The Minister for the Armed Forces (Nick Harvey): The defence technical training change programme is currently considering options for the future location-or locations-of defence technical training. St Athan is one of the options being considered.
Alun Michael: I really do not understand the Government's approach to this one. Does the Minister not realise that not going ahead with the St Athan defence training establishment as proposed snatches the advantages of integrated training away from all three services, and will be a body blow to south Wales, which is a region that has always been massively supportive of the services? Can we please have a decision from the Government on something positive about the future of St Athan?
Nick Harvey: The right hon. Gentleman will be aware that the private finance initiative project to deliver an integrated solution at St Athan failed-it simply was not possible to find a cost-effective solution and raise the funds necessary to build it. However, it does not follow that we have abandoned the proposition of an integrated solution. That is precisely what is being pored over at the moment by the change programme team. We hope to be in a position to draw that work to a conclusion as soon as possible.
Caroline Dinenage (Gosport) (Con): Does the Minister accept that, in these times of financial hardship, rather than building a new facility it would make more sense to consolidate defence training in areas with spare capacity, such as HMS Sultan in my constituency? It delivers outstanding engineering training and is in the heart of a military community.
The current training takes place at a variety of locations across the three services, some of which, including HMS Sultan, are in good order and could provide training well into the future. However,
I have to say that other locations are in rather less reputable states of order and will have to be replaced. The change programme is currently considering whether there are such overwhelming advantages to having everything on one site that they would overcome the case against leaving some of the better facilities, such as the one my hon. Friend mentioned. As soon as we have a conclusion, we will report to the House.
2. Mr David Hanson (Delyn) (Lab): What estimate he has made of the number of armed forces personnel and their dependants who will be affected by proposed changes to the uprating of armed forces pensions; and if he will make a statement. 
The Parliamentary Under-Secretary of State for Defence (Mr Andrew Robathan): The change in the future uprating of public service pensions to the consumer prices index applies to all new pensions coming into payment, those pensions currently in payment and to the future uprating of deferred pension rights. CPI is deemed more appropriate than the retail prices index because the Bank of England uses it to measure inflation and it is an internationally standard measure. We understand the concerns that have been raised about this matter, but such is the scale of the economic problems that we inherited that no part of society-not even the armed forces-can be fully exempt from the need to find ways to reduce the budget deficit.
Mr Hanson: I thank the Minister for that answer. He will be aware that the change to CPI will mean a lower pension for those currently on one, which will be particularly difficult for service personnel who are retiring early because of grievous injuries caused in conflicts we are currently undertaking. Will he confirm to the House whether the change is intended to be temporary for the purposes of deficit reduction, or whether he intends to short-change our personnel on a permanent basis?
Mr Robathan: We most certainly do care about those whose pensions may be affected. In April 2010, RPI was less than CPI-it was actually negative-so RPI is not always better than CPI for pension uprating. The move is intended to be permanent because it will go forward for all public sector pensions and will be how public sector pensions will be determined in the future. If the Opposition wish to change that, perhaps they should announce now that they will change all public pensions back to RPI, should they ever-God forbid-be re-elected to office.
Mr Jim Murphy (East Renfrewshire) (Lab): There is increasing anger about this policy, and that has now been joined and taken up brilliantly in a campaign by the Daily Mirror. Yet the Government will not say how much the move will save them; they will not admit that it could cost a young Afghan war widow £750,000 in payments; and they have not explained that although the deficit is temporary, this cut is permanent. I invite the right hon. Gentleman to offer a direct answer to a direct question: given that, as we now know, this is not about deficit reduction, has he consulted the armed forces families federations, and what have they told him about this permanent cut?
Mr Robathan: I shall be meeting the armed forces families federations in the very near future. However, I have been reading an article by the right hon. Gentleman in which he said that his pride in the armed forces was "lined with anger"-an interesting use of English! I was proud of the armed forces throughout the 18 years I served, and I, too, am angry-I am angry that we are faced with a financial situation that is damaging this country and our armed forces.
The Secretary of State for Defence (Dr Liam Fox): Iran does not yet have nuclear weapons as assessed. However, it continues to pursue uranium enrichment and the construction of a heavy water research reactor, both of which have military potential, in defiance of UN Security Council resolutions. We share the very serious concerns of the International Atomic Energy Agency about Iran not having adequately explained evidence of possible military dimensions to its nuclear programme. We will therefore respond accordingly.
Richard Harrington: I thank my right hon. Friend for that reply, but in the light of recent comments by Meir Dagan, who recently retired as the head of Mossad, about Iran's first nuclear weapon possibly being ready by the middle of this decade, will he make a statement on how the Government intend to proceed in their approach to Iran's nuclear programme?
Dr Fox: My hon. Friend raises perhaps one of the most important questions at the present time, which is: how do we assess Iran's intentions and how do we assess the time scale? Despite his long experience, I think that Mr Dagan was wrong to insinuate that we should always look at the more optimistic end of the spectrum. We know from previous experience, not least from what happened in North Korea, that the international community can be caught out assuming that things are rosier than they actually are. We should therefore be clear that it is entirely possible that Iran may be on the 2012 end of that spectrum, and act in accordance with that warning.
Mr Denis MacShane (Rotherham) (Lab): May I invite the Secretary of State to read the article in the current edition of International Affairs by Professor Nigel Biggar, the regius professor of moral and pastoral theology at Oxford? He argues that
"one lesson that we should not learn from Iraq is never again to violate the letter of international law and intervene militarily in a sovereign state without Security Council authorization. The law's authority can be undermined as much by the UN's failure to enforce it, as by states taking it into their own hands."
The right hon. Gentleman makes a useful point. With the United Nations having made the assessment that it has, it is clear that we have a moral obligation to carry forward the actions outlined, not least the economic sanctions, which are now beginning to have an effect. For Iran to have a nuclear weapon would be the worst
of all possible options for global security, not least because it is likely to usher in not only the end of non-proliferation but a nuclear arms race in the world's most unstable region.
Dr Julian Lewis (New Forest East) (Con): What sort of signal does it send to Iran and other hostile would-be proliferators that our nuclear deterrent could be put at ransom in the event of another hung Parliament, as a result of our not having signed the key contracts and the hostility towards the replacement of Trident evinced by the Liberal Democrats?
Dr Fox: The Government remain committed, including in the coalition agreement, to the renewal of our nuclear deterrent. As I am sure my hon. Friend would expect, I will be campaigning to ensure that the next Parliament is not a hung Parliament, but one in which we have a minority- [ Interruption ]-a majority Conservative Government.
Mr Russell Brown (Dumfries and Galloway) (Lab): I shall forgive the Secretary of State that slip of the tongue. Has he made any assessment of the breakdown of the P5 plus 1 negotiations in Istanbul, and can he say whether there are any plans to resume them?
Dr Fox: There is always a need to maintain the dialogue, if only to make it clear to Iran that there is no weakening in the position of the international community. It is also essential that, as well as just talking, real measures are taken. If we are serious about the Iran issue, we need to look at it this way. It is a binary question: Iran will either become a nuclear weapons state or it will not. If we are intent on the latter course, the international community needs to act as well as speak. At the present time, that primarily means ensuring that the financial sanctions, which are having an effect on the regime in Tehran, are fully implemented and that no domestic considerations are put ahead of international security and well-being.
The Parliamentary Under-Secretary of State for Defence (Peter Luff): The price for the future strategic tanker aircraft service was set in competition and also assessed against a public sector comparator before the contract was let in March 2008. Nevertheless, because I understand the concerns about the use of PFI for military procurement, I commissioned a thorough, independent review of the contract, which concluded that there was now no persuasive value-for-money case for pursuing an alternative mechanism to secure this urgently needed capability.
I thank the Minister for that reply. This is but one of many apparently wasteful and expensive private finance initiative projects within the Ministry of Defence-including, most recently, dog kennels at the Defence Animal Centre that are reported to cost more than rooms at the Park Lane Hilton hotel. Does the
Minister think there is a case for taking a very detailed look at the MOD's PFI contracts to lower their cost and improve value for money to the taxpayer?
Peter Luff: I agree with my hon. Friend and I am glad to say that a lot of work is being done within the work strands on renegotiation of PFI contracts. Three operational PFI projects have been selected and the pilot phase has commenced with the aim of making savings as part of the renegotiation process. The three projects are the Corsham development, Main Building redevelopment and the defence sixth form college. We expect to have the potential savings identified by the end of March.
Mark Tami (Alyn and Deeside) (Lab): Does the Minister accept that the AirTanker project secures tens of thousands of jobs in the UK and was the best option in comparison with the more expensive and sub-standard option put forward by Boeing?
Peter Luff: I am quite clear that the AirTanker will be an outstanding aircraft and do its job very well. It is urgently needed to repair a fragile air bridge and perform its main function of in-air refuelling as well. I understand, however, the hon. Gentleman's point of view.
The Parliamentary Under-Secretary of State for Defence (Mr Andrew Robathan): Veterans who are injured as a result of their service before 6 April 2005 can apply for compensation in the form of a war pension. For those whose disablement affects their ability to work, additional provision may be made in the form of supplementary allowances, paid in addition to the war pension.
Nic Dakin: I thank the Minister for his reply. Will he explain why it is proving so difficult, in terms of benefits, to treat the UK's atomic veterans as fairly and equally as the atomic veterans of other similar nations?
Mr Robathan: Absolutely. As the hon. Member for Scunthorpe (Nic Dakin) will know, the courts have now decided in favour of the Government. I pay tribute to those who took part in the tests many years ago, but it was about 60-odd years ago and I am afraid that the courts have found that there is no causal link whatever between many of the disabilities and illnesses suffered and exposure to any radiation.
Claire Perry (Devizes) (Con):
Will the Minister expand a little on his reply in respect of the long-term help that veterans will receive. He has referred to the short-term
help, but many of the injured veteran personnel in my Devizes constituency are concerned about where the support will be in 20 or 25 years' time.
Mr Robathan: My hon. Friend raises a very important issue. Injured personnel have a high profile and the support of the country at the moment, but in 15, 20 or 30 years' time, it might be rather different. We are putting in place a whole raft of initiatives. I pay tribute to the last Government, who put a lot of it together. We supported the personnel recovery centre, among others, and there will be such a centre in Tidworth. God willing, we look forward to opening it in the near future.
Gemma Doyle (West Dunbartonshire) (Lab/Co-op): The Deputy Prime Minister announced a "health for heroes" scheme for veterans in a newspaper article on 23 January. How much funding has the Ministry of Defence dedicated to this scheme?
Mr Robathan: This is not actually an MOD but a Department of Health measure. As I understand it, the whole mental health package is worth £400 million and it will be announced in April. Some part of it will go towards assistance with mental health problems among members of the armed forces. We already provide a great deal of support to those with mental health problems, not least through the "Fighting Fit" report of my hon. and gallant Friend the Member for South West Wiltshire (Dr Murrison).
