I ask the policing Minister to think about the open letter. The attempt to appease PCCs for threatening judicial review has not helped. Given the extent of the opposition, I ask that the Government go further than

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merely refining the proposals, and radically rethink them. These cuts are unsafe and unjust.

6.23 pm

Neil Coyle (Bermondsey and Old Southwark) (Lab): Despite the best efforts of Southwark police, my constituents are concerned about the cuts to the borough force and the loss of 200 officers since 2010. These cuts were made despite a concerted campaign by Councillor Michael Situ, cabinet member for communities and safety on Southwark Council, and my constituents are nervous at the prospect of a further cut of 25% or 40% to the borough’s resources.

Four particular groups of crime have been raised with me. The first is drugs and the antisocial behaviour relating to their use and sale. In parts of my constituency, there has been a rise in the visible use and sale of class A drugs. This is in central London. In particular, residents of Tissington Court, in Rotherhithe, feel that the police were unable, or lacked the resources, to tackle the regular sale and use of heroin within the block. Families felt unable to send their children up and down the stairwell because of the use of heroin and its impact in that stairwell, including the voiding of bowels there during the day. To get that issue resolved, it took an incredible amount of time, and a concerted effort on my part with the Rotherhithe councillors, who took it to the police along with the local tenants association.

There has been a lack of focus in the debate on business crime, although my hon. Friend the Member for Hove (Peter Kyle) raised the issue far more eloquently than I probably will. There are concerns that relate to businesses in my constituency. The rise in shoplifting has been raised with me by Tesco managers. Particular businesses have been targeted—for example, pub users have had their mobile phones stolen. We have seen a dramatic increase in commercial squatting across the constituency, which I raised with the Met commissioner. The Albion in Rotherhithe and The Elephant and Castle—unsurprisingly, located in Elephant and Castle—have been targeted. Even the Metropolitan police’s own building, the former forensic lab in Walworth, was squatted by about 80 people until it was emptied for sale.

My constituency has also seen a rise in commercial burglaries, particularly around Borough and Bermondsey, Long Lane and Tower Bridge Road. Cold Mountain Kit, next to my constituency office, was burgled on the day it opened. Businesses are losing profits and confidence when targeted in this way, as well as losing their stock and facing higher insurance costs. They also live in fear of repeat incidents in the face of cuts to our policing.

We have seen a drastic rise in street robbery, too. The South London Presscovered it just last week. A 46-year-old mum was mugged when picking her son up from school; a 70-year-old woman on Olney Road had gold jewellery stolen off her body; and an 85-year-old women was targeted for gold theft by muggers on Andrews Walk in a recent spate of incidents.

As other Members have mentioned, we have seen a dramatic rise in murders and knife crime in particular. It gives me no pride to say that Southwark has one of the highest murder rates in the capital. Knife crime has risen by 13% in England and Wales; and in 2013-14 only 16% of the knife crimes in Southwark led to charges being brought. I see that the hon. Member for Gower

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(Byron Davies) is back in his place, and he suggested that the police have the resources to deal with that. I think that is offensive to my local police force. With the track record of 16% of charges brought in cases of knife crime, the police clearly do not have the capacity to tackle that problem. Most recently, close to where I live in the constituency, 16-year-old Mohammed Dura Ray was murdered in a brutal knife crime on 14 September. His mum is desperate for answers and desperate for that terrible track record of solving knife crimes to be confronted.

Byron Davies: I did not say that the police had the resources; I said that they needed to use their resources properly—they need to be properly managed.

Neil Coyle: So the hon. Gentleman is suggesting that Southwark police are not using their resources properly. Brilliant! I thank him for that contribution.

I have met Mariama Kamara, the mother of Mohammed Dura Ray, and I am organising a knife amnesty in the constituency. The Prime Minister said he was unable to meet Mariama to discuss her concerns about policing locally. I hope that the Home Secretary or another Home Office would be willing to meet her.

The Minister for Policing, Crime and Criminal Justice (Mike Penning): I am naturally prepared to meet any constituents, so the hon. Gentleman could take that up with my private office, which is listening.

Neil Coyle: Fantastic. I am pleased to hear that news, and thank the Minister for jumping to his feet to make that assertion so quickly.

Residents tell me that visibility and trust are the key to local policing, as well as the key to both public and business confidence. That confidence is lacking. We have seen the closure of Rotherhithe police station and the change from safer neighbourhood teams to the cluster of five wards of PCSOs. That has taken officers off the streets, which has contributed to the rise in crime in particular areas. Trust is essential to effective policing, and PCSOs are some of the most trusted officers we have right on the frontline in our local communities. They are the most reflective and representative part of the Met police, and they are the ones most likely to face the cuts proposed in the comprehensive spending review.

In the face of rising crime and the prospect of what lies ahead, I ask Ministers to think what message they are sending to my constituents and local businesses if they continue along the course of cutting the numbers of police officers. In particular, I ask them what message they are sending to my constituent, Mariama Kamara, after the loss of her son. If the track record of local policing is not improved, her son’s death may never be solved.

6.29 pm

Anna Turley (Redcar) (Lab/Co-op): I feel privileged to speak in this debate because policing is one of the most important issues facing my constituents, many of whom feel besieged in their estates by low-level crime—well, I call it low level, but it makes people’s lives a misery. Antisocial behaviour and crime is devastating some of

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our communities. I was shocked to hear from the Home Secretary about the Government’s fantastic record, because for me and my constituents that record is one of broken promises.

Before coming to power, the Prime Minister promised to protect front-line policing, but he has cut 17,000 police officers. Even now, Conservative Members like to talk about the inheritance that they received in 2010, so I will take a few moments to speak about what they inherited. The Government inherited a record number of police—up by 17,000 from when we took office in 1997. They inherited a level of crime that was down by 43%, and the creation of police community support offers—I welcome the supportive comments from Members on both sides of the House about the great job done by PCSOs. Every single community had a neighbourhood policing team that was committed to spending 80% of its time on the beat, and to respond to non-emergency issues within 24 hours. They inherited a record of domestic violence that had fallen by more than 50%, and the reporting of rape had doubled. They inherited the first ever powers on antisocial behaviour and a guaranteed response within 24 hours, as well as the first ever national victims service. I am incredibly proud of the legacy that we left the Government, and disappointed to see them destroying it. Constituents such as mine are suffering.

Where are we now? In the last year, Redcar and Cleveland has seen a 77% increase in violence against the person, and a 25% increase in domestic burglary. There has been an 18% increase in criminal damage, and a 77% increase in sexual offences—a total overall increase in crime of 22%. That does not accord with the good news and rose-tinted spectacles on the Conservative Benches—[Interruption.] And the SNP Benches.

Since 2010, Cleveland has had an 18% cut to its policing budget, which means that it lost a quarter of its full-time officers and a third of its community support officers. Police officers in my constituency have not been replaced after being on long-term sick leave. People in my community are fed up with antisocial behaviour, and with people on bikes and horses running riot across their estates. They are fed up with arson on the Eston hills, and with cars being smashed in Roseberry Square. They are fed up with open drug deals and estates that are no-go areas. All that crime is a direct consequence of the lack of deterrent and visible policing on our streets, and that in turn is a direct consequence of the reduction in front-line officers and the disproportionate cuts that Cleveland police has received. That is deeply unjust because police officers in my area are committed, dedicated and brave, and we owe them a huge debt of gratitude. The very least we can do is ensure that they have the capacity and resource to do what we ask.

