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House of Commons
Monday 9 May 2011
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
Violence Against Women and Girls
The Parliamentary Under-Secretary of State for the Home Department (Lynne Featherstone): The action plan on tackling violence against women and girls was published on 8 March this year, and we have already delivered in several areas. We have provided more than £28 million of stable Home Office funding until 2015 for local specialist services, £900,000 of which has been made available until 2015 to support national helplines, and we have implemented legislation on multi-agency domestic homicide reviews after every domestic murder.
Lynne Featherstone: My hon. Friend is right to highlight the importance of women’s refuges. The Home Office has sent out a loud and clear message to local authorities by ring-fencing stable funding of £28 million and by saying to them, “You should do the same. These are not soft targets.” It would be a great shame if Northampton council chose to ignore that message.
Jane Ellison: Further to the Minister’s reply, will she respond specifically on female genital mutilation, which is a significant problem in this country as well as in the developing world? The Metropolitan police are taking it very seriously, but hundreds of women in London alone present every year with appalling complications associated with pregnancy and childbirth. Can we make this matter a priority, and work with all the agencies and charities to eliminate this abominable practice?
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Lynne Featherstone: Hon. Members on both sides of the House will agree with my hon. Friend—female genital mutilation is a brutal act of child abuse. On 24 February, I launched new multi-agency practice guidelines to raise awareness of FGM. One important symptom that I imagine hon. Members and others do not know of is that girls can be absent when they go to the toilet for a long time—say, 30 minutes. It is important that teachers and nurses understand that, and that we all highlight such symptoms.
Bridget Phillipson (Houghton and Sunderland South) (Lab): Specialist police domestic violence units have saved lives and improved the way in which police forces handle domestic violence across their force areas. What pressure is the Minister bringing to bear across Government so that chief constables are encouraged to protect those vital front-line services?
Lynne Featherstone: The message we continually send to forces throughout the country is the importance of supporting the sector and taking action on domestic violence, and I hope chief constables are listening today.
Stephen Twigg (Liverpool, West Derby) (Lab/Co-op): May I press the Minister on domestic violence? I chair Chrysalis, the Liverpool domestic violence charity, and Merseyside police force is one of a number that have cut their domestic violence units. Will the Home Office intervene to ensure funding so that forces such as Merseyside can have domestic violence units?
Lynne Featherstone: The Government’s message is loud and clear, but, as I said, it is up to the local chief constable on the ground. I hope chief constables are listening to that important message, which the hon. Gentleman is right to raise.
Mr Elfyn Llwyd (Dwyfor Meirionnydd) (PC): Is the Minister aware of a campaign with which I am involved to introduce changes to the Protection From Harassment Act 1997 in respect of cyber-stalking? Many young women and girls are terrified by what is happening to them day after day and the law needs changing. Will the Minister meet a small group to discuss where the law is failing and where we need to put it right?
Lynne Featherstone: The Government recognise people’s concerns about the legal definition of stalking—cyber-stalking or stalking in other contexts—and about how the 1997 Act is applied. I am happy to meet the group that the right hon. Gentleman mentions.
The Secretary of State for the Home Department (Mrs Theresa May): The Police Reform and Social Responsibility Bill will establish directly elected police and crime commissioners in every police area in England and Wales. They will hold police forces to account on behalf of the public and so strengthen the vital link between the public and the police.
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Nadhim Zahawi: I thank my right hon. Friend for that answer. Given recent moves to ensure that actions are available to constituents when MPs commit wrongdoings, is such an option being considered in respect of elected police commissioners?
Mrs May: I assure my hon. Friend that any police and crime commissioner who is convicted of an imprisonable offence, regardless of whether they are sentenced to a term of imprisonment, will be disqualified from their post. I think that that answers his question.
Mrs May: Starting on Wednesday, when the House of Lords Committee stage of the Police Reform and Social Responsibility Bill begins, there will be proper and due consideration of every aspect of the Bill. However, it is our intention that police and crime commissioners will be introduced across England and Wales.
Tom Brake (Carshalton and Wallington) (LD): Accountability of police forces to the public is essential, but so are robust checks and balances to challenge the actions of any commissioner who exceeds their powers or seeks to interfere in operational policing matters. Will the Home Secretary consider seriously the request from the other place that the new accountability arrangements be piloted and the checks and balances strengthened?
Mrs May: As I said in response to the previous question, there will be proper and careful consideration of all these issues as the Bill goes through Committee and its further stages in the House of Lords. I am aware that issues have been raised about the police and crime panels and how they use properly the checks and balances in place to hold police and crime commissioners to account. It is our intention to introduce commissioners across England and Wales.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab): The Home Secretary will know that on the Bill’s Third Reading five weeks ago we called on the Government to stop and think about the plans for police and crime commissioners, given the deep concerns about the lack of checks and balances in this American-style reform, but she refused. She will have heard Liberal Democrat Front Benchers’ plea to listen. The Deputy Prime Minister has now said that he supports pilots first, his parliamentary aide said this morning that this is the key area, in addition to the NHS, on which Liberal Democrats want to see changes, and Liberal Democrat peers are proposing a two or three-year pause for proper pilots to take place. Will the Home Secretary tell the House whether she is indeed listening, and whether she will consider amending the Bill to introduce pilots first?
I have to tell the right hon. Lady, after that lengthy question, that I answered the point about our intention regarding pilots in response to the previous two questions. I gently remind her that this is not an idea of which we have no experience: the Labour
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Government made the Mayor of London responsible for overseeing the Metropolitan police and therefore acting as a pilot for police and crime commissioners.
Yvette Cooper: So this, it seems, is the Home Secretary’s answer to the Liberal Democrats: they have done a pilot and it was the Mayor of London. In fact, as she will know, the Mayor of London works under a completely different arrangement, and I am not sure that the Liberal Democrats will see that as the Prime Minister’s so-called listening mode. These American-style plans concentrate considerable policing power in the hands of one person without putting in place the proper checks and balances. They are opposed by crime and policing experts and are deeply illiberal and not very British. The Deputy Prime Minister says he wants to hear a louder Liberal Democrat voice. It sounds like they are shouting, but she is not listening. The so-called new business relationship is just business as usual: the Conservatives take the decisions, the Liberal Democrats take the blame.
Mrs May: It was a coalition agreement commitment that we would introduce directly elected individuals to oversee police forces and to hold them to account, and that there would be proper checks and balances. Far from there not being proper checks and balances, as the right hon. Lady suggests, the police and crime panels will provide real checks and balances to the police and crime commissioner. Perhaps she needs to speak to the shadow policing Minister, the hon. Member for Gedling (Vernon Coaker), who a couple of years ago said that
“only direct election, based on geographic constituencies, will deliver the strong connection to the public which is critical”.
The Minister for Immigration (Damian Green): The policy will be fully implemented by the end of 2012. From then on, the estimated reduction is about 70,000 main applicant visas a year, plus a further reduction in student dependants of about 20,000.
Damian Green: This is an important point because when we proposed this radical change the universities were understandably worried. Following our announcement, however, we have received overwhelmingly positive feedback from the university sector. Indeed, Universities UK has said that the reforms
“will allow British universities to remain at the forefront of international student recruitment.”
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economy, does the Minister agree with the Home Affairs Committee that students should not be counted within migration numbers?
Damian Green: The problem with the approach of the Home Affairs Committee, which, as the right hon. Gentleman knows, I always take very seriously, is that this is not my definition or the Government’s definition; it is an international United Nations definition that an immigrant is someone who moves to and settles in a country for more than a year. Any attempt to solve the immigration crisis that the Government inherited simply by changing the definitions would not be credible with the British public. People know that we have an immigration problem, and they want stern, robust action to be taken to solve it. That is what the Government are providing, and it is much more effective than changing definitions.
Robert Halfon (Harlow) (Con): Is the Minister aware that, according to a number of stories, in addition to bogus colleges, there are colleges that engage in corrupt practices such as asking students for money in return for certificates? Will the Government take steps to crack down on those colleges as well, as they are often licensed by the Home Office?
Damian Green: Indeed we will. My hon. Friend makes a good point. This is about not just bogus colleges colluding with bogus students but bogus colleges conning would-be genuine students, both of which need to be stamped out. In the past 12 months we have revoked 21 tier 4-sponsored licences and suspended more than 70. We are also increasing our enforcement activities to drive out the widespread abuses we have found.
Mr Gerry Sutcliffe (Bradford South) (Lab): The Home Secretary and the immigration Minister have told us that the policy of reducing the number of student visas is an integral part of their overall policy to reduce net migration by tens of thousands by 2015, but the reality is that the policy is in tatters. The Home Secretary and the Minister say that that is the policy, but the Business Secretary and the Lib Dems say that it is not. The Prime Minister said recently:
“No ifs, no buts. That’s a promise we made to the British people.”
Damian Green: I think there was a question in the middle of that. I am happy to assure the hon. Gentleman that we will of course meet our commitment to reduce net immigration to the tens of thousands by the end of this Parliament. If he is going to talk about confusion, he should talk to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), who said that immigration was coming down in the last years of the Labour Government, although the figures that we have published show that it was going up. The points-based system without a limit was not solving the immigration crisis that her Government created, and this Government are taking effective action across the board that will resolve the crisis that we inherited.
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The Minister for Policing and Criminal Justice (Nick Herbert): Reconnecting the police with the communities they serve is at the heart of our police reforms. Regular beat meetings and new local crime maps are already enabling communities to hold their local police to account. We will build on this through the introduction of police and crime commissioners, providing an even more visible and accountable link between the police and the public.
Christopher Pincher: Sir Robert Peel, who founded the police force and represented Tamworth, said that the police needed to ensure that they had public support to perform their duties. That is as true today as it was in the 1830s. Will my hon. Friend congratulate Staffordshire police on doing just that? By cutting their back office and reorganising their organisation, they have been able to ensure that front-line services are not cut.
