. He added: “If operations like mine are postponed then it’s likely it will cause deaths. The decision could even be the death of me” There we have it: cancer patients having operations cancelled and trusts looking at delaying chemotherapy, yet these Ministers sit there with their NHS badges on their lapels. They should be ashamed of what is happening in the NHS today.
rose—
I will give way for the last time and then I will make progress.
Goodness knows the hon. Gentleman knows I am no apologist for Oxford University Hospitals Trust, but it is important that we do not make a crisis where there is not one. I have been assured by the University Hospitals Trust today that the leaked memo does not represent the current reality. I, like him, have concerns about recruitment, and I, like him, am worried about the future of recruitment in the NHS, but it is really important that we do not worry current cancer patients who will continue to receive their treatment.
I thank the hon. Lady for her contribution. The memo was emailed to oncology department staff in the last few days. If the trust is now backing down on that, all of us across the House will welcome it, but the point still stands: the trust was looking at delaying chemotherapy by four weeks and it referred to a lack of staff and capacity. As we know, this trust has cut many, many beds in recent years, including cancer beds and renal beds, and we know that it is under huge pressures.
Will the hon. Gentleman give way?
I will make some progress The hon. Member for Banbury (Victoria Prentis) rightly said that we do not want to make this more of a crisis, but the Secretary of State knows that cancelling elective operations as an impact on hospital finances. It means a loss of revenue for trusts that are already struggling to meet their deficit targets. Rather than allowing waiting times—
Will the hon. Gentleman give way?
I am not going to take any more interventions, I am afraid Rather than allowing waiting times to escalate further, why will the Secretary of State not commit today to giving hospitals emergency funds, so those cancelled operations can be rescheduled as soon as is reasonably possible and hospitals do not lose revenue and get further into problems with their deficits The Secretary of State knows that cancelling electives impacts on training of the next generation of surgeons and junior doctors, who are warning that they could lose out on as much as a sixth of their six-month training because the operations are not there for them to do. Will he tell us, if these cancelled electives continue, what is his plan to ensure that our junior doctors and surgeons can catch up on the training they need? Our patients deserve the best-trained surgeons and junior doctors in the world. Cancelling those electives impacts on their training. Will he tell us his plan for dealing with that We all agree that every penny counts in rising to the challenge of the winter crisis caused by Downing Street. I know the Secretary of State will tell us that we have had the—
Will the hon. Gentleman give way?
I said that I would not take any more interventions The Secretary of State will tell us about the winter funding, but we also know that the winter funding came far too late. NHS Providers has warned that it came far too late in December, and I am sure that many hospital trusts will be telling him privately in his morning phone calls that it came too late. Hospital trusts have to turn to expensive private staffing agencies to get through this winter due to the Government’s failure to invest in an adequate workforce to enable the NHS to deliver the care the nation needs. In many places, NHS trusts are effectively held to ransom by staffing agencies Last month, NHS Improvement refused a freedom of information request to publish how much these private agencies are costing individual trusts. Does the Secretary of State agree that that is unacceptable and that we should know how much extra money set aside for winter is going to private agencies? Will he undertake to produce a league table naming and shaming every single agency and stating how much they have been getting from each and every trust, so that we can have clarity on this matter The Secretary of State will no doubt tell us that the problems we are experiencing have arisen because we have an ageing society. Of course, we see pressures on the service because of the demographics not just in winter, but all year round. Patients with less acuity, often with sometimes three or four comorbidities—in particular, those being treated at this time of year—put huge pressure on the service throughout the year However, these demographic changes in society did not just drop out of the blue sky in the last few weeks. We have known about these trends for years and years, which makes it even more criminal that the Government have presided over eight years of underfunding in the NHS—£6 billion of cuts to social care—and have acquiesced in a reduction of 14,000 beds. We will probably see more bed reductions if we pursue the sustainability and transformation plans across the country. We have seen delayed transfers of care increase by 50% these last years On social care, the Secretary of State may have those words in his title now, but he has no plan to deal with the severe £6 billion cut we have had to social care in recent years.
Will the hon. Gentleman give way?
I am not giving way because we are pressed for time The fact that makes this winter crisis even more serious than anything that has gone before is not just the cuts to social care and to the community care sector, nor is it the underfunding of the NHS; it is that the crisis takes place against the backdrop of some of the most serious and far-reaching neglect of health perpetrated on the people of this country for more than century Sir Michael Marmot, a recognised authority on public health, has warned that this country has, since 2010, stalled in the task of improving the life expectancy of our population and that differences in life expectancy between the poorest areas in the country and the better- off have widened in recent years. This is what happens with austerity and cuts. This is what happens when the Government fail to invest in housing and the insulation of our housing stock. This is what happens when the Government allow fuel poverty to increase and oversee falling real incomes, benefit cuts for the poorest and rising child poverty. The shocking consequence is that the number of hospital beds in England taken up by patients being treated for malnutrition has doubled since 2010. Is not that a shame? Is not that a disgrace?
The hon. Gentleman is right about one thing, which is demographic change. That and an ageing population are directly behind some of the malnutrition figures, and he must not misuse those. Is it not the case that, as the Royal College of Nursing told the Health Committee just two or three years ago, the failure to plan for a rising and ageing population is a feature not of the past five years, but of the past 10 to 15 years? He should not pretend that the problem has appeared overnight.
When we had a Labour Government, we trebled in cash terms the investment going into the NHS. When we had a Labour Government, we had trolley waits, but under this Government we have had 560,000 people waiting on trollies and 2.5 million people waiting more than four hours in A&E. That is the difference between a Labour Government planning for the health needs of this country and a Tory Government cutting for the health needs of this country This is not just a winter crisis; it is a year-round funding crisis, a year-round staffing crisis, a year-round social care crisis and a year-round health inequality crisis, manufactured in Downing Street by this Government. We have had eight years of underfunding and cuts; 14,000 beds have been lost; the number of district nurses has been cut by 3,500; the number of mental health nurses has been cut; child and adolescent mental health services budgets have been raided; the number of GPs has fallen; we are 40,000 nurses short; community and mental health services have been privatised; and social care has been savaged and staff demoralised.
In my borough of Lewisham, CAMHS are facing a budget cut of up to £200,000, leaving many children without the treatment and services they need. Does my hon. Friend agree that the Government have failed to provide mental health services to some of the most vulnerable in society, particularly at this difficult time?
Half this country’s clinical commissioning groups are raiding children’s mental health services because the money is not in the wider NHS. Yet this Secretary of State remains in place, even though the truth is that doctors and nurses have lost confidence in him, patients have lost confidence in him, and it seems the Prime Minister has lost confidence him. He fights for his own job, but he will not fight for the NHS. Our patients are crying out for change, but they will look at the Health Secretary, still in post today, and see that, to coin a phrase, “Nothing has changed. Nothing has changed.” I commend our motion to the House.
I, too, start by offering, on behalf of the whole House, a massive “thank you” to all staff across the health and care system who went beyond the call of duty and gave up their Christmas and new year to keep patients safe. Their dedication makes the NHS the best healthcare system in the world. They visibly demonstrated their values, constantly putting the needs of patients before their own Attempts to politicise pressures on the NHS are a serious mistake. The last time the NHS had a difficult flu winter was 2009—the hon. Member for Leicester South (Jonathan Ashworth) might know that, because he was working in Downing Street at the time. In 2009, the shadow Health Secretary was Andrew Lansley. He refused to attack the Government, because it was an operational issue—in fact, the then Health Secretary, Andy Burnham, thanked him for his “measured tone”, which meant that “together we can give a reassuring message to the public”.—[Official Report, 12 June 2009; Vol. 493, c. 1056.] Sadly, I cannot say that to the shadow Health Secretary today. The hon. Gentleman, who has used some extraordinary language today, says that the NHS is on its knees. Let us look at the facts: since 2010, we have 14,000 more doctors, 12,000 more nurses on our wards and 5,000 more operations every single day; and in A&Es, which he talked about a lot, 1,800 more people are seen and treated within four hours every single day.
In the spirit of sounding conciliatory, I thank the right hon. Gentleman for giving way. The Royal Bolton Hospital made provision for the Christmas period, but despite that it has had to cancel all routine operations, as well as elective operations in trauma and orthopaedics, until 1 February. What financial assistance will he give my local hospital, so that it does not suffer as a result?
We did provide an extra £1.4 million to the hon. Lady’s local hospital before Christmas, to help it to deal with the immediate pressures, but let me deal with this issue of cancelled elective care operations. I agree with the shadow Health Secretary that it is a big deal for patients who are told that their planned procedure is to be postponed. No one minimises the distress that that causes, but last year and in previous winters operations were cancelled at the last moment, which is much more distressing and challenging for hospitals to plan around. The decision was taken this year to take a much more planned approach. We hope that, overall, fewer operations will be cancelled at the last moment, but we need to do this in a planned way.
I cannot help but intervene, because last year someone very close to me—a member of my family—was one of those people who was about to go into the operating theatre when the procedure was cancelled. I came to my right hon. Friend about the case. I can tell the House that that was not a good experience, so it is a much better approach to plan ahead and give people notice. Yes, emergencies will happen, but planning ahead makes for a better system. I think the Government have made a good move.
My hon. Friend is absolutely right. I hope she will not mind my saying that her case involved cancer, and one of the things that the planned approach allows us to do is make sure that we do not have to cancel cancer operations, which are the most important, at the last moment. That is essentially what we are trying to do: protect everyone who is in a life-critical situation.
I have to intervene. I had treatment and an operation for cancer. If my operation had been cancelled, I would have been able to come to this House and ask the Secretary of State personally to intervene, but I am speaking today on behalf of Carly O’Neill, who went to the press to talk about her cancer operation. What explanation does the Health Secretary have to give Carly O’Neill and other cancer patients for their operations being cancelled?
I say, very directly, that the instructions from NHS England could not have been clearer that cancer operations should not be cancelled, because they are deemed to be urgent. From the perspective of the Government and NHS senior leadership, such cancellations are not acceptable. If the hon. Lady knows of individual cases, she should raise them with me and we will look into the matter. It is precisely because we want to preserve capacity for people who need it the most that we have taken these difficult decisions.
The Secretary of State complains about politicisation of the NHS, but 90 colleagues from all parts of the House, including many Conservatives, are offering a different approach—a cross-party mature conversation to find a solution. Lord Saatchi, Baroness Cavendish and Nick Timothy are now arguing for the same thing. Will he now embrace that approach—a civilised approach to come up with a consensus for this country on how we secure our health and care system?
I have said publicly that, as we come to the end of the five year forward view, we need to seek a consensus on the next stage for the NHS. We will need significantly more funding in the years ahead, and we need to build a national consensus on how to find that funding. My own view is that we should try to do that for a 10-year period, not a five-year period. I am open to all discussions with colleagues about the best ways to do that, but, as we heard earlier from the shadow Health Secretary, the Labour party is not interested in being part of those discussions, which illustrates how difficult it is to reach consensus.
I will make some progress before giving way again Let us look closely at what the hon. Member for Leicester South has said. He used a lot of hyperbole today. He says the Government are sleepwalking into winter. This, of course, has been directly contradicted by Professor Sir Bruce Keogh, the medical director of NHS England, who has said: “I think it’s the one”— winter— “that we’re best prepared for…This year we started preparing” a year earlier. He continued: “We have…a good plan.” Chris Hopson of NHS Providers, who regularly criticises the Government when he disagrees with us, has said: “This time preparations have never been more thorough.”
I will make some progress and then give way further Let us look at those preparations. We have put £1 billion into the social care system. The biggest lesson from last year was that pressure in the social care system was making it difficult for hospitals to discharge. What has been the result of that investment? Combined with the extra £337 million in the Budget, it has freed up 1,100 hospital beds by reducing the number of delayed transfers of care. In total, 2,700 additional acute beds have been commissioned since November. The shadow Health Secretary told The Independent: “It is completely unacceptable that the 85% bed occupancy target…has been missed” What was bed occupancy on Christmas eve? It was 84.2%, so this had a real impact.
I have said I will give way in a moment, but I want to make some progress, too Secondly, because many patients can be better seen by GPs, last year’s spring Budget allocated £100 million of capital to help hospitals to set up GP streaming services. In the year the shadow Secretary of State says the Government were sleepwalking, the number of type 1 trusts with GP streaming tripled to 91% of all such trusts across the country. At the same time, we made it massively easier for people to access GPs and nurses over the Christmas period. For the first time, people could get urgent GP appointments at their own surgery, or one nearby, from 8 to 8, seven days a week, except on Christmas day. The number of 111 calls dealt with by a clinician increased to nearly 40%—nearly double the figure in the year before. That, too, has massively reduced pressure on A&Es.
I draw to the Secretary of State’s attention the fact that we continue to have no Northern Ireland Executive and therefore no local Health Minister, meaning that there is a specific problem in Northern Ireland. The NHS staff there are absolutely superb, but they have also been under enormous pressure in recent weeks, as have the ambulance crews. It is terribly demoralising and wearisome for them. The Government must take some responsibility, given the continued absence of a Northern Ireland Executive. What recent discussions—and with whom—has the Secretary of State had in Northern Ireland about dealing with the crisis in the NHS and among ambulance crews in Northern Ireland?
The hon. Lady will understand that because I am the Health Secretary for England, I have not been having an enormous number of discussions about the terribly challenging political situation in Northern Ireland, but I agree that it is incredibly unhelpful for the NHS in Northern Ireland if there is not an Executive. The former Northern Ireland Secretary—I know that the whole House wishes him well with his medical challenges—was very engaged in trying to address that issue, and I know that the new Northern Ireland Secretary will make it her top priority, too, precisely because it matters so much for public services.
The Secretary of State does not want to get drawn into Northern Ireland—I understand that—yet the Prime Minister seems willing at every opportunity to attempt to smear the Welsh NHS. Can we have some facts before us? Spending per head on the NHS and social care in Wales is 8% higher than in England, and it went up 4.5% last year. We are dealing with winter pressures and we are putting funding up, yet the Prime Minister seems to suggest otherwise.
The hon. Gentleman rather inconveniently forgets that the Barnett formula is a major reason why spending is significantly higher in Wales, but I do have something to say about the situation there, so I will oblige him a little later.
May I bring the Secretary of State back to the benefit of having GP-led services in hospitals to take the pressure off A&Es? I commend Solihull Hospital for doing just that and reducing appreciably the number of examples of winter pressures being raised with us? Could that be replicated across the NHS?
This is what is so disappointing about some of the shrill tones we have heard this week in the media and today in the House. Reforms across the NHS are making a real difference. I totally commend what is happening at Solihull. The key to solving the long-term pressures on our emergency departments is to be better at treating people in the community. The growth in emergency admissions in the vanguard areas of the NHS is about half the national average. This is the five year forward view that we are rolling out across the country. We need to celebrate the successes.
I want to make some progress before I give way again A very important point that we have not talked about much in this debate, although it is extremely relevant to people on the NHS frontline, is flu. This year, we have had a much bigger spike in the number of flu cases than at any time since the winter of 2009, but we also have in this country the most comprehensive flu vaccination programme in Europe. This year, for the first time, it was made available to those who are eight years and under and to care home staff. As a result, a million more people have been vaccinated for flu this year than in the year before. Uptake among NHS staff is at 59.3%, which is its highest ever level I say that because while the shadow Secretary of State tries to make the case that no preparations were made, the reality is that the NHS could not have been working harder to prepare for this winter. The result of those preparations is that A&E performance, having declined for six years in a row, last year stabilised for the first time, according to the latest verified data. In the week after Christmas, compared with the year before, we had fewer A&E diverts and more calls to NHS 111. Many Members have talked about trolley waits. It is totally unacceptable for people to be left on a trolley for a long time, but November’s figures, which are the latest verified figures, showed that the number of trolley waits had fallen by three quarters compared with the previous November, so a huge amount has been happening.
Does the right hon. Gentleman think that patients being treated in cleaning cupboards and six patients in four-bed bays without lockers, curtains or call bells are signs of good preparation for the winter crisis?
That is completely unacceptable, but it is disappointing that the hon. Lady stands up and runs down the NHS when her own trust, which received £3.4 million before Christmas to help with winter, has managed to improve its performance: last November’s figure was 91.8% compared with 77.7% a year earlier. That is a huge achievement for Mid Yorkshire Hospitals NHS Trust. Why will she not praise what is happening, rather than running the NHS down?
I support the leadership that the Secretary of State has offered during this winter crisis and the tone he has adopted in this debate. As a result, there is not the kind of crisis we have had in past years. Now that he has widened responsibilities for social care, will he help West Berkshire and Wokingham, which have had problems with past formulas and do not have enough money to take pressure off the hospital in the way he would like?
I will certainly revisit the issues in my right hon. Friend’s local authorities because I have looked at them before and know that there are particular pressures there. He alights on something else that the Opposition have not wanted to talk about, but which is very significant: the Prime Minister’s commitment to the integration of health and social care, which eluded the previous Labour Government over 13 years, despite their talking about it a lot. We are starting to see that happen in this country. Monday’s decision means that policy leadership will come back to the Department of Health, which will help us to make even faster progress.
I would like to take the Secretary of State back to his point about caring for people before they get to hospital and, in particular, issues to do with GPs. My local area has had difficulties recruiting GPs. It is vital that there is investment in increasing medical training for new doctors, so I plead with him to consider seriously the bid from Anglia Ruskin University to become the first medical school in Essex, where there is currently no pathway for our talented young people to train as doctors within the county.
I note my hon. Friend’s persuasive plea for her local university, Anglia Ruskin, but this is not a decision that I will be taking, because my own local university is also keen to offer more medical places. However, she is absolutely right to say that training the next generation of doctors and nurses is the long-term solution to these pressures.
I will make progress and then take a final set of interventions The heart of the shadow Health Secretary’s case is that winter pressures are caused by political decisions, not operational issues. Let us put aside the difficult winters that Labour had in 1999, 2008 and 2009, but if he is to drag politics into this, he cannot first say that this is the fault of politicians in England and then totally gloss over the responsibility of politicians in Wales, which the Royal College of Emergency Medicine says is “a battlefield” where “patient safety is being compromised daily” and the situation “is unsafe, undignified and distressing for patients and their family members.” I simply ask the shadow Health Secretary this: if it is the Government’s fault that one in nine A&E patients waits too long here in England, whose fault is it that one in six does in Wales? Whose fault is it that people in Wales are nine times more likely to wait too long for test results?
I thank my right hon. Friend for giving way. On the Welsh NHS, he is absolutely right. Mr Speaker, I ask for your indulgence while I quote an A&E nurse in Wales, speaking last week: “On every shift, both corridors are full of patients on trolleys. We are housing ambulance crews for longer than ever, due to beds not being available in the hospital. Patients are being nursed in inappropriate areas due to no space. I have seen nurses in tears. I myself have been in tears. This is the first time that I have ever been demoralised and embarrassed to say that I am an A&E nurse in Wales.” That is in Wales, under Welsh Labour. Does my right hon. Friend agree that there is pure hypocrisy coming from Labour Members, who should take notice of the mistakes being made in Wales?
I totally agree. This is the central flaw in the Labour party’s case. We know that winter is the most difficult time, but Labour says that there is political responsibility in one part of the UK while saying absolutely nothing about Wales. I notice that the shadow Health Secretary is looking down at his notes as we talk about Wales, but the reality is that that completely blows apart his case. According to the British Medical Association, there is one area in Wales where not a single doctor was available overnight, and the performance of one A&E has fallen to 40%, which is unheard of in England—or, indeed, Scotland However, there is a political decision, which my hon. Friend the Member for Chelmsford (Vicky Ford) mentioned, that has a big impact on NHS winter performance: the number of doctors we train. Not once in my time as Health Secretary have I heard Labour call for an increase in training places. [Interruption.] No, I have not. The simple truth is that there is no point throwing money at a problem if there are not doctors and nurses available to spend the money on. While I have been Health Secretary, we have had 40,000 more doctors, nurses and other clinicians working in the NHS, but we need more. That is why, under this Prime Minister, we have announced the biggest increase in training places for doctors and nurses in the history of the NHS.
I will give way to the hon. Member for Eltham (Clive Efford), and then to my hon. Friend the Member for Brigg and Goole (Andrew Percy).
I congratulate the Secretary of State on facing down the Prime Minister on Monday, when what emerged was one man, two jobs, no governor. He must accept that the £6 billion in cuts to social care since 2010 has had a major impact, particularly on winter crises. Does he regret the Government’s decision to take that money out of social care?
In 2010, we faced the worst financial crisis since the second world war. The hon. Gentleman will know which Government were in charge when that happened. People were talking about a run on the pound—I notice that the Labour party continues to talk about that—and the crisis had to be addressed. We, like other countries, had to make significant reductions in public funding, but when we got the economy back on its feet and started creating jobs—1,000 jobs a day since 2010—the first place into which we put extra money was the NHS and the social care system. There is £600 million more in the social care system than there was two years ago.
I want to make progress, because a lot of Members want to speak, but I did say that I would give way to my hon. Friend the Member for Brigg and Goole.
I thank my right hon. Friend for giving way. He knows of my interest in ambulance services. I was on duty for Yorkshire Ambulance Service as a responder this Christmas and new year, and will be again tomorrow night. When he talks about workforce planning, he rightly talks a lot about doctors and nurses. Will he say something about how our incredibly well-trained paramedics can be used better to relieve pressure in A&E and reduce delays there?
I thank my hon. Friend for his work as a first responder; that is a fantastic example in his community. We have 1,700 more paramedics than we did seven years ago. My hon. Friend is absolutely right because the role of paramedics has changed dramatically over recent years. It used to be about scooping people up and taking them to hospitals; now, we are treating many more people on the spot. Paramedics have an extraordinarily important role, but it has changed. There is a changed emphasis, as in other parts of the NHS—a move towards doing as much as we can to treat people safely outside hospitals and to keep them at home, because we know that is the safest way.
I am grateful to the Health Secretary for giving way. The simple fact is that if we want more care in the community, the Government have to stop slashing social care budgets. If we want to stop people appearing at hospital with preventable conditions, we need to stop cutting public health funding. The Government do not have an economic record to be proud of, but even looking at the public spending that is being made, we see that the Government are penny wise and pound foolish.
I am sorry, but 3 million additional jobs have been created, so we do have a strong economic record, and that is why we have increased funding for social care recently. We have increased NHS funding significantly. As for slashing funding, the hon. Gentleman’s local trust received £9.7 million before Christmas.
Will my right hon. Friend reflect on the issue of beds? As a result of the measures that he has taken in recent weeks, Shrewsbury and Telford Hospital NHS Trust in my area managed to release an extra 120 beds to help it to cope with the significant winter pressures that it faced. Does he agree that community hospitals such as my area’s Bridgnorth Community Hospital and Ludlow Community Hospital, which have community beds, have a role to play in releasing pressure on acute hospitals from patients who no longer need acute care?
I agree. I want to take this chance to thank my hon. Friend for being an absolutely superb Minister of State at the Department of Health. The fact that the NHS is better prepared this year than it has been for very many years is partly because of his efforts, and I commend him for his fantastic contribution.
I shall give way one final time before I conclude my speech.
Does my right hon. Friend agree that the calibre of local trust leadership can play a huge role? In Gloucestershire, new trust leadership has tackled serious internal financial failings head-on. As a result, A&E times have been slashed and turned around, which meant that A&E waiting targets were met in December. Does he agree that that shows what can be done with the right leadership?
It absolutely does, and no one campaigns more vigorously for his local trust than my hon. Friend. Just before Christmas, I visited his trust’s Gloucester site and met the management and staff. The situation there is extraordinarily impressive and a great inspiration to many parts of the NHS I finish on the issue of funding. The shadow Health Secretary has been using very strong language, but he has conveniently overlooked the fact that in the past four years, real-terms funding for the NHS has increased by £9.3 billion, which is £5.5 billion more than his party promised in 2015.
Will the right hon. Gentleman give way?
I will conclude, because a lot of hon. Members want to speak The shadow Health Secretary is right that there are real pressures, so what are the facts? We spend 9.9% of our GDP on health, which is 1% above the EU average, and about the same as the EU15—the western European countries—but we want to spend more, so in England, from 2011, funding went up by 15.6%. In Wales, Labour chose to increase funding by only 8%. This motion is about money. When it comes to NHS funding, Labour gives the speeches, but Conservatives give the cash.
Like others across the House, I thank all staff in all four UK systems, who, as the Secretary of State has said, have gone above and beyond the call of duty to focus on their patients, and I do not think any debate we have in here is intended to upset or insult any of them Before the hon. Member for Ludlow (Mr Dunne) perhaps leaves the Chamber, I want to thank him for his service as a Minister of State for Health, whom I often met across the Chamber, but I also want to correct a comment he made in answer to my question on Monday. He claimed that the number of patients waiting longer than 12 hours in A&E in England was half the level of that in Scotland. Naturally, I would have expected the Minister to know all the stats and what they mean: in England data are only published for the percentage of patients who meet, or do not meet, the four-hour target. There is no publication of data on eight hours or 12 hours. The clock restarts for patients who require admissions, and that is defined as from the decision to admit until they get a bed and is known as trolley waits. So 48,000 patients waited over four hours on a trolley after their four-hour wait in A&E to get a bed, and the 109 he was referring to had waited over 12 hours on a trolley for a bed after the four or five hours they had waited in A&E. Therefore, it was utterly incorrect to compare that with the Scottish data, where we have a single clock from when the patient starts right through until they get to where they need to go. I simply want to clarify that while the hon. Gentleman is in the Chamber.
I know that comparing England and Scotland is one of the pastimes that Scottish National party Members like to engage in—it is a fascination for them—but the reality is that in my constituency of Stirling, served by the excellent NHS Forth Valley in Larbert, only 57% of patients were seen within four hours in the last week of last year because we have a flu epidemic in Scotland, as they do in England, and that should be acknowledged.
If the hon. Gentleman gives me a little longer, he will find that I intend to talk about the flu epidemic, but before he gets too celebratory he might want to wait until tomorrow when we will have comparable data, because while in Scotland the data are published every week, in England they are published only every month. I am glad, however, that we no longer wait six weeks after the end of a month, which is 10 weeks after the start of it, but get it a fortnight later. So that will be available tomorrow, and then he can compare hospital trusts in England with hospitals in Scotland to his heart’s content. I would have thought that, as someone who celebrates the United Kingdom, he might want to praise the fact that Scotland has led the entire UK since March 2015 on emergency admissions and A&E Having corrected that, all of us recognise that this is a particularly tough winter because there has been an outbreak of flu on top of a bad freeze. I point out to those who think the worst is past that the flu season lasts until March and at the moment this is an outbreak, not an epidemic, but it comes on top of underlying pressures, and across the four nations this has involved staff having to go above and beyond the call of duty Whether it was how Public Health England said it or how the media reacted to it, this business of stating in public that the flu vaccination does not work is unfortunate and irresponsible. The flu vaccination recipe is planned by the World Health Organisation at the beginning of each year. It will already be working on next year’s flu. It does not have a crystal ball and people who have what we in the medical profession call a retrospectoscope should recognise that that tool was not available at the time when the decisions were made. Producing vaccine is a biological process that takes months, so the decision is made in March for the northern hemisphere, and all the companies produce to that recipe. Headlines in Scotland implying that the Scottish Government popped down to Boots and took the wrong vaccine off the shelf are therefore facile, and that also encourages people not to bother We already have falling vaccination rates in childhood vaccination and in flu. We should be pointing out that multiple flu viruses are circulating. While all the talk in the media is of Australian flu, in Scotland that is about a quarter of the strains that are circulating One of the issues with flu is that it happens in cold weather, and in Scotland we get the coldest weather in the United Kingdom, so we have double the rate of flu that there is down here in England. We also had a worse freeze, and are continuing to have a worse freeze. So when the data come out tomorrow, I think we will see that Scotland will still lead the UK. We will not be performing to the level we want. We have not met the 95% target for emergency departments since August, but England has not met them since 2015 and, sadly, Wales has not met them since 2008. So this is a challenge across the board, but Scotland has been more resilient. I call on all MPs to encourage staff and other people to get a flu vaccination, because this will continue until March and it is still absolutely worth doing The Secretary of State often talks as if the problems in A&E are due to people who should not be there. If we talk to anyone who works in A&E, they will say that, by and large, that is not the case. With people getting fractured ankles and fractured wrists on the ice, A&Es will have been very busy with having people carted in and X-rayed, and what we call in Scotland getting a stookie put on before they go home. That is all going to take time, but anyone who works in A&E would say that the key issue is frail, sick people, often with multiple conditions, and whether they fractured their hip falling on the ice or have a respiratory problem secondary to flu, they need a bed and the issue in England is that there are not enough beds.
I work in A&E and spent some shifts in recess working in A&E—on new year’s eve and just a few days ago, on Sunday. I agree that many of the people attending A&E, particularly at St George’s where I work, are there because they are frail, but they are also there because this Government have ensured they cannot get an appointment with their GP, our social care is in crisis and we do not have mental health budgets.
I thank the hon. Lady for her intervention Obviously, the shape of medicine has changed. More is delivered in primary care—as a surgeon, I well know that more surgeries are delivered in a day—but if we are doing a straightforward operation on an older patient, they will still always require longer rehabilitation; they are more likely to stay overnight or several days, and if they have fractured their hip, they will require full rehabilitation before they go home. The problem is that the number of beds in England has been halved since 1987—under successive Governments—and the NHS stats released for the end of the second quarter of 2017-18 show that almost 1,000 beds have been lost even since the winter of last year, when the situation was described as a humanitarian crisis. That was a mild winter that did not have a flu outbreak on top. England has only 2.4 beds per 1,000 population, whereas the EU15 that the Secretary of State refers to has 3.7, and we in Scotland have more than four. If we are running constantly with bed occupancy rates of over 85% or 90%, that is where the issue lies.