In the time I have left, let me raise two brief issues that I hope the Home Secretary and her team will consider. First, the continued short-term funding position that the police find themselves in is unsustainable. Being allocated funding in December each year for a financial year that starts only three months later is a poor way to run such a pivotal public service, and it inevitably leads to short-term thinking, reactive decision-making, and therefore not to the best outcomes. The police need a multi-year settlement that incorporates the best estimates, and takes into account comprehensive spending reviews, funding formulas and transitional arrangements.

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My second point is about the disproportionate impact of the cuts. Although police areas receive the same cuts in percentage terms, that does not equate to equal pain for all areas in either percentage or cash terms when it comes to overall funding. There is disproportionate demand in areas of high unemployment such as my constituency, and in areas of high vulnerability and disadvantage. I ask the Government to go away and think again, and in the meantime I am delighted to support the motion.

6.33 pm

Jack Dromey (Birmingham, Erdington) (Lab): Last night in Alum Rock in Birmingham, the shadow Home Secretary and I saw British neighbourhood policing at its best, and a community transformed from a troubled past to a safe place to live with a thriving economy. Why? Because of 10 years of the patient building of good community relationships, as well as outstanding neighbourhood police officers such as Inspector Chris Smith and Sergeant Ifti Ali, who both said, “We love the job”. Local residents and retailers were waxing lyrical about their relationship with their neighbourhood police officers—my hon. Friend the Member for Hove (Peter Kyle) was right about the importance of good neighbourhood policing to strong local economies.

My hon. Friend the Member for Redcar (Anna Turley) is right to say that one of the great legacies of the last Labour Government was neighbourhood policing. The Labour Government provided 17,000 more police officers and 16,000 PCSOs. They introduced local policing with local roots, giving people a local say and creating strong partnerships with the community and other key stakeholders. We were given evidence of that by my hon. Friends the Members for Bootle (Peter Dowd) and for Dewsbury (Paula Sherriff), both of whom made excellent speeches.

The Home Secretary has described the police as crime-fighters, but we have a wider vision than that. Policing is about preventing crime and diverting people from crime. That model is celebrated worldwide and is often celebrated in the House, but now, tragically, a generation of progress in the reduction of crime is being reversed.

The first duty of any Government is to maintain the safety and security of their citizens, but in the last five years this Government have made swingeing cuts. A total of 17,000 police officers have gone, which broke a promise given by the Home Secretary, and 4,500 PCSOs have gone as well. We have seen the progressive hollowing out of neighbourhood policing. Communities complain increasingly that there is no longer any visible presence of police officers, and they are right. There are profoundly worrying signs that the Government are ignoring repeated warnings, and that—in the words of a past president of the Association of Chief Police Officers, Sir Hugh Orde—the “tipping point” is now being reached. I shall say more about that later.

It seems that the Government are determined to blunder on regardless, oblivious to the consequences of their actions. As for the Chancellor, who gives hubris a bad name, he appears to be impervious to criticism as he presses forward with his ideological agenda to shrink the state. The cuts of between 25% and 40% that are currently being discussed will result in catastrophic

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consequences for our police service in the next five years; indeed, forces have warned that they could reduce the service to its lowest level since the 1970s.

These cuts are not just huge but unfair, as is clear from the fiasco of the funding formula. Only this Government could acknowledge that the current formula was opaque and unfair, and then, having made a complete mess of the consultative process, replace it with a formula that was opaque and unfair. That process has been described by Conservative police and crime commissioners as unjustified, deeply flawed and shambolic. It now faces a legal challenge, and the hon. Member for South Ribble (Seema Kennedy) admitted that it gave rise to concern.

I pay tribute to the way in which the police service has coped with immense difficulties in ever more difficult circumstances, but we are now talking about the cumulative impact of the last five years and what is proposed over the next five years. What will that mean? As we heard from my hon. Friend the Member for Manchester, Withington (Jeff Smith), it will mean the end of neighbourhood policing as we have known it. As we heard from my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), PCSOs are becoming an endangered species. And as we heard from my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley), we are seeing a return to a reactive and discredited model of policing, with Robocops touring estates in cars rather than engaging with the community.

The thin blue line is being stretched ever thinner. The police are ever more removed from the communities whom they serve, and fewer and fewer of them are struggling to do ever more. As cuts in public agencies bite ever harder, the demands on the police, as the force of last resort, are becoming ever greater. We have already seen some of the consequences. Chief constables talk increasingly of becoming a blue light service. In some forces, response times have gone up by 57%, and in a number of forces, police are no longer turning out to deal with reported crimes such as burglary.

The Government cannot say that they have not been warned. In recent weeks, we have heard a chorus of voices from London to Lancashire. Police officers have spoken out, and powerful contributions have been made to today’s debate by my hon. Friends the Members for Burnley (Julie Cooper), for Halifax (Holly Lynch), for Ealing Central and Acton (Dr Huq), and for Lancaster and Fleetwood (Cat Smith). The message is clear: the growing impact is serious, and will become ever more serious during the next stages of this process.

Thus far, the Government have sought to hide behind a false alibi. They say, “Yes, we cut police, but we cut crime as well.” It is true that, as is the case in the western world, volume crime is falling. We have also seen the benefits of a generation of good neighbourhood policing in reducing some crimes, but the statistics do not give a full picture. The latest ONS statistics show a 5% increase in police recorded crime, and increasingly as police recorded crime is cleaned up with more effective recording, we are seeing a 9% increase in knife crime, sexual crime up 12% and hate crime up 18%, but it is the crime survey of England and Wales that the Government repeatedly depend upon. The only problem is it does not reflect the full extent of rapidly growing fraud and cybercrime. It is now being said by the police—by the national co-ordinator for fraud—that

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as 5.1 million crimes are included from the first quarter of next year, the crime survey will show an increase of 40%.

This is the worst possible time to cut the police service, not just because fraud and cybercrime are rapidly growing—RBS has said by 40% a year—but also because of twin challenges. First, there is the generational threat of terrorism. Powerfully evidenced by Peter Clarke, former head of counter-terrorism, and Mark Rowley, the current head is the fact that neighbourhood policing is the eyes and ears of the police service engaging with local communities. I have seen the success of that in the west midlands, which I am proud to represent. Secondly, as my hon. Friend the Member for Halifax said—she is from a police family—there are the immense challenges of child sexual exploitation and abuse. There is a great national will that we act, and the police are doing so, but in the west midlands alone the size of the public protection unit has gone up from 300 officers to 800 and they are struggling to cope. So it is the worst possible time to cut the police service.

The evidence is clear: the Government are putting public safety and the vulnerable at risk. I have searched high and low in the manifestos of Conservative Members and I cannot find one of them saying to his or her community, “Vote for me and I will support the cutting of 22,000 police officers.”

The time has come for the Government to listen to the growing chorus of concern, including from within their own ranks. The Home Secretary’s own PCC, the delightful old Macmillanite, Anthony Stansfeld, says he just cannot get home to the Home Secretary or the Prime Minister, who also lives in the Thames valley area, just how serious the mounting consequences are of what their Government are doing.