Nick Herbert: I strongly agree with my hon. Friend. Staffordshire police is a very good example of a force that has taken the decision to make savings while protecting neighbourhood policing. In so doing, it is ensuring the continuation of that visible presence that the public value.
Mr Burley: Under the current system, only 7% of the public understand that they can approach a police authority if they are dissatisfied with the standard of service provided. Will my hon. Friend outline what he is doing to improve this democratic deficit in police governance and end Labour’s woeful legacy on police complaints?
Nick Herbert: I agree: we are strengthening the police complaints system, while also proposing to strengthen police accountability through a democratic reform. Police authorities are invisible to the public. That will change when directly elected police and crime commissioners are elected by the people who will be able to hold their force to account; at the same time, the operational independence of chief constables will be protected.
Kerry McCarthy (Bristol East) (Lab): The Minister will be aware that Avon and Somerset police have had a difficult job recently in having to police disturbances in the city of Bristol. What help can the Department give that force as it tries to rebuild relationships with the community? More particularly, the cost of the policing operation over the bank holiday period was astronomical, so will any help be available for the force to cope with it?
We of course support the action the police took to uphold the rule of law. I particularly want to pay tribute to officers who were injured: violence against anybody is unacceptable, but it is totally unacceptable when it is used against police officers, and
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I am sure that the whole House will wish to support the police in their action. There are established procedures whereby forces can apply if they have incurred exceptional costs, and I am sure this force will know how to do so.
Ms Karen Buck (Westminster North) (Lab): My borough has been privileged to have an outstanding team of safer neighbourhood sergeants, who provide consistent contact with local communities, yet we are told that it is those sergeants who are most likely to be cut as the number of London police is reduced. Will the Minister assure me that safer neighbourhood sergeants, who take the lead in local communities in bringing the police and the public together, will be protected?
Nick Herbert: The hon. Lady knows that these decisions are taken by the commissioner of the Met, the Metropolitan Police Authority and the Mayor, and the Mayor has said that he wishes to begin recruiting again to maintain officer numbers and to protect safer neighbourhood teams. The force proposes to share sergeants between some of the smaller boroughs; that is a matter for them as they seek to ensure value for money and to keep officers on the streets, where the public want to see them.
The Parliamentary Under-Secretary of State for the Home Department (James Brokenshire): Alongside our proposed reforms to police and partners’ powers to tackle antisocial behaviour, we plan to give communities the right to force agencies to take action where they have failed to do so. Elected police and crime commissioners, and street level crime maps, will also increase the focus on the issues that matter most to local people.
Caroline Nokes: I thank the Minister for that response, but seek assurances on what the Government are doing to help ensure that persistent antisocial behaviour is dealt with by local authorities, the police and other agencies, and in particular on how the Government plan to support existing schemes such as Test Valley borough council’s CREW—community respect and environment week—initiative.
Clearly, antisocial behaviour is, at its core, a local issue, so it lends itself to local solutions. As 10,000 incidents are reported every day, I doubt whether any Member will not have a constituency case
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that touches on the subject. The powers on which we are consulting until 17 May are very much about local communities and equipping local agencies to deal with the problems they see, trusting their judgment to get on with the job.
Julian Sturdy: Further to the Minister’s response, how will constituents in my York Outer constituency be able to use the proposed community triggers to force police authorities and local councils to tackle antisocial behaviour?
James Brokenshire: I am grateful to my hon. Friend for highlighting the proposal on which we are consulting, which aims to enable communities to ensure that the police and local councils come together to respond to complaints that perhaps are not being addressed effectively. This is a positive way to deliver action, responding to the problems of antisocial behaviour in communities. We think that this is an important reform and we propose to take it forward.
James Brokenshire: My hon. Friend makes his point very well. We have been working closely with the housing Minister to ensure stronger powers to evict those who are most responsible for antisocial behaviour on housing estates. There must be proper deterrents to ensure that relief is given to hard-pressed communities that are suffering as a result of such behaviour.
Brandon Lewis: The police in Great Yarmouth have done excellent work in preventing antisocial behaviour by early intervention with voluntary local groups such as the Kickz project. Does the Minister agree that such intervention can have a hugely beneficial impact, and will that be reflected in the new proposals?
James Brokenshire: I congratulate the communities in my hon. Friend’s constituency on the practical measures they are taking to prevent antisocial behaviour. When interventions, orders and sanctions are required, it is important that they can be obtained speedily. As that has not happened in the past, the need for the police and local authorities to be able to secure the orders they require quickly is at the core of our proposals.
Keith Vaz (Leicester East) (Lab): Fiona Pilkington and her daughter committed suicide after suffering years of abuse from youths in Leicestershire. As the Minister will recall, the inquest jury noted that they had contacted the police 33 times, but that no link had been made between the complaints that had been made. The Government are rightly examining police performance. Will the Minister assure the House that this issue will remain a priority? The only way of preventing such tragedies is to ensure an immediate and serious police response.
I agree very much with the right hon. Gentleman. We have taken practical measures with police forces around the country to ensure that when complaints are made issues of vulnerability and
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repeat calls are picked up quickly, and so that tragic cases such as that of Fiona Pilkington can be identified much more efficiently and effectively. The provision of that practical relief is an important part of the changes we are seeking.
Chris Bryant (Rhondda) (Lab): I am sorry, but all this talk about community triggers and community maps is just a load of guff. The South Wales police force area contains two large cities that have to be policed. A large number of royal occasions and sporting events have to be policed. The last problem to which any time is devoted, especially when major cuts are being made to the South Wales police budget, is antisocial behaviour in areas such as the Rhondda. What will the Minister do to ensure that the police are given the instructions they need to tackle the real problems that people face, and that there is money with which to tackle it?
James Brokenshire: I am glad that the hon. Gentleman got to the question in the end. I remind him again of our responsibility and of the problems the Labour party left us, because there is still no recognition of that. We are giving the police the power they need to respond to the problems in the hon. Gentleman’s community and the communities of other Members throughout the House.
Andrew Gwynne (Denton and Reddish) (Lab): The Minister wants to introduce some form of direct election to improve accountability in local policing. Is he listening to the people of Greater Manchester, where the Government’s cut of nearly 1,400 police officers, which would have a disastrous effect on the battle against antisocial behaviour, was rejected so resoundingly on 5 May?
James Brokenshire: Here is another hon. Member who is still in denial. We believe that the financial settlement is fair and manageable, and that it need not have an impact on the fight against crime and antisocial behaviour on our streets. We are giving the police and local authorities the powers they need to respond to the problem, and, unlike the Labour party, which failed to deal with it in so many ways, we are committed to taking action to provide relief for our communities.
Diana Johnson (Kingston upon Hull North) (Lab): Given that the proposed criminal protection injunctions will weaken the sanctions available to the courts to punish and deter those engaging in antisocial behaviour, is it not clear that, at least in this instance, the “soft on crime” Liberal Democrat voice is being heard loud and clear in the Home Office?
James Brokenshire: The hon. Lady is wrong on that point, and I remind her of what the victims commissioner, Louise Casey—the antisocial behaviour tsar under the previous Government—said when we launched our consultation on the new antisocial behaviour powers:
“I am heartened by the announcement of the new proposals today that put tough enforcement action against perpetrators at the centre.”
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Mr Mark Spencer (Sherwood) (Con): Nottinghamshire police have made good progress on antisocial behaviour over the past 12 months by getting police officers out from behind their desks and on to the streets, but does my hon. Friend agree that they are not assisted by being bound to their 25-year private finance initiative contract, signed by the previous Administration?
James Brokenshire: As my hon. Friend makes clear, a number of the PFI and other contracts that were entered into did not necessarily deliver good value for money. On the costs that fall locally, we are working with forces to identify savings in operational PFI projects, including the option of renegotiating contracts to ensure ongoing value for money and service to our community.
The Parliamentary Under-Secretary of State for the Home Department (James Brokenshire): We do not recognise cannabis in its raw form to have any medicinal purposes; cannabis is a harmful drug. However, Sativex, a cannabis-based medicine, has been approved by the Medicines and Healthcare products Regulatory Agency as a safe and effective medicine for patients with multiple sclerosis.
Paul Flynn: In Canada, Austria, Germany, the Netherlands, Finland, Italy, Israel, Spain, Portugal and parts of the United States, patients can take medicinal cannabis in its natural form safely and legally. Why are seriously ill patients in our country, particularly those suffering the symptoms of multiple sclerosis, forced to break the law when they want to use their medicine of choice?
James Brokenshire: The advice we have received from the Advisory Council on the Misuse of Drugs confirms that cannabis is a significant public health issue. I certainly sympathise with anyone suffering from a debilitating illness, but we do not condone any illicit drug taking, for whatever reason. As I have indicated, GPs may prescribe Sativex in the circumstances mentioned. That is available, and we are dealing with its regulation.
Mr David Burrowes (Enfield, Southgate) (Con): That is not the most significant medical issue in relation to cannabis. In its higher form in particular, there are significant risks to young people, such as the probable causal link to mental illness, especially psychosis and schizophrenia. Will the Minister reassure the House that the Government will continue to take a tough line and ensure effective enforcement of the law on possession of cannabis?
I know that my hon. Friend takes these issues incredibly seriously, and has focused on drugs policy for some time. I assure him that our position is that the classification of “illegality” can influence behaviour and be a meaningful factor when people are contemplating taking drugs. That is why we do not have any proposals to change the classification of cannabis, and why we place so much importance on
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the current legal arrangements in ensuring we reduce supply and deal with these problems. There is no change of policy.
Alcohol Sales (Children)
The Secretary of State for the Home Department (Mrs Theresa May): The Government do not tolerate the sale of alcohol to children. The Police Reform and Social Responsibility Bill will double the maximum fine from £10,000 to £20,000, delivering on a coalition agreement commitment, and will extend the minimum period of voluntary closure that can be given for persistent under-age sales. We are also committed to working with the Sentencing Council and the Crown Prosecution Service to prosecute those found guilty of persistent under-age selling and to use the full range of sentences available.
