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House of Commons

Wednesday 26 October 2011

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Business Before Questions

London Local Authorities Bill [Lords]

Motion made, That the Bill be now considered.

Hon. Members: Object.

Mr Speaker: I was about to say, “The Question is that the Bill be now considered.” Objection taken. The hon. Member for Christchurch (Mr Chope) is always quick off the mark.

Bill to be considered on Wednesday 2 November.

Oral Answers to Questions

International Development

The Secretary of State was asked—

Central America

1. Kerry McCarthy (Bristol East) (Lab): What recent assessment he has made of the humanitarian situation in central America; and if he will make a statement. [76677]

The Parliamentary Under-Secretary of State for International Development (Mr Stephen O'Brien): First, on behalf all right hon. and hon. Members, may I express our sympathy, concern and deep condolences to the people of central America who are affected by the floods, especially those who have lost loved ones and their homes? The hon. Lady will have noted the statements made on 14 and 20 October by the Minister of State, Foreign and Commonwealth Office, my hon. Friend the Member for Taunton Deane (Mr Browne). We have made an assessment of need, and currently we judge that the Governments and national relief agencies of those countries, supported by neighbouring countries such as the United States, and agencies such as the United Nations and International Committee of the Red Cross, are responding well and providing sufficient essential humanitarian aid.

Kerry McCarthy: I appreciate that the Department for International Development is not involved in central America, but it is the best agency in the world for delivering disaster relief, as has been shown in places such as Pakistan. May I therefore urge the Minister to keep a close eye on the situation? Will he be ready to respond if our services—not just funding, but expertise—are called on?

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Mr O'Brien: I am grateful to the hon. Lady for noting the technical expertise of the UK response and the Department. Of course, with official advice, we are keeping very close track of the situation, and we will take the necessary steps as called upon. However, our attribution through the multilateral agencies that we fund is clearly playing its part. Therefore, the UK taxpayer is indeed supporting the relief effort in that part of the world.

Andrew Rosindell (Romford) (Con): May I thank the Secretary of State for his excellent recent meeting with central American ambassadors, including the high commissioner of Belize? Will the Minister confirm that the Government will work more closely with the countries of central America—an important part of the world with which we have a lot in common, and with which we should co-operate more closely?

Mr O'Brien: I am delighted to note that excellent meeting—the Secretary of State found it extremely enjoyable and helpful. Those many nations and our country are working to strengthen and develop our relationships, particularly on climate change and trade.

Jim Shannon (Strangford) (DUP): The people of the UK are very generous, but it is estimated that some 30% of humanitarian aid is removed at the harbour at which it arrives. Will the Minister give an assurance that he will have discussions with the countries that receive humanitarian aid to ensure that all of it gets to the people for whom it is intended?

Mr O'Brien: The hon. Gentleman raises an important point about ensuring that the money reaches the destination and serves the purpose for which it is intended. That is absolutely central to the redirection of the Department for International Development’s aid effort in the past year. We are ensuring that we align every effort to results, to ensure that the money reaches the purposes intended.

World Population

2. Richard Ottaway (Croydon South) (Con): What steps his Department is taking to meet the consequences for developing countries of a growing world population. [76678]

The Secretary of State for International Development (Mr Andrew Mitchell): Britain is extending to at least 10 million more couples the availability of contraception, so that women can choose whether and when they have children. We are also boosting programmes in health and education with a particular focus on girls and women.

Richard Ottaway: The world’s population will go past 7 billion this week, with profound effect. We have millions living in poverty, shortages of food and water and inadequate health provision. Does the Secretary of State agree that one root cause of that is the unmet demand for contraception from some 200 million women living in sub-Saharan Africa?

Mr Mitchell: My hon. Friend, who knows a good deal about this matter, is absolutely right. Indeed, I have been reading a pamphlet that he published—within the past two days, I believe—entitled “Sex, Ideology and Religion”, which is a treatise on population. He

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refers to the 215 million women who want, but have no access to, contraception. The Government are directly seeking to tackle that, not least in respect of the extra 10 million women. That is a good start, but we will do more over the next four years.

Ann McKechin (Glasgow North) (Lab): What steps is the Secretary of State taking to help women to enforce their legal rights to a minimum age for marriage, and to property and succession, which are clearly important to ensuring that women have a proper economic entitlement in their countries and to supporting planned families?

Mr Mitchell: The hon. Lady is right to mention early marriage, which we are seeking to tackle in particular. We have conducted a pilot study with the Nike Foundation, with which we work closely, on preventing early marriage in the Amhara part of Ethiopia. The results of that pilot are excellent, and I can assure her that we are including in all our programmes, as a fundamental pillar of our work with girls and women, the point that she accurately made about stopping early marriage.

Malcolm Bruce (Gordon) (LD): The Secretary of State is right to stress the rights of women to choose when to have children and how many to have, but does he also agree that the evidence is that if we can promote sustainable development the necessity for large families diminishes and population pressures tend to reduce, and that that ought to be at the heart of the Government’s objectives in partnership with our development partners?

Mr Mitchell: My right hon. Friend is absolutely right. A classic example is the work that the Government are doing and the priority that we accord to getting girls into school. We know that girls who are educated get married later and have fewer children. That is a good example of what he is saying.

Mr Speaker: I call Mr Barry Sheerman. He is not here.


4. Mr Douglas Carswell (Clacton) (Con): What assessment he has made of the effectiveness of budget support aid provided to Uganda. [76680]

The Secretary of State for International Development (Mr Andrew Mitchell): There is a narrow role for general budget support in Uganda, but I am reducing its level by 80% over the next four years.

Mr Carswell: Is there not a danger that budget support paid to the Ugandan Government helps to make them accountable to British officials, when we should be trying to make them more accountable to their own people?

Mr Mitchell: My hon. Friend, who knows a good deal about Uganda, is correct to say that that is a danger, which is why the Government have made it clear that wherever we use general budget support, we will always ensure that up to 5% of the money is spent on enabling civil society to hold its own Government and Executive to account.

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Tony Cunningham (Workington) (Lab): What steps is the Secretary of State taking to provide support and aid to the 2 million people forced from their homes by the terrible conflict in Uganda?

Mr Mitchell: First, I welcome the hon. Gentleman to his new position. He has emerged from six and a half years in the Whips Office, so it is a relief for everyone to hear that he can still speak.

The hon. Gentleman rightly makes it clear that the importance of tackling conflict should be at the heart of development policy. Of all the 28 countries with which we have a bilateral programme, about three quarters are directly engaged in or have recently come out of conflict. That is an important aspect of everything that we do.

Green Economies (Caribbean)

5. Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con): What steps his Department is taking to assist countries in the Caribbean to develop greener economies. [76681]

The Minister of State, Department for International Development (Mr Alan Duncan): We are supporting the Caribbean to develop greener economies both bilaterally and through multilaterals. That support includes the development of renewable energy, such as bioethanol from banana waste in St Lucia, developing and implementing a low-carbon growth strategy in Guyana, and helping Anguilla implement a 10-year plan for achieving carbon neutrality.

Dr Poulter: The Minister will be aware that at the Copenhagen summit there was discussion about funds being made available to islands such as those in the Caribbean, which are particularly susceptible to climate change, in order to combat the challenges that they face. Will he update the House on discussions his Department has had with those in the Caribbean, and other small islands, on supporting them in that respect?

Mr Duncan: Negotiations on designing the green climate fund instrument are not due to be concluded until the UN framework convention on climate change conference in Durban this December. The proposal that will be submitted to the conference would make resources for adaptation and mitigation available for all developing countries, including those in the Caribbean, and hence should also include other small island developing states.

Rushanara Ali (Bethnal Green and Bow) (Lab): As well as prioritising the need for developing greener economies in the Caribbean and other islands ahead of the Durban conference, what are the Government doing—I want to reiterate this point—to provide international leadership to ensure that the commitment made in Copenhagen to raise $100 billion per year by 2020 is met by the international community, so that, as has been said, the most vulnerable countries get the support that they need for adaptation and mitigation?

Mr Duncan: I can assure the House, and the hon. Lady, that climate change is one of the three pillars of our development policy in the Caribbean. The UK is working bilaterally in the overseas territories, as well as

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regionally across the Caribbean with institutions such as the Caribbean Community Climate Change Centre and the Caribbean Development Bank, as well as other donors, to promote green economies in the Caribbean and address the broader challenges of climate change.


6. Michael Connarty (Linlithgow and East Falkirk) (Lab): What plans he has to visit Palestine to assess the humanitarian situation. [76683]

The Minister of State, Department for International Development (Mr Alan Duncan): I visited the west bank in July and saw at first hand the difficulties faced by Palestinians, particularly in Area C. The Secretary of State is keen to visit when his schedule permits.

Michael Connarty: I am grateful for that positive response from the Minister. I am sure that, like me, he reads the reports of the Office for the Co-ordination of Humanitarian Affairs occupied Palestinian territory, which I believe every Member should look at regularly. Some 90% of the water in the aquifer in Gaza is undrinkable, while up to 80 million litres of raw or partly treated sewage is going into the sea, and the Israeli authorities have just bulldozed six wells on the west bank. Surely nothing can be more pressing than a man-made humanitarian disaster on this scale. We must take positive action, and the Secretary of State must go and see it for himself.

Mr Duncan: Notwithstanding the difficulties of getting into Gaza, we have a broad measure of sympathy with what the hon. Gentleman has said. We are deeply concerned about the impact of restrictions on Palestinians living in Area C and Gaza. Access to water and land is restricted, food insecurity is high, and 18% of Palestinians in the west bank are living below the poverty line.

Martin Horwood (Cheltenham) (LD): The minority Bedouin population of Israel and the Palestinian territories is particularly vulnerable to the conflicts over water, land use and boundaries in that part of the world. Will Ministers raise their plight with the Israeli and Palestinian authorities as an urgent humanitarian priority?

Mr Duncan: We do that regularly, and—in answer both to that question and the previous question—we also reiterate that Palestinians have access to only 20% of west bank water resources, which means that Palestinians have the lowest access to fresh water in the region. As the hon. Member for Linlithgow and East Falkirk (Michael Connarty) said, 90% of drinking water in Gaza does not meet international standards. We continue to call on Israel to cease actions that prevent Palestinians from gaining access to the clean drinking water to which we are all entitled.

International Development Outcomes

7. Nick de Bois (Enfield North) (Con): What assessment he has made of the international development outcomes of the UN General Assembly; and if he will make a statement. [76684]

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The Secretary of State for International Development (Mr Andrew Mitchell): Our focus at the United Nations General Assembly was threefold: maintaining momentum on the girls and women agenda; driving forward the lessons of the Government’s humanitarian and emergency response review; and ensuring that people focus on achieving the millennium development goals by 2015. Progress is being made in each area.

Nick de Bois: I thank the Minister for that answer. A year on from the Secretary-General’s Every Woman, Every Child initiative, launched at last year’s General Assembly, what progress is the UK making on the commitment to save the lives of 50,000 women and 250,000 newborns?

Mr Mitchell: I thank my hon. Friend for his comment. We now publish—in the bilateral aid review and the multilateral aid review—precisely who we will support to achieve those objectives and how we will do it. Over the coming years we will be able to demonstrate that we are going further than we set out in the bilateral aid review, and the results that we achieve in all these areas—particularly in saving lives and advancing contraception—point to extremely good progress.

