| Previous Section | Index | Home Page |
10.53 am
Mr. Archy Kirkwood (Roxburgh and Berwickshire): I am pleased to follow the hon. Member for Normanton (Mr. O'Brien), who has a reputation as a doughty fighter. As he said, his last Adjournment debate took place at the end of the previous Parliament. I have taken the opportunity to refresh my mind on the content of and exchanges in that debate, which was valuable, as was the hon. Gentleman's speech this morning. I agree with his analysis. For some time now, we Liberal Democrats have been in the vanguard of the argument. We were led to the conclusion that the CSA's lack of operational success was such that it should be wound up and started again.
I thank the Secretary of State for Social Security for staging this debate. It was absolutely right that she should come to the House. It is five years since the legislation was put on the statute book. I confess that I was one of the people who was taken in at the time. I remember making speeches about benefit penalties for non-co-operative mothers--that is still a problem--but otherwise I did not foresee the difficulties and the extent to which this would cause dislocation and disruption throughout the nation.
The Secretary of State is brave and right to come before the House not with any great plans after a week and a half in office, saying this is what she is going to do and this is what she is not going to do, but to say that there are problems. In my opinion, she has made her position
absolutely clear. I strongly support the view that there is no question but that the principle of continuing duty of maintenance is sacrosanct. She is right to put that at the heart of her policy. If she keeps it there, she will certainly find strong support from the Liberal Democrats, irrespective of any differences we and the Government may have as the argument unfolds and as her reforms and review continue.
I acknowledge that it is not easy for the Secretary of State to open this subject in front of a new Parliament when she gets the kind of hard time that the hon. Member for Normanton, rightly, on behalf of his constituents, gave her. There is universal dissatisfaction with the operation of the system that the CSA was set up to achieve. It has not been working for five years; the House has a duty to attend to that. It is right that we should have this debate now. The Liberal Democrats will constructively and robustly argue for change where it is necessary.
There is a fundamental flaw at the heart of the legislation. It is not easy to know how to deal with it, but the concept of a formula is almost by definition unfair to the minority who do not fit the normal circumstances. There are always going to be people in life's rich tapestry who do not squeeze into the formula and there are always going to be casualties. What, more than anything else, encourages the disproportionately high level of non-compliance--we are a law-abiding nation at heart--is the fact that, in their heart of hearts, people do not believe that they have had justice; they think that no one has listened to their individual circumstances and they are incensed to the point of being driven into non-compliance. They are not naturally bad people or in any way untoward. They are perfectly ordinary citizens, but they do not believe that they have had a fair chance. They think that what has happened to them is contrary to natural justice so, for understandable reasons, they do not comply.
Mr. Bernard Jenkin:
As the whole taxation system is a based on the principle of a formula and the whole social security system, including means-tested benefits, is based on the principle of a formula, why is it not just, in this case, to have the principle of a formula? Much of life elsewhere is based on such a principle.
Mr. Kirkwood:
The analogy does not hold. Taxation rarely, if ever, takes into account second marriages, second families and all the different circumstances that individuals face.
Mr. Lilley:
Is the hon. Gentleman saying that it is right to have a tax system that does not take into account the complexities of life, but that it is wrong to have a formula that does, that it is right to have a tax system that does not take into account the fact that people may have responsibilities--responsibility does not even enter the calculation of people's tax--but that it is wrong to have a formula that does take into account such responsibilities?
Mr. Kirkwood:
There is some rough justice under the tax system, but I do not want to get too far into that argument.
Dr. Lynne Jones (Birmingham, Selly Oak):
May I help the hon. Gentleman? The previous Government were unable to come up with a formula and, in the Adjournment debate on the CSA on the final day of the
Mr. Kirkwood:
Not only were there 140 amendments; there were 35 statutory instruments in three years. I simply cannot agree with the proposition that that gives anybody a sense of security and of a system working properly and fairly. In fact, all those changes in the last Parliament exacerbated the delays. The target time for clearing cases has improved, but not enough.
It being Eleven o'clock, Madam Speaker interrupted the proceedings, pursuant to Standing Order No. 11 (Friday sittings).
The Secretary of State for Health (Mr. Frank Dobson):
With permission, Madam Speaker, I wish to make a statement on the future of health services in London.
Under the previous Government, there was growing concern about the health service in the capital. Londoners were especially concerned about the programme of hospital closures, which had almost halved the number of acute beds, and also about the availability of accident, emergency and ambulance services and the lack of adequate primary care.
At the general election, we made it clear that we wanted to make sure that every Londoner had access to high-quality services ranging from primary care close to home, to major specialist services in teaching hospitals of world renown. We promised a moratorium on all hospital closures in London while the future of health care for Londoners was reassessed against what Londoners really need.
We are keeping that promise, and today I can announce details of our review of health care in London. Londoners are entitled to expect that the review is conducted by people of distinction, integrity and independence. I am therefore pleased to be able to announce that the review will be conducted by an independent advisory panel. The five members of the panel are Sir Leslie Turnberg, president of the Royal College of Physicians, who will chair the panel; Francine Bates, assistant director, Carers National Association; Professor Ian Cameron, provost and vice-chancellor of the University of Wales college of medicine; Professor Brian Jarman, professor of general practice at Imperial college; and Denise Platt, head of social services at the Local Government Association. I am most grateful to them all for taking on this task.
The panel will review health services in London based on available information and any further work that it decides to commission. It will review health authority plans, to ensure that people living in every part of London have ready access to top-quality primary care provided by general practitioner practices or in new centres offering a wide range of services; top-quality continuing care--including rehabilitation services--for elderly and infirm people, provided at home, in community care centres and in nursing and residential homes; top-quality mental health services, including care at home, in the community, in residential accommodation, in acute psychiatric wards or in a secure environment; services that benefit from improved co-ordination between the national health service and local social services; accident, emergency and ambulance services capable of meeting foreseeable needs; local hospitals, whether providing a full range of out-patient and in-patient services or mainly day care, minor injuries and diagnostic/out-patient services; and major specialist hospitals providing excellence in treatment and care and in teaching and clinical and scientific research.
All that is in line with the Government's vision of a range of top-quality services for all Londoners. The panel will ensure the coherence of plans by health authorities and trusts, including plans for capital investment. The panel will advise, in particular, on the future of Bart's hospital, Queen Mary's' Roehampton and Harold Wood
and Oldchurch hospitals. The review will also take account of the new impetus that the Government are giving to improving public health through better health promotion and prevention.
The panel will report to the Minister of State, my hon. Friend the Member for Darlington (Mr. Milburn). It has been asked to report by the end of October this year. Its advice will be published, and the material that it considers while carrying out its review will be made available to people who want to see it. Individuals or groups who wish to submit written evidence to the panel are invited to do so. Any meetings or presentations will be at the invitation of the panel. In parallel with that, my hon. Friend will be visiting London health service organisations and meeting various stakeholders.
In line with our election promise, no hospital in London will be closed during the period of the review. Agreed service changes that do not involve hospital closures will continue, as will planning and consultation procedures, but any future changes at present being considered will be reviewed by the independent advisory panel.
In law, the panel cannot make binding decisions on the future of individual hospitals, but all such decisions in future will have to be taken in the light of the published recommendations of the independent advisory panel.
11 am
| Next Section
| Index | Home Page |