Dr Wollaston: In England alone, about 36 children every day are admitted to hospital as a result of alcohol-related harm. Will the Home Secretary consider making the reduction of alcohol-related harm an objective, and prioritise it in licensing decisions?
Mrs May: I am grateful to my hon. Friend for raising this issue, particularly given her experience as a general practitioner. I recognise the picture she paints, and I would add that half of all violent assaults are believed to be alcohol related, so there is a real issue with alcohol that we need to consider. We think there is merit in making health a material consideration under the Licensing Act 2003. The Police Reform and Social Responsibility Bill will make certain health bodies responsible authorities under the Act. We are talking to the Department of Health about what we might do to ensure that the health aspects of alcohol are properly taken into account.
The Secretary of State for the Home Department (Mrs Theresa May): I am grateful to my hon. Friend for raising this issue. Good progress has been made since CEOP commissioned its thematic assessment of localised grooming in January. A range of responses has been received from a variety of sources, including police forces, charities and local safeguarding children boards. Analysis of the data is ongoing and the final report is expected to be published in June.
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Margot James: I thank the Home Secretary for her answer. Whether or not CEOP forms a discrete part of the new national crime agency, what steps will be taken to work with mosques and Asian communities to make this organised exploitation of young girls culturally unacceptable?
Mrs May: My hon. Friend’s question enables me to say how strongly we support CEOP’s work. We want it to be a lead law enforcement body in protecting children nationally, so I am pleased to announce that it will form part of the new national crime agency and will continue to build on the work it is doing. In examining the issue of grooming, it is important to wait for CEOP’s thematic report, see the extent of this problem and, obviously, take CEOP’s advice on any action that needs to be taken in relation to particular communities, but I do not think we should see this as an issue that relates only to particular communities.
Mrs May: I thank the hon. Lady for raising this issue. I cannot give her an exact date, but fairly shortly we will be launching a consultation exercise in response to issues that have arisen concerning the sex offenders register. The question of online identities was raised in this House when I made the statement on the response to the F and Thomson case, and we are taking it on board, so I ask her to wait for that consultation.
Immigration and Asylum Law
12. Dr Julian Huppert (Cambridge) (LD): What her policy is on measures to ensure that children born overseas to unmarried male British citizens before 2006 are treated in a manner equivalent to those born after 2006. 
The Minister for Immigration (Damian Green): I am grateful to my hon. Friend for reminding the House of this odd hangover from previous legislation. Children born overseas to unmarried British fathers before July 2006 were unable to acquire citizenship by descent from their father. However, the UK Border Agency will register such people as British citizens if an application is made before their 18th birthday.
Dr Huppert: I thank the Minister for those comments. He was also sympathetic when my hon. Friend the Member for Carshalton and Wallington (Tom Brake) raised this matter two years ago. Will he seek a legislative opportunity to correct this situation by statute rather than rely on discretion, which may or may not be applied to children who may or may not be inside the country?
As I said, my hon. Friend makes a valid point. There is, however, an established registration route for children born to British unmarried fathers under section 3 of the British Nationality Act 1981, which allows the Home Secretary to register any child under the age of 18 as a British citizen, and this discretion has been used for many years. Of course those who are
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not able to register because they are over the age of 18 can instead naturalise as British citizens if they are resident in the UK and meet the requirements for naturalisation. As he says, any change to the nationality law would have to be made through primary legislation and there is no appropriate vehicle before the House at the moment.
Police (Regulation A19)
The Minister for Policing and Criminal Justice (Nick Herbert): Chief officers are responsible for managing the resources and staff available to them to ensure effective policing. Operational decisions, including on the impact of using their powers under regulation A19, are rightly a matter for them.
John Mann: What kind of answer is that? There is a seasonal saying at this time of year: “Cast not a clout till May be out.” Why are decent, hard-working, brilliant, experienced police officers in my area, in Nottinghamshire and across the country being forced to give up their jobs because of this Government, when my community and others want to keep them and when they want to keep working?
Nick Herbert: From the hon. Gentleman’s outrage, hon. Members would not know that under the previous Labour Government Nottinghamshire police numbers fell between 2004 and 2009. This is a procedure used by chief constables that the previous Labour Government chose to renew. The fact is that officers ordinarily retire after 30 years and they do so with a full and generous pension.
Anna Soubry (Broxtowe) (Con): I do not know whether the hon. Member for Bassetlaw (John Mann) has discussed this matter with the chief constable of Nottinghamshire, but I did on Friday. Does the Minister agree that it is imperative that when chief constables make these difficult decisions they should consult not only their communities but the Police Federation to ensure that we retain the best front-line officers?
Nick Herbert: I agree with my hon. Friend. Let me put this in context. I understand that some 130 of some 2,500 officers in the force may be retired under this provision. The independent Winsor review of pay and conditions recommended that this procedure should continue to be available to chief officers.
Vernon Coaker (Gedling) (Lab):
Approximately 2,000 police officers across the country with more than 30 years’ experience are being forced to retire under regulation A19 because of the 20% front-loaded cuts imposed by the Government. As we have heard from my hon. Friends, these include front-line beat officers, response officers, detectives and firearms specialists, although some, as we know, have been asked to return as volunteers. I want to ask the Minister a specific question: has he carried out an assessment of the cost implications for the Home Office, along with any other
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associated costs, of forcibly retiring these 2,000 experienced officers? Did any such assessment show that the cuts really were in the interests of the taxpayer?
Nick Herbert: I repeat to the hon. Gentleman that these decisions are made by chief constables in the interests of the efficiency and effectiveness of the force. This is a procedure that the previous Government chose not to change. The fact is that the total number of officers retiring with more than 30 years’ service who might be eligible for this procedure is about 3,000 of a total 140,000 officers. The question that the Labour party simply cannot answer is how it would have achieved the savings of more than £1 billion a year, which are the cuts it says it would have imposed on the British police.
The Secretary of State for the Home Department (Mrs Theresa May): A system that makes timely decisions and removes people who have no right to stay in the UK is the biggest deterrent to false claims. The Government are committed to increasing the speed and quality of the processing of asylum claims, and the UK Border Agency is making faster decisions and removing people more quickly.
Stephen Phillips: I am grateful to my right hon. Friend for that answer. Bogus asylum claims result in a huge cost to the taxpayer through asylum support. What will the Government be doing to reduce the amount of money spent on asylum support?
Mrs May: I am happy to tell my hon. and learned Friend that we have reduced the cost of asylum support by more than £100 million from the 2009-10 total, delivering substantial savings to the taxpayer. That is the result of action that has been taken to ensure that we clear up the legacy of old asylum cases, speed up the processing of asylum claims and remove more quickly those not entitled to protection. Our asylum improvement project aims to go further.
National DNA Database
The Parliamentary Under-Secretary of State for the Home Department (James Brokenshire): The changes we propose to limit the retention of the DNA profiles of people not convicted of any offence are based on the coalition agreement commitment to introduce the protections of the Scottish system in order better to balance public protection and individuals’ rights. The statistics show that simply increasing the number of DNA profiles on the DNA database does not necessarily increase the number of detections made via that database.
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Philip Davies: There are already 150,000 crimes in which a DNA sample has been taken at the crime scene and not been matched to anybody on the database. Surely the Minister accepts that having fewer people on the database will mean that fewer matches will be made and fewer criminals will be brought to justice. Will he explain how having more dangerous criminals on the streets enhances my freedoms?
James Brokenshire: I know that my hon. Friend looks at the facts and circumstances, so I ask him to look at what has happened in the past five years. Since 2004-05, an additional 2 million individuals were added to the national DNA database but there were 4,000 fewer detections as a consequence.
18. Chi Onwurah (Newcastle upon Tyne Central) (Lab): What discussions she has had with Northumbria police on the appropriate level of policing over the period of the comprehensive spending review. 
The Minister for Policing and Criminal Justice (Nick Herbert): I have regular discussions with chief constables and police authorities on a range of issues about policing. Decisions about the number of police officers and other police staff engaged by Northumbria police are a matter for the chief constable and the police authority.
Chi Onwurah: Recorded crime across Tyne and Wear fell by 14% in 2010 and has fallen by 47% since 2003. That has made a real difference in the lives of my constituents, but they are now naturally worried to learn that this Government apparently regard the big society as a substitute for proper policing. What reassurance can the Minister offer?
“I am determined that we will continue to reduce crime and protect police services that local communities across Northumbria want”.
The Secretary of State for the Home Department (Mrs Theresa May):
As I have previously informed the House, the first duty of Government is to protect the public. Following the death of Osama bin Laden, the overall threat level from international terrorism remains at severe and there is a continuing need for everyone to remain vigilant and to report suspicious activity to the police. Last week’s verdict from the coroner’s inquest into the London bombings on 7 July 2005 reminds us of the real and serious threat from terrorism. I have made a written ministerial statement on the verdict this morning. Across Government, we
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are carefully considering the current recommendations and we will respond in due course, at which time I would expect to make a further statement to the House. Nothing will ever bring back the 52 people who were murdered on that day, but I hope that the comprehensive, open and transparent inquests that have been held have brought some measure of comfort to the families and to all those affected.
Gavin Barwell: I thank my right hon. Friend for her statement. May I press her a little further? One of the coroner’s key findings was about the need for better co-ordination between Transport for London and London’s emergency services. Does the Home Secretary agree that there is a real need to reassure Londoners that if a tragic incident of this sort ever happened again, there would be better co-ordination than there was on this occasion?
Mrs May: My hon. Friend has made a very important and valid point. Of course, a number of the recommendations refer to Transport for London and to emergency responders. The proposals that have come specifically from the coroner will be looked at in great detail and with great care because it is absolutely right that we ensure that the lessons that can be learned from 7 July 2005 are learned.
Yvette Cooper (Normanton, Pontefract and Castleford) (Lab): I welcome the Home Secretary’s words about the 7/7 inquest and add our thanks to Lady Justice Hallett and the team. That inquest brought out the heroism and the tragedy of that terrible day. The moments of bravery shown by the emergency services, many members of the public, those who were directly affected and their families will be remembered, as will the tragic loss of the 52 people who were killed.