Mark Durkan (Foyle) (SDLP): What priority is the Secretary of State giving to improving food security and agricultural markets and, in particular, the role of women marginal farmers?

Mr Mitchell: This is a particular priority for the Government, not least in the horn of Africa, where we have seen severe food stress and food insecurity, especially in Somalia. It is also likely to be a focus next year, as we build on the progress being made through, for example, our work with the World Food Programme in Karamoja, where food insecurity and food aid are being replaced by progress and food security.


8. Kevin Brennan (Cardiff West) (Lab): What steps he is taking to support reconstruction in Somalia. [76685]

The Secretary of State for International Development (Mr Andrew Mitchell): Reconstruction in much of Somalia remains difficult because of the ongoing conflict. My primary concern is to help to save the lives of the 750,000 people, mostly women and children, who are facing starvation and disease.

Kevin Brennan: Does the Secretary of State agree that the recent interception of two young men from Cardiff—one from my constituency, the other from that of my right hon. Friend the Member for Cardiff South and Penarth (Alun Michael)—shows that it is in our national interest to ensure that we are engaged in reconstruction in Somalia? Will he commit to sustaining the Government’s support for the response in Somalia through 2012, and urge our Disasters Emergency Committee partners and others to do the same?

Mr Mitchell: The hon. Gentleman is absolutely right. The whole of our development budget is spent in Britain’s national interest, and a large chunk of it goes to support our own security and prosperity here at home. Somalia

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is one of the most dysfunctional countries in the world. It is a classic example of a failed state where, because we were unable to tackle the causes of deep poverty, we are now dealing with the symptoms of both poverty and deep insecurity.

Fair Trade Projects

9. Nic Dakin (Scunthorpe) (Lab): What steps his Department is taking to promote fair trade projects in developing countries. [76686]

12. Steve Rotheram (Liverpool, Walton) (Lab): What steps his Department is taking to promote fair trade projects in developing countries. [76689]

The Minister of State, Department for International Development (Mr Alan Duncan): DFID believes that people can never escape poverty without the opportunity to produce and trade freely. By promoting open markets and a strong framework for international trade, we are helping to support fair market access for poor people. We aim to double the number of fair trade certified producers to 2.2 million by the end of 2013, and to improve working conditions in global supply chains.

Nic Dakin: I thank the Minister for his response. What steps is he taking to ensure that the Doha round of talks is completed and that a fair deal on trade will be achieved for developing countries?

Mr Duncan: That is an essential objective for the entire Department. International progress towards the conclusion that we would like to see is proving somewhat difficult, but we will continue our great effort to try to secure an improved trading environment for the world.

Steve Rotheram: What steps is the Secretary of State taking to ensure that fair trade best practice is reflected in the Government’s public procurement policy?

Mr Duncan: We optimise as far as possible everything that DFID and the Government buy, so that the fair trade label appears wherever it possibly can within government. That remains our objective in all that we do.

Greg Mulholland (Leeds North West) (LD): We do indeed need more fair trade projects in developing countries, but that also relies on people buying more fair trade products here. Will the Minister commend and wish well the campaign to make Yorkshire and the Humber the first UK fair trade region?

Mr Duncan: We strongly support objectives of that sort. There are many towns across the country that have secured fair trade status. The Department and I—and, I hope, all of us—are enthusiastic supporters of fair trade, which is not just a notion but a sensible and practical approach to supply chains that ensures that some of the poorest people in the world can benefit from their hard work.


10. David Rutley (Macclesfield) (Con): What his most recent assessment is of the humanitarian situation in Somalia. [76687]

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The Parliamentary Under-Secretary of State for International Development (Mr Stephen O’Brien): Somalia remains in desperate crisis, with 4 million people affected and 750,000 at risk of starvation. Life-saving aid is getting through, but insecurity, access constraints and displacement are undermining effective delivery. The scale of need means that continued support is required through 2012.

David Rutley: Sadly, many people in Somalia, Ethiopia and Kenya are suffering from a terrible drought, although an official declaration of famine has been avoided. Will my hon. Friend tell the House what lessons can be learned from this about the importance of long-term investment in food security?

Mr O’Brien: My hon. Friend makes an important point. In addition to relieving the humanitarian crisis in Somalia, we must also recognise that resilience and the efforts to address food security as a strategic priority in the medium to long term underpin all our efforts, even in the humanitarian response, in Kenya and Uganda, where famine has not been declared. We have just heard from the Secretary of State about the efforts being made in Uganda.

Topical Questions

T1. [76692] Mr Ronnie Campbell (Blyth Valley) (Lab): If he will make a statement on his departmental responsibilities.

The Secretary of State for International Development (Mr Andrew Mitchell): We are supporting the national transitional council’s stabilisation work in Libya, which we have helped to plan since the beginning of the conflict. We are heavily engaged in helping to save lives in the horn of Africa, and we are boosting development in the Commonwealth ahead of discussions at the Commonwealth Heads of Government meeting in Australia later this week.

Mr Campbell: I understand that the Secretary of State will meet the President of Colombia in a few weeks’ time. Will he raise the issue of the assassinations and the killings? This year we have already seen 56 people killed for being human rights defenders. Will the right hon. Gentleman tell the President that the Arab spring might knock on his door one day?

Mr Mitchell: The hon. Gentleman is right to underline the importance of promoting human rights wherever we can. When I have discussions with the President of Colombia, I will certainly take on board the hon. Gentleman’s point. [Interruption.]

Mr Speaker: Order. There are far too many noisy private conversations taking place. The House will want to hear Mrs Helen Grant.

T4. [76695] Mrs Helen Grant (Maidstone and The Weald) (Con): What action is the Secretary of State taking to tackle forced marriage and early marriage in the developing world?

Mr Mitchell: As I mentioned to the hon. Member for Glasgow North (Ann McKechin), we are supporting specific pilot studies to try to reduce the awful levels of early marriage, not least in Amhara in Ethiopia, where

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we have secured extraordinarily good results. This is a key pillar of the activity that we support in all our programmes.

Mr Ivan Lewis (Bury South) (Lab): May I begin by paying tribute to the work of my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), my predecessor in the role of Opposition spokesperson on International Development? I can tell the Secretary of State that we will continue to support the Government where we agree on the 0.7% commitment and the importance of demonstrating aid effectiveness, but we will also challenge them where we think they are wrong.

What measures will the UK propose at next week’s G20 summit to ensure that there is a renewed push by the world’s leaders to achieve the millennium development goals? More specifically, now that the Department for International Development has launched its nutrition strategy, will the UK use the summit to urge other G20 members to endorse the Scale up Nutrition movement?

Mr Mitchell: May I first welcome the hon. Gentleman to his new position? I look forward to working with him as appropriate. He is quite right to identify the G20 summit next week as a key point where we can boost the interests of the developing world. He specifically mentioned nutrition, which is clearly very important, but the whole agenda for economic growth, which the G20 will address, is one that we should all support.

T5. [76696] Mr Peter Bone (Wellingborough) (Con): We are exceptionally lucky to have a Secretary of State who is so passionate about relieving poverty in developing countries—but does he agree that what we want is not more and more taxpayers’ money going in aid, but more and more trade? What can he do to open the European Union’s markets to developing countries?

Mr Mitchell: I think that I thank my hon. Friend for his first remark. He is right to point out that aid is a means to an end and not an end in itself. That is why the coalition Government have specifically said that wealth creation, entrepreneurialism, enterprise and economic growth should be right at the top of this agenda.

T2. [76693] Mr Michael McCann (East Kilbride, Strathaven and Lesmahagow) (Lab): Later this week the International Development Committee releases its report on the Government’s decision to withdraw bilateral aid from Burundi. Although I cannot comment on the report’s content, the evidence offered by DFID to the Select Committee to support that decision was heavily redacted. Will the Secretary of State explain how the decision to redact squares with the UK aid transparency guarantee?

Mr Mitchell: As I explained to the hon. Gentleman in the Select Committee, we release as much information as we possibly can in my Department, and we publish all expenditure above £500. I know that the Committee is concerned about the closure of the Burundi programme, but Britain is doing a huge amount for the country through its multilateral agenda. There are many other ways apart from having a country-to-country footprint to support development in Burundi, and we must make tough decisions in the interests of the British taxpayer as well.

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T7. [76698] Andrea Leadsom (South Northamptonshire) (Con): What consideration has my right hon. Friend given to issuing food vouchers rather than food aid in order to promote free enterprise and choice in the developing world?

Mr Mitchell: My hon. Friend is absolutely right. This agenda has been championed effectively, not least by Save the Children, and it is one reason why we prioritise social protection rather than food aid. The aim of all these policies is to try to get people off food aid into much greater food security—as seen, for example, in the project between Britain and the World Food Programme, which I talked about earlier.

T3. [76694] Chris Evans (Islwyn) (Lab/Co-op): In the past decade 4 million people have died in the Democratic Republic of Congo, and countless women and girls have been victims of sexual violence. What are the Government doing to ensure that political parties in the DRC refrain from violence during the forthcoming elections?

Mr Mitchell: The hon. Gentleman is right to draw attention to the importance of focusing on the DRC, because there will never be a peaceful Africa without a peaceful DRC. Britain is giving strong support to the democratic process. We have been responsible for the registering of nearly 30 million people in the run-up to the November elections, and we strongly support the United Nations force in the DRC—MONUSCO—which has a chapter VII mandate and is therefore able to protect citizens robustly, especially the women to whom the hon. Gentleman has referred.

T9. [76700] John Glen (Salisbury) (Con): What evidence can the Secretary of State give that our Government’s global leadership in increasing aid spending is encouraging other nations to adopt similar increases?

Mr Mitchell Over the last year there has been an increase in many countries’ support for development, which is quite right and in accordance with the commitments that they have given. Britain has been in the lead in that regard. All our spending is in our national interest, and large amounts of it support our security, and indeed our future prosperity.

Prime Minister

The Prime Minister was asked—


Q1. [76628] Luciana Berger (Liverpool, Wavertree) (Lab/Co-op): If he will list his official engagements for Wednesday 26 October.

The Prime Minister (Mr David Cameron): This morning—[Interruption.] At least they do not have to do it in French.

This morning I had meetings with ministerial colleagues and others. This afternoon I shall travel to Brussels for further talks about the eurozone.

Luciana Berger: Yesterday it was reported that the Prime Minister had compared the families of those who had died at Hillsborough to

“a blind man, in a dark room, looking for a black cat that isn’t there”,

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and had complained that he was not being given enough credit for the release of all the Government documents relating to the tragedy. Will he take this opportunity to apologise to the relatives and friends of the 96 Hillsborough victims for those grossly offensive comments?

The Prime Minister: What I would say to all the victims and their families is that it is this Government who have done the right thing by opening up the Cabinet papers and trying to help those people to find the closure that they seek.

Mr Bernard Jenkin (Harwich and North Essex) (Con): Given that Chancellor Merkel has called formally on the European Commission to produce treaty texts to amend the European treaties, does my right hon. Friend agree with the following statements

“that the accumulated burden of policies, competences, tasks and budgets in the European Union has become too great…that locating ill-justifed powers at EU level can undermine democratic accountability; that the time has therefore come to identify those areas in which EU action is neither logical, justifiable or workable”?

