5 Jun 2013 : Column 1617

Barry Gardiner (Brent North) (Lab): As my hon. Friend knows, Northwick Park is just in my constituency and we share that border. Does he agree that whatever the future configuration of hospitals in north-west London, it is absolutely essential that the A and E unit at Northwick Park is expanded to cope and that that should happen before any reconfiguration?

Mr Thomas rose—

Madam Deputy Speaker (Dawn Primarolo): Order. I remind the House that there are nine speakers still to be called, and that the winding-up speeches will begin at 6.40 pm. That means that some Members who have been sitting in the Chamber will not be able to contribute. I therefore ask Members to be sparing with interventions, and to make them only when they are absolutely crucial. I also remind them that interventions must be short, and must relate to the point that the speaker was making at the time rather than be an extra debating point.

Mr Thomas: I share the view of my neighbour and hon. Friend the Member for Brent North (Barry Gardiner). We need that expansion to go ahead, and to go ahead soon.

In an intervention during the speech of my right hon. Friend the Member for Leigh (Andy Burnham), I raised the plight of many of my constituents who formerly used Alexandra Avenue polyclinic, an extremely popular walk-in centre which used to be open from 8 am until 8 pm, 365 days a year, to people who were genuinely concerned about their health and did not feel that they could wait to see their GPs. It was opened by Ara Darzi some five years ago. Amazingly, its opening was opposed by my political opponents in Harrow, but it quickly came to be greatly appreciated by, in particular, people living in the south Harrow and Rayners Lane area. Those people have noted with considerable regret that, after the last general election, the primary care trust decided to restrict the opening hours of their walk-in centre, but not those of the walk-in centre in Pinner, in the constituency of my other neighbour, the hon. Member for Ruislip, Northwood and Pinner (Mr Hurd).

As a result of the cuts that the primary care trust decided to make, the walk-in service now operates only between 9 am and 3pm on Saturdays and Sundays. The fact that it remains open at all is entirely due to the scale and strength of feeling about the loss of what was an excellent service, and the campaign that we were able to run in order to save it. Perhaps some of the £3 billion that the Prime Minister spent on what was—as others have already pointed out—a completely unnecessary reorganisation of the NHS could have been invested in keeping Alexandra Avenue polyclinic open, and some of the pressure that my constituents are imposing on Northwick Park hospital’s accident and emergency unit could have been alleviated.

Staff at the excellent Pinner ambulance station in Rayners Lane do an extremely good job, generally spending all their shifts out on the road. It is clear that they, like the rest of the staff of the London Ambulance Service, are under extremely heavy pressure. On occasion, ambulances have been used as temporary reception or holding areas at Northwick Park when patients cannot be admitted to A and E as they arrive because of the pressure on that department.

5 Jun 2013 : Column 1618

There is also concern about the district nursing service in Harrow. My personal experience of that service has been mixed. An elderly relative and, more important, that person’s carer have found it difficult to gain access to it by telephone when problems have developed. It has been slow to respond, and has demonstrated poor co-ordination with other parts of the local health care system. Again, funding was cut by the primary care trust.

The new clinical commissioning group has given notice to the local trust which runs the service that it may outsource the contract, but I am not convinced that that is the answer. Investment in staff—trained staff—and, crucially, investment in management time by the local trust seems to be the immediate requirement if the problems in the service are to be sorted out. Meanwhile, to those who are aware—as many of my constituents are—that the district nursing service is far from brilliant, it is hardly surprising that family members should want to delay the discharge of elderly patients from Northwick Park.

It is telling that the number of cancelled operations is rising fast at Northwick Park. So far, it has risen by some 13%. That is a further symptom of the crisis in the national health service, as evidenced by others—

Madam Deputy Speaker: Order. The hon. Gentleman’s time is up.

6.19 pm

Eric Ollerenshaw (Lancaster and Fleetwood) (Con): I have only a brief amount of time, so I will not repeat what other Members have said about demographics. I would also have liked to have talked about the NHS funding formula and the fact that Lancaster and Fleetwood is a rural area and there is no accounting for geography or the numbers of old people.

I agree with the hon. Member for Southport (John Pugh) and others who said we need a non-political debate. I shall focus on the question of staffing in A and E. People talk about crisis and chaos, but the majority of my electorate get a very good service from highly qualified professionals, who are working extremely hard. There is a staffing issue, however: we need to ensure there are enough properly qualified emergency specialist consultants working in A and Es both now and in the future and that they are not stretched to breaking point.

All this information comes from the doctors working in my A and E at the Royal Lancaster. This issue was also flagged up in a College of Emergency Medicine report, “The drive for quality”. The problem, which has been building over many years, is that ever fewer doctors want to move into the A and E specialty. That is largely because of the pressures of the work and the long and unsociable hours, including high-pressure weekend shifts that do not arise in other specialties. In turn, that leads to even more pressure on the few qualified consultants that remain, who have to work longer shifts and take on ever more responsibilities, and many of whom therefore eventually choose to go into other specialties as well. As a result, there is always a shortage of specialists.

To see how bad the problem was, I submitted a series of freedom of information requests last year, asking hospitals how many consultant emergency physician vacancies they had and how many people had applied

5 Jun 2013 : Column 1619

for posts when they were last advertised. There seemed to be some regional variations—and my area, the north-west, seemed to be having particular difficulties—but there were some worrying general trends. Without naming individual hospitals, here are some examples: one hospital advertised for a senior clinical fellow on three separate occasions over the course of nine months, but there were no suitable applicants; another hospital advertised for three consultant emergency physicians, but no one applied; elsewhere, seven consultant vacancies were reported in one hospital, representing some 33% of its planned consultant staffing rate.

Even when there are applicants, competition is fierce. One hospital advertised for six vacancies and received four applications, but three of them withdrew prior to interview, presumably because they had been poached by employers elsewhere. Worryingly, sometimes the quality of applicants is not up to standard, as in the case of the hospital which advertised for five consultant emergency physician vacancies, only to conclude that none of the applicants was appropriately qualified.

I again stress that, according to the College of Emergency Medicine, this issue has been worsening over many years. We need to work constructively to ensure that emergency physician status is better recognised and rewarded within the NHS, so it can recruit and retain the required quality staff. This might not all be about money, by the way, but we definitely need to do more to tackle the issue and to give due credit and due status to the physicians who maintain the existing A and E service—which, as I have said, for the majority of my constituents is a good service.

6.23 pm

Siobhain McDonagh (Mitcham and Morden) (Lab): I will be very brief, as I want all Members who wish to contribute to the debate to be able to do so.

It feels as though we are telling the public that somehow they are being irrational by attending A and E. They are being entirely rational, however, if they live in urban London. They are being rational because they cannot get access to their GP services. Their GPs have contracted-in times and their walk-in clinics have been closed, so their only alternative is A and E. The 111 service is also, in effect, A and E, because it is so risk-averse. Our current system is not based on what is best for the patient; it is based on what is going to cause the least legal damage to the NHS if things go wrong.

My local hospital, St Helier, is up for closure despite the fact that its A and E is the only one in south-west London that meets the targets. Its maternity unit is also to close, even though it is the most clinically safe unit in the country. It is very difficult to explain that that is a rational decision to any member of the public, including me.

On issues to do with the NHS and how consultations are carried out, we are told and implored to see things differently. How can we see things differently when consultations do not include the public and when consultations are held over the school summer holidays rather than at a time when people and halls are available, and those of us who rely on voluntary assistance in making our arguments can get people to provide it? Better Services Better Value in my constituency intends to start its consultation at the end of the month and run it over July and August, dismissive of the arguments of

5 Jun 2013 : Column 1620

the public that they cannot meet that timetable. Better Services Better Value has meetings without announcing where they are or what time they are at, and it does not even use microphones. I have been a publicly elected politician for more than 30 years and some of these NHS meetings I have attended have been the worst I have ever encountered during that time. If we wish to bring the public with us in difficult decisions, we have to be reasonable, fair and straightforward in our proposals. Nobody in my constituency understands why the solution to longer A and E waits is the closure of A and Es that are effective and actually work.

6.25 pm

Stephen McPartland (Stevenage) (Con): I am proud of the NHS and of the staff who work for it daily in my constituency; they are part of a huge team that saves lives every day.

The issue of A and E waiting times has shot up the political agenda, but I am concerned that many of the staff working in those departments will fear that their deeply held commitment to the job will not be getting the recognition it deserves. Across the country, 22 million people have visited A and E, with 96% being seen within four hours—that is nearly 1 million more people than a year ago, which is positive news.