The Government may be impervious to the mounting concerns and oblivious to the consequences of their actions, but Labour is not. Of course, as the shadow Home Secretary has said, sensible savings can be made. We identified that ourselves in terms of a national procurement strategy, which was rejected by the Government. Of course we need a sensible reform agenda. We need to raise standards, hold the police to the highest standards and root out wrongdoing. We also need greater diversity. The Home Secretary was right to challenge the police to rise to the challenge of greater diversity, but it is wrong then to make it nigh-on impossible for the police to do that because, effectively, most police forces cannot recruit to achieve it.

The Government have to stop blaming the police for things that the Government are responsible for. All over the country I meet police officers who say to me, time and again, “They never have a kind word to say about us.” That remorselessly negative tone, combined with the growing pressures, is seeing morale plummeting and sickness and stress leave soaring. The Policing Minister says on many occasions that somehow Labour are criticising the police; on the contrary, we are standing up for a police service that is under immense and growing pressures from his Government.

We are rooted in the communities we serve and we listen to the voices of the police and the public because, ultimately, this is about the kind of country we want to live in and the kind of police service we want. We want

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policing by consent, in the great tradition of Robert Peel. The British model of policing is the expression of British values. Tonight, all Members have the opportunity to search their conscience and decide whether to stand up for the British police service. We will vote to do precisely that. Our position is clear: Labour is the party of public safety, and the Tories are putting public safety and security at risk.

6.45 pm

The Minister for Policing, Crime and Criminal Justice (Mike Penning): We have had a really good debate, up until the last five minutes. I always stand up and say in public that I am proud to be the Minister responsible for the best police force in the world, so how the hon. Member for Birmingham, Erdington (Jack Dromey) can say that we never stand up for the police, I do not know. That was a strange thing to say. Colleagues who read Hansard tomorrow will see that Members on one side of the House have been supporting the police this afternoon and that those on the other side have been scaremongering yet again.

Thirty-four colleagues have made speeches this afternoon, and many of them have talked about the size of the police force. What I am interested in, as the Policing Minister, is how many police are on the frontline doing policing jobs. I am sure that other colleagues are interested in that, too. We are interested in how many warranted officers are out there. Her Majesty’s inspector of constabulary has said more than once that the size of the workforce gives no indication whatsoever of the quality of the service, and that it is the quality of the policing that matters.

We are still in the consultation, which, with the Home Secretary’s permission, we have extended so that more colleagues, police and crime commissioners and chief constables can have a say in the funding formula changes. The chief finance officer for Lancashire has said:

“We welcome the Government’s decision to fully review the police funding formula”.

Tony Lloyd, the police and crime commissioner for Greater Manchester, has said:

“I therefore urge you”—

presumably he means me and the Home Secretary—

“to commence the review as soon as possible.”

Several of my predecessors have spoken in the debate today, and in earlier debates, saying that chief constables and PCCs from the 43 police authorities for which we are responsible banged on their doors and said that the funding formula policy was opaque and not fit for purpose. That is why we have come forward with a new funding formula. I have said from the outset that there will be winners and losers, and that is true. We are still very much in listening mode, however. I am still in listening mode, and I would not do anything else, because if you have a consultation, that is exactly what you should do.

We have also heard extensively, particularly from Opposition Members, that crime is rising and that fraud has suddenly appeared in the statistics. Well, fraud has been out there for some time, but only one Government have had the courage to put cybercrime and fraud into the statistics—this one. We are leading the world by saying that crime is changing and that those crimes should appear in the statistics.

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The hon. Member for Birmingham, Erdington said that crimes such as sexual offences, fraud and domestic abuse were rising. As the Policing Minister, I am absolutely chuffed that people have the courage to come forward and report those crimes. The Office for National Statistics has said that the overall increase is likely to be due to the increased reporting of certain offences, such as fraud, sexual offences and domestic abuse. The ONS is not issuing a puff on behalf of the Government; it is saying what it thinks the rationale behind the figures is.

Any crime in any community is really difficult, but crime has fallen while we have reduced the funding for the police. That truly must be one of the most important things that we can look at. It is not so much about how much money you throw at the police. The previous Administration threw money at the police force over 13 years, but what did we get from that? Did we actually get warranted officers? We are now looking carefully at the funding formula. We will also make sure that we look very carefully at capabilities.

Keith Vaz (Leicester East) (Lab) rose

Mike Penning: I apologise to the Chairman of the Home Affairs Committee, but I have limited time. If I find time towards the end of my speech, I will give way, but I will not do so at the moment. [Interruption.] We would have had a lot more time if the shadow Minister had not kept on interrupting Back Benchers all the way through the debate, and Back Benchers would also have had more time to speak. I will just use my time, if I may.

One of the eminently important things to do is to make sure that the money we give to forces is spent correctly and that forces spend it. Our 43 authorities have £2.1 billion in reserves. I will not name and shame each individual force, but—at the end of the day, we are talking about money being tight, and there are real issues about forces wanting more money—hon. Members should take a close look at the forces that have £2.1 billion of taxpayers’ money sitting in reserves. They should take a look at how their local forces do procurement. They should go on to the Home Office website and look at how much their local force spends on body armour. For instance, why does one force spend nearly £300 more on body armour? All body armour has to be type-approved and it cannot be done on the cheap, so why is that the case? Why does one force have 100 warranted police officers not on operational duty because they are not fit? Some 10% of its operation force is not in. If they are not fit for duty, sadly—as when I was a fireman and was not fit for duty—they have to leave, because we need people on the frontline to do those jobs.

As was said by my colleagues on the Government Benches, when we look around the country, we can see forces that are doing exceptionally well in working with other blue-light organisations, particularly the fire service. We can look at Hampshire, which has been very well represented on the Government Benches during the debate. Hampshire has been enormously forward-thinking in what it has done. I have been to Winchester, where the brand new fire station happens to be in the police station. If one goes across the yard where the police and the fire service jointly train, one finds the police firearms unit at the bottom of the yard. That was a joint procurement, and it is a joint way of working. We need to see more of that, and we will.

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Mrs Drummond: Will the Minister give way?

Mike Penning: I will not give way at the moment.

Like Hampshire, other forces have real skills. I know the marine service in Hampshire does excellent work, and we need to look carefully at how it is funded in this difficult funding situation. Other forces around the country are starting to work with other blue light services. In Northamptonshire, the very forward-thinking PCC is not only bringing the fire service alongside the police, but is talking very closely to other blue light services, particularly the ambulance service.

In Hertfordshire, which is my own force, I have one of the best chief fire officers in the country. He must be, because just under 10 years ago he helped to put out Buncefield. He was the chief fire officer at Buncefield, which blew up half of my constituency. He is the chief executive of the PCC’s office, so he and the PCC can work closely together, keeping costs down and making sure that that approach is the way forward. We can see not only where that is starting to work, but how other forces can learn from the work being done in places such as Hampshire and Northamptonshire.

During the course of the debate, I did not want to interfere in Scottish National party Members’ little personal disagreements with Labour Members, but I thought that I might just help them a bit now. In an intervention earlier on, I think the lead spokesman for the SNP mentioned the effect that VAT is having. [Interruption.] Well, whichever SNP Member it was because, to be fair, one of them did. There was a bit of whingeing—that is what it is called in my part of the world—about VAT.

During the debate, I decided to take a look at why the Scottish nationalists are so worried about the fact that they cannot get their VAT refund. As they put their business plan together for combining the fire and police services in Scotland, including the savings they thought they would make, they took into consideration the fact that they would not be able to claim VAT back and would not get VAT refunds. I therefore find it strange that having done their business plan in 2012 and brought it in, they come to the House today to complain about the Chancellor not giving them their VAT refunds.