Does he share my surprise that those words were written by the Deputy Prime Minister more than 10 years ago?

The Prime Minister: I have read that pamphlet too, and what it says is good, sound common sense. We do not know exactly when treaty change will be proposed and how great that treaty change will be, but I am absolutely clear, and the coalition is clear, about the fact that there will be opportunities to advance our national interest, and it is on those opportunities that we should focus.

Edward Miliband (Doncaster North) (Lab): Does the Prime Minister agree that, at today’s European summit, we need not just the sorting out of their problems by Greece and Italy and the proper recapitalisation of Europe’s banks, but an agenda to help Europe, and indeed Britain, to grow?

The Prime Minister: What it will be absolutely necessary to do this evening is deal with the key elements of the eurozone crisis, which is acting as a drag anchor on recoveries in many other countries, including our own. That will require decisive action to deal with the Greek situation and a proper recapitalisation of the banks, which has not happened across Europe to date—and the stress tests that have been carried out have not had credibility—but, above all, it will require the construction of the firewall of the European fund to prevent contagion elsewhere. That is the most important thing. The right hon. Gentleman is right to suggest that a wider growth strategy across Europe is required. That was debated on Sunday, and all the Commission’s proposals—on completing the services directive, completing the single market, liberalising energy policy and cutting regulation—could have been written right here in London.

Edward Miliband: The point I would emphasise to the Prime Minister is that those are long-term measures, but we also need immediate action for growth, and that needs to happen not just at European meetings, but at the G20 next week.

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We know that the Prime Minister’s real focus has, unfortunately, not been on sorting out the eurozone crisis; it has been on sorting out the problems on his own side. He said on Monday that his priority is to repatriate powers from Europe: which powers, and when?

The Prime Minister: One serious question, then straight on to the politics; how absolutely typical!

Let me make this point to the right hon. Gentleman: the idea that we could go into the meeting this evening about the future of Europe arguing that Britain should add an extra £100 billion to its deficit is a complete and utter joke.

Let me answer the question about our relationship with Europe very directly. The coalition agreement talks about rebalancing power between Britain and Europe. This coalition has already achieved bringing back one power: the bail-out power that the right hon. Gentleman’s Government gave away.

Edward Miliband: The Prime Minister said in this House on Monday:

“I remain firmly committed to…bringing back more powers from Brussels”—[Official Report, 24 October 2011; Vol. 534, c. 27.]

but yesterday the Deputy Prime Minister was asked about his plan and he said:

“It won’t work, it will be condemned to failure.”

So one day we have the Prime Minister saying yes to repatriation, and 24 hours later the Deputy Prime Minister says no. On this crucial question, who speaks for the Government?

The Prime Minister: Let me quote what the Deputy Prime Minister said yesterday. He said that there is a perfectly good case for

“rebalancing the responsibilities between the EU and its member states.”

What a contrast with what the leader of the Labour party said. Jon Sopel asked:

“Let me ask this single question. Yes or no answer. Has Brussels got too much power? ”

The right hon. Gentleman replied:

“I don’t think it has too much power.”

So the situation is very plain: there is a group of people on this side of the House who want some rebalancing, a group of people who want a lot of rebalancing, and a complete mug who wants no rebalancing at all.

Edward Miliband: Why does the Prime Minister not come clean about the split between himself and the Deputy Prime Minister? This is what the Deputy Prime Minister was asked:

“Is David Cameron wrong to promise at some point the idea of another treaty that might bring powers back?”

He said this:

“This Government, of which I’m a Deputy Prime Minister, is not going to launch some sort of dawn raid, some smash and grab raid on Brussels. It won’t work, it will be condemned to failure.”

So which is it: who speaks for the Government? It is no wonder the Prime Minister’s Back Benchers are saying there is no clarity in the Government’s position, and the secretary of the 1922 committee said the Government’s “position is politically unsustainable.” Is it the Prime Minister’s position to get out of the social chapter: yes or no?

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The Prime Minister: It is this coalition that has worked together to get us out of the bail-out fund—to get us out of the Greek bail-out—and to deliver this year a freeze in the European budget. That is what this coalition has achieved. The split that we have is between the right hon. Gentleman and reality, and we have the greatest proof of that. I talked to the House about this on Monday, but it is so good that I have got to do so again. When he was asked if he wanted to join the euro, he said:

“It depends how long I’m prime minister for.”

That is the split: it is between the Labour party and reality.

Edward Miliband: The Prime Minister will be going to the Council in December to negotiate on behalf of Britain, and treaty change may be on the agenda. I ask him the question again. His Education Secretary said on the radio yesterday morning:

“I think we should take back powers over employment law”,

but his Deputy Prime Minister disagrees. What is the Prime Minister’s position?

The Prime Minister: I tell you what would be on the agenda if the right hon. Gentleman was going to the meeting in Brussels tonight. We would not be discussing Italy. We would not be discussing Greece. It would be Britain handing out the begging bowl asking for a bail-out. We know that he now wants to join the euro. The other thing that Labour Members want to do is leave the International Monetary Fund. They had the opportunity in this Parliament to vote for an increase in IMF funds, which was agreed at the London Council by their own Government—they rejected that. So we now have the extraordinary situation where they want to join the euro and leave the IMF. It is not France they want to be like—it is Monaco.

Edward Miliband: It is no wonder the Prime Minister had a problem on Monday, because the truth is that he led his Back Benchers on, making a promise that he knows he cannot keep and that is ruled out by the coalition agreement. We have a Prime Minister who cannot speak for his Government. On the day of the eurozone crisis, we have a Prime Minister who has spent the last week pleading with his Back Benchers, not leading for Britain in Europe.

The Prime Minister: I might have had a problem on Monday, but I think the right hon. Gentleman has got a problem on Wednesday. The truth is that if he went to that meeting tonight, his message to Berlusconi would be, “Ignore the markets, just carry on spending” and his message to the rest of Europe would be that Labour thinks that you should spend another £100 billion adding to our deficit—after they had finished laughing there would be no time for the rest of the meeting. [Interruption.]

Mr Speaker: Order. Members should calm down and listen to Sir Peter Tapsell.

Sir Peter Tapsell (Louth and Horncastle) (Con): “Pas trop de zèle” was Talleyrand’s advice to Leaders of the Opposition, which meant that he thought that they should not exist in a permanent state of hysteria.

The Prime Minister: As ever, nothing but wisdom from my right hon. Friend.

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Q2. [76629] Angela Smith (Penistone and Stocksbridge) (Lab): Can the Prime Minister tell us whether any more projects have been awarded investment by the regional growth fund? Does the tally still stand at just two businesses helped by his flagship policy?

The Prime Minister: I am afraid to say that the hon. Lady is completely wrong. There are about 40 projects that have been green-lit for funding, and this is completely on schedule. Fifty bids were successful in round one, receiving a conditional allocation of £450 million to deliver 27,000 new or safeguarded jobs, with up to 100,000 jobs in supply chains. Instead of carping she should be welcoming that.

Q3. [76630] Mark Pawsey (Rugby) (Con): My constituency was recently pleased to welcome Mary Portas as part of her review of Britain’s high streets. Does the Prime Minister agree that Rugby’s positive approach to new housing, which will create new customers for the high street, is an effective way of supporting town centres?

The Prime Minister: I am delighted that Mary Portas has made it to Rugby, and I agree with what my hon. Friend said. We do need to build more houses in our country and we do need to reform the planning system, but we want to do it in a way that gives more control to local people, so that we can actually make sure that we have thriving high streets in the future.

Sandra Osborne (Ayr, Carrick and Cumnock) (Lab): The whole town of Cumnock, in my constituency, is in a state of shock following the very brutal murder last weekend of a very popular local man, Stuart Walker. Will the Prime Minister join me in sending condolences to Stuart’s family and, amid much unhelpful speculation about the motivation for this murder, will he join me in calling on local people who have any information to come forward to the police to help them with their inquiries?

The Prime Minister: I certainly join the hon. Lady in sending condolences to her constituent’s family, and what she says is absolutely right. It was once said that the police are the public and the public are the police; the police cannot solve crimes without the help of the public and I hope that everyone will co-operate in the best way they can.

Q4. [76631] Gavin Barwell (Croydon Central) (Con): My 14-year-old constituent Lillian Groves was killed outside her home by a driver who was under the influence of drugs. He was sentenced to just eight months in jail and was released after four months. Will the Prime Minister agree to meet Lillian’s family to hear their case for “Lillian’s law”, a package of measures to ensure that in future we take the menace of drug-driving as seriously as we currently take drink-driving?

The Prime Minister: I think that my hon. Friend speaks for the whole House when he says that we really have to make sure that we start treating drug-driving as seriously as drink-driving. This issue has been raised repeatedly, but not enough has been done. One of the things that we are doing is making sure that the police

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are able to test for drug-driving and making that drug-testing equipment available. As we test that and make sure that it works properly, we can look at strengthening things still further, and I am very happy to do as he says.

John McDonnell (Hayes and Harlington) (Lab): It was reported over a week ago that the Bank of England had reprimanded one commercial bank, and there may be others, that tried to manipulate the gilts market to exploit quantitative easing. Could the Prime Minister ask for a report on this matter and, if it is true, will he explain to the bankers that we will use the full force of the law against them if they try to rip off the taxpayer?

The Prime Minister: The hon. Gentleman makes a good point. It is very important to send a message to all people in financial services that there is not something called white collar crime that is less serious than other crime. Crime is crime and it should be investigated and prosecuted with the full force of the law.

Q5. [76632] Duncan Hames (Chippenham) (LD): Proposals before the House next week will see cuts to legal aid funding for advice services, which in the case of Wiltshire citizens advice bureau amounts to £250,000 a year. I welcome the £20 million stop-gap the Government have found to replace this funding next year, but will the Prime Minister ensure that the Government put in place lasting funding arrangements to sustain these services on which so many people rely? [ Interruption. ]

The Prime Minister: My hon. Friend makes an important point. It is no good people shouting this down; every party in the House has accepted the need to reform legal aid. [ Interruption. ] You say you have not but you have accepted it. The figures are very clear: we spend £39 per head in this country on legal aid compared with £18 per head in New Zealand, which has a similar legal system, and in Spain and France the spending is as low as £5 per head. As my hon. Friend has said, we are putting in the £20 million additional funding for not-for-profit organisations and we have also rightly praised the local councils that have gone on funding citizens advice bureaux. I shall certainly look at what he says because that very important organisation does vital work for all our constituents.

Paul Blomfield (Sheffield Central) (Lab): I am sure the Prime Minister will join me in congratulating Sheffield university’s advanced manufacturing research centre, which celebrated its 10th anniversary yesterday and today with a series of events at Westminster, organised in partnership with Boeing and Rolls-Royce. Will he also join me and the Select Committee on Business, Innovation and Skills in endorsing the aim of growing our manufacturing gross domestic product from its current 12.5% to nearer the 20% enjoyed by most of our competitors, and will he commit the Government to work with—

Mr Speaker: That is enough. We have got the drift.