The hon. Lady refers to the decreasing number of available beds; does she agree that we have a bottleneck now in many hospitals due to the lack of social care? In one day over the festive period in my area, just over half of ambulance transfers were completed within the required period. The Secretary of State likes to quote statistics at me, but I would like to give him that one to think about.
There will obviously be lots of bandying around of figures, and talking about the four-hour target and the achievements and the numbers, and, as I have said, it serves as a thermometer to look at the entire system from the patient turning up at A&E to their going home. That is what this is a measure of, and it is there to flag up concern. While we will be getting that data, we do not need it; we have already seen ambulances 12-deep, and have already heard that 75,000 patients are stuck in ambulances for between half an hour and an hour, and 17,000 stuck for more than an hour. As was mentioned by the right hon. Member for North Norfolk (Norman Lamb), who is no longer in his place, this means that those ambulances are not available to respond to other 999 calls, which endangers patients.
I think the hon. Lady for giving way, and I apologise if she was still answering the point made by the hon. Member for Dewsbury (Paula Sherriff). I accept her point that many of those who are in A&E need to be in A&E, but the reality is that admissions to A&E have gone up 20% over the past 10 years to 6 million per year. Does she agree that more interventions could be made by GPs to prevent some of those admissions from being made and to allow people to be looked after in their own homes?
I am not 100% sure whether the hon. Gentleman meant attendances at A&E or admissions, which is what he said—
Attendances.
Attendances at A&E tend to be higher in the summer, when kids are on bikes and trampolines, and up trees. It is admissions that are higher in winter, when A&E is dominated by people who are sick. Of course we want primary care and the 111 system to work, so that people do not use A&E as a first port of call, but the problem comes when that all gets too complicated and patients cannot work out where they should go. That is when they go to A&E. It is important to make it really clear where they should go to address which problems Having seen the crisis last year, when there was no flu, snow or ice to blame, I believe that there are underlying structural problems. The target was met comfortably until 2013, when the Health and Social Care Act 2012 changes kicked in and NHS England started to become fragmented and to be based on competition instead of co-operation. I would welcome the establishment of a cross-party group here to work on this, so that we did not always have to have these debates, but it would have to look at the structure and unpick what has been done to NHS England in the past four and a half years. Carrying on breaking it apart will not provide a solution.
Does the hon. Lady agree that the Government’s plans to establish accountable care organisations, which will exacerbate the fragmentation in the NHS, through secondary legislation are completely wrong and will make the NHS crisis even worse?
I completely agree that establishing accountable care organisations only through secondary legislation is utterly wrong. We have had multiple debates about STPs, and I have said that going back to place-based planning is the right way to integrate and develop a local service, but there should not be a private company at the top making the decisions. There needs to be a publicly accountable body. There is going to be yet another big reorganisation in NHS England, and the proposed structure needs to be debated in this place, not behind closed doors. Yes, money is tight, with the NHS seeing rises of just over 1% a year in the past seven years compared with almost 4% in the past, but it is estimated that between £5 billion and £10 billion is being wasted in the healthcare market itself, through bidding, tendering and profits, and now through this habit of companies suing if they do not win a contract It is crucial to move back to developing services for a community. It is also crucial that health and social care should be integrated, and I welcome the combination of both titles in the Secretary of State’s role, if that means that we are going to work towards meaningful integration, but it must be done in a structured, responsible and legalistic way.
The Government spend an awful lot of time attacking the Welsh NHS. In terms of the Secretary of State’s new cordial attitude in not attacking any NHS services, will the hon. Lady join me in condemning former Prime Minister David Cameron’s comment that Offa’s Dyke was the line between life and death, depending on which country one lived in? Wales has an integrated health and social care service, which is also integrated with local government, with a £60 million fund having been established over the past five years. She referred to the cross-party working that could happen, particularly if the Government were willing to engage properly in these services rather than attacking the Scottish and Welsh Governments on NHS care. Does she agree that we could use such working to learn good practice?
The four health services are very different. In essence, we have four laboratories. NHS England is by far the largest, but they all face different as well as similar challenges. I am sure that if there were more discussion of how things have been done, there could be more lesson-learning in different directions In 2010, we were promised that there would be no more reorganisation. The same promise was made in 2015, but NHS England is now facing another reorganisation, in the STP system and in accountable care. It is crucial that the focus should be not on bottom-line, budget-centred care but on patient-centred care. It is wrong that any such changes should be introduced through secondary legislation. They must be introduced in this place—either through debate, in Committee, through convention or in a royal commission—to enable us to come up with a structure that will function. Since 2013, the deficits have gone up, the waiting time failures have gone up and the stress on staff has gone up, making it even harder to keep hold of people. Let us put the patient in the middle, but let us also support the staff who look after the patient.
Order. We are grateful to the hon. Lady for her contribution. I must advise the House that, on account of the large number of Members interested in contributing to the debate, there will be a four-minute limit on Back-Bench speeches with immediate effect.
It is good to be back after using the NHS’s maternity services I am proud of our NHS, and I am tired of Opposition Members talking it down. Our healthcare system is one of the best in the world, and while there is more to do, we should continue to improve our NHS with excitement for the opportunities ahead. We need to be honest about our current situation. We have an ageing and expanding population, and other strong-performing healthcare systems around the globe are facing the same pressures as we are. As a member of the all-party parliamentary group on Taiwan, I was fortunate to see at first hand the excellent healthcare provision over there, yet Taiwan’s own Ministers shared with the delegation the fact that they are facing the same pressures as we are It is a wonderful thing that we are living longer. It is a credit to advances in medicine and evidence of the effectiveness of this Government’s care policies and the strong performance of our NHS. This Government began preparations for winter pressures earlier than ever before. They drew up plans to free up 2,000 to 3,000 beds, extended the flu vaccine programme and provided help to GPs to extend working hours. In my own area, the Mid Yorkshire Hospitals NHS Trust and the Leeds Teaching Hospitals NHS Trust each received an extra £3.4 million for their winter preparations. As the director of acute care at NHS England has stated, the NHS is better prepared for winter than ever before. Furthermore, from 2015, the Government continued to increase investment in the NHS, from £101 billion in 2015 to £120 billion by 2020. It is simply false for the Opposition to claim that the health budget has been cut since 2010 But this is not always about how money is invested; it is also about how it is used. During my university studies, in a dissertation focusing on economic and healthcare policy, I looked at investment per capita compared with healthcare outcome. There is a lot of waste in the NHS, but the Government’s strong record on tackling it has put us in a better position than ever before to tackle winter pressures. Cutting the use of expensive agency staff, the positive impact of NHS self-driven improvements and the consolidation of services are only some of the examples of areas in which excellent progress has been made in order to deliver better value for money for the taxpayer, to deliver results in the light of our ageing and expanding population, and to prepare us better for winter Having sat on the Health Committee, I am fully aware that there is still more to do, but I am strongly encouraged by the Government’s actions and those of my right hon. Friend the Secretary of State. I would like to take this opportunity to congratulate him on his additional responsibilities. Integrating health and social care makes sense, and it will only serve to better prepare the NHS for winter. I wish him much success with the important task ahead. I know that this is an area he is passionate about. GP working days and a seven-day NHS are only some of the areas in which work has begun, and this will ensure that the winter preparations get better and better. I join my right hon. Friend in urging those on the Opposition Benches to look at their own record in Labour-run Wales During the winter months of last year, I myself required the care and help of the NHS on a number of occasions. During my pregnancy I developed a temporary heart condition, and I have to say that the care was absolutely excellent. The Government’s investment in mental health provision for people having babies is also excellent. The NHS also saved my husband’s life when he had stage 4 cancer. I commend the Government for their work, and I wish my right hon. Friend every success in his new role.
I want to talk about the situation at my local hospital, the Royal Stoke University Hospital. Winter crises there are hardly new, but they have escalated year on year, and our hospital features luridly in the national press each winter. It is often the most affected, and it is no coincidence that its funding deficit is England’s worst. This winter, however, is the first time that Royal Stoke consultants have taken to social media to apologise for 36-hour A&E waits, for corridors yet again jammed with the frail elderly on trolleys, and for what they now describe as third-world conditions The background is that of all the areas subject to the so-called sustainability and transformation plans, Staffordshire is the worst performing in the country. Before the 2015 general election, we exposed locally a funding deficit, prior to the STP, that would have reached £250 million a year by 2020. Since then, the issues have been exactly the same, but the figure for health and social care has now more than doubled. The Royal Stoke now accounts for over £100 million of it, having taken over the crisis-ridden Stafford Hospital, for which extra Government funding has now ended. The response so far has not been to invest in change, but to launch a scorched-earth policy. Community Hospitals have been closed, rehabilitation wards shut, drug and alcohol services axed, and lip service paid to the prioritising of mental health. The effect is most acutely felt at A&E and in admissions to Royal Stoke University Hospital, which is already brimming to capacity and struggling to discharge hundreds of patients because social services are also in crisis. On 23 November, I attended a clinical commissioning group “Designing Your Future Local Health Services” consultation at Bradwell Hospital in Newcastle-under-Lyme. It is a hospital close to my heart. At the turn of the millennium, before I became an MP, I chaired our local “NHS Care for All” campaign, which saved Bradwell Hospital as a facility precisely to take pressure off the Royal Stoke. My father passed away there in 1997 and my mother, a former nurse, passed away there after a catastrophic stroke three years ago At the end of March last year, our local CCGs closed Bradwell Hospital, with Longton and Cheadle community hospitals have gone beforehand, and wards at Leek Moorlands Hospital have closed since then. I was not the only person at the November meeting to label the consultation a sham. I also said that I wished the meeting could have happened at the end of February this year instead, after the winter crisis, the flu and the norovirus had bitten, as they are doing now. The CCGs had tried to pull the plug on Bradwell in the autumn of 2016, but they had to keep it open for another six months to cope with last year’s winter crisis. As late as November, they were saying they had no plans to reopen the hospital, but there was an inevitable volte-face in December Lurching from crisis to crisis is no way to run and plan a health system, and it is not only MPs, campaigners, patients and their families who are saying that. Last year, working with local councillors, including Charlotte Atkins at Staffordshire County Council and the indefatigable Joan Bell at Stoke-on-Trent City Council, the reformed local “NHS Care for All” campaign, which is chaired by the energetic Councillor Allison Gardner from Newcastle-under-Lyme, succeeded in getting our hospital closures referred to the Secretary of State. The advice of his independent reconfiguration panel was published just before Christmas, and it was damning of the CCGs. The verdict was delivered to him on 18 October—well before the winter crisis—and we would have thought that he would have reacted, but just one week later the chief executive of two of our local CCGs was appointed to run all six Staffordshire CCGs. That is a reward for failure in our area. Things have to change. The Royal Stoke University Hospital has to be given more investment, because more cuts will simply mean that next winter’s crisis will be even worse.
Unfortunately, I had to rush a family member to hospital last Saturday afternoon at a time when my local GP surgery is no longer open, but that gave me a chance to see at first hand how the winter pressures are being dealt with, and I have some good news to share with the House Our local GPs came together this year and agreed to run an urgent care centre at the hospital with a doctor on duty 24/7. On arrival, we saw a notice in reception stating that the average waiting time was three and a half hours, so I settled down to see how it was all going to work. The absolute key to the smooth running of this healthcare frontline was triage. Calmly and efficiently, a doctor and nurse quickly assessed who needed to be seen by whom and where. People could either just turn up or they could ring 111. The hon. Member for Central Ayrshire (Dr Whitford) is right that things need to be that simple or people will just go to A&E. Sensibly, children and frail elderly patients were seen the quickest, so we were in and out of the hospital in an hour and a half, and we were even directed by the thoughtful GP to a pharmacy that was still open late at night. So I want to place on the record my thanks to the staff at Solihull Hospital and to our CGG, led by Dr Anand Chitnis, for their foresight in conceiving how to provide better emergency cover, and I commend the model to the House Today’s motion states that the Government have failed “to allocate adequate resources to the NHS” However, investment in the NHS will increase from £101 billion in 2015 to £120 billion in 2020, which is £2 billion more than the NHS asked for in its own plan for the future. The question of how much money is needed is just as important as how it is spent. It is right to remember that we are not the only country with an ageing society that is facing such challenges. Not only do we spend more than the EU average, but new research shows that we spend more on healthcare than the average for OECD countries For all my 20 years as MP, Labour has claimed at every election that the Conservatives will privatise the NHS, but we have not. It is dishonest and misleads the public, worrying them unduly, and distorts the view of young people who do not yet have years of experience of Conservatives consistently putting more money into healthcare. I am therefore glad that the Prime Minister has given the Secretary of State the additional responsibility of social care, because every grown-up politician knows that we cannot sort out the problems of the NHS without also working out how to get people out of hospital in a timely fashion and into proper support in the community. Our attempts to tackle that funding issue were discredited at the general election when our policy was characterised as a dementia tax, which shows that no party will crack the problem on its own without cross-party determination. I therefore challenge the Labour party to give up the vote-harvesting approach to the NHS and to support a royal commission on health and social care for the sake of everyone who needs it.
Time is short and many hon. Members want to speak in this important debate, so I will get straight to my points. There is no doubt that the recent winter crisis is the result of the Government’s chronic underfunding of our health service. I know it, Opposition Members know it and, most importantly, the public know it. Even the Government know that the crisis is down to the underfunding that has happened while they have been in power, so why are they doing nothing serious about it? The answer is similar to what they are doing with local government funding: they are doing nothing because they just want to push their ideological agenda of privatisation The Government know that hospitals must still provide services, and hospitals are forced to put many contracts out to tender under the Health and Social Care Act 2012. The Government know that, willing or not, hospitals will eventually have to turn to private companies that can provide services to the NHS at cut-rate prices. One example of that back-door privatisation is currently happening at hospitals serving my constituents. Bradford Teaching Hospitals NHS Foundation Trust has been forced by Government-imposed budget restraints into planning to set up a private company to provide services that are vital to the people of Bradford, and that private company will actively seek to make a profit. Just let that sink in for a moment—hospitals are setting up private companies with the intention of making a profit for the hospital. That is how bad it has become, with hospitals needing to supplement their funding through whatever means possible. It is a slippery slope from here towards ever increasing privatisation and private company involvement in the NHS. Hospital trusts are services, but this Government are turning them into businesses Privatisation will not save the NHS from the ruin that the Government have eagerly forced upon it. The only way that private companies will be able to offer cut-rate prices is by cutting the employment rights of staff and cutting corners. That will not prevent another winter crisis; it will only encourage one, with private companies putting the safety of health services at risk. I am very concerned that the private company being established in Bradford will put safety at risk by lowering the rigorous hygiene standards, by cutting cleaners and slashing cleaners’ hours. Healthcare services should be provided by the best operator, which in almost all cases is the NHS itself, not the lowest bidder The Government need to recognise that the public will not thank them for privatising the NHS, because that will not solve the crisis in our NHS—only proper funding at the level the NHS says it needs will do that. We have to ask whether the Government want to be thanked by the public and their plans for the NHS are in the best interests of the public, or whether they want to be thanked by big business and their plans are in the best interest of big business. This crisis makes it clear to me which one it is.
It is a pleasure to follow the hon. Member for Bradford East (Imran Hussain) It is depressing to hear the Opposition laying into the NHS, which is an extraordinary group of real people working day in, day out to look after all our constituents when their health needs to be supported and mended. I commend all the staff across Northumberland’s healthcare family who have worked so hard not only over the past few weeks but 365 days a year to look after all of my constituents Much can be achieved through good planning to pre-empt the winter health crisis, as it is known, and the increased impacts that winter brings. I have an unfair advantage in Northumberland because Northumbria Healthcare NHS Foundation Trust has been led and built into what it is now under the great auspices of Jim Mackey, whom we lent to NHS Improvement for a couple of years to try to share such skills across the whole NHS. It is lovely for us to have him back, so I thank Ministers for sending him back up to Northumberland As a result of 15 years of intelligent planning by senior leadership, we have had no blanket cancellations in Northumberland, and we have an unchanged schedule except only for specific cases. No clinically time-sensitive operations will be cancelled, and most operations are carrying on as normal. In November, the trust decided to transfer one surgical ward to general medicine to ensure greater capacity—thinking ahead to the regular changes that winter weather tends to bring We have almost no delayed transfer of care in Northumberland, thanks to the sophisticated planning set in motion by Jim Mackey and his team some years ago, working directly with Northumberland County Council so that our social care and our healthcare work hand in glove. It works, and we are doing it in Northumberland. I urge every MP to encourage their councils to build that relationship, because it genuinely works. I also continue to encourage the Government to make sure our accountable care organisation is one of the first to be signed and sealed so that our holistic healthcare family works for patients Flu hit the north-east first, but we are functioning and coping well. Our statistics are good, with bed occupancy at 91%, and yesterday we met our A&E waiting time targets in 95% of cases. Our nursing vacancies are at a historic low of only 1%, again thanks to planning and a positive recruitment campaign in specific staff group areas where we knew there would be shortages. As a result, our nursing agency usage in Northumberland is very low Nothing is ever perfect, so I continue to raise the thorny local issue of community hospitals, where our bed provision is currently lower than it should be. Increased provision would help to relieve pressures caused by delayed transfers of care by ensuring that there is support for those who have a level of vulnerability and who cannot, or should not, go home straight from the acute hospital environment. In a rural patch, community nurses cannot practically provide such support in the way that it could be provided in an urban environment. Community nurses just cannot get to as many places in a day when they have to travel miles and miles between patients. The community hospital framework must be part of the new bigger social care model I thank both the Prime Minister and the Health Secretary for fighting to bring healthcare and social care together in one place, because that will start to do what we already see in Northumberland. I would like every MP to be able to tell the same positive story in the months and years ahead.
Here we are again discussing the latest winter crisis in our NHS. I stood here last year and spoke of the horror stories I had heard from my constituents and ex-colleagues of hospital staff working their fingers to the bone and doing the jobs of two, three or even four people, often without food, breaks or even time to go to the toilet. Yet, 12 months on, here we are again with many of the same challenges and none of the fixes promised by this Government I join my parliamentary colleagues in expressing a huge thank you to each and every one of our hard-working NHS staff—doctors, nurses, receptionists, cleaners, porters, radiographers and everyone else. I often speak of our public sector heroes, and today is no different. Thank you from the bottom of my heart. I express a special thank you to the paramedics who rushed my father, my dear dad, into hospital on 28 December. My gratitude is infinite Last year, the Government said the winter pressure was due to more patients being seen by the NHS. That figure is rising year on year, so why have the Government not put sufficient resources in place to deal with it? The Health Secretary previously said there are far more doctors and nurses in our NHS than there were seven years ago. In my area, the Mid Yorkshire Hospitals NHS Trust currently has 230 nursing vacancies, compared with 110 last year, with nursing numbers across the trust down over the same period from 1,752 to 1,607. That picture is somewhat different from the one painted by the Secretary of State, who has used figures that the Library says should be “used with caution” as suggesting “Changes in the number of staff can sometimes reflect organisational changes and changes in the structure of services, rather than genuine changes in staffing levels.” Indeed, staffing levels are so low at Mid Yorkshire Hospitals NHS Trust that the Care Quality Commission has deemed it to be a risk to patient safety My colleagues and I were heavily criticised during last year’s debate for asking the Government to spend more money, and once again we hear the same criticism this year. Will they tell us what the solution actually is? We need more nurses, and obviously there are training implications, but more money is needed to pay for them, and it is the same with doctors. There needs to be less bed-blocking, and more money is needed in social care. It is only right that serious questions are asked in this House when the Budget gives more money to pay for Brexit than to pay for our NHS The sad reality is that NHS deficits are rising astronomically across the country, with multimillion-pound shortfalls being recorded and balancing the books becoming impossible for most trusts. The £350 million made available in the Budget is no more than a drop in the ocean, and it has been proved over and again over the past few weeks that the money does not even scratch the surface And what of the cost of cancelled operations, both to trusts and especially to patients? People are being left in tremendous pain and at significant risk as a result of cancellations. I know of one man who is waiting for an operation to close his skull following life-saving brain surgery earlier this year. The surgery itself is not classed as urgent, but until it is completed, he is at increased risk of death should he bang his head accidentally. As a result, he rarely leaves the house and has to wear a helmet at all times. Another person who contacted me is waiting for a new knee. He is in excruciating pain and is unable to move around unaided. He has been on sick leave for three months and is suffering severe financial hardship as a result of loss of earnings As well as the accounts of cancelled operations, in recent days I have heard stories from local hospitals of six patients being squeezed into four-bed bays with no curtains and no dignity, no lockers and no bells. Patients are being given hand bells or are told to ask the patient next to them to ring the bell should there be an emergency. Patients are being placed in store cupboards, as we heard earlier. It has now become almost the norm at this time of year—
Order.
Like many Members, I wish to start by paying tribute to our primary care staff—the GPs, practice nurses, receptionists, community staff and district nurses; all those working in acute trusts in my local hospitals; mental health staff; social care workers; ambulance staff; and of course the volunteers, to whom we owe so much. They are a team, and any part of the NHS is weaker if one part is weaker, which is why I hugely welcome the change in the Secretary of State’s title, whereby we now have Department of Health and Social Care. That is a long overdue move, but we should all welcome it At my local Luton and Dunstable University Hospital NHS Foundation Trust, the increase in activity in recent years has been phenomenal: 83,000 more people were seen in under four hours in A&E in 2016-17 than in 2009-10; and 17,000 more operations and 46,000 more diagnostic tests were carried out in 2016-17 than in 2009-10. I pay tribute to the enormous amount of work. There are 166 more hospital doctors and 224 more nurses there now than in 2010. All that is welcome, as was the £1.116 million of extra winter pressure money put in I have spoken to the director of operations at the hospital this morning, and she told me that it was the busiest new year we have seen in a long time and that this situation had started two days before new year and gone on until this weekend. She said things have returned to a more normal basis now and, although there are a number of contingency beds open there, things are nothing like they were over the new year period. I pay tribute to the extraordinary way in which they coped with very difficult circumstances I received a letter on Monday from the East of England Ambulance Service NHS Trust, which said that on an average day it receives 3,000 calls but that on new year’s day, it received 4,800 calls. I defy any ambulance trust in the country to be able to cope with that significantly increased number of calls adequately. Indeed, I understand that on the days before and after the number of calls was also topping 4,000 a day. Our constituents want us to tell it as it is, and I received an email from a practice manager in one of my local surgeries saying that on 4 January there was a six-hour wait for a blue light ambulance. Just as the Prime Minister apologised, I would absolutely want to say, as a Member of Parliament, that I am not satisfied with that situation and we have to try to do better, notwithstanding the heroic efforts made We have committed to train 25% more doctors and 25% more nurses, and I hugely welcome the new nursing associates and nursing apprentices. What are we going to do, however, to put the NHS on more of an even keel? Let me briefly suggest six areas where we can make progress: first, it is unacceptable that nearly 10% of NHS England’s budget goes on type 2 diabetes; progress on tackling obesity is vital; more progress on the Getting It Right First Time scheme, which is saving billions for the NHS, will help; I make a further plea to the Treasury to make sure that we stop GPs leaving—those on the old pension scheme are disfavoured by the tax treatment; and we have to drive through the sustainability and transformation partnerships to really integrate health and social care.
Thank you for giving me the opportunity to speak in this debate, Madam Deputy Speaker. I have worked in the NHS since 1996, as a doctor, in hospitals, as a GP and as a commissioner of services, and I must say that it feels as though we are going back to the ’90s at the moment, with long waiting times. Even before this unprecedented decision to suspend operations for a month, we were already breaching 18-week targets in many trusts. From a patient point of view, it feels as though the standards are deteriorating, particularly in my constituency, with the difficulty people face in accessing an ambulance when they need it I wish to share two insights into the problem and two potential solutions. My first insight is that, no matter what Ministers say, some of this is about the money. We have seen an anaemic level of growth in NHS funding in the past eight years. As we have heard from others in this debate, we have also seen cuts to social care funding and to public health budgets. We have also had a long-standing underinvestment in prevention, general practice and out-of-hospital care, although I appreciate that that is being reversed now. The money that came in the Budget was too little, too late. It is hard for commissioners and providers to spend that money when they get it at the last minute, because they have to get people to come in to do the work to spend that money. Had the money come earlier, we would have been able to put in place much better contingencies As well as this situation being about money, it is also about having the wrong strategy. There has been planning for reactive services, but at the same time we have been cutting prevention. We have been doing planning for healthcare services, but not enough planning for social care services. We have also been planning by giving this emergency injection of cash to acute hospital services, but while we have been cutting, prioritising and fragmenting community services. We have seen 5,000 fewer community nurses and a 45% reduction in the number of district nurses since 2010 What do I suggest should happen now? We need to change the strategy. We cannot just respond by providing more and more acute hospital beds. We need to focus on prevention; on having good-quality community services, community nursing, social care; on having better palliative care, because most people want to be able to die in their own home, not in hospital; and on having more emphasis on screening. We also need to focus on poverty reduction and tackling deprivation, as people living in poverty are much less likely to access prevention and much more likely to be acutely admitted to hospital. I include in that people with mental health problems—the most vulnerable people Integration is the right direction of travel, but we have to change some things about how it is being achieved, the first of which is the name. Calling these organisations “accountable care organisations” lends people to think that this is an idea captured from the United States. We might call them “public health boards”—something that puts the needs of populations at the centre of healthcare and of healthcare planning. We need to make sure that the leadership teams of these organisations are focused on out-of-hospital care and not on just providing more and more acute hospital services. There is also a fundamental contradiction to address, because we still have section 75 of the Health and Social Care Act 2012, which mandates competition, yet we are trying to get organisations to collaborate So it does not have to be like this—it is not inevitable. Huge praise must go to the staff, and I myself have done shifts over the short recess. With the right type of investment, the right preventive strategy and proper collaboration, uninhibited by competition, we can do better.
It is a great pleasure to follow the hon. Member for Stockton South (Dr Williams), who qualified in 1996. I have about 10 years on him, and since 1984 I cannot recall a winter when there was not talk of pressure. We have to understand that this is not a new phenomenon. I particularly recall the bad winter of 2009, and the very positive way in which the then Opposition approached it and helped the then Government, in the interests of not politicising and not weaponising this issue. It is pity we have not seen the same thing repeated We need to give due credit to managers in the NHS. They come in for a lot of flak all the time, but we have seen a managed process this year and it has taken a great deal of input to make sure we do the best we can to disadvantage patients the least; I pay tribute to that much-maligned group. The only way in which I can see we can make this better is by running a lower bed occupancy rate, which is okay, but has opportunity costs attendant upon it. The reality of doing such a thing, which would avoid the sort of cancellations we have seen this winter, as in any winter, is severe, and I do not think many right hon. or hon. Members would wish to see those things That brings me on to the Commonwealth Fund, which was rightly cited by the Prime Minister earlier in response to my question in Prime Minister’s questions. She was right to say that on access, equity, the care process and administrative efficiency—four of the five points the Commonwealth Fund looks at—the NHS does very well. The problem is with the last one, which is clinical outcomes, where we run 10th out of 11, with the 11th being the United States of America, which nobody here wishes to emulate. We do not do well on clinical outcomes—we do not do well on cancer, on stroke or on heart attack—and we need to do something about it. It is no good citing OECD averages. We need to be comparing ourselves with Denmark, Germany, France and the Netherlands, not with the basket of countries included in the OECD Where does all that lead us? It leads us to a debate about resources. Having talked about management, which is vital, we need to address long-term resources. I entirely support those who wish planning to be done on a 10-year rather than five-year basis. That is vital, and we must also ensure that we have the necessary funding for the improvements we need to achieve to get outcomes up to the level enjoyed by our peer-group nations in western Europe, not the basket of nations with which we are often erroneously compared. How do we do that? We have to take the public with us and work across party boundaries. None of the decisions that will ultimately be made about the future of our national health service in this, its 70th anniversary year, are necessarily going to be easy. It is important that we at least try to get some level of cross-party consensus. We can do that by establishing a body that is above politics. The route to which I am drawn is the establishment of a royal commission, with all its problems The Merrison commission was the last big royal commission that considered matters to do with the health service. It came in for a lot of criticism, but most of its recommendations, made 40 years ago, were ultimately rolled out into Government policy. With the right terms of reference, such a body would be effective. That seems to me to be the right and proper way to deal with the future, particularly the sustainable funding future of our most treasured of national institutions. I very much hope that my Front-Bench colleagues will listen to those of us from all parties—particularly the recommendation from the Centre for Policy Studies this week—who think we should set up a royal commission in this 70th anniversary year to consider the future of our national health service.
