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Mr. Brake: Obviously, I do not expect the Minister to reveal what is in the Queen's Speech, but does he expect that, in next year's annual report, the word "done" will appear against commitment 115 which relates to greater protection for wildlife?
Mr. Mullin: As the hon. Gentleman knows, the priority that the Government attach to their programme is a matter for finer minds than mine. They are wrestling with the problem even as I speak. However, the Government take the issues seriously, as I hope to demonstrate if I get the time to do so.
We have proposed new powers for the agencies, the most significant of which will allow them, for the first time, to refuse consent for damaging operations. There would be a right of appeal against refusal, but no expectation that the agency would be obliged to offer compensation for activities for which consent is refused. I believe that that answers some of the points raised by my hon. Friends.
We shall also provide the agencies with new powers to combat neglect and to address management issues, so as to secure the positive management that delivers conservation benefits. My hon. Friend the Member for North-West Leicestershire (Mr. Taylor) asked about positive management orders on SSSIs, and our new powers to combat neglect anticipate the procedures that he mentioned, including powers for conservation agencies to draw up objectives for positive management on a site and to make an order requiring action to be carried out, subject to appeal to my Department.
We shall introduce increased penalties for damage to SSSIs, and increased powers to require restoration. We shall also introduce additional powers to deal with third party damage, where greater powers and better enforcement are necessary.
We shall provide the agencies with additional powers of entry to land, and more flexible powers to purchase SSSI land compulsorily, although we envisage that both those provisions would be needed to be used only exceptionally. We shall emphasise the responsibilities of public bodies towards special sites and we shall also propose amending the financial guidelines on management agreements issued under the Wildlife and Countryside Act 1981, to move further away from compensating managers for not damaging sites and towards paying for positive management. That deals with another point that has been raised.
We are absolutely clear that further legislation is needed to underpin partnerships and to provide better means of addressing problems. We have proposed significant new powers for the conservation agencies. However, deliberate damage is rare: what we need to address is neglect and unsympathetic management, which is a bigger problem. Legislation alone will not solve all the problems, and we will be looking for a range of other options to deliver our objectives. The National Assembly for Wales will, in many cases, be responsible for deciding how to proceed in Wales.
The majority of sites remain in agricultural use, so that our overall policies for agriculture, including the development and implementation of agri-environment schemes, remain of fundamental importance. The overall outcome of recent negotiations on common agricultural policy reform, to which the hon. Member for Ashford referred, represents a small step--I shall not make too much of this point--in the right direction. It has potential benefits for the environment generally, and for sites of special scientific interest. The Government have consulted widely on the implementation of optional elements of CAP reform in the United Kingdom, including attaching environmental conditions to subsidy payments, and modulating payments to provide additional savings for a limited number of environmental and structural measures.
A significant number of SSSIs are also in wetland habitats, and are often listed as Ramsar sites of international importance, or they may be affected by issues concerning the quality and availability of water resources. We are fully aware of the public concern over the effects of over-abstraction of water from wetlands. We have asked water companies to include environmental and quality improvement programmes costing around £8 billion in their business plans for the years2000-05, including measures to deal with the adverse effects of effluent or over-abstraction on 102 SSSIs.
The debate today has also referred to several other matters, including, for example, planning and development. We confirmed in the framework document that we would clarify planning policy guidance to reflect the national importance of sites of special scientific interest, with a strong presumption against development that would significantly affect the sites. The test has already been introduced, in relation to trunk roads, through the transport White Paper. We propose issuing for consultation a revision of planning policy guidance note 9 on nature conservation and planning next spring.
In the short time left to me, I shall deal with the questions of my hon. Friend the Member for Don Valley about Thorne and Hatfield. She graphically expressed her concern about several sites, but especially about Thorne and Hatfield moors in her constituency. Let me emphasise that we acknowledge the international importance of the best examples of our peatland resources. They will be included in the Natura 2000 series, through which we deliver our obligations under the European Union's nature conservation directives, or they will be listed as Ramsar sites--wetlands of international significance.
The habitats regulations will also require a review of all extant permissions and consents--including planning permissions that were granted prior to their inclusion in the list of candidate special areas of conservation, or their classification as a special area of protection for birds, under the birds directive. Where the review, which will be carried out by the local planning authority, concludes that the integrity of the site is likely to be adversely affected, the consent will have to be modified or revoked, unless Ministers decide that an imperative reason outweighs the conservation interest.