The Prime Minister: I very much agree with what the hon. Gentleman says and I am pleased to note that the Deputy Prime Minister hosted Sheffield university at No. 10 Downing street to celebrate its success. I think we are seeing some positive signs of rebalancing in our economy. Recently I was at the big investment that BP is

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making in the North sea, as well as at the opening of the new Airbus factory in Broughton in Wales. If one looks across our auto industry, whether it is Nissan, Toyota or Jaguar Land Rover, one sees that all those companies are expanding and bringing more of their production and supply chains onshore. There is a huge amount more to do, but we have to accept that we start from a low base as, sadly, manufacturing production has declined so much in the past decade.

Q6. [76633] Karen Lumley (Redditch) (Con): Will the Prime Minister join me in welcoming the nearly £1 million that has been received in Redditch for the pupil premium? Will he persuade the Secretary of State for Education to push for a national funding formula as soon as possible?

The Prime Minister: Discussions about a national funding formula are ongoing. It is a difficult issue to resolve because of the historical patterns of differences of funding around the country. I think the pupil premium is a major step forward; it will be up to £2.6 billion by the end of this Parliament. The Institute for Fiscal Studies report says that we have made spending on education much more progressive by the action we have taken. We have taken difficult decisions but at the heart of that was a decision to protect the schools budget and per-pupil funding and, on top of that, to add the pupil premium to make sure that we are looking after the less well-off in our country.

Q7. [76634] Gloria De Piero (Ashfield) (Lab): Last month, a leaked Downing street report said,

“We know from a range of polls that women are significantly more negative about the Government than men.”

Why does the Prime Minister think that is?

The Prime Minister: When you are making difficult spending decisions and have a difficult economic situation, and household budgets are under huge pressure from things like petrol prices, food prices and inflation, clearly, that impacts women. The Government want to do everything they can to help women and that is why we have lifted 1 million people out of tax, the majority of whom are women, and that is why we are putting much more money and time into free nursery education for two, three and four-year-olds. That is also why, for the first time, we have agreed that women working fewer than 16 hours a week will get child care. And we do not just care about this issue at home: because of what we are doing through international aid, we will be saving more than 50,000 women in childbirth around the world.

Nadine Dorries (Mid Bedfordshire) (Con): The Infrastructure Planning Commission has made one decision—to grant planning permission for the giant American waste company Covanta to build a 600,000 tonne incinerator in Mid Bedfordshire. Thousands of people in Bedfordshire responded to the consultation, saying that they do not want this. The small print of the decision says that the decision is subject to special parliamentary procedure. Will the Prime Minister please let the people of Bedfordshire know that this Government are not like the previous Government, that we listen to local concerns and that we will ensure that that monstrous rubbish-guzzling atmosphere-polluting incinerator will not be imposed upon the people of Bedfordshire?

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The Prime Minister: My hon. Friend makes an important point. There are difficult planning decisions that have to be made, but what the Government have done is made sure that the planning system is more democratic and reports to Parliament, and that Ministers have to take decisions and be accountable. I cannot speak for how those Ministers have to make those decisions. They have to make them in their own way, but we have ended the idea of the vast quango with absolutely no accountability, as my hon. Friend rightly says.

Q8. [76635] Mr Jeffrey M. Donaldson (Lagan Valley) (DUP): The Prime Minister has warned African countries that unless they improve gay rights, he will cut their aid, yet in many African countries where we pour in millions of pounds of aid, Christians face great persecution and destruction of churches, lives and property. Here in the UK, anyone who displays a Bible verse on the wall of a café faces prosecution. Was Ann Widdecombe right when she said that in the 21st century hedgehogs have more rights than Christians?

The Prime Minister: Ann Widdecombe is often right—not always right, but often right. The right hon. Gentleman makes an important point. The way we judge our aid decisions is to look at human rights across the piece. That means how people are treating Christians and also the appalling behaviour of some African countries towards people who are gay.

Q14. [76641] Stephen Lloyd (Eastbourne) (LD): In Eastbourne we recently recruited 181 apprentices in 100 days. My local training provider, Sussex Downs, tells me that 91% of its hospitality apprentices go into full-time jobs. Does the Prime Minister agree that apprenticeships work and in Eastbourne they work particularly well?

The Prime Minister: I am happy to agree with my hon. Friend about that. We found funding for an extra 50,000 apprenticeships last year and achieved almost double that because of the enthusiasm that there is among the business community and among young people. We are now running at about 360,000 a year and hope to achieve about 250,000 more apprentices than were planned under the previous Government. It is an important development in our country. We want to make sure that apprenticeship schemes are aimed at young people who need work and also aimed at the higher level—people going on to get degree-equivalent qualifications, so it is not seen as a second best. For many people it is the right career path, and there are companies in Britain such as Rolls-Royce where many of the people on the board started with an apprenticeship.

Q9. [76636] Mr David Hanson (Delyn) (Lab): On reflection, is now the right time for the Prime Minister to scrap Labour’s indeterminate sentences for public protection, as the Justice Secretary wants to do? They were introduced to save dangerous violent criminals from harming the British public. Will the Prime Minister accept from me that the decision should not be about prison places, but about the protection of the British public?

The Prime Minister: My right hon. and learned Friend the Justice Secretary will make an announcement about this shortly. What the right hon. Gentleman will find is

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that we will be replacing a failed system that does not work and which the public do not understand with tough determinate sentences. People have always wanted to know that when someone is sent to prison for a serious offence, they do not, as currently, get let out halfway through. We will be putting an end to that scandal and I expect it to have widespread support.

Q10. [76637] Mary Macleod (Brentford and Isleworth) (Con): If women were to start businesses at the same rate as men, we would have 150,000 more businesses per year in this country. I have some exceptional female entrepreneurs in my constituency, such as Cath Kidston. What can my right hon. Friend do to encourage more female entrepreneurs to create growth and jobs for the country?

The Prime Minister: There are many things that Government can do. In the last Budget there were a series of steps such as the enterprise finance schemes that we have established and the changes to capital gains tax. The biggest change is a change in culture, encouraging people to take that first step and supporting them along the way as they go.

Alison McGovern (Wirral South) (Lab): Last week the House, to its great credit, supported unanimously full transparency from Government in respect of all documents relating to the Hillsborough disaster. Will the Prime Minister join me in calling on South Yorkshire police, following the example of my hon. Friend the Member for Sheffield South East (Mr Betts), to commit to the same openness and ensure that the Hillsborough independent panel has unredacted access to all papers?

The Prime Minister: I will certainly look at the issue the hon. Lady raises. I am not fully aware of the situation regarding the police papers and do not want to give her a flip answer across the Dispatch Box. The Government have done what we should have done with regard to the Cabinet papers, but I am very happy to look at the point she raises and get back to her.

Q11. [76638] Mr Edward Timpson (Crewe and Nantwich) (Con): Will my right hon. Friend join me in praising all the adopters and foster carers in Crewe and Nantwich and elsewhere for the fantastic work they do and encourage others to come forward to foster and adopt and to recognise during national care leavers week that we can do much more to provide care leavers with the sustained and enduring support that they often need and always deserve?

The Prime Minister: I completely agree with my hon. Friend. He speaks from great experience, as his parents have helped to foster around 90 children over the past few decades, which I think is a magnificent example. As I said in my party conference speech, we really need to attack every aspect of this issue. It is a national scandal that there are 3,660 children under the age of one in the care system, but last year only 60 were adopted. We have got to do a lot better. Part of it is about bureaucracy and part of it is about culture, but a lot of it is about encouraging good foster parents and adoptive parents to come forward and giving them security in the knowledge that the process will not be as bad as it is now. Thorough-going reform is required. My hon. Friend the Minister

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with responsibility for children is leading this work and I am confident that we can make some real breakthroughs in this area.

Q12. [76639] Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op): On 11 August the Prime Minister told the House that there would be a report to Parliament on cross-Government activity relating to gangs. Where is that report and when will we see it?

The Prime Minister: We are working intensively right across Whitehall on the gang issue, because I think that in the past, frankly, this was something that was dealt with in the Home Office and there was not the same input from other Departments, so we are doing exactly that, and when we are ready to make a report to Parliament we will do so.

Q13. [76640] Harriett Baldwin (West Worcestershire) (Con): When I worked in the private sector—[ Interruption. ] When I worked in the private sector I benefited from statutory maternity leave. Will the Prime Minister remind the House how this Government are making work more flexible and family-friendly?

The Prime Minister: How typical of the Opposition. If someone talks about the private sector or job creation, all they have is a lack of respect and sneering. It is absolutely typical. My hon. Friend speaks from great experience. We want to be a family-friendly Government, which is why we are putting the extra hours and help into nursery education, increasing child tax credit, by £290 for the least well-off families, and why we will also be introducing proper help for flexible parenting.

Q15. [76642] Ms Karen Buck (Westminster North) (Lab): Westminster police command is now being required to lose 240 police community support officers, slashing by two thirds the number of PCSOs doing security and counter-terrorism work, and every single PCSO in the borough must now reapply for their own job. What message does the Prime Minister think this sends to the public, who want to see visible, patrol-based policing on their streets?

The Prime Minister: The point I would make to the hon. Lady is this: we are asking the Metropolitan Police Authority to find a cash reduction over the next four years of 6.2%. We face an enormous deficit in this country because of what we inherited from the Labour party. We have to make difficult decisions. Frankly, I do not think it is impossible to find a 6.2% cash reduction while keeping good front-line policing at the same time, and I am very confident that my good friend Boris Johnson will do exactly that.

Andrew Bridgen (North West Leicestershire) (Con): Is the Prime Minister as enthusiastic as I am about the Localism Bill and the prospect that it will deliver real growth and empower local communities? Does he agree that the best way to tackle political disengagement is through local accountability?

The Prime Minister: My hon. Friend makes a very good point. We all know that we are not building enough in this country to provide houses for our young

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people, to end the scandal of overcrowding and to reduce the number of people on housing waiting lists. The best way to get that to happen is to ensure that local people really feel they have a say in and control over development in their own area. That is the way to square the circle. The top-down targets under the previous Government did not work, but the localist approach will.

Mr Jamie Reed (Copeland) (Lab): The Prime Minister, when Leader of the Opposition, pledged to fight bare-knuckled against hospital closures. Will he give the House a guarantee today that for as long as he is Prime Minister there will be no hospital closures on his watch?

The Prime Minister: The pledge I can make to the hon. Gentleman is the one I made when I visited his constituency, which is that we are funding the expansion of his hospital.

Heather Wheeler (South Derbyshire) (Con): I congratulate the Prime Minister and thank him for all the work that the Department for Education is doing on free schools. Can he please give encouragement to the two sets of parents’ groups that are looking to build two free schools—a junior and a secondary school—in South Derbyshire?

The Prime Minister: I can certainly give my hon. Friend that encouragement. I think the free schools policy is a great success, as we see a number of really high-quality schools coming in across our country, and it is depressing to see the attitude of the Opposition towards this policy. What we had was a new shadow Education Secretary, who in the first flushes of the job, said that he would support free schools, but as soon as Unite picked up the phone to him he had to drop that altogether. Do you want to know what their policy is now, Mr Speaker? He said:

“What I said…is we oppose the policy…but…some of them are going to be really good”—


“run by really good people and we’re not going to put ourselves in a position as a Labour Party of opposing those schools”.

So, they oppose the policy but they support the schools. What a complete bunch of hypocrites.