It is a pleasure to follow the hon. Member for South West Wiltshire (Dr Murrison) As a nurse who has worked in the NHS for more than 40 years, I know too well the effects of the winter crisis. Yes, winter is the time when the NHS faces pressures, but the Government have claimed that they were better prepared for this winter crisis, with their national medical director explaining that they had been preparing since last winter. How can that be true when the Government announced that they would postpone non-urgent operations? Not only does that put patients’ physical and mental health at risk, but it creates a backlog of operations, which NHS staff will still have to catch up on Unison spoke out about the handling of the NHS only in February last year. It also highlighted the Government’s promise in their manifesto to properly fund the NHS. In their 2017 manifesto, the Government pledged to give the NHS the resources it needs. In the autumn, they also pledged that the NHS would receive an additional £377 million to ease winter pressures, but they failed to disclose the fact that although they are providing funding, they are undercutting that by asking the NHS to make savings in some areas Where has the funding the Government provided to ease winter pressures gone? The Royal Wolverhampton NHS Trust provides services to the hospitals in Wolverhampton that care for patients in my constituency. Hospital staff have been working under increasing pressure, because for more than half the days between 20 November and 31 December last year, bed occupancy in the Wolverhampton trust was above 90%. Over the same period, one in six ambulance handovers were delayed for more than 30 minutes. This would not be happening if, as the Government claim, the NHS was well prepared There has been widespread outrage over this winter crisis, but NHS staff have been highlighting the pressures on the NHS throughout the year, and for many years. We have campaigned, met the Minister, written articles and held protests about the Government’s treatment of the NHS and the underfunding over the past seven years. When will the Government face the fact that the funding they have provided is simply not enough?
I do not want to go through the increase in the number of operations carried out by the NHS, or to describe the enormous pressure of the numbers of people being seen by the NHS—plenty of other Members have already done that. I wish to concentrate on delayed discharges of care, which are an important factor not only when it comes to increasing the throughput of people in the health system, but in ensuring that people do not go into hospital in the first place In Oxfordshire, we have addressed delayed discharges of care in two ways, as part of our future planning for the NHS. First, with respect to the hospital in the town of Henley, I have been among those who have been active in trying to achieve the right balance with social care by ensuring that there are no beds in the hospital. There are beds in the neighbouring care home for those people who urgently need to stay, but all the emphasis is on ambulatory care—the treatment of patients in their own home—on which I have worked closely with the Royal College of Physicians. More and more patients now understand that they can get the right sort of treatment in their own homes and do not have to spend time in hospital. The approach has been taken on the best of medical advice and I am grateful to the doctors who have supported it. I invite Ministers to come to see for themselves how the hospital works Secondly, we do cross-party work in the county involving all MPs who represent Oxfordshire. I chair the group that has a relationship with the clinical commissioning group, not so much to hold it to account, but to ensure that it is focused on the things on which it says it will focus. One of the CCG’s great achievements is its focus on delayed discharges of care. I shall cite a couple of the figures so that Members will understand the CCG’s enormous achievement over the past year in planning for the better treatment of delayed discharges of care. At the end of December, the number of Oxfordshire patients whose discharge of care was delayed was 96, whereas the number in May had been 181. That is a magnificent achievement, as the number of delayed discharges of care has been almost halved. When Ministers hear about that half, they should understand that it is not a half increase but a half decrease in the number of people whose discharge of care was delayed. That improvement has been achieved by making sure that the right resources are in place for those patients who need them to return home. It has not happened because people are going home without the support that they need Finally, on the story in The Times this morning about Churchill Hospital, I have with me a letter from the hospital saying it has not implemented any changes to cancer treatment whatsoever. I am happy to provide a copy of that letter to the Library so that Members can read it.
It is a pleasure to follow that thorough speech by the hon. Member for Henley (John Howell) On Monday, I asked the then Minister of State, the hon. Member for Ludlow (Mr Dunne), what the Government were doing about the crisis in the ambulance service. He responded by saying that a new ambulance response programme has been introduced to try to deal with category 1 calls more rapidly. The reality is that two months after so-called improvements were put in place in the north-east, an elderly constituency of mine who collapsed in his own home on new year’s day had to wait 14 hours for an ambulance Last week, in the intensive care unit at the University Hospital of North Tees in Stockton, two people died from influenza on the same day. One of them was a constituent of mine. On new year’s eve, I attended the urgent care centre at the University Hospital of Hartlepool and then the ambulatory care unit at Stockton with my son. The car parks were crammed full, the sick were presenting themselves thick and fast, and the ambulances were once again backed up. When will the Government admit that this is not just a winter crisis, but a crisis in our NHS full stop—a crisis of their own making?
I am really pleased to be able to contribute to the debate. Although the Opposition have, as expected, used this occasion yet again to weaponise our NHS, I want to take this opportunity to praise it and all those who work in it, particularly in my constituency, where the staff at Southport Hospital are professional, dedicated and hard working There will always be times when our NHS comes under great pressures, and winter is one of them. That was why, in 2017, the Government and the NHS began preparing for the winter earlier than ever before. Last autumn, the Secretary of State visited my local hospital. He had a meeting with me and the interim chief executive in which we talked through the plans that had been put in place for the coming winter, as well as paying tribute to excellent staff who had worked so hard and continue to do so. Those preparations involved working with a range of partner organisations, including the local clinical commissioning group, the local authority and the emergency services, which provided better joined-up thinking and better care for patients Although the deferment of elective operations is never ideal, fewer were deferred this winter than in previous years, which should surely be welcomed. I am certain that the situation will further improve over the coming years. It is important to remember that we have a record of continuous investment in the NHS, even though we have been faced with extraordinarily difficult economic circumstances. The Department of Health’s budget has been protected since 2010 and continues to rise. We can spend more on the NHS only when we have a strong economy, which is something that we clearly would not have under Labour. The numbers speak for themselves: our investment in the NHS will rise from £101 billion in 2015 to £120 billion by 2020. Research from the Nuffield Trust shows that the UK spends well above the EU average I must welcome the Government’s multimillion-pound investment in Southport District Hospital over this winter. I was delighted when Southport and Ormskirk Hospital NHS Trust was granted an additional £1.326 million in funding to help to cope with winter pressures. Southport Hospital and the wider health system has prepared earlier and more extensively than ever before for winter this year, with a focus on securing the right numbers of doctors and nurses and increasing bed availability, as well as making sure that there is strong social and community care support available to help to discharge patients from hospital quickly The extra funding was announced as part of a £337 million immediate funding boost for NHS hospitals this winter in the recent Budget, which is in addition to the extra £2.8 billion of investment over the next two years. This was, of course, welcome news for Southport patients and residents. We all want to know that the NHS is there for us and our families whenever we need it. I am pleased that the Government have given the NHS extra support at this critical time of year, when cold weather and flu can increase pressures on hard-working hospital staff One of my constituents recently contacted me to tell me about the excellent treatment that his elderly mother had received at Southport Hospital over the Christmas period, after she suffered a serious health scare. His mother and his family were unanimous in their praise for the paramedics who brought her to hospital, the nurses who treated her with unparalleled kindness, and the doctors who sought to get her back to full health as soon as they possibly could. His mother said of her treatment that “we couldn’t have asked for more.” It is my absolute pleasure to put on record their sincere thanks to my right hon. Friend the Secretary of State, whose brief now includes social care. I am sure that he will make a success of that job as he has done in health It is ultimately thanks to our strong economy that we can make this extra investment in the NHS. Polls show that the NHS is the institution that makes us most proud—
Order.
I am afraid that too much of what we have heard from Ministers and some Government Members has tried to pass off the pressures that we are seeing in the NHS as just what happens every year. I have worked with the NHS for around 20 years, and let me tell Members that those pressures are not what we see every year. Cancelling operations for a whole month is extremely serious. In one week alone, 300 operations were cancelled in Leicester, including for patients such as 80-year-old Kenneth Roberts, who was due to have his hip operation tomorrow. He is in so much pain that he is on liquid morphine and has to use crutches or a wheelchair to get about, and his wife, Jenny, is physically and mentally exhausted, too One of the real problems is the absence of any acknowledgement from Ministers of the huge knock-on effect that rescheduling a whole month’s operations will have. It will simply mean that existing patients who are already on the waiting list will have to wait even longer, too, and it will be very, very difficult to bring that list back down. As my hon. Friend the Member for Stockton South (Dr Williams) said, a number of Labour Members have a terrible sense of déjà vu. We remember the 1990s, with ambulances queuing up outside A&E and millions of patients left languishing on waiting lists. I also remember the predictable cries from some right-wing commentators that the NHS’s time was up and that it could no longer survive as a service free at the point of use. I am afraid that we will see that coming back again all too soon The truth is that we are not dealing with the long-term underlying demands on health and care services—our ageing population, and more people living with one, two or more chronic conditions who desperately need more preventive services in the community—and huge technical advances. Yes, the Government talk about that, but they do not understand the scale of the challenges or the response that is required. The truth is that, since 2010, the NHS has had an average annual real-terms increase of 1%. That figure compares with 3.5% historically and 5.5% under the previous Labour Government. On top of that, we have had huge cuts to social care, and the dreadful, wasteful, pointless Lansley reorganisation, which has given reform a bad name. Unless the Government change course, we will see increased rationing as patients are waiting in the NHS, leaving thousands in pain and distress, and increased rationing as a result of eligibility criteria in social care, leaving millions of older and disabled people without any support at all. That is not what the people of this country want The Government need to put in place a bold 10-year strategy of investment and reform for both the NHS and social care. They should drop the idea of a separate social care Green Paper—we cannot look at the two separately—and they should heed calls from 90 Back Benchers for a cross-party convention. I am worried about the idea of a royal commission, as that would take too long. We know the options for investment and reform, so we need to get on with the job. I suggest a shorter process of six to eight months to try to get cross-party agreement, particularly on funding for social care, because any party that comes up with a substantial proposal risks being obliterated by its opponents, and we need a proposal for funding that will last whichever Government are in power. In the 70th anniversary of the NHS, I urge the Government to act.
I regret that Opposition Members have continued to politicise this issue. I speak as someone who has worked in the health service for more than 20 years. I worked in A&E under the previous Labour Government and coped with the winter pressures—when there were ambulances queuing round the block, when major incidents were declared because we could not take in any more patients, and when patients were cared for in corridors, including cupboards, and left lying on floors on makeshift mattresses. To continue to blame one Government or the other does nothing for patients or staff. If we continue down that route, we will be here not just next year or the year after, but in five, 10 or 15 years’ time This is not just about throwing money at the problem. We have heard today that Wales gets 8% more funding per person than the rest of the UK, yet it is also facing pressures this winter. Hospitals there are also cancelling operations and appointments, so this is clearly about not just funding, but what is done with the money I pay tribute to my local health service. In a debate at this time last year, I asked why the two trusts in my constituency were not coping when a neighbouring trust in Worthing was able to cope with virtually all its patients. A year later, after the imposition of special measures, after the CQC put in extra resources, and after a new management team were put in place, I am proud that both my local hospitals have coped with not just a 6% increase during non-winter periods, but an 11% increase in the number of patients not just visiting A&E but being admitted to A&E. They have not had to cancel hospital appointments, they have not had patients waiting in corridors and they have not had ambulances queueing round the block That tells me that this is not just about how much money people put into the service; it is about what they do with that money. Let us look briefly at what my local trust has done to stop the crisis which seems to have happened in other parts of the country. NHS staff, including doctors, nurses, porters and ambulance staff, have worked tirelessly throughout, and I pay tribute to them. It is also about the management, and the new management teams in Eastbourne and Brighton have done tremendously well to turn those services around It is also about better planning. My local community health trust has seen a 38% reduction in delayed discharges, so going into the winter period, it had an occupancy rate of about 84% in acute hospitals. That was achieved by working together with community services. A major Government or departmental reorganisation is not needed; change can be achieved by working locally, which is what the trust is doing This is also about working with social services on social care. Opening up 40 community beds in Newhaven has taken a huge amount of pressure off local hospitals, and both my trusts say that the emergency money provided this winter—nearly £2 million to each hospital trust—has enabled them to keep those beds open. It has enabled patients to be admitted to the acute centre for treatment, and then moved to the community hospital and be discharged safely and securely We need to look at capacity. If there is going to be an 11% increase year on year in the number of patients coming through the door, the solution is not just providing more money; it is about looking at the service and how it is delivered. My local trusts have done it, and there is no reason why that cannot happen in the rest of the country. Once again, I pay huge tribute to Brighton and Eastbourne Hospitals.
The crisis in the national health service this winter is real, and patients and NHS staff are feeling its effects. Thousands of operations have been cancelled, and ambulance crews and patients are waiting in A&E. On one day at Arrowe Park Hospital in my constituency, 26 ambulances, with patients and paramedics, were forced to wait more than an hour just to hand over patients. For 21 days in the period between 20 November and 31 December, we had a bed occupancy rate of over 99%, which is not safe or acceptable. Nineteen per cent. of ambulances that arrived had their handover delayed for over 30 minutes in that period, and 8% were delayed for more than an hour. We have heard of the terrible ordeals suffered throughout the country by patients and NHS staff stretched to the limit. Cancer operations have been cancelled and less serious elective surgery has been postponed until the end of January. It is estimated that 55,000 operations will be delayed, but there is another crisis in the NHS this winter that deserves parliamentary attention: the Government’s plan to make regulatory changes to facilitate the introduction of accountable care organisations. The Government have failed to provide any time for parliamentary scrutiny of that plan on the Floor of the House. Accountable care organisations and accountable care systems are ideas that have been imported from America. In the US, Government and private insurers award large contracts to commercial bodies to run and provide services. We all know the horror stories of how expensive healthcare is in the US and how people with complex conditions find it difficult to obtain insurance. We hear stories of people with cancer who are forced to sell their home to pay for care. Those horror stories are real, so we all have a responsibility to guard against any introduction of private health insurance models in the UK, which is why we must scrutinise ACOs ACOs bring together health and social care so that there is a single finite budget to provide for a specific population. Once that budget has been spent, there is no extra money. ACOs are being developed for delivery in 44 STP areas rather than the country as a whole. It follows that if there is an increase in demand for healthcare in one of those areas—because of an epidemic or a serious accident, for example—the money that is taken out for that squeezes the rest of the system for health and social care A great strength of the NHS is that it provides a large risk pool for everyone in England so that they can be supported. Why would a Government who are committed to a national health service choose to replace a large risk pool with 44 little risk pools? It does not make any sense. At the heart of the issue is the serious fact that ACOs are non-NHS entities, so we need clarity from the Secretary of State. We need him to answer serious questions on the Floor of the House. Will ACOs be private companies? It seems logical that they might be, given that the idea has come from America and the Secretary of State considers that the American healthcare company, Kaiser Permanente, provides one of the best examples of practice in integrated care If ACOs are allowed to operate, they will be given multi-billion-pound health and social care budgets for 10 years or more. They will blur the boundaries between health and social care, and there is real concern that there will be an increase in the types of things for which people will be asked to pay. An ACO, once established, would have control of a huge budget for an area’s entire health and social care needs, so it would have a huge amount of power to determine what it does and, crucially, what it does not commission I have received a lot of correspondence from constituents who are very concerned that the introduction of ACOs is yet another major step towards the wholesale privatisation of the national health service. They have expressed real concern that ACOs could be a means to introduce private health insurance models area by area. That could not be done on a national basis because it would be politically unacceptable. Let us have no more talk about taking the politics out of the NHS. The NHS is a political entity. People need to take responsibility for their decisions around the Health and Social Care Act 2012.
May I begin by disagreeing profoundly with the hon. Member for Wirral West (Margaret Greenwood)? As a health professional and as a doctor who has worked in the health service for 15 to 20 years, spending more than two hours listening to Opposition Members putting negative after negative on the NHS has been profoundly taxing, and it has been hard for me to remain in my seat I worked in the NHS in A&E in the Christmas and new year period. Yes, I saw people waiting much longer than we would like. I also saw a seriously injured child who came in and received the very best treatment. People and equipment were available, and all the necessary hospital staff were available for his treatment. At times there were a dozen people around his bed, and I am pleased that we could give him the treatment that he needed to survive. We need to get away from always picking out the negative points. We must remember that more people are being treated and survive, and that they are real, genuine people who go on to live long, healthy lives and are really pleased with the NHS treatment that they receive from people such as me and the millions of NHS staff working over Christmas and on new year’s day We have heard a lot of negatives from the Opposition, but we should look at what we can do to improve. I did not hear anything from the shadow Secretary of State about what he was going to do to make things better if he was in charge.
I will not take much time, but I have some suggestions. It is the over-75s who are mainly going to A&E. They are more unwell than they used to be. Why do we not get volunteers with medical experience to phone up people on every GP list and make sure that the over-75s are okay? They could urge them to turn up at the GP as soon as they become unwell, and not to wait until they reach a state in which they need intravenous drugs and have to go to A&E.
I thank the hon. Lady for her intervention, but I fear that she is mistaken because the people most likely to attend A&E are the under-19s. The over-65s represent about 20% of attendances at A&E but, following their attendance, the vast majority require admission to hospital, so they are in a slightly different category Those who are awaiting admission after they have been seen are the group who are waiting on the trolleys in A&E. People are waiting for those patients to be moved on to the wards so that the ambulances can be freed up and those patients treated. I have a solution to suggest, about which I met the Secretary of State earlier this week following my work in A&E over the winter period, when I observed ambulance crew waiting next to trolleys with their patients. They could not leave until they had properly handed over their patients It is really important that patients’ care is handed over properly, but equally we need those ambulances back out on the streets to collect the patients who are waiting at home. We could do much better if we cohorted the patients. For example, if three ambulances came in with six ambulance crew members on board, one ambulance crew could look after the patients while the other two went back out to see more patients. It is not all about money; some of it is about the inventive use of staff to create safe and efficient protocols I want finally to talk about the postponement of operations, which is very upsetting when someone has waited a long time for an operation and psyched themselves up for the pain and distress they know they will experience, and they may be nervous and fearful We have several choices. We could run hospitals at a very low capacity all summer—which is hugely expensive—so that there is a lot of free capacity ready for the winter; we could say that we will not do as much elective work over the winter, but then we might cancel operations that do not need to be cancelled—we may be giving more notice, but patients might have been able to have their operation; or we tell people that we will plan their operation but there is a possibility that if the winter is acutely busy, it will need to be postponed. None of those choices is ideal; all have pros and cons. We need an adult, cross-party discussion about the best way; otherwise, whichever option is chosen by the Government of whichever party is in power, the other side will criticise As many hon. Members on both sides of the House have suggested, we need to take the politics out of the health service, recognise that the vast majority of patients receive excellent care from the health service, which is doing more than ever, and consider together how we improve the areas that need improvement.
It is interesting to follow the hon. Member for Sleaford and North Hykeham (Dr Johnson). I have to say respectfully that I wholeheartedly disagree with her. She speaks of some kind of NHS utopia, but that is not the reality that I have seen on our A&E frontline. I am an A&E specialist and I have worked in our NHS for the past 12 years When we look around an A&E department, everything is on display in high definition: people’s pain, fears, courage and hopes; the unfailing dedication, expertise and strength of the staff who work there; and yes, the state of the NHS, which is in turmoil. It is in crisis, which is turning into disaster. From hospitals across the country, we have heard that the problem is not a surface or temporary issue The symptoms of the NHS crisis are all connected and multiply into new problems. That is not seen in statistics alone, but it is seen in A&E departments, which are completely overcrowded. People feel forced to come to A&E who should not be there: people who could not get a GP appointment or who had to wait too long for a hip replacement and are now in severe pain. Taken together with the emergency cases—from heart attacks and strokes to road traffic accidents—it is simply too much for the resources that we have The reality is stark. Cubicles are full because there is no space to move patients on to wards. The wards are full because our social care system is woefully inadequate and broken. When all beds are full, we see ambulances queuing up outside hospitals. They are full of patients who cannot get hospital care. What do we say to a mother or a father who is in an ambulance with their child, scared and anxious, and has to wait outside the hospital for another hour? Doctors are too stretched to do the job we are trained to do. We are the recipients of first-class education and training in the UK and we cannot deliver the very thing that we know to be right: to treat the cause, not just the symptoms. There is little time for prevention On new year’s eve, when I worked in A&E, we had a teenage girl who fainted. We treated her and spent time talking to her, but we pride ourselves on being able to find root causes: is there an underlying eating disorder or is she being bullied at home or at school? To have those conversations, we need to build trust, which takes time. If we do not do that, the patient is more likely to return, sometimes in pain because their operation has been cancelled. A teenager who faints at school might need to be part of child and adolescent mental health services. That all places a burden on our already stretched NHS. It will not change until this Government decide to live up to their most sacred duty: the protection of the health and security of us all. The NHS is underfunded and overwhelmed.
Does my hon. Friend agree that desperate patients should never have to resort to smuggling out secretly filmed footage of trolley-lined corridors with people sitting on the floors, such as the footage I have received from my constituents visiting and working at William Harvey Hospital in Ashford?
I agree that it is deplorable that patients should feel that they have to do that. The historic underfunding of the NHS is not an economic necessity; it is a political choice made by this Government, which is why they will not change their direction to protect us So, what must we do? We must change the Government. Until we do, the NHS will continue to crumble around its heroic staff, who will carry on giving their all; I am honoured to stand alongside them. We see their work not in the headlines, but in the most harrowing, important and joyful moments of people’s lives. As NHS practitioners, we cannot always change the outcome; but with time and resources, we can change the journey. It is time that we saw a change in our A&Es, our hospitals and our Department of Health.
It is a pleasure to follow the hon. Member for Tooting (Dr Allin-Khan). For what it is worth, I thank her, my hon. Friends the Members for Lewes (Maria Caulfield) and for Sleaford and North Hykeham (Dr Johnson) and other medical colleagues who have spent time working in our service over this period, looking after constituents. Their public service is second to none. I also thank my hon. Friend the Member for Ludlow (Mr Dunne) for the work that he has done within the Department, and I welcome the new team. I also echo many colleagues from around the Chamber—across parties and from all geographies of the country—in thanking NHS staff, ambulance drivers, paramedics and those who work in our county social services, all of whom are trying to play a part I am going to be distracted slightly, because I am going to take strong issue with the peroration of the hon. Member for Wirral West (Margaret Greenwood), who said with full Momentum fury, “The NHS is a political entity.” I say to the hon. Lady, with the greatest of respect, that it is not. The national health service is a publicly funded service, free at the point of use, which is populated and staffed by publicly motivated and qualified public service medics and others, who look after our constituents and their health needs. They are not politicised; they are motivated by care. [Interruption.] Rather than chuntering from a sedentary position, I urge the hon. Lady to sit and reflect on her words, because her comment was one of the most dispiriting remarks that I have heard during my time in this House. While she is reflecting on her comments, she might also wish to reflect on the fact that, whenever the Treasury writes another cheque for the national health service—I am sure that practitioners will appreciate this—it always has to take into account the £2 billion a year private finance initiative albatross bequeathed by the Labour party I want to draw the attention of the House, as I did during the statement on Monday by my hon. Friend the Member for Ludlow, to the importance of bedded community hospitals. Dorset CCG, under the leadership of Tim Goodson, has listened to our community campaign and has saved the beds in Westminster Memorial Hospital in Shaftesbury. In my judgment, the provision of those beds is absolutely pivotal in providing the link between the acute sector and people making their journey to recovery and then being on their way home. The collaborative work between the NHS and Dorset County Council—where there are social care officers with computers that are interlinked with and embedded within Westminster Memorial Hospital, working out the discharge care programmes—is pivotal. I appreciate that what we are doing in Dorset is not unique, but I also appreciate that it is not replicated everywhere; it does merit attention We should be focusing on far better advertisements for the use of our pharmacies, and we should ensure that community pharmacies are a much more collegiate network of service provision, taking pressure off GPs and A&E departments. I urge the Minister to ensure that CCGs are better encouraged to make sure that their boards include a representative from the pharmacy community. This siloed approach does not help the provision of care for our constituents.
I am pleased to follow the hon. Member for North Dorset (Simon Hoare) because I, too, want to touch on transitional healthcare Before I do so, I want to acknowledge the incredible, amazing, professional care that is provided across our healthcare service. We all agree that the love and care that is there is incredible. However, there are clear challenges, and we note those too. We have heard so much about them in the evidence provided today. This is not just about the long hours and the complex challenges that are placed at the door of health professionals. It is about the stress of not having the additional conversation that you need to have, the stress of not being able to treat somebody as a whole person but only being able to focus on the acute situation before you, and the stress of trying to keep somebody alive as their respiratory condition is deteriorating but you cannot get the doctor down because you know they are caring for someone in an even more acute situation. I know; I have been there. I have worked in acute medicine for 20 years, and I know very well what has happened over those 20 years. I agree with hon. Friends who hark back to the 1990s, when, as today, our NHS was in a terrible state. It did improve when Labour put the investment into the NHS, and we cannot deny that finance is at the heart of what is happening Bed occupancy is an issue for my local trust, which has faced a real crisis in acute care over this winter. I commend it for all it has tried to do to avert the situation, but we have had multiple days of 100% capacity in our acute medical facilities. The council has closed care homes. The trust has closed a transitional care unit. We have an empty hospital adjacent to our acute hospital, sitting on land that NHS Property Services is going to flog off as opposed to seeing how it can invest in better care for the people of my community. We need to really invest in the facilities that we need for the future, particularly around transitional care. We should have a complete review of what is needed with regard to the NHS estate The influenza outbreak this winter has had a more serious impact in York than across the rest of Yorkshire and has been one of the worst in the country. That has had a real impact on staff as well as the acuity and volume of patients coming through the door. On top of that, we have had norovirus and DNV—diarrhoea and vomiting. This is all putting challenges into the system We absolutely must have a coherent public health strategy as we move forward. We know that there is social inequality in who gets access to inoculations. We also need to make sure that we lay out a proper strategy. That is not happening. The fact that public health is separated off from acute health is a barrier. We need to draw them together to make sure that we have a proper public health workforce in the community I want to touch on funding. Our trust is in the capped expenditure process. I am still waiting for a meeting with the Minister to discuss the impact of that. The trust does not have the flexibility and the resources that it needs, and that is having a serious impact on the health crisis we are seeing in York. We need to move the situation forward to make sure that we have the resources where we need them At the moment, the NHS is really sick. When patients are sick, they need solutions. I trust that we will start hearing solutions from the Government.
It is an honour to follow the hon. Member for York Central (Rachael Maskell). I entirely agree with her about being very careful before the NHS sells off property or land for non-health uses. There is a reason why our health facilities are in the places they are, and they could be better used for things like intermediate care I had the honour of visiting County Hospital in Stafford on Christmas day, and I saw the wonderful care being provided there. County Hospital is of course the Stafford hospital, which went through the Francis inquiries and the trust’s special administration. I just want to pay tribute to the staff there, who have done an amazing job in bringing the hospital up to the standard it is now at. We want more services put back into that great place, but it is an example of what can happen when people get behind change, and when the patient and safety are put at the heart of care I also visited Royal Stoke on new year’s day. The hon. Members for Newcastle-under-Lyme (Paul Farrelly) and for Stoke-on-Trent North (Ruth Smeeth) have already mentioned the huge pressures that the hospital has been under during the past few weeks, and I would not deny that. I saw for myself the trolleys in the corridor and the real pressure under which the staff were working, but I have to say that the care I saw there was exemplary in those conditions. As the hon. Member for Newcastle-under-Lyme mentioned, some serious issues have to be tackled, not least the fact that Stoke, and to some extent Staffordshire, are systemically underfunded, as we can see from the figures. I will write to the Secretary of State about that in due course I want to bring some figures to the House’s attention. They are not the most recent figures, but they are from an international health organisation—I think it was the World Health Organisation—three or four years ago, when it asked patients in a number of developed countries whether they could get proper access to good healthcare. The UK performed best: only 4% said that they could not get good access to reasonable healthcare. In Germany, the figure for those who said they could not do so was 15%, and in France it was 18%. When we consider the challenges we face and the needs for the future—I absolutely agree with much of what has been said in this debate—we must not forget how our national health service performs and how it is an egalitarian service, providing access to people of all backgrounds across all our communities I fully agree with what has been said by Members on both sides of the House—by the hon. Member for Leicester West (Liz Kendall) and by my hon. Friend the Member for South West Wiltshire (Dr Murrison)—about the fact that we need a 10-year cross-party approach and that we need it urgently and quickly. The Green Paper on social care is a start, but the approach must be more extensive. I urge the Secretary of State and his new team, as well as the Minister on the Front Bench today—the Under-Secretary of State for Health, my hon. Friend the Member for Winchester (Steve Brine)—who has done a great job over the past few months, to consider widening the Green Paper to cover health and social care, especially now that the Department is an integrated one. “Social Care” should not just be stuck on the end of its name Finally, I pay great tribute to all those who continue to work day in, day out to provide some of the best healthcare in the world. It can be better, and we must make sure that it is.