Caroline Flint:
Will my hon. Friend give way?
Mr. Mullin:
If my hon. Friend will forgive me, I will not, because I have a lot more to say about the points in which she is interested. I shall do my best to say as much about them as possible, although I may have to write to her about some matters.
We drew attention to those obligations and associated procedures in our statement of 12 May 1998. Where permission is revoked or modified, there is an entitlement to compensation, and the Government have indicated that they would consider reimbursing the local authority where compensation costs were high. We have sought advice from English Nature on the effect of existing permissions on a number of international sites and are considering that carefully.
Part of Thorne moors is already a candidate special area of conservation and English Nature is giving further consideration to whether it should be listed as a Ramsar wetland. I am also pleased to confirm that, in the last few days, English Nature began consulting owners and occupiers about the classification of parts of Thorne and Hatfield moors as a special protection area for birds. We shall seek to reach an early decision, once consultations are completed and we receive its report. Classification of the site as a special protection area for birds will inevitably lead to a review of the permission under the habitats regulations.
In addition, the Government are urgently considering ways of expediting reviews on candidate special areas of conservation in the light of the continuing delays in the
process, to which I have already referred, for drawing up a final list of sites for the Atlantic biogeographical region, of which the United Kingdom forms a part. I cannot say more about that today, but I hope to be able to do so very soon.
I now come to the subject of peat. Wider issues--
Mr. Deputy Speaker (Sir Alan Haselhurst):
Order. I am afraid that the Minister will have to write to his hon. Friend the Member for Don Valley (Caroline Flint) on the remaining points. His time is up. We now come to the next debate.
Mr. Steve Webb (Northavon):
In desperation, I have initiated a debate on orthopaedic out-patient waiting times. I feel able to achieve something for my constituents on many of the topics about which I receive letters, but on this subject, I feel helpless.
In the few years that I have been a Member of Parliament, I have received a stream of letters, telling me of increasingly outrageous waiting times. I do my best--I write to the trust, to the health authority and to the Government--but, every month, the letters keep coming. Therefore, I am grateful for the opportunity that the debate gives me to raise the issue of where the buck stops--with the Minister of State on behalf of the Department of Health.
I start with a brief excerpt from a letter from a general practitioner in Yate in my constituency, who copied to me his letter to the Secretary of State dated 18 October. It reads:
I shall cite two cases that show how people on the ground are experiencing these delays. My constituent Mrs. Evans, a civil servant from Chipping Sodbury, now gets around on crutches because of her orthopaedic problems. She would like to stop work because of the pain that she is in, but she has received a letter saying that she will have to wait 78 weeks to see a consultant. She cannot afford to take 78 weeks off work, so she is getting by by working part-time, in pain. She told me that she feels betrayed because she paid national insurance when she could and now, when she needs the system, it is not there.
I told Mrs. Evans--admittedly, with some trepidation--that 78 weeks was a relatively short wait. It did not help her to hear that 104 weeks was the norm, and that 78 weeks seemed a step in the right direction. However, as the chief executive of the relevant trust wrote to me about Mrs. Evans,
Having seen that waiting times were shortening slightly, I was shocked to receive a letter from a constituent, Mrs. Aze, who sent me a letter from the trust, saying that she would have to wait not 78 weeks and not 104 weeks, but between 115 and 125 weeks--nearly two and a half years. Mrs. Aze says:
Mrs. Aze has found out that it would cost £8,000 to obtain a private operation. She cannot afford that. She has been told that she could get a private consultation to skip the 125-week wait, and then wait for an NHS operation, but the health authority, understandably, does not encourage that because, although it would solve one person's problem, it would not tackle the underlying problem.
Not surprisingly, the Aze family wrote to everyone that they could think of. On 29 October, they wrote to the previous Secretary of State. He did not reply, of course; he passed the letter to the south-west region of the national health service executive. Its parliamentary business officer wrote:
I know that action is being taken. The health authority has set up an investigation into out-patient waiting times, which will take 12 to 18 months to complete. Why is that only now being done? I was elected two and a half years ago, and within weeks was receiving letters saying that out-patient waiting times would be 104 weeks. Why has the subject only now acquired urgency? Why did not the investigation start two years ago?