Debbie Abrahams (Oldham East and Saddleworth) (Lab): Can the Prime Minister explain why his Secretary of State for Health was able to make concessions to the Liberal Democrats on the Health and Social Care Bill in the other place last night, but was unable to recognise the need for those changes when it was debated here? Is that not more about doing political deals rather that doing what is right for our NHS?

The Prime Minister: We are doing what is right for our NHS, and that is why average waiting times for in-patients are down, average waiting times for out-patients are down, hospital infections are at their lowest level ever, the number of mixed-sex wards is down by 91% under this Government, the number of managers is down and the number of doctors is up. If the hon. Lady wants to see further improvements to the Health and Social Care Bill, she will have plenty of opportunities.

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Tom Brake (Carshalton and Wallington) (LD): Two thirds of young people involved in the riots had a special educational need. Does the Prime Minister agree that that underlines the need for complex solutions which tackle educational underachievement and rehabilitation as well as punishment?

The Prime Minister: Of course, as I have said many times at this Dispatch Box, we have to look behind the statistics and what happened and ask ourselves how we

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have allowed so much to go wrong in our society. Clearly, education and special educational needs play a role in that, but I do think it is important, and the public want, to see swift justice and punishment handed out when people break the law. We did see that at the time of the riots, and I think we should see it all the time.

Mr Speaker: I appeal to Members leaving the Chamber to do so quickly and quietly.

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Points of Order

12.32 pm

Bill Esterson (Sefton Central) (Lab): On a point of order, Mr Speaker. In this morning’s Westminster Hall debate about the future of BBC local radio, the Minister used the word “priggish” in response to my intervention in which I asked him to address concerns, which many right hon. and hon. Members have raised, about a loss of jobs and an impact on vulnerable, elderly and disabled people who rely on BBC local radio. The debate was attended by more than 50 Members from all parts of the House, and it had been good natured and consensual. I wonder whether “priggish” is appropriate in a parliamentary debate. If not, should the Minister come to this place to apologise not only to Members but to those who face losing their jobs and those who rely on such services?

Kevin Brennan (Cardiff West) (Lab): Further to that point of order, Mr Speaker.

Mr Speaker: Order. Before the hon. Gentleman comes in, I know he is bursting with enthusiasm, but he must contain himself.

What I would say to the hon. Member for Sefton Central (Bill Esterson) is that control of that sitting was the responsibility of the Chair in Westminster Hall. It sounds like an intriguing debate, and it may well be that I should study it at some point, but I have nothing to add at this stage.

Kevin Brennan: On a point of order, Mr Speaker.

Mr Speaker: Obviously not on the same subject, because I have already given a ruling. I know that the hon. Gentleman will be dextrous enough to devise an alternative point of order on a wholly unrelated subject.

Kevin Brennan: Indeed, Mr Speaker. In Prime Minister’s questions, the Prime Minister used the phrase “a bunch of hypocrites” and the word “mug”. Could you make it clear that they are in order? I would like to be able to use “mug” in the House to describe the Deputy Prime Minister, knowing that I would be in order, and also to be free with the use of “a bunch of hypocrites” as often as I please when describing the coalition Government.

Mr Speaker: What I would say to the hon. Gentleman is, I hope, simple and clear: what is involved, in my

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judgment, is not a matter of order but of taste, and for the avoidance of doubt I would prefer not to hear either term used in the future by any Member.

Greg Mulholland (Leeds North West) (LD): On a point of order, Mr Speaker. Like many in the House, I warmly welcome the Government’s e-petition system, which triggered our important debate on Monday. However, I want to ask your advice, because there is no guidance on whether Members of Parliament should sign e-petitions. I believe that they should not do so, because such petitions call for debates. May we have some clarity on the process?

Mr Speaker: In a sense, it is flattering to me that the hon. Gentleman seeks my guidance, but it is not appropriate for me to provide it. My simple advice is that it is for the hon. Gentleman as an individual Member to decide whether to sign a petition, and I offer that advice to all hon. Members—make your own judgment on the merits of the case. There is no rule, no Standing Order and no matter of parliamentary proprietary involved one way or the other.

Dr Julian Lewis (New Forest East) (Con): Further to that point of order, Mr Speaker, while we are on the subject of Monday’s important debate, which was the result of a Backbench Business Committee decision, would it assist the House if you were to indicate that when the Committee chooses a resolution for debate, it should not normally be subject to amendment, certainly not to amendments tabled by Front Benchers, and probably not to amendments tabled by Back Benchers who did not attend the Backbench Business Committee to try to have their suggestions adopted?

Mr Speaker: I am sure the hon. Gentleman understands that the Chair preserves, rightly, a certain discretion in these matters, and I always look at each case on its merits. Suffice it to say that I respect the Backbench Business Committee process. I am strongly in favour of clarity and straightforwardness in debates of this kind, and any proposed amendments tend to be considered by me in the light of that criterion.

If there are no further points of order, we come to the ten-minute rule motion, for which the hon. Member for Bolton West (Julie Hilling) has been so patiently waiting. That has the advantage that the Chamber is rather quieter now.

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National Curriculum (Emergency Life Support Skills)

Motion for leave to bring in a Bill (Standing Order No. 23)

12.37 pm

Julie Hilling (Bolton West) (Lab): I beg to move,

That leave be given to bring in a Bill to require the Secretary of State to include the teaching of emergency life support skills in schools as a compulsory part of the National Curriculum; and for connected purposes.

Every year, 150,000 people die when first aid could have made a difference. Thirty thousand people have a cardiac arrest outside a hospital environment, but fewer than 10% survive to be discharged from hospital. Emergency life support skills are a set of actions needed to keep someone alive until professional help arrives. They include cardiopulmonary resuscitation—CPR—putting an unconscious person into the recovery position, dealing with choking and serious bleeding, and helping someone who may be having a heart attack.

Those skills are crucial at the time of a cardiac arrest when every second counts. For every minute that passes, the chance of survival falls by 10%. If CPR is started immediately, the time that someone remains in a shockable and hence reversible condition will be prolonged. It also means that more brain function will remain, and more of them will be left if they are resuscitated. It is not often that any Government have the opportunity simply, cheaply and immediately to save lives, but my Bill would allow them to do just that. Teaching these crucial life-saving skills to every school pupil would make a tangible difference to civil life in this country.

We know how it is when someone collapses or has a road traffic accident. Everyone stands around in a circle waiting for someone to act, usually too frightened to intervene. Now let us imagine a situation in which every school leaver could step in and attempt to save lives: fear gone, skills in place. Currently only 7% of people in the UK know first aid. We should compare that with Seattle, where one is rarely more than 12 feet away from someone who can save one’s life. There, one cannot graduate from school or gain one’s driving licence without learning first aid skills.

The Government like to compare us internationally. In France, Denmark and Norway, emergency life support skills are already a compulsory part of the curriculum. Norway educated 200,000 people in just six weeks. A number of states in Australia include ELS, and in America it is part of the curriculum in 36 of the 50 states. Training is happening in the UK, but the only way to ensure that all children are taught these essential skills is by placing them in the national curriculum. The British Heart Foundation has worked with me on this Bill, alongside other charities such as the Red Cross and St John Ambulance. The British Heart Foundation has more than 1,400 Heartstart schools, three quarters of which are primary schools. It has trained more than 760,000 children, a significant number of whom have had to put their life-saving skills into practice; and 625,000 children have been taught valuable life-saving skills through the St John Ambulance first-aid materials.

Let us imagine the difference that would be made if my Bill became law and every child became a life saver. The Government say they want the national curriculum

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to reflect the essential knowledge and understanding that people should be expected to have to enable them to take their place as an educated member of society. Surely knowing how to save the life of a family member or a member of the public would enable children to have an impact on the health of society. Ensuring that life-saving skills are taught in schools provides the chance to instil in all children how valuable life is and how important it is to be a good citizen. My Bill would provide a real, lasting cultural heritage.

There are several places where ELS would fit into the national curriculum—in PE, in science, in personal, social and health education, or in citizenship—and it takes only two hours to teach. That is just 0.2% of a school year, or the equivalent of one cross-country run. In just two hours of their school life, children can learn the skills to save a life. The skills should be taught from year 7 and refreshed each year until the pupil leaves school. In fact, the skills can be taught to younger children; I have heard some amazing stories of how young children have saved lives. Moreover, these measures would be popular. Seventy per cent. of parents, 78% of pupils and 86% of teachers have said that ELS should be taught in schools.

One of my local schools, Smithills, runs the British Heart Foundation’s Heartstart scheme. ELS is taught in a variety of ways, and the school is now aiming to widen the scheme so that during the school holidays parents and siblings are able to learn these vital skills too. The teacher in charge, Adrian Hamilton, told me that learning how to save a life in an emergency really engages the children at Smithills. He believes that it goes a long way towards helping them to become better citizens and that it should be an expected part of what happens in schools.

Since I started to promote emergency life support skills, I have heard some tragic and some inspirational stories. I met Beth, the mother of Guy Evans who sadly died at the age of 17 in 2008. Guy was riding his motorcycle when he had a sudden cardiac arrhythmia. He fell off his motorbike and lay there while his friends stood around not knowing what to do. If only they had been taught emergency life-saving skills, they would not have faced the trauma of watching their friend die without doing anything to help. They would not now be living their lives full of the suspicion that perhaps, if only they had known what to do, Guy would still be alive. Beth has been campaigning ever since to get ELS into the school curriculum and into driving tests.

I also met Tabitha. When she was 17, a week before the summer holidays, she ran to join friends and teachers on a fire drill. She does not remember anything else, but she collapsed with heart failure. She had been born with a congenital heart defect that nobody knew about. Fortunately, her school secretary had been taught CPR and so administered it until, first, an emergency responder, and then the paramedics arrived. Tabitha made it to hospital with all her faculties still intact, where she had emergency surgery and made a full recovery. Tabitha is now a voluntary emergency responder and, like Beth, is working hard to get ELS taught in schools.

I received correspondence from St Aidan’s primary school in St Helens telling me about a year 6 pupil who was with her parents and 15 other adults when her eight-year-old brother started to choke on his food. He went blue and virtually collapsed at the table. All the

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adults stood around not knowing what to do, but the year 6 child jumped into action, put her training into use and saved her brother’s life. If she had not been there, 15 adults might have watched a little boy die in front of them.

Sheringham Woodfields, a complex needs school, told me about the enormous sense of achievement its pupils feel when they realise that they can save a life. One of its pupils received a bravery award when he saved somebody on the Norfolk broads.

A few weeks ago, 15-year-old Patrick Horrock had a heart attack in Hindley leisure centre, just next door to my constituency. A member of staff performed CPR and another used a defibrillator to restart his heart. Patrick is alive and well because people knew what to do and had the tools to do it.

Peter Roberts, a 12-year-old, was enjoying teacakes with his mum when he realised that she could not breath, speak or shout. She was choking on a currant. Peter stepped in and delivered his training perfectly, doing back blows. After the third blow, the currant came out. What makes the story even more moving is that Peter’s mum is paraplegic, following a parachuting accident a few years ago. She had no feeling in her windpipe and did not realise that she was choking. Peter saved her life.

