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Westminster Hall

Wednesday 8 January 2014

[Mr James Gray in the Chair]

Planning Reform

Motion made, and Question proposed, That the sitting be now adjourned.—(Mr David Evennett.)

9.30 am

Mr David Heath (Somerton and Frome) (LD): It is a pleasure to serve under your chairmanship, Mr Gray.

I am delighted to have secured the debate today. I ought to start with two disclaimers. First, although I served for 12 years on a county council, a strategic planning authority, I have never served on a district council and am ignorant of some of the niceties of local planning procedure. Secondly, despite some small differences in government with the Minister—I have rather an affection for productive agricultural land, which he affects not to share—I believe in principle in the reforms introduced by the Government. It is absolutely right that we turn around the principles of planning to make it more responsive to local people and base it on local priorities rather than on a Whitehall-knows-best approach.

The reason for calling today’s debate, however, is simply that the reality in many local authorities at the moment—certainly for those in my constituency in Somerset—is the precise reverse of that. In the absence of agreed local plans and agreed five-year supply, far from empowering local communities, we are disfranchising them from decisions that will have the most profound impact on their local areas. That is what I want to impress on the Minister today.

I could give a number of examples from my constituency, such as the villages of Evercreech, Rode or Beckington, all in Mendip, or Huish Episcopi, where a recent planning inspector’s decision has gone in completely the opposite direction to that wished by the district council, and by local people, as evidenced through the parish council. As an illustration, however, I will use the village of Norton St Philip, which I have raised with the Minister before in the Chamber. It is an example of what is actually happening on the ground.

Norton St Philip is a beautiful village: it is an historic settlement and a conservation area; it has, arguably, one of the oldest pubs in the country; and it was the scene of a battle during Monmouth’s rebellion. It has everything going for it, including one of the most spectacular views from the said pub’s car park across the village cricket pitch to the church—a view that one might wish to see anywhere in the country. The village also has the fortune, or misfortune, of being only a few miles away from Bath, with its inflated Georgian infrastructure. Those few miles are green belt, and Norton St Philip is therefore in reasonably high demand as a dormitory village for the cities of Bath and, to a lesser extent, Bristol.

The problem that Norton St Philip faces at the moment is that it is under siege from developers, with five applications already before planners and a further two in the pipeline. That could have a disastrous effect on the fabric and nature of the village.

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Guy Opperman (Hexham) (Con): I congratulate my hon. Friend on securing the debate. I am enjoying the reverie across the car park, the pub and the village green. Does he agree that, although we all want development on brownfield land first, the most important idea to take to the Minister is that housing projections by local authorities must be realistic and ascertainable rather than unrealistic?

Mr Heath: I will be touching on five-year supply in a moment, because it is critical to what is happening.

Let me say a little more about Norton St Philip. Under the new Mendip plan, it has been classified as a “primary village”, and along with that goes a requirement for 70 new homes. That is predicated on the newly reopened shop and post office. Without that shop and post office, Norton St Philip would revert to being a secondary village, with a requirement for 40 new houses. Setting that aside, what has happened already is 73 new houses. The applications before the planning authority provide for a further 223 houses in that small village. In other words, were those applications to be approved, the size of the village would be doubled, without any improvement to the infrastructure, and, needless to say, the character of the village would be hugely changed in the process.

I am particularly exercised by one of the applications, although I know that Members of Parliament should always be cautious about getting involved with local planning decisions. Nevertheless, to build on what is called Great Orchard, which is the site of the battle of Philip’s Norton, the skirmish during the rebellion, seems to me to be an extraordinary proposition. It is deep within the heart of the conservation area of the village and would put at risk some 200 metres of the finest dry stone wall to be seen in Britain. I apologise to hon. Members if I am exercising my Baedeker view of my constituency, but it is vital to understand that the village is an important and historic settlement. I cannot see the circumstances in which such a proposition would be approved, and of course it was not—it was not approved in the local plan and was not part of what was reserved for development.

People in the village are perfectly happy to ensure that the building that is already taking place and that which is projected in sensible places go ahead. They are not averse to development in the village. However, they do not want their village destroyed. That is a perfectly proper proposition.

David Simpson (Upper Bann) (DUP): I congratulate the hon. Gentleman on obtaining this important debate. Does he agree that one of the major problems with planning—it has been for many years—is inconsistency? One council area will approve one thing; the neighbouring council area will not approve it. There needs to be the flexibility, especially with town centre developments. If we are to regenerate our town centres, we need that flexibility, but inconsistency in planning has been a problem for many years.

Mr Heath: I agree that we need flexibility, and that is better determined by local people understanding local needs, rather than by an inspector in a planning department—in Bristol in our case—determining a case on the basis of rules derived from Whitehall. Local people should determine what is best for their area.

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Andrew Bingham (High Peak) (Con): Perhaps my hon. Friend’s constituents are like mine. It is not nimbyism and they are not against development per se. Does he agree that it is all about a sense of proportion? Things seem to be out of all proportion, which is what is causing concern.

Mr Heath: The hon. Gentleman is absolutely right. Let me come on to where I think things are going wrong. We have a free-for-all at the moment, an avalanche of applications that are opportunistic in nature, because the local plans have not been agreed.

The Minister has said on a number of occasions, “Well, it is up to local authorities to have their plans approved.” He is right—of course it is up to them, and everyone understands that, but he underestimates the difficulties and the extent of the changes in the process. The early adopters of local plans had an easy time. Some of the local plans, which the Minister can look at in his office, are paper thin and would never get through the process now, but because they were done right at the start, they went through. The smaller rural district planning authorities in particular are now struggling with an extraordinarily cumbersome and complex process.

Let me deal with some of the issues that are bedevilling that process. The key is the five-year supply, which I have mentioned. There is a lack of definitive guidance on how it is to be calculated. There was a clear promise from the Department for Communities and Local Government that definitive guidance would be produced in August last year, but it has not appeared. Two things are happening as a result. First, planning authorities are struggling to understand exactly what is required. Secondly, plans are being picked apart at planning inquiries by clever QCs, who are going back to the first principles in the planning framework and using those to override any sensible local decision making.

There are tensions within the system. Historically, census figures have been used, but it now seems as though economic aspiration is a key factor. Economic aspiration is fine, except that if it does not come to fruition, an area is left with the houses but not the jobs, which does not make sense.

There is also the fundamental problem that housing supply is effectively determined by the house builders themselves and what they say they will be bringing forward in a particular year. Let us not kid ourselves: there are a limited number of national house builders that effectively have an oligopoly of supply. They are coming forward with figures that might look all right on paper, but the house builders will build only when the margin meets their requirements, and the profit margin on those developments is relatively high. The Government might wish to see more houses built—I certainly do, as we desperately need them across the country—but developers are interested in banking development land rather than building when their marginal profit is not at its greatest.

As a result, we have perverse incentives for developers to acquire permissions but not develop the projects. We have what are called technical starts, where developers will put in a road and say, “We have started that project, but we are not actually going to build any houses yet—we will leave that for the moment. Meanwhile, let’s get on with our next application for the next bit of land that we see.” That can distort the entire local plan and what emerges from it.

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The second key factor is the weight that the emerging local plan has in planning inspectorate decisions, as it is developed, consulted upon and submitted to the Department. The Minister said to me in the House a few months ago that the plan has weight, but that is not evidenced by the decisions taken by planning inspectors, who are not working on the basis of ministerial aspiration but of regulations—quite rightly, as that is the only basis they can work on—which require them to look at different criteria. We are therefore seeing inspectorate decisions that do not match the desires of local communities for local planning.

I have to say to the Minister that, when we are talking about large conurbations, sometimes it really does not matter which bit of land is developed—there is capacity for spread, so if one development comes on it is possible to deselect another bit of land to bring everything back into kilter—but when we are talking about small market towns and rural areas, the topography does not allow for that. If the wrong bit of that sort of community is developed, it does not help to deselect what would have been the right bit for development. Deselection does not work.

There is another aspect concerning the inspectorate that I shall mention in passing: the perverse decision, which has been evidenced more than once now, that because a particular design of building is right in one place, it will necessarily be right anywhere. As a result of that, we have lost the sense of the vernacular, which is key to good planning. We should be able to ensure that the buildings in a particular area suit how buildings in that area have been built historically and fit with the urban or rural community landscape. Instead, the same model of house is relabelled in different parts of the country: in Somerset, they would probably call it a thatched cottage, despite the fact that it is an executive four-bed home, whereas in the north it would be called the Ullswater model or something like that. It is nonsense. Such decisions show whatever the visual equivalent is of having cloth ears.

I have a number of modest requests for the Minister. First, I want emerging local plans that are on the point of publication to have real weight in the planning process—to have what is called materiality. That is simply not the case at the moment. If he wants that to happen, he has to make it happen by regulation—to instruct planning inspectors that they have to give the plans real weight and back local councils in doing the right thing. That is the whole principle of localism.

Secondly, the Minister needs to provide definitive guidance on the five-year supply, to show exactly what is to be taken into account and how it is to be calculated. He must not leave it to clever QCs representing house builders to determine what is right for a particular local area. That is not localism, but an absolute divorce from it. Until we have that clear guidance, I do not believe the situation will improve.

Thirdly, we need to give real weight to the views of parish councils. That is a gap in the new legislation. At the moment, they are virtually non-people, and do not have the locus they should have in planning decisions. I recently read a speech by the Minister about the importance of neighbourhood plans. We went down that road with the previous Government and their village plans.

I have 135-odd villages in my constituency, and many of them spent months and years of really hard work on developing their village plans, thinking that what they

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were doing would affect future planning decisions and ensure that what was built matched needs and locality. The reality was, of course, that those plans were completely ignored. I am worried that neighbourhood planning will go down exactly the same road. Indeed, people are now so cynical that they might not engage with neighbourhood planning in the first place, because they do not believe it will have an effect. Unless we can show that it will bring a real improvement to local planning decisions, people will not engage.

Chris White (Warwick and Leamington) (Con): My hon. Friend has mentioned backing local councils and parish councils as well; that is an important part of this discussion. There is a problem, however, when those two organisations come into conflict. On my website there is a petition, with nearly 2,000 signatures, objecting to our current plan. How does he think district councils and parish councils could work together better to create greater consensus among local residents?

Mr Heath: That is important, and I believe there is a duty of co-operation within the local planning process that involves that sort of consideration. As I said, I have never sat on a district council in my life, but I know from my experience as leader of a county council, where we were dealing with matters such as mineral planning, that getting consensus is a long and iterative process. I do not believe that it is impossible for local people to achieve that consensus when they work together with shared objectives, but it is difficult when a plan is overridden by an inspector at appeal, or, worse still, when a district council feels so powerless to resist planning appeals that it rolls over in advance of them. We have seen that time and time again with local councils.

Steve Baker (Wycombe) (Con): My hon. Friend has made a powerful case outlining the mess that we are in. Just to be clear, is he content that the system should, ultimately, leave decision-making powers with the unelected planning inspector, or does he agree that those powers ought to be much closer to the property owner, the householder and the community?

Mr Heath: Ultimately, I would like the planning inspectorate to be redundant and local plans to be sufficiently robust to provide for the planning environment and, if necessary, local planning courts to determine whether there is a clear breach, but we are a little way away from that. In fact, the situation is quite the reverse: Her Majesty’s planning inspectors—I am not criticising them because they are only doing their job within the rules they have been given—are the planning authority for many of our rural areas. That cannot be right.

Jim Shannon (Strangford) (DUP): Will the hon. Gentleman give way?

Mr Heath: I am trying to conclude to give as many hon. Members as possible a chance to speak, but I will give way.

Jim Shannon: The hon. Gentleman has talked a good deal about the impact of housing development on rural communities and so on. Does he have the same concern about the drive for green energy, wind turbines and the targets set by Europe? Does he believe that the same

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consideration should be given to the impact on householders, as the hon. Member for Wycombe (Steve Baker) mentioned in his intervention, so that they may object and a balance can be struck in the countryside between the drive for green energy and the impact on people and the quality of their lives?