In August, I received a letter from Avon health authority. We seem to be exchanging many letters on the topic. After telling me about all the money that the Government are putting in, which does not seem to be making much impact, the geographical director of the health authority says:
My plea is, will someone, somewhere, take responsibility for this disgraceful situation? I have been writing these letters for two years, and two years is a fairly typical wait in my authority area to see a consultant. I am impatient for action. My constituents are impatient. That is why I have raised the topic today.
Where do we go from here? What does the future look like? This morning, I spoke at length to the chief executive of North Bristol NHS trust. She tells me that the case of Mrs. Aze has moved on considerably. She tells me that Mrs. Aze was told that she would have to wait between 115 and 125 weeks because she had been referred by her GP to a specialist orthopaedic surgeon; that she has now been placed on the list of the fifth orthopaedic surgeon--who, I understand, is more of a generalist--and that therefore she will wait not 125 weeks, but perhaps 25 weeks. I should like to think that her waiting time has been shortened by 100 weeks as a result of my intervention, but I doubt it. However, that does not change the underlying issue.
In response to my debate, and in response to my publicly raising the issue locally, the health authority still admits that 70 weeks is a typical wait. Although Mrs. Aze was an extreme case of someone who wanted to see a specialist orthopaedic consultant, and although this individual case is nearer resolution than it was, Mrs. Evans and many other people are still no nearer resolution.
12.30 pm
"I have an 81 year old patient who was referred for an Orthopaedic appointment in June 1998 . . . he . . . heard nothing . . . We . . . phoned the hospital who told us that"
the likely date for his
"appointment was April 2000; he will have therefore waited 22 months."
That gentleman will have to wait 22 months to see a consultant, perhaps to be placed on a waiting list. I have written to all the bodies involved. All express concern, but little happens.
"waiting times for orthopaedic outpatient appointments . . . continue to be unacceptable."
The trust does not deny that. The chief executive was
"delighted that the Trust was able to appoint a 5th orthopaedic consultant",
as a result of which waiting times have come down from 104 to 78 weeks. The chief executive says:
"I . . . acknowledge that a reduction in waiting times from 104 weeks to 78 is scant comfort for the patient,"
and that there is a health authority problem. She says:
"the area served by Avon Health Authority is under-resourced in terms of orthopaedic surgery".
Ominously, she continues:
"however, there are no resources earmarked for further investment in orthopaedic services, and there are no plans to provide additional capacity for orthopaedic outpatient appointments."
3 Nov 1999 : Column 253
Therefore, waiting times have shortened slightly, but, this summer, the trust chief executive told me that it was a health authority problem, and that there were no plans for extra investment. When we write to the trust, the trust does its best, but says that the health authority is responsible.
"I am approaching 70 years of age . . . my GP . . . considers that I am in need of an examination in the near future to prevent me from becoming a cripple . . . It is obscene to send . . . a letter to a patient who has been referred to you for ACTION",
saying that it will be 125 weeks before she is seen.
"how sorry I was to read about your wife's wait for an outpatient appointment . . . The Government sets a standard waiting time of 26 weeks".
We all fell about when we heard that, because it is nothing like the experience of real people. The letter continues:
"clearly North Bristol NHS Trust are not keeping to this target,"--
we had noticed that--
"so I will refer your letter to"
the chief executive of the health authority. For what?
"I will ask her to write to you with an explanation for the delay".
So the constituent writes to the Government, assuming that the Government have a hand in the matter. The Government pass the problem down to the regional branch, and the region says that the trust is not performing and that it will ask the health authority to explain why. Understandably, the constituent feels slightly dissatisfied with that response.
"monitoring of the service agreement between ourselves and the . . . Trust shows an under-performance of 2,203 new outpatient attendances. We remain in very close dialogue with the Trust on this issue."
3 Nov 1999 : Column 254
I would like to be a fly on the wall and listen to that dialogue.
However, let us get this straight. The trust says that Avon health authority area is under-resourced in terms of orthopaedics--which is true, given the number of orthopaedic consultants per head of the elderly population. Therefore, the trust says that the authority is part of the problem. The authority says that the trust is under-performing. The Government say, "We will get the health authority to write to you to explain why the trust is not performing".
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