The Parliamentary Under-Secretary of State for Defence (Peter Luff): The Ministry of Defence does not have offset agreements in defence contracts. We do invite prospective offshore suppliers to propose, on a voluntary and non-contractual basis, how they would work with UK companies in support of a contract placed overseas. Following the publication of a Green Paper in December, all policy issues relating to the acquisition of defence equipment are the subject of a consultation that closes on 31 March.
Mr Sheerman: Will the hon. Gentleman consider looking at this offset very seriously? Other countries use offset to great benefit, some using it to stimulate investment in environmental technologies. I know that the Government are consulting, as he says, so will he meet a group who have been discussing the issue and some of the industry leaders to discuss it further?
The Parliamentary Under-Secretary of State for Defence (Mr Gerald Howarth): As I reported to the House during Question Time on 13 December, we are supporting defence exports through an active and innovative defence diplomacy initiative, working closely with the UKTI Defence and Security Organisation. Exports help to build and enhance relations with allies, to support UK defence industry, and to drive down the cost of equipment for Britain's armed forces. Ministers and officials from across the Government, including my right hon. Friend the Prime Minister, are already actively promoting British defence exports overseas.
Eric Ollerenshaw: Does the Minister agree that there is a real potential for increased defence exports and the increased jobs that they would bring to every part of the country? Perhaps he sees the Type 26 global combat ship as a perfect example of that potential.
Mr Howarth: The global combat ship frigate programme does indeed present a tremendous opportunity for the United Kingdom to put the policy into practice. I am delighted to say that we are in close discussion with the Canadians. My right hon. Friend the Secretary of State has just returned from an extremely profitable visit to Malaysia, Australia, New Zealand and Turkey. All those countries have expressed interest in joining the United Kingdom in a collaborative programme that would have the benefit of bringing together not only members of the Commonwealth but some of our key allies, while also driving down costs for the Royal Navy.
Mr Stephen Hepburn (Jarrow) (Lab): Will the Minister tell us how he will protect the United Kingdom's defence industry, as other Governments throughout the world protect theirs? Or will he be leaving it open to market forces, which will inevitably mean that our armed forces will be supplied by foreign Governments and companies?
Mr Howarth: The United Kingdom is the second largest exporter of defence equipment in the world. This is a fantastic opportunity that builds on the very strength of Britain's defence industry, which is the second most successful in the world. It is that on which we are capitalising, it is that which we are determined to support overseas, and it is that which, I am pleased to say, commands respect overseas. Let us not knock it; let us support it.
Duncan Hames (Chippenham) (LD): At a time of necessary cuts in Government, some of my constituents would like to see the UKTI Defence and Security Organisation closed. What assurances are the Government given by our allies who receive defence exports that they will not use them to harm or, indeed, to intimidate their own people?
Mr Howarth: I am very sorry that the hon. Gentleman wants to see UKTI DSO closed. I can see a few Opposition Members whose faces reveal that they view that prospect with great alarm, as indeed do all my hon. Friends-as well as, I see, the shadow Secretary of State, the right hon. Member for East Renfrewshire (Mr Murphy). UKTI DSO is doing a fantastic job, but that job is not done in isolation; it is done in accordance with long-established law, under which we ensure to the best of our ability that we do not export irresponsibly.
I repeat to the hon. Gentleman, who clearly failed to understand the purport of my original message, that defence exports are not there simply to generate income. They are there to strengthen alliances with existing allies, and to promote alliances with new, important allies, in a very volatile world.
The Parliamentary Under-Secretary of State for Defence (Peter Luff): The Government are determined to drive out the mismanagement of the equipment programme experienced under the last Administration. Developing a balanced, affordable programme must be our first priority. The strategic defence and security review and the current planning round process are major steps on the road to achieving that, but ongoing acquisition reforms, the work of the defence reform unit, and the appointment of Bernard Gray as Chief of Defence Matériel are also signals of our determination to address the issue successfully.
Mr Raab: I thank the Minister for his answer. I also welcome Lord Currie's review of single-source pricing regulations. The major projects reports produced by the National Audit Office in 2009 and 2010 issued scathing assessments of the last Government's record of purchasing defence equipment. How will the Currie review ensure better value for money for taxpayers?
Peter Luff: My hon. Friend is right to highlight the importance of the review, which I announced to the House last week. Given that some 40% of work by value is secured through this route, it is crucial to the taxpayer that we secure value for money from procurements. It is important for industry to be given incentives to reduce costs, and this will be good news for small and medium-sized enterprises, many of which find the present procedures for procuring work exceptionally onerous. Moreover, by making industry more competitive on world markets we will increase our export potential. It is a win-win situation.
Jim McGovern (Dundee West) (Lab): Can the Minister tell the House what the implications of the strategic defence and security review are for organisations and companies that depend almost entirely on Ministry of Defence contracts-for example, Remploy? The Remploy factory in my constituency depends entirely on MOD contracts and its workers are frightened for their jobs. Can he give me assurances that I can offer to those workers that their jobs are secure for the future, based on MOD contracts?
Sir Alan Beith (Berwick-upon-Tweed) (LD):
What is the nature of the inquiries taking place into the procurement of the search and rescue helicopter contract? Do they
involve the police or potential disciplinary action? When will we know whether the contract has been completely invalidated by what has been discovered?
Peter Luff: The investigation into the issue notified by the preferred bidder is ongoing. Until the issue has been properly considered it is not possible to progress to procurement. I hope that it will be possible to make a further statement to the House on the way forward. No decision has yet been taken on this matter and, in view of the issues involved, there is nothing more I can say at this stage to the House.
The Minister for the Armed Forces (Nick Harvey): As I said in answer to my hon. Friend on 8 November, all relevant costs, including those arising from any necessary relocations, will be given full consideration prior to any decision being taken. However, because the facilities she refers to are a major infrastructure installation, operated by contractors, it would inevitably be expensive to relocate.
"The costs of relocating out of Marham would be very high".
He also described the economics of making that decision as being "not...clever". When is he going to present a full analysis? Given the state of the deficit, does he agree that cost should be a major factor in making the decision?
Nick Harvey: Let me make it clear to the House that the primary consideration in the basing study will be the military advantages and the military necessity of locating particular things in particular places. We will, of course, have to take account of the financial climate in which these decisions are being made and their socio-economic impact. We are addressing all these things and hope to make a full announcement in the spring.
Mr Kevan Jones (North Durham) (Lab): I wonder whether the Minister would care to comment on last week's press reports that he told a meeting at RAF Lossiemouth that RAF Marham would be too costly to close. Those comments will have appalled those working at RAF Lossiemouth and RAF Leuchars, who believed that they would get a fair hearing from Ministers as they carried out their base review. Should we not conclude from his comments that the review is nothing but a sham?
I should correct the hon. Gentleman by saying that the meeting in question took place at RAF Kinloss. What I said to the Moray Task Force, whom I was meeting at the time, was that the costs of moving the in-depth maintenance facilities from Marham and, indeed, paying to relocate the staff of the contractors involved would be so prohibitive that it would potentially undermine any savings that might accrue from closing a
base. The economics of moving the in-depth maintenance facilities for Tornado at this stage in Tornado's life cycle would, as I said on Thursday last, be very questionable indeed.
The Parliamentary Under-Secretary of State for Defence (Peter Luff): The National Audit Office's recent major projects report shows that the well-documented problems with some of the largest procurement projects have generally been caused by poor and deliberate policy decisions, and that project management itself is improving. But we are doing more to improve project management, including: running a programme to increase skills; forming a major projects performance board to review our most significant projects regularly; and appointing Bernard Gray as Chief of Defence Matériel, where he will build on the improvements made by his predecessor.
Stephen Barclay: Following numerous Select Committee recommendations, the Department's own guidelines run to eight pages in setting out what should be included in project histories, yet the £4 billion Nimrod project history runs to just two pages; makes no mention of senior responsible owners or senior staff changes; and took the Department seven weeks to produce, even though it already has this document, which is marked unclassified and had no redactions. Will the Minister write to me within the next month listing all the major defence projects that do not comply with the Department's own guidelines on documentation and what the gaps in documentation are?
Peter Luff: I am reluctant to turn this into a diary session for my diary secretary, but I think it would be very helpful to discuss this important issue with my hon. Friend. Departmental good practice guidance on maintaining project histories allows scope for project team leaders to interpret it and decide what best meets the needs of their project depending on its size, complexity and nature. The format and content are not mandated and, frankly, the problems with the Nimrod MRA4 project are about the most well-documented of any major procurement programme we have.
The Secretary of State for Defence (Dr Liam Fox):
Based on what I saw on my recent visit to Afghanistan, including my conversations with commanders and politicians, I assess that important security gains are being made. They are not irreversible and we can expect a high tempo over the winter and throughout the year. Although there are many challenges, there is cause for cautious optimism in the growth of the Afghan national
security forces. We have the right strategy, numbers and equipment in place and now a little strategic patience is required to ensure that we are successful. Both 2011 and 2012 will be key years in that regard.
John Glen: I thank my right hon. Friend for that reply. Does he agree that the best way forward for Britain's long-term strategic security interests is to form long-term relationships between the international security assistance force military leaders and the Afghan police and military commanders? What observations would he make on the level of co-operation between UK forces and Afghan security leaders?
Dr Fox: That is an ongoing and progressing relationship. I point my hon. Friend to one particularly successful project-the police training taking place in Helmand. Those involved in that project throughout the country would recognise that what the British armed forces are doing is very possibly and very probably the leading project of that kind. If we can not only continue with what we are doing but export it as best practice to others, we will be making a doubly important contribution.
Mr Bob Ainsworth (Coventry North East) (Lab): Gains that are clearly being made by our armed forces at an operational level will be undermined if we do not get things right at the strategic level. The growing of the Afghan national security forces and the attacks being made on the Taliban leadership will not be enough on their own: what is being done to pump some life into the reconciliation process? Surely we need to get that strand of work up and running and get the Americans committed to it before the 2014-15 deadline.
Dr Fox: The right hon. Gentleman is absolutely correct. It has always been the case that there could not be a political settlement without a military settlement and vice versa. We now have quite large military gains on the ground, as he says, but he is quite correct that those gains cannot be maintained unless we get an acceleration in the pace of the political programme. There are gains being made at national and local level but they are neither widespread nor deep enough. We need to ensure that throughout this year we push the Government of Afghanistan to understand that we need to make progress now, while we have a reasonable following wind, because this is the crucial time to be able to get the gain on the ground that will make what we are trying to achieve sustainable.
Mr James Arbuthnot (North East Hampshire) (Con): Does my right hon. Friend acknowledge that all the emphasis in recent months has been on the withdrawal of our combat troops by 2015 and that it would be worth while concentrating on putting some more flesh on the bones of the role that we will continue to play after then, including, perhaps, in officer training?