It is important that Lady Justice Hallett’s recommendations are taken forward and that the relevant services have the resources to do that. May I ask the Home Secretary when she expects to be able to report back to the House on the detail of her response to those recommendations? Can she give the House a sense of whether she expects to be able to support the broad thrust of the recommendations because they were each considered in great detail and it is important that they can be taken forward?
Mrs May: I thank the right hon. Lady for her question. On the issue of timing, the formal position is that anybody to whom recommendations are made is given 56 days to respond to the coroner’s report and recommendations. We will be responding within that timescale but, as I indicated in my previous answer, I intend to do so within a timescale that will enable me to make a statement to the House about that response. I am sure she will understand that as the recommendations were made to a number of bodies across government, as well as Transport for London, it is necessary to co-ordinate that response and make sure that all considerations have properly been taken into account.
On the right hon. Lady’s final point, significant improvements have already been made since 7 July 2005, but the Government are always looking to learn lessons from that incident and any other incidents that take place—should they do so. In doing that, of course we always put at the forefront of our thoughts the
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intention of ensuring that we can provide the highest level of public security and safety possible, but sadly we can never guarantee that no further terrorist incident will take place.
The Minister for Policing and Criminal Justice (Nick Herbert): Collaboration by police forces is important both to improve operational effectiveness and to save money. A study by Deloitte a couple of years ago found that Yorkshire and the Humber could realise savings of some £100 million over five years by co-operating more effectively. That is the kind of thing that we want all forces to do.
T3.  Pamela Nash (Airdrie and Shotts) (Lab): Can the Minister confirm that student visitor visas, which have recently been increased to 11 months, will not be included in general immigration statistics?
The Minister for Immigration (Damian Green): Yes, as indeed I made clear in answer to a previous question. The definition of an immigrant is somebody who comes here for more than 12 months, so student visitor visas, like tourist visas, are for visitors, not for immigrants. They therefore do not come under immigration limits.
T6.  Claire Perry (Devizes) (Con): May I press the Home Secretary a little further on the 7/7 inquest? Like so many MPs in our constituencies on Friday, I was listening to the wall-to-wall coverage of the inquest and was struck by the harrowing stories of the survivors and the surviving family members. It has been nearly six years since the event. Can my right hon. Friend tell us, while we wait for the end of the formal response period, what lessons the security services have learned since the event?
Mrs May: As I said in response to the shadow Home Secretary, the Security Service has indeed made some changes since those events on 7 July 2005, has looked again at what is coming out of the inquest and will look with great care at the two specific proposals that are aimed at the Security Service in relation to the potential for further lessons to be learned. I draw the attention of my hon. Friend and the House, however, to Lady Justice Hallett’s words when she said that there was no evidence at all that the Security Service knew of and therefore failed to prevent the bombings on 7/7.
T7.  Paul Flynn (Newport West) (Lab): Is any Minister capable of answering a question without blaming the last or the next Labour Government? Can the Home Secretary explain who is responsible for the 350 job losses in Gwent? Efficiency savings will save 20 of them; what about the other 330?
I assume that the hon. Gentleman was speaking about the police, although I do not think the word passed his lips. He asked whether any Minister can get up and not make reference to the mess that we were left by the previous Government. The reason savings are being requested from police forces, and the
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reason across government we are having to make cuts in public sector spending, is the deficit that we were left by the Labour Government. Had Labour been in government, it would be cutting £7 for every £8 that we are cutting. The issue for the hon. Gentleman and his right hon. and hon. Friends is where they would make those cuts.
T9.  Mike Freer (Finchley and Golders Green) (Con): The Minister is aware of the 60 or 70 Yemeni Jews who are trapped in Yemen. What can he do to help to facilitate the visa applications of those families with strong British links?
Damian Green: I am grateful to my hon. Friend for bringing up this issue. He will understand that it would be inappropriate for me to provide a running commentary at the Dispatch Box on individual applications for asylum or any other form of immigration, but I am aware that he has written to me about the matter and I will reply to him shortly.
T8.  John Robertson (Glasgow North West) (Lab): Will the Minister say a little more about how happy the universities were about the new visa system, and in particular what he would say to Glasgow Caledonian university, which has been suspended from sponsoring foreign students and had a 28-day suspension imposed on it? What would he say to the university, which finds the situation difficult and the sentence disproportionate?
Damian Green: I would say to Glasgow Caledonian university, and to the hon. Gentleman, what I would say to any university: all tier 4 sponsors who are given the privilege of bringing people to this country must ensure that they fulfil their sponsorship duties and that their students comply with the requirements of the immigration rules. As he knows, the tier 4 licence was suspended on 20 April following concerns about abuses of the immigration system. The university was given 28 days, from the date of suspension, to make representations against the decision. We are still within that 28-day period and obviously are in dialogue with the university. I hope that he will endorse the fact that we have immigration rules in this country and that they need to be enforced.
Duncan Hames (Chippenham) (LD): It will soon be 50 years since the last royal commission on policing, during which time the challenges faced by our police forces have changed dramatically, as have the expectations placed on them. Will the Minister consider the case for a fresh royal commission?
Nick Herbert: I think it was Harold Wilson who said that royal commissions take minutes and waste years. More recently, Her Majesty’s inspectorate of constabulary has said that there is no time for a royal commission. There are important and urgent decisions that we need to take in relation to police financing and enhancing accountability, which is what the Government intend to do.
Paul Goggins (Wythenshawe and Sale East) (Lab):
Ministers have confirmed in parliamentary answers that in the period 2010-12, 45 individuals with terrorist convictions will be released back into the community. Can the Home Secretary assure the House that all relevant agencies will work closely together, that they
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will have the necessary resources to manage those offenders back into the community and that she and the Justice Secretary have a clear understanding that anyone in breach of their licence conditions will be returned to prison immediately?
Mrs May: The right hon. Gentleman makes a very important point. It is, of course, essential that the various agencies involved work together. I can assure him that they will be working together, as they have been. One of the developments of recent years, which is very welcome, is the way in which the Security Service and the police have worked together on counter-terrorism matters. They will continue to do so and are very conscious of the issues relating to the release of offenders who have completed their prison sentences.
Mr David Davis (Haltemprice and Howden) (Con): A year ago, I was approached by a whistleblower with an allegation that there had been criminal misuse of CCTV and automatic number plate recognition information by the Home Office and a part of the Metropolitan police. I established that the individual knew the insides of the organisations concerned and ongoing operations and that he had no obvious reason for malice or deceit. I sent the information to the Home Secretary. Since then, despite a number of reminders, I have had no response from the Home Office. Will she now tell me when that investigation will conclude?
Angela Smith (Penistone and Stocksbridge) (Lab): Police community support officers play an important role in policing our communities, so will the Minister join me in congratulating the new Labour administration in Sheffield on its decision to restore the funding for 10 PCSA posts that had been cut by the previous Lib Dem administration?
Nick Herbert: The Government decided to maintain the ring-fencing for the neighbourhood policing fund outside London so that funding would continue to be available for police community support officers, whom we support because they do an important job as part of the policing family, working alongside police officers.
Mr David Ruffley (Bury St Edmunds) (Con): The Home Secretary’s plans to cut police red tape, which were announced this morning, will sadly save each police officer only 20 minutes each week. Why is she not being more radical?
This is not the end of the story. Indeed, we are working in a number of ways to ensure that we continue to cut police bureaucracy. My right hon. Friend the Minister for Policing and Criminal Justice is looking at savings in bureaucracy that can be made across the criminal justice system. Chris Sims, the chief constable of West Midlands police, is the ACPO lead on reducing bureaucracy and is looking at other ways of reducing bureaucracy. Sara Thornton, the chief constable of Thames Valley police, is looking to reduce the 600 different
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guidance documents that ACPO provides to police forces to fewer than 100. Those examples show that this is work in progress, but our commitment is absolutely clear.
Ian Austin (Dudley North) (Lab): Given the civil war that has erupted among Government Members, may I offer the Home Secretary some support from the Opposition and tell her how grateful I am for her enormous contribution to our stunning electoral results in Dudley North last week, when we won for the first time ever two seats in Gornal—Upper Gornal and Woodsetton? That would not have been possible had it not been for the public anger at the huge number of police officers she is sacking in the west midlands.
Mrs May: I think that there was something at the end there about policing in the west midlands, but I did not quite catch it. I should be very happy to explain to the hon. Gentleman, as I did earlier, that changes to the budget in the west midlands, as to every other police force, are a direct result of the financial mess that was left by the previous Labour Government. I also say to him that it ill becomes Labour to crow about election results, given that in last week’s election it failed to take an overall majority in Wales, failed in Scotland and stood still in England. I suggest therefore that he keep a little quieter about it in future.
Jason McCartney (Colne Valley) (Con): What consultation has taken place with universities, such as the university of Huddersfield, to assess the impact of changes to student visas and the number of students who stay on after their studies to take the post-study work route?
Damian Green: As my hon. Friend may have heard me say earlier, there was a full consultation. It obviously included the university of Huddersfield and was widely welcomed by universities. We now have a system whereby graduates can stay on so long as they have been offered a specific graduate-level job. To answer his precise question, we calculate that the effect on numbers will be that instead of 38,000 staying on as before, roughly 19,000 will stay on in future.
Katy Clark (North Ayrshire and Arran) (Lab): The Home Secretary will be aware of the concerns about the activities of under-cover police officers, such as Mark Kennedy. Her Majesty’s inspectorate of constabulary is carrying out a review; will the Home Secretary undertake to make a statement to the House once the outcome of that review is known?
Mark Pawsey (Rugby) (Con): I recently spent time with special police constables in Rugby, targeting antisocial behaviour and under-age drinking by sticking Alcohol Watch stickers on bottles and cans. Will the Home Secretary join me in recognising the very valuable work carried out by the special constabulary?