I have great respect for the shadow Secretary of State, but I do not think the A and E crisis is as acute as the Opposition like to suggest. The reality is that in some areas A and E is going incredibly well. Let me talk about my constituency and the Lister hospital, where our team sees about 135,000 patients a year, about 25% of whom are children, with 21% of the patients seen by our A and E department being admitted to hospital.

I shall read a couple of quick reviews from the past few months. One said:

“I Twice needed help in last 2 months, in each case response on phone was excellent and doc phones back within 20 min. Ambulance was there quickly and I was in A&E within the hour. Excellent treatment there and can’t recommend the service highly enough. Could not have done better anywhere. Everyone involved needs to have a big thank you and how lucky we are to have such a great service. I am 83 and still going strong because of this great care. Again thank you all very much.”

Another said:

“I was recently admitted to Lister via A&E and can only praise every member of staff who dealt with me from that point until I left.”

A third said:

“My son quickly became very ill with strep A and toxic shock syndrome and from the immediate ambulance response to being put in the Short Stay Unit after A&E, he received the most wonderful care and compassion. All of the staff were lovely and we can’t thank them enough.”

So A and E across the country is not as bad as people like to make out. I visited the A and E in Stevenage, spending two and a half hours sitting in the waiting room and then being dealt with very courteously and professionally. It was a very positive experience. I have also been out with the ambulance service in Stevenage and gone around the constituency. I dealt with a number of 999 calls, one of which involved a nine-year-old boy being rushed to A and E. He was dealt with incredibly efficiently by the teams there, who were waiting for him upon his arrival and helped to save his life. They had to put him into an induced coma because of the severity of the condition he was admitted with.

5 Jun 2013 : Column 1621

I know that there are issues to address in some parts of the country, but in Stevenage we are benefiting from a £150 million redevelopment of our hospital, which will make it one of the most modern and advanced facilities in the UK. As part of that, a new £20 million A and E unit is being built at the moment. It will be fully open in autumn 2014. I visited the building about a month ago and I can tell hon. Members that it is almost twice the size of the current one. It will have a range of fantastic facilities and services; we have doubled the equipment and doubled the number of people. The staff have been involved every step of the way in designing the new facility with the builders, even pushing the carts around the building to understand the best way in which they can achieve what they want. It will also have a dedicated adult section and a dedicated child section. The Lister hospital and its A and E are doing a great job in my constituency for people every day. A legion of doctors, nurses and clinical staff are doing this fantastic job, and I am proud of them and I am proud of the A and E in my constituency.

6.29 pm

Mr Kevin Barron (Rother Valley) (Lab): I was beginning to think that the debate was about A and E services in London, so I am pleased to be able to say a few words from these Back Benches. The views of people from the north on the London-centric debates we have in this country have been pretty consistent—so let me move on very quickly.

I have been active in health in Parliament over the many years I have been a Member, particularly during the previous Parliament when I chaired the Select Committee on Health. Until a few weeks ago, I had never heard anyone put the case that any problems we had in primary care, or even in secondary care, were to do with the 2004 contract agreed with GPs by the then Government.

On 21 May, I came in to hear the urgent question and listened to the Secretary of State talk about the concept that as

“a result of those disastrous changes to the GP contract, we have seen a significant rise in attendances at A and E”

and the

“direct consequence of those disastrous 2004 changes to the contract”

even though my right hon. Friend the Member for Leigh (Andy Burnham) had said that on that very day

“the chief executive of the NHS Confederation told the Select Committee on Health that there is no link between today’s pressures on A and E and the 2004 contract”.—[Official Report, 21 May 2013; Vol. 563, c. 1055-57.]

Yet today we have heard that argument again. I never heard it when I was on the Health Committee; I never heard it until this year, and I do not believe it. That is my fundamental position.

I am pleased to see that the Secretary of State has come back into the Chamber. On 21 May, my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) asked the Secretary of State how many walk-in centres had been shut since May 2010. The right hon. Gentleman said:

5 Jun 2013 : Column 1622

“I can assure the hon. Gentleman that many more walk-in centres would be shut if we had to cut the NHS budget, which is what the Labour party wants to do.”—[Official Report, 21 May 2013; Vol. 563, c. 1065.]

My hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) asked the Secretary of State

“how many walk-in centres have closed since May 2010? Will he accept that those closures are linked to the rise in A and E attendance?”

He replied

“that if we followed her party’s Front-Bench policy of cutting the NHS budget from its current levels, many more urgent and walk-in centres would have to be closed.”—[Official Report, 21 May 2013; Vol. 563, c. 1069.]

The walk-in centre in Rotherham stops people going to the A and E. It is open 12 hours a day, seven days a week, unlike doctors’ surgeries. During that urgent question, we heard talk about lights going out at 5 pm. When did GPs’ lights not go out at 6 pm at any point in my lifetime? They would start at 4 and go on to 6 pm. The lights were never on in primary care and it is such centres that are really helping.

Today, we have eventually found out that 25% of walk-in centres—that is, 26 of them—have closed. When the one in Rotherham opened, there was opposition from one of the doctors in my constituency who publicly campaigned against it, but that was all about the money that went into his private individual business. That is wrong. The Secretary of State should get off the political fence and start making decisions about what is happening to health care and our people, rather than about what will happen in 2015 at the next general election.

6.32 pm

Martin Horwood (Cheltenham) (LD): I am grateful to previous speakers, particularly the hon. Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for Mitcham and Morden (Siobhain McDonagh), who made some of the comments I would have made and therefore saved me a good minute.

The crisis in emergency departments is multifaceted and we are facing a downgrade of the emergency department in Cheltenham general hospital. The rationale has not been funding pressures or extra admissions but, as the hon. Member for Lancaster and Fleetwood said, the shortage of emergency doctors. The College of Emergency Medicine recommends that we should have 20 emergency medical posts over the two A and Es in Cheltenham and Gloucester. The trust has only just managed to fill the 12th, so we are at not much better than half strength. That has obvious safety implications and has driven the trust’s recommendations for downgrading A and E at Cheltenham.

The staff shortages have their root in work force planning issues that date back many years. They must date back to the Secretary of State’s predecessor’s time and, clearly, to that of the previous Government, too. The hon. Member for Ealing North (Stephen Pound) was quite right, however, and we should not be playing a party political blame game. We should simply admit that we have a really serious problem and work out what to do about it.

The College of Emergency Medicine suggests that the initial recruitment to the discipline is quite respectable and that retention is the problem. Emergency medicine

5 Jun 2013 : Column 1623

involves long hours, with a 24-hour cycle of shifts, and is an intense and stressful form of medical practice. I hate to accuse anyone of mercenary motivation, but of course those who work in emergency medicine cannot moonlight in private practice, either, which makes it less attractive from that point of view. So we do need a rethink nationally. I welcome the urgency with which the Government are now addressing that. It should have been done years ago.

In the meantime, changes inevitably are being proposed by local hospital trusts. I do not think we can blame them for that, but, as the hon. Member for Mitcham and Morden said, the process must be open, accountable and transparent. That was, after all, the idea of the new structures that the right hon. Member for South Cambridgeshire (Mr Lansley), the previous Secretary of State, foisted on us in the new system.

The consultation in Gloucestershire has raised real questions. Why has not the trust even tried to pay more for emergency medical posts, as it has the freedom to do so as a foundation trust? Could it have looked more seriously at overseas recruitment? Why has it not been prepared to wait for the Keogh review, or the Secretary of State’s urgent review of recruitment, before making the changes permanent? Why was it not prepared to trial changes just for a year, as Liberal Democrat members of the health overview and scrutiny committee requested yesterday? I deeply regret the fact that Conservative councillors on that committee from all over Gloucestershire voted down that very modest compromise proposal and backed the downgrading of A and E in Cheltenham.

In my detailed evidence I raised issues of increased mortality, and of possible increases in health inequalities resulting from these changes, but I have no evidence that my submission, or the thousands of petition signatures that we gathered locally, have been properly considered at all. The primary care trust consultation website actually disappeared halfway through the consultation process because, of course, the primary care trust ceased to exist and handed over to the new clinical commissioning group. The obvious suspicion locally is that this was a foregone conclusion, and that it is only a matter of time before the trust proposes the outright closure of the A and E at Cheltenham.