Mr Heath: With the greatest respect to the hon. Gentleman, I do not want to divert this debate to energy, which is a completely different issue. I have always suggested that energy generation should be subject to the same sort of planning considerations as other industrial development. Although I am strongly supportive of renewable energy, I do not believe that it overrides all other considerations and I believe that such matters are best decided at local level. However, I do not want to derail this debate, which is about more routine planning policy.

Jason McCartney (Colne Valley) (Con): Will my hon. Friend give way?

Mr Heath: This is the last time I will give way because I want to give other hon. Members a chance to speak.

Jason McCartney: I congratulate my hon. Friend on securing this debate, the importance of which is evident from the turnout this morning. It is interesting to hear that he has 135 villages in his constituency. I will name just five communities in mine: Lindley, Linthwaite, Upperthong, Netherthong and Golcar. They are facing the prospect of open land being pounced on by developers because my Labour-run Kirklees council’s local development framework is up in the air and it is refusing to use the latest figures from the Office for National Statistics. The nub of the matter is that when local councillors on the planning sub-committee listen to local concerns and are minded to refuse an application, its planning officers run roughshod over them, so there is no local democracy and no local accountability.

Mr Heath: The nomenclature of the villages in my hon. Friend’s constituency is as euphonious as those in mine. I could trade some wonderful village names with him. I am grateful for his intervention.

I have said that I want four things to be considered: the materiality of emerging local plans, a definition of “five-year supply”, the position of parish councils, and the vernacular, which is really important. I urge the Minister to look at that. It may seem to be a minor matter, but simply allowing uniformity of design throughout the country is contrary to the organic way in which architecture has developed in this country and is a hugely retrograde step.

I want to make one more suggestion. Central Government often put huge pressure on local councils to do things within time scales and castigate them if they do not. Could the same discipline be applied to the Government in terms of non-determination? It seems to me that local authorities are desperate to get local plans certified. Why do we not have a period following completion of the local plan process—perhaps six weeks from the plan being lodged with the Department—when it will be certified or will be deemed to have been certified irrespective of the planning Minister’s decision? It is no good the Government saying that they do not

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have the resources to deal with the issue—they do not accept that argument from planning authorities. The suggestion is a modest but good one, and I am sure that the Minister, being a radical Minister, will want to adopt it.

Something is seriously wrong not with the principle but with the operation of planning reform. It is causing great concern throughout the country. There is concern that communities will be distorted by opportunistic developments that our local authorities are apparently powerless to stop in the present circumstances. We must look closely at that. I do not want suburban sprawl across my rural constituency, but I see a risk of that. Of course I want houses to be built—we have a desperate need for them— but I want the right houses in the right places for the right reasons determined by local people. Those are exactly the principles that the Minister has espoused in his planning reforms. What I do not want, to almost quote the immortal words of Peter Seeger, is little boxes made of ticky tacky.

Mr James Gray(in the Chair): Order. A glance round the Chamber demonstrates that quite a lot of hon. Members are trying to catch my eye. I want to make two points. First, the drill is that hon. Members write to Mr Speaker indicating their intention to speak in debates. Those who have not done so will be at the bottom of the list rather than the top. Secondly, I have the authority to impose a time limit, but I do not believe in time limits. I believe that we should have self-regulation and good manners rather than rules, so if hon. Members restrict themselves to about five minutes that would be extremely helpful.

9.56 am

Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab): It is a pleasure to serve under your chairmanship, Mr Gray. I take on board your comments and will be as succinct as possible. I thank the hon. Member for Somerton and Frome (Mr Heath) and congratulate him on securing this important debate. The Government’s planning reforms are of great importance on Teesside and in East Cleveland and I intend to discuss their effect in those areas and raise the concerns of my constituents and local government leaders.

Planning policy makers have the difficult job of reconciling conflicting interests, but the Government’s approach to planning policy, particularly their Localism Act 2011, is distinctly centralist. The national planning policy framework ties the hands of local planning committees and removes much of their discretion in making decisions about planning applications based on local conditions. On Teesside, Stockton-on-Tees borough councillors, both Labour and Opposition, have been particularly vocal about that. Stockton council is not in my constituency, but its members have made several very valid and interesting points.

In November 2013, Stockton council passed a motion calling for an urgent review of the NPPF. It resolved that the framework effectively removed planning control from the local community and placed it in the hands of developers. It also made the interesting and valid point that that is coupled with massive reductions in available funding for the remediation of brownfield sites and that

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local authorities are effectively forced into permitting development on greenfield sites. A Thornaby Independent Association councillor questioned the reason for the very existence of a planning committee under the NPPF regime. Despite that, Stockton council has been under continual attack by the hon. Member for Stockton South (James Wharton) for its planning decisions. He branded the council’s leader “Bob the Builder”, despite the fact that since May 2010 the hon. Gentleman has not once objected to a planning application, and his Government are coercing the council into making the decisions. When Yarm councillor Mark Chatburn defected from the Tories to UKIP, he cited as one of his main reasons the hon. Gentleman’s silence prior to planning decisions and his refusal to utter a word of criticism of the NPPF.

It is not just Stockton council that finds itself under attack. Redcar and Cleveland borough council has been subjected to criticism about its draft local plan from local Liberal Democrats. I have submitted a response to the consultation on this document, as has my colleague Anna Turley, Labour’s prospective parliamentary candidate for Redcar, who urged the inclusion of a commitment to a traditional pier and stressed her opposition to proposed developments in Marske.

Confusingly, however, despite criticism by the hon. Member for Redcar (Ian Swales) and Redcar and Cleveland Liberal Democrats of the council’s draft plan in the press and their focus leaflets, they have not responded to the consultation. Will the Minister explain why the Redcar Liberal Democrats have failed to respond to this consultation when Ministers repeatedly tell the House about the importance of having a strong local plan? Does he believe that their silence is indicative of a belief that local plans are unimportant, not locally controlled and subservient to diktats originating in Whitehall?

Jason McCartney: On a point of order, Mr Gray. Surely the general atmosphere of Westminster Hall debates is about raising issues on behalf of constituents. We are listening to a blatant political speech, which names particular people. What is your judgment on that?

Mr James Gray (in the Chair): That is not a point of order. I have listened very carefully to all the speeches made in the Chamber this morning, and if they were out of order, I would have made the hon. Member concerned know that they were. So far, the hon. Gentleman who is speaking is making political points, and he is perfectly entitled to do so in a Chamber such as this.

Tom Blenkinsop: Thank you, Mr Gray. On a final note, the Government have abolished most of England’s regional government and governance structures, but has the Minister considered reintroducing a regional element into planning? Currently, one of the few parts of joined-up thinking in the formation of local plans is neighbouring authorities responding to each other’s consultations, with the Tory Hambleton district council, for example, responding to Redcar and Cleveland’s plan, supporting the construction of housing in my constituency so as to avoid its having to be built in the constituency of the Secretary of State for Foreign and Commonwealth Affairs, the right hon. Member for

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Richmond (Yorks) (Mr Hague). That seems like a very unco-ordinated way to co-ordinate development. If requirements were determined on a regional basis, it would be more efficient and would allow for more strategic planning. Again, I thank you for calling me to speak on this important matter, Mr Gray, and I look forward to the Minister’s response.

Mr James Gray (in the Chair): Before we move on, I remind the hon. Gentleman that when he mentions another Member in a speech, it is a convention of the House that he lets that Member know. He may therefore find it appropriate to apologise to the Members he mentioned, if he had not given them due notice, and let them know what he said about them.

Tom Blenkinsop: Thank you for your time, Mr Gray. I informed the two hon. Members and I am fully aware of the rule.

Mr James Gray (in the Chair): I am grateful—well done.

10.1 am

Sir Tony Baldry (Banbury) (Con): Here we are again. I will try to be as brief as possible, and I will put the full text of what I had intended to say on my website—tonybaldry.co.uk. I am sure that constituents and right hon. and hon. colleagues will read the text in full, because I want to make three succinct—I hope—points in supporting and endorsing what my hon. Friend the Member for Somerton and Frome (Mr Heath) said.

The first is on the five-year housing supply, which will be a requirement—not only when there are approved local plans, but until 2031. At any point between now and 2031, developers will be able to come forward and say to a local authority, “At this moment, you haven’t got a sustainable five-year housing supply, so we are entitled to build wherever we want within your district”.

At present, there is no agreement on the methodology used by planning inspectors to determine the five-year housing supply. Two distinct methodologies seem to be used by planning inspectors. Different methodologies are used in different cases. One is now referred to in planning shorthand as the “Liverpool” method of calculation, and the other as “Sedgefield”.

In a recent decision in a planning appeal in my constituency at Deddington, the planning inspector calculated housing supply locally on what could even be described as a third method and a variation of “Sedgefield”; it might be described as “Sedgefield-lite”. It is simply not good public policy for local councillors, chief planning officers and others not to know what methodology a planning inspector will adopt in calculating whether a local planning authority has met its five-year housing supply. Ministers have to make clear and unambiguous the methodology that they expect planning Ministers and everyone else to use in calculating the five-year housing supply.

My second point is about brownfield sites. It has been an article of faith in the planning system, quite rightly, that one should bring forward brownfield sites first, but if local authorities are so keen and need to have their five-year housing supply, they will bring forward sites

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that are easiest to develop in the five-year supply. Invariably, those are greenfield sites, so brownfield sites will get put to the back.

I give as an example the Banbury canalside site in my constituency. The intention is to have that built in the centre of the town on an area that was in the flood plain, but now no longer is, because we built adequate flood defences. The plan is for 950 houses, but my district is so determined that it has to meet its five-year housing supply that that brownfield site is being put back rather than being brought to the front of the queue. That is daft.

I can see the situation changing only if planning inspectors, in calculating the five-year housing supply, give credit in housing numbers for brownfield sites when local authorities can demonstrate that they are undertaking sustained and credible work to make a brownfield site available in the market. Otherwise, given how the five-year housing supply is working at present, brownfield will be put to the end of the queue rather than being brought to the beginning of the queue. As I said, that is daft.

My third point relates to neighbourhood plans. All of us understood that, with the new national planning policy framework, neighbourhood plans and localism were going to be really important, but neighbourhood plans have to clear two hurdles. First, they have to be consistent with the local plan, and secondly, at present the community has to complete its neighbourhood plan until such a point as is agreed by a local referendum. Many of the communities that have started neighbourhood plans carry them out diligently and earnestly, but they are unlikely to complete them within a year or 18 months, by which time I suspect that a large number of them will be redundant.

A classic example involves the community in Deddington, a village in my constituency. People there are busily undertaking a neighbourhood plan, entirely consistent with the provisions set out by the Government. A landowner and developer come along and put in a planning application to build up to 85 houses on the edge of the community, which is refused by the local authority but allowed on appeal. Under the agreed local plan, because of what is happening with most of Cherwell’s new housing—we have planned for nearly 17,000 houses in our agreed local plan between now and 2031, so we are hardly not stepping up to the plate to meet housing requirements—Deddington is due to take something like 80 new houses to the end of the survey period in 2031. However, the location of up to 85 has already been decided—not by the local community, but on the basis of whoever happened to get their planning application in first. With respect, that is not neighbourhood planning. It is not a plan-led system; it is a system of first come, first served.

If a local planning authority has submitted an agreed local plan and if neighbourhoods are carrying out a neighbourhood plan consistent with the rules set out by the Government, in a timely and proportionate manner, I suggest that any planning application that will effectively pre-empt the neighbourhood plan should be dismissed on grounds of prematurity, in that it would effectively rob local communities of the opportunity to determine their future. Thank you, Mr Gray. If any colleagues would like the full text of what I was going to say, they should please refer to my website.

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10.6 am

Annette Brooke (Mid Dorset and North Poole) (LD): I congratulate my hon. Friend the Member for Somerton and Frome (Mr Heath) on securing today’s debate. I would like—in a timely fashion, obviously—to reinforce some points that he made.

We have a dilemma. We all believe in local decision making. Nobody could have been more pleased than me when the regional spatial strategy was abolished and we lost our proposed new town, which had not been supported by any democratically elected person. That was good. Like the Minister, I want a planning system that will play its role in contributing to providing our much-needed homes. At the moment, things are clearly not working together and at the right pace.