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undertakes. Indeed, we would like to encourage more people to become specials, because they perform a very important role in policing their communities.
Dame Anne Begg (Aberdeen South) (Lab):
Now that Aberdeen passport office has closed, my constituents face a long journey for a face-to-face interview about their first passport. They are expected to travel to Dundee, 70 miles away, but, because of the extra work caused by the closure of other offices throughout north-east Scotland, they have now been told that they will have to
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go either to Edinburgh or even to Newcastle. It appears that the alternative arrangements that the Government promised have not been put in place, so will the Minister look at the issue to make sure that they are put in place and it is not impossible for my constituents to get a passport?
Damian Green: I am grateful to the hon. Lady for drawing that issue to my attention. I will certainly look into the individual circumstances of her constituents applying for a passport for the first time.
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Points of Order
Mr Tom Watson (West Bromwich East) (Lab): On a point of order, Mr Speaker. May I ask whether you have had notification of a statement from the Government on delaying the decision on the BSkyB takeover bid in the light of the criminal trial just being launched involving computer hacking and contractors with News International?
Thomas Docherty (Dunfermline and West Fife) (Lab): On a point of order, Mr Speaker. Recently, the Procedure Committee published its eagerly sought report on hand-held electronic devices and tweeting in the Chamber. Will you update the House on whether that report has simply been accepted as a new procedure for the House or whether we will have a full debate on the matter and a vote?
Mr Speaker: The short answer to the hon. Gentleman is that the report would need to be debated by the House. That has not yet happened. However, I would certainly expect that before any decision were made and enforced, right hon. and hon. Members would have had the opportunity to debate the issues, which I know are of great and consuming interest to the hon. Gentleman and others.
Mr Speaker: I do not think there can be anything further to it. [ Interruption. ] Well, I will give the hon. Gentleman the opportunity to reflect on the matter for a moment and see whether his point is still valid.
Dr Julian Lewis (New Forest East) (Con): On a point of order, Mr Speaker. It was very reassuring, on entering the Palace of Westminster today, to see the flag of the United Kingdom flying from Victoria tower. Given that the European Union has apparently been issuing orders that the EU flag should be flown over public buildings and a photograph sent to Brussels to prove that it has been done, can you tell the House whether you received any such instruction and what your reaction would have been had you received it?
Grahame M. Morris (Easington) (Lab):
On a point of order, Mr Speaker. Is there anything you can do to improve the provision of access to quality national newspapers across the parliamentary estate? I am
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particularly concerned at the lack of availability of copies of the
Obviously, Conservative Members are too. Could you confirm to the House whether you are fortunate enough to receive copies in your residence, and whether it is your view that all Members should have the right to a broad and balanced political perspective on the events of the day?
Mr Speaker: I am in favour of a broad and balanced diet of newspapers, because it is analogous to the benefits of a broad and balanced diet more widely. I am not in the habit of regularly reading the newspaper to which the hon. Gentleman refers. I am all in favour of people having access to it if they so wish, but if he is asking whether it is delivered to me, the answer is no.
Ms Gisela Stuart (Birmingham, Edgbaston) (Lab): On a point of order, Mr Speaker. I would be grateful for your advice on whether parliamentary courtesies also apply to the Prime Minister, who, last Friday, together with some of his colleagues, visited Queen Elizabeth hospital in Birmingham, Edgbaston to get some decent advice on how to reform the NHS, but the local Member of Parliament was not notified.
Thomas Docherty: Further to my point of order, Mr Speaker. While the Leader of the House is present, could you confirm whose decision it will be as to the timetabling of the vote on the Procedure Committee report? Will you, Mr Speaker, or the Leader of the House decide on that?
Mr Speaker: The answer is that these matters are ordinarily determined through the usual channels. If the hon. Gentleman remains interested in this matter, a suitable opportunity for him to pursue it would be at business questions this Thursday. I look forward with eager anticipation to seeing him in his place on that occasion.
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Future of the NHS
That this House notes the growing concerns over the Government’s handling of the NHS and the effect its policies are having on hospitals and patient care; and calls on the Government to uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care, to use the present pause in the progress of the Health and Social Care Bill to make fundamental changes, including dropping the damaging and unjustified market-based approach, and to concentrate efforts instead on achieving sound efficiencies, better clinical quality and improved integration of services.
We have called this debate after the Prime Minister was forced to order an unprecedented pause in his health legislation last month. He was forced to do so because of the growing criticism, confusion and crisis of confidence over the Government’s NHS reorganisation. It was unprecedented because he told his Health Secretary to stop what he was doing while 45 others on the NHS Future Forum work out what he should be doing. It looks as though the Prime Minister is listening to anybody and everybody on the NHS except the Health Secretary.
We have called this debate after the Deputy Prime Minister’s flagship policy was sunk in the AV referendum last week. He is now trying to find a replacement, and claims that changes to the Health and Social Care Bill are his new No. 1 priority. The Deputy Prime Minister and his party are up to their necks in the Tory NHS plans. He and the Prime Minister co-signed the foreword to the White Paper last summer, and he signed off the NHS legislation in Cabinet before Christmas. He and his Lib Dem MPs have backed the Bill at every stage in Parliament. In Committee, his Lib Dem Health Minister led the rejection of Labour’s amendments—the amendments that he now says he wants to make.
Now that the Lib Dems are making many of the arguments that Labour has been making since early autumn, people may ask what the Deputy Prime Minister has been doing for the past year, when he changed his mind and why. People may suspect that the deal he is stitching together has more to do with saving his party than safeguarding the NHS.
Sajid Javid (Bromsgrove) (Con): Will the right hon. Gentleman tell the House whether he still believes that the Government’s plans are “consistent, coherent and comprehensive”? If not, when did he change his mind?
Charlie Elphicke (Dover) (Con): I thank the right hon. Gentleman for being so generous in taking interventions. He has told the House that the plans are wrong. However, in January 2010, he said to the King’s Fund:
“The general aims of reform are sound”.
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John Healey: There is nothing wrong with the general aims of the changes, but what the Government are doing is different from what they are saying. In one third of the legislation, they are not setting up GP consortia or reducing bureaucracy in the NHS, but setting up the NHS as a full-blown market. That is the wrong prescription for our NHS, and it is patients who will suffer.
Christopher Pincher (Tamworth) (Con): The right hon. Gentleman seems to be suffering from amnesia, which, by the way, is treatable on the NHS. On 30 November, he said that he supported our proposals to move public health functions from primary care trusts to local authorities. If he does not believe in reorganisation any more, how does he intend to achieve that move?
John Healey: In principle, that is a good move. The Opposition, including those of us on the Front Bench, have said that it makes sense in principle to give local authorities a lead responsibility on public health; after all, they are responsible for things that affect public health such as housing, employment and a good environment. The Government’s failure is that local authorities are not getting the powers or resources to do the job properly. The provisions in the Bill will fragment the NHS and make it harder, not easier, for them to do that job.
Mr Dave Watts (St Helens North) (Lab): Can my right hon. Friend explain why the Secretary of State says in public that the change is not about the privatisation of our hospitals, when in fact that is exactly what his officials are doing behind closed doors?
John Healey: My hon. Friend has been pressing that point with his local hospital, because it is quite clear that the hospital’s managers were forced to look at privatising it and having its management run by a private company. I fear that under the provisions of the Health and Social Care Bill, more hospitals will be driven to the brink and will have to face the prospect of insolvency or a takeover by the private sector companies that are lining up to make the most of the Government’s plans for the NHS.
Grahame M. Morris (Easington) (Lab): On the transfer of responsibility for public health, can my right hon. Friend explain how withdrawing the funding for the public health observatories, which have informed health policy, will help improve public health?
John Healey: My hon. Friend gives good service on the Health Committee and follows the details of the matter more closely than most in the House. He has an important point, because the quality of health services for patients is inevitably affected by the deep and fast cuts in other areas. People in local authorities are experiencing difficulty in continuing to provide good social care, which is causing problems for the people who depend on that care and for the NHS.
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in the last Parliament, which some Conservative Members opposed? Does he agree with that policy?
John Healey: The independent sector treatment centres played a part in clearing the backlog and improving waiting lists. They introduced the extra capacity that allowed the Labour Government, through a combination of investment and reform, to achieve the highest levels of patient satisfaction with the NHS ever and the lowest waiting times ever.
Mr Kevan Jones (North Durham) (Lab): My right hon. Friend will have seen the nauseating, sanctimonious and preaching sermons of the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) after the election results on Thursday. Does he understand why the right hon. Member for Wokingham (Mr Redwood) and others are concerned that the Liberal Democrats are going to scotch a policy that they have been signed up to from day one?
John Healey: My hon. Friend is absolutely right, and he makes the point that I have begun to make to the House. The Liberal Democrats have been up to their necks in this for the past year, and welcome though their late conversion is, the House is entitled to ask exactly why the Deputy Prime Minister now believes that radical changes to the Health and Social Care Bill are required.
If the Deputy Prime Minister is not going to sell out the principles of the NHS like he has the principles of his party, he must toughen the tests for the Bill and help stop the market free-for-all in the Government’s plans. If he and his party mean what they say, they can start today by backing us and backing the motion. It calls on the Government to drop
“the damaging and unjustified market-based approach”,
“uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care”.
Andrew George (St Ives) (LD): If the right hon. Gentleman is concerned about consistency, he will know that since the publication of the White Paper last year, my concerns about the proposal have been well established. The motion, however, castigates top-down reorganisation. Will he apologise for the previous Government engaging in substantial top-down reorganisations time and time again, including the introduction of the independent sector treatment centres, which lost millions and millions of pounds of taxpayers’ money?
Some of the reorganisations in the 13 years of our Government played an important part in the reform and the great gains that patients saw in the NHS. However, it is also the case—and we learn from
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this—that reorganisations often take longer, save less, cost more and have less impact on improving care for patients than envisaged at the outset. We learned that lesson towards the end of our 13 years, which is why we had a period of important stability in the NHS, but it is a lesson that the Conservatives have failed to learn—extraordinarily so, as we all thought that they had learned it, because NHS reorganisation is exactly what the Prime Minister promised not to do before the election.