It seems like only yesterday that I was working in the NHS, leading a group of GP commissioners preparing for the Health and Social Care Act 2012 and, every year, preparing for winter. Such was my experience of preparing for that Act that it led to my giving up my day job and deciding to become an elected politician and to enter this House. My colleagues at the time said to me, “Try to bring some sense to the debate going on, which is often so ill informed.” Today, we have heard some very well informed contributions, and I hope to offer some prospect of moving forward. I want to talk about the 2012 Act. Its purpose was to modernise and avoid a future crisis, as well as to put clinicians at the centre of commissioning, free up providers to innovate, empower patients and give a new focus to public health, and it has categorically failed on all counts. Does the Act matter to patients? All reorganisations take people’s eye off the ball, but this one has been in an altogether different league. Long-standing problems have persisted and necessary changes have been put on hold as managers try to put back the infrastructure that was so wantonly destroyed by the Act In my constituency, South Bristol Community Hospital, a long-awaited community hospital, serves an area of very high health need. It is intended to support those with chronic illness in the community and to work with GPs, as well as to provide an urgent care centre and access to therapies. Much has been achieved by those on the frontline in the hospital, but it falls between five NHS bodies This week, a constituent highlighted a problem after she was told that her appointment had been cancelled because the person it was with was no longer in post. She persevered with the booking, but it was not possible to tell her whether another appointment would be forthcoming. I have taken the matter up on her behalf, but I have to write to three different people to try to find an answer. Colleagues know that that is the situation across the piece No one body is assessing health needs, talking to the local population and ensuring that services meet those needs and are reversing health inequalities, so how do we move forward? My strong view is that we should not be talking about the superstructures or the money, although the money is important. We are at a critical point. We have had centralised planning and control. It did not work, ultimately, and the era of the market and competition is also not working. We need now to put accountability at the very heart of the system Accountability can be a key driver of change and improvement, and it is vital in a functioning democracy. All the bodies involved spend taxpayers’ money, but no one understands who is responsible and who is accountable for how they spend that money. That includes us in the House; we are also mystified Local MPs are expected by their constituents to stand up for local services, ensuring that there are enough resources, and to be able to make a difference when things go wrong, but we have no role locally in how the mandate is delivered or in the alignment of the voted national budget with local delivery. Critically, neither do local people. They do not understand how their national taxes relate to the local service We are pivotal in helping with that understanding. Local managers should be supported in sharing the great work that they do, but they also need to share the realities of cost and quality with MPs and local people so that we are all well informed. However, that will happen only if national leaders are supported when they fulfil their duty of candour and speak out about the reality of choices, which national leaders have done It is no secret that the money the NHS is allocated is insufficient to do all that is promised in the NHS constitution, to the quality that we expect. It is also well evidenced that we have the most effective and efficient service in the world, with productivity outstripping other sectors of our economy. So on behalf of our constituents, we should be putting the public centre stage, considering how to actively improve the NHS and understanding what the money can deliver. We have to give patients and the public genuine influence over decisions affecting the care that they, their families and their communities receive, and the responsibility that goes with that influence Being able to follow the money is a key part of accountability. We should all be part of that to help to inform the next stage in the development of the NHS.
There is no doubt that the NHS is under unique pressures, with demand going up every year, especially in a county such as Somerset, where we have an increasing ageing population. Somerset is a great place, but many people retire there, which increases the problem First and foremost, I want to thank all those working in the NHS in Taunton Deane. The extra £435 million invested in the NHS to deal with winter pressures is to be welcomed, as is the new forward planning. While it is not desirable to have an operation cancelled, the more notice one can have of that, the better. I referred to that earlier; I have personal, family experience of it. Without a doubt, having notice definitely helps I shall focus on A&E in particular. The A&E department at Musgrove Park Hospital in Taunton, which is Somerset’s main hospital, has seen 68,000 people through its doors in the last year, which is a huge increase, but there are nine consultants working there and there is 24-hour senior cover. I contacted the chief executive just this week for an update on how the hospital is doing. He reports that it has been extremely busy and that there has been record demand. That has had an impact on waiting time, but the staff in that department and in hospital more widely, as well as the wider community, have been fantastic in their response, often going above and beyond There has been much talk today about adequate funding for our health services. While that is important, it is also important to get the right management structures in place. In that respect, I want to highlight and praise Dr Cliff Mann, a senior consultant at Musgrove Park Hospital in the emergency department. He has just been awarded an OBE for his services to emergency medicine. During his time as president of the Royal College of Emergency Medicine, Dr Mann lobbied the Government to get changes in staffing and worked hard around education in A&E. He devised a special A&E hub, which is an excellent model. It is working really well at Musgrove and ought to be rolled out further. It brings together in the emergency departments primary care; 24/7 support for mental health issues; a seven-day, 12 hours a day community pharmacy, and a seven-day, 14 hours a day in-house frailty team. I believe that model is working To touch on equipment at Musgrove Park Hospital, it is still dealing with a pre-1948 intensive care unit and theatres. There have been redevelopment plans since the 1980s, and we are still waiting. In the autumn Budget, the Chancellor announced a welcome £3.6 billion investment in capital projects of that sort, and I make no bones about fully supporting the campaign to get new theatres at Musgrove. I know many people who would benefit—indeed, members of my own family have recently been treated at the hospital. There is a top-class team working there, producing excellent results, but those staff deserve new and better facilities. I believe Musgrove Park is the only hospital in the south-west without updated theatres, so I ask Ministers to support it I applaud the linking of social care with health. That is essential. Somerset County Council faces a very difficult situation in social care, so any help will be welcome. If the council got into the next pilot of retained business rates, that would help its funding and finances, and therefore its efforts on social care I applaud the Government for their action this winter. Things are much better. There is always more to do, but this Government are right behind the best health service in the world.
I start by paying tribute to the incredible staff working in our NHS. Keeping the nation fit and healthy is a noble calling. They make the NHS what it is—a national treasure—and they ought to be proud. Many participants in today’s debate know someone who might not be with us today, or whose quality of life would be significantly worse, had it not been for the NHS I would like to take this opportunity to pay tribute to Elle Morris, an 11-year-old cystic fibrosis sufferer and friend in my constituency, who sadly lost her fight last week. Elle’s family have expressed their thanks to the NHS workers who looked after Elle with such love and care right until the end, and supported her parents, Becky and Ian, and her sister Cara. Elle was a pioneer of raising awareness of cystic fibrosis and opt-out organ donation, and I speak on behalf of Crewe and Nantwich in saying how much she will be missed and how proud of her we all are. Breathe easy, Elle Everyone has quoted the facts and figures relating to the debate, and I will not repeat them. We all treasure the NHS, and it needs to be funded. My constituents do not want the Prime Minister to apologise for the NHS crisis. They want the Government to act and to resolve the crisis. By rewarding the Health Secretary, the Prime Minister will have sent a clear message about her vision of the NHS. Conservative Members have an opportunity to prove that theory wrong by supporting the motion, which calls on the Government to increase cash limits for the current year, allowing hospitals to resume a full service to the public. Actions speak louder than words, and today we will discover whether the Prime Minister’s apology was sincere.
It is a pleasure to follow the hon. Member for Crewe and Nantwich (Laura Smith) in this important debate on the NHS and the challenges that, unfortunately, it tends to face in winter. We should bear in mind that, for decades, winter has given the NHS challenges to meet, and as a result, clinicians have been asked not to take time off in January. Last Friday, I spent time with a GP practice, where staff confirmed that the flu epidemic is one of the worst they have seen for many years. From the perspective of patients, it is wrong that those who have waited months for surgery—perhaps routine, but for a condition that has an impact on their lifestyle—have been told that it has been cancelled. We need to change, but I believe we need to change the entire structure. It is all very well and good for the Opposition to write cheques that they know would bounce. What we have to do is reform the NHS within the resources available. We also have to consider the impact of the ageing population and the challenge—which we embrace, of course—of looking after them. In the last decade, 17% of this country’s population was over 65; in the present decade, the proportion rises to 20%; and in the next decade, it will be 30%. That might be why the number of hospital admissions has risen by 40% over the past 10 years. I am delighted therefore that the Department of Health is now responsible for social care, and particularly reform to it; that is long overdue. We need a cross-party approach. I am aware that every governing party tends to say that, but I would ask Opposition Members to please rally round. There are some great ideas that we can all get around I want to focus on the pressures facing GP surgeries and the pressures that puts on our hospitals. Too many patients are going to A&E because their GP surgery is not there for them. I spent some time with a GP who had just returned from visiting a patient he had made comfortable at home. He pointed me to another area my hospital trust covers where that patient would have been put into hospital for some weeks, which would not have been good for the patient or all those other patients waiting for their care. We have seen huge demand from the elderly. I am still greatly concerned that the social care system is set up on a local authority basis. Many local authorities to which people retire do not have the same business rates as other areas—they have a lot of elderly folk but not the business to fund them—and certainly not as much council tax. In looking at reforms, I would like the Government to consider putting social care on the same footing as the central NHS.
Will my hon. Friend give way?
I will not, I am afraid, because of time. I am sorry I would like to see more powers given to CCGs, or perhaps a tier above, to enable them to intervene where GP surgeries are not functioning as they should be. At the moment, there is no sharing of data, so CCGs cannot see where surgeries might be about to fall over. We expect CCGs to intervene and take over when things go wrong, but that is often too late, so I would like to know if more taskforces could be put in place. It is clear that the GP model that we have continued with since 1947 is not the GP model that younger GPs want to buy into: they do not necessarily want to buy into the practice model, are concerned about litigation and do not necessarily want to stay in the same place for all those years. We need great reform, therefore, and I add my support to the voices on both sides of the House saying that perhaps a royal commission is the way to take this forward.
I will concentrate on my main point in the 90 seconds being given to me. NHS staff have said that this winter crisis was predictable and preventable. Bedford Hospital NHS Trust was one of the 24 trusts that issued a warning saying they were at full capacity. Patients, including many elderly and frail people, are routinely stuck in the back of ambulances in logjams waiting to get into A&E. The NHS is coping with an increase in demand, while being severely underfunded. We have also learned that Bedford walk-in medical centre in Putnoe is now under threat. Some 40% of our walk-in centres nationwide have closed under the Tories since 2010. Commissioners take decisions in response to budgetary constraints and cut services that are on the face of it costly to provide, but the human costs of such cuts are catastrophic, especially in places such as Bedford, whose hospital is already struggling to cope I finish by thanking all the staff who worked hard over Christmas and gave their time, when they could have spent it enjoying time with their families.
We have heard some excellent contributions today. The depth of the crisis is reflected by the fact that no fewer than 38 Members put in to speak, and although we only managed to hear from just over 20 Back-Bench Members, they were from all four corners of England. Owing to the time constraints, I cannot refer to them all, so I will just pick out a few, particularly from those still working in the NHS, such as my hon. Friend the Member for Stockton South (Dr Williams), who said it felt like we were going back to the 1990s and that it did not have to be like that—this decline is not inevitable. I totally agree with him on that We also heard from my hon. Friend the Member for Wolverhampton South West (Eleanor Smith), who brought her 40 years of service in the NHS to the fore and made the valid point that cancelling operations now creates a backlog, which will cause problems later on. We know that many trusts are already failing to meet their 18-week target Perhaps the most compelling contribution was from my hon. Friend the Member for Tooting (Dr Allin-Khan), who worked in A&E over Christmas. She was absolutely right to say that many people attend A&E because they are not getting the treatment that they need from elsewhere in the system, due to a squeeze on funding. She also made the valid point that many people are not being discharged as quickly as we would like because of massive cuts to social care over the years. Her contribution was excellent, and she made the point that these conditions have arisen not by accident, but because a political choice has been made After two years in which the A&E target has been missed altogether, we now know that waiting times shot up in recent weeks. Some hospitals cannot see even half their patients within four hours at A&E. The Secretary of State knows a little about waiting: there was a gap of an hour and 42 minutes between his entering No. 10 on Monday and confirmation that he was continuing in his job. Perhaps he was left waiting in a corridor. I hope that he was at least offered a chair. He would have to double that time, and double it again, to begin to appreciate how long some patients are having to wait, often in great discomfort and pain. Following the reshuffle on Monday, the Health and Social Care Secretary has had a rebrand, but if it took him over five years to work out that his actions might have some bearing on social care, how much longer will it be before he learns that the message that he hears about underfunding in the NHS is so consistent because it is true? How long before he realises that, on his watch, standards have deteriorated by almost every measure? How long before he realises that the decisions that his Government have taken have led to the litany of woe that we have heard today?
I do not know whether my hon. Friend has seen that an emergency consultant at Charing Cross Hospital has said that staff were practicing “battlefield medicine” there. By that, he meant that when a blue-light ambulance arrived, staff had to decide whether to take someone out of the resuscitation room to put the arrival in, or to leave the arrival in the corridor until a bed space was free. That same hospital faces losing all its emergency beds and its blue-light A&E. Does he agree that we have to rethink further reductions in beds and A&E capacity, given the crisis that we are in?
I thank my hon. Friend for his contribution. He is absolutely right. Those working on the frontline have made many statements about just how acute the problem is. Bed numbers have dropped rapidly in recent years. The worry is that under STPs, even more beds may be lost The Health Secretary today denied there is a crisis, but he admitted it on Twitter, where he asked of Tony Blair, “does he not remember his own regular NHS winter crises?” If the House wants to make a comparison with Tony Blair, I will help it: in the last winter under Tony Blair, between October and December 2006, one in 50 patients spent longer than four hours in A&E. In November, under this Health Secretary, one in 10 did Of course, behind every single figure is a vulnerable patient who is being let down—a patient like 87-year-old Esme Thomas, who, according to the BBC, waited 22 hours to be admitted to a ward at Weston General Hospital, or the patients at Pinderfields Hospital in Wakefield, who, as we have heard, were photographed lying on the floor, some still attached to drips. If the best that we—one of the wealthiest nations in the world—can offer people who are ill is an uncomfortable metal chair, something has gone badly wrong. What do the Government say to the nurse who told “ITV News” that there had been times when she had spent whole days treating patients in the hospital car park? Those stories should shame the Government into action Of course, it is not just those attending hospital who are suffering; so are those who are not able to go to hospital at all: 55,000 operations have been cancelled this month. When asked about this, the Prime Minister said that it was all “part of the plan.” If it was all part of the plan, why were the operations arranged in the first place? This is not a plan; it is a shambles The human cost of this crisis is devastating. Even before the worst of the winter had reached us, a one-year-old baby with a hole in her heart had her life-saving operation cancelled five times. Her parents were told that their daughter could go into cardiac arrest during the operation, so I cannot begin to imagine the anguish that they must have gone through in preparing themselves for the operation five times. Or what about the 12-year-old autistic girl from my constituency whose operation to remove her tonsils has been postponed? She has had at least eight bouts of infection in the past year, and because of her autism, the delay to her operation has caused her anxiety. It was a huge deal to build her up for the operation after her pre-operative assessment, particularly given the prospect of spending a night in hospital, but after the cancellation, she is anxious that when she gets her new operation date, that will be cancelled as well. If leaving these children anxious and in pain was part of the plan, it is a plan this Government should be ashamed of Across a whole range of indicators the NHS has experienced its worst performance since records began, and that was before we headed into this winter. Let us be clear: I do not for a second hold the people who work on the frontline responsible for this. Indeed, it is only through their dedication that the health service keeps going, despite the best efforts of this Government to destroy staff morale—whether an entire generation of junior doctors alienated, the next generation of nurses deterred from entering the profession by tuition fees, or the thousands of staff up and down the country who are frankly fed up of rota gaps, pay restraints and meaningless platitudes from this Government Only this afternoon we hear that the Care Quality Commission is postponing routine inspections, presumably because it knows a winter crisis is on. This is an unprecedented step that sends a huge signal to the Government that this is not just normal winter pressures Let us hear from some of those staff working on the frontline. A&E doctor Adrian Harrop said the claims that the NHS had never been better prepared were “misleading, disingenuous nonsense”. He also said: “The system I’ve been working in in recent days and weeks seems under-resourced, underfunded and understaffed.” Tracy Bullock, chief executive of Mid Cheshire Hospitals NHS Foundation Trust, said: “I’m 34 years in and I’ve never seen anything like this.” These are honest, hard-working professionals—the lifeblood of the NHS—and Conservative Members know full well we could have repeated dozens of similar comments from NHS staff, because at the bottom of all this is the unescapable, indisputable fact that under this Government the NHS is in the middle of the longest and deepest financial squeeze in its entire history, and it is a squeeze that, as we have heard today, is having devastating consequences We warned time and again that, unless early and substantial action was taken, we faced another severe winter crisis, and that is exactly where we are today. We have had an apology but no action from the Government. Patients deserve to know when this crisis will be solved and when their cancelled operations are going to take place, and this country deserves a Government fit to run the NHS. I commend this motion to the House.
Happy new year to you, Madam Deputy Speaker. We have had a good debate this afternoon with some well-informed—as the hon. Member for Bristol South (Karin Smyth) put it—contributions from both sides The NHS is a service that we are all immensely proud of; we can agree on that. Even during the challenging winter period it continues to deliver overwhelmingly safe and effective care to thousands of our constituents, and we should never lose sight of that. We have heard examples of that today, including from my right hon. Friend the Member for Meriden (Dame Caroline Spelman), who spoke with her usual calm about the triage model she saw working well in her area when she had to go to hospital over the holiday period. My hon. Friend the Member for Stafford (Jeremy Lefroy) was among many Members who visited the NHS over the recess period and he spoke, as well he might, and as well as he usually does, about the safe care he saw being delivered As my right hon. Friend the Secretary of State, and before him the Prime Minister, said earlier, we have done more preparation for winter this year than ever before, planning earlier to make sure the NHS is better prepared. More than that, we have put in the money, in the form of an additional £337 million for winter pressures and an additional £1 billion for the social care system this year. As the Public Health Minister, I am proud of our flu vaccination programme, already the most comprehensive in Europe, which has been extended even further. This was planning ahead We have also allocated £100 million of capital funding to help hospitals set up GP streaming systems at their A&Es, reaching 91% coverage by the end of November. This, too, was planning ahead; they did not just appear overnight. And for the first time ever, people were able to access GPs nationally for urgent appointments from 8 am to 8 pm seven days a week over the holiday period Of course, there were additional pressures this year: very cold spells in December, a sharp uptick in flu and respiratory conditions, and higher hospitalisations from confirmed cases of flu than in the peak of winter last year.
There are also questions about NHS leadership. As the Minister is aware, Staffordshire is under great pressure. The Secretary of State received reports about the closure, with lack of consultation, of community hospitals in our area on 18 October, which slated two local CCGs. Yet a week later the NHS appointed the chief operating officer of those two CCGs to oversee four more in Staffordshire. Will the Minister ask his right hon. Friend the Secretary of State to explain that decision?
The sustainability and transformation partnerships have been established across England—I am sure that the hon. Gentleman will have engaged with the one in his area—and they take local decisions about how services are organised in local areas. I implore him to engage with his STP; indeed, I know that he is already doing so. If he wishes to talk to me about this, he can of course do so Let me respond to some more of our contributors. The hon. Member for Bristol South always speaks sensibly. She spoke about the public representation and involvement in STPs. I agree that we could do more in that area, and as the Minister responsible for STPs, I want to see that we do so. Her point was well made. The hon. Member for Crewe and Nantwich (Laura Smith) spoke about her constituent, Elle, who lost her battle with cystic fibrosis. She speaks up for her constituents well, and very emotionally, and if she continues to do that, she will do extremely well in this House The hon. Member for Stockton South (Dr Williams) is a new Member, and I already have a lot of respect for him. In his typically sensible contribution, he made some sensible suggestions for improvement in the NHS. He went on to talk about how we could do better on prevention, and he was absolutely spot on. We all agree that prevention is part of our one NHS. He said that this was not all about money, and I agree. Money is a key part of this, however, and that is why we spend 9.9% of our GDP on healthcare, which is above the EU average The hon. Member for Leicester West (Liz Kendall) said that this is not what happens every year, but the NHS is under great pressure at this time every year. A headline from The Guardian newspaper on 27 October 2001 stated “NHS faces another winter of crisis”. The NHS is often under pressure at this time of year, and the important thing is how we prepare for that. As I have said, we are better prepared than ever. It is a shame that the hon. Lady is not listening to my response. [Interruption.]
Order. I hesitate to interrupt the Minister, but I do not understand why there is so much noise on the Opposition Benches. I would not be surprised if Members were heckling the Minister, but they are simply making a noise, so the Minister cannot be heard. He is answering the questions that he has been asked this afternoon, and those who asked the questions ought to want to hear the answers.
Thank you, Madam Deputy Speaker. The Members appear to be heckling themselves The hon. Member for Wirral West (Margaret Greenwood) said that the NHS was a political organisation. I totally disagree. The NHS is an organisation run by hard-working people who are public servants. They go to work every day to do a job for our constituents, and the NHS is not a political organisation. The Labour party is a political organisation, and it is politicising the NHS—
Will the Minister give way?
I will not give way; the hon. Lady has had her say My hon. Friend the Member for South West Bedfordshire (Andrew Selous) spoke about leadership, and he was absolutely right. He knows the Luton and Dunstable University Hospital NHS Foundation Trust, which has been ably led by Dame Pauline Philip. She has achieved 98.6% of patients meeting the four-hour target. That is the kind of leadership that can be achieved, which is why Dame Pauline was brought in to NHS England to help with our national response to winter pressures My hon. Friend the Member for South West Wiltshire (Dr Murrison) said that this was all about outcomes and that, on cancer, we do not do well. We have had the best cancer outcomes ever in our country, but I agree that our ambition for the long term needs to be even better and that we need to aim higher. His point on a royal commission is noted. My hon. Friend the Member for Henley (John Howell) spoke about the out-of-hospital care work that Henley’s hospital is doing. I thank him very much for his invitation. My ministerial colleagues also heard what he had to say, and it was good to hear about the cross-party working that is going on in Oxfordshire. My hon. Friend the Member for Southport (Damien Moore), a new Member of the House, talked about joined-up care and continuous improvement. He reminded us that without a strong economy there is no strong NHS. This is not the Government’s money; it is the public’s money. We need to spend it well, and I think we are doing so My hon. Friend the Member for North Dorset (Simon Hoare) spoke about community pharmacies, a subject close to my heart. They play a key part, and better integration of them within the NHS is part of the prevention and primary care agenda. I completely agree with the points that he made. My hon. Friend the Member for Taunton Deane (Rebecca Pow) spoke about the A&E hub at Musgrove Park Hospital. That sounds very interesting indeed, and the new Minister of State, Department of Health and Social Care, my hon. Friend the Member for North East Cambridgeshire (Stephen Barclay), was also interested to hear what she had to say. We would like to come and see it, and we will take her up on her invitation Finally, I welcome back my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) and congratulate her on the birth of Clifford. She spoke very well, as always, about the integration of health and social care, saying that it can only make sense and will only serve to make the preparations for next winter better I hope to end this debate on a note on which both sides of the House can agree. We are all truly thankful for the extraordinary dedication of NHS staff in caring for their patients—our constituents—during this extremely challenging time. As ever, they are doing a brilliant job Question put and agreed to. Resolved, That this House expresses concern at the effect on patient care of the closure of 14,000 hospital beds since 2010; records its alarm at there being vacancies for 100,000 posts across the NHS; regrets the decision of the Government to reduce social care funding since 2010; notes that hospital trusts have been compelled by NHS England to delay elective operations because of the Government’s failure to allocate adequate to the NHS; condemns the privatisation of community health services; and calls on the Government to increase cash limits for the current year to enable hospitals to resume a full service to the public, including rescheduling elective operations, and to report to the House by Oral Statement and written report before 1 February 2018 on what steps it is taking to comply with this resolution.
On a point of order, Madam Deputy Speaker. Can you confirm that the effect of the Government refusing to defend their position in the Lobby this afternoon is that the motion that stands in the name of the Leader of the Opposition has been endorsed by the whole House and that we should therefore expect the Secretary of State to come to the House before the end of the month to make an oral statement to explain to our constituents when their cancelled operations will be rescheduled?
What I can confirm to the hon. Gentleman is that the House has just voted to carry the motion that was before us. The motion therefore stands. As to what the Secretary of State will say or do over the next few weeks, I am sure that he will be back at the Dispatch Box in the near future as he is a most assiduous attender of this Chamber, but we all appreciate that he has other work to do, and we look forward to seeing him doing that.
I beg to move, That this House believes that rail franchising is failing to provide adequate services for passengers or value for money for taxpayers; notes that regulated rail fares have risen by 32 per cent since 2010 while planned investment has been cancelled; opposes the recent bail-out of Virgin Rail Group East Coast; and calls on the Government to run passengers’ services under public sector operation I welcome the hon. Members for Orpington (Joseph Johnson) and for Wealden (Ms Ghani) to their new ministerial positions and wish them success in their new posts. I also pay tribute to the right hon. Member for South Holland and The Deepings (Mr Hayes) for his 18 years of continuous Front-Bench service. He was a pleasure to work with, and I would like to think that we can continue the sort of relationship that we had in non-contentious areas, where the result was improved legislation. I also congratulate the Secretary of State for Transport on his superb stewardship of the Conservative party. There has never been a finer record: no elections lost; no major scandals; and membership maintained at around 70,000—not bad for 27 seconds’ work I am delighted that the Secretary of State is in the Chamber to provide answers to a number of questions that I and other Members have for him. Unfortunately, no Minister was available on 2 January to explain the highest fare increases in five years, so I hope that he will provide us with some clarity today. Sadly, the entire rail debate is characterised by a lack of candour and transparency from both the Government and some quarters of the rail industry.
Does my hon. Friend share my concern that my constituents who use Northern saw fare increases of nearly 5%—the biggest in the country—and that we are still having to use Pacer trains? They are virtually as old as me: 42 years old.
I agree entirely with my hon. Friend. It just adds insult to injury when such hikes in rail fares go alongside appalling services It is time that Secretary of State woke up from his state of denial. It is time for him to come clean and admit that he has made mistakes. No one is perfect, but he should acknowledge his failures, and take responsibility for the decisions he has made, the policies he has pursued and their consequences. I urge him to be entirely unambiguous with the House today. The Government’s defence of their rail franchising system is totally indefensible, and this is not the first time that the Government have been in the Chamber this week to defend the indefensible.
In south Wales, First Great Western reduced and cancelled services over Christmas and new year—there was chaos—yet it has been handed a franchise extension. Is it not time we had performance-related franchises and performance-related franchise extensions, rather than franchises being extended automatically no matter what the service?
My hon. Friend makes a good point, and I will return to those themes. The Government are unable to accept that the franchise model, which is demonstrably failing, is a betrayal of the public who plough billions of pounds of taxes into the railway. It is a betrayal of the passengers who face eye-watering fare rises year after year. It is a betrayal of the hundreds of thousands of dedicated and passionate people who have worked in the rail industry for decades.
I thank the hon. Gentleman for his kindness to me just before Christmas. Will he confirm whether fare rises have been faster under this Government or the last Labour Government?
Labour’s position is that if we were in power, we would not raise fares by the retail prices index or by RPI plus 1. We would save each member of the travelling public £500 during this Parliament.
I will make a little progress, but I will take interventions later In 2016, the Department for Transport set out that its aims and objectives for rail franchising were “to encourage a flourishing, competitive passenger rail market which secures high-performing, value for money services for passengers and taxpayers whilst driving cost effectiveness.” The Department has clearly failed to meet those objectives. The latest collapse of the east coast franchise, which was announced in November, makes a mockery of the Department’s 2016 aims. Virgin-Stagecoach did not deliver and defaulted on their contract, and the Secretary of State has given them a gift.
Given that this is the third occasion in just over a decade that a private contractor has announced that it wishes to hand back the keys to the east coast franchise, was it not a fundamental mistake for the Government not to allow East Coast, which successfully ran the franchise for more than five and a half years and paid back £1 billion to the Treasury, to continue its good work? Instead, the Government ideologically said that anyone could bid to run the franchise except the state-owned company that had run it so successfully.
My right hon. Friend makes a perfect point. I have no doubt that that will be a consistent theme throughout this debate The Government should have followed Labour’s example. When the operator defaulted in 2009, Labour took the contract back into the public sector. If a company defaults, it does not deserve a contract. Taking a contract back into the public sector would mean that there is no reward for failure, and other companies in the industry would not expect the same treatment. In the light of what happened with the east coast franchise, what plans does the Secretary of State have to renegotiate the TransPennine Express, Northern and Greater Anglia franchises?
The hon. Gentleman makes a valid point. Is not the biggest danger of the Secretary of State’s decision that other franchisees might come looking for a handout?
Indeed. That point is entirely consistent with the issues I am putting before the House. Labour would not have let Virgin-Stagecoach off the hook on the east coast franchise. To return to what my right hon. Friend the Member for Leeds Central (Hilary Benn) said, did the Secretary of State consider taking the east coast franchise into the public sector following the default—yes or no? Does the Secretary of State not worry that, because he refuses to use a public sector operator even as a last resort, struggling train companies now know he has no option but to bail them out in the event of a failure Such failures are not confined to the east coast franchise. Today’s National Audit Office report highlights a litany of errors in the Government’s planning and management of the Thameslink, Southern and Great Northern franchise. Those blunders have caused misery to millions of people, and it is the Government’s disastrous handling of the franchise that led to industrial action on the line.
Does my hon. Friend accept that this morning’s report was scathing about the dreadful performance of Northern rail? My constituents are not as dependent as I am on the east coast franchise to get up and down the country, but the local franchises are how ordinary people get to work.
My hon. Friend makes his point powerfully.
I will not respond in detail until I make my speech, but it is important to put on record that this morning’s report had nothing to do with the Northern rail franchise. I hope the hon. Gentleman will confirm that to the House.
I will do that very thing. I will confirm that the damning report was about Thameslink, Southern and Great Northern, not Northern, and showed that that franchise has been appallingly managed.
Rail companies could do more to make passengers’ lives easier. Many local stations, such as Langley Mill in my constituency, do not have a ticket machine, so people cannot collect pre-paid tickets. Should it not be a condition of any franchise that passengers travelling from such stations can use email proof, instead of their facing this “computer says no” attitude that we get from so many rail companies?
We do have to think about much more flexibility across our railway, as well as greater accessibility for people from not only every walk of life, but all different localities, as some facilities are not as they should be Some industry commentators have said that the Secretary of State accepted rail franchise bids that were excessive and unrealistic. Can he confirm that winning bids are accepted in the expectation that they will be paid in full? Does he anticipate that the premium payments on the South Western Railway, Greater Anglia, Northern and TransPennine Express franchises will be made in full? Several other franchises look vulnerable in the light of the east coast decision. Passenger growth is slowing across the railway amid weaker consumer confidence, rising fares and changing work patterns. Rail passenger usage has fallen for consecutive reporting periods, and that has included a stark decline in season ticket purchases, which are the core business of rail companies. The fact that passengers are being priced off the railway is threatening the sustainability of the network as a whole.