Neighbourhood plans sound so good; we hear about the examples that have gone to referendum—the great success of Thame and others. The number of neighbourhood plans sounds good, but I suspect that it represents a tiny proportion of what is needed. I believe that there needs to be more support, although I accept that the Government are supporting the process, because it is such an important way forward. I do not think that we should lose sight of that on the Government side, because it was a great innovation.

I agree with my hon. Friend that the emerging local plan has to have more material weight in the inspectors’ considerations. I do not know how that can be achieved, but in the past an emerging plan certainly had weight. Perhaps developers are finding new ways of getting around things. The Government must concede the point, given the number of places that do not have fully adopted plans as such, and support those areas that do not have fully adopted plans.

I have mentioned housing projections to the Minister. I feel that our local residents have to be able to understand where the local projections have come from and why they are there, at the scale they are at. It would then be easier to get a community buy-in.

I want to touch on the need for authorities to co-operate, because I am not convinced that they are doing so very well at the moment. My hon. Friend the Member for Cheltenham (Martin Horwood) likes to make the point that Cheltenham is very constrained, in terms of where new development would be suitable. My constituency is very constrained because of protected heathland. We have these dilemmas. There is a duty to co-operate, but I think we need to look more at how local authorities can form natural partnerships and work together to meet housing and other infrastructure needs.

I shall briefly touch on rural exception sites, which I have raised with the Minister. I was a big fan of rural exception sites until last week, I think it was. In my constituency, one has come in for 35 homes. There is a recently adopted plan in that part of the constituency. The parish is working up its neighbourhood plan, but that site has not been consulted on at all. It seems totally wrong that that could come in without a proper round of community interaction. It may well result in houses at the end of the day, but I am finding it difficult to see how it fits with our new planning framework.

I also want to touch on good design. There are instances in which we should accept that higher density can be good design and meet some of our objectives. I have to use those words carefully, because that is not

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always the most popular thing to say, but I just ask generally what encouragement the Minister is giving for good design.

I believe that the Minister has commented on how we could approach the problem of planning permissions being given but not implemented. I would like him to comment on what more he should be doing, because the public need confidence that what land is coming forward is not just the easiest picking when there are outstanding planning permissions that could be implemented.

Mr James Gray (in the Chair): It gives me great pleasure to call someone who has so often called me to speak— Mr Nigel Evans.

10.11 am

Mr Nigel Evans (Ribble Valley) (Ind): Thank you, Mr Gray. It is a pleasure to serve under your chairmanship.

I say to my hon. Friend the Minister that if he is under any illusion or delusion that the planning system is working well, all he needs to do is listen to the hon. Members who are speaking here today. This is rather a large turnout for Westminster Hall. Hon. Members are talking about their anxieties and frustrations and the fact that their constituencies are under siege. I certainly feel that myself, because the Ribble Valley is under siege.

I was first elected in 1992. I said to my executive that I hoped that after my days in the House, when I handed the Ribble Valley over to my lucky successor, it would be in better shape, or at least in no worse shape, than when I became its Member of Parliament. I was doing rather well until 2010, when the planning system started to change. We in the Ribble Valley are under siege.

There are not as many villages in my area as in that of the hon. Member for Somerton and Frome (Mr Heath), but there are many wonderful, lovely villages and towns, including Clitheroe, the main market town. The whole area is under siege. We do not have our core strategy in place, and it seems as if that is a green light to every speculative developer to put in a planning application, with no protection for the local authority or for the people themselves.

Dr William McCrea (South Antrim) (DUP): Does the hon. Gentleman accept that a development in a small village area can turn communities into strangers? One developer can come in for a vast site in a small village area that will more than double the number of properties. That is not good for communities.

Mr Evans: I agree with every word that my hon. Friend has just said. Barrow in my constituency is a perfect example of a village where planning applications have gone in that would more than double its size. The people are up in arms against that. I hope that the public will get protection against that application, which I think is barmy.

There are a number of other areas. Clitheroe is the largest town; applications have gone in all over the place there, and many have been granted on appeal. Somebody did suggest getting rid of the inspector, or the inspectorate. That would make me smile more than anything else, frankly.

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The frustration for many of my local councillors is that they go out and tell the people what they will do when they are elected; the people tell their councillors what they want when planning applications go in; and the councillor stands up for them and says, “No, we don’t want to see 1,000 houses in Clitheroe”. However, the decision is then overturned or, as in this particular case, the local authority gets the feeling that if it did turn the application down, it would go to appeal, cost it a lot of money to defend its position and the application would then be allowed. In many cases, local authorities are allowing certain applications when their hearts tell them that they should not.

Andrew Bingham: Does my hon. Friend agree that the scenario that he eloquently lays out and which I have seen in my High Peak constituency is damaging people’s faith in democracy across the board? They see their elected representative making one decision and an unelected representative overturning it.

Mr Evans: I totally agree. It means frustration on the part of not only the people, but the councillors. They shrug their shoulders and say, “Well, what is the worth of being a local authority councillor if we are making these decisions on behalf of the public and then they are overturned?” Or, even worse, the local authority is told, “Listen, you’d better accept this planning application. Otherwise, it’s going to cost you a lot of money and you will lose.”

Steve Baker: My hon. Friend has made the point with great clarity and passion, but I cannot forbear from saying that those of us who stood for election on the Conservative manifesto stood on a platform of a radical decentralisation of power—an invitation to the people to join the Government of Britain. I think that he will agree with me that those of us who stood on that platform with enthusiasm are rather disappointed that it has come to this.

Mr Evans: More than disappointed. I used to use a counter-argument against those in my constituency who said, “This is a disaster. This is what is going to happen if the Localism Bill goes through.” I said, “No, localism will give power back to the local authorities.” Now, when we look at what has happened, it seems as if there has been some Orwellian double-speak. Localism sounds as if it is giving power back to the local people when in essence it has not done that at all—quite the contrary. If people want to build houses, localism is fine. If people want to go against the building of the houses, localism does not help them one jot.

I was elected as a Conservative. I am a Conservative; just as the name on the tin suggests, I want to conserve—I want to conserve what is best in our area. The position is as my hon. Friend the Member for South Antrim (Dr McCrea) said. If people in the Ribble Valley want to live in Manchester, that is fine—they can go and live there. What we do not want is Manchester coming to us. We do not want to see these towns growing at such a rate that we do not even recognise them.

The Ribble Valley is one of the nicest places to live in the whole country; it is one of the jewels. I say that it is like the Lake district without the lakes—even with the rain we have been having, we still do not have the lakes,

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thank goodness. People want to live there for a certain reason. I know what the Minister is talking about when he says that people deserve the right to have a roof over their heads. Everyone deserves a home; I agree with him on that, but we need to look at areas that neighbour places such as the Ribble Valley—such as Burnley, Preston, Pendle and Hyndburn—and see what we can do to regenerate some of the run-down areas there. We need to ensure that homes that are run-down are made available to people in those areas and that they do not have to flee those areas and live somewhere else.

I will finish shortly because I know that many other hon. Members want to speak, but I just want to say this. I believe that we ought to have a planning system that is based on consent—the consent of the local people. I finish by referring not just to housing but to wind turbines. When fairly well everybody in a local area is saying no to three wind turbines in a suburban area and the council turns the application down because it has listened to what the local people say, but it then goes to the inspectorate and the inspectorate passes it, there must be something wrong in the system because we are not listening to the people. Minister, listen to the people.

10.18 am

Andrew George (St Ives) (LD): It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend the Member for Somerton and Frome (Mr Heath) on securing this very important debate. Its importance is demonstrated by the number of hon. Members who have turned up. I know that there are many who could not attend who would have attended otherwise.

The primary issue being debated is housing projections in our areas. Many of the issues that have been described apply to my own area in Cornwall. The Isles of Scilly are rather different: it is a very protected environment and one where the projections and pressures are not the same.

I fear that the debate is being characterised, or rather could be characterised from the Whitehall and ministerial perspective, in a certain way. I fear that what people are hearing is the rather complacent and self-satisfied voice of the contentedly housed seeking to deny opportunities for the unhoused or the inadequately housed—in other words, the nimby argument.

The view is that the role of Government, through their policies and the inspectorate, is to ensure that there is balance in the system and that that group of people are seeking to resist simply from the perspective of wanting to protect their own property values, scenery and lifestyle—the drawbridge mentality, which often applies to people living in a rural setting. The view is that the role of this system is to stand up against those kinds of pressures. That is a rather simplistic view of how the system operates in an area such as mine. Cornwall is not a nimby place. The housing stock has more than doubled in the past 40 years, but local people’s housing problems have significantly worsened over that period.

We cannot be accused of being nimbys, but successive Governments’ policies have been counter-productive for the region. They have ensured that projections are maintained, but those projections have been utterly unsophisticated. Many of the Office for National Statistics

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projections over the past 10 years have been significantly undershot, and I believe that the ONS model for setting projections is rather flawed. When there is a high projected figure, what happens—not only in the five-year supply, as my hon. Friend the Member for Somerton and Frome has said, but in the system as a whole—is that even in areas that have not been designated for housing development, the hope value on all surrounding land becomes extremely high, because of the expectation that planning permission will be relatively easily obtained. As a result, it becomes impossible to implement schemes to deliver affordable homes, which require low land values.

Such policies have a counter-productive impact. That sits against the aims of the exceptions policy and “Planning Policy Guidance 3”, which was established in the early 1990s under the then Environment Secretary, Nicholas Ridley. The principle behind that policy was absolutely correct. If a strict and controlling system that protects the local community is established and a genuine exception, which follows the policy, is granted, it is possible to achieve low land values and deliver affordable homes in rural areas. The setting of high projections will never achieve that.

The exception described by my hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) is clearly not a proper exception. An exception would have to be brought through with the support of parish council housing associations and others, and the necessity for it would have to be clearly demonstrated by a community needs assessment. My hon. Friend’s example is a rather curious one. Over the past few years in Cornwall, we have seen a lot more housing—we are the second or third-fastest growing place in the United Kingdom—but housing problems have soared. In the Penzance area, rough sleeping and homelessness is second, proportionately, to London, so the policy has clearly failed.

The Government must stop imposing projected figures on Cornwall. Cornwall council will have a debate next week in which it will say that if it does not accept the ONS projected figure, that figure will be imposed on the council. That is not a basis on which Cornwall can establish a plan to meet local housing need. Meeting the desperate need for affordable homes, not accepting projections that divert us from achieving that aim, is ultimately what matters. Otherwise, we end up with more second homes, more unoccupied property, more investment property and more retirement homes. Those sectors have certainly grown in Cornwall, while opportunities for the local population to find adequate housing have significantly decreased.

I hope that the Government will recognise that the issue is sophisticated and difficult, and that they will give local authorities the power to meet local housing need rather than forcing on them thousands of houses that will not help to meet that need.

10.24 am

Sarah Newton (Truro and Falmouth) (Con): I congratulate my hon. Friend the Member for Somerton and Frome (Mr Heath) on securing this timely debate. It is a great pleasure to follow a fellow Cornish MP, my

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hon. Friend the Member for St Ives (Andrew George), who has in a nutshell articulated our dilemma in Cornwall. We have welcomed a lot of people into Cornwall; there has been a lot of inward migration and a lot of house building, but we still have a chronic housing situation. People who are born and bred in Cornwall, who work in our local economy and contribute a great deal to it, cannot afford to live there. Because so many colleagues want to contribute to this debate, I shall take the lead from my right hon. Friend the Member for Banbury (Sir Tony Baldry) and say that my speech will be on my website in its entirety. I associate myself very much with the comments that he has made.

With brevity in mind, I seek some simple assurances from the Minister. As my hon. Friend the Member for St Ives has said, Cornwall council will meet next week to attempt to agree its plan, and some specific assurances from the Minister today would help the councillors in that process. Our councillors are being told by the planners that unless they accept a projected housing target based on what Cornwall has delivered over the past 10 years, the planning inspector simply will not agree the plan. To help the plan-making process, I urged Cornwall council to undertake a local needs assessment, which it has done. That assessment looked at the number of homes that are needed in Cornwall for those who currently do not have the right type of genuinely affordable housing, and the number needed to support the growing businesses in Cornwall. The local needs assessment demonstrated that Cornwall has been over-delivering properties at a rate of up to 1,000 a year, and that we need a much smaller number in order to meet our obligations and our desire to provide the right sorts of homes and achieve sustainable growth.