That suspicion was strongly reinforced yesterday. Within hours of the health overview and scrutiny committee meeting, the trust issued a joint statement with the new clinical commissioning group, instantly announcing that the changes would now be going ahead on a permanent basis, despite the fact that the trust has not actually considered the outcome of the consultation exercise at either its board or the CCG’s board. That is not open, accountable and transparent, and it must be in future.

6.36 pm

Barbara Keeley (Worsley and Eccles South) (Lab): We have a crisis in A and E; that is clear from this afternoon’s debate. The King’s Fund report this week detailed the worst performance in nine years, with 5.9% of patients waiting more than four hours. It has been suggested that patients are just going where the lights are on. Is that the case?

I got information on A and E from the chief executive of Salford Royal NHS Trust, comparing the third and fourth quarters of 2011-12 with those in 2012-13. He

5 Jun 2013 : Column 1624

found that there are 10% more ambulance arrivals every day. We actually have sicker patients, with more arriving by ambulance. There has been a 13% increase in admissions of people staying longer than 72 hours, and fewer are staying for shorter periods. There are 25% more triages into the hospital’s resuscitation area, and there has been a significant increase in risk and co-morbidity among patients and increased admissions into critical care. There is something going on there.

We know that the rising demand for A and E is particularly concentrated in those aged over 85, and cuts in social care budgets are now widely acknowledged as contributing factors. My local authority of Salford must make £24 million of cuts this year. It is the third year of cuts, and now the authority, having held on to services meeting a moderate level of eligibility, is moving to meeting only substantial levels of eligibility, taking £3.5 million out of adult social care this year and £3.5 million next year. Our former Salford primary care trust had already cut the two walk-in centres that we had, and axed the pilot of active case management for people with long-term conditions.

How is that affecting people? What do carers say? Carers UK has carried out a survey of 3,500 carers, 55% of whom are caring for a person who has been admitted to emergency hospital services in the past three years. A significant percentage of those carers referred to areas where additional support could have prevented those emergency admissions. What types of care were needed? Six per cent. said that they, the carer, needed replacement care because they were ill themselves; 21% per cent. needed a higher quality of care and support for the cared-for person; 10% needed adaptations in the home, and 7% would have been helped by telecare and telehealth. Those findings tie in with some of my casework in recent weeks, when I have heard some very similar cases.

The King’s Fund report tells us that the prospects for adult social care are bleak. Councils are planning to reduce their budgets by another £800 million a year. That is a cumulative cut since 2010 of 20% in adult social care. My local hospital tells me that patients are coming in sicker, they are admitted for longer stays, they require more time and attention and they are now heavy resource-users. It is time that Ministers stopped making excuses and started dealing with this crisis.

Madam Deputy Speaker (Dawn Primarolo): I call Andy Slaughter. You have one minute.

6.39 pm

Mr Andy Slaughter (Hammersmith) (Lab): I am most grateful, Madam Deputy Speaker.

A report in the Evening Standard last Thursday revealed that a spot inspection of Charing Cross hospital in my constituency showed that it was

“so overcrowded that operating theatres were turned into makeshift wards”.

The hospital

“used the theatres when it ran out of critical care beds—with doctors caring for seriously ill patients because there were no nurses available.”

Charing Cross is one of the four hospitals that are to lose their A and E department—indeed, in the case of Charing Cross hospital, it is to be demolished, with

5 Jun 2013 : Column 1625

97% slated to go. I plead with the Secretary of State to accept the point made by my right hon. Friend the Member for Leigh (Andy Burnham) and to review all these closures. The services are in crisis. Please, do not go ahead with any closures of vital A and E services, particularly in north-west London, until a proper review has been carried out and the crisis has been seen for what it is.

6.40 pm

Andrew Gwynne (Denton and Reddish) (Lab): We have had a full and thorough debate, with some 18—or perhaps 17 and a half—Back-Bench speeches. I pay tribute to my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson), my hon. Friend the Member for Lewisham East (Heidi Alexander), my right hon. Friend the Member for Exeter (Mr Bradshaw) and my right hon. Friend the Member for Cynon Valley (Ann Clwyd), who made a very personal contribution to the debate, as well as my hon. Friends the Members for Ealing North (Stephen Pound), for Harrow West (Mr Thomas) and for Mitcham and Morden (Siobhain McDonagh), my right hon. Friend the Member for Rother Valley (Mr Barron), and my hon. Friends the Members for Worsley and Eccles South (Barbara Keeley) and for Hammersmith (Mr Slaughter). I also pay tribute to the right hon. Member for Charnwood (Mr Dorrell) and the hon. Members for Totnes (Dr Wollaston) and for Southport (John Pugh), and other Members, too many to mention individually, who contributed to the debate.

I start by paying tribute to the thousands of doctors, nurses and health care assistants who provide extraordinary and professional care in our A and E departments. They are there for us when we need them most and we owe them a huge debt of gratitude. It was apparent from the Secretary of State’s speech that he has absolutely no plans to deal with the disastrous situation in A and E that is entirely of this Government’s own creation. We know that, since this Government came to power, there are 4,000 fewer nurses, the disastrous NHS 111 service is in meltdown, walk-in centres are being closed and social care is in crisis. All those factors contribute to the current crisis in our A and E. We have all seen the news reports of ambulances queuing outside hospitals, with unacceptably long waits and some people even having to be treated in tents in car parks. It is time for Ministers to stop blaming others and to get a grip on the crisis in A and E.

Bluntly, what we are seeing today in A and E is the culmination of three full years of mismanagement of the NHS, with a needless top-down reorganisation and the waste of billions of pounds that could and should have been spent on front-line care. The truth is that there is no grip on the NHS in England. No wonder things are going so wrong so quickly.

When Labour left office, A and E was performing well, with 98% of patients seen within the four-hour target time. Since the election, the number of patients waiting more than four hours has nearly trebled and ambulance queues have doubled. Only yesterday, in a report by the King’s Fund, we saw that A and E waits are at their worst for nine years, with more than 313,000 patients waiting more than four hours between January and

5 Jun 2013 : Column 1626

April this year. Simply put, under this Government more people are waiting longer. The proportion of patients attending A and E who have to wait longer than four hours is at its highest for 10 years. What more proof do Ministers need to understand that A and E departments are under real pressure and that action is needed, and needed now?

Many patients cannot even get through the doors of our hospitals. We have a shameful situation in which growing numbers of patients are waiting in ambulances to get into A and E because those departments are full. Equally shameful is the number of patients experiencing the indignity of waiting for hours on trolleys in A and E before they can be found a bed on the main hospital wards. It is almost as though we are back to the future—back to the bad old Tory days of the 1980s and ’90s.

There are many other factors that have pushed A and E into the danger zone. Indeed, A and E is a bellwether for the overall state of the NHS and social care. The Government’s cuts to local authority budgets have seen £2.6 billion taken out of adult social care since the election alone. As a result, many older and vulnerable people are having services withdrawn that could have helped them to stay healthy and independent in their own homes, and many others face rising charges for the care that they need. That is a major cause of the A and E crisis, as fewer older people get the care that they need at home, and ever more have to be admitted to hospital. It also means that there are delays in ensuring that appropriate support is available at home, or in the community, which delays a patient’s discharge. That has a knock-on effect right through the hospital: with no free beds on the wards, A and E staff cannot admit patients to the hospital wards, and with A and E full, ambulance staff cannot hand over patients.

As we have heard, under-staffing is also causing huge problems in the health service. Since the election, more than 4,000 nursing posts have been lost from the NHS, and the Care Quality Commission has warned that one in 10 hospitals is failing to meet the standard for adequate staffing levels. Hospitals are continuing to make severe cuts to front-line staffing, with many operating below recommended levels. Under this Government, right across England, we are seeing the closure of well-used NHS walk-in centres, meaning that more people are having to go to major A and E departments when they could be helped elsewhere.

Lastly, there is the meltdown of the 111 helpline; NHS England identified the poor roll-out of 111 services as one of the main reasons for the deterioration in A and E department performance. As the 111 service uses staff who do not always have clinical training, they are more likely to play it safe, meaning that more people are being directed towards A and E departments. Over Easter, callers in 30 areas waited for more than an hour for a call back, and in some regions more than 40% of calls were abandoned by patients. One patient waited 11 hours and 29 minutes.