Since Southern rail fares went up in the new year, three quarters of rush-hour services between Balham and Victoria have not arrived on time. If the delays we have seen so far are replicated throughout the year, Balham commuters will waste a total of 30 hours stuck on delayed trains. Southern rail is not fit for purpose. Does my hon. Friend agree that it is time for action?
I could not agree more. It is fascinating that we still await the revelation of appendix 9 of the Chris Gibb report, which detailed the future of that franchise. We have not seen it. That report was commissioned by Southern, which set the terms and conditions. [Interruption.] The Secretary of State is muttering from a sedentary position, but that is the reality. Southern set out what that report should be about and it has not published the very kernel of that report, which was on the future of that service.
I congratulate my hon. Friend on the case he is making. He mentions the cost of season tickets. My constituents are also served by appalling services from Northern. It is hardly worth their investing in a season ticket, given that trains are often either cancelled or so crowded that they cannot get on to them. Does he agree?
I do agree. The great concern about all that is that it is not achieving the modal shift we all want. It brings people to the point where they say, “The railway is not for me. I may as well get back in my car.” That is the opposite of what we should be doing.
My hon. Friend is making an excellent case. Does he agree that, given the widespread evidence of the lamentable failure of some of the rail companies—consumer dissatisfaction, price rises and so on—there is a strong case for developing models of ownership that involve the users of the railways, those who work on the railways and investors in the railways? Such a form of co-operative and mutual ownership may well operate effectively and efficiently, with enormous public support.
I am grateful to my hon. Friend for making that point. It is important that the voices of passengers and those who work in the railway industry are heard, because they are the people who not only use the service but are committed to making it work.
My constituents in Brighton will certainly agree with the hon. Gentleman 100% when he criticises Govia Thameslink Railway/Southern; it is adding insult to injury to put prices up when the services that people in Brighton are getting are so awful. On the issue of cost, rail fares have gone up by 23% over the past 20 years and the cost of driving has gone down by 16%. Does the hon. Gentleman agree that privatisation is absolutely failing passengers, and that instead of lining shareholders’ pockets we should be investing in our railways?
I could not agree more. In fact, we have seen prices rise by 32% since 2010, which underlines the hon. Lady’s point.
The hon. Gentleman and I have enjoyed cordial exchanges on many issues, but I suspect this will not be one of them. The point has been made about rail fare increases under privatisation. I did a little research into fare increases under nationalised British Rail over the same length of time for which the private companies have operated. In 15 of 22 years there were above-inflation increases, and over that period rail fares were 60% higher after inflation was taken into account. Why would nationalisation automatically lead to lower fares?
I like to think that the hon. Gentleman and I can disagree with one another without being disagreeable. He has a good memory and is going back rather a long way. The Conservative party has been in power since 2010—eight years—and we are concerned today with the record of the current Government. We are not going back through all our yesterdays.
The hon. Gentleman is two years younger than I am, so he will well remember the state in which the railways used to be. Does he not agree that we have seen a terrific improvement in the quality of the trains, the service and the attitude of the staff? An excellent service has been developing; would he agree that that is because of privatisation? Would he further agree that investment in our railways is at a record high?
I regret that many passengers’ experiences do not match the right hon. Lady’s experience. The evidence is that people are dissatisfied with the services they receive throughout the country. I respectfully suggest to her that going back over things in the way she is doing is not helpful. Had British Rail received public investment at the rate at which the Treasury has poured investment into the private operators, we would have had a gold-standard railway in this country.
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I really want to make progress because a lot of people want to speak All the factors I have described undermine the growth forecasts that are so central to the Government’s model and the undeliverable bid assumptions of operators. FirstGroup won the TPE—TransPennine Express—franchise in December 2015 based on revenues increasing by 12% a year. In one of his first acts in office, the Secretary of State awarded the Greater Anglia franchise to the Dutch state-owned rail company Abellio in August 2016. The deal commits the company to paying the Government £3.7 billion to run the line for nine years. That is more than the east coast franchise. Reports suggest that Abellio’s bid was £600 million more than the next bidder. Like the TPE and east coast bids, Abellio’s bid was based on double-digit annual revenue growth. The company’s boss described the £3.7 billion price tag as “scary”. Does the Secretary of State guarantee that the Treasury will receive the full premium payment of £3.7 billion from Abellio Greater Anglia by 2025—yes or no?
My hon. Friend is making an excellent case. Is not one of the problems that these companies make such commitments and then set about destaffing and deskilling our railways to make more profit, so that they can pay back the Government?
The whole issue of overbidding and making promises that cannot be kept is a consistent characteristic of the modern rail environment If the Government’s rail franchising system cannot deliver competition and payments to the Treasury, what is the point of it? The Secretary of State will no doubt be able to give a clear and straightforward answer to that.
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As I allow an intervention for the last time, perhaps the former Secretary of State can give us some indication of the point of a franchising system that does not deliver the promised premiums.
Will the hon. Gentleman tell us, during the course of his speech, how franchising changed between 1997 and 2010, when it was defended continually by the previous Labour Government as the best way to see extra investment in the railways? While he is telling us that, will he also confirm that there are actually more people employed on the east coast main line than there were under the previous people operating that line? Will he welcome the fact that the Pacer trains, which were referred to earlier, will actually go as a result of the new Northern franchise, that the Secretary of State has brought in?
Let me take the last point first. The European Union dictates that persons with restricted mobility are not served by the Pacers. The time of the Pacers has been up for a long time, and I am glad to see the back of them. I am glad that plenty of people work on the railways, and delighted that the previous Labour Government went about making the railways safe, given the disaster that was Railtrack, which delivered us Potters Bar, Hatfield and Paddington. That was the legacy that the previous Labour Government inherited, and we turned our railways into the safest in Europe, so I am very proud of what we did Direct awards and franchise extensions in the rail industry have been overlooked in many of the rail debates. These are contracts that the Government cannot or will not refranchise, and which they are ideologically opposed to running in the public sector. The train companies name their price to the Government for running these hand-to-mouth contracts, which simply keep the trains running in the short term and provide no long-term benefits or investment The west coast route has operated on a series of direct awards since 2012, with reports of another extension beyond 2019. Another key inter-city franchise, Great Western, has been operating under a direct award since 2013, when the Government cancelled the franchise competition. Scandalously, Great Western may run as a direct award for 10 years until 2023. The Government cannot refranchise the rail operation because their management of Network Rail has been so poor and the Great Western electrification programme has been such a shambles I predict that there will be more direct awards and contract extensions to rail franchises announced by the Government. The east midlands franchise is already on an extension to 2019 and will probably get another one. I also predict that the Secretary of State will need to give Virgin and Stagecoach a direct award on the east coast because he will not be able to deliver on his east coast partnership by 2020. It is simply inconceivable that he will be able to establish a framework, gain regulatory support, put the idea out to tender, receive and evaluate bids, and award the contract within the timeframe he has set out. A direct award to VirginStagecoach on the east coast will allow the companies to continue to profit from the line while they invest even less Once again, the Secretary of State needs to be entirely candid with this House: does he, or does he not, anticipate giving Virgin-Stagecoach a direct award to run rail operations on the east coast while he sets out his east coast partnership? Can he confirm whether that will take place? If he does, can he tell the House how much less the value of premium payments to the Treasury would be under this arrangement than under the original franchise What is the Secretary of State’s solution to his failing franchising model, as competition dwindles and premiums to the Exchequer reduce? It is quite simple: more taxpayer and fare-payer support for train operating companies. The next franchises to come up are Southeastern and west coast. Under his new revenue support arrangements, taxpayers will top up revenues if growth targets are not met. What is the point of franchising if the operators do not take any risk? In return, the Government will want close financial monitoring of the operators. Do we really want civil servants in Marsham Street poring over train company balance sheets? Is there not enough DFT interference in the railway already Rail privatisation’s vested interests have spent more than 20 years trying to get franchising to work. Despite the Government changing and tweaking the system for them time after time, all they have done in return is to reveal ever more and new sorts of failure, while the public continue to suffer substandard services and ever-higher fares. Enough is enough. We need to change the system entirely.
May I begin with the one thing on which we agree this afternoon? I thank the hon. Member for Middlesbrough (Andy McDonald) for his generous comments about my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes), who has been a great servant of my Department and other Departments for a very long period. He has been on the Front Bench for 19 years, in government and in opposition. That is an epic career, and we all very much appreciate the work that he has done, particularly on legislation and on building bilateral discussions and so on, so I pay tribute to him for all that he did. I am grateful for the warm words from the hon. Member for Middlesbrough. Apart from that, we have just heard about 25 minutes of complete nonsense from the Opposition. I suspect that you would say it would be unparliamentary of me to call them hypocritical, Madam Deputy Speaker, so I will not do so, but I have no doubt that others in the know will be astonished by the gall with which they simply forget their actions in government; with which they pretend that their ideas will not cost a penny—I keep hearing that, but it is absolutely untrue—and with which they make inaccurate claims based on a lack of facts about subjects they appear not to understand Let me set out why the Opposition’s ideas do not stack up and why their positions do not add up.
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I will make some progress and then take interventions I shall also set out why the Opposition’s policies make no sense for the travelling public and why their pronouncements on the east coast main line are wrong. I shall also explain why it is this Government who have set about the task of modernising and upgrading our railways—the biggest programme of investment since the steam age—after 13 years of a Labour Government who quite simply failed to deliver the infrastructure improvements that this country needed. It has taken Conservatives to begin to change that.
I will make some progress and then take a few interventions I do not like to see train fares rise. I particularly did not like, as a rail user of some 35 years, to see fares rise by nearly 20% in real terms during Labour’s years in office. I did not like, in those years, to see fares rise in cash terms by an average of 67%, so I am relieved that we have been able to limit the increase in train fares to just 2% in real terms since 2010, even while we invest billions in upgrading the network. That increase is still more than I would wish, but it is much, much less than the increases under Labour and much less—[Interruption.] The hon. Member for Middlesbrough was simply unwilling to answer the question that my hon. Friend the Member for Bexhill and Battle (Huw Merriman) correctly asked. Under Labour, fares rose much faster than they have under this Government That does not make it any easier for those who faced increases last week. I had hoped to be able to bring down the rate of increase from the higher retail prices index rate to the lower consumer prices index this year. That remains my goal, but there is a problem. The industry is locked into RPI and has been for years. The biggest barriers to change are the unions whose members’ pay amounts to almost a third of the costs of the industry. Currently their pay rises in line with or above RPI inflation every single year.
In a recent report, the head of the National Audit Office said: “Some of the problems could have been avoided if the DfT had taken more care to consider the passengers in designing the rail franchise.” Secretary of State, may I ask whether you recognise that statement, and do you apologise to the passengers?
Order. The hon. Gentleman is not asking the Secretary of State—he is asking the Chair.
Through the Chair, I would like to ask whether the Secretary of State recognises that severe criticism from the head of the NAO. Will he apologise on behalf of his Department to my constituents—rail passengers from Eastbourne—and passengers across the south-east?
I make no apologies for the huge investment programme in the Thameslink network, the massive expansion of London Bridge station, which has just been completed, and the introduction of brand-new 12-coach trains across the network. What I do apologise for is that we were not able to avoid the extraordinarily ill-judged actions of the trade unions, which caused massive trouble for passengers. The hon. Member for Middlesbrough talked about the Gibb report. Chris Gibb had a simple conclusion, which was that although there were problems on the network—that is why we are spending £300 million on improving it—by far the biggest disruptive factor was the trade unions Of course, we want rail staff to be paid fairly, but trade union leaders such as Mick Cash drive up ticket prices for hard-working people. The same unions that want CPI increases on fares want RPI—[Interruption.] The hon. Member for Middlesbrough should listen. The RMT guidance to their negotiators is that “any attempt by an employer to link a pay award to CPI…must be refused.” Mick Cash wants bigger rises for his members and lower rises for passengers. Where is the money coming from? It does not add up. Labour’s policies do not add up, and the unions’ policies do not add up Of course, you will remember, Madam Deputy Speaker, who pays the Labour party’s bills. Even the shadow Secretary of State has received financial contributions from the RMT. The Opposition are in the pockets of the trade unions, and that is simply not acceptable.
I know it has taken 100 years for the Conservative party to realise it, but we are the Labour and trade union movement. The Secretary of State needs to understand that. It is the cleanest money in politics—I would rather take from trade unions than from hedge fund managers and private health companies, as some who populate the Conservative Benches do.
The hon. Gentleman is bankrolled by the people who are inappropriately disrupting parts of the network and are politically driven. They disrupt the lives of passengers for political purposes. The Labour party should disown the unions and their current action. The hon. Gentleman’s conduct on this is not acceptable,
On my daily commute, as I walked through London Bridge station—as I know my right hon. Friend does—where there have been a lot of difficulties for me and my constituents, I noted that it is now an absolute temple to travel. We should talk positively about our rail system and not just knock it.
On a point of order, Madam Deputy Speaker. I do not know whether you heard what I did, but I think that I have been accused of unacceptable behaviour. I really think that needs to be clarified. I have tried to conduct myself with all civility and propriety, and what the Secretary of State said is regrettable. I seek your guidance on that point.
The Secretary of State did use a phrase that included the words “not acceptable”. He might wish to repeat what he wanted to say in slightly different words, because the shadow Secretary of State has a point about the precise use of words in the Chamber.
Madam Deputy Speaker, I think it is unacceptable to defend inappropriate strike action around the country by people who should not disrupt the lives of passengers. I wait with interest to hear any Labour Member say that the strikes are wrong. Sadly, I have not heard that for 18 months. I am waiting patiently. [Interruption.] The hon. Member for Middlesbrough says from a sedentary position that it is about safety, even though the safety regulatory authorities say that it is not. That is the shame of it.
Why has the RMT been able to negotiate successfully in Scotland and in Wales the question of driver-only trains, which is concerning for the public, when we cannot get that here in England? Is it something to do with the Secretary of State?
Driver-only trains have been operating in this country for 30 years. The ASLEF union recently reached a perfectly sensible agreement with GTR about the development of new train technologies. Yet today the RMT is striking on South Western Railway, even though that company has said that it does not plan to take the second person off the train. That is an absurd position. Of course, the hon. Lady will remember the comments of the president of the RMT at the TUC conference, where he said that the real aim is to create a national rail strike and bring down the Government. That is my concern. It is about not passengers but political motivation, and that is not acceptable.
I sat here and watched the Secretary of State chuckle and smile as my hon. Friend the Member for Middlesbrough (Andy McDonald) made his contribution. My constituents have been suffering from the most dreadful services from Southern and Thameslink, and that is no laughing matter The Secretary of State refers to industrial action. The NAO report is clear that his Department did not check whether GTR had enough drivers and did not have a proper understanding of the condition of the network when it was setting the requirements of the franchise. The report is absolutely clear that the “cumulative effects” of the decisions made by his Department “have negatively impacted on passengers.” The Secretary of State can talk about industrial action all he wants, but when is he going to accept responsibility and, as the hon. Member for Eastbourne (Stephen Lloyd) just demanded, apologise to our constituents for the dreadful misery they have been suffering?
I have been Secretary of State for 18 months. Let us be clear what I have done. There are a number of problems on the network—I have never made any attempts to hide that. The infrastructure is not good enough, which is why we have launched an immediate £300 million programme to upgrade some of the areas of the network that are failing too often and why we have changed ways of working. I asked Chris Gibb to go in and bring together the operation of the track and the train on a daily basis in order to improve things. London Bridge has been opened, and we are now able to run longer trains for passengers. Those are brand-new trains going through the hon. Gentleman’s constituency. Chris Gibb, who everybody has rightly said is a well regarded, independent figure, said that above all, the unacceptable disruption to the hon. Gentleman’s constituents was caused by the trade unions. The Labour party and the unions demanded the publication of Chris Gibb’s report. It was published, and that is what it said. They may not like it, but that is what it said.
This could turn into a really good debate on the future of the rail industry, but I suggest that the Secretary of State is making it a bit too partisan. Could we not return to what everyone across the House knows to be the serious problem—the quality of management and the broken franchising system? Will he get on to that?
The biggest problem is that we have not had enough new trains or enough investment. That is why it is right and proper that this Government are spending more than any since the steam age on improving the infrastructure, and why new trains are being introduced right across the country. There are new trains on the Great Western routes, on the east coast main line and in the north. Every single train in the north of England is being replaced or refurbished as new in a transition programme of a type that has not been seen for decades and decades. That is what the railway really needs.
And, indeed, there are new trains on South Western Railway. The problem is that the new trains are designed to have the doors opened by the driver. South Western Railway has guaranteed to schedule two members of staff—continuing to have a guard—on every train, so it now comes down to the ridiculous argument of which of them opens the doors. I remember when we used to be allowed to open the doors ourselves.
My right hon. Friend is absolutely right; it is a completely pointless strike. This is what frustrates me. I normally have a good relationship with the shadow Secretary of State, but it frustrates me that he will not stand up and say to the unions, “Why will you not stop this action?” We have been very clear that on South Western Railway, the second member of staff is staying on the train. On Southern, there are more members of staff working on trains today than there were before the industrial dispute started, so why on earth is the dispute carrying on? It is wrong. Why cannot everyone one in this House say, “Just get back to work”?
I will take two more interventions, and then I will make some progress.
The Secretary of State may not actually be able to answer my question at the moment, but the Minister may be able to later. Could he give us an indication as to how much investment there will be in new infrastructure and new railway carriages between 2010 and 2020? How does it compare with the kind of investment that took place between 1997 and 2010?
I cannot give the exact numbers, but we are investing tens of billions of pounds in the railways over the period that my right hon. Friend mentioned. Crucially, the private sector that the Labour party seems to dislike so much is investing billions of pounds in those new trains. The new trains that are arriving in all parts of the network right now are being funded not by the Government, but by the private sector This is the key flaw in Labour’s arguments. Actually, if we get rid of the private sector in the rail network, there will not be any new trains, because this is about billions of pounds that is coming from elsewhere. That money comes otherwise from the Treasury—it has to compete with money for schools and hospitals. Through the public-private organisations that work side by side in our railways, we are delivering a huge infrastructure investment programme and, at the same time, a transformation of our rolling stock. That is what is necessary.
I will take one more intervention and then make some progress.
It is an interesting concept that the travelling public have got a good deal that is paid for by the private train operating companies. I just checked what it would cost me if I left the House of Commons and went to Durham now. It would cost me £153 standard class—or £236 first class, but of course we are not allowed to do that. A similar journey at the same time of day from Frankfurt to Munich in Germany would cost £39 and tuppence. How is it that our travelling public are getting a good deal from this fragmented privatised system?
In this country, under Governments of both persuasions, we have taken decisions about the right balance between the cost of the railways being borne by those who use the railways and those who do not. Yes, the hon. Gentleman may be quoting walk -up fares, but he can go and buy an advance ticket for the east coast route at a fraction of the cost that he described.
rose—
I am going to make some progress now, I am afraid, because the shadow Secretary of State asked a variety of questions about the east coast main line and I want to respond The reality is that sometimes the private companies get it wrong. The situation on the east coast franchise is a clear example. Virgin and Stagecoach overbid, and they are paying, and will pay, the price. I repeat—they will pay the price I have listened with interest to some of the ill-informed comments about the situation on the east coast line in the past few weeks. I have heard some absurd claims from people who do not understand what they are talking about. So let me explain to the House what the position is. I am not agreeing to early termination of a contract in 2020; no one has asked me to. This railway is paying a huge premium to the taxpayer and continues to do so, but the issue is that this franchise is not delivering the profits the operator expected and is at risk of not making it as far as 2020.
Will the Secretary of State give way?
No—forgive me, but I am going to explain this in detail Passenger numbers are rising on this railway; customer satisfaction is up; and the line is generating a healthy and growing operating surplus that is providing a much greater return to the taxpayer than when it was in the public sector. It is also worth saying that it is running more services and employing more staff. The money that the franchise pays to the Government is today 20% higher than it was under public ownership. But Virgin and Stagecoach got their numbers wrong. They have been losing money steadily, and have now lost the best part of £200 million in the past three years. Despite that, I am holding them to their full financial obligations, taking every last penny of the £165 million guarantee that we insisted on when they took on the franchise.
rose—
I am going to finish this point, and then I will take the hon. Gentleman’s intervention, if that is okay That is a huge sum of money for a British business with a market capitalisation of under £1 billion pounds. It is also one of the biggest bonds of its kind ever provided in the rail industry. But despite Labour’s claims, this is not a bail-out. There is no viable legal mechanism through which I can extract any more money from the company. My Department is preparing contingency plans as we do not believe that the franchise will be financially viable through to 2020. I clearly have a duty to do that for passengers. When we reach a conclusion that works, I will come back to this House and make a statement. However, I do plan to go ahead with the east coast partnership, as I indicated in my statement a month ago. People in this country do not understand the separation of track and train, and as part of our reforms we are bringing the two together, as Sir Roy McNulty recommended in his report. I now give way to the hon. Gentleman.
I am grateful to the Secretary of State. Can he make this clear? He is talking about the parent company guarantee, which will be paid. What about the premium payments from 2020 to 2023, which amount to £2 billion? Is the company going to pay those premiums, or not?
As I have just said, we are currently not convinced that the franchise will make it as far as 2020, so we will put in place alternative arrangements. The hon. Gentleman was clearly not listening to what I was saying. However, this railway will continue to deliver a substantial operating surplus—a premium to the taxpayer—whatever the situation. Whatever happens, this railway will continue to deliver large sums of money to the taxpayer.
If I heard the Secretary of State correctly, he was confirming the article in The Sunday Times saying that the full contract, as it was let, was not legally enforceable. If that is the case, will he confirm it, and will he explain to the House why he agreed a contract that was not legally enforceable? If it is not true, why will he not demand the full £2 billion?
The hon. Gentleman has not understood the finances of the rail industry. The money that the taxpayer receives from the operating profit—the taxpayer receives the lion’s share—will continue to flow into the public coffers whatever happens. The contract that was let between Virgin-Stagecoach and the Government will be fully enforced—I repeat, it will be fully enforced—and I make the absolute commitment to the House that that will happen I will now make further progress. We have heard this afternoon, more explicitly than we have previously heard it, that the Opposition’s policy is to return to the days of British Rail. There is somehow the idea that this will bring nirvana, but it actually only takes a moment’s thought to realise how flawed their thinking is, assuming they have done any the first place Our network suffers from three main problems. First, the infrastructure, which is already run in the public sector—Labour Members forget that—is often old and unreliable. About two thirds of the problems on our rail network result from issues with the publicly run infrastructure. This is not about who runs it and who owns it, but about investment in the infrastructure. That is why I am pleased to have just announced a further £20 billion renewal programme for infrastructure—concentrating on replacing older points, signals and the rest, and upgrading systems—so that we have a more reliable railway. That is the first problem, and the first solution The second issue is that the system is heavily congested. It would not matter who was running the railway, because routes into places such as London Waterloo or Manchester Piccadilly would still be full. What those stations and routes need is longer trains, and that is why the private sector, supported by the Government, is now investing in longer trains all around the country—in Manchester, all around London, in the west country and in the west midlands. That is the next priority. Probably the biggest renewal of rolling stock in modern times is taking place at the moment, and it is certainly by far the biggest in Europe. That is what is necessary. Someone on an eight-coach train that is full in the morning needs a 10-coach train, and that is what we are delivering. It is also why we are expanding capacity routes such as Thameslink, which will make a huge difference through central London, and why we have opened the Ordsall Chord in Manchester, which will provide linkage across the city and create extra capacity on trans-Pennine routes Thirdly, the system is organisationally too fragmented—too many people debating with each other, rather than solving problems for passengers—which is why our strategy is to bring back together the day-to-day operation of the track and the trains. Those are the three challenges facing the network today, and they are why passengers are often frustrated. We are working to address those problems with solutions and investment. That is the right strategy for the rail network, and shifting around the organisation, renationalisation and the rest of it will not solve those problems. Let us concentrate on the things that will make the difference for passengers, not on moving the deckchairs, as Labour Members seem to want to do.
Will the Secretary of State update the House on his discussions with the Welsh Government about devolving responsibility for the franchise in Wales? We are halfway through the bidding process, which the Welsh Government are conducting, yet powers over the franchise remain in Westminster, despite the British Government’s promises to hand them over.
That is simply untrue. The re-letting of the Wales and the borders franchise is being handled entirely by the Welsh Government. The interesting question is whether they are actually going to be able to deliver on their promises to electrify the Cardiff valley lines, the infrastructure of which I have given them as well. They have been given the opportunity to create an integrated metro railway for Cardiff, and I will be interested to see whether they can deliver what they have promised. They have control over the Wales and the borders franchise. The only power I have retained is to make sure that we look after the interests of people on the English side of the border. I am afraid the hon. Gentleman is just not right.
Has the Secretary of State seen, as he has mentioned this area, the proposals made by Professor Mark Barry for an electrified Swansea metro, which, through straightening the line, would reduce by half the time it takes to travel from Cardiff to Swansea? Implementing those proposals would provide the electrification David Cameron promised, an integrated Swansea metro and a shorter journey time.
I have not seen those proposals, but I say to the hon. Gentleman that I think it more likely than not that we will see on the Welsh valley lines and the Cardiff metro lines the same approach that I have taken in south Wales—using hybrid technology rather than electrification. That is what I think will be done.
Dirty diesel.
From a sedentary position, the hon. Gentleman talks about dirty diesel. What we are now seeing is the arrival of new technologies that will transform the way our railways work. We will soon see hydrogen trains. The new generation of trains—hybrid trains—is much cleaner than its predecessors. New technology is giving us extra versatility Many Members want to speak, so I shall conclude. Today, I am afraid that we have heard from Labour Members a position based on sand. They want lower fare rises, but will not tell us how those will be paid for because their numbers do not add up. The irony is that in London, where Labour is in power, the fares are going up by more than fares in the rest of the country. By contrast, we are addressing the real problems on the rail network. We are providing the investment that the railways need Somebody mentioned disruptions over Christmas. Yes, I know passengers had a disrupted time. The reason for that is that we are spending billions of pounds across the country. At some point, the work has to be done. Those people who walk into London Bridge station in the mornings, as well as those people up in the north-west where improvements are happening and people elsewhere across the country, will now see new facilities—broader facilities, expanded facilities—that will make a real difference to passengers.
The Secretary of State is quite right that technology and investment will make a huge difference. Will he confirm that modern digital signalling will allow the railway to run many more trains an hour safely on the same piece of track, which could be the cheapest and best way to deal with the bottlenecks?
My right hon. Friend is absolutely right. We are already seeing that Thameslink is going to use digital signalling in a way that has never happened before in this country. We will use digital signalling in the improvements on the trans-Pennine route and elsewhere. This Government are investing in the railway. This party believes in the railways. It understands the need to expand capacity on the railways We have not done enough for much too long. In the years since privatisation, passenger numbers have grown and grown after the years of decline in the days of British Rail. So the pressures have increased, as have the challenge and the need to invest. That is why we are spending billions of pounds on the infrastructure, building stations such as London Bridge, building routes such as Crossrail and replacing every single train in the north of England. It is why we are acting in a way that, during 13 years in power, the Labour party never did.
Order. Before I call the Scottish National party spokesman, I should say that it will be obvious that a great many Members wish to speak and that we have limited time. It should be noted that a great many Members intervened on the two Front-Bench speakers. The Members concerned were generous with their time, but hon. Members, who may all now sit down, must take responsibility for the time that their interventions take up, which is noted by the Chair. Therefore, we will have an initial time limit of four minutes per speaker, but I do not anticipate everyone who has indicated to me that they wish to speak having an opportunity to do so because there simply is not enough time.