Clearly, there will be a role for the United Kingdom to play in that period, but it would be impossible to assess now what it will look like without knowing what the contribution from the international community will be. We very much hope that our international allies in ISAF will recognise that the concept of in-together, out-together is a sensible one and that countries do not simply transition from the safe areas that some might be
in at present, right out of Afghanistan, but instead take part increasingly in the NATO training mission. By that means, we can have a proper share of responsibility after the transition away from combat forces. I think that would give us greater legitimacy and would give the mission greater acceptability in the UK.
Mr Jim Murphy (East Renfrewshire) (Lab): I agree with so much of what the Defence Secretary said in response to those questions. I returned from Afghanistan yesterday with the Leader of the Opposition and the shadow Foreign Secretary. We were all moved by both the bravery and the modesty of our armed forces in Afghanistan. I agree with the Defence Secretary that people are moving away from a sense of reluctant pessimism to cautious optimism about the effort in Afghanistan. With the international forces exiting combat roles by 2015, as he mentioned, and given the point that he made about training the army, which has to be strong, even though most recruits cannot read and write, and many recruits cannot even count the number of bullets to place in a rifle, what success has been there so far in trying to persuade some of those nations, which are leaving earlier than us, to commit to that training effort not just in their own areas, but across the whole of Afghanistan?
Dr Fox: May I say first how grateful we are to the Leader of the Opposition for reasserting the bipartisan approach to Afghanistan? It is very important for our national security and for the morale of our armed forces. I am grateful for that support, even if I know that it is not endorsed by all sections of his party. That makes the decision even braver and even more in the national interest, so I thank him for that.
The right hon. Member for East Renfrewshire (Mr Murphy) is right that it is important that we encourage those of our allies who may be moving out of a combat role into a training role. The decision taken by Canada in recent weeks is welcome. We wait to hear more details of the decision that may be taken by the Dutch. The National Security Council, on the Prime Minister's instruction, has sought to find areas where Ministers have a particular personal engagement, where we might be able to maximise the pressures that we can bring to bear to get exactly that training mission outcome.
The Secretary of State for Defence (Dr Liam Fox): We are currently considering the initial gate business case for the successor submarine and, as part of the next phase of work, we would expect to purchase some long-lead items so that the first boat can be delivered in 2028. This is normal good practice for major build programmes.
Dr Fox: By definition, until the initial gate business case has been approved, I am not able or prepared to give a figure. We will make that information available in due course, when decisions have been made.
John Woodcock (Barrow and Furness) (Lab/Co-op): May I say how pleased I was to accompany the Minister with responsibility for procurement, the Under-Secretary of State for Defence, the hon. Member for Mid Worcestershire (Peter Luff), around Barrow shipyard a couple of weeks ago? The Defence Secretary knows that of the £3 billion of so-called savings in the Trident value-for-money review, more than half are deferments. Will he tell the House the increased cost of deferment, and why he thinks that approach is acceptable, given how often he spoke out against it when he was in opposition?
Dr Fox: There are two imperatives. The first is to ensure that we have the successor programme. The second is to ensure that we do it within the financial constraints that the Government are forced to take on board, given the economic position that we inherited. Through the value-for-money study, as the hon. Gentleman well knows, we looked to see how we could extend the life of the current programme, if possible, to minimise the expenditure in early years. That is helpful not only in reducing the deficit in the period set out by the Government, but in ensuring the success of the programme itself.
Tessa Munt (Wells) (LD): It would appear from the answers to freedom of information requests that the steel, the computer systems and the combat systems, among other things, for the first submarine have been ordered and will have been paid for. It also appears that the three reactors for the first three submarines will have been ordered and paid for before MPs can scrutinise the main gate business case. What will remain unspent for the first submarines? Will we be so financially committed that the whole main gate decision is made irrelevant?
Dr Fox: Whatever amount of money is spent on the lead items, technically it is up to any Parliament at any time to determine whether any programme can or cannot go ahead. It is clear from the coalition agreement that we are committed to maintaining a continuous at-sea minimum credible nuclear deterrent that will protect this country from nuclear blackmail and ensure that we make our role apparent in reductions in total nuclear armaments.
Paul Flynn (Newport West) (Lab): How can the Government, who plan to save money by closing libraries and selling off our forests, justify wasting tens of millions of pounds on a useless virility symbol when they cannot give any plausible future situation in which Britain might use a nuclear weapon independently?
Dr Fox: I have explained the same point to the hon. Gentleman before. I can only explain it to him; I cannot understand it for him. What is important about the concept of deterrence is deterrence; that we do not need to use it. The whole point of deterrence is to make it clear to any potential aggressor that we will not even consider the impact of nuclear weapon strikes against the United Kingdom and so will maintain a nuclear deterrent to ensure that we never get to that position.
14. Gregg McClymont (Cumbernauld, Kilsyth and Kirkintilloch East) (Lab): What assessment he has made of the effect on armed forces pensions of proposed changes to indexation arrangements for public sector pensions. 
The Parliamentary Under-Secretary of State for Defence (Mr Andrew Robathan): No robust assessment of the kind requested can be made as future movements of the retail price index and consumer price index are not known. To use the current 2010 rate as the basis for any forecast would give an unreliable representation of future payments in the long term as these rates will fluctuate over time.
Gregg McClymont: I thank the Minister for his answer, but does he not agree that most studies suggest that CPI produces a higher pension than RPI? Does that not count as a cut in military and service personnel pensions?
Mr Robathan: If I may gently prod the hon. Gentleman, he has it the wrong way round: RPI is more likely to produce a higher pension than CPI, which is not what he said. As I pointed out to the right hon. Member for Delyn (Mr Hanson), there was no upgrading of pensions at all in April 2010 because RPI was negative in 2009, and that is the way things are. It was a hard decision, but we believe that it is in the best interests of the country and of the armed forces as a whole.
15. Grahame M. Morris (Easington) (Lab): What estimate his Department has made of the cost to the public purse of returning British troops from Germany (a) between 2010 and 2015 and (b) between 2015 and 2020; and if he will make a statement. 
The Minister for the Armed Forces (Nick Harvey): The strategic defence and security review stated the Government's aim to withdraw all forces from Germany by 2020. That objective is now being taken forward within a wider basing study aimed at making the best possible use of the defence estate. The basing study will take into account a range of factors, including cost, and is expected to report in the spring. Any costs incurred as a result of rebasing should be offset by the savings made in the longer term. While on a day-to-day basis it is more expensive to base troops in Germany than in the UK, this policy is not primarily about saving money. It is about enhancing our operational effectiveness and welfare.
Grahame M. Morris: I thank the Minister for that answer, but how much will the UK Government need to pay the German Government in compensation or reparations when our bases are vacated by British troops and handed back to German control?
The Government may need to pay redundancy costs to locally employed civilians, depending on circumstances, and costs might also be incurred in buying out any contractual obligations. However, the UK Government are not obliged to compensate either the Federal German Government or local communities
for the impact of the British Army leaving Germany. The net injection to the German economy is around £700 million a year, so the hon. Gentleman might like to reflect on whether that might be better injected into the British economy.
Patrick Mercer (Newark) (Con): The Minister will be aware of the considerable capital investment programme of the past 10 years for garaging and other heated facilities for armoured vehicles of the British Army of the Rhine. Will there be a similar programme in this country, or will the vehicles remain in Germany?
Nick Harvey: There is a general principle that we do not ask the Army to relocate to premises that are inferior to those in which they are already stationed. It would certainly be our intention to ensure that that is the case when they return to the UK.
16. Kevin Brennan (Cardiff West) (Lab): What recent assessment he has made of how the commitments in the strategic defence and security review are to be funded from his Department's budget settlement. 
The Secretary of State for Defence (Dr Liam Fox): The strategic defence and security review established the policy framework for the Ministry of Defence and the armed forces, and the capabilities that they will need to meet future challenges. It includes a period of rebalancing over the next few years as we transform, but further work is required to fully balance the books because we are not there yet and are still in planning round 11.
Kevin Brennan: In a recent Financial Times article on the subject, headed "MoD faces fresh crisis over funding", which predicted a £1 billion shortfall for each year, a senior military figure is quoted as saying:
"Every day at the MoD these days seems like a day at the dentist."
Dr Fox: I have no idea, but, given that I can pick in any one newspaper on any one day at the present time some quotation from some senior former or serving military personnel, I can put all sorts of interpretations on all sorts of things. What I am very clear about is that Ministers and the military will work together to deliver the SDSR and our 2020 vision. Hopefully, through that period of transformation, we will come out with armed forces properly equipped and shaped for Britain's proper national security.
The Parliamentary Under-Secretary of State for Defence (Mr Andrew Robathan):
I have regular discussions, as does my right hon. Friend the Secretary of State, on civilian reductions. There is also an ongoing dialogue
between officials and the recognised departmental trade unions over the implementation of the civilian reductions.
Luciana Berger: I thank the Minister for that response. Can he kindly outline which units in the Ministry of Defence he anticipates the 25,000 job losses announced in the strategic defence and security review will come from? If he cannot say now, can he outline when he will be able to end the uncertainty?
Mr Robathan: That is a perfectly reasonable question from the hon. Lady, but I am afraid I cannot say now. There are two things that I should say, however: first, my right hon. Friend the Secretary of State and I are meeting the trades unions about those reductions late in February; and secondly, the permanent secretary to the MOD announced on Friday night-released, therefore, to most people this morning-the forthcoming launch of the voluntary early release scheme. I am sure that the full text will be in the Library.
The Secretary of State for Defence (Dr Liam Fox): My departmental responsibilities are to ensure that our country is properly defended now and in the future, that our service personnel have the right equipment and training to allow them to succeed in their military tasks and that we honour the armed forces covenant.
Dr Fox: There can be some savings on contract renegotiation, and they are currently being discussed, but in the very near future I shall set out a new set of rules for the management of financial projects, which I hope will ensure that we get real-terms control over budgets. Far too often, we have been looking at post-mortems by the National Audit Office, and in my previous profession I did not regard post-mortems as a satisfactory outcome.
T2.  Christopher Pincher (Tamworth) (Con): As my right hon. Friend seeks to build the armed forces covenant, will he pay close attention to the Strachan report and, in particular, those recommendations to offer enhanced accommodation allowances, expand the pilot shared equity scheme and encourage banks to offer forces-friendly mortgages, so that members of our armed services get a firmer foot on the property ladder?
Dr Fox: It was, indeed, a valuable set of recommendations, and we are going through them one at a time at the moment. I am instinctively very much in favour of all the elements that my hon. Friend sets out, and in the very near future we shall in fact produce some further projects, which I hope will provide considerable enhancements to some elements of the covenant not previously covered-and at minimal cost to the taxpayer.
"limit our ability to deploy maritime forces rapidly...increase the risk to the Deterrent, compromise maritime counter terrorism, remove long range search and rescue, and delete one element of our Falklands reinforcement plan."