It is no good Ministers arguing that there has been a large increase in the number of people attending A and E, driven by changes to out-of-hours care that were caused by Labour’s renegotiation of the GP contract in 2004; that was nine years ago. The Secretary of State’s spin was blown out of the water by the Chair of the Select Committee on Health, the right hon. Member for

5 Jun 2013 : Column 1627

Charnwood—and by the chief clinical officer at Stockport clinical commissioning group, who said:

“The focus on the 2004 GP Contract as a main cause is not only a incorrect assumption but also serves to distract the public from the urgent debate that’s needed about the choices the NHS, the public, media and politicians now need to make”—

his words, not mine.

The Government parties should and must do more to protect the NHS from the immediate crisis, so will they now implement our A and E rescue plan? The Secretary of State derided our initiative to use underspends in the NHS budget to put an extra £1.2 billion into social care over the next two years, but that investment would not only relieve pressure on A and E, but help tackle the scandal of care services being withdrawn from older people who need them.

Will the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), review all 111 contracts? Early indications are that the number of cases referred to nurses has fallen from 60% through NHS Direct to just 17% with 111. What will she do about that? Will she also ensure that all hospitals have safe staffing levels, and intervene to prevent further job losses? Will she halt the closure of NHS walk-in centres and await the review that is being conducted by Monitor to see what the impact is on the local community and the NHS? Will she immediately and personally review all planned A and E closures and downgrades, and use the very latest evidence of local pressures to ensure that plans are based on robust clinical evidence?

Instead of accepting responsibility for the mess that they have created, the Government have spent recent weeks casting around for scapegoats. We have seen them blame the winter weather; influenza; bank holidays; immigrants; GPs; and today’s latest from the public health Minister, female doctors, because they get married, have children and work part time. [Interruption.] She protests, and I notice she had to put out a statement this afternoon to

“clarify discussion on female GPs” .

She said:

“I fully support women GPs, my comments were not intended to be derogatory.”

The truth is that this Government do not even know who to blame any more. It is just not good enough. While the components of the A and E crisis might be complex, the real cause is simple: you just cannot trust the Tories with the NHS.

6.50 pm

The Parliamentary Under-Secretary of State for Health (Anna Soubry): Oh dear, what a pity. Until the hon. Member for Denton and Reddish (Andrew Gwynne) rose to speak, it was going rather well. There was almost an outbreak of consensus after a number of thoughtful contributions from Members on both sides of the House. Unfortunately, as ever, the hon. Gentleman had to fall back into the old ways of cheap party political points and cheap partisan comments. I agree with him on one point. [Interruption.] Hon. Members may want to calm down and chill out a little. The hon. Gentleman rightly paid tribute to all the doctors, consultants, nurses, receptionists and everyone who works in our accident and emergency departments.

5 Jun 2013 : Column 1628

Helen Jones: Even the women?

Anna Soubry: That sort of cheap comment does the hon. Lady no justice whatsoever or credit. Let me explain to her—I was here for the debate, and she was not—that I did not in any way blame women doctors. As someone who has worked as a woman professional all my life, I really do not want to hear any lessons from Opposition Members. What I did was echo the comments of the president of the Royal College of General Practitioners, and I paid tribute to all our GPs for their hard work and dedication to our NHS, and to their patients.

There are immense pressures on the NHS as a whole, and on A and E in particular. Our A and E departments are dealing with 1 million more people than they did when the previous Government were in power. The causes of that increase in demand are complex: a long, cold winter; an ageing population; and more people with long-term conditions. The system itself, let us be honest, has not helped, from poor integration between health and social care to the lack of public confidence in out-of-hours primary care services. We can have an argument about the 2004 GP contract, but as the hon. Member for Southport (John Pugh) rightly said, it has not helped. Today, we have a situation in which, if people do not know where to go, or they are not sure that they will get a good service, they go to A and E. In a recent hearing by the Select Committee on Health, Dr Patrick Cadigan, a registrar from the Royal College of Physicians, set out the position perfectly:

“Patients will go where the lights are on. In many of these alternatives, the lights are not on after five o’clock in the evening or at weekends.”

That presents a set of challenges that the Government are determined to address. First, it is important that we deal with the current situation, and we are.

Barbara Keeley: Will the Minister give way?

Anna Soubry: No.

Already, emergency departments have recovered from the dip in performance over the winter. [Interruption.] The hon. Member for Denton and Reddish did not give way, and I am adopting his admirable approach in this debate.

For each of the past five weeks, the four-hour waiting time target has been either reached or exceeded. The average wait in A and E is currently 50 minutes. More importantly, we are making the NHS fit for the future: a future where care is designed and delivered around the specific needs of an individual patient; where care is integrated across primary and secondary care and across health and social care; and where local clinicians, not national politicians, decide what is best for their communities. The Government have taken tough decisions that will create a strong and sustainable NHS, now and for generations to come. The Health and Social Care Act 2012 has finally brought local health and social care communities together to design integrated services around the needs of their patients, building in strength for the future. So if more services are needed outside hospitals, local clinicians working with community partners can make those decisions, without having to wait for a Minister to tell them what to do.

5 Jun 2013 : Column 1629

We have not stopped there. We have provided £7.2 billion to local authorities for social care. We have given hospitals the ability to carry over underspends—free to pool their budgets locally to improve care for patients. We have new urgent care boards which will use the savings from the marginal rate emergency tariff to reduce pressure on A and E. The NHS Medical Director, Sir Bruce Keogh, is currently reviewing the provision of urgent and emergency care. This autumn the vulnerable older people’s plan will set out how we will improve primary and out-of-hours services for the frail and the elderly and how we can remove barriers to integrated care. At every step of the way we are putting local doctors and nurses in charge and designing care around the patient.

I shall deal briefly with some of the very good speeches that were made on both sides of the House. We heard first from two former Secretaries of State for Health, the right hon. Member for Holborn and St Pancras (Frank Dobson) and my right hon. Friend the Member for Charnwood (Mr Dorrell). Both were eloquent and informed. I have to say that the speech and the comments of my right hon. Friend found more favour with me. The hon. Member for Lewisham East (Heidi Alexander) asked for a grown-up debate, and we had a good contribution from my hon. Friend the Member for Totnes (Dr Wollaston). I have addressed the unfortunate remarks that she made, perhaps not having read Hansard, if I may say so.

I turn to other valuable contributions. The right hon. Member for Cynon Valley (Ann Clwyd) made a contribution, as we would expect. Then we heard from my hon. Friend the Member for Brigg and Goole (Andrew Percy), who spoke briefly about his local experience in his constituency and brought those experiences, rightly, into the debate. He touched on walk-in centres, an issue that was raised by—I nearly said my hon. Friend; I beg his pardon if that is in any way disparaging to him—the right hon. Member for Rother Valley (Mr Barron), who beautifully forgot that any decision about the future of any walk-in centre is a local decision. It is for local people—[Interruption.] I am not knocking anybody; I am explaining the facts. I appreciate that the right hon. Member for Leigh (Andy Burnham) has a problem with the facts, but the facts are that these are local decisions made by local communities and local clinicians.

My hon. Friend the Member for Bracknell (Dr Lee) gave a thoughtful and challenging speech, and I hope that many will take that away and listen to what he said. I shall deal briefly with the comments of my hon. Friends the Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for Stevenage (Stephen McPartland) and the hon. Member for Cheltenham (Martin Horwood), who spoke about some of the difficulties that we have with the recruitment of doctors. Departmental officials have met. We know that it is a problem. We have worked with the College of Emergency Medicine and we know that we need to tackle the problem. We did that in 2011 and those issues will in due course be considered. I hope we will see some changes.

The hon. Member for Mitcham and Morden (Siobhain McDonagh), as ever, championed her local hospital, as I expect her always to do, but she spoke about a lack of public consultation and many of us will take away her wise observations on that. It is important to remind the

5 Jun 2013 : Column 1630

House of the comments of my hon. Friend the Member for Lancaster and Fleetwood. He, like others in the debate, reported that his constituents get a good service from good staff. All of us should remember that.

To conclude, in challenging circumstances, and with this Government’s support, the people of our NHS are performing admirably. There are over 400,000 more operations now than under Labour. The proportion of cancellations remains unchanged. Fewer than 300 people—276—are waiting more than a year for an operation, compared with 18,000 under the Labour Government. Some 8,500 more clinical staff are working in our NHS, including 5,700 more doctors. MSRA rates have halved. Mixed-sex wards have been practically abolished. We are finally moving towards a paperless NHS by 2018. In addition, in stark contrast to the Labour party’s plans, we now have a protected NHS budget, with real terms—

Ms Rosie Winterton (Doncaster Central) (Lab) claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

The House divided:

Ayes 227, Noes 299.