A young mum from the Cotelands pupil referral unit in Surrey was able to save her young son from having to have skin grafts because of the way she dealt with a serious accident. Christopher Boylan, a 17-year-old from Merseyside, saved his mum’s life by performing CPR when she suffered cardiac arrest. He had learned CPR at the Scouts.

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Brittany Bull Targett, a 13-year-old, saved 11-year-old Charlie when he fell off his bike and knocked himself out. Brittany said:

“He was choking on his own blood so I cleared his airway, cleared the blood out, and put him in the recovery position. I have never done anything like this before and it was thanks to the training we had at school that I knew what to do”.

There are many such stories of people who are alive and well because someone knew what to do. I cannot imagine anything more awful than standing by and watching someone lose their life when it could have been saved if only I or someone else had known what to do. Some of my local firefighters who are Heartstart tutors said something to me that really made me think. One of the reasons that we do not act when somebody collapses is that we are scared of making things worse. They said that if a casualty has stopped breathing, they are dead. Somebody else cannot make them any deader, but they can give them the chance to live.

Cardiac arrest does not discriminate between young and old or between genders and races; it can happen to the fittest people. Tragically, 12 young people die every week from undiagnosed heart conditions. Too many of us do not know what to do. My Bill would enable our children to have the essential skills to save a life and to never have to stand by and do nothing. I do so wish that it would become law.

Question put and agreed to.


That Julie Hilling, Craig Whittaker, Rosie Cooper, Simon Kirby, Tom Brake, Steve Rotheram, Andrew Percy, Nic Dakin, Valerie Vaz, Chris Ruane, Mr Kevin Barron and Justin Tomlinson present the Bill.

Julie Hilling accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 20 January 2012, and to be printed (Bill 240).

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Opposition Day

[Un-allotted Day]

National Health Service

12.48 pm

Andy Burnham (Leigh) (Lab): I beg to move,

That this House recalls that the Prime Minister made a series of personal pledges on the NHS in the run up to the General Election which were carried over to the Coalition Agreement; believes it is now clear he has failed to honour three of the headline commitments in the Coalition Agreement; notes firstly that Treasury figures from July 2011 confirm that NHS spending fell in real terms in 2010-11, contrary to the guarantee that health spending will increase in real terms in each year of the Parliament; notes secondly recent central approval of changes to hospital services, in breach of a moratorium on such changes; notes thirdly the Prime Minister’s continuation, despite widespread opposition, with the Health and Social Care Bill, contrary to the pledge in the Coalition Agreement to stop top-down reorganisations of the NHS; believes there is mounting evidence that the combination of an unprecedented financial challenge combined with the biggest reorganisation in the history of the NHS is damaging patient care and leading to longer waiting times; is concerned that huge cuts to adult social care in England will further limit hospitals’ ability to cope with coming winter pressures; and calls on the Government to listen to GPs and NHS staff, drop the Bill and accept the offer of cross-party talks on reforming NHS commissioning.

We read today that the Government were in open retreat last night on their Health and Social Care Bill in the House of Lords. Given that, we thought it only right to bring the Secretary of State here today to be held to account by this elected House. He tried to shuffle off his responsibilities and dug in when the Bill was in this place, only to give in down there. That came just hours after he had to confirm that he would still take oral questions in this House, despite a claim to the contrary by his preferred candidate to take over the running of the NHS. The Secretary of State may be on the run, but we will not let him hide. Our NHS is too precious to too many people in this country to be carved up in dodgy coalition deals in the unelected House. His Bill is unravelling before his eyes, and coalition health policy is in chaos. Today, we hold him to account for that.

To be fair to the right hon. Gentleman, the responsibility is not all his. It goes right up to the door of No. 10 Downing street. People will remember only too well, in the run-up to the general election, the then Leader of the Opposition’s ostentatious shows of affection for the NHS, his airbrushed face on the posters and three very personal promises—real-terms increases in every year of this Parliament, no accident and emergency or maternity closures, and no top-down reorganisation of the NHS. He protested his love for the NHS, and at photo call after photo call on the wards he routinely wore his heart on his sleeve. As we now know, he was protesting a little too much, and today we expose the hollowness of his promises.

Tracey Crouch (Chatham and Aylesford) (Con): May I take this opportunity to congratulate the right hon. Gentleman on his new post? He is back where he once was, but on the other side of the House.

Last year, in The Guardian, the right hon. Gentleman stated that it was

“irresponsible to increase NHS spending in real terms”.

Does he still stand by that statement?

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Andy Burnham: I am not sure whether I should thank the hon. Lady for reminding me that I am now a shadow of my former self, but I thank her for her words. I will come to the precise question that she asks. I did indeed say those words, and I will explain why in a moment.

I was talking about the three headline promises that the Prime Minister made on the wards. They were part of a calculated and self-serving political strategy to detoxify the Tory brand, not a genuine concern for the NHS. It was cynical because, as we will show today, those were cheques for the NHS that the Tories knew they could not cash, and promises that they had no real intention of keeping. Let us take the Prime Minister’s three personal promises in turn, starting with the one on NHS funding. It will be good to get to the bottom of that once and for all.

At the last election, Labour promised to guarantee to maintain NHS front-line funding in real terms. The now Prime Minister, by contrast, offered real-terms increases. How big those increases would be was undefined, but that did not matter. The important thing was that, according to the requirements of the detoxification strategy, it sounded as though the Tories were planning to spend more.

I remember well our resulting exchanges with the then shadow Health Secretary, now the Heath Secretary, on the hustings. Indeed, the Prime Minister has in recent weeks been quoting what I said then, as the hon. Member for Chatham and Aylesford (Tracey Crouch) did a moment ago. I did indeed say that it was cynical and irresponsible to make those promises, and I repeat that today.

Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con): Does the right hon. Gentleman consider “protecting the front line” to be the closure of many hospitals throughout the UK, mergers and the loss of vital cardiac services in such places as Ipswich? That was exactly what happened when he was Secretary of State.

Andy Burnham: The hon. Gentleman goes right to the heart of my speech today. We made those difficult decisions to get the NHS ready for the future. We grasped the nettle and took services out of hospitals and moved them into the community, because that is what has to happen if we are to have an NHS that is sustainable for the future. He stood on an election manifesto that promised the opposite. It was a dishonest pledge, and I will come to it in a moment.

I said a moment ago that it was irresponsible to promise real-terms increases. I say that because I completed a spending review of the NHS in March 2010 and knew the figures inside out. I had also been in detailed discussions with the Treasury on the funding of adult social care, in preparation for a White Paper. The implication of what the Conservatives featured on an election poster—cutting the deficit on an accelerated timetable while giving the NHS real-terms increases—could mean only one thing: unpalatable cuts to other public services, particularly adult social care, on which the NHS relies.

Despite that, the election pledge was carried over into the coalition agreement, which could not be clearer. It states:

“We will guarantee that health spending increases in real terms in each year of the Parliament”.

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A year ago, at the time of the comprehensive spending review, the official figures claimed that that had been delivered, with a 0.1% settlement—essentially the same as Labour promised at the election.

Mark Simmonds (Boston and Skegness) (Con): Does the right hon. Gentleman recall that before the general election, when he was Secretary of State, he said in the now infamous King’s Fund speech that the state should always be the preferred provider, irrespective of the quality of care that it provided to patients? Does he stand by that statement today, or is he now trying to drive a patient-centric health service rather than putting political ideology above patient care?

Andy Burnham: I think I should refer the hon. Gentleman back to the King’s Fund speech, because I did not say the NHS should be the preferred provider regardless of the quality of care it provided. I believe that the public NHS should have the first chance to change, and that was the preferred provider policy. We did not want to pull the rug from under the public NHS with a policy of “any willing provider”. If the NHS needed to change, we wanted to tell it, “You have to rise to the challenge, and you have a chance to do so. If you cannot, other providers will get a chance to come in.” That was the preferred provider policy, and I would be grateful if he did not misrepresent it.

As I said, a year ago the Government provided a 0.1% increase—or that was the headline, but the fine print began to emerge and their case began to fall apart from day one. It soon became clear that for the years 2011-12 to 2014-15, that figure included an annual £1 billion transfer to local government, ostensibly for social care but not ring-fenced, so councils would be free to spend it as they saw fit. The health funding settlement therefore already went below a real-terms increase. That transfer turned the apparently minuscule real-terms increase into a real-terms cut.

That still leaves 2010-11. When the coalition came into government, it immediately required primary care trusts to cut spending by increasing waiting times and restricting access to treatment, to generate an underspend in 2010-11.

The Secretary of State for Health (Mr Andrew Lansley) indicated dissent .

The Minister of State, Department of Health (Paul Burstow) indicated dissent .

Andy Burnham: Ministers are shaking their heads, but I will read them the Treasury figures published in July this year, and let them tell me then that what I have just said is not true. The public expenditure statistical analyses from this year provide official confirmation of what I have just said. They show that in 2009-10 health spending was £102,751 million. That was in the last year of the Labour Government. In 2010-11, health spending was £101,985 million. There we have it in black and white—the first real-terms cut in health spending for 14 years. In fact, it is the first real-terms cut since the last year of the last Tory Government in 1996-97.

Henry Smith (Crawley) (Con): I am interested to hear how the right hon. Gentleman is trying to manipulate those figures. How does he reconcile what he is saying

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with what his party’s Administration is doing in Wales, where the health service has been cut and hospital infections and waiting times have risen?

Andy Burnham: The hon. Gentleman uses the word “manipulate”. May I say that I take great exception to that? I have read out the Treasury statistical analysis from this July. If he is telling me that I have misrepresented it, let him stand up again now and say so. If not, he should hold his peace. I remind him that his party’s Government delivered a much deeper cut to Wales than to Scotland or Northern Ireland. The Labour Administration are now dealing with the consequences of that.

Ben Gummer (Ipswich) (Con): The right hon. Gentleman’s figures depended on the lack of what he called a ring fence in the social care transfer of £1 billion. I can assure him that as far as Suffolk is concerned, there is absolutely no problem in trying to deal with the ring fence. In fact, the county council spends more than the amount that was previously ring-fenced, because of the pressure on social care.

Andy Burnham: The hon. Gentleman was not listening. The social care transfer comes in for the years 2011-12 to 2014-15, but I was talking about the year 2010-11 and, in the year ended, there was a real-terms cut to the NHS, as confirmed by Treasury figures. This debate is about that fact. He and his hon. Friends stood at the election, with those airbrushed posters all around them, promising that they would not cut the NHS, but in their first year in office, they delivered a real-terms cut to the NHS.

Barbara Keeley (Worsley and Eccles South) (Lab): Is it not the case that, whatever Government Members say, 82% of councils offer social care only in critical and substantial cases, that thousands of people up and down the country are suffering the loss of their services, and that that will have a real hit on the NHS in years to come?

Andy Burnham: My hon. Friend makes a very important point. That was precisely why I said it was irresponsible for the Conservatives to promise increases to the NHS in the way that they did, on a much-reduced public spending envelope. That has led to precisely the consequences that she describes. Indeed, that hidden cut to adult social care has been quantified at £2 billion.

I remember well Conservative party claims before the election about death taxes, but what about the dementia taxes that the Conservatives have loaded on to vulnerable older people up and down this country, who are now paying more out of their own pockets to pay for the care that they desperately need? That is the effect of cutting adult social care and cutting council budgets in that way.