Cornwall councillors are being told that the good evidence base that has been gathered in that local needs assessment cannot be used, or the planning inspectors will throw out the resulting plan. I seek an absolute assurance that if Cornwall councillors, when they meet next week, can provide an adequate evidence base that supports the building of a certain number of homes based on realistic population growth and observed household composition rates, the planning inspector will accept that number. Any reassuring words that the Minister can give about the methodology that councillors can use in making their decision next week would be most welcome, because we desperately need to agree the plan. There has been a huge amount of consultation and very good work is going on in neighbourhood planning, but that plan has to be agreed.

As so many other hon. Members have described today, a developers’ free-for-all is going on in Cornwall and a huge number of speculative planning applications are being made. We need to use the tools that the Government have laid out in a new plan-making process to ensure that we have development in Cornwall, but that it is sustainable and fits in with our unique environment. Our key industries are tourism, farming, fishing and food production. Only yesterday the Secretary of State for Environment, Food and Rural Affairs quite rightly pointed out how much more food we need to produce in our own country, and how food security will become an increasing issue. Those are key industries for Cornwall, and we can make a key contribution to the nation if councillors are given the tools to balance the need for housing with the need for a sustainable environment.

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10.29 am

Harriett Baldwin (West Worcestershire) (Con): I would like to add my congratulations to the hon. Member for Somerton and Frome (Mr Heath) on securing the debate so early in the year. It is a pleasure to serve under your chairmanship, Mr Gray. I declare an interest as a home owner in the Malvern Hills district, which has recently been found to be the second best place to live in the midlands, but I think it was severely underrated in that survey. It is a wonderful place to live.

I have had the pleasure of attending two debates on the south Worcestershire development plan in this Chamber in the past few months—one on 24 October and one on 20 November—so I do not want to talk too much about my local area, but about national planning issues. I have some questions for the Minister. I agree with the many colleagues who said that we are in a much better place, as far as planning is concerned, than we were when we had the top-down regional spatial strategies so favoured by the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop).

I completely agree with other colleagues who said how important home building is in our areas and how important it is for the economy, which is beginning to show signs of recovering from the dreadful recession we had under the Labour Government. I know how keen the Minister is to see the promising increase in the rate of home building continue, and I have some suggestions as to how we could speed up housing development by clarifying the guidance to the planning inspector. It is my view that the Planning Inspectorate is holding up growth in many areas, and we have heard many examples of that today.

In my area, we are a bit further on than the hon. Member for Somerton and Frome: our local plan was agreed by the councils over a year ago—as far in the past as December 2012. It was then submitted to the planning inspector in May 2013 and it took him until 28 October to give his interim thoughts on stage 1 of the inspection. That is a total of five months. He found that the duty to co-operate was being met and he had many good things to say about the plan, but he still wants further information and has rejected all seven methodologies presented to him for housing projections. We are playing a game of “pin the tail on the donkey” in the dark with the planning inspector and guessing what sort of housing numbers he wants to see. He has told us that the next stage of part 1 will start on 10 March 2014—a delay, with five months between that date and the continuation of stage 1. He has also written to me to say that he cannot give a time scale at this point for stage 2.

I wanted to see how long our process took compared with what hon. Members had seen around the country. There is a good spreadsheet on the Department for Communities and Local Government website of the 350-odd local plans currently in different stages of development. It categorises them by whether a council has published its local plan, submitted its plan, whether the plan has been found to be sound and whether the plan has been adopted. I thought it would be helpful to see how long the process takes. In about half the cases, the plan has been fully adopted. It is interesting to note that the time between a plan being submitted and being found to be sound has increased substantially in the past year. Since the national planning policy framework

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became live at the end of last March, the number of days between a plan being submitted and being found to be sound has increased from nine months on average— a normal human pregnancy—to 14 months. There is a material difference: the time period is not as long as an elephant’s pregnancy yet, but it is certainly increasing—the size of the mammal is going up.

My first question to the Minister is whether the delay—the increase in the time between the plan being submitted and having it found to be sound—is due to a national shortage of planning inspectors. My neighbour and newly knighted colleague, the hon. Member for Mid Worcestershire (Sir Peter Luff), tabled some parliamentary questions at the end of last year. He was told that 80 plans are in the process of inspection across the country, which, in the Department’s view, will take 25 full-time equivalent planning inspectors, and it is currently recruiting additional inspectors. I would like an update from the Minister on the recruitment of those additional inspectors.

Secondly, is the delay since the NPPF became active a deliberate strategy? Does the Minister believe that it is encouraging more home building? I submit that that is a mistaken view. It would be helpful if we heard whether he had noticed any difference between the number of new homes bonuses paid out in local council areas that have an adopted plan and the number paid out in those areas that do not. Is there a statistical difference in the rate of housing delivery? Housing delivery will speed up and the arguments about planning will slow down if a plan is given significant weight in the planning process.

I conclude by saying that my thesis is the same as that of many hon. Members here today. The goal of the Minister, the Chancellor, the Prime Minister and indeed the country of delivering more homes and building local democracy into the heart of that process will be better achieved if the Minister told his inspectors to move immediately to give almost full weight in the planning process to plans that have been submitted and democratically agreed.

10.36 am

Neil Carmichael (Stroud) (Con): It is a great pleasure to serve under your chairmanship, Mr Gray. I give my hearty congratulations to our hon. Friend the Member for Somerton and Frome (Mr Heath) on securing a worthwhile opportunity to set out our thoughts on planning.

The essence of the debate is that increasingly relying on an inspection regime to sort out problems is not localism, but quite the reverse. That is the cornerstone of most Members’ contributions today. Stroud district council is busily preparing its local plan, but it is of course a Labour-led administration, which is bound to hamper progress, and it has a committee system, which is not ideal.

Delays have left many communities spinning in the wind, as gusts of developers come along and make proposals here, there and everywhere. I have been the recipient of many messages from communities saying, “What are you going to do to protect the integrity of our area while we don’t have a local plan?” I reiterate the point made by my hon. Friend and others: while emerging local plans are still being formulated, we must give them more prominence in inspection considerations. That matters because if we are talking about localism

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and giving local people a voice, we must be bold enough to do it. We must give emerging local plans some consideration.

The same logic, incidentally, applies to neighbourhood planning. When we go around our patches, as I do, encouraging neighbourhood plans, the response heard is, “Well, that won’t be sufficient to stop what’s being proposed.” That is absolutely true unless or until such plans are given recognition in the planning process, too. If a community is concerned about what will happen to it, a neighbourhood plan is a good way to do something, but we must give that plan some traction. We should not only think about the local plan as a whole, but consider emerging neighbourhood plans. They are a clear illustration of what communities are thinking, if they are bold enough and sensible enough to have one.

Many hon. Members have talked about housing numbers. It is important to bring together two issues. The first is co-operation among councils. They must talk to each other and understand the scope and content of their plans and their relationship to each other’s plans. That is essential. Secondly, this is not just about housing numbers, but about the economic conditions that prevail in an area. We need planning authorities to take much more account of the economic factors, which should have a bearing on housing numbers. The Minister needs to express that clearly, so that councils have to consider the economic issues, as well as the obvious question of housing numbers.

Time is obviously short, so I shall finish by saying that we want to see local communities planning and we want to see more houses. We need to understand the value that more houses can bring to local communities which need to feel involved and have ownership of the developments. That is another essential point that needs to be transmitted to local authorities. In short, we do not want an inspection-led regime, because that is not localism; it is effectively the nationalisation of planning. We want the reverse, and we want to be able to say to local authorities, “Those of you that are doing something, do it well and be respected.”

10.40 am

Roberta Blackman-Woods (City of Durham) (Lab): It is a pleasure to serve under your chairmanship again, Mr Gray. I congratulate the hon. Member for Somerton and Frome (Mr Heath) on securing this debate. He has very eloquently raised important constituency issues this morning, and I shall return to the specifics of his speech in a minute or two.

I hope that Government Members and others will forgive me for not mentioning them individually; there are rather a lot of them. Everyone spoke earnestly and lucidly on behalf of their constituencies. I particularly thank my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) for helping me to feel a little less lonely on the Opposition side and for raising important issues that affect his area. He highlighted inconsistencies in the Government’s approach to planning at the moment.

This debate follows one on a broadly similar topic. Lots of Government Members attended that debate a few months ago in October. It was about what happens

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with local planning decisions when there is not a local plan in place. There was some dispute among Members about whether there was a need for additional housing in rural areas, and that has been reflected to a degree in some of the contributions today.

I want to put on the record that I agree with some of the issues raised by the hon. Member for Somerton and Frome, particularly those about technical starts; land banking; land supply; the need to get better quality into our house building system; the need to strengthen brownfield policy further; and how we take more notice of neighbourhood planning. I concur with all those points and will talk about them in more detail in a minute or two.

We know that we need more housing, including in rural areas. I shall not rehearse again all the figures that I gave last time. Suffice it to say that, to secure a typical mortgage, a rural resident needs to earn £66,000. With the average rural income standing at just over £20,000, there clearly is a problem with affordability, partly as a result of insufficient supply.

The situation in rural areas is part of a wider problem. For decades, under successive Governments, house building has stayed low relative to demand. Private house building completions in England have been relatively static for more than 30 years, averaging about 130,000 per annum. That is below the peak average of 180,000 per annum in the 1960s. There is an ever-growing gap between supply and demand, which means that millions of hard-working people are increasingly priced out of buying their own home.

Recent data from Glenigan show that although approvals for new housing are improving, they are not yet at the levels recorded for 2007, and are not high enough to deliver the output of about 200,000 houses per year that most sensible commentators suggest we need to meet demand, so we must address the housing shortage.

The Government are right—I want to emphasise this—to allow housing need to be objectively measured locally as outlined in the NPPF, but as the National Housing Federation has stated in its briefing for today’s debate, more could be done to clarify the methodology used. Indeed, it appeared to back Labour’s call that we need a common methodology to be applied across all local authorities to ensure a consistency of approach. That might help to address some of the concerns raised by Members this morning.

I also agree with other Members who have contributed today that development sites need to be identified by local communities, with a stronger emphasis on neighbourhood planning and with consent at the heart of the planning system. I think that that can be helped in a number of ways. I have paid tribute to the Minister before for his support for neighbourhood planning; he has the Opposition’s support. We want him to think about how neighbourhood planning can be strengthened and how we can better integrate neighbourhood planning into the local plan-making system.

I also applaud the precedence that the Government have given to local plans in the determination of planning applications, but, as many hon. Members have said this morning, the process of getting them adopted is still too slow, with only 55% of authorities having an adopted local plan. I know that 76% of councils have published a plan, but there are still not enough of them in place.

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In the meantime, we have a situation in which, as many hon. Members have mentioned today, the Planning Inspectorate, and in some instances local authorities, are approving inappropriate schemes in the absence of a local plan, or they are not taking enough note of a local plan.

A few months ago when we debated the issue, the Minister had nothing much to say about how he would remedy the situation. I hope he has stronger words of comfort for us today. It is clearly an issue that relates to many areas and it is causing anxiety locally. Worryingly, the Local Government Association has said that local decisions taken in line with emerging local plans are being overturned by the Planning Inspectorate. I agree with it and others who have said that this will undermine trust in the planning system and result in development that does not reflect the needs of local communities. That is the opposite of what we all want.

The LGA also points out, helpfully, that it is not planning that is the barrier to growth. Councils are approving 89% of all planning applications, and planning permissions are up 31% on 2012. Indeed, planning approvals are at a 10-year high, so it should be possible to have the housing we need and to reject inappropriate development as defined locally at the same time. Otherwise, the current system risks breeding further resentment towards development. Instead, we should be supporting a planning system that more readily favours development based on consent.