Division No. 23]


6.59 pm


Abbott, Ms Diane

Abrahams, Debbie

Ainsworth, rh Mr Bob

Alexander, rh Mr Douglas

Alexander, Heidi

Allen, Mr Graham

Anderson, Mr David

Ashworth, Jonathan

Austin, Ian

Bailey, Mr Adrian

Bain, Mr William

Balls, rh Ed

Barron, rh Mr Kevin

Bayley, Hugh

Beckett, rh Margaret

Begg, Dame Anne

Benn, rh Hilary

Benton, Mr Joe

Berger, Luciana

Betts, Mr Clive

Blackman-Woods, Roberta

Blomfield, Paul

Bradshaw, rh Mr Ben

Brennan, Kevin

Brown, Lyn

Brown, rh Mr Nicholas

Brown, Mr Russell

Bryant, Chris

Buck, Ms Karen

Burden, Richard

Burnham, rh Andy

Campbell, Mr Alan

Campbell, Mr Ronnie

Caton, Martin

Champion, Sarah

Clark, Katy

Clarke, rh Mr Tom

Clwyd, rh Ann

Coaker, Vernon

Coffey, Ann

Connarty, Michael

Cooper, Rosie

Cooper, rh Yvette

Corbyn, Jeremy

Crausby, Mr David

Creagh, Mary

Creasy, Stella

Cruddas, Jon

Cryer, John

Cunningham, Alex

Cunningham, Mr Jim

Cunningham, Sir Tony

Curran, Margaret

Dakin, Nic

Danczuk, Simon

Darling, rh Mr Alistair

David, Wayne

Davidson, Mr Ian

Davies, Geraint

De Piero, Gloria

Dobbin, Jim

Dobson, rh Frank

Docherty, Thomas

Donaldson, rh Mr Jeffrey M.

Donohoe, Mr Brian H.

Doran, Mr Frank

Doughty, Stephen

Dowd, Jim

Dromey, Jack

Dugher, Michael

Eagle, Ms Angela

Eagle, Maria

Edwards, Jonathan

Efford, Clive

Elliott, Julie

Ellman, Mrs Louise

Engel, Natascha

Esterson, Bill

Evans, Chris

Field, rh Mr Frank

Fitzpatrick, Jim

Flello, Robert

Flint, rh Caroline

Flynn, Paul

Francis, Dr Hywel

Gardiner, Barry

Gilmore, Sheila

Glass, Pat

Glindon, Mrs Mary

Godsiff, Mr Roger

Goggins, rh Paul

Goodman, Helen

Greatrex, Tom

Green, Kate

Griffith, Nia

Gwynne, Andrew

Hain, rh Mr Peter

Hamilton, Mr David

Hamilton, Fabian

Hanson, rh Mr David

Harman, rh Ms Harriet

Harris, Mr Tom

Havard, Mr Dai

Healey, rh John

Hepburn, Mr Stephen

Hillier, Meg

Hilling, Julie

Hodge, rh Margaret

Hodgson, Mrs Sharon

Hood, Mr Jim

Hopkins, Kelvin

Howarth, rh Mr George

Hunt, Tristram

Irranca-Davies, Huw

Jackson, Glenda

Jamieson, Cathy

Jarvis, Dan

Johnson, rh Alan

Johnson, Diana

Jones, Graham

Jones, Helen

Jones, Mr Kevan

Kaufman, rh Sir Gerald

Keeley, Barbara

Kendall, Liz

Khan, rh Sadiq

Lammy, rh Mr David

Lavery, Ian

Lazarowicz, Mark

Leslie, Chris

Lewell-Buck, Emma

Lewis, Mr Ivan

Llwyd, rh Mr Elfyn

Love, Mr Andrew

Lucas, Caroline

Lucas, Ian

Mactaggart, Fiona

Mahmood, Mr Khalid

Malhotra, Seema

Marsden, Mr Gordon

McCabe, Steve

McCann, Mr Michael

McCarthy, Kerry

McClymont, Gregg

McDonagh, Siobhain

McDonald, Andy

McFadden, rh Mr Pat

McGovern, Alison

McGovern, Jim

McGuire, rh Mrs Anne

McKechin, Ann

McKenzie, Mr Iain

McKinnell, Catherine

Meale, Sir Alan

Mearns, Ian

Miliband, rh Edward

Miller, Andrew

Morden, Jessica

Morrice, Graeme


Morris, Grahame M.


Mudie, Mr George

Munn, Meg

Murphy, rh Mr Jim

Murphy, rh Paul

Murray, Ian

Nandy, Lisa

Nash, Pamela

O'Donnell, Fiona

Onwurah, Chi

Osborne, Sandra

Owen, Albert

Pearce, Teresa

Perkins, Toby

Phillipson, Bridget

Pound, Stephen

Qureshi, Yasmin

Raynsford, rh Mr Nick

Reed, Mr Jamie

Reed, Mr Steve

Reynolds, Emma

Reynolds, Jonathan

Robertson, John

Robinson, Mr Geoffrey

Rotheram, Steve

Roy, Mr Frank

Roy, Lindsay

Ruddock, rh Dame Joan

Sarwar, Anas

Sawford, Andy

Seabeck, Alison

Shannon, Jim

Sharma, Mr Virendra

Sheerman, Mr Barry

Sheridan, Jim

Shuker, Gavin

Skinner, Mr Dennis

Slaughter, Mr Andy

Smith, rh Mr Andrew

Smith, Nick

Smith, Owen

Spellar, rh Mr John

Straw, rh Mr Jack

Stringer, Graham

Stuart, Ms Gisela

Sutcliffe, Mr Gerry

Tami, Mark

Thomas, Mr Gareth

Thornberry, Emily

Timms, rh Stephen

Trickett, Jon

Turner, Karl

Twigg, Derek

Twigg, Stephen

Umunna, Mr Chuka

Vaz, rh Keith

Vaz, Valerie

Watson, Mr Tom

Whitehead, Dr Alan

Williams, Hywel

Williamson, Chris

Winnick, Mr David

Winterton, rh Ms Rosie

Wood, Mike

Woodcock, John

Woodward, rh Mr Shaun

Wright, David

Wright, Mr Iain

Tellers for the Ayes:

Phil Wilson


Tom Blenkinsop


Adams, Nigel

Afriyie, Adam

Aldous, Peter

Alexander, rh Danny

Amess, Mr David

Andrew, Stuart

Bacon, Mr Richard

Baker, Norman

Baker, Steve

Baldry, Sir Tony

Baldwin, Harriett

Barclay, Stephen

Barker, rh Gregory

Baron, Mr John

Bebb, Guto

Beith, rh Sir Alan

Bellingham, Mr Henry

Berry, Jake

Bingham, Andrew

Binley, Mr Brian

Birtwistle, Gordon

Blackwood, Nicola

Boles, Nick

Bone, Mr Peter

Bottomley, Sir Peter

Bradley, Karen

Brady, Mr Graham

Brake, rh Tom

Brazier, Mr Julian

Bridgen, Andrew

Brine, Steve

Brokenshire, James

Brooke, Annette

Bruce, Fiona

Buckland, Mr Robert

Burley, Mr Aidan

Burns, Conor

Burns, rh Mr Simon

Burrowes, Mr David

Byles, Dan

Cable, rh Vince

Cairns, Alun

Campbell, rh Sir Menzies

Carmichael, rh Mr Alistair

Carmichael, Neil

Carswell, Mr Douglas

Chishti, Rehman

Chope, Mr Christopher

Clark, rh Greg

Clarke, rh Mr Kenneth

Clifton-Brown, Geoffrey

Coffey, Dr Thérèse

Collins, Damian

Colvile, Oliver

Cox, Mr Geoffrey

Crabb, Stephen

Crouch, Tracey

Davey, rh Mr Edward

Davies, David T. C.