We today the nail the position once and for all. The real position is worse than the one I described because of spiralling inflation, which in effect means even deeper real-terms cuts for the NHS this year and in all the years that follow.

Chris Skidmore (Kingswood) (Con): The right hon. Gentleman mentions that the £2 billion transfer from the NHS social care budget is not ring-fenced, but I am sure he is aware that ring-fencing can have the perverse

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effect of ensuring that local authorities do not spend existing budgets. Will he clarify his position? Is ring-fencing a good idea or not?

Andy Burnham: I disagree with the hon. Gentleman. I said that it was irresponsible to pledge the money for the health service in the way that the then Opposition did in the run-up to the election precisely because I realised that more would be needed for adult social care. However, if the NHS is to transfer money to local government for adult social care, we must be certain that it will pay for that and not for weekly bin collections or for whatever else he thinks is more important than supporting older, vulnerable people with the costs of care. He makes my point that that money should have been ring-fenced, so that adult social care could have been protected.

Chris Skidmore indicated assent .

Andy Burnham: The hon. Gentleman nods, but I am afraid that that was not the Secretary of State’s policy.

Grahame M. Morris (Easington) (Lab): I compliment my right hon. Friend on how he is moving the motion. What are his views on the impact of the reduction of funding for the NHS on the front line, and on the number of hospital trusts that are breaching the 18-week target?

Andy Burnham: I am grateful to my hon. Friend for those words and I shall come to precisely that point, but let us be clear about this one: the Prime Minister promised a real-terms increase, but he has delivered a real-terms cut. He stands at the Dispatch Box week after week boasting about increasing health funding when he has not. All the while, NHS staff deal with the reality on the ground of his NHS cuts. Does he not realise how hopelessly out of touch he sounds? Hospitals everywhere are making severe cuts to services, closing wards, reducing A and E hours and closing overnight, making nurses redundant, and cutting training places. Last week, The Guardian revealed the random rationing that is taking place across the country. There are cuts to pay for management services, one third of neo-natal units are reducing the number of nurses, and midwife places are being cut despite the Prime Minister’s promise to recruit 3,000 more.

Dr Poulter: The right hon. Gentleman is making a great deal out of cuts. The Government have committed an extra £15 billion to the NHS over the lifetime of this Parliament, but the Opposition have consistently failed to agree to commit to any additional funding. Will he make that commitment now?

Andy Burnham: A moment ago, the hon. Gentleman acknowledged that I protected the NHS front line as Health Secretary. As Health Secretary, I would not have introduced a £2.5 billion reorganisation when the NHS is facing severe financial stress.

Dr Thérèse Coffey (Suffolk Coastal) (Con): Is it fair to say that under his leadership of the NHS, Monitor suggested that it needed to make efficiency savings? Those are coming through now, but the right hon. Gentleman is trying to present them as cuts to front-line services.

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Andy Burnham: No. Let me explain the position to the hon. Lady so that she understands it. It is correct that in the previous Parliament, not Monitor, but the chief executive of the NHS, suggested that the NHS would have to make around £20 billion of efficiency savings over the four years of this Parliament. That is called the Nicholson challenge, which I accepted. However, contrary to what the Prime Minister said at the Dispatch Box last week, it was intended that every penny of that money would go back into the NHS to help it to deal with the pressures that it faces. I am afraid that the Government are again misrepresenting my position.

My position is different from the Secretary of State’s because that challenge, on its own, would have been all-consuming for the NHS, meaning that it would have had to focus every ounce of its energy on rising to that challenge. The last thing in the world that the NHS needs is a huge reorganisation, because it will take its eye off the ball, meaning that it cannot rise to that challenge.

Paul Farrelly (Newcastle-under-Lyme) (Lab): Is my right hon. Friend aware that during the so-called “pause for thought”, nothing was done to stop the NHS reorganising ahead of legislation that was yet to go through Parliament? Was that not contemptuous of both Parliament and of the genuinely held concerns of Liberal Democrat coalition partners?

Andy Burnham: Frankly, it is disgraceful that primary care trusts were allowed to disintegrate before Parliament had given its consent to those changes, leaving the NHS in limbo in most communities represented in the House. I have said that the Government have put the NHS in the danger zone, and I mean it. There is no capacity on the ground to help the NHS through these difficult times. It has lost the grip it would have needed to take us through the financial challenge, and I lay that charge directly at the Secretary of State’s door.

Joan Ruddock (Lewisham, Deptford) (Lab): Will my right hon. Friend give way?

Andy Burnham: I will give way in a moment.

I mentioned that the Prime Minister is out of touch, and that he promised to recruit 3,000 more midwives and then handed out redundancy notices to them. However, if the Prime Minister is out of touch, I worry that the Secretary of State is in outright denial. On 11 October, when my hon. Friend the Member for West Lancashire (Rosie Cooper) asked him about the practice of hospitals re-grading or down-banding nursing posts to cut their costs, he replied:

“I am not aware—my colleagues may be—of…trusts…seeking to manage their costs by the downgrading of existing staff. If you are aware of that, then, by all means, tell us, but I was not aware.”

The very next day, that version of events was directly contradicted by Janet Davies of the Royal College of Nursing, who said that

“the Royal College of Nursing has raised the issue of downbanding with the Secretary of State on a number of occasions, alongside other concerns such as recruitment freezes and redundancies in the NHS…Our members’ survey released earlier this month also revealed that 7% of nurses expect to be downbanded in the next 12 months”.

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If the Secretary of State would like to correct the evidence that he gave to the Select Committee on Health and confirm that he was aware of the practice of down-banding, he can be my guest right now.

Mr Lansley: I am grateful to the right hon. Gentleman. I do not change a word of what I told the Health Committee—it was entirely accurate. I have checked the records, and at no stage had the RCN raised that issue with me.

Andy Burnham: The Secretary of State directly contradicts, on the record, a spokesperson from the Royal College of Nursing. If he stands by his evidence, will he publish the minutes of his meetings with the RCN in which it states that the issue of down-banding was specifically discussed?

Mr Lansley: Will the right hon. Gentleman give way?

Andy Burnham: When I am ready.

Will the Secretary of State promise today to publish those minutes?

Mr Lansley: Yes, I shall publish the minutes of those meetings, but I resent the implication from the right hon. Gentleman that I would stand at this Dispatch Box or sit before a Select Committee and say anything other than what I believed to be the complete truth.

Andy Burnham: If that is the case, I respectfully ask the Health Secretary why he has not responded to a letter from my hon. Friend the Member for West Lancashire—

Rosie Cooper (West Lancashire) (Lab) indicated assent.

Andy Burnham: My hon. Friend is nodding. Why has the Secretary of State not responded to the letter that my hon. Friend sent to him several weeks ago pointing out the discrepancy between his evidence and the statements from the RCN? If he wants to adopt a pious tone in the House, he needs to reply to his letters on time and put his facts on the record.

Mr Lansley: Will the right hon. Gentleman give way again?

Andy Burnham: Is the right hon. Gentleman telling or asking? [Interruption.] I give way to the right hon. Gentleman.

Mr Lansley: If the right hon. Gentleman is going to insult me, he ought at least to give way. I have seen no letter from the hon. Member for West Lancashire (Rosie Cooper). I have seen a letter from the Chairman of the Health Select Committee, to which I approved an answer.

Andy Burnham: Well, that is no good to me. We have not seen that answer. The right hon. Gentleman needs to reply to hon. Members’ correspondence in a timely fashion, especially when it relates to serious issues about discrepancies between his evidence and statements made by the RCN.

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Rosie Cooper (West Lancashire) (Lab): I would like to inform both my right hon. Friend and the Secretary of State that I did, in fact, write to you but have received no reply. In my letter, which I shall ensure gets to you again, I asked you to publish the minutes of that meeting. It was very clear. One or other of you have made a severe error.

Mr Speaker: Order. We must preserve the proper parliamentary terms. Nobody has written to me and I have not made a severe error. We will leave it at that.

Andy Burnham: It is clear that we will get to the bottom of this, because the Secretary of State has committed to publishing the minutes, and if he is suggesting that the RCN has been inaccurate, he needs to produce the evidence.

That takes me to the Prime Minister’s second personal promise on the NHS, which deals with hospital reconfiguration and the mythical moratorium.

Tony Baldry (Banbury) (Con) rose—

Andy Burnham: I shall give way in a moment.

If we thought that the Conservative party’s promises on funding were bad enough, the sheer audacity of its claims on hospital closures is breathtaking. Before the last election, the right hon. Gentleman toured the country promising the earth to every Conservative candidate he met. I recall seeing his commitments—I have them here—pile up in the Ashcroft-funded glossy leaflets that landed on my desk in the Department of Health. He said that he would reopen the accident and emergency department in Burnley; he said that he would save and A and E in Hartlepool, but, scandalously, only if the town elected a Conservative MP; and I well remember the day he visited his hon. Friend—although, after this week, I doubt that the Government Front Bench team still consider him a friend—the hon. Member for Bury North (Mr Nuttall) and promised the people of Bury in the leaflets I have here:

“Vote Conservative and if there is a Conservative government the maternity department will be kept open.”

It could not be clearer. However, the maternity department at Fairfield hospital is scheduled to close next March. It is disgraceful. However, the Prime Minister’s most shameful politicking came in north London. I lost count of the number of times he promised to save the A and E department at Chase Farm hospital.

Chris Skidmore: On a point of order, Mr Speaker. Is it in order for the right hon. Gentleman to name my hon. Friend the Member for Bury North (Mr Nuttall) without telling him?

Mr Speaker: Yes, it is.

Andy Burnham: I point out to the hon. Gentleman, with his clever point of order, that I did contact the office of the hon. Member for Bury North and, indeed, the hon. Member for Enfield North (Nick de Bois).

Mr Speaker: Order. I am grateful to the right hon. Gentleman for that clarification, but perhaps this is an opportunity for me to make the position clear. I am not cavilling at the hon. Member for Kingswood (Chris

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Skidmore), but the position is basically this: if a Member is going to impugn the integrity or attack the record of an individual hon. Member, the Member who is the subject of the criticism should be notified in advance. The fact that someone simply intends to refer to another Member and something that may or may not have happened in his constituency during an election campaign, or at any other time, is not something of which prior notification is required.

Andy Burnham: After that rude interruption from the hon. Member for Kingswood (Chris Skidmore), I shall get back to my script.

Just days after the election, the Prime Minister went to Chase Farm hospital, with the Secretary of State, to announce the coalition’s new policy of the moratorium and the following commitment in the coalition agreement:

“We will stop the centrally dictated closure of A&E and maternity wards.”

I have with me the photograph from that very visit of the Secretary of State holding up a placard stating his opposition to any changes to the A and E at Chase Farm hospital. However, he has recently failed to prevent those changes to the A and E department and maternity unit at Chase Farm hospital, leaving the new hon. Member for Enfield North writing a desperate letter to the Prime Minister stating that his constituents had been utterly let down by them both. I do not know whether the Prime Minister or the Secretary of State have the decency to feel embarrassed today, hearing these cynical promises repeated in the House. The proposed moratorium and opposition to closures were purely political and designed to help the Conservatives win votes in marginal seats. That is a fact.