The Prime Minister’s broken promise on NHS reorganisation is part of the reason for the growing doubt and distrust about whether he is making the right decisions for the right reasons on the NHS. He promised to give the NHS a real rise in funding, but the Budget this year confirmed a £1 billion shortfall in England. He promised to protect front-line services, but nursing posts are already going, and the Royal College of Nursing expects 40,000 NHS jobs to go in the next four years. The Prime Minister promised a moratorium on hospital A and E, and maternity service closures, but some are now going ahead, and more will follow—without public consultation—under the Health and Social Care Bill plans.
Miss Anne McIntosh (Thirsk and Malton) (Con): I am following the shadow Minister extremely closely. The last Government opened a treatment centre in my old constituency, Vale of York. I am having great difficulty understanding what we are proposing to do, following what Labour did in York.
John Healey: Let me help the hon. Lady. For the first time, all parts of the NHS, including the commissioning job, will be opened up to private companies and subject to competition. As I have said, independent sector treatment centres played a part in our being able to clear long waiting lists and restore the quality of service to the NHS, as well as in supplementing the mainstream NHS, not substituting for it, which is what will happen under her party’s Bill.
The Minister of State, Department of Health (Mr Simon Burns): Just for the sake of balance, will the right hon. Gentleman confirm that such treatment centres were also prime cherry-pickers and that between 2003 and 2009, the private sector was paid £250 million for not carrying out a single operation?
John Healey: The right hon. Gentleman will know from his current position that the premium that we paid in the first wave of treatment centres was stopped in the second wave. He will also know that by the end of our period in government we had stopped the independent treatment centres programme; and he ought to know that built into his Bill’s impact assessment is what it calculates to be a 14% premium, paid to providers under his proposals.
Mr Stephen Dorrell (Charnwood) (Con):
The right hon. Gentleman has just implied that the Government were proposing to introduce, for the first time, private sector expertise into the commissioning process of the health service. Will he correct that statement to the
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House by confirming that under the world-class commissioning programme, the previous Government explored exactly that proposal?
John Healey: No. What I am referring to is the provision in the Bill to allow the job of commissioning to be outsourced to private companies. That has never been done before. It is there in the Bill and it is a big risk for the future.
The Secretary of State for Health (Mr Andrew Lansley): Will the right hon. Gentleman just be clear to the House and get it accurate? The Bill sets out that commissioning consortia are statutory bodies covering the whole of the country in the public sector. Therefore, if they use private sector commissioning expertise—which the Bill does not require them to do—that is not commissioning responsibility. In the two years leading up to the election, primary care trusts increased their use of management consultancy by 80%, so they did use the private sector, whereas commissioning consortia do not have to.
John Healey: The point about the Health Secretary’s legislation is that it allows consortia to outsource in whole the job of, not the responsibility for, commissioning. He made the point that the consortia are public bodies, but they meet none of the standards of public governance. They can meet in private. As the right hon. Member for Charnwood (Mr Dorrell) has said, that serious job should be done by properly constituted and governed public authorities, but that is a loophole in the Bill.
Clive Efford (Eltham) (Lab): Like my right hon. Friend, I heard the Prime Minister and Deputy Prime Minister over the weekend say that there will be changes to the Bill. However, every Government Member who has intervened has defended the position in the Bill. Will we see changes as a result of pausing, listening and reflecting, or not? Will the Liberal Democrats have a spine tonight and vote with the Opposition to get changes to the Bill?
John Healey: My hon. Friend puts the position and the challenge, especially to the Lib Dems, very clearly. The challenge to Conservative Members is this: they must recognise that the Prime Minister made the NHS his most personal pledge before the election. People wanted to believe him, but in just one year the NHS has become his biggest broken promise. My hon. Friend mentions the pause. In our Opposition motion in March, we urged the Government to
“pause the progress of the legislation in order to re-think their plans”.—[Official Report, 16 March 2011; Vol. 525, c. 374.]
However, many of the signs point to the Prime Minister’s “pause to listen” being a sham. Just one week after the announcement, and in fact on the day that the Health Secretary received that historic vote of no confidence at the Royal College of Nursing, the NHS chief executive wrote to NHS managers to tell them that
“we need to continue to take reasonable steps to prepare for implementation and maintain momentum on the ground”.
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Mr Ben Bradshaw (Exeter) (Lab): My right hon. Friend is absolutely right. Do we not face the worst of both worlds? The Government appear to be saying that GP consortia should be voluntary rather than compulsory, but primary care trusts are being abolished, and in some cases have been already. If that pause is serious, the Government need to stop that dismantling of the NHS and go back to the drawing board.
John Healey: My right hon. Friend is absolutely right, and he draws on his experience as a former Health Minister. While implementation continues apace, there is a so-called pause in the legislation. His point is exactly the one made by the all-party, Tory-led Health Committee in a recent report. If the Prime Minister wants to prove to NHS patients and staff that his pause is not just spin, he must shelve the Bill and make radical changes to his NHS reorganisation plans.
Mr John Baron (Basildon and Billericay) (Con): The shadow Secretary of State speaks as if no reform is needed. However, given that our cancer survival rates are well below the European average and that that costs thousands of lives in this country, does he accept that reform of how the NHS treats cancer patients is necessary?
John Healey: The hon. Gentleman has great expertise in, and commitment to, cancer care. He is right that our survival rates continue to lag behind those of parts of Europe, but I am sure he is aware that the rate of fall in deaths from cancer has accelerated in the past decade. On that basis, and with continued investment and reform, we have a chance of catching up to European levels. However, the reforms proposed in the Bill, as many cancer charities and those who represent patients testify, raise the concern that the great gains made by the cancer networks in integrating and co-ordinating services for cancer patients and sufferers will be put at risk.
“enormous—beyond anything anybody from the public or private sector has witnessed”.
He is right. At this time of tight finances, the Government are piling on extra pressure and putting the NHS at risk with this reorganisation. The Health Committee warned in January that the NHS efficiency challenge was
“already a high-risk strategy and the White Paper increased the level of risk considerably”.
Now nearly £2 billion that was promised for patient care is being held back to cover the cost of reorganisation, and hospitals are being forced to cut back on costs by one third over the next five years, as all are forced into foundation status by 2014.
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amounts the following year. He described that as an almost impossible task. More importantly, however, it puts at risk the strategy for better services and better value for money, and the strategy for more integration of hospital and community services. He said of the Government’s plans that the sheer distraction of reorganisation and insistence on competition will scupper our chance of doing that.
The pressures of this high-risk reorganisation are one the reasons that, just one year into this Government, patients are starting to see the NHS go backwards again under the Tories, with waiting times rising, operations delayed, services cut back and front-line jobs lost. This is not just a problem with the timing or pace of change, however, and nor is it a problem of presentation. In fact, the closer people look at the plans, the more concerned they become, which is why there is growing criticism of the Tory plans for the NHS from doctors, nurses, patients’ groups, NHS experts, the Health Select Committee, peers in all parts of the House of Lords and now even the Lib Dem leader. The closer people look, the more fundamental and far-reaching they see these changes to be.
Today, the Royal College of General Practitioners warned the Prime Minister that his health Bill undermines our comprehensive health care system and will cause “irreparable damage” to the core values of the NHS. So far Ministers have branded such criticisms as scaremongering, but people in the NHS are already starting to see this happen. The Government’s first act was to remove national waiting time standards—the patients’ guarantee that they would be seen and treated quickly—which the Health Secretary described as “clinically unjustified targets”, but the patients do not see it that way, and nor do the surgeons. The president of the British Orthopaedic Association described the delays now being faced by patients as “devastating and cruel”.
The NHS Bill takes the break-up of our NHS still further. National Institute for Health and Clinical Excellence decisions on what drugs or treatments patients should have on the NHS become optional for commissioning consortia, and for the first time since 1948 the Secretary of State will not be responsible for delivering a national health service or for defining its scope. In future, the power to decide what health services will be provided free at the point of need—as now—and what further services will be charged for will rest with the new commissioning consortia. That was the basis of the concern expressed today by the Royal College of General Practitioners. These consortia will be able to meet and take decisions in private, and to outsource commissioning to private companies; but they will not even need to have a GP on their board—in fact, they will not need to have a board at all.
Nadhim Zahawi (Stratford-on-Avon) (Con): The right hon. Gentleman mentioned the Royal College of General Practitioners. What does he think it makes of his policy, revealed in Pulse, to strip GPs of all financial responsibility?
When the hon. Gentleman reads his next edition of Pulse, he will see my correction of that report, and note that the first five paragraphs were all reported and contained no quotes from me. He ought to know that after a survey by the British Medical
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Association found that more than half of doctors believed that they would spend less time with their patients as a result of these changes, the chairman of the BMA council, Dr Hamish Meldrum, said:
“This survey shows that the government can no longer claim widespread support among doctors as justification for these flawed policies.”
It is not the five clauses that set up the GP consortia that cause the most concern. It is the 85 clauses that set up the NHS as a full-scale market, and it is part 3 of the Bill, which opens up all areas of the NHS to private health companies; removes requirements for proper openness, scrutiny and accountability to the public and to Parliament; allows NHS hospitals to go bust and face a commercial insolvency scheme; places the judgment of the new competition regulator—just like those for gas and electricity—at the heart of decisions about the future of the NHS; and, for the first time, makes the NHS subject to the full force of UK and European competition law. That means that, in the long term, we will see clinical planning in the NHS being replaced by market competition, service integration being replaced by corporate cherry-picking, public accountability being replaced by commercial confidentiality and the public ethos at the very heart of our NHS being replaced by the profit motive.