Davies, Glyn

Davies, Philip

Davis, rh Mr David

de Bois, Nick

Dinenage, Caroline

Djanogly, Mr Jonathan

Dorrell, rh Mr Stephen

Dorries, Nadine

Doyle-Price, Jackie

Duddridge, James

Duncan Smith, rh Mr Iain

Ellis, Michael

Ellison, Jane

Ellwood, Mr Tobias

Elphicke, Charlie

Evans, Graham

Evans, Jonathan

Evennett, Mr David

Fabricant, Michael

Fallon, rh Michael

Farron, Tim

Featherstone, Lynne

Foster, rh Mr Don

Fox, rh Dr Liam

Freeman, George

Freer, Mike

Fullbrook, Lorraine

Fuller, Richard

Gale, Sir Roger

Garnier, Sir Edward

Garnier, Mark

Gauke, Mr David

George, Andrew

Gibb, Mr Nick

Glen, John

Goodwill, Mr Robert

Gove, rh Michael

Grant, Mrs Helen

Gray, Mr James

Green, rh Damian

Greening, rh Justine

Grieve, rh Mr Dominic

Griffiths, Andrew

Gummer, Ben

Gyimah, Mr Sam

Hames, Duncan

Hancock, Matthew

Hands, Greg

Harper, Mr Mark

Harrington, Richard

Harris, Rebecca

Hart, Simon

Harvey, Sir Nick

Haselhurst, rh Sir Alan

Hayes, rh Mr John

Heald, Oliver

Heath, Mr David

Heaton-Harris, Chris

Hemming, John

Henderson, Gordon

Herbert, rh Nick

Hinds, Damian

Hollobone, Mr Philip

Hopkins, Kris

Horwood, Martin

Howell, John

Hughes, rh Simon

Hunt, rh Mr Jeremy

Huppert, Dr Julian

Jackson, Mr Stewart

James, Margot

Javid, Sajid

Jenkin, Mr Bernard

Johnson, Gareth

Johnson, Joseph

Jones, Andrew

Jones, rh Mr David

Jones, Mr Marcus

Kawczynski, Daniel

Kelly, Chris

Kirby, Simon

Knight, rh Mr Greg

Kwarteng, Kwasi

Laing, Mrs Eleanor

Lamb, Norman

Lancaster, Mark

Lansley, rh Mr Andrew

Latham, Pauline

Laws, rh Mr David

Leadsom, Andrea

Lee, Jessica

Lee, Dr Phillip

Leech, Mr John

Lefroy, Jeremy

Leslie, Charlotte

Lewis, Brandon

Lewis, Dr Julian

Liddell-Grainger, Mr Ian

Lidington, rh Mr David

Lilley, rh Mr Peter

Lloyd, Stephen

Lopresti, Jack

Lord, Jonathan

Luff, Peter

Lumley, Karen

Macleod, Mary

Main, Mrs Anne

May, rh Mrs Theresa

Maynard, Paul

McCartney, Jason

McCartney, Karl

McIntosh, Miss Anne

McLoughlin, rh Mr Patrick

McPartland, Stephen

McVey, Esther

Menzies, Mark

Metcalfe, Stephen

Miller, rh Maria

Mills, Nigel

Milton, Anne

Mitchell, rh Mr Andrew

Moore, rh Michael

Mordaunt, Penny

Morgan, Nicky

Morris, Anne Marie

Morris, David

Morris, James

Mosley, Stephen

Mowat, David

Mulholland, Greg

Mundell, rh David

Munt, Tessa

Murray, Sheryll

Murrison, Dr Andrew

Neill, Robert

Newmark, Mr Brooks

Newton, Sarah

Nokes, Caroline

Norman, Jesse

Nuttall, Mr David

O'Brien, Mr Stephen

Offord, Dr Matthew

Ollerenshaw, Eric

Opperman, Guy

Paice, rh Sir James

Parish, Neil

Patel, Priti

Paterson, rh Mr Owen

Pawsey, Mark

Penning, Mike

Percy, Andrew

Perry, Claire

Phillips, Stephen

Poulter, Dr Daniel

Prisk, Mr Mark

Pritchard, Mark

Pugh, John

Raab, Mr Dominic

Randall, rh Mr John

Reckless, Mark

Redwood, rh Mr John

Rees-Mogg, Jacob

Reevell, Simon

Reid, Mr Alan

Rifkind, rh Sir Malcolm

Robathan, rh Mr Andrew

Robertson, Mr Laurence

Rogerson, Dan

Rosindell, Andrew

Rudd, Amber

Ruffley, Mr David

Russell, Sir Bob

Rutley, David

Sanders, Mr Adrian

Sandys, Laura

Scott, Mr Lee

Selous, Andrew

Shapps, rh Grant

Sharma, Alok

Shelbrooke, Alec

Shepherd, Sir Richard

Simpson, Mr Keith

Skidmore, Chris

Smith, Henry

Smith, Julian

Smith, Sir Robert

Soames, rh Nicholas

Soubry, Anna

Spelman, rh Mrs Caroline

Spencer, Mr Mark

Stanley, rh Sir John

Stephenson, Andrew

Stevenson, John

Stewart, Bob

Stewart, Iain

Stewart, Rory

Stride, Mel

Stunell, rh Andrew

Sturdy, Julian

Swales, Ian

Swayne, rh Mr Desmond

Swinson, Jo

Swire, rh Mr Hugo

Tapsell, rh Sir Peter

Teather, Sarah

Thornton, Mike

Thurso, John

Timpson, Mr Edward

Tomlinson, Justin

Tredinnick, David

Truss, Elizabeth

Turner, Mr Andrew

Tyrie, Mr Andrew

Uppal, Paul

Vara, Mr Shailesh

Vickers, Martin

Walker, Mr Robin

Wallace, Mr Ben

Ward, Mr David

Watkinson, Dame Angela

Weatherley, Mike

Webb, Steve

Wharton, James

Wheeler, Heather

White, Chris

Whittaker, Craig

Whittingdale, Mr John

Wiggin, Bill

Willetts, rh Mr David

Williams, Mr Mark

Williams, Roger

Williamson, Gavin

Willott, Jenny

Wilson, Mr Rob

Wollaston, Dr Sarah

Wright, Jeremy

Wright, Simon

Yeo, Mr Tim

Young, rh Sir George

Zahawi, Nadhim

Tellers for the Noes:

Mr Robert Syms


Mark Hunter

Question accordingly negatived.

5 Jun 2013 : Column 1631

5 Jun 2013 : Column 1632

5 Jun 2013 : Column 1633

5 Jun 2013 : Column 1634

Business without Debate

Delegated Legislation

Motion made, and Question put forthwith (Standing Order No. 118(6)),


That the draft Local Transport Act 2008 (Traffic Commissioners) (Consequential Amendments) Order 2013, which was laid before this House on 25 March, in the previous Session of Parliament, be approved.—(Anne Milton.)

Question agreed to.

Motion made, and Question put forthwith (Standing Order No. 118(6)),


That the draft Reservoirs Act 1975 (Exemptions, Appeals and Inspections) (England) Regulations 2013, which were laid before this House on 26 March, in the previous Session of Parliament, be approved.—(Anne Milton.)

Question agreed to.

5 Jun 2013 : Column 1635

2011 Public Disorder (Compensation)

Motion made, and Question proposed, That this House do now adjourn.—(Anne Milton.)

7.14 pm

Mr Steve Reed (Croydon North) (Lab): I am grateful for this opportunity to raise an issue that is of great interest to my residents in Croydon North and to many other people across London and in other parts of the country that were affected by the riots in the summer of 2011.

It is almost two years now since the riots hit Croydon. Businesses were burned to the ground, shops were looted, and homes were destroyed. The Prime Minister and the Mayor of London walked along the devastated London road in the central part of Croydon and promised people that they would not be forgotten and that, while the state had failed to protect them during the riots, it would stand by them as they tried to rebuild their lives. Since becoming the Member of Parliament for Croydon North last November, I have met business owners and residents whose lives were damaged by the riots. They feel completely abandoned by a Government who promised to help them when the TV cameras were on but walked away when the media glare died down.

It is instructive to know how much has actually been paid out compared with the amount that has been claimed. I put in a freedom of information request to the Metropolitan police and found out that that now, nearly two years after the riots took place, only one seventh of the £250 million that was claimed had been paid out—that is, £35.8 million. The Metropolitan police rejected outright half of all claims that were filed, yet the Government continue to claim, and I fear may claim again tonight, that the majority of cases have been settled. The Government might have closed the files, but the cases have not been settled to the satisfaction of the people who were affected. They feel very strongly that the Government have given up on them and walked away. It is no wonder that the chair of The High Street Fund, Sir William Castell, has described the Government’s compensation schemes as a “disgrace” because of how slow they have been at paying out to people who need and deserve that additional money.

I have here some quotes from the Prime Minister during the debate in this Chamber on 11 August 2011. He said:

“I confirm that any individual, home owner or business that has suffered damage to or loss of their buildings or property as a result of rioting can seek compensation under the Riot (Damages) Act 1886, even if uninsured.”