We heard a contribution from the Welsh nationalists earlier, with a lot of talk about the Silk commission and its recommendations as to whether or not policing should have been devolved. There was no agreement on the Silk commission by the political parties in Wales in respect of whether policing should be devolved. That is the situation. When they are trying to agree on what was going on, it is important that we get the facts absolutely correct.

As Members on both sides of the House have said, in the 21st century we need to make sure that the money of the taxpayers who send us here is spent correctly. We need to make sure that we continue to have the best police force in the world. We need to make sure that the public have trust in the police force in this country. It is imperative that the people elected to this House to represent their communities do not scare them with estimates of how many police they will lose, whether they will be attacked on the way home and whether there are different situations going on. Nobody knows exactly what the funding will be. Some Members have

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conflated the spending review, the funding formula, the chiefs looking at where co-operation can take place and whether some forces would like to amalgamate formally—I do not know whether that is the case, as no business plans are on my desk—or informally, as West Mercia and Warwickshire have done, very successfully. A lot more work could be done across the country, but we should not, as politicians, stand in Parliament and scare our constituents by saying that the police force in this country is going to collapse or that crime is dramatically rising, because it is not.

It is fundamentally wrong for an Opposition party to campaign against cuts and then for Opposition Members to come to this House to tell us that they would have a 10% cut—if people were stupid enough to elect them. That is seriously dangerous. As with their policy on PCCs, they have no policies. Vera Baird and Paddy Tipping clearly won the argument in the Labour party, saying that it should reverse its policy and there has been another huge U-turn on PCCs. Now the Opposition have said, with all their colleagues behind them, “The cuts the Tories have made over the last five years are terrible. They are massively affecting policing in our community. Oh, by the way, we will cut it by another 10%.” It is an absolutely ludicrous position. Anybody with any sense will not be going through the Lobby with the Labour party. The Scots Nats are not going to go through with the Labour party, and that tells me something.

Question put.

The House divided:

Ayes 214, Noes 343.

Division No. 109]

[

6.58 pm

AYES

Abbott, Ms Diane

Abrahams, Debbie

Alexander, Heidi

Ali, Rushanara

Allen, Mr Graham

Anderson, Mr David

Ashworth, Jonathan

Austin, Ian

Bailey, Mr Adrian

Barron, rh Kevin

Beckett, rh Margaret

Benn, rh Hilary

Berger, Luciana

Betts, Mr Clive

Blackman-Woods, Dr Roberta

Blenkinsop, Tom

Blomfield, Paul

Bradshaw, rh Mr Ben

Brake, rh Tom

Brennan, Kevin

Brown, Lyn

Brown, rh Mr Nicholas

Bryant, Chris

Buck, Ms Karen

Burden, Richard

Burgon, Richard

Burnham, rh Andy

Butler, Dawn

Byrne, rh Liam

Cadbury, Ruth

Campbell, rh Mr Alan

Campbell, Mr Ronnie

Carswell, Mr Douglas

Champion, Sarah

Chapman, Jenny

Clwyd, rh Ann

Coaker, Vernon

Coffey, Ann

Cooper, Julie

Cooper, rh Yvette

Corbyn, Jeremy

Cox, Jo

Coyle, Neil

Crausby, Mr David

Creagh, Mary

Creasy, Stella

Cruddas, Jon

Cryer, John

Cummins, Judith

Cunningham, Alex

Cunningham, Mr Jim

Dakin, Nic

Danczuk, Simon

David, Wayne

Davies, Geraint

Davies, Philip

De Piero, Gloria

Doughty, Stephen

Dowd, Jim

Dowd, Peter

Dromey, Jack

Durkan, Mark

Eagle, Ms Angela

Eagle, Maria

Efford, Clive

Elliott, Tom

Ellman, Mrs Louise

Esterson, Bill

Evans, Chris

Farrelly, Paul

Farron, Tim

Field, rh Frank

Fitzpatrick, Jim

Flello, Robert

Fletcher, Colleen

Flint, rh Caroline

Flynn, Paul

Fovargue, Yvonne

Gapes, Mike

Glass, Pat

Glindon, Mary

Godsiff, Mr Roger

Goodman, Helen

Green, Kate

Greenwood, Lilian

Greenwood, Margaret

Griffith, Nia

Haigh, Louise

Hamilton, Fabian

Harman, rh Ms Harriet

Harris, Carolyn

Hayes, Helen

Hayman, Sue

Healey, rh John

Hendrick, Mr Mark

Hepburn, Mr Stephen

Hodge, rh Dame Margaret

Hodgson, Mrs Sharon

Hoey, Kate

Hollern, Kate

Hopkins, Kelvin

Hunt, Tristram

Huq, Dr Rupa

Irranca-Davies, Huw

Johnson, rh Alan

Johnson, Diana

Jones, Gerald

Jones, Graham

Jones, Helen

Jones, Mr Kevan

Jones, Susan Elan

Kane, Mike

Kaufman, rh Sir Gerald

Keeley, Barbara

Kendall, Liz

Kinahan, Danny

Kinnock, Stephen

Kyle, Peter

Lammy, rh Mr David

Lavery, Ian

Leslie, Chris

Lewell-Buck, Mrs Emma

Lewis, Clive

Lewis, Mr Ivan

Long Bailey, Rebecca

Lucas, Caroline

Lynch, Holly

Madders, Justin

Mahmood, Mr Khalid

Mahmood, Shabana

Malhotra, Seema

Mann, John

Marris, Rob

Marsden, Mr Gordon

Maskell, Rachael

McCabe, Steve

McCarthy, Kerry

McDonald, Andy

McDonnell, John

McGovern, Alison

McInnes, Liz

McKinnell, Catherine

Meale, Sir Alan

Mearns, Ian

Miliband, rh Edward

Moon, Mrs Madeleine

Morden, Jessica

Morris, Grahame M.

Mulholland, Greg

Murray, Ian

Nandy, Lisa

Onn, Melanie

Onwurah, Chi

Osamor, Kate

Owen, Albert

Pearce, Teresa

Pennycook, Matthew

Perkins, Toby

Phillips, Jess

Phillipson, Bridget

Pound, Stephen

Pugh, John

Qureshi, Yasmin

Rayner, Angela

Reed, Mr Steve

Rees, Christina

Reynolds, Jonathan

Rimmer, Marie

Ritchie, Ms Margaret

Robinson, Mr Geoffrey

Rotheram, Steve

Ryan, rh Joan

Shah, Naz

Sharma, Mr Virendra

Sheerman, Mr Barry

Sherriff, Paula

Siddiq, Tulip

Skinner, Mr Dennis

Slaughter, Andy

Smeeth, Ruth

Smith, rh Mr Andrew

Smith, Angela

Smith, Cat

Smith, Jeff

Smith, Nick

Smith, Owen

Smyth, Karin

Spellar, rh Mr John

Starmer, Keir

Stevens, Jo

Streeting, Wes

Stringer, Graham

Tami, Mark

Thomas, Mr Gareth

Thomas-Symonds, Nick

Thornberry, Emily

Timms, rh Stephen

Trickett, Jon

Turley, Anna

Turner, Karl

Twigg, Derek

Twigg, Stephen

Umunna, Mr Chuka

Vaz, rh Keith

Vaz, Valerie

Watson, Mr Tom

West, Catherine

Whitehead, Dr Alan

Williams, Mr Mark

Wilson, Phil

Winnick, Mr David

Winterton, rh Ms Rosie

Wright, Mr Iain

Zeichner, Daniel

Tellers for the Ayes:

Vicky Foxcroft

and

Conor McGinn

NOES

Adams, Nigel

Afriyie, Adam

Aldous, Peter

Allan, Lucy

Allen, Heidi

Amess, Sir David

Ansell, Caroline

Argar, Edward

Arkless, Richard

Atkins, Victoria

Bacon, Mr Richard

Baker, Mr Steve

Baldwin, Harriett

Barclay, Stephen

Bardell, Hannah

Baron, Mr John

Barwell, Gavin

Bebb, Guto

Bellingham, Mr Henry

Benyon, Richard

Beresford, Sir Paul

Berry, Jake

Berry, James

Bingham, Andrew

Blackford, Ian

Blackman, Bob

Blackwood, Nicola

Blunt, Crispin

Boles, Nick

Bone, Mr Peter

Borwick, Victoria

Boswell, Philip

Bottomley, Sir Peter

Bradley, Karen

Brady, Mr Graham

Brazier, Mr Julian

Bridgen, Andrew

Brine, Steve

Brock, Deidre

Brokenshire, rh James

Bruce, Fiona

Buckland, Robert

Burns, rh Sir Simon

Burrowes, Mr David

Burt, rh Alistair

Cairns, Alun

Cameron, Dr Lisa

Carmichael, Neil

Cartlidge, James

Cash, Sir William

Caulfield, Maria

Chalk, Alex

Chapman, Douglas

Cherry, Joanna

Chishti, Rehman

Churchill, Jo

Clark, rh Greg

Clarke, rh Mr Kenneth

Cleverly, James

Clifton-Brown, Geoffrey

Coffey, Dr Thérèse

Collins, Damian

Colvile, Oliver

Costa, Alberto

Cowan, Ronnie

Cox, Mr Geoffrey

Crabb, rh Stephen

Crouch, Tracey

Davies, Byron

Davies, Chris

Davies, David T. C.

Davies, Glyn

Davies, Dr James

Davies, Mims

Davis, rh Mr David

Day, Martyn

Dinenage, Caroline

Djanogly, Mr Jonathan

Dodds, rh Mr Nigel

Donaldson, rh Mr Jeffrey M.

Donaldson, Stuart Blair

Donelan, Michelle

Dorries, Nadine

Double, Steve

Dowden, Oliver

Drax, Richard

Drummond, Mrs Flick

Duddridge, James

Duncan Smith, rh Mr Iain

Dunne, Mr Philip

Ellis, Michael

Ellison, Jane

Ellwood, Mr Tobias

Elphicke, Charlie

Eustice, George

Evans, Mr Nigel

Evennett, rh Mr David

Fabricant, Michael

Fellows, Marion

Fernandes, Suella

Field, rh Mark

Foster, Kevin

Frazer, Lucy

Freeman, George

Freer, Mike

Fuller, Richard

Fysh, Marcus

Gale, Sir Roger

Garnier, rh Sir Edward

Garnier, Mark

Gauke, Mr David

Gethins, Stephen

Ghani, Nusrat

Gibb, Mr Nick

Gillan, rh Mrs Cheryl

Glen, John

Goodwill, Mr Robert

Gove, rh Michael

Grady, Patrick

Graham, Richard

Grant, Mrs Helen

Grant, Peter

Gray, Mr James

Grayling, rh Chris

Green, Chris

Green, rh Damian

Greening, rh Justine

Griffiths, Andrew

Gummer, Ben

Gyimah, Mr Sam

Halfon, rh Robert

Hall, Luke

Hammond, Stephen

Hancock, rh Matthew

Hands, rh Greg

Harper, rh Mr Mark

Harrington, Richard

Harris, Rebecca

Hart, Simon

Haselhurst, rh Sir Alan

Heald, Sir Oliver

Heappey, James

Heaton-Harris, Chris

Heaton-Jones, Peter

Henderson, Gordon

Hendry, Drew

Herbert, rh Nick

Hinds, Damian

Hoare, Simon

Hollingbery, George

Hollinrake, Kevin

Hollobone, Mr Philip

Holloway, Mr Adam

Hopkins, Kris

Howarth, Sir Gerald

Howell, John

Howlett, Ben

Huddleston, Nigel

Hunt, rh Mr Jeremy

Hurd, Mr Nick

Jackson, Mr Stewart

James, Margot

Javid, rh Sajid

Jayawardena, Mr Ranil

Jenkin, Mr Bernard

Jenkyns, Andrea

Jenrick, Robert

Johnson, Boris

Johnson, Gareth

Johnson, Joseph

Jones, Andrew

Jones, rh Mr David

Jones, Mr Marcus

Kawczynski, Daniel

Kennedy, Seema

Kerevan, George

Kerr, Calum

Kirby, Simon

Knight, rh Sir Greg

Knight, Julian

Kwarteng, Kwasi

Lancaster, Mark

Latham, Pauline

Law, Chris

Leadsom, Andrea

Lee, Dr Phillip

Lefroy, Jeremy

Leigh, Sir Edward

Letwin, rh Mr Oliver

Lewis, Brandon

Lewis, rh Dr Julian

Liddell-Grainger, Mr Ian

Lilley, rh Mr Peter

Lopresti, Jack

Lord, Jonathan

Loughton, Tim

Lumley, Karen

Mackinlay, Craig

Mackintosh, David

Main, Mrs Anne

Mak, Mr Alan

Malthouse, Kit

Mann, Scott

Mathias, Dr Tania

May, rh Mrs Theresa

Maynard, Paul

Mc Nally, John

McCaig, Callum

McCartney, Jason

McCartney, Karl

McDonald, Stewart Malcolm

McDonald, Stuart C.