A belated happy new year to you, Madam Deputy Speaker. I also welcome the new Ministers to the Front Bench and pay tribute to the work done by the previous Minister, the right hon. Member for South Holland and The Deepings (Mr Hayes). He certainly knew how to conduct himself at the Dispatch Box, and perhaps the Secretary of State should be thinking about how he conducts himself. He said that the hon. Member for Middlesbrough (Andy McDonald) spoke for 25 minutes just talking rubbish, but he then spent 18 minutes just union bashing before getting on to any substantive point. Let me be probably the first in the Chamber today to congratulate Virgin on its recent decision to stop selling the Daily Mail on the west coast route. I am sure that many Members will agree when I say that I hope other outlets follow suit. That is probably the last compliment I will pay Virgin, but I want to commend the hard work of its staff. I encounter them fairly regularly on the west coast route and I can certainly testify to their professionalism and hard work The motion covers rail franchising in general and the bail-out of Virgin East Coast in particular. It is fair to say that there are opposite views across the Chamber on the merits of privatisation and franchising—we have already seen that in this debate—but one thing I am really confident about is that the Transport Secretary wrongly connects cause and effect when it comes to the privatisation of the railway. It can be argued, and has been, that British Rail was struggling, with poor rolling stock that was outdated, but that is only half the picture. Any under-investment in British Rail and rolling stock was due to Government constraints. Passenger numbers were affected by the recession, in terms of both affordability and commuters having jobs to travel to. Spending power for investment was further hampered by the safety-critical upgrades required following the 1988 Clapham rail crash, and upgrades needed to service the Channel tunnel links—yet another example of investment in the south-east of England to the detriment of the rest of the United Kingdom The response of John Major’s Government to the problems in British Rail was to privatise and sell it off, but they did that at such a pace that there was no co-ordinated or strategic approach. History shows that that rushed privatisation gave us Railtrack, which eventually went bust and was replaced by Network Rail. If ever there was a demonstration that infrastructure is best owned and managed by the public sector, to avoid profit being put before safety, that is the prime example. I do not pretend that Network Rail is operating as efficiently as possible, but it certainly does not put profit before safety The franchise approach to privatisation gave us a model in which the countries of Great Britain were the only ones to have completely divested themselves of any public stake in passenger rail operations. Given the problems since then, that appears to be another clear example of the UK leading the world, but leading it down completely the wrong path. What rail privatisation gave us was a complex model—stuck doggedly to by the Tories and the Blair and Brown Governments—of charging, interactions, private companies requiring large profits, and ticketing arrangements, and a way for companies and the network owner to play a game of blaming each other for problems The problems are aptly summed up in the report on the southern rail franchise just published by the National Audit Office, the main conclusion of which is that it cannot be demonstrated that the franchise has delivered value for money. The operator blames Network Rail and the unions. The Government blame the unions, as we heard again today from the Secretary of State, but completely ignore the part they played. The bottom line is that 60% of cancellations were due to Govia Thameslink and 40% due to Network Rail. It was the UK Government who set up the model that was supposed to align with the complex infrastructure upgrades; it was the UK Government who took the revenue risks, which means that strikes cost the taxpayer money; and it was the UK Government who awarded the franchise based on even further roll-out of driver-only operation; so the initial unwillingness on the part of the UK Government and Transport Secretaries to get involved is shameful The NAO also makes it quite clear that the Department for Transport had a large responsibility, especially in relation to access to the network and timetabling pressures. I am concerned that the DFT’s lack of understanding of pressures arising from upgrades and timetabling will have an impact on the west coast franchise and HS2 awards. Is that the reason why the invitation to tender for the west coast franchise, which was due in November 2017, still has not been issued and we do not know when it will happen Other franchise issues include the failed award of the west coast franchise in 2012. I am sure that, had Virgin Trains won that franchise in 2012, it would happily have taken it rather than threaten court action. As we have already heard, the case led to direct awards. According to a Library briefing, 12 of 16 franchises have now been subject to direct award. Further failures by the Department for Transport give us the worst of both worlds—there is no competition, and short-term awards provide no incentive for long-term investment, yet the companies are still guaranteed a profit. That is a poor set-up.
According to the House of Commons Library briefing, the direct award for the west coast franchise mentions a commitment to work to remodel Carstairs junction, which is seen as significant bottleneck in the network. Anyone who has travelled on the line knows that time spent at Carstairs is often time that could be shaved off a journey, therefore making rail more attractive. Does my hon. Friend agree that the Government should increase investment to remove bottlenecks such as Carstairs junction?
I agree with my hon. Friend. Carstairs junction could be a major blockage for HS2, as well as the other operation, so I hope that the Minister was listening to her intervention and will explain why, if the remodelling was a part of the direct award, it has not happened yet.
The hon. Gentleman decries the lack of competition from direct awards, so have he and his party considered the report of 18 months ago from the Competition and Markets Authority calling for more on-track competition within franchises as an alternative to the increasing allocation of monopolies through franchising?
I am not against competition per se. There is certainly lots of information about models that are deemed to work better than others. One aspect of competition is that the public sector should be allowed to make its own bids for operating franchises. A bit of competition might help to drive innovation, but in no way should the public sector be barred from the process We then have the Virgin Trains East Coast shambles on the east coast line. The Transport Secretary stood at the Dispatch Box again to say that there was no bail- out. When he responded to me during proceedings on the statement, he claimed that the parent company guarantees would protect the taxpayer, but we now have confirmation that franchise fees were backloaded, meaning that Virgin was able to walk away without paying the £2 billion premium track fees it was supposed to pay. That was confirmed at the Dispatch Box. He said, “It’s okay, we’re going to get the £165 million parent company guarantee,” but that is considerably less than the £2 billion premium fees the taxpayer would otherwise have received, so the argument is nonsense. To say that the franchise might have failed is no excuse. It is testament, again, to the failed model currently being operated by this UK Government. The very fact that Stagecoach’s shares went up after we heard news of the new model proposed by the Transport Secretary tells us who is walking away with the best deal from the new arrangements The east coast main line gives us proof that public ownership can work. When the previous franchise failed, it was successfully run as a public operation that paid over £1 billion in track rental fees to the taxpayer and returned a nominal profit of £42 million from the overall operation. The large private companies would not suffer a £42 million profit, because they would think it too little, but it would be welcome for the public sector and could drive further investment. Another failing of the franchise model is that it only allows big companies to operate, and they chase massive profits, at the behest of their shareholders The public-private alliance model proposed by the Transport Secretary might in theory be an improvement but, again, it is bonkers not to revert to the working model under the public franchise. The new model will still contain risk in terms of multi-layer operations and interactions, and even the timetabling to get it in place, as was outlined by the hon. Member for Middlesbrough.
One of these new models is the Oxford to Cambridge line, in respect of which the Transport Secretary has said he is happy to devolve power to a private company. Does my hon. Friend therefore find it strange that the right hon. Gentleman would not be willing to devolve an operation such as Network Rail to Scotland, where we could make a real difference for the travelling public?
I agree with my hon. Friend and I was going to come to that point later. I cannot understand the UK Government’s intransigence over devolving Network Rail, which it is anticipated would save the taxpayer £30 million and increase accountability to the Scottish Government I have touched on some of the causes of the demise of British Rail. Since privatisation, passenger numbers and investment have increased, but again we need to go back to cause and effect, because that was not a direct consequence of privatisation. It has been possible to lever in private investment, but that is recouped through passenger fares and public subsidy—that is the bottom line. When the Government allowed private investment to come in, they decided to be a bit bolder in specifying increased services, new rolling stock and other improvements for the franchises. However, that same ambition could be replicated either under nationalisation or by allowing public sector investment, rather than everything being levered in through private investment. Following privatisation, there was also an upturn in the economy, so a range of factors actually contributed to better passenger experience and increased numbers. The Transport Secretary really needs to move away from his “private equals good; public equals bad and inefficient” mentality, but I fear that today there are no signs of that changing In its 1997 manifesto, Labour reneged on its commitment to renationalising the rail system, but it at least commissioned the McNulty review in 2009 to identify better value for money in the railway franchise system. Incredibly, the Tory Government sat on that report for six years before coming up with modest proposals to vertically align the infrastructure and passenger operations in an alliance model Alliances can be made to work, or at least to work better than they do under the current franchise system. The ScotRail-Abellio alliance is the only franchise that stipulates that all staff must be paid the real living wage. It also guarantees trade union representation at every franchise board meeting, no compulsory redundancies and 100 new apprentices. Rather than making staff’s terms and conditions a mechanism for greater profit, the Scottish Government have incorporated protecting them into the contract. On passenger experience, there will be new rolling stock, 23% more carriages, a new approach to cycling interaction, and a drive to expand tourism. Those aims, ambitions and protections contrast directly with the attitude of the Secretary of State and the Tory’s southern rail franchise That is not to say that there were not teething problems with the new Abellio alliance, but it is now the best performing large franchise in the UK. Even so, the Scottish Government are putting in place measures to allow a public sector procurement bid to be submitted either at the end of the franchise or at the mid-point, where there is a possible break. The success of CalMac ferries in competing in the private sector shows how this can be achieved As we heard in the intervention made by my hon. Friend the Member for Inverness, Nairn, Badenoch and Strathspey (Drew Hendry), if responsibility for Network Rail was devolved to Scotland, with the body under the control of the Scottish Government, the operation of rail services in Scotland would be much more efficient, and there would be much more accountability. That would give us a better way to move forward.
On the devolution of Network Rail, does the hon. Gentleman accept that power over devolved franchises has already been devolved? Enhanced capability was devolved in May 2016 whereby public sector bids could be brought forward for ScotRail. That was known well in advance of the current tender. Is it not the case that ScotRail could have been in public hands today if the Scottish Government had delayed that tender?
A small history lesson: it was the UK Labour Government who refused to hand these powers over to Scotland. They had the chance to do so in 2000 and 2005. Since the Scottish National party Government came to power in 2007, they have written to three Transport Secretaries to ask for the powers to be devolved to Scotland, and three times that has been refused. The shortlist for the ScotRail-Abellio tender process was drawn up in November 2013, so the initial invitation to tender came way before that. The contract was awarded in October 2014—a year and a half before the new powers came into play. It is absolutely ridiculous to say that the Scottish Government could have sat on their hands and waited for future powers that might not have come. They did come, the Scottish Government will use them in the future, and they are preparing that public sector bid, so I thank the hon. Gentleman for that intervention.
Does my hon. Friend agree that the experience from our casework is that Network Rail is not an accountable body at all? When we try to raise constituency cases, or make complaints about works on the line or things that it wants to do, it is very difficult to get any answers from it, because it just does not want to consult. It just wants to do things and pays lip service to community engagement.
It is certainly a big problem. Network Rail is too big. The fact that it is effectively accountable to two Governments, but ultimately to the UK Government, causes further problems The Labour party is calling for full-scale renationalisation. I am certainly not against that—there is clear merit to keeping all moneys within the public purse—but I have concerns about the model proposed in its manifesto, in that the result might be something that is too large to be fully accountable, which touches on my hon. Friend’s intervention. Labour’s proposed model shows that it believes that the railway can be nationalised within the EU single market, given the EU firewall proposed between rail access and the network/operations side of the business, so the argument that we cannot be in the single market and have national railways clearly falls, as the Labour party itself recognises. We do know that nationalisation works, given how many state-owned railway companies current operate in the UK, and of course they are doing so under EU rules. The Tory anti-nationalisation attitude is therefore clearly utter nonsense The Library briefing on rail structures suggests there is no agreed best model operating in the world, but it does give some excellent examples of variations in models. What is clear is that public sector involvement or state-owned franchise companies can work. The UK has a franchise model that has not worked effectively, and a change of thinking is undoubtedly required.
Order. There is now a limit of four minutes on Back-Bench speeches.
We have rightly heard from the Secretary of State that there is record investment in the railways and a record number of passengers, yet Opposition Members are here to criticise the running of the railways. I am sure we will hear many tales of woe from Opposition Back Benchers, but the reality is very different. There are problems, and we have heard from my right hon. Friend about the Virgin Trains East Coast situation, which is not desirable, but of course, to some extent Virgin predicated its income projections on improvements to be made by Network Rail, and of course Network Rail, being a nationalised organisation, usually delivers late and over budget. The Secretary of State was somewhat critical of Virgin, and it clearly should have taken note of the fact that Network Rail failed to deliver on the promises made on the west coast route some years ago, so there is some legitimate blame on both sides Regrettably, I am old enough to remember the days of British Rail, a failed nationalised monolith and a watchword for failure. Until 1992 there were direct train services to my constituency, but British Rail cut them, and the new Minister, whom I welcome to his place, will be hearing a lot from me about the need for through services to Grimsby and Cleethorpes The Government support the rail network to an enormous extent. Many of the figures cited in an article in the 13 October edition of Rail magazine were repeated in The Times last week, including that £925 million was invested by the private sector in the rail network in 2016-17. The shadow Secretary of State failed to identify how any Labour proposal would bring forth that money. The reality is that cuts are made under all Governments and usually the first thing that goes is capital infrastructure expenditure. There is no way that a renationalised network under a Labour Government would be able to raise the approaching £1 billion that the private sector is currently investing.
What does the hon. Gentleman think the state-owned German rail company that owns a substantial chunk of our franchises does with the profit it makes here in our privatised system? It invests that profit in its own system, through subsidised fares there. That seems ludicrous to me and most of the travelling public.
Perhaps they are a little more free-market and capitalist-minded over in Germany At present, competition is for the franchise; what we want is more competition in the running of services, and one way we can achieve that is through open access operators. Hull Trains and Grand Central both run on the east coast main line and provide services to areas that in the main do not get a service from the main franchise holder. Indeed, I understand that Grand Central will shortly put forward a proposal for direct trains from King’s Cross through to Scunthorpe, Grimsby and Cleethorpes. I hope that the Minister will be supportive of that, because it would be a great boost to the local economy.
My hon. Friend has mentioned open access, and I agree with the points he is making. Does he agree that open access tends to produce a higher satisfaction rate among passengers and rail users?
My hon. Friend is absolutely right. Hull Trains and Grand Central both get very high satisfaction ratings The House should take note of last year’s Transport Committee report on rail franchising. It states: “Open access has been a success, albeit on a limited scale to date. The balance of evidence points to potential benefits in open access having an expanded role on long distance routes.” It goes on to state: “Reforms are needed if open access is to be expanded on the network. We recommend that the Department and the ORR work together, as they develop the financial framework for the railways over Control Period 6”. I hope that the new Minister will make it one of his priorities to look more closely into introducing open access operations on to the railway, in order to provide genuine competition and to improve services, particularly on those routes that are struggling at the moment.
Will the hon. Gentleman give way?
I will not take any more interventions; it would be unfair to others Reference has been made to fare increases. It is a fair point that there has to be a balance involving what the taxpayer is prepared to put into the network. I gather that the net contribution from the taxpayer for the last financial year was £4.2 billion. That is not an insignificant amount. While mentioning fares, may I be critical of the rail operators? Tickets are often not checked, and barriers at stations often do not operate. That is something that urgently needs to be looked at.
No other nation in the world runs its railways like the UK has done since the flawed and ideological fragmentation and privatisation carried out by the Major Government in the mid-1990s, and there is a reason for that: it just does not work very well. In particular, it has not worked on the east coast main line. Since rail privatisation, of the three private operators of that franchise, one has gone bust, one has defaulted on the contract and one has been allowed to avoid payments of hundreds of millions of pounds—possibly up to £2 billion—that it undertook to pay to the taxpayer This latest and grossest private franchising failure is a capitulation by the Transport Secretary to Virgin Trains’ demand to be let off the consequences of its overbidding to get the contract. The Transport Secretary has done this in an effort to prevent the embarrassing spectacle of another very public failure in the private operation of InterCity East Coast. This follows his predecessor’s ideologically motivated decision to strip Directly Operated Railways of the operation of the east coast main line mere weeks ahead of the 2015 general election. In doing this, the Transport Secretary has simply given in to the self-interested and costly demands of the train operating company The only east coast operator that has not gone bust, defaulted or received a bail-out from the taxpayer was East Coast Main Line, a wholly-owned subsidiary of Directly Operated Railways—itself a company wholly owned by the Government—which was established by Lord Adonis when he was Transport Secretary in 2009. In other words, it was a publicly owned company. It took over when National Express defaulted, and it ran the line very successfully. Its record is clear and stands in stark contrast to what has happened before and since. It made all its required service payments, returning more than £1 billion to the Treasury. It invested all its profits straight back into services, paying out zero dividends to greedy private owners—because it did not have any—and it achieved some of the best results on the east coast of any operator since records began.
On my hon. Friend’s point about the east coast main line, because of the ideological decision by the Government, profits of £1 billion going back to the Treasury have been forgone. At the same time, we are allowing a private franchise not to pay £2.1 billion to retain its franchise. Does she agree that it is economic madness to retain that service in the private sector?
My hon. Friend is correct. Money is clearly no object in trying to avoid the embarrassment of yet another failure of the franchise in the hands of a private operator. Why did the coalition Government decide to re-privatise the operation? The date is a clue, as it happened just weeks ahead of the 2015 general election. The decision was cynical, ideologically motivated and costly to the public purse Our policy at that time was clear. We wanted to keep East Coast in public hands to act as a public sector comparator to the private franchises. We wanted to keep the operational expertise in Directly Operated Railways to enable us gradually to take the operation of the railways back into public ownership as franchises ended without having to pay enormous amounts to buy out contracts. Just changing the order of franchise competitions to enable that re-privatisation cost the public purse hundreds of millions of pounds. Indeed, the consequences of that lamentable decision are being seen today in the ongoing chaos and waste of money that the franchising system is inflicting on our railways—now spectacularly reinforced by the Transport Secretary’s capitulation to the financial interests of the private train operating companies on the east coast main line The Transport Secretary is effectively institutionalising massive taxpayer bail-outs, which he has renamed “partnerships”, and I predict that this will not be the last such bail-out. He is effectively institutionalising giving in to the tendency that the private companies have shown over the years of gaming the franchising system to keep taxpayer subsidies while avoiding making the payments that they are contracted to make. Virgin-Stagecoach is not the first train operating company to do that and it will not be the last. The system delivers lucrative near-monopoly rail contracts on the basis of post-dated payment promises by private companies that can simply be abandoned when they become due, with no penalty attached for behaving badly The Government are now institutionalising the reality that the private companies take the profits but the taxpayer provides almost all the investment in trains, track and infrastructure and covers any losses. That is the very definition of a licence to print money. Private train bosses are simply laughing all the way to the bank, and this Secretary of State, for ideological reasons, is allowing them to do so. We cannot go on like this. It is time that this costly and failing system was ended. It has not worked, and it will not work in the future. We need to ensure that we do things better.
Thank you, Madam Deputy Speaker, for calling me to speak in this debate. It is a pleasure to follow the hon. Member for Garston and Halewood (Maria Eagle) despite my not agreeing with what she had to say. The cost of an annual ticket from Colchester to London is now £5,104 and I am in no doubt that that is a huge amount of money for my constituents. However, despite what is claimed by the Opposition, including the hon. Lady, the fares are not lining the pockets of rail companies. For every £1 spent on fares, 97p goes on the running and improvement of our railways. However, when our constituents pay such amounts to travel to work they need to see value for money To be fair, passengers on Abellio, which runs the service to Colchester, will see real benefits from the new franchise. Over 1,000 brand-new carriages are coming into service from next year, at a cost of over £1 billion—I assume that that is another £1 billion that Labour would borrow. There will be free wi-fi for all passengers at stations and on trains. Season ticket holders and those who buy their tickets in advance will benefit from automatic Delay Repay. All those things will make a massive difference, and I have only one ask for the Department. The new 15-minute threshold for Delay Repay was announced after Abellio was awarded the franchise, so as things stand it is likely that it will not be introduced until a new franchise is awarded in 2025. My constituents, Abellio and I would like to see that implemented earlier, so I ask the Department and the new Minister, my hon. Friend the Member for Orpington (Joseph Johnson), whom I welcome to his place, to see whether they can make it happen as soon as possible However, I will not stand here and pretend that the current franchising system is perfect. We still have issues with competition and with the number of companies coming forward.
On competition, my hon. Friend may remember a Transport Committee report in which we found that the same big companies were bidding and that there was not enough competition.
I have served on the Transport Committee with my hon. Friend for two years. He is right that, in the invitation to tender for our most recent franchise on the Great Eastern main line, the three companies that put in a bid were Abellio, the existing franchise holder; National Express, which had had the franchise taken away when it was given to Abellio; and FirstGroup, which had had the franchise taken away when it was given to National Express. He is right that we need to encourage more bids Large franchises mean that multimillion-pound bonds are put up by companies that are looking to run the services, and there is a lot of risk even for large companies. We should consider creating smaller franchises that carry less risk, thereby attracting more interest and more bids, delivering more competition and, ultimately, better value for taxpayers’ money.
Would allowing councils, local authorities and other public bodies to bid for franchises not be a good way of ensuring more competition, and competition that people can control?
The honest answer is most likely not, but I agree that we need more competition. I agree with my hon. Friend the Member for Bexhill and Battle (Huw Merriman) that we need more open access.
My hon. Friend is making a fine point. I welcome more competition, and I would welcome the involvement of groups from the charitable and non-profit sectors. The idea that the public sector should underwrite risk with taxpayers’ money is what we are moving away from.
My hon. Friend makes an eloquent point.
Will the hon. Gentleman give way?
I am sorry, but time is limited and I have taken enough interventions My hon. Friend the Member for Bexhill and Battle is right that we need to consider more open access in which two or more companies operate on the same franchise, where the line can support it. I appreciate that many lines cannot support such open access, and the Great Eastern main line is a prime example of where it would be very difficult. Where we do have open access, operators tend to have higher satisfaction ratings, which proves that competition can offer benefits for passengers Ticketing is another thing that could be improved. I would like season tickets to take inspiration from the fare capping on the London underground. Buying an annual ticket, as opposed to a monthly ticket, offers a substantial discount. If a person’s employer does not offer a season ticket loan, it can be difficult for them to afford a one-off payment of often thousands of pounds—in the case of Colchester to London, about £5,000. Passengers should not pay less just because they can afford such a large amount in one go, so I urge the Government to look into capping season ticket travel on new franchises so that passengers will never pay more than the cost of an annual ticket in a single year. That would instantly save commuters hundreds of pounds, and it would be made easier by the implementation of smart ticketing, which we are seeing rolled out across franchises Our rail network has undergone an extraordinary transformation since privatisation. Passenger journeys, down a third between 1960 and 1995, have doubled. We have one of the safest railway networks in Europe. The focus must now be on doubling down on competition and value for money as part of the franchising process, and not on taking away all competition and returning to the days of British Rail. I encourage the Government to set a 40-year vision to transform our railway, rather than listening to the Opposition’s plans for returning our railway to the state last seen 40 years ago.
It has been quite a week for the Transport Secretary, but even by his standards this debate might qualify as a low point. My constituents listening to this debate will be absolutely astonished to hear the rosy picture he painted. For most of my constituents in Wigan it is not so much a daily commute as a daily struggle to get on trains that are older than I am and that are often late, overcrowded, dirty and cold, for which they are rewarded by seeing their fares go up every year The human cost is enormous. I am contacted every week by constituents who are tired, stressed, anxious about money or seriously considering giving up their job because they do not know how many more bedtimes, bath times or story times with their kids they can miss. We are failing in one of the basic functions of the state, which is to provide a decent public transport service. There is a much wider cost in towns like mine.
We have head from Ministers that higher fares will fund improved services. I come from Manchester, the city that had the first railway station, yet we find that the stations and railways in my constituency are in desperate need of investment. Levenshulme station is one of those. It has been hit by consistent flooding over the holidays, and lights in the station did not work for days, posing a real danger to passenger safety. In the 21st century, the station still does not have disability access. Ultimately, the passengers, who are paying higher fares—
Order. I have tried to let the hon. Gentleman make his point, but he has now made a longer speech in that intervention than most people who are sitting here will get to make in the next half an hour, because we are going to have very tight time limits. Many Members have made very long interventions, which means some others will not get to speak at all. If hon. Members want to be fair, they know how to do so.
My hon. Friend is right, because in a town like mine, which is typical of many around the country, people commute into nearby cities for work—Manchester is my nearby city, so I am familiar with it. Two thirds of my constituents commute out of the borough for work every day. For our town, the economic interest is enormous, because when they return to Wigan they spend in our local shops and businesses, sustaining our high streets and our local pubs. He will know as well as I do that towns across this country are ageing. The Centre for Towns research we launched last year showed that towns lost 25 million people under the age of 25 over the past 30 years, so public transport is the artery that keeps the heart beating in towns like mine. It has always been thus—towns such as Manchester and Birmingham grew and thrived because of the development of the railways, which enabled them to trade with one another. So how is it that 200 years later a report from the Institute for Public Policy Research finds that it takes longer to get from Liverpool to Hull than it does to get from London to Paris I will give the Minister one example of why these decisions, which are being made hundreds of miles away from the people who are affected, are broken. In 2015, the Department for Transport awarded the northern rail franchise to Arriva and, as part of that deal, which we were told would give us a better service, the decision was taken to axe the direct service from Southport through Wigan and into Manchester Piccadilly. Two thirds of people who commute from Wigan to Manchester commute to the south side of the city, but they were breezily told by their Government that instead they could commute into the north side of the city and arrive at work mid-morning. If they had been consulted at all, they would have told the Secretary of State why that was a problem. It has taken five MPs from three political parties two years of hard work to try to persuade the Government to sort this out, and we still have not managed to resolve it. No wonder four and a half times more people commute by train in London as a proportion of the population than in my region of the north-west. Decisions are made hundreds of miles away from the people who are affected, with no understanding and no thought given to the reality of their daily lives. I say to the Minister, who is not paying attention at the moment, that he will soon have to pay attention because the level of anger that this is creating across the country is immense The data analyst Tom Forth pointed out recently that for a scheme to be funded in Leeds, it needs to provide twice the return on investment of a scheme in London. How can that be sustainable? I just say this to the Minister: if we had been given the power to make these decisions for ourselves, we would have made very different decisions in recent years. We would have prioritised local services and connecting up our great regional cities before we started investing in High Speed 2. We would never have got into a situation where we were faced with losing the guard on the train. I will tell him what that will do: it will make our railways no-go areas for many people, including women late at night, people with disabilities and older people, who make up the bulk of my constituents We would talk far more about buses. In my constituency, it is now often cheaper for a family to get a taxi than a bus—how is that sustainable? The Secretary of State was very fond a few years ago of the phrase “take back control”. If he means anything at all by his word, he will give us back control, because we could hardly do worse than this Government.
Order. Following on from what I said a few moments ago, I now have to reduce the time limit to three minutes.
It is a great pleasure to follow the hon. Member for Wigan (Lisa Nandy) This morning, on my daily commute to this place—I am one of the few people who are fortunate enough to be able to commute here from East Sussex—I walked through London Bridge station, which has caused me and many of my constituents enormous difficulties because it has been rebuilt and its tracks reconstructed. It now looks absolutely fantastic and is a shining example of the £40 billion investment that the Government have put into the railways and the difference that that has made I wish to talk up our railways and their success. Let us remember that since 1997, under the current Administration and the previous Labour Administration, the number of passengers on our railways has doubled. The rail system now largely pays for itself; it does not need the £2 billion a year taxpayer subsidy that British Rail took to not run things properly. When we compare our rail system to those in Europe, we see that we have the second safest railway after Ireland; that we have the second best-performing railway in terms of passenger feedback, second only to Finland; that we use our rail system over 60% more than the European average; and that we have put more investment into our railways than any other EU country. We should talk up the rail system’s success, because not only is there all that, but it employs 250,000 people, releases about £11 billion of costs that would otherwise go on congestion charging, reduces carbon dioxide emissions by 8.4 million tonnes, and adds £10 billion to our gross value added. So we should all talk about the success of our rail story Of course, though, there are challenges. We have certainly seen challenges with the Southern network. We have really suffered with strikes and a poorly performing operator, and that has been laid bare today. Nevertheless, we should not forget that the unionisation of the rail network has caused enormous problems. It should be well remembered that the same train drivers who have now pledged to drive the trains that they said were not safe have taken a 28.5% pay rise. That is a much greater pay rise than the passengers who are paying for their rail tickets each year got. All Members need to recognise that costs such as that result in our passengers paying more and more Let us give something back to the passengers. At the moment, Network Rail has to compensate rail operators for any delays it causes. Only a third of the passengers who experience those same delays claim their compensation, so train operators are keeping the money. I want the train operators to be required to bank that money.
Is my hon. Friend making the point that I suspect he is going to make about automatic Delay Repay being included in future franchise agreements?
I am indeed; I thank my hon. Friend for helping me to finish my sentence. The rail operators should be required to bank that money and put it in a pot so that it can be spent only on new technology for trains. That technology would mean that everybody would be required to tap in and out of their train journey, and if by the time they got to their destination they were more than 15 or 30 minutes late, they could have the compensation credited to their bank account when they tapped out. In this day and age, there is no need for passengers to go through the timely, costly and bureaucratic exercise of claiming, which is why they currently do not claim. I have introduced a private Member’s Bill, which I hope will be given its Second Reading at the end of March, and I would like the Minister to get behind it. I believe that the technology does exist and that, with more will, the train operators could put it in place. That would give more back to the passenger It is all well and good to talk about the public good, and I recognise a lot of Network Rail’s good work, but it has also been responsible for a large proportion of the delays for which the train operators have taken the flack. It is time to do more than just stick with what we have; we should make all the track the responsibility of the train operators. We should also question whether some stations should be transferred out of Network Rail’s control.
In the short time I have, I wish first to pay tribute to all the staff who work on this country’s railways. They do an excellent job of getting our trains moving under difficult circumstances. I also pay tribute to the work of the shadow Secretary of State, my hon. Friend the Member for Middlesbrough (Andy McDonald), who over the past few weeks has been standing up and making the case for the British public, who deserve a better service than they have been getting. I agree with one thing the Secretary of State said—I, too, pay tribute to the former Minister, the right hon. Member for South Holland and The Deepings (Mr Hayes), who has now left the Department. He understood the value of trade unions. He was one of the few Conservative Ministers who would regularly meet the unions, because he understood that by working together, management and workforce, we can provide a better service I want to make two points. The first is that, since the botched privatisation of the 1990s—it was a privatisation too far—we have lost the important transport integration that we once had in this country. I was born and raised, and still live, in the port and railway town of Holyhead. The ferries used to be full of people coming across to our country and going to continental Europe. They would get a train, bus or another means of transport. That has now been broken by the franchise agreement. Each mode of transport now operates in a silo, and we need to get that integration back I believe in the private sector, the public sector and, indeed, the not-for-profit sector having a stake in British industry and in our British transport system. I wish to make the case to the Minister, whom I welcome to his place, for the not-for-profit sector. In Wales, our water is run by the not-for-profit sector, which meets all the criteria of the European Union and provides an excellent service. It invests its profits back into the company, and customers get a better service from it than they do from many of the private, ideologically run ones in England. There is therefore a model that works, and it is the not-for-profit one. The sector values its customers and its workforce, it makes money and it reinvests its profits During the passage of the Wales Act 2017, which was before Parliament in 2016, I and other Members asked for the Railways Act 1993 to be changed so that Wales could have a not-for-profit company for its franchise. That would have worked, but the Government resisted it. I say to the Minister that at this late hour, he should look again at the 1993 Act and allow Wales to run its affairs in a way that is good for customers, good for its communities and good for growth across the country. If the Government are serious about spreading wealth, they need to improve their rail systems and fix the broken franchise system.