Tony Baldry: I apologise for not having intervened quickly enough earlier, but the right hon. Gentleman says that he accepts the Nicholson challenge. Given that efficiency savings will have to be made in the NHS, where does he envisage those savings being made? It seems to me that every hospital trust will have to make efficiency savings somewhere, as a result of the Nicholson challenge.

Andy Burnham: The hon. Gentleman asks a very fair question. It is precisely such issues—about how to produce the savings—that are the important issues. Care has to be taken out of the hospital setting and we have to prevent too many elderly people, in particular, from going into hospital in the first place if we are to create an NHS that is able to face the future and that is financially and structurally sound. That is why I take such exception to the naked opportunism that we saw before the election, when I, as Health Secretary, was taking on some of those difficult challenges and grasping the nettle, including in my own backyard in Greater Manchester, where there was a difficult review of maternity and children services, involving the closure of four maternity units and shrinking their number to eight. We did that, we took on that debate, and yet the now Health Secretary was touring those marginal constituencies in Greater Manchester, saying that he would overturn our decision in office, but he has not done it. That is precisely the point that I am making to the House. We need a Health Secretary prepared to take those difficult decisions, if the NHS is to be able to make the savings that will sustain it in the long term.

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Joan Ruddock: I am grateful to my right hon. Friend for giving way, because like the hon. Member for Banbury (Tony Baldry), I missed the opportunity to intervene when efficiency savings were being discussed. Does my right hon. Friend agree that the key to this problem is proper discussion with the experts within the health service—with the nurses, doctors and all the people who administer our fantastic service? They are the ones who can give us ideas for efficiency savings. The hallmark of the Government is their failure to listen to the professionals.

Andy Burnham: My right hon. Friend makes an important point. When we were in government, we said that there had to be a clinical case for change, if changes to hospital services were to be made. I mentioned Greater Manchester a moment ago. There was a clinical case to support those reforms. The experts, to which she rightly pointed, said that about 50 babies’ lives would be saved every year by specialising care in fewer locations. In such circumstances, politicians have a moral obligation to listen to those experts and to make changes, no matter how politically difficult they are. That is why I say that it was sheer opportunism of the worst kind for the Government, when in opposition, to say that they would have a moratorium on any changes and to tour those marginal constituencies promising to overturn decisions, when in fact they had no intention of doing so. I put it to the House that the people of Bury, Burnley and Enfield have now clearly discovered what opportunism there is from those on the Conservative Front Bench.

Sarah Newton (Truro and Falmouth) (Con): Does the right hon. Gentleman therefore welcome one of the Government’s first actions, which was to change the NHS operating guidelines for reconfigurations to ensure categorically that clinicians and the communities they serve were in the driving seat for future reconfiguration of the NHS?

Andy Burnham: If that is the case and the people of Enfield are in control of the decision, would Chase Farm A and E be closing? What the hon. Lady describes is a complete and utter reinvention of the moratorium policy. She stood on an election manifesto that promised a moratorium. Where is it? It has not materialised. It is a mythical policy that was designed to win votes; it had nothing to do with the good stewardship of the national health service.

Mr Andrew Love (Edmonton) (Lab/Co-op) rose—

Andy Burnham: I give way to my hon. Friend, who has a nearby interest in Chase Farm.

Mr Love: I thank my right hon. Friend for giving way, and yes, I do have an interest because constituents of mine have been affected by the decision at Chase Farm. Not only did the Secretary of State come to Chase Farm immediately after the election, but he announced the change in policy on reconfigurations. He introduced the so-called four tests, none of which has ever saved any unit, in any part of the country. The reality is that he seriously misled the people of Enfield, who are now bearing down on their Member of Parliament, who also misled them on this policy. It is an outrage and they feel badly let down by this Government on health service reform.

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Andy Burnham: For the avoidance of doubt, let me address directly what my hon. Friend has said. A moment ago I mentioned a photograph of the Secretary of State on a visit to Chase Farm hospital just days after the election, when he announced his so-called moratorium—although no one has yet seen any evidence of it. He is holding up a placard in that photograph that says, “HANDS OFF! Chase Farm A & E”, underneath which are the words: “I oppose any cutbacks to our A & E,” and on the bottom we can see his signature. How on earth he can square that with the letter that he recently exchanged with his hon. Friend the Member for Enfield North, I do not know. I do not know how the Secretary of State can reconcile those two things in his mind or how he could look anyone in Enfield North in the eye, having promised them that he would save their accident and emergency department. It is quite scandalous. People across the country are discovering that the Prime Minister’s moratorium is utterly meaningless, as A and Es restrict opening hours and maternity wards close.

We now come to the third of the Prime Minister’s broken promises, on NHS reorganisation. Again, the coalition agreement could not have been clearer:

“We will stop the top-down reorganisations of the NHS”.

I have never understood how those in the coalition could possibly sign up to those words, when only weeks later they would bring forward a White Paper heralding the mother of all reorganisations, the biggest since 1948. I can see the cynical politics behind the Prime Minister’s first two pledges, but on this pledge at least he was right. A reorganisation is precisely the last thing that the NHS needs right now. I am clear: the abandonment of that pledge is the Prime Minister’s biggest mistake in office. If he ploughs on, he will ultimately pay a heavy price for it, because it is a catastrophic error of judgment to combine the biggest ever financial challenge in the NHS with the biggest ever reorganisation.

As Health Secretary, I was told by officials that rising to the financial challenge would require every ounce of our energy and focus. The NHS would need stability. Instead, this Government have picked up the pieces of the jigsaw and thrown them up in the air, distracting the service at the very moment it needed maximum focus. Grip has been lost; the NHS is drifting.

Henry Smith: Does the right hon. Gentleman not agree, however, that our NHS needs greater efficiency and localism, and that this requires reorganisation?

Andy Burnham: I said just a moment ago that I was the one who put my name to the Nicholson challenge, because that money was going to help the NHS respond to the new demands placed on it at this difficult time, so the hon. Gentleman need not lecture me about efficiency. He needs to tell me how placing a moratorium on change in the NHS helps it to respond and deliver those efficiencies. That is the contradiction of his position, and he stood for election on that policy, as did others.

Grahame M. Morris rose—

Andrew George (St Ives) (LD) rose—

Andy Burnham: I will give way to the hon. Gentleman and then to my hon. Friend.

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Andrew George: I accept that the Health and Social Care Bill is the longest and most incoherent suicide note in NHS history. Indeed, I am robust on this issue: I have voted against the Bill and will continue to take that view. However, considering that the right hon. Gentleman was involved when preferential arrangements were provided for private sector providers coming into the NHS, is this debate not an opportunity for him to acknowledge that at the Dispatch Box and apologise to the House for what was a rather ridiculous and one-sided policy?

Andy Burnham: Let me first acknowledge the hon. Gentleman’s courage in standing up and voting against the Health and Social Care Bill. I just wish that more of his Liberal Democrat colleagues had similar conviction and principle, and could stand up to the Government on a Bill that he knows—and which, in their heart of hearts, many of them know—will seriously damage the NHS.

The hon. Gentleman also asked me about the introduction of private sector capacity. I will not apologise for that, because that additional capacity was brought in to bring down NHS waiting lists, something that benefited his constituents. By bringing in that extra capacity we brought down NHS waiting lists to an all-time low and delivered the 18-week target. I am not going to apologise for that. The reason the NHS commands such strong support in the country today is that people’s experience of it improved in those years. I mentioned the preferred provider policy a moment ago. I believe that the private sector has a role to play in delivering world-class care to patients, and I am happy to put that on record.

Mr Kevin Barron (Rother Valley) (Lab): At the heart of the current Bill are the 98 clauses that introduce competition law into the national health service—something that the last Government did not pass even one clause to do. Is not the ideology lying at the heart of the Bill what will wreck our national health service?

Andy Burnham: My right hon. Friend makes an incredibly important point. Make no mistake: if the Bill passes, the NHS will never be the same again. The Bill will unpick the fabric of a public national health care system—a planned system—and turn it into a free-for-all, as he says. Indeed, it is unbelievable to see a letter in The Guardian today from senior Liberal Democrats—many of whom made the same argument a few weeks ago as my right hon. Friend—now saying that, because of a few tweaks to the Secretary of State’s powers, the time has come to abandon all their concerns about the provisions. That is a ridiculous statement to make. If they still have concerns about competition and privatisation, they should have the courage of their convictions and stand up against the Bill, instead of writing sanctimonious letters to The Guardian.

Grip has been lost; the NHS is drifting. However, the Government cannot say that they were not warned. Sir David Nicholson, the chief executive of the NHS, told the Public Accounts Committee that the reorganisation had increased the scale of the financial challenge:

“I’ll not sit here and tell you that the risks have not gone up. They have. The risks of delivering the totality of…the efficiency savings that we need over the next four years have gone up because of the big changes that are going on in the NHS as a whole.”

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This has been a lost year in the NHS—a crucial year, when it needed to face up to the financial challenge—but things are not getting better. We face months of further uncertainty, as the Secretary of State battles on with his complicated and unwanted Bill. Four-hundred and ninety pages, 70-page letters to peers, amendments made on the hoof: it is a total mess. The NHS deserves better than this. Even the man the Secretary of State brought in to run his new NHS Commissioning Board describes his Bill as “completely unintelligible,” and went on to say:

“It is going to be messy as we go through a very complex transitional programme.”

And this from the Secretary of State’s friends.

The harsh truth is that the Secretary of State has comprehensively failed to build the consensus he needs behind his Bill. GPs do not want it; nurses do not want it; midwives do not want it; patients do not want it. I say to the Prime Minister and the Health Secretary today: stop digging in. Drop this Bill. If they do, my offer still stands, as our motion makes clear. We will work with the Secretary of State to reform NHS commissioning, giving GPs and other clinicians a bigger role. That can be achieved without legislation and a major structural upheaval of the entire NHS. It can be done through existing legal structures, giving immediate stability and saving millions.

We make our offer again today, as it is time for all politicians to put the NHS first. It is slipping backwards, and the warning signs are there for all to see. Waiting lists and waiting times are getting longer, with a 48% rise in the last year in the numbers of patients waiting more than 18 weeks. When patients are waiting longer, it is unforgivable that £2 billion to £3 billion has been set aside to pay for the costs of reorganisation. It is also unforgivable that £850 million is being spent on making people redundant who will end up being re-employed elsewhere in the system, in the new clinical commissioning groups.

We are witnessing a return to the bad old days of waiting longer or paying to go private. This is just a glimpse of the future. If the Bill passes, the NHS will never be the same again. We have all seen the adverts on television for the health lottery. Is this the right hon. Gentleman’s early marketing and his new brand name for our NHS?

Bob Blackman (Harrow East) (Con): Does the right hon. Gentleman not accept that one of the severe problems that the national health service is facing came about on his watch, when primary care trusts were allowed to build up huge deficits without making the economies and efficiencies that should have been made at that time, rather than on this Government’s watch?

Andy Burnham: I have never said that the NHS was perfect, or that there were no challenges during our time in government. But let me tell the hon. Gentleman what happened when the NHS was facing those deficits in 2006 and 2007. We took a grip at the centre and we brought those trusts back into financial balance, through hard work. There was a turnaround team in the Department, and we made sure that those difficulties were tackled at root. I do not see the same grip in the national health service right now. I see drift and lack of focus, and I see huge distraction as a result of this unwanted Bill.