Dr Fox: Here is the extent of the humbug. The previous Government, in March 2010, actually took the Nimrod MR2 out of service, so there was already a capability gap by the time this Government came to office. First, we looked at the strategic environment, and the service chiefs and the intelligence services advised us that the gap that would be left could be managed with the assets that were already being used to fill the gap that the previous Government left when the MR2 was withdrawn. Secondly, the financial project itself was too long over time, and too far over budget-it was not able to fly and carry out the tasks that were asked of it. It should have been cancelled years ago. This Government had the nerve to do it; the previous Government did not.
T3.  Richard Harrington (Watford) (Con): Will my right hon. Friend explain the steps that he is taking to ensure that in future the defence budget is put on a sustainable footing, so that future incoming Governments do not have to cancel capabilities such as the Nimrod MRA4 because of the reckless spending of their predecessors?
Dr Fox: None of us wanted to see reductions in the defence budget for their own sake. What the House and the country need to understand is that the size of our national deficit is a national security problem. Next year, this country will be paying £46 billion in debt interest against a defence budget of only £37 billion. Even if the current Government eliminate the deficit within five years, that debt interest will rise. That is money being paid for nothing because the last Government were unable to contain their urge to spend, spend, spend.
T4.  Mr David Crausby (Bolton North East) (Lab): Can the House be assured that the pace of submarine production at the Barrow shipyard is sufficient to retain the skills that will deliver an independent, British-made successor to the Vanguard submarine?
Dr Fox: Yes. In the SDSR, we are committed to the seventh Astute submarine, partly to ensure that the skills base was there as we went through to the successor programme. We regard the ability to build and maintain our nuclear deterrent successor programme as part of our sovereign capability.
T6.  Julian Smith (Skipton and Ripon) (Con): What steps is the Minister taking to ensure that British small businesses get a greater share of defence contracts, in terms not only of volume, but of value?
The Parliamentary Under-Secretary of State for Defence (Peter Luff): My hon. Friend is absolutely right to highlight that very important plank of our policy towards the defence industries. At present, we are consulting through the Green Paper and I urge him to respond to that consultation. There are 18 separate questions on what we can do to improve the relationship between small and medium-sized enterprises and the MOD.
I draw my hon. Friend's attention to the outstanding work of the Centre for Defence Enterprise, which is bringing innovative SMEs into the defence market for the very first time, and is very much welcomed by those SMEs.
T5.  Catherine McKinnell (Newcastle upon Tyne North) (Lab): The Big Lottery Fund has recently extended the deadline for the excellent Heroes Return 2 scheme, administered from Newcastle, that provides funding to help veterans and their families take part in commemorative visits, either in the UK or abroad. Like many right hon. and hon. Members, I have been encouraging my constituents to take advantage of the scheme. Will the Minister outline what support he and his colleagues are providing to encourage uptake of that funding?
The Parliamentary Under-Secretary of State for Defence (Mr Andrew Robathan): We certainly support the scheme, which I understand is largely run by the Royal British Legion, although I do not have the details at my fingertips. It is an excellent scheme. We support the national lottery, the Royal British Legion and the whole programme.
T7.  John Glen (Salisbury) (Con): Given the Government's desire to improve armed forces accommodation and obtain greater value for money for the taxpayer, does the Minister accept that useful lessons can be learned from the Canadian Government's example of outsourcing the management of armed forces housing, a policy that produced savings and improvements to accommodation facilities?
Mr Robathan: My hon. Friend is right. We are looking at every option as to how we can make housing for our troops more efficient. We shall certainly look at what my hon. Friend has mentioned as well; if he wants to make a submission, he is very welcome so to do.
Angus Robertson (Moray) (SNP): The Ministry of Defence is aware that Moray is the most defence-dependent community in the UK and uniquely faces the threat of a double RAF base closure. Does the Secretary of State understand the damage that the delayed basing announcement is having on the economy of the north of Scotland? Why is there a delay in the announcement in the first place, given that the RAF made its basing recommendation at the end of last year?
Dr Fox: We have some evidence, but not the final submission, on that. Of course, we are also awaiting from the Army the elements of rebasing that may be part of the issue relating to the return of British troops from Germany.
I fully understand that many have an increased level of anxiety because of the time taken to make those decisions. But they are not single decisions; they are
interrelated decisions. Although I do understand, I am afraid that we have to ensure that we make the right decision, not just a quick decision.
T8.  Mr Douglas Carswell (Clacton) (Con): Shortly after the formation of the coalition, Lord Levene and others were appointed to review defence procurement. Some of us hoped that that might mean a radical reform of protectionist procurement. What progress can the Minister report on Lord Levene's review and any recommendations that may be forthcoming?
Dr Fox: Before the general election, we set out four aims for procurement: that it would give our armed forces what they need when they need it, at a reasonable cost to the taxpayer; underpin our strategic relationships; give greater stability for planning; and increase exportability. Those are all still aims that we are hoping to achieve. The review is well under way. The Defence Reform Unit has considered a number of these issues. Together with the appointment of the new Chief of Defence Materiel, I can assure my hon. Friend that, if anything, we will be at the radical end of reform.
Mr Brian H. Donohoe (Central Ayrshire) (Lab): I know that Ministers touched on this issue earlier, but air-sea rescue is of enormous interest, not only to me but to the nation. I have attempted to get the answer to this question, so can he tell me whether the lead Department is the Ministry of Defence or the Department for Transport? When can we expect a statement in the House about this issue?
The Minister for the Armed Forces (Nick Harvey): Both Departments are involved, but the lead Department is the Department for Transport, and any statement to the House will come from Transport Ministers. We hope that that will happen as soon as possible but, as I think the hon. Gentleman will understand, legal complexities are at play. The key thing is to decide how we are going to take forward search and rescue facilities, and I hope that the Department for Transport will be in a position to make a statement to the House very soon.
T9.  Mel Stride (Central Devon) (Con): Will my right hon. Friend join me in recognising the importance of the contribution of smaller countries to our mission in Helmand province, and, in particular, the very gallant and disproportionate contribution made by Estonia and Denmark?
Dr Fox: Few things give me greater pleasure in this House than to acknowledge the sacrifices made in Afghanistan by some of the smaller countries, two of the most important of which were mentioned by my hon. Friend. I hope to make a visit to Afghanistan with Defence Ministers from some of those countries. The whole House will want to place on record our solidarity not only with the families in Denmark and Estonia who have suffered loss, as have families in the United Kingdom, but with the outstanding military contribution that they have made, which is perhaps, in many ways, a good example to some of the sleeping giants in NATO.
Diana Johnson (Kingston upon Hull North) (Lab):
The Government have pledged 12 new Chinooks, which are crucial for the UK defence industry capacity and for
national security because of their role in Afghanistan. Can the Minister confirm that the Government have signed the contracts for these new helicopters? If not, can he explain what that means for the British defence industry, when he expects the contracts to be signed, and when these much-needed Chinooks will enter theatre?
Peter Luff: I can confirm the answer to that question when the current planning round is settled, but I assure the hon. Lady that we understand the importance of these helicopters for the mission in Afghanistan.
Bob Russell (Colchester) (LD): A key player in the security situation in Afghanistan is Pakistan, which, in the war on terror, has seen more of its civilians and security and military personnel killed than any other country. Last week, I was part of a Commonwealth Parliamentary Association delegation to Pakistan. Will the Secretary of State join me in thanking the Government and people of Pakistan for their efforts to date and encourage them to maintain that level so that our forces in Afghanistan are supported?
Dr Fox: What we are attempting to deliver in Afghanistan will not be possible without the support of the Government of Pakistan. Perhaps a good note for all of us to have would be one that reminds us to thank the Government of Pakistan when they do what is helpful to the mission rather than criticise them when the opposite is true. It is also of great importance that we in the United Kingdom, and our allies, make it clear that we have a post-Afghanistan strategy for Pakistan and that we intend to have a long-term programme of help and encouragement.
Chris Williamson (Derby North) (Lab): The Health Protection Agency has said that servicemen present during atomic bomb tests more than 50 years ago have since been plagued with cancers and rare medical conditions. Did the Minister see reports in the media yesterday that the MOD has ignored urgent calls for research into the health of nuclear test veterans, and will he agree to have the DNA of test veterans studied as a matter of urgency?
Mr Robathan: There have been many studies into the health of those who witnessed the explosions on Christmas Island, and they have concluded that those who witnessed the explosions have not suffered greater health problems than others. I stand by the clinical and legal position on that, as did the previous Government, whom the hon. Gentleman would presumably like to say he supports.
Nick de Bois (Enfield North) (Con): Has the Secretary of State assessed the state of rehabilitation services for members of the armed forces who have received trauma care, and who are living with complex, life-changing injuries? Will he accept representations from me on behalf of a constituent?
I would be happy to accept representations. The trauma care given by the medical services in the armed forces is excellent. There is a 25% chance of survival, whereas there is only a 6% chance of survival in the national health service. The Secretary of State for
Health and I went to Birmingham 10 days ago for the opening of the new Surgical Reconstruction and Microbiology research centre at the Queen Elizabeth hospital. That is an excellent facility that leads the way in trauma care in this country.
Thomas Docherty (Dunfermline and West Fife) (Lab): Given that the Department is currently holding a consultation on how to decommission nuclear submarines, will the Secretary of State give my constituents a cast-iron guarantee that not a single bolt will be taken out of those submarines until a waste route has been identified and, crucially, established?
Andrea Leadsom (South Northamptonshire) (Con): Will my right hon. Friend confirm that avoiding nuclear arms proliferation, wherever it comes from, is a key objective of his Department? Will he update the House on what he is doing to pursue that objective?
As I mentioned earlier, the House will be aware that there is one great threat to global non-proliferation: the ambitions of Iran. There is no more important policy for long-term security and for the maintenance of the non-proliferation treaty than ensuring
that Iran, although it may have access to civil nuclear capabilities, does not become a nuclear weapons state. I do not think that I could have ended on a clearer note.
Mr Bob Ainsworth (Coventry North East) (Lab): Why, when the Prime Minister said there would be no cuts in infantry capability while we were on a combat mission in Afghanistan, is the strength of the Royal Marines being cut?
Nick Harvey: There is a very small headcount reduction in the Royal Marines-the right hon. Gentleman is quite right. However, those units were not going to be deployed to Afghanistan and, in consequence, this will not undermine the effort in that country.
Greg Mulholland (Leeds North West) (LD): The city of Leeds has very close connections with HMS Ark Royal, following the remarkable fundraising campaign by local people and the adoption of the ship in 1941. On 12 February, the crew of HMS Ark Royal will be given the freedom of the city of Leeds and will take part in a parade. Will the Secretary of State join me in saying what a wonderful event that will be? Does he agree that there should be a permanent commemoration of this link?