The issue is important for the Minister, because the NPPF states clearly that weight should be given to emerging local plans, but, in practice, this appears to be being ignored by PINS. Members have this morning called for greater guidance to be given to the Planning Inspectorate.

Andrew George: Will the hon. Lady give way?

Roberta Blackman-Woods: Forgive me, but I am terribly short of time.

The hon. Member for Somerton and Frome made an excellent point: the issue is not simply about housing numbers. It is about employment, proper infrastructure and leisure. We need to talk not only about housing numbers, but about building communities. This is an issue that is often not considered strongly enough by the Planning Inspectorate. Again, I want to emphasise the need to do something about quality and about protecting our ancient woodlands. Perhaps the Minister will say something about that. It is an added concern for us all after the past week. What is the Minister going to do to speed up the system for getting local plans approved? That is clearly the key to getting the development that we want.

Before I sit down, I should say that while we have been having this debate we have all learned about the very sad death of our colleague, Paul Goggins. I am sure that all Members will join me in sending our deepest condolences to his family and friends.

Hon. Members: Hear, hear!

10.50 pm

The Parliamentary Under-Secretary of State for Communities and Local Government (Nick Boles): Thank you, Mr Gray, for calling me to speak. It is a pleasure to serve under your chairmanship.

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First, I absolutely echo the condolences that the hon. Member for City of Durham (Roberta Blackman-Woods) has just extended to the family of Paul Goggins. I had not understood that he had died, and it is a very sad day. He was a gentleman who commanded respect and affection across the House.

I congratulate my hon. Friend the Member for Somerton and Frome (Mr Heath) on securing this debate, which has become something of a “Groundhog Day” experience for me. I am absolutely sure that this is not the last time that I will have this experience, although whether I will end up with Andie MacDowell at the end of the movie is open to question.

I welcomed many of the questions that my hon. Friend asked, but I must object very strongly to how he opened his speech. He seemed to imply that I was not a supporter of maintaining agricultural land for farming. I heard some bellows from up above, where my recently departed father, a sheep farmer in Devon, and my rather-longer-ago departed grandfathers, farmers in the Mendips and in Devon respectively, were outraged at the implication that I am anything other than a passionate supporter of farming.

Mr Heath: I am very pleased to hear that. I just seem to remember that the hon. Gentleman once called agricultural land “boring”.

Nick Boles: My hon. Friend is such an experienced Member that I am surprised he believes what he reads in the newspapers.

In the very short time available to me, I will try to cover some of the main issues raised this morning, chiefly by my hon. Friend but also by other hon. Members. That means that I will not be able to answer every question. In particular, I would like to write to my hon. Friend the Member for West Worcestershire (Harriett Baldwin) about the questions that she put about the Planning Inspectorate. I will copy in everybody in Westminster Hall today with the answers, because they were very good questions but technical ones, and I would like to come back to her specifically on them.

The first issue is housing projections. What is the role of figures from the Office for National Statistics in supporting housing projections? The fundamental situation is that, just as we expect local authorities to make plans to meet their needs for schools and for social care, we expect in the national planning policy framework that local authorities will make plans to meet their housing needs. Those plans have to be evidence-based. Of course, we cannot entirely reject ONS population projections, because the ONS is our national statistics body and those projections are the best that we have, although I entirely understand why they are often wrong and flawed, as all projections necessarily are.

What I have said, however, does not mean that those ONS projections are the last word. It is absolutely open to any authority—Cornwall council will certainly have this opportunity—to look at the actual figures achieved in the past, relate them back to the projections that were in place then and then say why it thinks that projections are not the last word and that different numbers have an evidence base. It is absolutely open to authorities to do that, but their numbers must be based on evidence; they cannot be based on assertion alone. Authorities must

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use evidence and that evidence will be challenged in an examination by developers and others, so it needs to be pretty robust.

I will now address the subject of the five-year land supply and particularly the question put by my hon. Friend about this rather vexed question—I cannot believe that we are all getting into this business whereby we are all experts on Sedgefield and Liverpool, not as places, football teams or constituencies, but as methods of calculating land supply.

What “Sedgefield” and “Liverpool” simply refer to is a particular question. If an area has had an under-delivery of housing in the past, how quickly—in the area’s new plan—should it catch up on that under-delivery? Rather than getting into the whole question of, “Is it Liverpool and is it Sedgefield?”, which will mean precisely nothing to our constituents, I will just read out what the draft guidance, which we hope to finalise in a very few weeks, says about this issue:

“Local planning authorities should aim to deal with the under-supply within the first five years of the plan period where possible.”

Now, some things are not possible; some things will conflict with other sustainability policies that are very important in the NPPF. However, it is not unreasonable to expect that, where past performance has undershot need, if it is possible we should try to catch it up at the beginning of the plan and not during the full 15-year life of the plan.

Caroline Nokes (Romsey and Southampton North) (Con): I thank the Minister for giving way on that specific point. Of course, by catching up quickly in the plan, my local authority—Test Valley borough council—faces a situation where in years six to 15 it is unable to include sites such as windfall sites, which we know will inevitably come forward. Does the Minister have any plans to allow my local authority to include windfall sites again, or are such sites off the agenda for ever?

Nick Boles: I cannot comment on any particular plan, but windfall sites absolutely can form part of a plan. Where an authority can evidence that it has had a consistent delivery of housing through windfall sites in the past, and it is reasonable to expect that there will continue to be such a delivery of housing through windfall sites, it is absolutely reasonable to say that part of its planned projections assumes a level of windfall site delivery. There is nothing in the policy to prevent that.

I will move, very briefly, to the question of the weight of emerging plans. The hon. Member for City of Durham was absolutely right to say that it was a vexed issue in the last debate that we had on this subject. We are trying to make this issue clearer in the draft guidance and although the consultation has closed on that draft guidance, as far as I am concerned consultation never closes.

If hon. Members would like to look at that draft guidance, they should refer to the Department’s website. I would be very happy to take any comments or concerns from them. We have also invited my right hon. Friend the Member for Arundel and South Downs (Nick Herbert) and the Economic Secretary to the Treasury, my hon. Friend the Member for Loughborough (Nicky Morgan),

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who both had very serious concerns about this process, to meet the chief planner to discuss in detail how it will work.

Nadhim Zahawi (Stratford-on-Avon) (Con): I did not get the opportunity to speak; I will put my speech on the website. The Minister can go further than issuing draft guidance and actually amend the NPPF, because all is not lost. He does not have to come back to Westminster Hall and have “Groundhog Day”. He can also take into account the cumulative effects of development within the NPPF, at paragraphs 186 and 187, to close a loophole that he has been hearing about today; he has also heard about the pain that that loophole has caused. I also have other suggestions that I will write to him about.

Nick Boles: I thank my hon. Friend for that intervention. We are not looking to change the NPPF, because after such a dramatic change in the planning system, stability has an enormous value.

However, what we are looking to do in the draft guidance, which we hope to confirm shortly, is to make it clear that it is sometimes reasonable—in exceptional circumstances, but exceptions happen all the time—to refuse a planning application. That is the case if, one, the application is so substantial that it runs the risk of undermining the plan to which it is being referred, and, two, where a local plan has been submitted for examination—it has not yet passed examination, but has been submitted. A refusal can also happen in the case of a neighbourhood plan, when it has entered into what is called the local authority publicity period; it has completed consultation but it has not yet gone to referendum or, indeed, to examination. Before the plans have been examined, they will have material weight and they can, in exceptional circumstances, be used just on the basis of prematurity to refuse an application, if the application is so substantial that it could completely knock the legs out from that emerging plan.

I hope that I have reassured hon. Members. We have listened very carefully to the concerns that have been expressed. As I say, we have met other Members who have had concerns about this issue and we have done our utmost to listen to them, and to try to reflect those concerns.

I simply point out that that is not entirely within our gift, because, much as I understand how my colleagues from all parts of the House would dearly love to abolish the Planning Inspectorate, I can tell them where these things would end up if we abolished it—they would end up in court. It would cost their local authorities a lot more money to fight these things in court than it does to fight them either through an examination or in an appeal with the Planning Inspectorate. Planning inspectors are a better solution for local councils and local communities than the available alternative in a system where the rule of law enables people to challenge Government decisions whenever they like.

In the minute or so I have left to me, I will address the very important point that my hon. Friend the Member for Somerton and Frome made about design. To reassure him, hopefully, I will read the draft guidance about the very point that he made:

“Development should seek to promote character in townscape and landscape by responding to and reinforcing locally distinctive patterns of development and culture, while not preventing or discouraging appropriate innovation.”

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Local vernacular is critical to making people feel that development is a friend, and is actually helping and supporting communities rather than undermining, challenging or alienating them. It is something that matters a great deal to me. I believe that if we built more beautiful houses in more beautiful places, we would build more houses, and ultimately that is what we all want to achieve.

Mr James Gray (in the Chair): I thank the 11 hon. Members who spoke and the eight who intervened. Will they please now leave the Chamber swiftly and quietly? I congratulate the hon. Member for Finchley and Golders Green (Mike Freer), who nobly acted as Parliamentary Private Secretary in the previous debate and will now introduce his own debate.

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Joint Committee on Vaccination and Immunisation

11 am

Mike Freer (Finchley and Golders Green) (Con): It is a pleasure to be here today under your chairmanship, Mr Gray. I am grateful to Mr Speaker for granting this debate on the work of the Joint Committee on Vaccination and Immunisation. I requested this debate following the JCVI’s decision on the 2 October 2013 to undertake further work on key issues surrounding the human papillomavirus, or HPV, vaccination programme. I understand that some colleagues may wish to comment on other aspects of the JCVI’s work. I want to focus particularly on the Committee’s decision to consider—I use its word—“urgently” vaccinating men who have sex with men, on attendance at sexual health services, and adolescent males. I intend to focus my remarks on that work now being undertaken with regard to the HPV vaccination programme, specifically in terms of exposure to HPV-related cancers, which are increasing in boys who have sex with females and the MSM community.

The decision of the JCVI to prioritise consideration of vaccinating MSM is noteworthy, not least because the minutes of its October meeting accept that a full economic model might not be necessary where sexual health clinicians can develop independent guidelines. Historically, the JCVI has often rejected vaccination of adolescent boys and MSM on economic grounds, so it is a major step forward for it to say that heath clinicians with expertise—particularly at sexual health clinics—can take such a decision on clinical grounds. That is welcome.

It is important—I have no doubt that my hon. Friend the Minister will need to ensure it—that any decision on extending vaccinations is clinically and financially sound. I do not seek to undermine that decision. I wish to stress the economic benefits of extending the vaccination swiftly, rather than stress other issues of equality, which I raised in an Adjournment debate last year.

Jim Shannon (Strangford) (DUP): I thank the hon. Gentleman for bringing this important health matter to Westminster Hall for consideration. There have been significant positive results from vaccinating women and girls for HPV, so clearly there is an advantage shown in doing that. That consolidates the hon. Gentleman’s request for the same vaccination to take place in men and boys as well. Does he agree that the same should happen with regard to men as has happened for women and girls?

Mike Freer: The hon. Gentleman makes a good point that repeats some of the discussion we had in last year’s Adjournment debate. The success of the vaccination programme among girls has had a dramatic impact on HPV-related cancers among women. However, the flaw was that it assumed herd immunity for boys who were having sex either with girls or within the herd. But of course, not all boys have sex with girls: some—shock, horror!—have sex with other boys, and not all boys have sex within the herd. Increasingly, in a global economy, and particularly in Europe where the vaccination programme is not the same, adolescent boys in this country are exposed to women who have not been vaccinated. It is important to close the loophole for

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adolescent boys having sex with unvaccinated girls and those having sex with unvaccinated boys, who, obviously, grow to be unvaccinated men.

If the JCVI has agreed to urgently review the economic case for extending the vaccination programme, why is this debate needed? Before I discuss that, it is worth reminding ourselves what health problems we are trying to prevent. I recall, during the Adjournment debate, seeing the duty Whip sink ever further on the Bench as we discussed certain topics and cancers. This is not a pleasant subject, but I would rather discuss an unpleasant subject than have to deal with it our hospitals.