I agree with the Deputy Prime Minister that no Bill is better than a bad one, but I say to him that this is a bad Bill. That is why we have opposed it from the outset, and that is why we say that it must be shelved in its current form and that radical changes must be made. For us, for the NHS and for NHS patients, this is the test of the Prime Minister’s promise to protect the NHS. I commend the motion to the House. [ Interruption. ]
The Secretary of State for Health (Mr Andrew Lansley): The right hon. Member for Wentworth and Dearne (John Healey) has not only presented a weak motion to the House but managed to make a weak speech in support of it. The motion is completely silent about the problems that the NHS faced when we came to office. It is completely ignorant of the challenges that the NHS faces, and completely devoid of any recognition of the ongoing efforts of NHS staff to offer the very best standards of patient care, day in and day out. I am happy to make it clear, however, that I support the staff of the NHS every day, as we all must. I am not interested in a motion that ignores that; I am interested in supporting NHS staff to deliver the best possible care for patients.
This debate is supposed to be about the future of the NHS, but the right hon. Gentleman had nothing to say about its future. He wanted to talk only about politics and the Health and Social Care Bill. What happens in the NHS every day is not the same as the content of the Bill, important though that is; it is about quality of care and the outcomes that are being achieved for patients. I will ask the House to reject the motion, because I intend to use the debate to be positive and to show how we will give the NHS a stronger future.
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Mr Lansley: That is complete nonsense. This is not about me: it is about what the staff of the NHS want. They want the ability to be able to deliver care for patients without being told what to do by the top-down bureaucracy and targets of the Labour Government. They want the ability to deliver the care that patients need, to join up health and social care and to integrate the pathways of care. Our Bill is about giving them the structure that will allow them to do that. They want every penny that we as taxpayers provide to the NHS to get into the hands of front-line staff, and for the absolute minimum to go in waste and inefficiency. That is what they want, and that is not about me, it is about them.
Mr Watts: Given that today and on previous occasions the Secretary of State has claimed that the Government are not trying to privatise our hospitals, will he publish all the documents that have passed between his Department and my NHS trust, because they will demonstrate that that is exactly what he intends to do? He intends to try to privatise my hospital.
Mr Lansley: The hon. Gentleman will know, because the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns) has told him in the past, that when NHS trusts are moving to foundation trust status, there will be an agreement, but it is not about privatisation. When the hon. Gentleman’s party was in government, it said that the only way Hinchingbrooke NHS trust could turn its management around was for it to be prepared to look for the best possible management. That is the extent of what we are talking about, and it was done under his Government.
This will require change. We are not going to spend £5 billion on bureaucracy. We are not going to let the number of managers double in future as it did under Labour, and we are not going to let the number of managers increase six times as fast as the number of nurses. Since the general election, we have 3,500 fewer managers and, as a consequence, 2,500 more doctors and 200 more nurses.
Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op): On 19 March, the interim chief executive of Monitor said that under this Bill, doctors talking to providers about health care would be the same as Marks & Spencer talking to their suppliers about which brand of washing powder to buy. Is that the Health Secretary’s vision for the future of the national health service?
No, not at all, and I do not believe that Monitor believes that either. The hon. Lady can see that the proposal in the Bill is clear. It was the Labour Government who established Monitor as a regulator
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and who introduced competition into the NHS. The Labour Government did all those things, but Monitor’s job is not to impose competition rules but to deliver what is in the best interest of patients.
Mr Graham Stuart (Beverley and Holderness) (Con): The shadow Secretary of State is a decent man and an experienced Minister. The reason his speech was so weak is that he had no conviction because he has been forced by the union paymasters of the Labour party and of the shadow Leader of the Opposition to deliver the sort of speech previously given by the far left who inhabit the Benches way over there. My right hon. Friend should not listen to those voices; he should press ahead and make a difference for patients, not politicians.
Mr Lansley: I agree with my hon. Friend that the shadow Health Secretary is a decent man, and at the turn of the year he quite decently expressed his support for the Bill’s principles and his understanding that it was consistent, coherent and comprehensive. It makes one wonder what happened to him in the interim. Did the trade unions—the paymasters of the Labour party—get to him and tell him that they did not like the idea that patients should be able to get the care they need or the idea that we should get resources into the front line rather than into the vested interests of the NHS?
What we are going to do is put patient care at the heart of our reforms. We are not going to let hospital productivity continue to decline as it did over the last decade. Under Labour, we saw a 15% decline in productivity, yet we heard nothing from the shadow Health Secretary about that. It is this Government who are taking action to improve hospital performance by changing the way hospitals are paid to reward excellence—for example, by not paying for unnecessary readmissions of patients who are discharged too soon.
Jesse Norman (Hereford and South Herefordshire) (Con): Hereford hospital is labouring under a very expensive private finance initiative contract. Does my right hon. Friend not think it a tragedy that the last Government cast good sense and good economics away, forcing so many hospitals into PFI?
Mr Lansley: My hon. Friend makes an important point—that it was under the Labour Government that many of these projects were undertaken, and they are leaving an enormous bill in the NHS for future taxpayers and future NHS organisations to meet. A contract is a contract, as the right hon. Gentleman and the House will understand, and we inherited contracts from the Labour Government, many of which were very bad contracts, such as the ones on IT that we have had to renegotiate. Frankly, it is due to my right hon. and hon. Friends in the Treasury and ourselves at the Department of Health that people have been put into the Queen’s hospital in Romford to look at how we can resolve some of these PFI problems and reduce those costs. We need to increase productivity in the NHS and cut out much of the waste in it.
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how often were patients having to go into mixed-sex accommodation when the rules on single-sex accommodation were breached? We did not know, because when Labour Members were in government they would not tell us. Since we started publishing the data in December, the number of patients put into mixed-sex accommodation without justification has halved.
Mr Pat McFadden (Wolverhampton South East) (Lab): The Secretary of State talks of service to patients. Does he accept that the amount of time for which patients must wait for treatment is extremely important to them? Does he also accept that the number of people waiting more than four hours to be treated in accident and emergency departments is at its highest for six years, and that the number of people waiting more than 18 weeks for non-urgent operations is at its highest for three years?
The Secretary of State attacks our targets, describing them as “top-down bureaucracy”. Does he not accept that they are actually a guarantee that people who cannot afford to go private and pay will not have to wait in pain, but will be treated within a reasonable time frame?
Mr Lansley: I do not accept the right hon. Gentleman’s premise. Waiting times in the NHS are stable. We had a conversation about that during the last session of Health questions, but perhaps the right hon. Gentleman was not in the Chamber and did not hear it. The average waiting time is nine weeks. The operational standard requires 90% of admitted patients to be seen within 18 weeks—that is in the NHS constitution—and it has been maintained, although the figure was 89.9% in February after a winter during which critical care beds were full because of flu.
The right hon. Member for Wentworth and Dearne talked of four-hour waits in A and E as if the fact that a patient had been discharged within four hours were the only issue. He should go and talk to the families of patients who, in the past, were discharged from the emergency department at Stafford general hospital and left to die.
What matters is how long it is before a patient is seen by a qualified professional, and how long it is before that patient is treated. What about those who leave without being seen? What about those who are not given the care that they need, and have to return to the emergency department? Those are the things that matter to patients, and those are the things that are now part of the accident and emergency quality indicators which, this April, we said that we would publish for the first time. It is we who are focusing on services for patients. Labour Members had 13 years to look at what really mattered to patients and at the real quality of what was delivered to patients, but they did not do it, and we are going to do it.
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Mr Edward Leigh (Gainsborough) (Con): Sadly, despite massive increases in funding over 15 years, there has been an undoubted catastrophic decline in NHS productivity. Does my right hon. Friend accept that many of us on the Government Benches feel that if we are to save the NHS there is no alternative to more co-operation with the private sector, and that he should stick to his guns?
Mr Lansley: My right hon. Friend made that point when he chaired the Public Accounts Committee, and it should silence Labour Members, because the Public Accounts Committee has said exactly the same thing since the election under the chairmanship of the right hon. Member for Barking (Margaret Hodge)—that productivity in the NHS declined consistently under Labour.
Mr Speaker: Order. The House is in a very excitable state. The issues are of the highest importance and they provoke strong feelings, but the debate must be conducted in an orderly way, and the Secretary of State is entitled to a decent hearing.
I remember Labour’s scaremongering during the election about cancer waits, for example, but in 13 years in government they never actually looked at cancer survival rates. They never looked at the results for patients. It took this Government to publish the first outcomes strategy for cancer, which made clear that what matters to patients—
Mr Bradshaw: If things were so terrible under the Labour Government, why was public satisfaction with the NHS at record levels when we left office, and why were waiting times at record lows? Both are now going in the wrong direction. Will the Secretary of State please tell us—we have not yet received an answer to this question—what will happen in those areas now that GP consortia are to be voluntary? He has already abolished the primary care trusts, so who will be responsible?
Mr Lansley: It was also a period during which complaints to the NHS reached their highest ever levels. If we ask the public who they think are best placed to design the services patients need, we will find that the answer is their general practitioners, hospital doctors and nurses, not politicians on either the Government or the Opposition Benches. This is about doctors and nurses being in charge, not politicians.
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It took this Government to focus on cancer outcomes. It took this Government to provide the drugs patients need through the cancer drugs fund. Under Labour, patients went without new cancer medicines that patients in every other European country were getting access to. It is this Government who are investing in more diagnostic equipment, and more screening and early diagnosis, so that we get better outcomes.
Angela Smith (Penistone and Stocksbridge) (Lab): I must say that I admire the consistency with which the Secretary of State defends his proposed legislation. However, will he tell us what he plans to concede, given the threatened veto by the Deputy Prime Minister and the Liberal Democrats?
Mr Lansley: I do not want to correct the hon. Lady, but everything I have been saying up until now has been about defending the NHS and defending our focus on delivering better results by giving the NHS greater front-line devolved responsibility. That is not a matter of debate and disagreement between the coalition parties; we are all in favour of that. The point is this: how can the Bill best support the principles on which we are agreed? I thought the right hon. Member for Wentworth and Dearne and the Labour party were agreed on those principles; that seemed to come out from his interview last week. Indeed, at the end of his speech today I was not quite sure whether or not he agreed with us.