Dr Fox: This is a commendable link. I am happy to join my hon. Friend in congratulating the city of Leeds. Whenever there is an example of civic life recognising the sacrifices of our armed forces, both are enriched.
The Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs (Alistair Burt): With your permission, Mr Speaker, I would like to make a statement on the situation in Egypt. First, may I apologise on behalf of the Secretary of State for his absence? The House may be aware that he is attending a Foreign Affairs Council today, where this issue is at the top of the agenda.
The calls for political reform in Egypt have been peaceful, but the general unrest has become increasingly dangerous, with elements of violence leading to lawlessness in some areas of major cities such as Cairo, Alexandria and Suez. Severe restrictions on freedom of expression, including the closure of internet access and mobile phone services, have only fuelled the anger of demonstrators. We have called on the Egyptian authorities to lift those restrictions urgently.
I am sure that the House will join me in expressing our deepest sympathies to all those affected by the unrest in Egypt, including the families and friends of those who have been killed and injured. Casualty figures remain unclear, but it is estimated that at least 100 people have died. On Saturday, the army took over responsibility for security in Cairo, and its role has so far been welcomed by protestors. Our aim throughout these events has been to ensure the safety of British nationals in Egypt and to support Egypt in making a stable transition to a more open, democratic society.
I turn first to consular issues. There are an estimated 20,000 British tourists in Egypt, the majority of whom are in the Red sea resort of Sharm el Sheikh, where, according to our latest information, the situation remains calm. We estimate that there are a further 10,000 British nationals in the rest of Egypt.
On Friday 28 January we changed our travel advice to advise against "all but essential travel" to the cities of Cairo, Alexandria, Suez and Luxor due to the severity of demonstrations there. On Saturday 29 January, we heightened our travel advice further to recommend that those without a pressing need to be in Cairo, Alexandria and Suez leave by commercial means where it was safe to do so. Those in Luxor are advised to stay indoors wherever possible. A daily curfew remains in place throughout Egypt from 3 pm to 8 am.
Cairo airport is open, but has been operating under considerable difficulties. The situation was particularly difficult yesterday, but our ambassador in Cairo reports that it has eased a little today. Flights are operating but are subject to delays or cancellation. The majority of British nationals have been able to leave Cairo airport today. We estimate that about 30 British nationals will remain at the airport overnight, to depart on scheduled flights tomorrow. The situation also appears to be improving in Alexandria, with road access to the airport now secure. We have staff at Cairo airport working around the clock to provide assistance to any British nationals who require it. We also have staff in Alexandria, Luxor and Sharm el Sheikh, who are providing regular updates about the situation on the ground in those parts of Egypt and staying in close touch with tour operators and British companies on the ground.
Additional staff reinforcements from London and the region have been sent to Egypt to help embassy staff maintain essential services in these difficult circumstances. A 24-hour hotline is available for British nationals to call if they need assistance or advice, and help is also available around the clock from the crisis resource centre at the Foreign and Commonwealth Office. I am sure the House will join me in recognising the hard work and dedication shown by all our staff, in both Egypt and London, in responding quickly and professionally to the unfolding events.
I turn to the political situation in Egypt. The UK has major strategic interests in Egypt, which has played an important role as a regional leader, including in the middle east peace process, and we are the largest single foreign investor. The scale of the protests is unprecedented in Egypt in the past 30 years. We have called on President Mubarak to avoid at all costs the use of violence against unarmed civilians, and on the demonstrators to exercise their rights peacefully.
In response to the growing protests, President Mubarak announced on 28 January that he had asked the Government to resign. On 29 January, he appointed the head of the Egyptian intelligence services, Omar Suleiman, as his vice-president and Ahmed Shafiq, most recently Minister for Civil Aviation, as Prime Minister. Further Cabinet appointments have been made today. However, demonstrations have continued and are now focused on a demand for President Mubarak to resign.
It is not for us to decide who governs Egypt. However, we believe that the pathway to stability in Egypt is through a process of political change that reflects the wishes of the Egyptian people. That should include an orderly transition to a more democratic system, including through the holding of free and fair elections and the introduction of measures to safeguard human rights. Such reform is essential to show people in Egypt that their concerns and aspirations are being listened to.
We continue to urge President Mubarak to appoint a broad-based Government who include opposition figures, and to embark on an urgent programme of peaceful political reform. We are also working with our international partners to ensure that those messages are given consistently and that technical and financial support for reform is available. The Prime Minister has spoken to President Mubarak and President Obama. The Foreign Secretary has spoken to Egyptian Foreign Minister Aboul Gheit, Secretary of State Hillary Clinton and EU High Representative Baroness Ashton over the weekend, and he will also be discussing the situation in Egypt with EU colleagues at the Foreign Affairs Council today.
The situation in Egypt is still very uncertain. The safety of our citizens is our top priority, and we are putting in place contingency plans to ensure that we are prepared for all eventualities. I commend this statement to the House.
The House is united today in expressing our concern at the loss of life in Egypt since last Wednesday. As the Minister said, it has been reported that more than 100 lives have been lost, and I join him in expressing condolences to the families and friends of all those who have been
killed or injured. Thousands of courageous Egyptian citizens have taken to the streets to demonstrate for the basic political freedoms that we in the United Kingdom can take for granted. We welcome what the Minister has said today in support of an orderly transition to a broad-based Government who will address the legitimate grievances of the Egyptian people.
Two weeks ago, we expressed concern about the speed at which the Government were offering support to British nationals who were stranded in Tunisia. We welcome the lessons that have clearly been learned since then, as this has ensured a swift response in getting the information and guidance that the Minister has described to British nationals in Egypt. As he said, the Foreign Office has issued travel advice urging British nationals not to travel to Cairo, Alexandria, Luxor or Suez, and to leave by commercial means when it is safe to do so. I thank the Minister for updating the House today on the assistance that is being given to those British nationals trying to leave Egypt, and I join him in commending the hard work and dedication of the FCO's staff in Egypt and here in London. I also welcome his announcement of additional staff. Can he assure the House that the Government have contingency plans in place to cover every eventuality, and that they now have enough consular officials on the ground to provide the necessary advice and assistance to UK nationals in Egypt?
The European Union has an important role to play in promoting regional stability and security in the middle east and north Africa, and it is encouraging to hear that Egypt is at the top of the agenda for today's European Foreign Affairs Council. Does the Minister agree that the European Union should place greater emphasis on supporting the development of democracy, pluralism and human rights throughout the middle east and north Africa?
Over the past 30 years, Egypt has played a crucial role in fostering steps towards the middle east peace process. There are legitimate concerns that a political vacuum in Cairo could undermine the already precarious prospects for peace. Can the Minister update the House on discussions with Egypt's neighbours, including Israel and the Palestinian Authority, who have important concerns for the peace process and for the stability and security of the wider region? The Minister told us that the Prime Minister had spoken to President Obama about events in Egypt. Could the Minister update the House on the progress of those discussions with the US Administration?
A disturbing feature of the past week's events has been the regime's censorship of independent media. I join the Minister in calling for an urgent end to restrictions on internet access and television broadcasting across Egypt. As he said, it is not for the United Kingdom to decide Egypt's future path; that is a matter for the people of Egypt. Does he agree, however, that the United Kingdom has a responsibility to those people to support their demands for freedom and to encourage an orderly transition to a more open, democratic and pluralist Egypt?
Alistair Burt: I thank the hon. Gentleman for the tone and content of his remarks, and particularly for his appreciation of the work of our consular staff in London and Egypt. I think that he and I see the political situation there in very similar terms.
In answer to the hon. Gentleman's question on consular staff, we have 20 members of staff at Cairo airport. They are very visible, because they are wearing orange bibs so that people can see them. I understand that we are the only Government who have staff there. Indeed, a number of them slept there last night in order to be on hand constantly to deal with any issues and to show a degree of solidarity with the British citizens who were required to spend the night at the airport because of the curfew restrictions. We hope we have enough people in place to do the job of answering all the questions.
In terms of EU support over a period of time, Egypt has an association agreement with the EU, which is implemented through a jointly agreed action plan. Although Egypt has implemented some of its commitments on economic reform, progress has been more limited on political and social reform. Indeed, the engagement with the EU contains vital steps on political and social reform-those are pressed on all nations that wish for such relationships. It is only to be hoped that reform ideas will be further implemented as a result of the events that we have seen taking place.
The hon. Gentleman mentioned the middle east peace process. He is right that this situation has come at a very difficult point in that process. An awful lot of work is being done to try to get the parties closer together. Egypt has been an ally in terms of moderate Arab opinion, and of course made its own arrangements-a peace agreement-with Israel some time ago. Clearly, whatever Government emerge in Egypt, and whether the president continues or something else happens in due course, our strategic interests remain the same. We clearly hope for a Government in Egypt who see the middle east peace process as the absolute bulwark to the solutions that are needed in that whole region, and who see that it is crucial to proceed with the process. I know that those concerns are shared in Israel.
I welcome what the hon. Gentleman said about media restrictions, and we are pressing Egypt extremely hard on those matters. Egypt has international commitments to freedom of expression, which has been severely curtailed by restrictions on the internet and electronic media. Our sense is that that actually does no good at all, because of the way in which information spreads these days. Clamping down on one media simply squeezes the bubble and more information appears elsewhere. For all sorts of reasons, not least in respect of getting information to people when there are security difficulties, which we need to do, it would be best not to stop information spreading.
The Prime Minister has had conversations with US President Obama, as the Foreign Secretary has with Secretary of State, Hillary Clinton. Again, there is a common feeling that the demands of the people in Egypt for political reform have been long-standing, and that they are not going to go away, whether they are suppressed or repressed. The only way forward is to look for a proper political process that will give an orderly transition to a state of government of which political reform, free and fair elections, and an acknowledgment and acceptance of free expression, are key parts. On that, the US and UK are absolutely agreed.
Finally, the hon. Gentleman mentioned support for the people of Egypt. As I indicated earlier, it is not for this country to decide what Government there might be, but there are principles that underpin a stable society.
Openness, transparency, accountability and a free political system are, in fact, not agents of dangerous change, but the foundations of political stability. The Government share that view with all in the House. We hope that there is an orderly and peaceful transition towards such a future for the people of Egypt.
Sir Malcolm Rifkind (Kensington) (Con): The Minister has acknowledged that while the departure of President Mubarak would be welcomed on democratic grounds, it would also remove one of the most powerful forces for foreign policy moderation in the middle east. Does he also acknowledge that Egyptian public opinion is far more radical on the peace process and other issues than the President has been, and therefore that the emergence of populist Government could carry the risk of Egypt aligning itself more with Syria and Iran, which would have very disturbing implications for the prospects of peace in the region?