Nine out of 10 cases of genital warts are HPV-related; oral-related HPV infections—men are six times more likely than women to have oral infections—increase the risk of cancers of the mouth, throat, neck and head cancers; and there are HPV-related penile and anal cancers: HPV is associated with 80% to 85% of anal cancer in men. In 2009, just after the HPV vaccination programme started, there were more than 6,500 cases of these cancers, with 47% of penile cancer and 16% of head and neck cancers thought to be HPV-related. The latest incidence data show that in 2010 there were 437 incidences of anal cancer and 5,637 of oropharyngeal cancer, 515 instances of penile cancer and 180,000 instances of genital warts. Rates of HPV-related cancers are on the rise in the UK. Throat cancer has overtaken cervical cancer as the leading HPV-related cancer. I am pleased that the JCVI has accepted that there is an urgent need to review the clinical and economic case for extending the programme to adolescent boys and MSM.

I should like to put on record my thanks to my hon. Friend the Minister’s predecessor, my hon. Friend the Member for Broxtowe (Anna Soubry),for her support in this matter and for facilitating a teleconference, which she and I and representatives of the Terrence Higgins Trust had with the Chairman of the JCVI, which I believe gave some impetus to this change of heart and the speeding up of the work by the JCVI. That was a significant breakthrough.

The key point in this debate is that although the JCVI’s urgent report is due at some unspecified point later this year, the procurement of the next round of HPV vaccinations will commence in October or November this year. I am concerned that if the JCVI does not report in time and this procurement round is missed, we may have to wait four more years—I believe it is a four-year procurement round—before the HPV vaccination programme is extended to adolescent boys and MSM, if that is the recommendation.

Alison Seabeck (Plymouth, Moor View) (Lab): I congratulate the hon. Gentleman on bringing this subject to the House. I share his concerns. Is he also concerned that although the JCVI undoubtedly does some excellent work, it does not share the flexibilities of the National Institute for Health and Clinical Excellence, in terms of its medical and health assessment processes? Would he welcome some movement there, which might in turn help bring this vaccine forward more quickly?

Mike Freer: The hon. Lady makes a good point and speaks, probably, with more knowledge than I have. If NICE is able to react more swiftly than the JCVI, I am

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sure that my hon. Friend the Minister will take that point away and consider whether the two organisations could share best practice. Clearly, as new drugs come on the market and new issues arise, we must ensure that the health advisers are able to respond quickly to changes.

The key point I was making is that if we miss the procurement window, and if we have to wait four more years, boys and the MSM community would be unnecessarily exposed to HPV-related cancers. There is not just a personal cost to those who become exposed to HPV-related cancers: the NHS would be exposed to treatment costs that might be mitigated or avoided if we get the JCVI to report in time for the procurement round later this year.

If we look at the costs, we can start to see the scale of the savings. To put that into perspective, the three-dose HPV vaccination programme currently costs some £260. I understand that the JCVI is also considering whether that may be reduced to a two-dose vaccination, which would reduce the outlay. Let us compare that with the £13,000 cost per patient of treating anal cancer, the £11,500 cost per patient of treating penile cancer, the £15,000 cost per patient of treating oropharyngeal cancer, or the £13,600 cost per patient of treating vulvar and vaginal cancer transmitted by an infected male. In 2010, the total cost to the NHS of treating genital warts was £52.4 million. If we multiply those figures by four, we can see the clear economic benefits of bringing forward the decision to coincide with the next procurement round.

The clinical reasons and the economic benefits are evident, and I hope that my hon. Friend the Minister will confirm today that, at best, the JCVI will be able to report in time for the procurement round later this year or, at worst, that any contract procured later this year will have flexibility built in to allow the Minister and the Department of Health to extend the vaccination programme to adolescent boys and MSM at some point after the report.

11.12 am

Pauline Latham (Mid Derbyshire) (Con): It is a delight to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend the Member for Finchley and Golders Green (Mike Freer) on securing this important debate.

I wish to change the subject and address meningitis B. A vaccine is available, and the Minister and the Department have decided that it is not cost-effective. I wonder what costs they have taken into account. Was it the lifelong costs of looking after a child such as my constituent Isabelle, who contracted meningitis B when she was seven years old? Isabelle was given a 0.7% chance of survival. She survived, but she had to have both her arms and both her legs amputated. She is the most amazing little girl. She is so bubbly, so bright and so cheerful given what she has to deal with, but there is the cost to the NHS, the cost of education and the cost of continuing care for the rest of her life—she is now 10 years old. She has to have four sets of legs and two sets of arms, which change regularly and cost thousands of pounds each. She has to have two wheelchairs, one portable and one mechanical, because she cannot walk far.

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Isabelle has to have continuing care in school. Someone has to sit with her in classes because, clearly, there are things that she cannot do. She cannot easily carry her books from class to class, for instance, and she will need such care not just for the rest of her school and university life but for the rest of her working life, because she will be limited in what she is able to do.

Isabelle is the most amazing child that I have ever come across. She has come through such terrible circumstances. Her family had to make the awful decision that both her legs and both her arms had to be amputated. No parent should have to make that decision, and no child should have to live with that consequence for the rest of their life. She is not the only such child in this country; there are a lot of children in that situation with varying degrees of disability.

When the Minister reconsiders universal vaccination, will she bear it in mind that although it is expensive, the emotional costs of what Isabelle’s family went through outweigh that expense? The Minister should consider the matter in the round, not just the cost to the NHS of vaccinating every child. We should consider what vaccination is doing for the whole country in saving money and preventing parents from having to make such a terrible decision. It must have been agony for the parents, the child and the family to survive in that situation. Will the Minister reconsider what can be done to ensure universal vaccination against meningitis B?

11.15 am

The Parliamentary Under-Secretary of State for Health (Jane Ellison): It is a pleasure to serve under your chairmanship, Mr Gray.

I congratulate my hon. Friend the Member for Finchley and Golders Green (Mike Freer) on securing this debate and on again bringing this important subject before the House. He has been a great champion. I also congratulate my hon. Friend the Member for Mid Derbyshire (Pauline Latham) on raising another vital aspect of the Joint Committee on Vaccination and Immunisation’s work, to which I will also respond, albeit briefly.

It may help the House if I provide some background. The JCVI is an independent departmental expert committee, and it is a statutory body constituted to advise the Secretary of State for Health on the provision of vaccination and immunisation services. The committee and its invited experts represent some of the finest clinicians and academics in the UK and Europe, and all members are selected for their expert knowledge of matters concerning vaccination, immunisation and associated disciplines, including immunology, virology, bacteriology, paediatrics, general practice, public health and health economics.

We all recognise that the NHS budget is a finite resource. New vaccination programmes and extensions to existing programmes represent a significant cost to the health service in terms of both vaccine procurement and administration. Obviously, it is essential that any recommendations from the JCVI on changes to the national vaccination programme are supported by evidence of cost-effectiveness.

The JCVI has adopted a methodology for assessing cost-effectiveness that is in line with that used by the National Institute for Health and Clinical Excellence. Using those processes, the committee basically ensures

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that increased spending on immunisation does not result in an overall decrease in the health of the population because resources are diverted from more cost-effective health care interventions. We all recognise that those decisions are not easy.

My hon. Friend the Member for Mid Derbyshire makes a powerful case for the meningitis B vaccine, which the JCVI is currently reconsidering. The updated statement published on 25 October 2013 reflects the JCVI’s recognition of the burden and severity of meningococcal meningitis and septicaemia in the UK and the need to explore the potential for their prevention through immunisation. The situation is difficult when we have a new vaccine, in this case against meningitis B, but lack important evidence on its effectiveness. We need to know how well the vaccine will protect, how long it will protect for and whether it will stop the bacteria spreading from person to person. At the committee’s next meeting in February, if it feels it is in a position to make such a decision because it is in possession of all the relevant facts, the JCVI will make a final recommendation on whether meningitis B immunisation should be introduced. Obviously at that point we will carefully consider and respond to the recommendation. I hope my hon. Friend is reassured that the recommendation will get proper and careful attention.

On the issue raised by my hon. Friend the Member for Finchley and Golders Green, the primary aim of the UK’s national HPV vaccination programme, which began in 2008, is to prevent cervical cancer related to HPV infection. The HPV vaccine protects against two strains of HPV—16 and 18—that currently cause some 70% of cervical cancer.

As HPV is responsible for virtually all cases of cervical cancer, preventing the disease is the major aim, but as my hon. Friend rightly says, HPV infection has been associated with other cancers including cancer of the penis and anus, and some cancers of the head and neck. The precise proportion of those diseases that can be attributed to HPV infection is less well defined, but evidence is emerging all the time, so HPV infection should be taken seriously.

Evidence from clinical trials demonstrates that the HPV vaccine has a very high efficacy against the precursors of cervical cancer. Evidence of efficacy against cancers at other sites is emerging, and it is recognised that the current programme may therefore provide protection against a wider range of HPV-related cancers in females and, indirectly, in males than originally envisaged.

It is also worth saying that the UK’s HPV vaccination programme has been a considerable success, with this country having some of the highest coverage in the world—something we can be very proud of. A recently published study by Public Health England provided new evidence that the programme is successfully preventing HPV infections in young women in England, and that adds to our confidence that the programme can achieve its aim of reducing cervical cancer.

With a high uptake of HPV vaccination among girls, transmission of HPV between girls and boys should, as my hon. Friend said, be substantially lowered. Many boys will be protected against HPV infection and will, therefore, be at reduced risk of developing the related cancers we have spoken about, such as anal, head and neck cancers. However, I appreciate that he is particularly concerned that the current programme does not extend

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to men who have sex with men. He argued strongly that that is an apparent health inequality, and he raised the issue with my predecessor in last July’s debate, for which I was present.

As my hon. Friend will know, the JCVI has recognised that, under the current programme, the protection that accrues from reduced HPV transmission from vaccinated girls may not extend to men who have sex with men. He made the additional point about men who might have sex with girls and women from elsewhere who have not been subject to the broad coverage provided by our programme.

That is why, in October 2013, the JCVI agreed to set up a sub-committee on HPV vaccination to assess, among other issues, the question of extending the programme to MSM, adolescent boys or both. The JCVI therefore recognises the issue as a priority, and I congratulate my hon. Friend on championing it, because the attention it received in Parliament was obviously part of the reason it was given a fresh look and is regarded as a priority. I know the JCVI took events in Parliament into account, and, indeed, my hon. Friend made his case directly.

The sub-committee will aim to identify and evaluate the full range of options for extending protection from HPV infection to men who have sex with men, and that will cover a range of settings, including genito-urinary medicine clinics. However, as my hon. Friend will be aware, GUM clinics may not be the best setting for offering vaccination, as those presenting may already have been exposed to infection, so their ability to benefit from vaccination will inevitably be limited.

The sub-committee is scheduled to meet for the first time on 20 January, when it will assess currently available scientific evidence and consider what further evidence is required to advise the JCVI on the suitability of possible changes to the HPV programme. For the reasons I outlined earlier, any proposals for the vaccination of additional groups will require supporting evidence to show that it would be a cost-effective use of NHS resources.

Public Health England has begun preliminary modelling to assess the impact and cost-effectiveness of vaccinating MSM, in anticipation of further guidance on the issue when the HPV sub-committee meets. Further work, to assess the impact and cost-effectiveness of vaccinating adolescent boys against HPV infection, is also planned, but it will take some time to do that important modelling, and I am conscious that that is one of the predominant concerns on my hon. Friend’s mind. These are complex issues, and the development of the evidence base and the mathematical models by PHE, as well as the deliberations of the JCVI itself, take time. However, that process and the time it takes ensure that we get important decisions right and that decisions are taken

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on the basis of the best evidence. We cannot, therefore, undertake to take decisions hurriedly, because they are big decisions with, potentially, big implications.

Should the JCVI recommend the targeted vaccination of MSM, flexibility around contracted volumes in the current vaccine contract may allow a programme to be undertaken without the need for a new round of vaccine procurement—the numbers involved are relatively small in the context of the existing programme—if additional vaccine was available from the manufacturer in the required quantities. We are therefore cautiously optimistic that we can accommodate targeted vaccination of MSM in the existing programme, were it to be recommended by the JCVI. I hope that is a little encouraging for my hon. Friend.