In response to my right hon. Friend the Leader of the Opposition, he said of the money that would be made available that

“the Riot (Damages) Act has no cap at all…people will be able to apply to the police and the Government will stand behind the police.”—[Official Report, 11 August 2011; Vol. 531, c. 1054-59.]

The Government’s promises were good. What the Prime Minister offered to do was exactly what they should have been doing; the tragedy is that the reality has not matched the rhetoric.

What I hope to demonstrate, and hope the Minister will respond to, is my fear, and the fear of many people who have suffered as a result of the Government’s failure to intervene, that the Government are hiding

5 Jun 2013 : Column 1636

behind definitions to avoid paying up. For instance, they are refusing to replace damaged, old business equipment with new business equipment, even though in many cases businesses are unable to buy like for like, and therefore cannot replace them, get their businesses going again and get their livelihoods back.

The Government, and the Metropolitan police, have also failed to define the riots properly in some parts of London. My right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) has been in correspondence with the Home Secretary about Chalk Farm, where the riots were defined as “public disorder”, which means that the Riot (Damages) Act does not apply to businesses and individuals in that part of London who were affected.

Statistics do not give the full scale of what happened. They fail to tell us the human side of the Government’s failure. Individual stories tell us much more than statistics. I would therefore like to refer to two specific cases involving constituents of mine whose lives remain blighted by riots that happened nearly two years ago.

First, a gentleman called Mr Mumtaz Hassan and his wife ran a dry cleaning business on the London road in west Croydon. Their business was burned down by a mob and as a result their livelihood has been destroyed. Two years later, they have not been paid a single penny in compensation. All they have been offered is like for like. It was an old business that they had taken over. They cannot afford, with what is on offer to them, to pay for new dry cleaning equipment. As a result, that family risk losing their home, because they have no livelihood or income to maintain their mortgage payments. Two years later, the riots are still creating new victims and it is time that the Government stepped up and helped people as they promised in the immediate aftermath of those events.

Secondly, Miss Charlene Munro is a single mother who at the time lived in a flat above a business on the London road with her three-year-old son. When they saw rioters rushing down the London road, smashing and looting their way through the shops, they fled their home. They returned the next day to find the shop and the flat where they lived burned down and all their possessions destroyed. Absolutely everything they owned was gone. She put in a not unreasonable claim of just £6,000 for all her possessions. She received a paltry £2,500 in payment, which is absolutely inadequate to replace all the possessions, clothes and electronic goods that the family owned. She is unable to replace them. In her attempt to build a new home for her three-year-old son, she had to go into debt and is now so burdened with debt she has been forced to file for bankruptcy. The Government say that her case has been settled. It is not settled in any meaningful way other than that the Government have simply closed the file and are refusing to provide her with the support she deserves and was promised.

Some businesses are still being held liable for rent or mortgage payments on properties that have been burned down. Many insurers are going far too slowly in dealing with claims for damaged property and goods.

Mr David Lammy (Tottenham) (Lab): I am grateful to my hon. Friend for the manner in which he has brought this issue back to the House. Is he also concerned about premiums rising in riot areas such as his and mine, and does he agree that the absence of engagement

5 Jun 2013 : Column 1637

with the Riot (Damages) Act 1886 means that areas are being abandoned and that that could lead to a Detroit-type scenario in this country, with completely barren areas without any insurance presence?

Mr Reed: I thank my right hon. Friend for his intervention. I compliment him on his work as the Member for Tottenham in standing up for riot victims not just in his constituency, but elsewhere in London. That has been of great reassurance to my constituents as well as his. I absolutely agree with him. The issue is not just that premiums have gone up in areas hit by the riots; businesses have even told me that they cannot get insurance at all.

If we hollow out whole areas of London, we will further blight the lives of people who, through no fault of their own, were victims of hooligan mobs trashing and looting their way through London. We need the Government to step up to the mark, take on the issues that confront these areas and work with insurance companies to ensure that whole areas do not get blighted because of incidents two years ago that were nothing to do with the people who were living their lives peacefully and running businesses there.

Jim Shannon (Strangford) (DUP): I thank the hon. Gentleman for giving way. I spoke to him beforehand about wanting to make a helpful intervention. The Northern Ireland Compensation Agency has been in place for many years and has helped victims of public disorder and, indeed, terrorist attacks get redress and financial assistance quicker and more efficiently. Does the hon. Gentleman think it would be helpful for the Government to contact the agency to ask it about its processes in order to enable victims in London to get redress quicker and more efficiently and not find themselves in a morass of bureaucracy?

Mr Reed: I thank the hon. Gentleman for that helpful intervention. I hope that the Government will look at other parts of the United Kingdom that have more experience of disorder and that therefore have more agile and nimble ways of responding to it. It would be foolish not to consider such experience and I hope that the Minister will take the hon. Gentleman up on his generous offer and speak to him about experiences in Northern Ireland.

Keith Vaz (Leicester East) (Lab): May I compliment my hon. Friend on the way in which he has brought his communities together? I and the Home Affairs Committee visited Croydon just after the riots and I visited it again just before his election. Local people tell me that he has played an important leadership role in ensuring that their cause is brought to Parliament and is prosecuted properly.

Mr Reed: I am very grateful to my right hon. Friend for that intervention, which, typically, was extremely generous and kind.

In many cases, compensation under the Riot (Damages) Act cannot kick in until the insurance process has been completed. Too many insurers have taken too long to complete the process, leaving businesses unable to claim

5 Jun 2013 : Column 1638

under the Government schemes. As a result of all the factors I have mentioned, the compensation is falling desperately short of the claims.

In the light of the two examples I have given of people from Croydon who have suffered, I want to give a further quotation from the Prime Minister. He was asked by the hon. Member for South Basildon and East Thurrock (Stephen Metcalfe):

“Will the Prime Minister assure me that no business will be lost and no livelihood subsequently lost because of the actions of those thugs and hooligans, and that the £20 million support fund, if deemed not big enough, will be increased to make sure that those things do not happen?”

The Prime Minister replied:

“Of course we will keep the issue under review, and there is the Riot (Damages) Act as well as the £20 million scheme. I believe that should be enough, but my hon. Friend the Minister of State, Department for Business, Innovation and Skills will be on the case.”—[Official Report, 11 August 2011; Vol. 531, c. 1083.]

Those were the warm words, but where are the help, the compensation and the action that were promised? These people are victims, not perpetrators. The riots are still creating new victims, but the Government are not doing enough to help them. I am afraid that the Government’s promises have been shown to be hollow. By failing to act, the Government are complicit in the suffering that people continue to endure in my constituency and elsewhere.

I ask the Minister to look at three things. First, please will he look again at the claims that are disputed? He may consider them to be settled, but too many people whose lives face ruin do not. Secondly, he must consider allowing old business equipment that was destroyed during the riots to be replaced by new equipment where there is no reasonable possibility of the business owner acquiring like-for-like replacements at the value of the property that was lost. Thirdly, please will he consider funding the businesses and individuals who are still being forced to pay mortgages on property that was destroyed? If the property does not exist, it is impossible for the business person to make an income to pay the mortgage. If they are forced to dip into their own finite resources, they will end up being bankrupted and will again be victimised, having already suffered loss during the riots.

Frankly, it is scandalous that people in Croydon who lost so much are still waiting for compensation nearly two years later. People in Croydon, across London and in all affected areas of the country looked to the Prime Minister and believed that the failure of the police to protect them, their homes and their livelihoods during the riots would be made good. That has not happened and it must be put right.

7.28 pm

The Minister for Policing and Criminal Justice (Damian Green): I thank the hon. Member for Croydon North (Mr Reed) for raising this important subject. I take this opportunity to pay tribute to his predecessor, Malcolm Wicks, who was extremely assiduous, as all those who knew him would expect, in representing the victims of the riots in his constituency before his very sad death.

I am, of course, aware that the Croydon North constituency was one of the areas most severely affected by the riots of August 2011. I, like everyone in the

5 Jun 2013 : Column 1639

House, sympathise with the individuals and businesses in that area, across London and across the country that experienced losses because of the riots.

Given the tone adopted by the hon. Gentleman, it is important to make sure that we have the facts and figures on the record. I note, for example, from local media coverage in March 2013, that it was claimed that as many as 40 claims for compensation under the Riot (Damages) Act 1886 appeared to be outstanding in Croydon alone. It is simply not the case that there are 40 outstanding uninsured cases in Croydon, as only 11 uninsured cases remain unresolved nationally, nine of which are in the Metropolitan police area.