McGarry, Natalie

McLaughlin, Anne

McPartland, Stephen

Menzies, Mark

Mercer, Johnny

Merriman, Huw

Metcalfe, Stephen

Milling, Amanda

Mills, Nigel

Milton, rh Anne

Mitchell, rh Mr Andrew

Monaghan, Carol

Monaghan, Dr Paul

Morgan, rh Nicky

Morris, Anne Marie

Morris, David

Morris, James

Morton, Wendy

Mowat, David

Mullin, Roger

Mundell, rh David

Murrison, Dr Andrew

Neill, Robert

Newlands, Gavin

Newton, Sarah

Nicolson, John

Nokes, Caroline

Norman, Jesse

Nuttall, Mr David

O'Hara, Brendan

Offord, Dr Matthew

Oswald, Kirsten

Parish, Neil

Patel, rh Priti

Paterson, rh Mr Owen

Pawsey, Mark

Penning, rh Mike

Penrose, John

Percy, Andrew

Perry, Claire

Phillips, Stephen

Philp, Chris

Pincher, Christopher

Poulter, Dr Daniel

Pow, Rebecca

Prentis, Victoria

Prisk, Mr Mark

Pritchard, Mark

Pursglove, Tom

Quin, Jeremy

Quince, Will

Raab, Mr Dominic

Redwood, rh John

Rees-Mogg, Mr Jacob

Robertson, Mr Laurence

Robinson, Mary

Rosindell, Andrew

Rudd, rh Amber

Rutley, David

Sandbach, Antoinette

Scully, Paul

Selous, Andrew

Shannon, Jim

Shapps, rh Grant

Sharma, Alok

Shelbrooke, Alec

Simpson, David

Skidmore, Chris

Smith, Chloe

Smith, Henry

Smith, Julian

Smith, Royston

Soames, rh Sir Nicholas

Solloway, Amanda

Soubry, rh Anna

Spelman, rh Mrs Caroline

Spencer, Mark

Stephens, Chris

Stephenson, Andrew

Stewart, Bob

Stewart, Iain

Stewart, Rory

Streeter, Mr Gary

Stride, Mel

Stuart, Graham

Sturdy, Julian

Sunak, Rishi

Swayne, rh Mr Desmond

Swire, rh Mr Hugo

Syms, Mr Robert

Thewliss, Alison

Thomas, Derek

Thompson, Owen

Throup, Maggie

Timpson, Edward

Tolhurst, Kelly

Tomlinson, Justin

Tomlinson, Michael

Tracey, Craig

Tredinnick, David

Trevelyan, Mrs Anne-Marie

Truss, rh Elizabeth

Tugendhat, Tom

Turner, Mr Andrew

Tyrie, rh Mr Andrew

Vaizey, Mr Edward

Vara, Mr Shailesh

Vickers, Martin

Walker, Mr Charles

Walker, Mr Robin

Warman, Matt

Watkinson, Dame Angela

Weir, Mike

Wharton, James

Whately, Helen

Wheeler, Heather

White, Chris

Whiteford, Dr Eilidh

Whittaker, Craig

Whittingdale, rh Mr John

Wiggin, Bill

Williams, Craig

Williamson, rh Gavin

Wilson, Mr Rob

Wilson, Sammy

Wishart, Pete

Wollaston, Dr Sarah

Wood, Mike

Wragg, William

Wright, rh Jeremy

Zahawi, Nadhim

Tellers for the Noes:

Guy Opperman

and

Jackie Doyle-Price

Question accordingly negatived.

4 Nov 2015 : Column 1078

4 Nov 2015 : Column 1079

4 Nov 2015 : Column 1080

4 Nov 2015 : Column 1081

Lisa Nandy (Wigan) (Lab): On a point of order, Mr Speaker. I would be grateful for your advice. The House will be aware that last week a statutory instrument was passed upstairs in Committee that would allow surface-level drilling in national parks and areas of outstanding natural beauty for the purposes of what is commonly known as fracking. It is yet to be taken on the Floor of the House, but today the Government issued a consultation on this very subject on their departmental website, which at the very least causes considerable confusion, but at worst may supersede the statutory instrument itself. Have you received any indication from a member of the Treasury Bench or a Government Minister that they intend to make a statement on the subject to the House?

Mr Speaker: I am bound to say to the hon. Lady that I have received no such indication. To date, nothing disorderly has occurred and, as I understand it, the relevant regulation has not been passed. Whether the issue of the consultation paper is to the taste of the hon. Lady or others is a matter for her, but with regard to propriety and order, nothing improper or disorderly has occurred.

4 Nov 2015 : Column 1082

I must answer factually that, as of now, I have received no such indication, although what might be thought to be a request for such a statement will have been heard on the Treasury Bench. I thank the shadow Secretary of State for what she has said.

Business without Debate

Public Accounts Commission

Ordered,

That Mr Richard Bacon, Deidre Brock, Mr Nicholas Brown, James Cartlidge, Sir Edward Leigh, Ian Murray and Mr Andrew Tyrie be appointed, and that Stella Creasy and John Pugh be discharged as members of the Public Accounts Commission under section 2(2)(c) of the National Audit Act 1983.—(Chris Grayling.)

European Union Documents

Motion made, and Question put forthwith (Standing Order No. 119(11)),

EU Merger Control

That this House takes note of European Union Document No. 11976/14, a Commission White Paper: Towards more effective EU merger control, and Addenda 1 to 3; and supports the Government’s approach of questioning the proposal to widen scope of the EU Merger Regime (EUMR) to include acquisitions of non-controlling minority shareholdings, given that the evidence does not suggest it is justified.—(George Hollingbery.)

Question agreed to.

Delegated Legislation (committees)

Ordered,

That the Prison and Young Offender Institution (Amendment) Rules 2015 (S.I., 2015, No. 1638), be referred to a Delegated Legislation Committee.—(George Hollingbery.)

petition

Parking Restrictions in Scunthorpe

7.15 pm

Nic Dakin (Scunthorpe) (Lab): The petition is from constituents who have been affected by the changes in parking regulations that were brought about in order to address one problem and have created another problem for the health and wellbeing of my constituents on Newland Drive.

The petition states:

The petition of residents of Scunthorpe County Constituency,

Declares their objections to the parking restrictions which have recently been imposed by North Lincolnshire Council on Newland Drive, Scunthorpe.

The petitioners therefore request that the House of Commons urges the Secretary of State for Communities and Local Government to request North Lincolnshire Council to review the new parking restrictions and the impact on local residents.

And the petitioners remain, etc.

[P001552]

4 Nov 2015 : Column 1083

Palliative Care

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

7.16 pm

Maria Caulfield (Lewes) (Con): I am pleased to have secured this debate tonight on the important topic of access to palliative care for those who are dying. There are three key reasons why this debate is so timely and so important. First, it follows hot on the heels of the assisted dying debate that we had here on 11 September. No matter how Members voted, there was cross-party support for the movement for better access to palliative care in this country. Secondly, it is an important subject because from my experience as a cancer nurse working in one of the best cancer units not only in the country but in Europe, I have seen at first hand the difference that good palliative care can make, not just to patients and their families at the time of death, but in the last few weeks and months, making patients’ lives as fulfilling as possible.

Thirdly, the debate is important and timely because it fits in with the discussion of the Access to Palliative Care Bill in the other place. That Bill aims to ensure that wherever people are in the country and whatever disease they are suffering from, palliative care services are available to them. It would put palliative care services into the mainstream for the many, not the few.

Nick Thomas-Symonds (Torfaen) (Lab): I congratulate the hon. Lady on securing this debate. Should we not see palliative care in its broadest sense, including medical care as well as social care? That co-ordinated approach could make end of life far more tolerable and would mean that people had to go into hospital to a far lesser extent.

Maria Caulfield: I agree, and I will highlight that point later in my speech.

For me, palliative care is about support and services that help to achieve a good death and underpin the care in someone’s final weeks and months of life. What happens now is that all too often the provision of palliative care is distributed on the basis not of need but of availability, and depends on the diagnosis, where the person is treated, and sometimes even their age, leading to a patchy and ineffective service. We heard during the Adjournment debate on Monday night about the impact of not having good bereavement services, which stays with relatives not just at the time someone dies but for years afterwards, and may never go away if they have had a bad experience.

This patchy service continues despite all the hard work in recent years reviewing palliative care provision across the country. As far back as 2008, an end-of-life care strategy was produced, and in 2011 the National Institute for Health and Care Excellence produced quality standards, yet palliative care services remain patchy. To highlight that further, let us look at a few more statistics.

Unfortunately, we know that 100% of us will die eventually, and that three quarters of those deaths will be expected. That means that three quarters of the population could benefit from palliative care, but currently only 48% of people who have palliative care needs receive palliative care support. Of the 500,000 deaths

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that occur in this country every year, 82.5% are among the over-65s, yet fewer than 15% of that group have access to palliative care. That tells us that those who need it most often have the hardest job accessing it. For older people, death is often seen as inevitable and not something that palliative care should be helping with.