Vaccine supply contracts are let for as long a period as is considered appropriate, taking into account the timing of potential changes to JCVI advice, policy and market forces, as well as Government procurement guidance. Obviously, longer contracts can secure firm prices for a longer period and allow for more accurate budget planning. However, we are exploring the flexibility we have in existing contracts to align the window for the new contractual discussions with any potential recommendations by the JCVI, especially on the wider vaccination programme, were that what it recommended. We have not completed that work yet, but what I have seen so far leads me to conclude that we might be able to do something around the existing contract. We are looking at that to ensure we do not miss the window of opportunity, which my hon. Friend identified as a chief cause of concern.

In conclusion, this important work has yet to be completed. We have to get some clarity on the time lines. We cannot achieve one of the things my hon. Friend mentioned—bringing the work on the assessment forward—because we have to review the available evidence and fill in any gaps if further evidence is needed. A decision on the vaccination of adolescent boys will probably require the development of quite a complex model to determine whether vaccination would be cost-effective, because the numbers involved are large. Such a model may identify a need to generate additional evidence, so a decision on that wider programme is not likely before 2015. However, as I said, the evidence to support a decision on a selective programme to target men who have sex with men may become available during 2014.

I can certainly give my hon. Friend the commitment that I will keep under careful review the timetable for key decisions when the committee makes its assessment and look at how they align with what we know about the flexibility we have under the procurement contract. We will keep that under careful consideration. I conclude by congratulating him again on bringing this important issue before us and on continuing to keep it on the Government’s agenda.

11.26 am

Sitting suspended.

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Health Care (London)

[Mrs Anne Main in the Chair]

2.30 pm

Ms Karen Buck (Westminster North) (Lab): I am grateful for the opportunity to speak on the subject of the NHS in London, and delighted that so many colleagues from the four corners of London want to say something about the health service in their areas. I want to sketch out, with some specific reference to local issues, the momentous changes that are happening within London’s health care and the extent to which the Government have made necessary changes far more difficult to achieve than should have been the case. I fear the results.

When I applied for this debate before Christmas, I did not know that I would spend a large part of the next two weeks experiencing the health care system with a close relative, who was admitted to hospital on Christmas day. We went through the whole process of ringing 111, of paramedics, of the ambulance, of A and E and of spending two weeks in St Mary’s hospital. I can confidently say two things on the basis of that experience. First, I have seen, and my relative has experienced, nothing but kind and efficient health care at St Mary’s and within the health care system in general. It is true that, over the years, there have been instances of the health care system falling far short of the standards that we expect, but it is also true that most health care professionals and auxiliaries are doing a stunningly good job for the people of London and the rest of England.

There is kindness and the effective delivery of health care everywhere we look in our health service. We must be careful not to succumb to the tendency—I see this too often from Government Members—to talk down the health service’s achievements. It is completely right that Sir Mike Richards of the Care Quality Commission said in his comments on the first wave of inspections that

“there are some very good hospitals in this country, and it is possible, within the NHS, to receive good, excellent, even outstanding care.”

Secondly, from my observations this past fortnight, I can say that the health service is under extraordinary pressure. One would expect not to have the level of staffing for the two-week period of Christmas and new year that one might have outside the holiday period, but it has been alarming to note instances of health care auxiliaries being two thirds below planned staffing levels and nursing being down by one third. Incidentally, I was also shocked to discover when talking to health care assistants that they sometimes work an 11-hour day for a £90 day rate, which is not the London living wage—it is the minimum wage. How can we expect people to provide the intensity and quality of care that we want when we do not pay them even the living wage? That causes me great concern.

Pulling back to the wider picture, as our experiences have demonstrated, the health service is under extraordinary pressure, particularly in the emergency service. Some of that is unsurprising in London, because the capital has the fastest-growing population and has had the fastest rise in the over-65 population of any region in the country. It also has the highest demands on mental

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health care services and an overwhelming concentration of rarer and more difficult conditions, including tuberculosis, which places particular pressures on London.

Unsurprisingly, those facts are showing themselves in A and E attendance and waiting times. Just before Christmas, the London assembly found that more than half of London’s A and E departments failed to meet their waiting time targets for more than half of last year. Across the capital, Londoners had to wait for more than four hours on 202,000 separate occasions. A and E attendance has soared in London since 2010 and is up by 47% at St George’s hospital in Tooting, 46% at St Bartholomew’s Hospital, 33% at West Middlesex university hospital and 35% at Hillingdon hospital. For my own Imperial College Healthcare NHS Trust, even a relatively modest increase of 19% equates to an extra 44,812 people seen last year compared with 2010. Cancelled operations were running at a 12-year high even before the winter, owing to pressure on hospital beds. One London hospital, Barts, topped the national list with 649 elective operations cancelled in the first half of last year.

Vacancy rates are a particular concern in London. Regionally, 11% of nursing posts are vacant, compared with a national average of 6%. At some London trusts, the rate is more than 20%. The regional total represents more than 6,000 vacant nursing posts in London. The Royal College of Nursing, which kindly briefed me for this debate, says:

“Our worry is that the hard work of some trusts in protecting posts is being undermined by a lack of available, suitably qualified nurses to take vacant positions, raising obvious questions about whether training is being commissioned at the level needed.”

Given that pressure, it is beyond dispute that there is a need to carry on changing how health care is delivered, which we all accept and have accepted for many years. The broad principles mapped out by Lord Darzi in 2007, which were not new, proposed a greater concentration of high-level surgical services to save lives, and better community and primary services to reduce unnecessary admissions and enable speedy hospital discharge. Both the demand side of the equation, which is driven by an ageing population and the challenge of chronic conditions, and the delivery side, which utilises the opportunities of new drugs and surgical techniques, push us to the same conclusion. There is clear agreement in principle that we need to carry on with the changes.

The central thrust of my argument, which will be echoed by colleagues, is that managing change of that scale requires that essential preconditions are met. Those preconditions are, however, not being met at the moment, and in some cases the means of delivering them are going into reverse. First—all are important, but this is the first—there must be public confidence in the process, and that confidence is so catastrophically lacking.

Labour colleagues who are facing the closure or downgrading of their A and Es will know what their own communities are telling them, which is that closing A and E units in the midst of an A and E crisis is utterly perverse and should not happen until and unless trusted alternatives are in place. In that context, clause 118 of the Care Bill confirms everyone’s worst fears, because, having failed to win public confidence in London and other parts of the country, Ministers want to give powers to special administrators to override local opposition.

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Dame Joan Ruddock (Lewisham, Deptford) (Lab): I am most grateful to my hon. Friend for giving way, and I congratulate her on her brilliant speech, which hon. Members understand from our experiences.

If clause 118 of the Care Bill goes through, every hospital and potential patient in the country will be faced with a situation in which no regard is given to clinical standards or clinical needs. The service will be based entirely upon accountancy. That is what the challenge was in Lewisham hospital. That was what was overturned. The people who knew about it—the consultants, the patients and the commissioning groups—all utterly opposed the trust special administrator proposals. We were right and we won the case. With the new powers, however, all that would be set aside and no one would be heard.

Mrs Anne Main (in the Chair): Order. Before I call Ms Buck, I ask that interventions are brief. There will be time to make contributions later. This is a well attended debate and many Members have asked to speak.

Ms Buck: My right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) is completely correct. Lewisham hospital brilliantly exemplifies the argument.

Secondly, there must be effective partnership working between hospitals, primary care providers and local authorities in the delivery of services. It was the failure even to inform partners that elective surgery had already moved from St Mary’s hospital to Charing Cross hospital that prompted my debate some weeks ago, to which the Minister replied, and which subsequently prompted an apology for the breakdown in communication. That was not only a matter of leaving someone off an e-mail circulation list, but a complete unwillingness to collaborate even within the national health service, let alone with outside bodies such as the local council, which is responsible for social care delivery.

Furthermore, those three boroughs—Kensington, Westminster and Hammersmith—are part of a pilot scheme to demonstrate integration, yet what happened in the relationship between the Imperial College trust and those local authorities could not have been further from integration—it was like something written for a comedy sketch.

Even worse, fundamental confusion remains about how north-west London hospitals are to be configured with Hammersmith—my hon. Friend the Member for Hammersmith (Mr Slaughter) is in his place and I am sure will comment—which has a different spin on its hospital provision from Westminster, even though they are joined in a tri-borough arrangement. Even after the Secretary of State has blessed the restructuring of west London hospitals, just weeks before Imperial concludes its outline business case, we cannot even have a clear agreement on the status of Charing Cross hospital or, by extension, of St Mary’s. That goes to the very heart of whether we can have confidence in the new structure of the national health service.

Thirdly, everyone needs to keep focused on the key issues, and that takes me to the devastating impact of the Government’s ill-considered reforms on the strategic management of London’s health service. The service should be focused like a laser on delivering the vision

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set out by Lord Darzi, but instead it has been fragmented, diverted and injected with rules on competition when integration should be the key objective.

The King’s Fund report of only some months ago, “Leading health care in London”, stated that the recent NHS reorganisation and the abolition of strategic health authorities and primary care trusts have resulted in an “absence” of health care system leadership in London. The report states:

“The NHS reforms have created a much larger number of organisations in London and their purposes are not always well aligned; the risks of incoherence and inconsistency are high…Reorganising the NHS in London in such a fundamental way has made a challenging situation much more difficult”.

That is so significant that the country’s top emergency doctor has said that the current A and E crisis could have been averted two years ago had the Government heeded warnings of a looming collapse in casualty ward staffing.

The president of the College of Emergency Medicine has said that Ministers and health chiefs were “tied in knots” by the challenges of implementing the coalition’s health reforms from 2011 onwards, leading them to ignore the first warnings from the college of imminent crisis—that the NHS was failing to recruit enough A and E doctors. Therefore, London, which possibly has the most complex challenges and the greatest need for integrated strategic leadership, actually has the least such leadership. Had leading health care managers and professionals been able to concentrate on dealing with such tasks, we might have had some opportunity to build public confidence, carry people with us and make the changes. In fact, the exact reverse has happened.

Finally, we need community and social care and other support services that minimise unnecessary admissions, especially for chronic conditions, and facilitate early discharge. Again, we can all agree on the principle. There are some excellent specific examples of integrated practice and of people working hard to deliver it, but there are also some harsh truths of individual experiences and the funding of social care.

The reality is illustrated in letters from my constituents in response to the moving of elective surgery from St Mary’s. One letter states:

“When I had my mastectomy I was sent to Charing Cross Hosp. After the operation I went home by bus and underground holding my drainage…bottle…from my operated breast. In the same way I travelled after my cardiac arrest on my second lumpectomy due to anaphylactic shock!”

That is only one hazard of putting patients with no family far from where they live. A second letter states:

“They took my City of Westminster Taxi card from me and so I have to pay for taxis to take me to St Marys Hospital and…Charing Cross. I pay £6.50 there and the same coming home (£26 one way to Charing Cross). I cannot walk far”—

—she is unable to use public transport—

“as I get out of breath. I am 84 this year”,

diabetic and

“have had one breast removed with cancer.”

Another constituent told me:

“I have lost my…home help”—

due to the cuts in social care—

“If I’m ill, I wait for it to go away.”

London as a whole faces a £1.14 billion shortfall in social care funding as a consequence of the pressures on adult social care and of the extra costs likely to arise because of the cap—in principle, that is a good thing,

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but obviously revenue is necessary to fund social care costs. That situation is London-wide and has been set out clearly in a London Councils report. My local authority also set the situation out clearly in a report to the health and wellbeing board, which states:

“As a result of reductions in local government funding Adult Social Care…has to deliver substantial savings in 2013/14”—

£4.4 million in Hammersmith and Fulham, £2.1 million in Kensington and Chelsea, and £2.9 million in Westminster. The report continues:

“These are very large savings; the cumulative effects are much bigger than any other savings programme delivered in the local authorities in the past.”