Mr Baron: Given that our cancer outcomes are well below the European average, the need for NHS reform is well established. However, as my right hon. Friend the Secretary of State will know from my having raised the issue with him previously, the entire cancer community will breathe a sigh of relief if the guaranteed funding for cancer networks can be extended to 2014 when the transition period for GP commissioning comes to an end, as we would risk losing a lot of expertise if we were to end it in 2012. Will he address that point?
Mr Lansley: The support for cancer networks will continue during the course of this year and the start of next year, but when the NHS commissioning board takes responsibility for commissioning, including the relationship with consortia, it will need to decide how to manage its commissioning responsibilities. However, as I have told my hon. Friend in the House previously, it is now looking—we will look at this over the coming months—at how it can use networks as a basis for having precisely the kind of commissioning structures we want, and it is my expectation that that would include cancer networks that are not only helpful for providers, but that tie together commissioners and providers in understanding the future strategy for cancer.
The House knows of my commitment to the NHS; Opposition Members know of that, too. They know that I have not spent seven and a half years as shadow Secretary and Secretary of State to see the NHS undermined, fragmented or privatised. They know that
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that was never my intention; it is not my intention. Before the last election, we were absolutely clear that we would protect the NHS, but we are doing more than just protecting it; we are strengthening it. We are enabling clinicians to lead a more integrated, responsive, accountable NHS—not fragmented, not privatised, not based on access to insurance, and not compromising quality for price—and, equally, an NHS that is not run by a top-down, unaccountable bureaucracy, but that is locally led and locally accountable.
As the right hon. Member for Wentworth and Dearne admitted, this is a comprehensive, consistent and coherent vision, and it is an evolution of the better policies of the last 20 years. It was the last Labour Government who introduced patient choice; we will extend it and give patients the information they need to make it work. It was the last Labour Government who introduced practice-based commissioning; we will make it real, with health professionals designing integrated pathways of care with decision-making responsibilities. It was the last Labour Government who introduced foundation trusts; we will deliver on their broken promise to take all NHS trusts to foundation status. It was the last Labour Government who introduced payment by results, but left it half baked, distorting services and hindering joined-up care; we will change it so that it genuinely supports the best care for patients. Of course, it was the last Labour Government who brought the independent sector and competition into the NHS, but we will not follow their lead by giving the independent and private sector providers the opportunity to cherry-pick services and by giving them financial advantages over NHS providers.
Gordon Birtwistle (Burnley) (LD): Will the Secretary of State confirm that the meeting patients needs programme put forward by the previous Government, which closed down many accident and emergency units and many children’s wards, will not happen again under this new regime? Will he confirm that that is because local people and local GPs will be consulted first, as opposed to having the programme driven through with no support and no consultation, as under the previous Government?
Mr Lansley: I completely understand and agree with my hon. Friend. I thought it was outrageous for the shadow Secretary of State to say, “Oh, they promised a moratorium and now some closures are taking place.” Why? Because we were left what were, in effect, faits accomplis by the previous Government and it was impossible to change them. [Interruption.] My hon. Friend the Member for Maidstone and The Weald (Mrs Grant) would feel the same as my hon. Friend the Member for Burnley (Gordon Birtwistle).
I can confirm that we agree on the issue of principle and that I am not questioning the Secretary of State’s personal commitment. The issue remains one mentioned in the motion: the extent to which the policy in the Health and Social Care Bill is not just another top-down reorganisation of the sort that the coalition Government said they would stop and the extent to which the policy being driven through Parliament, on which a listening exercise is taking place,
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delivers what is in the coalition agreement. The debate is about the extent to which the Bill reflects the coalition programme agreement.
Mr Lansley: My hon. Friend will know that the coalition agreement supports, in essence, all the principles of the Bill, with the exception of the specific consequence of the abolition of the strategic health authorities and primary care trusts. As with the whole of the Bill and its related measures, that proposal was the subject of collective agreement and it flows directly from the belief, shared not least by him and his Liberal Democrat colleagues, that we need much stronger local democratic accountability in the NHS. We are constructing health and wellbeing boards as an integral part of local authorities, and he will know that the overwhelming majority of local authorities which have volunteered to be early implementers of that approach believe precisely that democratic accountability is an essential part of the future of the NHS.
Mr Lansley: Let me just make some progress. We need this modernisation for the NHS because of the challenges it faces in the future. We need to deliver £20 billion of efficiencies over the next four years. I remind the House that that requirement was set out originally under a Labour Government in 2009 without the merest hint of irony—I say that given that they created the inefficiencies in the first place. Today, I can give the House some figures that the Labour party would wish that people did not know. If Labour’s spending plans for the NHS at the last election had been implemented over this spending review period, the NHS budget would have been cut by £30 billion compared with what we have put into the NHS over the spending review period. So let the right hon. Member for Wentworth and Dearne get up now and explain: how was the NHS going to deal with £20 billion of efficiencies while he was cutting £30 billion out of it, instead of it getting the extra £11.5 billion it is getting from taxpayers through this coalition Government?
John Healey: After 20 minutes of the Health Secretary’s speech, the hon. Member for St Ives (Andrew George) finally brought him to his own plans and he was clearly very uncomfortable. What does he say when the Prime Minister wonders how he got the Government into such a mess over his plans? What does he think of the chair of Monitor’s observation that the approach being taken is a combination of
“previously unannounced policies, a complete failure to build the necessary political and professional consensus and an apparent disdain for the detailed planning of implementation”?
I suppose the one thing the right hon. Gentleman has learned about being in opposition is that it is best for a party to try to forget everything that it did in government, because it will not be held to account for it. He has also recognised that the best thing is to have no ideas of his own. He does not even seem to know whether he agrees with our ideas or opposes them. We do not have any answers from him. The right hon. Gentleman’s quotation was from the former, not current, chair of Monitor, who knows perfectly well
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that these measures were in our respective manifestos and were brought together in the coalition agreement. They have a mandate. From my point of view, this is not just about the electoral mandate but about how we can deliver the best care for patients and see through principles that I thought the right hon. Gentleman’s party, as well as ours, believed were right.
Let me make it clear that the challenges in the NHS are about more than just clearing up Labour’s mess. We must recognise that there are now more pensioners than children under 16, alcohol-related admissions to hospital have doubled and emergency admissions have risen by 12% in just four years. Obesity in this country has doubled in the last 25 years. Under Labour, the demand for health care was rising while productivity was falling. The only way that Labour could cover those risks was by massively increasing the budget and that is no longer an option. Mounting pressure on the NHS is inevitable and the status quo, as Labour recognises, is not an option. The NHS needs modernisation.
Mr Lansley: Yes, I will. Some 220 pathfinder consortia have come forward, representing the equivalent of 45 million patients across England—that is, 90% of the population. They are not obliged to do so. They have volunteered to come forward to demonstrate that they can deliver better services for patients.
Mr Speaker: Order. I am going to try to be helpful to the hon. Member for Easington (Grahame M. Morris). When a Minister gives no indication of giving way, a Member must not simply stay on his or her feet. The situation is clear: the Secretary of State is not giving way at the moment. Once again, I appeal for the restoration of some sort of calm. The Secretary of State should be heard with a degree of civility—[ Interruption. ] Order. I ask Members to reflect on how our proceedings are regarded by members of the public whose support we sought not that long ago.
“a greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes”.
We are already delivering on our vision. We are extending patient choice and involving patients more in decisions about their care. We are cutting back Labour’s waste and reducing the bureaucracy that stifles and undermines doctors and nurses. We are putting clinicians at the heart of commissioning, with almost 90% of the country now covered by new pathfinder consortia.
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We are driving down hospital-acquired infections, sustaining and improving the performance of the NHS, stopping Labour’s arbitrary box-ticking and focusing on the outcomes that matter. We have a world-leading framework for the results that matter to patients: reducing avoidable mortality; enhancing recovery after treatment; improving quality of life for those with chronic conditions; maximising safety and cutting the number of infections; and continually improving patients’ experience of their health care. Those are the outcomes for which we and the NHS will be accountable.
Let me be clear: there will be substantive changes to the Bill to deliver improvements for patients. There is only one issue for me, however: will it deliver better care for patients? That is why we will pursue NHS modernisation and why we will stick to our principles. It is why we are listening to improve the Bill. That is what the coalition Government are committed to. Today, led by the NHS future forum, we are engaging with the health service and beyond to ensure that the legislation delivers on those principles.
Unlike the Labour party, which has retreated to its union-dominated, regressive past, we will not retreat. We will be progressive with those principles. Just last week, the right hon. Gentleman called for a return to Labour’s top-down targets and for GPs to be stripped of all their financial responsibility. He has called for the NHS to be run by a bureaucracy, not by doctors and nurses. Critics of the Bill must answer this question: if they do not want patients, doctors and nurses to be in charge of the NHS, then who do they want to be in charge?
The right hon. Gentleman has turned his back on two decades of NHS modernisation. We will never accept the Labour party’s prescriptive, top-down bureaucracy or its waste. We did not accept Labour’s plan, which would have meant taking £30 billion out of the NHS in England over this Parliament and we will not follow the route that the Labour party in Wales has taken, where it is cutting the NHS. Instead, we are increasing the NHS budget over this Parliament by £11.5 billion. We will equip the NHS to deliver better and improving services by using more resources more effectively. We will empower patients with information and with choice. We will empower doctors and nurses to shape services for their patients. We will bring together the NHS, public health and social care in a combined local strategy. We will make the NHS genuinely locally led, while meeting national standards. We will focus relentlessly on the quality and outcomes we achieve for patients. We will protect the NHS and strengthen it. We will do that not by living in the past, but by modernising for the future. We want a modern service that is true to its core values. The Labour party’s motion offers no future for the NHS. We on the Government side will give the NHS a stronger future, and I urge the House to reject the Labour party’s motion.