Alistair Burt: My right hon. and learned Friend makes an important point. Egypt's place in ensuring regional security and helping towards finding a way through the very difficult problems in the middle east is well known. No one quite knows what will come out of the greater involvement of the democratic process, but it is to be hoped that Egypt's strategic interests are in regional stability and in furthering the peace process. It will be a matter of free and public debate as to how that argument continues, but this country's strategic interests and those of others are best served by a Government of whatever sort who recognise my right hon. and learned Friend's point-that is a Government who ensure stability in the region, and as I indicated earlier, a Government who help all parties to move towards a middle east peace process settlement as quickly and effectively as possible.
Mr Jack Straw (Blackburn) (Lab): Does the Minister not recognise that stability sought through non-democratic means, including the removal of people's freedoms, can only be temporary, and that although democracy can have many inconvenient consequences, including the election of people we do not like, it is far better, in the medium term, for the stability of the region and Egypt's future that there be free and fair elections in which candidates of any party and persuasion can stand and take office?
Alistair Burt: The right hon. Gentleman speaks the truth. Of course, democracy has its difficulties-we all understand that very well. However, as I tried to indicate in the conclusion of my earlier remarks, it is absolutely clear that the forces of democracy, including free expression, criticism, accountability and transparency -however uncomfortable-are a better foundation for longer-term stability than anything that seeks to repress those feelings, as we have seen not only in Egypt, but in other places. I am quite sure that whatever the democratic process produces will have to be acknowledged by countries around Egypt. However, we all hope that the process will bring people to a recognition that the opportunity to express their feelings about how they wish their country to develop should be taken maturely and effectively.
Sir Menzies Campbell (North East Fife) (LD): Does the Minister accept that in formulating our response to events in Egypt we are to some extent hindered by the ambiguity of previous policy towards not only Egypt but the region, which appeared to put security of energy supply-particularly oil-above issues of democracy and human rights? How will the Government set the balance?
Alistair Burt: Over a number of years, this country and others have engaged consistently in conversations with those in Egypt and other countries in the area about the need for political and social reform. Two weeks ago, I was at a conference in Doha with G8 countries and those representing the broader middle east and north African area. It was the seventh time that this conference had taken place and such engagements had occurred, and a recurring theme was how political and social change could happen in the region. G8 countries sent a consistent message, as the European Union has done over a period of time, and as this Government have done, and I do not think that there is an inconsistency in trying to achieve stability in such a way.
Chris Bryant (Rhondda) (Lab): Is there not the danger that the longer the Egyptian Government try to keep the top on the pressure cooker, the more people will be forced or inclined to look towards radical alternatives, not only in Egypt but elsewhere? Is not the role of organisations such as the BBC World Service of even more significance, therefore, given that we are trying to ensure that people have access to a fair interpretation of events on the ground?
Alistair Burt: As I indicated earlier, free expression is very important. People access information about what is going on by a variety of methods-it is clear that the information tide will never be rolled back. The BBC World Service has played its part, and a new and reformed BBC World Service will continue to do just that.
Richard Ottaway (Croydon South) (Con): The Minister said that Egypt is no Tunisia. In population terms, it is the largest Arab state and a force for moderation, and the treaty with Israel is important and enduring. As highlighted by my right hon. and learned Friend the Member for Kensington (Sir Malcolm Rifkind), a disorderly transition could lead to huge uncertainty, particularly as far as that treaty is concerned.
Alistair Burt: My hon. Friend is absolutely right. That is why all nations, including the EU, the United States and partners, are united in asking for an orderly transition. Opposition can no longer be repressed, but there must be an orderly transition towards a reformed Egypt to ensure stability for us all and not least the middle east peace process.
John McDonnell (Hayes and Harlington) (Lab):
I appreciate the Minister's position in that the Government do not want to be seen to be interfering directly in the affairs of another state. However, it is clear that the diplomatic message that President Mubarak is getting is being interpreted by him to mean that he can remain in
power. May I suggest to the Minister that it is certainly open to the House to express the view that it is time for Mubarak to go?
Alistair Burt: The hon. Gentleman makes his own point, but he is correct in his first interpretation, which is that it is not for the United Kingdom Government to dictate to the Egyptian people how they should govern themselves.
Rehman Chishti (Gillingham and Rainham) (Con): The international community has called for substantial and basic reforms in Egypt. What is the time line by which the international community expects that to happen, and will the current instability and insecurity be taken into account?
Alistair Burt: In the present context, time lines are genuinely difficult to estimate. Nobody knows quite what will happen with those who are gathered in the square or how long protests will continue. Whatever the time line is, I think that the international community would agree that it should naturally be as short as possible. The expression of the people has been clear. There is a process to be gone through, but it must be quick and effective, and it must lead to a reformed Egypt, as far as political change and democracy are concerned.
Mike Gapes (Ilford South) (Lab/Co-op): The Minister referred to developments in different parts of Egypt. Does he have any information about what is happening with the Rafah crossings and the tunnels into Gaza? There is potential for people to take advantage of the current instability and send rockets or other materials into Gaza, with wider destabilising consequences in the region.
Alistair Burt: I understand the concern with which the hon. Gentleman speaks. We have no information at present to suggest that that is happening, but his strictures are well noted and will, I am sure, be taken into account.
Robert Halfon (Harlow) (Con): Following on from the previous question, from the hon. Member for Ilford South (Mike Gapes), has my hon. Friend had a chance to assess the role of the Muslim Brotherhood, particularly given its close relationship with Hamas in Gaza and the potentially destabilising effect on Israel? Does he agree that democracy is not just about elections, but about religious tolerance, property rights, the rule of law and human rights as well?
Alistair Burt: I thank my hon. Friend for his question. The general sense is that events in Egypt have not been influenced by one particular political group or orchestrated in any way. Although the two countries are different, much as with the events in Tunisia, what has happened seems to have been, as far as possible, a spontaneous expression of concern about political freedoms. Although the Muslim Brotherhood is plainly a part of the political force in Egypt, we have no evidence to suggest that it has been involved in creating what is currently happening. My hon. Friend is absolutely right as well that with democracy and governance come responsibilities. The world would be disappointed if a reformed Egypt adopted any extremist attitudes similar to those he described from the parties he mentioned.
Keith Vaz (Leicester East) (Lab): Tomorrow the Minister, the Foreign Secretary and the Minister of State, Department for International Development will meet Dr Abu-Bakr al-Qirbi, one of the longest serving Foreign Ministers in the Arab world. I would caution the Minister not to treat each Arab country as being the same or to treat what is happening in Egypt in a similar way to what happened in Tunisia or Yemen, which has particular issues that need to be addressed. In telling countries about the need for reform, we should encourage democratic movements, rather than letting it appear that we are giving lectures about how countries should be run.
Alistair Burt: The right hon. Gentleman knows Yemen as well as any Member of the House, and I am sure he would not expect us to treat all countries in the region in any way similarly. There may be similar tensions, but each country is different and each is approaching its problems differently. There is an established process, entitled the Friends of Yemen, involving a group of countries working with Yemen to deal with its issues, but it is very much a Yemeni-led process, which His Excellency Dr al-Qirbi is well in charge of, and there is an excellent relationship with the United Kingdom. There are tensions in Yemen that cannot be ignored, but the Government are fully apprised of them, and we are working on a partnership basis.
Stephen McPartland (Stevenage) (Con): Stevenage is the home of the Egyptian Coptic cathedral in the United Kingdom. I attended a memorial service with the Egyptian ambassador earlier this month, after a terrorist attack in Alexandria that killed 23 Christians. Will the Minister assure the House that during these times of protest we will be sending a clear message that attacks on unarmed civilians and minority groups will not go unpunished?
Alistair Burt: I am grateful to my hon. Friend for raising that issue. The attack on the Coptic church over the new year was one of the most upsetting aspects of what has become a wave of attacks against minority communities throughout the middle east. It is absolutely right that such attacks are condemned. Indeed, the Egyptian Government have been quick to condemn that atrocity and to give us confidence, as best they can, that those involved will be met with the full rigour of the law. With any instability, there is always a danger that the situation will be exploited. So far, we have no evidence that any minority community is bearing the brunt of any of the lawlessness, which we would all wish to see ended as soon as possible.
Jeremy Corbyn (Islington North) (Lab): Will the Minister join me in condemning Mubarak's attempt to shut al-Jazeera, which has proved to be an effective reporting mechanism? Does he agree that none of the attempts to shut the media will stifle the message that large numbers of young people are very angry at 30 years of human rights abuse, neo-liberal economics and unemployment, and that until those issues are addressed there will be no stability or peace in Egypt or indeed in any other country that follows those policies?
The hon. Gentleman is right to condemn attempts to shut any electronic media, including al-Jazeera. It is completely self-defeating. There will always be
ways to provide information and we have, indeed, urged on the Egyptian Government the opening up of all electronic media, including al-Jazeera, as soon as possible.
Alistair Burt: I thank my hon. Friend for making a pertinent point. We urged on the Egyptian authorities the appointment of independent monitors for the elections, as we have done in respect of the presidential elections that are due, all other things being equal, in September this year. A measure of transparency would have been very welcome in those parliamentary elections, and we will continue to press this route on the Egyptian authorities.
Mr Andy Slaughter (Hammersmith) (Lab): There are a great many people of Egyptian origin in this country, including many of my constituents. No doubt we all share their concerns not just about what is happening in Egypt, but about the safety of friends and family. What my constituents asked me to put to the Minister is, first, that this opportunity for reform should not be missed; and, secondly, that if and when the old regime falls, there are likely to be profiteers escaping from the country with ill-gotten gains. Will the Minister assure us that they will not be given sanctuary in this country and that British banks will not support any attempt to take money out of Egypt illicitly?
Alistair Burt: The hon. Gentleman raises an interesting point. It was noticeable, particularly in respect of Tunisia, that the international community moved quickly in response to the Government's requests to stop money that they considered to have been abstracted illegally. The British Government would consider any similar requests, should they emerge-but that is some way down the line, as the hon. Gentleman will, I am sure, appreciate.
Mr Tobias Ellwood (Bournemouth East) (Con): I thank my hon. Friend for his statement. These are dramatic events, which happen once in a generation, and the mother of all Parliaments should salute the people-power that overthrows a dictator. Does my hon. Friend agree, however, that other nations should be looking closely at what has happened in Tunisia and is happening in Egypt? Does he also agree that we should use our influence cautiously, as we need only look over our shoulders at what happened in Iran and Algeria to see how things can turn out?
My hon. Friend draws attention to the fact that although the underlying tensions in many of the countries in the region might be similar, each country is indeed different. Reactions to protests such as we see in Egypt are different and the reactions are often different some months after the protests. Algeria remembers, of course, the dark days of its civil war and would understandably have no wish to go down that road again. The people's revolution in Iran-or, at least, the attempted people's revolution in Iran 18 months ago-was savagely repressed. Nobody quite knows what the process
will be in Egypt. Having experienced those examples, however, what the international community can say clearly is that in this case we would like an orderly process of reform. The opportunities for that are there; we very much hope that both parties will seize the chance and produce an Egypt that they would be proud to see taking its place in the international community.