It is a pleasure to be called in this debate. We have talked about express trains, and I will now have to do quite an express speech Over the past couple of hours, I have been interested to hear the arguments being made. I must say that I do not agree that the answer to this clarion call to fix our transport network is to bring back British Rail. It is easy to look back at the past through rose-tinted spectacles. It is like those who say that they love the idea of steam trains running up and down the main lines. Yes, it is beautiful to see the Torbay Express go through, but as a practical modern transport system we have clearly moved on. As has been touched on, the one thing that some people miss, if they think the public sector is the instant solution, is that Network Rail is in the public sector. Having sat on the Public Accounts Committee at a time when the handling of the Great Western modernisation programme was under scrutiny, I can safely say that that was nothing near a success—in fact, it was almost a textbook example of how not to manage a project. What people are interested in is the services that they get. Personally, as an MP, my priority is: what do my customers get; what do my residents get; and what services are there? It is not necessarily whether the system is publicly or privately run Looking at the future franchises, I am conscious that a consultation is under way about whether the Great Western franchise should be split—I can see the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) in his place—and whether our section should split away from the section that serves south Wales. When that was first proposed, I made the point that actually, the current franchise is similar to the old Great Western Railway company area—with some exceptions on the edges. Perhaps that raises some questions about franchises. Yes, it is good to have smaller franchises, as that makes services more local, but by the same token there also has to be a sustainable franchise to maintain the services of a large railway and the main rolling stock More locally, there are some key projects that I hope any franchise will look at taking forward. It has to start with £600,000 to fund the study of the main line through Devon. Those who know the network will know that there is only one railway line west of Exeter St Davids, which makes it particularly vulnerable at Dawlish, so we need to consider a long-term solution. Not only major schemes but schemes to improve the line and to cut journey times would be of benefit both to my constituents and to those further west. Any franchise could also look at cross-country lines, but it must be clear that it must maintain some of the direct routes from key areas for the Bay, such as from Manchester and the southern midlands directly into Paignton and Torquay. I was pleased that some of the changes were blocked by a previous rail Minister, and I hope that that will continue to be the case For me, the debate must ultimately be about the outcome for passengers. It is great to sit here and talk about whether the rail service should be public or private, but, actually, ownership is not the key; it is what it delivers that makes the difference to people living in our constituencies.
It is blindingly obvious to many of our constituents that the current model of rail franchising and profiteering from our railways is broken, inefficient, fragmented and unjustifiably expensive. Our private railways are subsidised by more than £5 billion of public money every year—and that is before the bail-out of Stagecoach-Virgin East Coast and the missing £2 billion. It is no wonder it is being called the great train robbery British passengers pay the highest fares in Europe to travel on sometimes packed services while rail companies are laughing all the way to the bank. Since 2010, fares have risen three times faster than wages, and the 3.6% increase last week was the steepest hike in five years. Conservative Ministers said that higher fares would fund improved services, yet long-promised investment, including rail electrification, has been scrapped I want to focus on the current dispute at Merseyrail, where 207 guards may be scrapped. I have had an Adjournment debate on this topic, and I will not repeat all the answers I was given in the short time available today. Against the backdrop of police cuts and rising crime, the role of the guard in Merseyside is more important than ever. The Merseyside travelling public have supported the retention of guards throughout the dispute, amidst grave concerns about passenger safety. Is it fair that Merseyside passengers should pay fares that Merseyrail’s owner, Abellio, uses to pay for Dutch public railways, but do not enjoy the same safety standards as passengers on Dutch railways The franchising system fails to allow for good industrial relations. Train operating companies have little interest beyond the term of their franchise agreements, effectively buying a licence to print money. Changes to staffing are strategic decisions that should be considered many years in advance with the agreement of staff and their trade unions, but that is never the case. The antagonistic strategy adopted by the Government has had an adverse impact on passengers. It is high time that we had a Labour Government willing to bring our railways back into democratic public ownership. The Merseyrail dispute is not going to disappear. Reluctantly or not, the Government and regional and local politicians will have to engage further if we are to get our railways moving again in 2018. I say to Merseyrail’s owners, Abellio and Serco, that they should not do deals on Merseyside that they think they can hide in their corporate offices.
I am grateful for the opportunity to speak in this debate. I have only three minutes, so I will go as quickly as possible I am a new Member in the House, and regrettably I come to these debates and I hear the same stale and artificial arguments by Opposition Members. That has happened again today: we immediately reach a position where private is bad and public is good. That argument is totally stale and artificial, as the hon. Member for Liverpool, Walton (Dan Carden) has just demonstrated for the past three minutes or so The hon. Member for Huddersfield (Mr Sheerman), who is no longer in the Chamber, said that the discussion had become entirely partisan very early on. I think that the partisanship of the discussion was demonstrated when the motion was tabled, critiquing franchising in both concept and totality. That is the ultimate problem, because the Labour party seeks to take some examples, which I acknowledge and accept are not good, from around the country, and extrapolate from them to say that there is a systemic problem forever with rail, which means that it needs to be changed The evidence from the system is that more people are travelling than ever before. We have 60 years of post-war history on the rail network. For 40 of those years the network was in public ownership and for 20 it was in private sector ownership. Much of those 40 years was uneconomic—the railways lost an incredible amount of money and the number of passengers who travelled on them reduced by a third.
rose—
No, I will not give way to the hon. Gentleman In the past 20 years, 13 of which Opposition Members stood up to defend and were under a Labour Government, there has been an increase in the number of passengers using the railway, more trains than ever and greater customer satisfaction about many parts of the line I want to make two points in the time I have left. Given that today is an Opposition day, I looked at an Opposition day debate in 1994, in which the former right hon. Member for Holborn and St Pancras, who was shadow Secretary of State for Transport, spoke. He said that privatisation would not get the necessary investment, secure the safety of the railway network or upgrade the lines. In the past 20 years, that has been shown to be wrong The franchise that serves my constituency, East Midlands Trains, is an example of one that works well. It is not perfect by any means, but in the past few years, it has worked well. Transport Focus says that it is performing well, especially on punctuality and reliability. In surveys, customer satisfaction is nearly 90%.
Does my hon. Friend recognise that the highly subsidised European models get much lower satisfaction rates? All they do is transfer the burden from the passenger to the entire taxpayer population. What we have in the United Kingdom is not perfect—no system is—but at least the people who use the service pay for it.
My hon. Friend is absolutely right. Time after time, I sit in the Chamber and listen to Opposition Members who really do not understand economics and where the money comes from, and do not get how we can pay for the railways and all the sweeties and goodies that they seek to give out If we consider the Midland Mainline franchise in 1996, a couple of years after franchising occurred, there were 14 trains a day between London and Sheffield and the average journey time was two hours and 26 minutes, with the fastest journeys taking two hours and 10 minutes. We now have more than double the number of trains on the midland main line between London and Sheffield and the average time is quicker than the fastest time was 20 years ago I do not want to claim that everything is perfect. Many things could be better about the midland main line and East Midlands Trains, but what I have heard today from the Opposition is, as the Secretary of State said, complete nonsense. We should recognise that much progress has been made in the past 20 years. There is much to do, but I will not sit here and listen to the sort of nonsense that has been expressed.
Like my hon. Friend the Member for Wigan (Lisa Nandy), I want to concentrate on my constituents’ concerns about their daily struggle to get to work, which is so unlike the rosy picture that the Secretary of State painted. They just want reliable services and affordable fares, which is not happening under the Government’s failed transport policy Key rail routes run through my constituency. Many people commute to Cardiff or Bristol and beyond. There has been remarkable passenger growth at stations such as Severn Tunnel Junction, where usage has risen by 297% in the last 20 years. Transport links to Bristol, one of the fastest growing economies outside London, are crucial for access to employment. The Government acknowledged that in the industrial strategy, which talked about better links between Wales and England However, the services to Bristol and beyond have for some years been plagued by reliability problems and chronic overcrowding. Commuters are completely frustrated. The Severn Tunnel Action Group, a fantastic local rail group, along with Magor Action Group on Rail, forensically survey commuters. They showed that, on half the commuting days at the end of last year, there was standing room only for those getting on at Severn Tunnel Junction, and on many days, only three carriages were available, not five. They also catalogued the delays and cancellations. Commuters, whose fares have gone up by 33% since 2010, feed back the daily occurrences of overcrowding: people being left on the platform, people fainting on the train and people being asked to stand in the toilets so that more people can get on At the same time, the Government announced last year that they would extend the Great Western franchise to March 2020 and maybe longer. Yes, we are getting electrification, but what was in the announcement that gave anyone faith that things would get better? As my hon. Friend the Member for Bridgend (Mrs Moon) said, Great Western got the extension without any conditions. The Government are rewarding the company without any notion of things getting better for my constituents. Where the Government have had an opportunity to help, they have not There is currently a process for the Wales and borders franchise, which is devolved. But the Government said to the Welsh Government in the agency document last year that “for the purposes of this franchise competition, no cross-border paths to Bristol may be proposed.” This is a missed opportunity, when the Welsh Government are planning bold infrastructure projects such as the South Wales metro, which will improve connectivity. The UK Government’s approach could not be in starker contrast to the Welsh Labour Government’s A constituent who complained about services to Bristol was told recently by Great Western, “That’s just how it is nowadays.” No, it should not be. The privatised rail system is not delivering, services are getting worse and fares are going up. We need the Government and rail companies to address these problems now and to take rail back into public ownership when the rail franchises expire.
Bearing in mind the strictures of the hon. Member for North East Derbyshire (Lee Rowley), I will try not to be too stale in my three minutes. We have heard a lot about the implications of the potential loss of £2 billion in premium payments following the premature ending of the east coast franchise. We have not yet heard what will happen to the promises made by Mr Branson and Mr Souter for improvements in the later years of those franchises. Are we still going to see—from Bradford, Middlesbrough and Lincoln—the two-hourly trains that were promised under those franchises? Are we going to see the direct train from Sunderland and the continuing increase in the number of trains from London King’s Cross There is now uncertainty over not just this franchise, but the trans-Pennine franchise in the north of England. There is lots of speculation that the operator will try to renegotiate because it promised £300 million to the Government for a service that was previously subsidised. Is it going to continue to do that? Following the remarks of my hon. Friend the Member for Garston and Halewood (Maria Eagle), I think that the idea of a public sector comparator is, quite frankly, common sense. Why cannot there be a public sector comparator? I think that there was a golden age—under a Conservative Government, mostly—between 2009 and 2015 on the east coast, when the dominant provider was a public service provider In reaction to some comments from the hon. Member for Cleethorpes (Martin Vickers), I do believe in open access at the margin. Open access only provides about 1% of services. I do not see why that could not continue under a system where the major franchises were in the public sector. No dominant provider—in the public or private sector—is likely to look at the needs of small towns such as Selby, which is served by Hull Trains, Eaglescliffe and Hartlepool. Morpeth is soon to be served by an open access operator. I hope that we would not neglect that under a Labour Government Northern Rail is owned by the German state, and I call on the Government to start talks. We can get a solution to the strikes that are affecting my constituents for three days this week. There is a simple solution in Scotland: the driver opens the door, and the guard closes the door and maintains safety. A solution can be reached, and the Government have a responsibility to try to reach it My final point is that we are still reasonably close to the Christmas season, which has just passed. I urge Ministers next year to fulfil the promises they made while in opposition on Boxing day trains. Fifty-eight hours is too long to close down the network. In opposition, the Conservatives said that they would do something. Trans-Pennine has made proposals that it will run trains to Manchester airport on Boxing day 2018; Northern Rail would provide 60 services. Ministers need to act.
I would like to engage the House on the question whether franchising works. My local radio station, BBC Radio Cambridgeshire, will next week be celebrating 25 years since this country started on the journey from British Rail to anything but British rail. I remember it rather well because I went to a Railtrack meeting at the time and asked what I thought was a naive question: “Who is going to sort out the problems of who is responsible when things go wrong?” We might think now that people would have thought about that point then, but it is still being argued about 25 years on When I talk to people in the industry, they tell me about the small army of people who spend their time not helping passengers or improving the railways, but arguing over who is responsible for paying when things go wrong. Of course, there are so many opportunities to game the system. There are so many ways in which operators can make their trains just not quite late enough to incur any penalties I made a bit of a social gaffe at a dinner recently. I was sitting next to someone from a train operating company and asked the rather unfortunate question. “What exactly is the point in train operating companies?” I wondered, like most people would, “You don’t own any trains; you don’t own any tracks, so what do you do?” They said, “Ah—we sell tickets and we innovate.” That explained it—“Kind of like ticket touts, then?” I suspect I am not going to be invited back for a follow-up. That is the problem with many of these people. It is a very complicated system My hon. Friends have already raised some of the issues on two of the routes that serve my city of Cambridge. I am grateful for the piece in The Sunday Times that was mentioned, where we learned a bit more about the East Anglia franchise—its £3.7 billion price tag. The managing director was right to describe it as “scary”. That was negotiated in and around the time of the referendum in 2016, and, amazingly, renegotiated very hurriedly in the days afterwards—completely out of public sight, as usual, and all shrouded in commercial confidentiality. Within six months, the company had sold a 40% stake of itself to a Japanese company. Does any of this matter? I think it does. These are our public services being bought and sold, speculated on and turned into financial instruments, when what we actually need is an environmentally sustainable, cost-effective, reliable, sensible transport system that people in my constituency can afford With regard to the other route, I am afraid that a National Audit Office report revealed, as has been eloquently explained by some of my hon. Friends, the appalling levels of service that constituents of mine are suffering. Many of them are paying almost £5,000 a year for a season ticket—a huge amount for the many young people in my constituency to have to bear In conclusion, I say to the train operating companies: take a look at the station clock. Tick TOC, your time is up—just like mine.
The subject of this Opposition day debate clearly highlights how this Government are not running the nation’s vital transport infrastructure in the interests of the many. We have heard how the franchise model is failing the east coast mainline. The taxpayer bail-out of the franchise by the Government is yet more evidence that our railways would be better off under public ownership. Let us not forget that the east coast main line franchise returned over £1 billion to the Treasury and was the best-performing operator on the network when it was in public hands. It seems that this Government are happy to reward failing companies for mismanaging our railways. This is not the only way that this Government are failing to deliver on transport policy, as the north of England has had a raw deal from central Government with regard to transport spending. Planned central Government spending per head of population on transport infrastructure for the next four years is £726 for Yorkshire and the Humber, versus £1,083 for London and the south-east. Meanwhile, money is frittered away on filling the pockets of private companies—money that would be better spent modernising the ageing infrastructure that is holding back places like my home city of Bradford. What is more, my constituents also have the pain of the 3.4% increase in fares this year, with average fares rising more than three times faster than wages—a slap in the face, and in the pocket, on top of years of insult from unfair underinvestment These figures are not acceptable, and have far-reaching consequences for the economy of the north of England and for the prosperity of my constituents. It is Whitehall’s failure to recognise that point that so enrages me. The north gets trees planted along the M62 while London gets Crossrail—hardly fair. An independent study of the north’s untapped potential set out how new investment, including High Speed 3, could unlock up to £97 billion and create 850,000 new jobs by 2050, with a stop in Bradford bringing in an annual boost of £53 million to the local economy and at least £1.3 billion for the whole region. The party of government made a manifesto promise about electrification of the trans-Pennine rail route ahead of the 2015 general election, but we are still waiting A radical rethink is needed from this Government to end the failed franchise model, to bring our railways back into public ownership and to invest properly in transport in the north of England. We in Bradford will not be fooled, satisfied or fobbed off with crumbs from the table.
In his speech, the Secretary of State said: “Let us concentrate on the things that will make the difference for passengers”. Today’s National Audit Office report says, among many other damning things, that “it is not clear whether the Department considered the…effects of its approach on passenger services.” There have been warm words, but no action The National Audit Office report is damning. It reveals that the Thameslink Southern and Great Northern franchise has failed to deliver value for money. Over the past three years, Croydon commuters have suffered the worst service performance on the national rail network. There have been more than double the number of delays and cancellations than the national average, and the service has the lowest satisfaction rate for any rail operator, yet fares have risen twice as fast as salaries In the time available, I want to point out two particular scandals to which my constituents have been subjected by the Department for Transport and Govia Thameslink Railway. The first is the design of the franchise and the vicious circle of low investment and declining performance that it threatens. Govia Thameslink’s management contract hands a guaranteed £1 billion per year to the operator, while the taxpayer shoulders the risk of ticket sale revenues. We were promised a £3.5 billion profit from this huge franchise, but instead the loss to the public purse was over £90 million last year. The hon. Member for North East Derbyshire (Lee Rowley)—he insulted us all, and then left—claimed that we do not understand economics, but there is no economic sense in that model The abysmal performance suffered by commuters in Croydon and the inflation-busting rises meant that passenger numbers dropped last year for the first time since the franchise was created. Passengers now pick up 70% of the rail network’s costs, meaning that if passengers continue to turn away from these shoddy, overpriced services, less money will be available to invest in desperately needed upgrades. That will lead to the cycle of lower investment and higher prices that we are already seeing Network Rail needs £1 billion to make Govia’s network fit for purpose. We must alter the track and sort out the Windmill Bridge junction in Croydon to stop the service from collapsing in the future. The Government claim—the Secretary of State pointed to this—that the £300 million put in place last year will go towards improving the network, but will the Minister confirm how much of that taxpayers’ money will actually go back to the coffers of Govia Thameslink in the form of fines for infrastructure failures My second point—I will make it briefly—is that while the Government have been shown what works, they refuse to act. The TfL-controlled London Overground has been turned from one of the country’s worst rail services into one of its best. What is more, the independent Gibb report, commissioned by the Secretary of State himself, recommended that Southern services, including some from Croydon, should be transferred to TfL as soon as possible. We need action, not just warm words.
Travelling by rail has always been something I enjoyed. My dad was a railwayman, and when I was nine, my family travelled to Italy by train, which was pretty exotic in the 1960s. Since being elected as the MP for Lincoln, I have had to use trains twice weekly, and it is often not a positive experience. I have to change trains at Newark North Gate, and I sometimes walk right across Newark to Newark Castle station, which can take up to half an hour Our rail network is currently unreliable. The trains are sometimes old and dirty, and the staff, who work hard, are demoralised. There is often a single coach from Newark to Lincoln, and it is usually absolutely packed, with no space for pushchairs, wheelchairs or cycles. It is an expensive way of travelling, and it does not persuade people who have a choice to do so to abandon their car, thereby making an environmentally sustainable travelling policy even harder to achieve As a result of the recent fiasco with the east coast main line, I, as an MP, as well as local businesses and Visit Lincoln, are worried that the six extra direct services we have been promised by Virgin Trains in 2019 may not happen in the end. Lincoln needs those services. My constituents need reliable, affordable trains, businesses need to attract customers and our tourist offer needs to keep on attracting visitors Lincoln has just got a brand new transport hub, of which we are very proud. It is my hope that Lincoln and the rest of this country will very soon get a Labour Government who will bring our railways back into public ownership so that we have the rail system we need and the kind of Government that this country deserves.
In the time available, I will confine my remarks to two key points. First, I ask the Minister not to split the Great Western franchise, but instead to focus his time and energy on investing in our train line. George Osborne, the former Chancellor, suggested a Devon and Cornwall franchise. That might have won headlines, but it won few supporters in the far south-west. Splitting Devon and Cornwall off from the Great Western franchise would condemn rail users in the far south-west to a second-class service. Labour and Conservative Members rightly oppose that appalling idea, but it seems that no lessons have been learned in the DFT. Instead of focusing on speed, resilience and affordability for the far south-west, we now have to defend yet another attempt to split our franchise. Splitting the west country services from those that go to Wales would reduce income for the south-west train line, risk investment and fragment our railways even further. I say to the Minister, who will shortly receive and consider responses from the consultation, “Please do not do this.” I welcome the Minister to his post, however, because I know that in the coming months he and I will speak an awful lot about trains, especially those around Dawlish. The priority for the Great Western franchise is investment, upgrades, resilience and faster journeys, not more fragmentation. The superb Peninsula Rail Task Force report—I encourage him to take it to bed to read if he has not yet done so—recommends investment in tracks, signalling, trains and timetabling from Penzance through Plymouth to Paddington. The full upgrade programme would cost £9 billion. Labour and the shadow Secretary of State, my hon. Friend the Member for Middlesbrough (Andy McDonald), have committed £2.5 billion from our infrastructure fund to upgrade the track, yet Ministers have not made any such investment or matched our pledge. It seems to voters in the far south-west that only Labour will invest in a long-term strategy for our railways I also recommend that the Minister reads the “Speed to the West” report, which follows the PRTF family of reports. It recommends cutting journey times between the far south-west and London from 3 hours 30 minutes from Plymouth to 2 hours 15 minutes. The first intervention on that, which would cost £600,000 and was mentioned by the hon. Member for Torbay (Kevin Foster), was, sadly, not funded by the Government before the deadline ran out at Christmas There is a last chance for the Minister to say that his Department will fund that £600,000. London receives billions of pounds for rail upgrades, but the far south-west was asking for just £600,000 and was ignored. Will he look at that again While there is cross-party support for rail investment in the far south-west, there is a sense in the west country that we are ignored by Ministers and this Government. The new trains that First has ordered for our route will come online this year. I welcome that investment, but I would be grateful if the Minister, in his new role, gave us the news that we want and the funding that we need for the train line in the far south-west.
In my constituency of Blaydon, as elsewhere in the north-east, the future of our railways is of great interest. We have our own experience in our region, with the example of a directly operated railway on the east coast main line. That service was taken under public control following the failure of two contracts in 2009. My constituents and others, including hon. Members in the Chamber, were out there campaigning to retain the east coast main line in public ownership. Not only have the trains provided a good service, but the company has returned £1 billion of premiums to the public purse. That is why it was, and still is, galling for so many people in the north-east that the franchise was re-privatised in 2015 on the basis that that represented “best value” for rail users and taxpayers No wonder so many of my constituents expressed disbelief at the Secretary of State again looking to tear up the contract and at the current franchisees—Stagecoach and Virgin, which are known to be struggling to make their anticipated profit—being allowed to walk away from their commitment to make payments worth more than £2 billion under the current contract. It is therefore hardly surprising that folk in the north-east are enthusiastic about Labour’s commitment to take back rail franchises as they expire. Rail franchising has proved ineffective and costly, encouraging bidders to submit over-optimistic and unrealistic bids. It is about time we looked at bringing rail back into public ownership so that we get the best possible value and the best possible service for passengers from their rail services I want to refer to the National Audit Office report that was published this morning and the Secretary of State’s response to it—blaming the trade unions. The Government set the contract terms and specifications for franchises. The Government say, “You don’t need a second guard on trains.” They bear responsibility for the problems in the rail industry and the industrial disputes that we face.
In my region, Abellio is running some trains with guards and some without. It is using its plans to introduce new trains in East Anglia as an excuse for threatening to remove guards’ ability to supervise the closing of the doors. I have a great fear that my constituents’ travel needs will be sacrificed on the altar of the rail operator’s intransigence. Abellio is quite capable of running brand new, safe and viable trains with guards who fully supervise the train, including by closing the doors. It can do that in Scotland and do it in the Netherlands The Conservatives say that our train operators are better than they would be if they were state owned, but many of our train operators are state owned—just not by this state. Dutch democratic decision takers believe that passengers in their country deserve rail services that involve guards ensuring the safe closure of doors, but here in England, Abellio is awarded a franchise that is based on the removal of that safety measure, and once the franchise is awarded, the Government claim that any disruption caused by industrial action is nothing to do with them. The franchising system reduces every decision to what the train operator can afford to do within the franchise it has agreed. I want a railway based on the best interests of passengers and of our country.
I have had to take the Beeching axe to my speech, but I will make a couple of points in the few minutes available to me I wanted to take up some of the points made by previous speakers, including the Secretary of State, with which I completely disagreed and which, frankly, were fake news. If we look at the evidence and compare train fares in the United Kingdom and European countries—their state operators own many of our franchises—the difference is stark. I do not accept that this is about particular fares in peak periods It is worth looking at the German-owned operators. Deutsche Bahn owns Northern Rail, which is the principal operator in my region. Some 42% of Deutsche Bahn’s revenue is made outside Germany, much of it here in the UK, but 93% of its investment is in the German railway, so the company is creating profits here to improve services back in Germany It is clear that regulated rail fares have risen by an average of 32% since 2010, which is three times faster than the average median wage has grown. The Secretary of State said that fares increased more rapidly, or to higher levels, under the previous Labour Government, but we have to factor in average wages. The Conservative policy of raising regulated fares by the retail prices index ensures above-inflation fare increases every year. Compare that with Labour’s stance as set out in the motion, which I support. We would peg fare rises to the consumer prices index, which would save the average season ticket holder £500 over the course of a year. That would affect everyone’s constituents. Indeed, the annual cost of a season ticket for one of the Prime Minister’s constituents travelling between Maidenhead and Paddington has risen by £732 since 2010 Passengers on our railways pay some of the highest fares in Europe for increasingly unreliable and crowded services, and that has been my experience. Passengers, our economy and our environment need affordable fares and reliable services, which I do not think the Tories’ policy is capable of delivering. Labour would take back our railways into public ownership as franchises expire and use the savings to cap fares, and we would upgrade and extend the rail network.
The debate has demonstrated that privatisation has led to a disastrous combination of service failure, disinvestment and profiteering from public subsidy. A particular absurdity of the Railways Act 1993 was that it banned any British public sector bids for franchises, but permitted overseas state-owned railway firms to bid. Hong Kong’s state railways will run Crossrail, the French state has stakes in the London Midland, Southeastern and Thameslink franchises, and Dutch state railways run the Greater Anglia and Scotrail franchises, having been awarded the latter contract, worth £6 billion, by the Scottish Government in October 2014. That came about after rail franchising powers were devolved to the Scottish Government in 2005. Labour, ASLEF, the Transport Salaried Staffs Association and the RMT trade unions appealed to the Scottish Government in October 2014 to delay the award of the new Scotrail franchise until the power to create a public sector bid was enabled by the passing of the Scotland Act 2016, which came into force in May that year and had been known about at the time of the franchise award. This practical measure to accelerate the return of a publicly owned and operated railway in Scotland was disregarded by the SNP, and as a result we are stuck with a railway in Scotland that will be owned by the Dutch state for another decade In the year since Abellio was awarded the franchise, fares have risen by over 12%, yet wages have increased by only 1.8%. Performance targets have been missed, many routes have been overcrowded, stops have been skipped—that has left passengers stranded—and customer satisfaction has not improved. All the while, Abellio sends its profits back to be invested in the Dutch railway network My constituency was once the centre of the British locomotive manufacturing industry. As a result of privatisation, British Rail’s world-class engineering and manufacturing divisions were sold off to foreign companies. They have subsequently been run down to the point where much of the UK’s rolling stock is imported from Europe or Japan, with virtually nothing exported from the UK. Other nations view their railways as a core part of their industrial and advanced manufacturing strategies. Restoring the public ownership of rail franchises would be an excellent first step towards a renaissance in the wider railway industry in Britain, the nation that gave railways to the world. I will be supporting the motion tonight.
Just before the summer recess, the Government announced they were abandoning plans for the electrification of the midland main line. A consultation on the new east midlands rail franchise announcement followed—a process that was rushed, chaotic and, as has recently come to light, a sham. Throughout the time when my constituents were feeding into the consultation process in good faith, much bigger plans were being put together behind the scenes, without consultation or even a whisper in Whitehall, under which Bedford train users will lose their peak-time east midlands service in May The announcement has hit my constituents hard. Many fear they will lose their jobs or have to give up work because the changes to the timetable will mean they cannot balance, or rearrange their lives around, their family commitments. Rail users nationwide have been betrayed by this Government, but Bedford commuters are taking a bigger hit than most. Bedford passengers are being forced into trains run by Govia Thameslink, which we learned today is the worst train operating company in the country. It is clear from the NAO report that the Government awarded the franchise to Govia in the full knowledge that disruption would be very likely. Bedford passengers have felt that disruption There is something fundamentally wrong with the franchising process. I expect the Transport Secretary to recommend to East Midlands Trains and Thameslink that Bedford rail users are entitled to reduced fares for their reduced services. Bedford is a growing commuter town, and the use of services is increasing year on year. It markets itself as an affordable place to live with a 36-minute commute to the capital. Over the last five years, the use of Bedford station has risen by 20%. The Government should be improving and increasing services, not reducing them, and I hope that the Transport Secretary will now commit to doing so and ensure that the new franchise includes a solution for peak-time trains to be reintroduced in Bedford.