More shockingly, between 50% and 70% of people who are dying say they would like to die at home, but only 30% actually do. Most people end up dying in hospital—just over 50%. Hospitals are amazing places, but they are acute settings helping to deal with urgent and emergency cases. While they do need to do more to provide better palliative care, we need to invest in our excellent hospice movement and facilities so that if people want to die in a hospice, they can. We also need to support our community outreach programmes so that if people want to die at home, they can have that choice too.

Jim Shannon (Strangford) (DUP): The need for palliative care always comes at a time when people and their families are feeling vulnerable. The importance of charities and Churches at that time is something that we all know very well. The hon. Lady referred to hospice care groups and organisations. Does she agree that their role should be recognised more by Government and by the authorities so that they can take better advantage of hospice care and do better for those people through it?

Maria Caulfield: I thank the hon. Gentleman. I absolutely agree. That point is picked up in the Bill.

The most shocking statistic concerns the diseases that people are suffering from. The London School of Economics says that 92,000 people a year miss out on palliative care help. At the moment, 88% of our palliative care provision goes to people with cancer. As a cancer nurse, I am certainly not saying that that needs to be reduced, but the majority of deaths are due to other diseases. Only 29% of people die of cancer, with 28% of deaths due to heart disease, 15% due to respiratory illnesses, 10% due to stroke, not to mention Alzheimer’s disease, motor neurone disease and multiple sclerosis. Until we ensure that palliative care provision is mainstream, and not just for patients with cancer, the majority of people will be denied access to a good death.

The Bill introduced in the other place comes up with solutions to resolve this situation and place the responsibility firmly in the hands of local clinical commissioning groups to ensure that all patients, no matter where they want to die or what disease they have, will get access to palliative care services. That will take the pressure off existing acute facilities that are currently having to provide them. The Bill makes some key practical proposals. The first is about the ability to admit people directly to palliative care facilities. This happens really well in a lot of places, but it does not happen everywhere. That goes back to the point made by the hon. Member for Strangford (Jim Shannon) about investing in our hospices to ensure that it can happen more widely. The Bill talks about support for healthcare professionals in all settings, so that whether they are an intensive care unit nurse or someone who works with motor neurone disease, they have a signposted facility to access specialist palliative care that helps them to help patients manage their symptoms.

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The Bill fits very firmly into the Government’s seven-days-a-week NHS in calling for the availability of seven-days-a-week palliative care services. As I know only too well, it is at 4.30 pm on a Friday that a patient will phone up in pain and say they cannot cope, when pharmacies are closed and it is possible to get a prescription but not a drug. Someone who is breathless and needs a chest drain often has to wait until the Monday morning, in the meantime being admitted to A&E or a medical assessment unit and then finding it very difficult to be discharged to go home. This is why we need a seven-days-a-week palliative care service.

The Bill calls for some really basic things that should exist now but do not, such as sufficient equipment for our community services. It is unbelievable that a ward nurse who wants to discharge someone with a morphine pump cannot do so because the pump belongs to the hospital. Unless the community has a spare pump, that patient will not go home. That is why only 30% of people are dying at home—they are stuck in hospital because communities do not have the necessary equipment to look after patients. There are shortages of mattresses and feeding pumps, which would make a crucial difference if they were available.

Sarah Champion (Rotherham) (Lab): I congratulate the hon. Lady on calling this debate on such an important and often overlooked issue. I support what she is saying 100%, but does she agree that it is not just the NHS, the community and the charitable sector that need to join up? Joining up health and social care would enable the seamless transition she is talking about.

Maria Caulfield: Absolutely. I am touching on some of the Bill’s highlights, but we also need to incorporate social care, because that is often the kind of support that carers need in order to be able to look after relatives.

The Bill also highlights the fact that medication is not available at all times. I know only too well that if a patient’s pain needs to be better controlled, they can get a prescription but they cannot get the drugs on a Saturday or Sunday or during the night. Once again, they are admitted to A&E for help in managing their pain. That is not acceptable.

Practical solutions are available to enable people to choose where they want to die. I was disappointed by the response of Lord Prior of Brampton in the other place when he dismissed the Bill so easily by saying that we did not need to legislate for good palliative care. I strongly disagree. If we can legislate for a charter of budget responsibility, which I strongly supported because it is important for this country to run a surplus, and if we can legislate to freeze VAT and national insurance because that is also vital to this country, and to charge 5p for every carrier bag, why can we not legislate to provide good palliative care for every person who needs it?

I urge the Minister to consider the Access to Palliative Care Bill, which is currently going through the other place, as a way to improve access to palliative services and to support patients, families and NHS staff.

Mims Davies (Eastleigh) (Con): On legislation, does my hon. Friend agree that it gives us as individuals and

4 Nov 2015 : Column 1086

families the opportunity to start thinking about the unthinkable, to improve the process and to shape the palliative care we will want in the future?

Maria Caulfield: I completely agree with my hon. Friend. We need to make death a normal part of life, but until palliative care is available to everyone it will still be seen as something that happens in dark corners in hospitals, when it should be happening at home.

The NHS is supposed to be there from cradle to grave, but this country is not getting death right. People are going abroad to commit suicide because they cannot face a natural death. We are doing something fundamentally wrong. I therefore ask the Minister to consider legislating on access to palliative care. Years of reviews have not solved the problem. With 100% of us facing death, we need to ensure that end-of-life care is treated as a priority.

7.28 pm

The Parliamentary Under-Secretary of State for Health (Ben Gummer): I thank my hon. Friend the Member for Lewes (Maria Caulfield) for bringing this very important subject to the attention of the House and for doing so with her characteristic passion and verve. It has been a pleasure to answer her points in several previous debates. She has made her points with great clarity and it is with great pleasure that I will respond to every single one.

I will start where I finished on Monday night. This debate is timely, because it follows closely on that evening’s Adjournment debate, which was brought to the House by my hon. Friend the Member for Colchester (Will Quince) and to which other Members contributed with such great passion, interest and detailed knowledge. I firmly believe that, unless the NHS understands that the basis of care is not the end point of healthcare but a good in and of itself, we will not build a satisfactory foundation for the medical care that we hope is the experience of the majority in the NHS. For people for whom the end point is not recovery, but good and decent care, we must ensure that such care is embedded in the foundations of the NHS. If we do not, we will not provide a suitable foundation for good care throughout the system. That is why I see palliative care not as something that is nice to have—an added extra or a bonus within the NHS—but as something that is crucial to the delivery of good care throughout the system, whether or not people are likely to survive at the end of their care in hospital, in the community or at home.

I share my hon. Friend’s judgment of the debate on the Assisted Dying Bill, which I found fascinating. No matter where Members came from in that debate, what was clear was their wish to cherish, support and improve the palliative care services in our country and to ensure that people had access to the very best services not only in the UK, but in the world. That is where I will start my general remarks.

My hon. Friend is right to point out that the provision of palliative care is variable across the country, and I will turn to that in a second, but it is one of the areas that we should be very proud of, not least because of the dedicated work that people like her provide across the system in specialist settings and because of the unique gift that we have in this country of the hospice movement.