Mr Stephen Hepburn (Jarrow) (Lab): I know the Minister will agree that one of the main causes of unrest in Egypt is the fact that a third of the population live on a few quid a day. Will he make sure that the British Government's position is to try to ensure that the Egyptian trade union movement is involved in any resettlement talks, so that poverty issues can be discussed?
Alistair Burt: It is not for the United Kingdom Government to dictate who might be part of political settlements in any country. I am sure that it is true that the trade union movement in Egypt has a part to play, but that is a matter for the Egyptian people to decide.
Geoffrey Clifton-Brown (The Cotswolds) (Con): As the House must be aware, Egypt is a highly important partner in the context of stability, not only in the middle east peace process but in the wider middle east through the Suez canal and into north Africa. Will my hon. Friend undertake to do all that he can to ensure a peaceful transition by ensuring a peaceful press, a peaceful judiciary and a transition to full, fair and open presidential elections later this year?
Alistair Burt: In mentioning the press, the judiciary and the democratic process of free and fair elections, my hon. Friend has put his finger on three of the essential items that make a country stable. They are all immensely important, no matter what difficult pains may be involved in that democratic process. I have no doubt that the Egyptian authorities will be well apprised of them, and I hope that they will be part of the process over the coming weeks and months.
David Rutley (Macclesfield) (Con): I am grateful for the Minister's assurances about what is being done to protect British tourists in Egypt. This morning, however, I was contacted by a constituent who had been told by his brother-in-law, based in Sharm el Sheikh, that some hotels were boarded up and food rationing was in operation. According to the website of the Foreign and Commonwealth Office, the situation is calm. Does the Minister agree that that information should be revised in order better to advise British tourists and other travellers and their families?
Alistair Burt: I thank my hon. Friend for raising that point. Although the situation in Sharm el Sheikh is genuinely calm and we receive regular updates on it almost hourly from our honorary consul, it is true that certain hotels have taken the precaution of ensuring the safety of their guests by warning them about the curfew and indeed, in some instances, erecting barricades. That has been done in response to their own concerns about what might happen; none of it has been done in response to incidents that have already happened.
Although guests and British tourists have understandably been slightly alarmed by what has been done, we understand that it has been done entirely for their own protection,
and that the situation is indeed calm. Our travel advice therefore remains that it is safe to go to Sharm el Sheikh, and we sincerely hope that that is still the case. If there were any changes we would know about them quickly, and would respond accordingly.
Tracey Crouch (Chatham and Aylesford) (Con): Will the Minister join me in condemning President Mubarak's use of the military aircraft that were deployed yesterday to threaten and intimidate legitimate protesters on the streets of Cairo?
Alistair Burt: I am sure that none of us who saw those pictures could quite work out what was intended to be conveyed, or whether it had delivered precisely what the Egyptian Government had intended. It is not for us to comment on the reasons for the deployment of aircraft, but we sincerely hope that it does not presage attempts to use any form of violence to deal with what is essentially a peaceful reform protest.
Stephen Mosley (City of Chester) (Con): There have been reports in the press about attempted looting of the Egyptian museum in Cairo, which is home to many unique artefacts of global importance, including the Tutankhamun treasures. Will the Minister ensure that the British Government send a strong message to Egypt about the importance of maintaining the safety of its unique archaeological heritage?
Alistair Burt: I understand that the Egyptian authorities were equally alarmed by the possibility that lawlessness would extend to looting which might involve their antiquities, and that they have responded accordingly. It is to the benefit of the whole world for those antiquities to be preserved and for the museum to be safe, and we are sure that the Egyptian authorities are well aware of the need to do just that.
Sajid Javid (Bromsgrove) (Con):
I thank the Minister for his statement. Ever since Egypt signed an historic peace agreement with Israel in 1979, we have rightly
considered her to be a very strategic and reliable ally. Has the Minister made any assessment of the impact of an abrupt regime change in Egypt on our own national security?
Alistair Burt: The Foreign and Commonwealth Office, in line with various other bodies, is indeed considering the implications of what all this might mean. While no one can say precisely where it will end, my hon. Friend is right to observe that the strategic interests of the United Kingdom are furthered by a Government, of whatever sort and whoever leads them, who retain the same strategic sense of the importance of stability in the middle east, the need to find a solution to the middle east peace process as quickly as possible, and the need to maintain the best possible relations with its neighbours, while also playing a part in ensuring regional security-particularly in relation to countries such as Iran.
Mel Stride (Central Devon) (Con): The Minister rightly states that it is, of course, for the Egyptian people to decide their Government's future. Nevertheless, will he inform the House what actions our Government may be able to take to minimise the possibility of an extremist Government taking over, as unfortunately happened on the Shah of Iran's fall in 1979?
Alistair Burt: The nature of my hon. Friend's question and the way in which he put it show that he appreciates that there is a limited amount that any external source can do to dictate to the Egyptian people what they might do with freedom of expression through the ballot box. The best thing we could do is make clear, once again, our belief that Egypt's interests would be best served by having a moderate reformed Government who look at their place in the world and at the dangers of extremism and themselves turn away from those who would advocate that course, either in the region or in the world. We believe that Egypt should find itself with a Government with whom not only Egyptians, but others would be comfortable.
Catherine McKinnell (Newcastle upon Tyne North) (Lab): On a point of order, Mr Speaker. I would be grateful for your guidance in relation to recent announcements made in the media about convictions following the Ratcliffe-on-Soar power station protest. As shadow Solicitor-General, I wrote to the Attorney-General on 14 January asking for an urgent update on this case-I am yet to receive a response. When I met the Director of Public Prosecutions on Tuesday, I was informed that the Independent Police Complaints Commission was investigating the case and that no comment could be made until that process was complete. Yet, on Friday, only a couple of days later, both the BBC and The Guardian appear to have been officially informed that the DPP will appoint a senior barrister to review all 20 cases, less than two weeks after sentencing took place. Given the significance of this case and the wider questions that arise for our criminal justice system, could you provide some guidance on how I may ensure that the Attorney-General, who is accountable to this House for the actions of the Crown Prosecution Service, ensures that announcements of this gravity are made to this House, and not directly to the media, particularly where an update has been specifically requested?
Mr Speaker: I thank the hon. Lady for her point of order. I am not familiar with the circumstances to which she draws attention, but I can say to her and to the House that I have not been informed of any Government intention to make a statement on this matter today. The hon. Lady asks for my guidance as to how best she might pursue the matter. The short answer is that she should discuss with the Table Office other opportunities for her to pursue the matter to what hopefully will be, from her point of view, a satisfactory conclusion.
Chris Bryant (Rhondda) (Lab): On a point of order, Mr Speaker. The BBC is reporting that at a recent meeting of the 1922 committee, and in relation to the Parliamentary Voting System and Constituencies Bill, the Prime Minister promised
"that no Conservative MP would lose out from the reduction in the total number of MPs from 650...to 600, and there would be no head-on contests between Tory MPs for the newly drawn constituencies."
Mr Speaker: I am very grateful to the hon. Gentleman for his attempted point of order, and I make three points, which I hope the House will readily understand. First, these are not matters for the Chair. Secondly, I am not responsible for the statements of the Prime Minister. Thirdly, I am most certainly not responsible for what takes place at the 1922 committee. I hope that that is pretty clear.
Jeremy Corbyn (Islington North) (Lab): On a point of order, Mr Speaker. You will have heard the statement on Egypt and everyone's plea that people in Egypt may have universal access to the media. In those circumstances, would you consider expanding the number of satellite channels available on the TV in this building to include al-Jazeera, which has given such good coverage of what is going on in Egypt?
The purpose of the Bill can be expressed in one sentence-to improve the health of the people of this country and the health of the poorest fastest. While the previous Government increased funding for the national health service to the European average, they did not act similarly to increase the quality of care. We spent more, but others spent better. In important areas, the NHS performs poorly compared with other countries. An expert study found that out of 19 OECD countries that were investigated, the UK had the fourth-worst death rate from conditions that are considered amenable to health care. If NHS outcomes were as good as the EU15 average, we would save 5,000 lives from cancer and 4,000 lives from stroke every year. We would also prevent 3,000 premature deaths from respiratory disease and 1,000 premature deaths from liver disease every year. This cannot go on: things have to change to protect the NHS and deliver better results for patients.
Mr Kevin Barron (Rother Valley) (Lab): I do not dispute what the Secretary of State says about European comparators, but what does he say to Professor John Appleby, who said last Friday that all those markers, some of which are not direct comparisons, are getting nearer to European targets? Professor Appleby suggested that the disruption that is going to take place in the health service will not help us to do that.
Mr Lansley: I would say two things to Professor John Appleby. First, the latest data published in EUROCARE-4, which I know the right hon. Gentleman will have seen, are clear about the gap between cancer survival rates in this country and others, and in recent years that gap has not diminished as it should have. He can read in last week's Lancet an authoritative study of cancer survival rates in this country and a number of others demonstrating that the gap remains very wide and that we have to close it. Secondly, the King's Fund supports the aims of the Bill and Professor Appleby, as a representative of the King's Fund, clearly understands, as we do, that if we are to deliver the change that is needed, we need the principles in the Bill.
People trust the NHS, and its values are protected and will remain so-paid for from general taxation, available to all, free at the point of delivery and based on need rather than the ability to pay. However, a system in which everyone is treated the same is not one that treats everyone as they should be treated. Our doctors and nurses often deliver great care, but the system does not engage and empower them as it should.
Geraint Davies (Swansea West) (Lab/Co-op):
On the John Appleby point, does the Secretary of State accept that what he actually said was that the rate of deaths from heart disease would be better in Britain than in France by 2012, on current trends, even though France spends 28% more on its health service? Is not that a
ringing endorsement of what is happening now rather than a prescription for blowing up the system as the Secretary of State suggests?
Mr Lansley: First, I have just answered the point about John Appleby. It is true in a number of respects, as I have made clear, that although there have often been improvements in the NHS, they have not been what they ought to have been. It was a Labour Prime Minister, back in 2001, who said that we must raise resources for the NHS to the European average, but he did not achieve results that compared with the European average.
Let me give the hon. Gentleman some examples. A recent National Audit Office report showed that as many as 600 lives a year could be saved in England if trauma care were managed more effectively. Too often, the latest interventions, which are routine in other countries, take too long to happen here. John Appleby used heart disease to illustrate his point. Primary PCI- percutaneous coronary intervention-using a balloon and stent as a primary intervention to respond to heart attack was proven to be a better first response years ago. I knew that because cardiologists across the country told me so several years ago. I remember a cardiologist at Charing Cross telling me, "I have a Czech registrar working for me who says that in the Czech Republic PCI as a response to a heart attack is routine, but it hardly ever happens in this country." Since then, it has been better implemented in this country, but that started to happen only when the Department of Health gave permission for its adoption.