The hon. Gentleman quite reasonably brought up some figures, so I am sure it will help him and the House if I quickly run through the latest statistics on compensation payments. They show that 577 uninsured claims were originally made, of which five remain outstanding—about 1% of the original total. A further 716 uninsured claims were later received by the Metropolitan police. These were largely made after insurance companies had repudiated claims. Only six of that latter group of claims are unresolved, which is again around 1% of the original total.

The largest category of outstanding claims represent insurance companies seeking compensation from police and crime commissioners for reimbursement of settlements paid to policyholders. This does not affect individuals or businesses who have received some form of payment from their insurance company: 3,935 of these types of claim were made and 270—about 7%—are outstanding. So far, PCCs, and in London the Mayor’s Office for Policing and Crime, have paid out just over £30 million in claims.

The hon. Gentleman brought up the Government’s initial response to the riots. Indeed, through the Department for Communities and Local Government, the Government quickly set up funds to help individuals and businesses to get back on their feet, and these schemes paid out £10.8 million.

With specific reference to compensation payments under the Riot (Damages) Act, the Government took swift action by extending the application period from 14 to 42 days, by replacing the antiquated prescribed form with a simple claims form and by setting up a Home Office bureau to act as a single point of contact to advise claimants and take in applications.

From recent correspondence with Members, I am aware of a few individuals—the hon. Gentleman mentioned them—who have had to continue making mortgage payments on properties left uninhabitable by the riots. I should say that this type of loss is not covered by the Riot (Damages) Act, and I shall come on later in my speech to the inadequacies we have identified in a what is a rather old Act. I have recently written to the Council of Mortgage Lenders, which has agreed to liaise with lenders to see whether a more sympathetic approach can be taken. I am happy to assure the hon. Gentleman and other Members that my officials are working closely with them. In the end, this is a commercial decision for mortgage lenders, but as I say, we are taking action on this.

Mr Lammy: My hon. Friend the Member for Croydon North (Mr Reed), other Members and me have pressed

5 Jun 2013 : Column 1640

this case for years with the Association of British Insurers. It must be unacceptable that people still find themselves in receipt of insufficient funds to get back on their feet.

Damian Green: As I say, particularly in the case of the mortgages, it is for the mortgage lenders to decide in the end, but I have explained that I am doing what I can to persuade them to take a sympathetic attitude to individuals who deserve help.

As the House will know, all those who made claims under the Riot (Damages) Act were offered sums in settlement. In case they were unhappy with their offers, the PCCs—and MOPAC in London—established a right of appeal, which a number of people have exercised. At the outset of the riots, the Government made a commitment to back the costs incurred by police forces in meeting Riot (Damages) Act costs, because that was another potential problem. We have provided that backing, and will continue to do so until the few remaining claims have been settled. So far the Government have paid some £30 million to forces to meet Riot (Damages) Act costs, as well as meeting the operational costs of policing the riots, which totalled £97 million.

Frank Dobson (Holborn and St Pancras) (Lab): As the Minister knows, I think well of him. Last time I inquired, however, officialdom did not know how many claims had been met in full and how many had been met partially. Do we know yet?

Damian Green: I do not have the figures to hand, but if the Department has them, I will write to the right hon. Gentleman and place a copy in the Library. I assume that he is referring to insurance claims rather than to Riot (Damages) Act claims. When it comes to insurance, there are three distinct classes. First, there are the people who are fully insured and who may over-claim, As we know, there are people who always over-claim. Secondly, there are the people who have insurance but subsequently find that they are underinsured. I consider many of those cases to be among the most complex and difficult. Thirdly, there are those with no insurance. It is the second and third groups who are eligible for compensation under the Riot (Damages) Act.

It may well be that the claims of some of those people will not be met in full. No doubt the hon. Member for Croydon North will be aware that some people in Croydon have withdrawn parts of their claims. It would obviously be inappropriate for me to comment on individual cases, so I shall not do so, but I am happy to discuss the matter with the hon. Gentleman privately.

Mr Reed: I agree with the Minister that it is wrong to refer to individual cases, but let me draw his attention to the overall statistics. The total amount claimed was £250.1 million, and nearly two years later only £35.8 million has been paid. Is the Minister not concerned about the fact that that is a far lower proportion than would normally apply to claims for damages, even if allowance is made for normal loss adjustment?

Damian Green: It would concern me more if part, or all, of the claims of a large number of people had still not been met. The figures that I have given, however, show that the number of such claims is very small.

5 Jun 2013 : Column 1641

Ideally, of course, we would have resolved all the claims by now, but I think that that is the key statistic. One of our main aims is to secure a complete resolution of the remaining few cases, but when there is a large batch of claims, some of those claims will always be more complex than others, and will take longer to resolve.

As I have said, many of the outstanding cases relate to claimants who were underinsured. It took time for the insurance element of those claims to be settled before the underinsurance element was submitted to PCCs or to MOPAC for consideration under the Riot (Damages) Act¸ which is why 5% of the insurance claims from small and medium-sized businesses remain outstanding after the 2011 riots.

Let me now focus specifically on what I take to be the hon. Gentleman’s central point, which is that some people have received smaller amounts of compensation. It is important to bear in mind the fact that such compensation is ultimately paid for by the taxpayer, and that claims therefore need to be properly substantiated. All uninsured claims were reviewed by loss adjusters using standards applied in the insurance industry. All victims were dealt with sympathetically. Where documents such as receipts for goods purchased were destroyed, secondary evidence was requested, such as bank statements, to substantiate lifestyle.

In addition to losses that cannot be substantiated, there are other reasons for individuals and businesses receiving less compensation than they sought. A number of claimants sought compensation for things not covered by the Act, such as personal injury, vehicle damage and business interruption. Excluding the costs associated with the reinstatement of buildings, adjustments were made downwards because claims made under the Act were assessed on an indemnity, rather than a new-for-old, basis. I take on board the point that that causes much of the disappointment, but that is the way the law is framed. In some ways this issue directly links to the purpose of the Act.

Mr Reed: It is more than a matter of disappointment for people who are unable to re-establish their livelihood and are therefore facing the loss of the family home because they can no longer meet the mortgage payments. The Government stood up after the riots and said nobody would lose their business or their home, so they did not intend for this to happen. Surely the Minister should act.

Damian Green: I was about to come on to that point. The Act is a safety net, which exists to provide some level of compensation. It should not be seen as a direct replacement for an insurance policy. The aim now is to

5 Jun 2013 : Column 1642

encourage as many people as possible to obtain insurance, and we will need to look at any difficulties in that regard.

Turning specifically to Croydon, I am aware of the claims relating to the terrace on London road. The situation there is complex because of the number of people who were underinsured and because of the sums of the losses involved. Before rebuilding work can commence, it is important that most, or all, of these claims are resolved.

In recent months, the Home Office, Croydon council, the Metropolitan police, MOPAC, the insurers and the loss adjusters have been working together to finalise settlements on these claims. At the local level, Croydon council has been working with the landowners on London road to try to bring forward a suitable and appropriate development. They have already engaged with an architect to assist in this process. Meetings have also taken place between officials and MOPAC and the insurers, and the offer of a further meeting chaired by the deputy mayor for policing and crime has been proposed if it is thought that that will help speed things up. MOPAC and Croydon council, as well as the Home Office, are therefore doing their best to speed things up.

Frank Dobson: Surely the principle should be that if anyone lost their property or business as a result of this criminal activity, which we all deplore, the Government should say that the minutiae of the law should not be used as a way of weaselling out of compensating people, so no one loses out.

Damian Green: That is part of the principle of the Act, but it is not the whole point of it. The right hon. Gentleman has been a Minister and he knows that Ministers have to obey the law like everybody else.

I take the point about money, and MOPAC has been making some interim payments. I understand that about £10 million has been paid out, including some to residents of London road.

Underlying all this is the unsatisfactory nature of what is 19th century legislation. As I set out in a written ministerial statement last month, we have appointed Neil Kinghan to conduct an independent review of the Act. That has already begun and is expected to be completed by the end of September.

Mr Lammy: Will the Minister ask Neil Kinghan to meet Members and constituents who have been affected, because he has not got in touch so far?

Damian Green: Well, he only started two days ago, I think. He is very keen—

7.44 pm

House adjourned without Question put (Standing Order No. 9(7)).