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That is why the Economist Intelligence Unit, only a few weeks ago, judged that this country had the finest palliative care in the world in terms of access to services and the quality of those services. I do not say that in order to say that there is nothing to do—quite the opposite. The Economist Intelligence Unit pointed out that there are examples of extraordinarily good care across the country. I want to ensure that the experience is not variable, and that no matter where one is in the country, one receives the finest care.

Where should one look? I will point to a few examples of where exceptional care is being provided. In Bedfordshire, Sue Ryder has brought together palliative care services across the county. There is a brilliant linking up of services, whether they be in the community, in hospital or at home. As my hon. Friend knows well, home can encompass care home settings and private homes. That is a beacon of good practice that has been brought together by an expert charitable institution.

The Airedale, Wharfedale and Craven clinical commissioning group has blazed a trail with its expertise in palliative care, particularly through its adoption of the gold line telephone number, which is used not just by clinicians, but by families. People are lucky if they need palliative care and live in the Airedale clinical commissioning group area, because they are likely to receive the very finest palliative care available anywhere in the world.

I know that my hon. Friend has experience of hospital palliative care as a cancer nurse at the Royal Marsden, where exceptional care is provided that is comparable to the best care anywhere in the world. She will also be familiar with the work that is done at Frimley Park, where there is a comprehensive palliative care programme that goes across the hospital and is not seen as a bolt-on extra. The John Radcliffe hospital in Oxford has a similar approach with similar ends.

Sarah Champion: The Minister is citing excellent examples, but does he agree with me—I think that this is the intention behind the debate—that we should not just have exceptional examples, but 24/7 care wherever people are and whatever their condition is?

Ben Gummer: I agree completely with the hon. Lady. I was just about to turn to the very useful intervention that she made earlier, in which she said that palliative care is a mark of the integration of the health and social care sectors. It is no coincidence that one often sees good palliative care where there is good integration of health and social care. In a sense, the state of palliative care is a proxy for where care is well integrated and where it is not. That is why it should be seen as part of the larger challenge of achieving successful integration, on which there is a good deal of cross-party agreement.

My hon. Friend the Member for Lewes mentioned the fact that many people do not die where they would choose. She will be aware of the Choices survey, which was launched by my predecessor in the coalition Government, the right hon. Member for North Norfolk (Norman Lamb). It has reported, and the Government have committed to replying to it. She can take that as an indication that there is policy to come, and that we will study carefully the things we have set up. We intend to ensure that people have greater access to the services they require to ensure that they can die where they wish.

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We made that commitment in our manifesto—we were very clear about it—and we intend to deliver on it, as we intend to deliver on the rest of our manifesto.

My hon. Friend was entirely right to point out that that will require changes in services where they are not good. That will require commitments on palliative care nurses and the spreading of training. They have been achieved in Airedale, but have not been achieved in other clinical commissioning groups, where care is sometimes significantly lacking. There is much to do in some areas of the country. If I may use Bevan’s words, it is about universalising the best. We know what the best looks like. We now need to ensure that we spread it across the rest of the country.

My hon. Friend was right that palliative care has, unfortunately, in some cases been associated with cancer care. That is not how it should be seen. She will be aware in great detail of the European Partnership for Action Against Cancer system, which is being used to ensure that cancer patients can indicate their wishes for the end of life. It can also help clinicians to manage that end-of-life period. The EPAAC system was originated and developed specifically for cancer patients, but we intend to roll it out for patients no matter what the cause of their death.

My hon. Friend mentioned the need to provide services 24 hours a day, seven days a week. Without wanting to state the obvious, that is one reason why we want to get a seven-day NHS working. When people need the NHS—whether they need medical attention that will save their life or pain relief that will mean that the end of their life is bearable—it cannot be right if treatment is deferred to a Monday because we do not have services available on Saturday and Sunday. That is the crux of what the Government are trying to achieve across our NHS reforms: we want to achieve a truly seven-day NHS.

Briefly, on the Bill introduced by Baroness Finlay in another place, I cannot disagree with the general sentiments of the proposal. The degree of variability that we have is obviously wrong and we must put it right. It should be right, in a sense, to say, “Let us legislate in order to make it so.” I have reservations about the Bill—I have made them clear to Baroness Finlay—but I should like to outline them to explain why I believe it may not achieve what it wants to achieve, and why, on a wider point, it might be counterproductive.

If enacted, the Bill would be the first instance in the history of the NHS that means we would make specific clinical demands on clinical commissioning groups about a specific clinical area. To take an analogy, we have not had a cancer services Bill that demands things of CCGs on cancer services. The Bill would therefore set a precedent, which requires very careful consideration. My current judgment, and that of the Secretary of State, is that we do not want to determine that demand from the centre in the manner in which Baroness Finlay wishes.

There are other instruments for achieving what Baroness Finlay wishes to do, such as the mandates to CCGs and to Health Education England. There are ways to achieve by similar means the same ends that she wishes to achieve, which is putting certain obligations on CCGs to ensure that they commission care in a way that we expect. We need to be careful about how we do it. Airedale is so good because it has come to that point by

4 Nov 2015 : Column 1089

itself and developed its approach organically. Other CCGs around the country have come to equally good solutions in a different way.

I would not want to impose a solution from the centre that squashes the local innovation of good leaders. I think we can all agree that the NHS in the past has not been good at allowing staff locally to celebrate leadership and innovation. There are lots of brilliant people in the NHS who have great ideas, but they do not feel empowered to bring them forward. We need to be careful, therefore, about imposing solutions from the centre, either from the Department, NHS England or this place, that do not recognise the ability of local people to come up with local solutions. I have told Baroness Finlay that I want to develop policies that do what she wants to do but not by the means she proposes. I hope to empower local people to get to where she wishes to go, and I hope to do so in a manner that celebrates success and exposes failure, so that we can put it right, and universalises the best as quickly as possible, without taking a top-down approach, which might have the contrary effect.

We are in a better position than other countries because of the remarkable work of charities and voluntary bodies over the last few years, and we have now accumulated a mountain of evidence from charitable groups and Government. My hon. Friend pointed to the 2011 NICE guidelines, but there were also the five priorities outlined last year in “Priorities of Care for the Dying Person”, and we now have the NHS Choices review, to which the Government will respond. We have enough paper evidence. We know what looks good, how to make it happen and that it needs to happen, and we know that many people die in circumstances that leave much to be desired. I

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point in particular to those who die in hospital. It is clear from the VOICES survey, which tracks the experience of families and individuals at the end of life, that people’s experience of dying at home and in community settings, especially in hospices, is generally much higher than in hospitals. Broadly—I generalise—half of people in hospital do not have an optimum experience of death.

We can change some things quite quickly, but we have got to this point because of the sustained effort over many years and the accumulation of evidence in a clinical area where Britain leads the world. I pay tribute to my hon. Friend and other colleagues with expertise in this area, to the many academics who have worked hard on this, and to the hard work of NHS England and its director of palliative care, Professor Bee Wee, who is a remarkable clinician. Over the next few years, as we fulfil our manifesto pledge, I hope that all parties can work together on this, calling on the experience of people from every part of the country—it was great to hear from the hon. Members for Torfaen (Nick Thomas-Symonds) and for Strangford (Jim Shannon), who shared their experience from other parts of the UK. If we can bring all this together, I think we can do something rather remarkable for people with no medical hope at the end of their life but to whom we should give the absolute guarantee that their care will be exceptional and will make what is never going to be a happy moment at least bearable and full of meaning for them, their families and their loved ones.

Question put and agreed to.

7.43 pm

House adjourned.