The same was true of thrombolysis for stroke. That happened too late in this country, after such changes had taken place in other countries, because health care professionals there were empowered to apply innovation to the best interests of patients earlier.
Nadine Dorries (Mid Bedfordshire) (Con): Does my right hon. Friend agree that, given the disparity in survival rates in trauma care and in many illnesses, including cancer care and heart attacks-citizens in this country are twice as likely to die of a heart attack as those in France-the NHS is in desperate need of modernisation?
Mr Lansley: My hon. Friend is right. We need not only to match European spending, as we do now, but to ensure that we achieve European-level results. It is not just about benchmarking, which we know we must do. We must benchmark ourselves against the best in the world if we are to deliver the best results for patients. We must also constantly make sure that we achieve a modernised health service that delivers the best possible care-sometimes going ahead of what others achieve, and applying innovation more quickly.
In some ways, as we know-for example, in mortality rates from accidents and from self-harm, and in equity of access to health care-the NHS leads the world, but our doctors and nurses are regularly hobbled by a system that treats equality as sufficient, when what we need is both equity and excellence.
Mr Denis MacShane (Rotherham) (Lab):
Given the Secretary of State's praise for health care systems in Europe, which we are all connected to, will he consider
allowing British patients to seek such health care in Europe, paid for by the NHS?
Mr Lansley: With his knowledge of European matters, the right hon. Gentleman knows that we are in the later stages of the collective approval through the European Union of the European cross-border health directive, which allows precisely that and makes it clear that the same criteria are applied to patients seeking health care in other countries as would apply were they to seek it through the NHS in this country.
Why did spending more not deliver better results? We know why that is- [Interruption.] No, better results should have been achieved. Hon. Members on the Opposition Benches need to realise this, because it has been at the heart of their failure in public service reform over the past decade: the Office for National Statistics said a few weeks ago that productivity in the NHS fell in every one of the past 10 years. It fell by 1.4% a year in hospital services.
Despite a huge amount of money rightly invested in the NHS, taxpayers and patients were not getting the service that they should have had. Billions of pounds have also been wasted on an ever-growing bureaucracy, taking money away from the front line and away from patient care. The number of managers doubled under Labour. I give way to the Chair of the Public Accounts Committee.
Margaret Hodge: I thank the right hon. Gentleman. He is right to draw attention to the fact that productivity has fallen in the past 10 years, but should he not consider whether it is wise in those circumstances to distract people from driving up productivity and achieving savings by the unnecessary institution of reform? That is just taking people away from the thing that they should be concentrating on.
Mr Lansley: The right hon. Lady should understand, as I will go on to explain, that we are not distracting the NHS from the need to improve services for patients. We are enabling the NHS to improve services for patients. In her role on the Public Accounts Committee, she should understand that right across the public services, one of the consequences of dealing with the deficit is that we will have to reduce the costs of bureaucracy and administration.
We will do that in the NHS as much as anywhere else, but we will not do it in the way that the Labour party pressed us to do, which was to cut the NHS budget-[Hon. Members: "What?"] Yes, Opposition Members did exactly that. We will increase the NHS budget. As we set out in the spending review, we will increase the NHS budget
by £10.7 billion over the life of this Parliament-investment that Labour opposed-and we are determined to get far more for British taxpayers' money.
Angie Bray (Ealing Central and Acton) (Con): My right hon. Friend will be aware that there has recently been an excellent reorganisation of stroke treatment in London, with a number of hospitals earmarked as emergency centres, all of which, crucially, are within 30 minutes of every Londoner. Once patients have been through the emergency procedures and are stabilised, they are returned to local stroke centres, which are also earmarked as part of the whole programme. Can he reassure me that that kind of regional organisation of hospitals, which has delivered good results, will not suffer through some of the proposed reforms?
Mr Lansley: Thank you, Mr Speaker. I can give my hon. Friend the Member for Ealing Central and Acton (Angie Bray) precisely that reassurance. I was with NHS London at the beginning of last week, and it is clear that GP commissioning groups are coming together with providers to develop those kinds of commissioning plans, going beyond trauma and stroke care, which has already happened in London, to look, for example, at the integration of diabetes care between primary care and hospital services.
Under the Bill, patients will come first and will be involved in every decision about when, where, by whom, and even how, they are treated-"there must be no decision about me, without me." The 2002 Wanless report called for patient engagement, but that did not happen. Now it will. Because patients cannot be empowered without transparent information, an information revolution will give them more detailed information than ever before, showing them and their doctors the consultants who deliver the best care, giving them control over their own care records and enabling everyone to access the care they need at the right place and at the right time. Patients and their doctors and nurses will be able to see clearly which provider of health care offers the best outcomes and to make their decisions accordingly.
Ian Lucas: The right hon. Gentleman is being generous in giving way. If those proposals are so important and necessary, why were they not included in the Conservative party manifesto at the general election?
Mr Bernard Jenkin (Harwich and North Essex) (Con): May I assure my right hon. Friend that this is not being greeted by local GPs in my constituency as some disruptive revolution, but as a logical extension of all the debate and development in the NHS over the past 20 years or more on giving patients more power and GPs more control over the allocation of resources?
"We will strengthen the power of GPs as patients' expert guides through the health system by enabling them to commission care on their behalf."
"putting them in charge of commissioning local health services."
Mr Lansley: I am sorry, but 57 Members wish to speak, as you have rightly told us, Mr Speaker. I will give way as often as I can, but more than one intervention for each Member is excessive. [ Interruption. ] I have just quoted from the coalition agreement and our manifesto, so hon. Members have heard both.
Through the outcomes framework, which we published in December, we will stop the top-down, politically motivated targets that have led to real quality being sidelined. We will ensure that we focus on the outcomes that really matter and back them up for the first time with quality standards that are designed to drive up outcomes in all areas of care. Those standards have not been dreamt up in Whitehall, but are being developed by health professionals themselves. Similarly, doctors and other health professionals will not be told by us how to deliver those standards. The standards will indicate clearly what is expected, but it will be up to clinicians to decide how to achieve them. At every step, clinical leadership-that of doctors, nurses and other health professionals-will be right at the forefront. It will be an NHS organised from the bottom up, not from the top down.
The shift in power away from politicians and bureaucrats will be dramatic. The legislation none the less builds on what has gone before. It is not a revolution, but as the shadow Secretary of State said just a fortnight ago:
"The general aims of reform are sound-greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes-and are common ground between patients, health professions and political parties."
Emma Reynolds (Wolverhampton North East) (Lab): The right hon. Gentleman quoted the National Audit Office earlier. Does he agree with the statement in its report that his revolution in and upheaval of the NHS risk undermining the quality initiative-the so-called QIPP programme-that the previous Government introduced?
Mr Lansley: No, far from it-actually, quite the contrary. It is only by virtue of our ability to engage front-line clinicians more strongly in the management and design of care that we will deliver those quality, innovation, productivity and prevention ambitions; and it is only if we cut bureaucracy and the costs of bureaucracy that we will be able to get those resources on to the front line more effectively. I made it very clear, and the shadow Secretary of State endorsed the view, that there is consensus about the purposes of reform, but if Labour now voted against the Bill, although we do not know whether it will, it would abandon that consensus and, indeed, its own policies when in government.
Mr Lansley: I just wish that the hon. Gentleman would look at the latest published data. Since the election, we have reduced the number of managers in the health service by almost 4,000 and increased the number of doctors. For the first time, there are more than 100,000 doctors in the NHS, and we are increasing the number of health visitors, after years of their numbers being reduced under the previous Government. He should get his facts right before he starts flinging accusations about.
The Labour party, when in government, pioneered patient choice; Labour said, "We must have patient choice." I remember John Reid, when he was a Member, saying that the articulate and the well-off negotiated their way through the health service, and that he wanted to give choice to everybody in the health service. He was right. The social attitudes survey in 2009 found that more than 95% of people felt that they should have more choice, but that fewer than half of patients actually experienced it. The Labour party started down the road of extending choice; we will complete that journey.
Andrew George (St Ives) (LD): On patient choice in health service design, is the Secretary of State aware that in Cornwall the primary care trust has engaged in the transfer of community hospitals and services without adequate public consultation and at breakneck speed? If "no decision about me, without me" is to apply to service design and patient involvement, is he prepared to intervene to ensure that the public are involved in such important decisions?
Mr Lansley: I am grateful to my hon. Friend for that point. I have not previously been asked to comment on the matter, nor have I received information about it, but from my visits to Cornwall I entirely endorse his view about the importance of community hospitals in accessing services. He will see that, in the Bill, a specific duty is placed on the commissioning board and each commissioning consortium to reduce inequalities in access to health care. He will see also that, through the Bill, we will strengthen accountability where major service change takes place, because it will require not only the agreement of the commissioning consortium, representing as it were the professional view, but the endorsement of the health and wellbeing board, which includes direct, local, democratic accountability. Points have been made about what was in manifestos, but the Liberal Democrat manifesto was very clear about the need for democratic accountability in health service commissioning-and so there will be.
Let me return to the point, because the previous Government also went down the route of practice-based commissioning. It was their policy, but, as the shadow
Health Minister, the hon. Member for Leicester West (Liz Kendall) said, many GPs felt that
"they didn't always get the power, responsibility and resources they might have wanted."
On our definition of quality, Opposition Members say "quality matters". It does, and it was under the Labour Government that Ara Darzi pioneered the thought that quality must be at the heart and an organising principle of the health service. It is we now who are going to make that happen. We are publishing quality standards. We are putting into this legislation a duty to improve quality that extends to all the organisations that commission and provide NHS services.
Mr Ronnie Campbell: Will there be public accountability for the private companies that will come in and do the commissioning for the doctors? I can see their people getting top salaries-the executive getting £200,000 and the financial officer getting £250,000. That is the sort of thing that we are trying to stop. What will happen when these companies run things for doctors?
Mr Lansley: The accountability in the NHS will be for the quality of the service being provided. The hon. Gentleman may not have agreed with the last Labour Government on this, and perhaps many in the Labour party are now changing their view on what was pursued by that Government, but it was that Government who introduced and encouraged a policy of "any willing provider". In 2003, Alan Milburn said:
"If I can get a private-sector hospital to treat an NHS patient, then for me the person remains an NHS patient."
Everybody in the NHS who provides NHS services will be accountable through the- [Interruption.] The money will follow. The Chair of the Public Accounts Committee is here. Where public money goes, accountability for its use will follow.
Mr Lansley: Let me complete this point, then I will give way to my hon. Friend the Member for Basildon and Billericay (Mr Baron). On the point of allowing the independent sector to be a provider to the NHS, I should say that it was the right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State's predecessor, who said that
"the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate."-[ Official Report, 15 May 2007; Vol. 460, c. 250WH.]
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