Rail fares in this country are five times those in Europe as a proportion of wages. No wonder UK commuters are fed up with rising prices and worse services, and 76% of people now support renationalisation of the railways. The Government are in a minority position, running a railway for a few by the few. In my constituency, prices for off-peak fares have risen by 43% since Northern Rail took over the franchise just 18 months ago, hitting commuters, students and people who simply need to get to work When I asked Northern Rail why it had seen the need to raise prices by so much, it simply said, “Because we can.” This franchising model is a licence to print money and rip off commuters. My constituents tell me that they do not even want a seat on a train; all they want is to be able to stand up and not get pressure bruises, have their feet stood on or have to stand crammed with three other people in a stinking toilet space. Those are the sorts of journeys that constituents are suffering for an hour or more—we have the longest journey times in Europe—to get to work. The Minister might think it is funny, but will he ride a commuter train from my constituency to experience the service that my constituents face? I ask him to address that, because the Government do not seem to understand the needs of commuters—ordinary working people who need a decent train service at a time when our roads are congested and overcrowded There is no investment where it is needed. We get no answer from the Department for Transport on the Hope Valley capacity scheme, relating to journeys between Manchester and Sheffield—the most crowded and needed services. That small increased capacity scheme has sat there for 18 months. That is the record of this Government. They are failing commuters and the British people.
Fares, franchises and failure, all entwined: that is how my hon. Friends have summarised the issues that dominate passengers’ experience of the railways today. My hon. Friends the Members for Lincoln (Ms Lee), for Wigan (Lisa Nandy), for Newport East (Jessica Morden), for High Peak (Ruth George) and for Bedford (Mohammad Yasin) really brought to the fore the impact that this is having The rail sector is full of fantastic people, but it is distracted from its core function of providing passengers with affordable access to a fully integrated system—train and track, wheel and steel—that works across the entire network and enables seamless intermodal travel. While the Secretary of State is firmly at the faultline, defending a broken system that he has made far more centralist in its control than even Labour’s national rail service will be, it is passengers who have to straddle the cracks, continually having to pay, and pay again, for the basic purpose of going to work or having a day out with the family, and as we have heard, they pay for poor performance, as my hon. Friend the Member for Croydon Central (Sarah Jones) set out It is not just Labour Members who are increasingly highlighting the failure of the Government; the hon. Member for Cleethorpes (Martin Vickers) also spoke of problems with franchising. “Putting passengers at the heart of the rail service” should be the Government’s mantra, but sadly it is not. Research by Transport Focus, the official voice of the travelling public, found in the largest survey of its kind that failure on ticketing is the No. 1 issue for passengers. The issue is not only the 32% rise in fares since 2010—three times the rise in wages, as my hon. Friend the Member for Easington (Grahame Morris) said—the 3.4% increase on last year’s ticket prices and the 3.6% increase for season ticket holders; everyone believes that they are being diddled out of a fair price—and they are right. There is different pricing depending on which operator runs the service, what time a person logs on to book their ticket, and when and at what time of day their journey is When this is coupled with extortionate ticket price increases, passengers ask where their hard-earned cash is going—and it is a good question. Let me tell them: £725 million went straight into the pockets of shareholders. While Thomas might be under the Fat Controller’s orders, today passengers are most certainly under those of the fat cats. It is a great train robbery. Then there is the financial haemorrhage from multiple tiers of private subcontractors across the network, each taking their cut, and the exorbitant cost of leasing trains and the huge profits harvested there. Fragmentation brings additional costs, too. But this scandal pales into insignificance when passengers consider that when Richard Branson’s Virgin Group gets into a bit of a pickle, it goes cap in hand to the Secretary of State, and makes demands of him. Just look at how quickly the Secretary of State buckled on this—a point made eloquently by my hon. Friend the Member for Garston and Halewood (Maria Eagle), joined by my hon. Friends the Members for Gateshead (Ian Mearns), for Keighley (John Grogan), for Bradford South (Judith Cummins), for Blaydon (Liz Twist), and for Glasgow North East (Mr Sweeney) The Department for Transport, under the Secretary of State’s orders, set up a franchise on the east coast that would involve Network Rail in delivering infrastructure upgrades, but due to the Government’s failed control period 5 process and the scaling down of the infrastructure upgrades, Network Rail was unable to deliver. The Government did not even speak to Network Rail about this when touting for an operator who would rip the service out of public hands—which, by the way, put £1 billion into the Treasury, to be reinvested in public transport. No, they just blindly put out a contract that was undeliverable, and the Government need to understand that it is their responsibility; they let the franchise. VTEC said it could not reap the gains it was hoping to under the infrastructure improvements, and guess what it did? It went to the Government to put the pressure on and now has been let off £2 billion, and the Secretary of State will not come to the Dispatch Box to deny this fact. It is a complete and utter shambles, as are so many other services; we have heard today from my hon. Friends the Members for Cambridge (Daniel Zeichner) and for Plymouth, Sutton and Devonport (Luke Pollard) about the impact these services are having on their communities. So not only are the passengers paying for this now, but they are also having to prop up dodgy deals. And they are dodgy deals: we just need to look at the way these train operators are working their way through the system to get as much money as possible not just out of ticketing, but also by threatening to sue the Government and seeking compensation payments. It is a complete scandal The problems are clear: a failed, fragmented franchise system; private profits over passenger interest, with a resultant decline in patronage, as we are now seeing; and a Secretary of State who refuses to put the passengers’ interests at the heart of the railway. That is why Labour will introduce a new public railway owned by the public and working for the public. This is not about going back, as we will not revisit the models of railways past, but take us forward—and not just take our rail services forward, but our economy too Drawing on global best practice, Labour’s rail system will really be for the many and not the few—fares overhauled; smart ticketing; new lines opening; more capacity; more seats; more trains; embracing high-tech and digital rail; making space for freight and smart logistics; clean and green with electrification, not a return to dirty diesel; planning for the long term; and no more on-off, start-stop funding. The whole railway system will be working as one, with passengers and businesses knowing the deal and being at the heart of the deal, as my hon. Friend the Member for Ynys Môn (Albert Owen) has called for for Wales—and my hon. Friend the Member for Glasgow North East has said he does not want to see the fragmentation reintroduced now by the Scottish Government As my hon. Friends the Members for Liverpool, Walton (Dan Carden) and for Ipswich (Sandy Martin) said, we must make our railways safe, and we will make them safe and accessible by ending the scrapping of the guards—a resolve the trade unions are calling for today—so that disabled people can have their dignity restored in using rail, while women can feel safe on trains both day and night. This is the rail service that the British people are demanding, and it will take a Labour Government to deliver it Before I sit down, may I welcome the new Transport Minister to his place, and hope that he does not take to defending the indefensible in his new role, as he sought to in his previous role earlier this week? We have a transport crisis and we need this Government to do something about it or, better still, make way for a Government who will.
We have had a full and excellent debate on the important subject of rail franchising, and I thank the Members on both sides of the House who welcomed me to my new position. I pay tribute to my predecessor, my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes), who acquitted himself exceptionally well in this role over a considerable period of time A lot has been said in today’s cordial debate—it has certainly been a more pleasant debate for me to sit through than the urgent question on Monday—and I will endeavour to respond to as many of the points raised as possible, but let me start by recapping some of what has been achieved, initially by looking at privatisation in the round. The statistics are compelling: last year we published our rail spending commitments for 2019 to 2024, and we will be investing £48 billion in our railways, as well as investment from private sources My right hon. Friend the Member for Derbyshire Dales (Sir Patrick McLoughlin) asked for specific comparisons between investment from 1997 to 2010 and from 2010 to 2020. As we have repeatedly made clear, this Government are making the largest investment in our railways since the Victorian era, with £48 billion over the five years from 2019. Let me give the House an example of what that means in practice. We will have ordered 7,122 vehicles for the rolling stock fleet, compared with 5,720 in the period from 1997 to 2010. That should give Members a feel for the tangible and practical impact that the increased investment will have. It will mean improvements in punctuality and reliability for passengers, as well as supporting thousands of jobs in the supply chain and activity in the wider economy The privatisation of our railways has succeeded. Passenger journeys have more than doubled since 1995, and we have a claim to being the most improved railway in Europe, and the safest major railway, too. And all this is happening in what is not only one of the oldest railway networks in the world but one of the most intensively used. In fact, more people are travelling on our railways today than in any year since the 1920s, and on a smaller network. It is thanks to this success that we are investing £38 billion in Crossrail and HS2 in the period up to 2019, and £48 billion in the years to come.
The Minister has just said that the privatisation of our railways has succeeded. Will he tell us whether the Government will vote against the motion this evening?
Privatisation is succeeding, and we can see that in the increased numbers of passengers using the network. The motion speaks for itself, and hon. Members are welcome to—
rose—
I will give way to my hon. Friend.
I welcome the new Minister to his place, and I hope that he will be as successful in this job as he was in his last one—[Interruption.] He was very successful. As he is listing investments, I hope that he will not forget the £1 billion investment that we are making in the midland main line.
I certainly do welcome that investment in the midland main line. That is one of the many investments that we are making across the country, and it is part of the £38 billion that we are spending in the control period to 2019. As I said, a further £48 billion is yet to come. This will mean new stations and rejuvenated older ones Before Christmas, my right hon. Friend the Secretary of State set out a new approach to delivering rail services. It does not require the colossal reorganisations of the kind that nationalisation would entail. It will deliver the best of both worlds, keeping the benefits of privatisation while maintaining vital infrastructure in public hands and preparing our railway to meet the challenges of the future. Earlier in the debate, the Secretary of State addressed the recent accusations regarding the east coast franchise. It is wrong to describe this as a bail-out. When Virgin Trains East Coast was awarded the contract, it committed £165 million to support the business if it failed to perform as expected. As my right hon. Friend said, we will hold the company to that commitment in full. It has met all its commitments to the taxpayer so far and it is continuing to do so. Make no mistake: we will hold all guarantors, including Stagecoach, to those financial commitments We have been making significant progress with industry on the Secretary of State’s vision for the east coast partnership from 2020, and on plans to meet that commitment. We stand by that commitment in full. I was asked about a direct award to Virgin-Stagecoach, and I refer the House to the answer that the Secretary of State gave earlier. My Department is preparing contingency plans, as we do not believe that the Virgin Trains east coast franchise will be financially viable through to 2020. We intend to return to the House in due course, once those plans are in place Many hon. Members raised the issue of fares. These are at the heart of the massive investment that is going into the railways, and it is of course right that that investment should be derived not just from taxpayers’ money. Passengers benefit from the improvements that our investment programme is delivering, and it is right that they make a contribution towards it. On average, 97p in every pound that passengers pay—
claimed to move the closure (Standing Order No. 36). Question put forthwith, That the Question be now put Question agreed to. Main Question accordingly put. Question agreed to. Resolved, That this House believes that rail franchising is failing to provide adequate services for passengers or value for money for taxpayers; notes that regulated rail fares have risen by 32 per cent since 2010 while planned investment has been cancelled; opposes the recent bail-out of Virgin Rail Group East Coast; and calls on the Government to run passengers’ services under public sector operation.
On a point of order, Madam Deputy Speaker. The motion has been passed unanimously by the House, demonstrating that the rail franchising system has failed and that the railways should be run by the public sector. When can we expect a statement from the Secretary of State to outline his plans for implementing the will of the House?
The hon. Gentleman is quite right to say that the House has agreed to the motion. The Leader of the House has said that, following such occasions, the relevant Secretary of State will return to the House over the next few weeks to indicate what action the Government propose to take as a result of the motion being passed.
Thank you, Madam Deputy Speaker, for allowing the House the opportunity to consider the important issue of the academisation of primary schools in Cambridge. I will talk primarily about the necessity of both transparency and accountability in academy trusts and about the academisation process itself. The debate is timely, because just a few hours ago there was a meeting at St Philip’s C of E Aided Primary School in Romsey in my constituency to determine the school’s future after many months of uncertainty. It was local parents raising with me that process and the issues around it that caused me to take a particularly close interest in the case. The more I have seen of it and the more people I have spoken to, the more concerned I have become—hence the request for today’s debate I start by thanking those who brought the issue to my attention, who include not only local parents but the many people involved in local schools and the local educational system who have spoken to me over the past few weeks to explain the consequences of the process for the education system in my city and the surrounding area. I particularly thank Rachel Evans of the National Education Union, who has worked hard and carefully with parents and staff to try to achieve the best outcome for the school and the wider community Right at the outset, I want to say that I make no criticism of those involved locally, because I believe that they have all been doing their very best for the school, but it is the process they have been put through that causes me concern, and it should also trouble the Minister. Whatever one’s view of academies in general—I will come on to that—there must be something wrong with a process whereby parents, staff and the local community feel that they are just being informed about significant changes to a key local institution, but not involved in any meaningful way. They feel that it is being done to them, not with them. Schools are not businesses and are not privately owned—not yet, anyway. Schools are a key part of the fabric of our local communities, and we all know that they do better when they are a part of their community, with close parental involvement Although I am not an educationalist or an expert in this area, I was, like so many of us in Parliament, a school governor for many years. I was the chair of governors for a voluntary aided junior school in a rural market town for almost 10 years. I have known St Philip’s for a number of years, and it is a not a school that I would have had serious concerns about. It did experience a serious dip in results a couple of years ago and also had a problem when there was too long a delay in replacing an outgoing headteacher. That should interest the Minister, because he may want to reflect on why it takes so long to recruit good headteachers, particularly in high-cost areas such as Cambridgeshire—it is no easy task. But, as has been demonstrated by the swift recovery in results, the school clearly has a bright future, and I emphasise that point. I commend the many positive comments that parents made in their considered responses to the recent consultation, in which a strong view emerged that the school has improved dramatically. That leads to a frequently asked question: if the school is so improved, why the need for further change that might, in itself, be destabilising I do not criticise the interim executive board, which has been following its understanding of the procedure, but what a flawed procedure it is. Parents were informed by letter of a consultation in which the outcome was assumed to be academisation, and there was no sense of any alternatives being on offer. When parents rightly asked what say they had in any of this, the response was pretty much, “Yes, you can express an opinion, but this is what is going to happen.” Originally, only organisations in favour of academisation were invited to make presentations at today’s special meeting. Parents rightly protested, and I protested, and I am pleased to say that the IEB did invite people with differing views, including local councillors and a representative from my office. I do not know the outcome of the meeting, and I suspect parents do not know yet, either, but such protests should not have been needed for other views to be put. It still is not really clear what other options are being considered The apparently preferred option from the outset was joining the local diocesan multi-academy trust—the Diocese of Ely multi-academy trust, or DEMAT—but there is a question as to whether that is really the best way forward for a city school. Should the school be swallowed up by a sprawling organisation that covers a huge geographical area—I choose my words carefully, and I am sure the Minister understands what I am saying—and whose effectiveness by no means convinces everyone in the local area Also, what about the concerns of many in the school, which has a very diverse catchment, that a move to a diocesan trust poses real dilemmas? This is a voluntary aided not a voluntary controlled school, and parents are right to raise the distinction. It is notable that some who clearly express their Christian faith raise that very point. What consideration has been given to other, more local options—or, of course, the option, which the vast majority appear to want, that the school should be as it was before the dip, and is now, by staying with the local authority? To most people, the process did not seem to offer any of those choices, only a one-way path to academisation within one multi-academy trust What would the Minister say to a parent who says, as parents have said to me, “I don’t want my child taught by unqualified teachers”? That is one of the freedoms available to academies. How does that parent get a say and, more importantly, how do they influence the decision? What if we discover every parent in the school shares that view? How would they get the decision changed? The answer is not obvious. Maybe the Minister can enlighten us The St Philip’s saga illustrates a wider problem with academies and multi-academy trusts. They take public money but are not democratically accountable to their communities. We all know that local authorities are also too often flawed, but they are by definition accountable—people can vote them out and get rid of councillors. Academies in multi-academy trusts do not have to have local representation on their boards, either of parent governors, local councillors or staff representatives. Indeed, I am told by one so-called emerging local multi-academy trust that, when it sought to include local authority representation on its board, it was told by the Department for Education that it could not. Will the Minister confirm whether that is the case and, if it is, why locally elected representatives are so excluded? The processes followed by these trusts are far from transparent, which inevitably leaves communities anxious Some multi-academy trusts in my area—in fact most of them—have boards full of impressive management and business figures, and my area is fortunate to have such people available, but the boards are singularly lacking in people on the frontline: parents, teachers and school meal supervisors. They are the people who actually know what is going on I mischievously suggest that the Secretary of State for Environment, Food and Rural Affairs takes a look at some of these boards. He might observe that the “blob” is more resilient than he thought. For a truly depressing session, I can heartily recommend that he browses the array of websites promoting MATs in any area, but for today’s purposes I shall limit myself to discussing Cambridge. As he looks, he will come across an array of mission statements and management gobbledegook, much beloved of corporate consultancies and full of joyless jargon, such as “pursuit of excellence”, “uniting with a common purpose” and “an outstanding education for all children is at the heart of our vision”. I know they have to do it, as that is the nature of the system—I even have sympathy with the poor people having to sit down to draft this drivel—but it is nonsense and we all know it. It may give us a chuckle when we are watching “W1A”, but this is the real world and it is not honest Honesty in times of really tight budgets, not Silicon Valley-esque, vomit-inducing fluff, would say something like, “Trying to make ends meet and retain teachers for more than 18 months in a high-cost area through being part of an inspiring community that works together.” Some people, of course, are trying to do just that, but we have to read between the lines of the waffle to even discern a hint of it. Nowhere on those glossy, newly branded websites do we find what we might want to know: how many unqualified teachers are being employed? What changes have been made to the terms and conditions of those employed? What changes have been made as the school moves away from the national curriculum? Surely that is what should be up there in lights—the truth There is a further problem that the Cambridge experience has highlighted. The complex structures of MATs and academies make local accountability through the local media extremely difficult. They are of course overseen by the regional schools commissioners, another extraordinarily opaque structure, largely invisible to parents and the wider world; they have a slightly curious role, given that this Government abolished regions. Never mind; regional schools commissioners exist, but they are technically civil servants and so do not talk to the media. Schools going through this process are also reluctant to speak to the media, so it is not much of a surprise that few people in the local community have any idea what is going on. That might suit the Government’s purposes, but it is a rotten way to run public services in a democracy and it will come unstuck. It also raises the question: what are the Government so afraid the public might find out? In passing—this is rather topical—let me say that Cambridge people are suddenly waking up to the fact that, through these subterranean and opaque processes, Cambridge is to be the beneficiary of a new free school promoted by none other than Mr Toby Young. I think I can say with some confidence, given what the whole world now knows about him, that Cambridge will want none of that. Perhaps the Minister can also give us some guidance on how that can be stopped Why does all this matter? Because the system spends and allocates public money to educate children. Why should parents and communities not be able to simply and quickly ask questions and get answers? MATs are bound to release reports periodically, but they do not give the information that parents and local community members would like to see. As I have suggested, academies work to different rules from local authority-supported schools, so can we at least work out how this is going? I ask the Minister: how many unqualified teachers are there in each MAT in my constituency? How have terms and conditions changed, and what impact has that had on pupils’ education? I hope he will be able to answer, but if he cannot, why not, and who can? And why are parents and communities being kept in the dark Beyond those practical questions, there is the wider question of what schools are actually for. Of course, they are primarily there to educate children and to help them to fulfil their potential and flourish, equipping them with skills and knowledge for their lives. However, schools are more than that; they are also community hubs that bring people together, allowing neighbouring families to have conversations and facilitating community events, and they are spaces that people can access in times of need. We have seen recently the excellent work that schools have done in communities that have been stricken by the consequences of austerity and the underfunding of councils. A recent press article highlighted the support that a school in Southwark gave to local refugees, far beyond the call of duty So we need to stop seeing schools in a vacuum of exam obsession, blinkered by assessment and rote, and see them as environments for growth and local development. Proper local representation on academy boards would help to provide the longer-term vision needed for seeing through the development of a school beyond a single cohort, giving communities the means to hold schools accountable to the people they serve Furthermore, within the fragmented, opaque system I have described, there are costs as well. The emergence of multi-academy trusts has, of course, led to competition between trusts, which want to gather more schools into their organisations. Instead of organisations working collaboratively for the public good, we have trusts eyeing each other up, eager to pick up schools that may have had a blip—and it is even better if they have some financial reserves. Perhaps it should be like in football, with a transfer window so that schools can have some periods of the year when they do not have to fight off predators In my constituency, there are around eight different multi-academy trusts, all vying for increased growth. Each of those trusts will, to varying extents, have people working on marketing, management structures, brand development and logos, and they will be paying audit fees. As always, it is public money that is being spent. All this has resulted in a fragmented system of overlapping, opaque organisations that use the public purse in ways that no one understands locally It is all rather reminiscent of what happened to the national health service under the previous Conservative Government. I remember Frank Dobson having to come in and clear up the mess, and famously saying to competing NHS trusts that first and foremost they were all part of the NHS and that providing public healthcare needed to come first. Academy trusts need to be redirected to the purpose of education and the public good, not self-promotion As I have said, local education authorities were by no means perfect everywhere. Conservative-run Cambridgeshire certainly had and has its faults, but the professional support offered to schools was an important resource and should continue to be. I do not want to see a situation in which, by a process of attrition, it is no longer viable for such services to be available to schools I wish to draw my remarks to a close by looking forward. Fortunately, I think it is possible to adapt existing structures and improve local accountability and representation. By bringing a few of the trusts together, rebranding them as the education service and adding the voices of councillors, parent governors and trade union representatives, we could greatly improve the accountability of these organisations to the communities that fund them and that they should serve. In turn, we would increase transparency, which would rebuild public trust and embed our schools in their communities, instead of imposing new rules without consultation I must say that some of us saw all this coming, which is why in last year’s general election there was a different vision on offer—one that was much closer to the points I have just outlined. The Labour manifesto promised: “We will…oppose any attempt to force schools to become academies.” It also promised: “Labour will ensure that all schools are democratically accountable, including appropriate controls to see that they serve the public interest and their local communities.” In my view, those who work in our schools, send their children to them and support schools in their local areas are best placed to give insight into the ways that they should be run—a point that has been made frequently by the shadow Secretary of State for Education, my hon. Friend the Member for Ashton-under-Lyne (Angela Rayner). I can say with confidence that that view is shared by many of the people I spoke to in Cambridge in preparing for this debate I hope that the Minister will give some assurances to parents and staff at St Philip’s, and those at other schools in and around Cambridge who are likely to find themselves embroiled in similar discussions in coming months. There is a new Secretary of State for Education, so there is an opportunity for a new start and for working with communities, rather than against them Sadly, this has been a debate about structures, when in so many ways it would be much better if were talking about standards and what is needed to support, encourage and inspire teachers, who we know are the real key to higher standards. We should also be talking about how to pay those teachers sufficiently so that they can live in high-cost areas such as Cambridge, and so that they stay, rather than go, as happens all too often. I hope they will hear that the Minister has listened, and that the message from the Government will be, “We will work with you and help you to improve.” I hope the message is not that the only way is academisation by one route or another, because that is what it has felt like in Cambridge and, I fear, in many other places as well.
I congratulate the hon. Member for Cambridge (Daniel Zeichner) on securing this debate, which is timely as it allows me to outline why academies are an important element in the Government’s success and drive in raising standards in our schools. Today, there are 1.9 million more pupils in schools graded by Ofsted as good and outstanding than there were in 2010. Standards are rising in our secondary schools and in our primary schools. Teachers have more autonomy now to run their schools, and 154,000 more six-year-olds are reading more effectively as a consequence of not only the hard work of teachers but the reforms implemented by this Government. There are more young people taking double or triple science today: 91% are entered for those GCSEs today compared with 63% in 2010 We are a Government determined to raise academic standards right across the system in our schools. The reason why we are having this debate today and why the hon. Gentleman is raising these issues stems from the fact that Cambridgeshire County Council was concerned about standards at St Philip’s Primary School, which is why it issued a warning notice to the school. It is from that that we have the establishment of the interim executive board, which is now consulting parents about converting the school into an academy to be run by a multi-academy trust. There have been many hundreds of responses to the consultation process and it has extended the time for the process, so it does want to work with the local community and with parents. It wants to hear parental views. The overriding objective of the regional schools commissioner, this Government and Cambridgeshire County Council is to see standards improve in all our schools right across the country Since 2010, the number of schools benefiting from academy freedoms in this country has grown from 200, when the previous Labour Government left office, to more than 7,000. The system that academisation brings started under the previous Labour Government, and we have built on that process to give professionals the autonomy to run their schools free from political interference and to raise standards. We have now reached the point where 7,000 schools have that professional autonomy and that academy status More than a third of state-funded schools are now part of an academy trust. The multi-academy trust model is a powerful vehicle for improving school standards and raising academic standards by sharing, for example, financial back-office skills, facilities and teaching resources and partnering the best of our state-funded schools with schools that are struggling. Two thirds of our academies are converter academies. These are good schools that made the decision to become an academy, and many of them have established multi-academy trusts, helping other schools to improve. A further 2,000 schools have become academies with the support of a sponsor to help them to raise the quality of education that they are providing. Since 2014, the number of MATs has doubled. As of 1 January this year, 79% of all academies are in a multi-academy trust, with 62% of those academies in a MAT of five or more schools. Academies have been raising academic standards. More than 450,000 pupils now study in good or outstanding sponsored academies which were previously typically underperforming schools. Pupils in secondary converter academies are making more progress between the ages of 11 and 16 than pupils in other types of schools, and 90% of converter academies are rated as good or outstanding. For sponsored academies, since 2010, 65% of schools that were previously inadequate under local authority control are now rated good or outstanding since becoming a sponsored academy, where an inspection has taken place A good example of what academy sponsorship is able to achieve is the Harris Academy Battersea, which is the highest performing sponsored academy in England. In 2017, it registered a progress 8 score of 1.49, placing it within the top 1 % of all schools. The National Foundation for Educational Research reported that sponsored academies are significantly more likely to be rated as outstanding compared with similar local authority maintained schools. The professional autonomy of academy status leads to a more dynamic and responsive education system, giving head teachers the opportunity to make decisions based on the interests of their pupils and on local need, and it allows high-performing schools to spread that excellence across to other schools. The Government are determined to raised academic studies by encouraging evidence-based teaching, building on a knowledge-rich curriculum and by providing teachers and school leaders with the autonomy to drive school improvement.
I am grateful to the Minister for taking an intervention. He will know that there are other views about the success of these processes. I shall put to him again the essential point in my speech. If a school has recovered, its results are good and it is doing well, and if there is clearly strong support for it, as in this case, why would we want to destabilise it when there is strong support in the local community for it to stay as it is?
As I have said, in 2016, Cambridgeshire County Council issued the school with a warning notice. To ensure sustainability of standards the interim executive board was established. The board is consulting on the next steps, and it has made the decision that it is best for the school to become an academy under the diocese. It is consulting on that decision, and it is taking parents’ views into account. It had a meeting today, as the hon. Gentleman said, and it will continue to go through the process Overall in Cambridgeshire, 97% of secondary schools are academies or free schools, and we expect that to be 100% shortly. One third of primary schools are currently academies or free schools, and that number is expected to rise in the coming year, with 17 schools currently moving to academy status. In the hon. Gentleman’s constituency, there are six secondary schools. Five of them are academies, and the remaining school intends to become an academy this term. There are 23 primary schools and a maintained special school. Just two of the primary schools are academies or free schools, and four primary schools are currently going through the process of joining a multi-academy trust, which is significantly lower than elsewhere in Cambridgeshire In September 2014, 82% of primary schools in Cambridge were rated good or outstanding by Ofsted. In November last year, that rose to 91%, which is above the national average. Four of the five secondary academies have positive progress 8 scores, including Chesterton Community College, part of Cambridgeshire Educational Trust, which is in the top 1% of schools nationally and was recently graded by Ofsted as outstanding. Cambridgeshire Educational Trust is a great example of the development of the school-led system in which teaching approaches have raised academic results. It has successfully transferred that outstanding practice to a long-standing underperforming secondary school in Norfolk, and it has received approval to establish two new free schools in 2017, including a post-16 mathematics school in Cambridge, working in partnership with the university.
I appreciate the Minister’s generosity in giving way again. I deliberately tried not to single out organisations apart from the one that stimulated this debate. However, on the back of that eulogy, may I remind the Minister that he has not taken the opportunity to answer any of the questions that I posed? How many unqualified teachers have been employed? What changes to terms and conditions have been made in the multi-academy trusts to which he referred? It is hard to know how to find out.
The Diocese of Ely multi-academy trust does not use unqualified teachers in its schools. Nationally, about 95% of teachers are qualified. Many teachers who do not have qualified teacher status generally have a skill, knowledge or experience to bring to the school, which is why schools employ them Where standards do not meet expectations, the regional schools commissioner and the local authority work together to target underperformance. Action has been taken to ensure sustainable school improvement, including requiring poorly performing schools to join multi-academy trusts. For example, North Cambridge Academy, formerly Manor Community College, has been transformed by Cambridge Meridian Academies Trust. It began as a school in special measures, but is now graded as good, with pupils’ progress in the top 30% nationally I am aware that the hon. Gentleman has been involved with the St Philip’s Church of England Aided Primary School in Cambridge. As I said, the local authority established an interim executive board at the request of the former governing body, which felt unable to address the performance concerns at the school. Part of the interim executive board’s role has been to consider the school’s long-term future. Its decision on the future of the school is being discussed at the meeting today, which will include full consideration of academy status following a consultation exercise with parents and the community. The regional schools commissioner, Sue Baldwin, met the hon. Gentleman in October to discuss the future of the school. There is a strong relationship between Cambridgeshire County Council and the regional schools commissioner team, and they meet on a regular basis. Standards in our primary and secondary schools are rising. The Government’s education reforms have meant that 1.9 million more children attend good or outstanding schools compared with 2010. The academisation programme that the hon. Gentleman discussed has been key to raising those academic standards. Question put and agreed to.