That is on top of £8 million in cuts to the adult social care budget already coming into effect since 2011. The report states:

“Amongst big reductions to back office and support functions, the savings programmes also include reductions in the use of packages and placements, the greatest area of spend for ASC.”

Rather sweetly, it adds:

“Some of the savings projects may be difficult to deliver or may take longer than anticipated.”

It continues:

“Funding growth for packages and placements arises mainly in the Learning Disabilities, Mental Health and the Young Disabled care groups where client numbers are growing, but also in Older People, as people live longer and are supported in the community.”

There is an important point. There is an integration care fund, which is shifting money from the NHS into social care, but, as Westminster council’s report on the pressures on social care funding states, that funding will mainly be used for purposes that include:

“To sustain services, otherwise at risk from savings plans”.

We are in an extraordinary position. There is a transformation fund designed to put in place the services that would allow us to make changes in hospital care, with which in principle we agree—we would argue in some specific cases—but that funding is simply going to fill the gaps caused by the cuts in social care, which are the result of cuts to local authority budgets. In London, as we know, there has been a 25% cut in local authority funding, with a further 10% cut as a result of the Chancellor’s autumn statement. Much of that new money is simply sustaining services that would otherwise be at risk from savings.

Heidi Alexander (Lewisham East) (Lab): Is my hon. Friend aware of the estimate made by London Councils for the future? Between 2016 and 2020, we might see adult social care departments facing budget pressures of £1.1 billion owing to rising demand and some of the changes proposed by the Government. Does she agree that the future looks extremely bleak?

Ms Buck: I agree totally. A thoughtful and planned process throughout London that would allow us to build up community and primary services, reduce unnecessary A and E admissions, speed up unnecessary discharges and concentrate some of our specialist services in fewer sites is sensible, but the means to realise it have been pulled out because of the pressures on social care funding. Furthermore, the strategic leadership that would allow us to make changes has been undermined by a completely unnecessary, £3-billion, top-down reorganisation that we were promised would not happen.

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Stephen Pound (Ealing North) (Lab): I entirely associate myself with the earlier comments about the quality of my hon. Friend’s address so far. She talks about trying to have a logical and sensible planning process. Is she aware that London boroughs such as Ealing, ably led by Councillor Julian Bell, have had to divert intense amounts of resources in order to oppose something that is the antithesis of good planning? That is an additional double whammy against responsible local authorities, which have to divert scarce resources and face up to a desperately uncertain future.

Ms Buck: I totally agree. Local authorities are on the front line of delivering the social care made necessary by some of the planned hospital changes and they are under pressure. The councils have expertise and knowledge and they are, as my hon. Friend says, sensibly involved in planning services, so they are making thoughtful objections when they see that services cannot be delivered as we want. Indeed, they have to divert resources in order to make the case on behalf of their populations.

In conclusion, London’s NHS continues to save lives and to provide the same quality of care it currently provides. That is a tribute to tens of thousands of men and women on the front line, whether in the NHS or employed directly by local authorities, but it owes absolutely nothing to a Government who have let us down with a change process that we should have been able to work through. They have done that by the way they have treated local authorities and by the way that, through this unnecessary reorganisation, they have diverted attention and resources from the leadership that could ensure that London’s health care is delivered in line with the wishes of Londoners. The Government have let down London’s patients and the men and women who deliver health care to them.

2.50 pm

Mark Field (Cities of London and Westminster) (Con): It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate the hon. Member for Westminster North (Ms Buck) on securing this valuable debate. Although her conclusion was perhaps a little more hyperbolic than mine would have been in the circumstances, we work closely together, along with her hon. Friend, the hon. Member for Hammersmith (Mr Slaughter), to do our best for all our constituents. Over the past year or so, as we have tried to put our constituents first, we have had concerns about elements of the negotiations on this matter.

For all the lively debate about health care provision here in the capital, there is one thing on which we can all agree, as the hon. Lady made clear in her contribution: the pressures on the national health service here in London are huge and getting bigger. They are set to increase substantially, not only because the population is ageing but because of the hypermobility and hyperdiversity of that population. In the past, that was perhaps typical of inner London alone, but it now applies to the entirety of the capital.

At times, the national health service can seem a little like a national religion, whose traditions must not be questioned under any circumstance. In my view, if one good thing has come from the terrible events in Mid Staffordshire, it is that we can perhaps start to have a more honest and less ideological debate about where

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the NHS is performing well, where it is letting people down and how it can better tackle the future challenges to which the hon. Member for Westminster North referred.

I have enormous respect for the Secretary of State for unashamedly refocusing the NHS around patients rather than protecting the sanctity of the system. Thankfully, the patient experience at some of our central London hospitals is, as the hon. Lady rightly pointed out, a world away from what happened in Mid Staffordshire. The diversity of population and the presence of top-flight medical schools and universities, particularly in central London, inevitably draw global talent to our local hospitals.

I am often staggered by the quality of facilities here, be it the state-of-the-art birthing unit in St Mary’s or the Royal London, the beautiful Maggie’s cancer centre at Charing Cross or the brand new oncology unit at Barts in my constituency. Only yesterday, a constituent wrote to me about his young nephew’s recent stint in hospital. He said:

“Given it seems it is ‘in vogue’ to be ‘anti-NHS’ I wanted to let you know that my recent experiences with the high dependency unit at Chelsea and Westminster Hospital”—

that hospital is outside my constituency, but obviously caters for a lot of my constituents in the south of Westminster—

“were nothing short of exemplary. I am sure that my nephew’s speedy recovery was probably all down to the standard of care he received.”

More often in my constituency it is non-emergency services that fail to be so patient-focused. Londoners are spoilt for choice in so many aspects of their lives, and as a result they have the idea that they should expect to get a full choice in everything. Why should they not expect a similar consumer-driven, flexible and responsive system when it comes to primary care—one that allows them swift access to a GP or provides small surgical procedures outside hospital?

We have read a lot in recent days about the number of non-emergency cases being presented at A and E departments. I think that that is in part due to the hassle factor associated with the existing GP system. With the hypermobility of population in London, many people never bother to register with a GP, and those who do all too often find that they cannot get an appointment for days or at a time that is convenient for someone with a busy working life. It is therefore often a perfectly logical decision for those people to spend a few hours in A and E, where they are at least guaranteed to be seen.

Thankfully the story is rapidly improving for my constituents. The Central London clinical commissioning group has just extended its seven-day GP opening service from three practices to five. People are able to walk in and book a same-day appointment at those practices. They do not have to be a member of the practice to use the service, and registration with their own GP will not be affected. I also know that plans are afoot to locate more GPs within hospitals in London. That type of modern and practical response really needs to be rolled out more widely.

There are problems with the health service in central London, which my colleague the hon. Member for Westminster North has so carefully outlined. My own

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constituency will hopefully be affected for the better by the huge changes to be brought in by the “Shaping a healthier future” programme. That programme began some five years ago to respond to the challenges of a rapidly increasing population and the variation we were seeing in the quality of acute care. It has caused most controversy in its proposals to close a number of A and E departments.

My constituents are grateful, as are the hon. Lady’s, that St Mary’s hospital in Paddington has been confirmed as one of five north-west London hospitals to provide advanced comprehensive acute care. I am assured that there is a strong business case for even greater investment on that site and exciting plans are afoot in that regard.

The Minister needs to be aware, however, that there have been issues of communication over the relocation of elective surgery, as was raised earlier. I accept much of the wisdom in the reconfiguration of services in north-west London to allow for specialist centres rather than having hospitals that are jacks of all trades.

I accept that that is easy for me to say, given that two local hospitals in my constituency, Chelsea and Westminster and St Mary’s Paddington, are not affected, and I know that the issue is a great concern for many Members, who are hearing such concerns from many constituents. But I suspect the perceived success or failure of any reorganisation of this sort will come down to smaller things: how well plans are communicated; how quickly alternative, out-of-hospital services are in place; and how transportation is organised for patients, many of whom are impoverished or will have to travel further and rely on public transport.

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): On the acceptability of reconfiguration, we should never forget that many communities in London have a strong emotional attachment to a hospital that could have been in existence in some shape or form since the middle ages. That is why reconfiguration must go forward carefully and on a purely medical basis if it is to succeed in London.

Mark Field: That is right to an extent. I know that the hon. Lady spoke in a debate that I led in the House almost a decade ago on Barts, which is located in my constituency and has a special place in the hearts of many millions of Londoners—and, indeed, of people throughout the United Kingdom. The truth is that at that juncture, the private finance initiative was the only funding game in town and we all went along with it, but that £1 billion PFI has now caused major financial issues that, I am afraid, affect not just Barts but hospitals right throughout the north-east of London, as the hon. Lady is well aware. We all feel a bit depressed about that knock-on effect.

We have to accept that in London, broadly speaking, we do pretty well as far as hospital care is concerned. Being absolutely candid with everyone, because I know what it is like, in central London we have a very good service, and it is partly outer London that suffers as a result. That is because of the strength of the links to which the hon. Member for Hackney North and Stoke Newington (Ms Abbott) rightly referred—the passion that we have for our historic hospitals—and the amount of resource that is pushed into central London because

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the hospitals there are teaching hospitals with consultants, former consultants and alumni who are willing to make a strong case for the existence of those hospitals. Dare I say it, that makes it easier to make the case for Barts than for a hospital out in Romford or Whipps Cross, or one in the hon. Lady’s constituency.

We all have to face those issues. They have not arisen as a result of the reorganisation of the past three and a half years; this has been the situation in the capital for probably 40 or 50 years. I am aware that even in the latest reconfiguration there has been a sense that central London has got off slightly better than the middle portion of outer western London.

I turn to finance. There was a good outcome before Christmas for north-west London on commissioning allocations, as all of our CCGs received an uplift to offset inflation. However, I want to raise concerns about the funding formula used to determine allocation. The formula fails to take into account the needs of the large homeless population in Westminster, which places massive pressure on acute services. Rough sleepers are far more likely to attend accident and emergency; they attend six times more often than any normal member of the population. They are admitted to hospital four times more often and stay in hospital three times as long.

The formula also ignores the fact that CCGs are responsible for all attendances at urgent care centres or walk-in centres and for the costs of patients covered by reciprocal funding arrangements with other countries. Westminster welcomes more than 1 million commuters and visitors each and every day, many of whom will need health advice and care while they are here. It is important that a future funding formula recognises the impact of that on local health care services.

The proposed formula will exclude spending on community care. That cannot be correct considering the important move to provide more high-quality care at home and in the community rather than simply in hospitals. I welcome the Government’s assurances that the Advisory Council of Resource Allocation formula will not be accepted in its current state and that changes to the funding of CCG will be fully consulted on in future.

I turn to public health spending. A draft formula for local authorities was set out in the “Healthy Lives, Healthy People” consultation, which was published on 14 June 2012 and recognised that further work was needed on adjustments for age, fixed costs and non-resident populations. However, initial modelling by London councils suggests that Westminster would have a drop of 57% in public health funding. Central London and Westminster have unique population characteristics that make it more difficult to make public health improvements. They include the age structure, with a greater focus on working age and children, and levels of mental health problems and homelessness. Those are not properly reflected in the current formula.

The formula also fails to take account of substance misuse services, many of which fall outside the pooled treatment budget, which focuses on opiates and crack treatment. It also ignores the wider health and local authority investment needed to manage the individual family and community impact of drugs and alcohol on health and well-being.

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Westminster experiences a high level of population churn—I accept that many other London boroughs are in that boat—and that leads to additional demands for services, including NHS checks and other screening programmes.

Glenda Jackson (Hampstead and Kilburn) (Lab): Will the hon. Gentleman give way?

Mark Field: Other hon. Members want to speak so, if the hon. Lady will forgive me, I will finish with a request to the Minister. I would welcome an indication from the Government of when we can expect more clarity on how future public health allocations will be determined. I would also appreciate confirmation that the formula consulted on in June 2012 will not be used to determine public health funding allocation in future.

Mrs Anne Main(in the Chair): I will call the Minister and shadow Opposition spokesman at 20 minutes to the hour. About five hon. Members want to speak. That means, bearing in mind time for interventions, about seven minutes for speeches. That is just a suggestion.