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Dr. Julian Lewis: I agree with what the hon. Gentleman said about the out-of-hours service. Does he agree that one of the strange precursors of the present situation was the fact that the GPs who always used to be on call were given the option of taking a very modest reduction in their income in order to shed that major responsibility? Was not the present disaster an entirely predictable outcome of their being given that choice?
Steve Webb: The hon. Gentleman is right to say that what has happened was predictable, not least because the primary care trusts, which are now responsible for putting in place alternative provision, do not have the budget necessary to pay for the most expensive part of the provision, which is the bit that nobody wants to do—call-outs in the middle of the night and at weekends. That was foreseeable, and I am concerned that so far nothing is being done rapidly enough to address the matter. Lives are at risk as long as the problem is not addressed.
When things go wrong with out-of-hours GP cover, there is a knock-on effect on our accident and emergency departments. Again, I draw on my own constituency experience. Our accident and emergency departments are overstretched, partly because people often cannot get a GP out of hours, so they head down to the A and E department, which was never meant to provide many of the services that out-of-hours GP cover should provide. There are knock-on effects through the system when one part is not working properly.
I want to raise with the Secretary of State the issue of accountability in the NHS. For me, that is one of the biggest gaps. Trying to establish who is responsible in the NHS is like trying to grab hold of a greasy stick. To cite another constituency example, Frenchay hospital is set to be downgraded—to use the jargon—from being a major international hospital with more than 700 beds to being a community hospital with 50 beds. I have raised the matter in debates in the House on more than one occasion. Each time the relevant Minister of State has said, "Nothing to do with me, guv. This is a matter for the locals."
That sounds great, but when one finds out locally who made the decision, it is the unelected chairmen and chief executives of the trusts and the executives of the strategic health authority, none of whom we can vote out if we think they made the wrong decision. As far as I am aware, the overview and scrutiny committees are not in the business of sacking chief executives when they make the wrong decision. When my constituents and thousands like them are confronted with a decision that they do not like about a hospital trust or an accident and emergency department, whom do they hold accountable? The money for any reform will ultimately come from the Secretary of State, yet her Ministers tell me she is not accountable for what is going on. I should like to have a discussion with her about that.
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There are other important issues that we should flag up. There is a huge problem of capacity in our health service. Very often, when reform and modernisation take place, new hospitals are built with fewer beds than those that they replace. I am not convinced that, with a growing ageing population, we can get away with cutting bed numbers. Recently GPs in my constituency were written to and asked not to send people to hospital. The hospital had eight or nine wards closed because of infection, which is clearly germane to our debate, and therefore could not cope. The accident and emergency department was overwhelmed. Against that backdrop, telling my constituents that there should be fewer beds, not more, is a hard message to sell.
The NHS will try to be more efficient by driving people through more quickly, with higher bed occupancy and shorter stays, but we all know the problems with that. Linking that with the MRSA debate, there is clear evidence that driving up bed usage beyond certain critical thresholds is damaging for infection control. If beds are essentially never empty, how can standards be maintained? I am pleased that the Secretary of State appears to recognise that. When the Government came to power, bed occupancy was around 80 per cent.; by last year it was 87 per cent., and there are plenty who feel that that is too high.
Professor Barry Cookson of the Health Protection Agency has said that that high bed occupancy is related to the rise in hospital-acquired infections. He says:
"We have got to get down to 85% . . . Patients should realise that there is a certain safety level above which we start having problems."
Without going on at length about the targets culture, the danger is that one bit of the Department will say that waiting lists must be brought down and we must achieve this and that goal, and another bit will say that if bed occupancy is driven up beyond 85 per cent., 87 per cent. or 88 per cent., quality health care, another goal, will be sabotaged. I hope that the Secretary of State will oversee—dare I use the phrase?—a joined-up Department whereby a target in one area does not have a counterproductive effect elsewhere, as a plethora of targets are wont to do. Clearly we need to monitor and know what is going on, but a plethora of centrally driven targets can be counter-productive, and MRSA is a classic example of that.
Martin Salter: On the general issue of hospital-acquired infections, will the hon. Gentleman join me in condemning the scare tactics and downright lies put around in Conservative party advertisements during the general election campaign? In my constituency, we were treated to two separate advertisements on two separate days giving two entirely different figures for MRSA. In the Reading Evening Post the figure was 161 and in the Reading Chronicle the figure was 69. The true figure was 38. Does the hon. Gentleman agree that the Conservatives have lost all credibility on this issue?
Steve Webb: I agree with the hon. Gentleman that some outrageous scare stories were put out. As was mentioned earlier, for people to be afraid to go into hospital because of an exaggerated fear of what they might get is unacceptable.
Many practical things can be done, and we await the Government's Bill. Simple measures, such as more isolation facilities, have an important part to play. There
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is the danger that if we simply penalise hospital managers or staff, who often have limited room for manoeuvre, we may penalise the wrong people. We will look hard at what the Government have promoted, but practical measures can be taken to tackle these important areas.
Having taken on this role barely a week ago it would be presumptuous of me to lecture the House on the answers to all these problems. [Interruption.] Not that I would usually let that stop me. But one of the critical points that I want to make is that Liberal Democrats are passionately committed to making the health service, with its founding principles, work; that there are too many cases where the hard-working individuals within the health service, who are doing their best to deliver quality health care, are thwarted at every turn, whether by centralised targets or by counter-productive instructions from the Government; that we believe that there is an urgent need for health service reform; that many of the market-driven approaches and perhaps dogmatic approaches to private provision need looking at again—but that our health service has the potential to be great once again, and we, the Liberal Democrats, will be at the forefront of ensuring that it is.
Mr. Deputy Speaker: Mr. Speaker has placed a 10-minute limit on Back-Bench speeches, which takes effect from now.
4.58 pm
Mrs. Sîan C. James (Swansea, East) (Lab): It is with great pleasure and some humility that I rise to make this, my maiden speech. I am conscious of the trust placed in me by the constituents of Swansea, East, and I am pleased that I have the opportunity to speak in the debate on the Queen's Speech, in which we are discussing the most innovative and challenging proposals of an historic third-term Labour Government.
Being aware of the conventions and traditions of the House, I begin by recognising the contribution made here by my predecessor, Donald Anderson. His work and commitment to all parliamentary and constituency matters are legendary, and in a career that has spanned more than 30 years he has served his country and the people of Swansea, East well. His roots are deep in the communities of Swansea, but it is a less well-known fact that Donald has Norwegian blood. One of his forefathers, a Norwegian sailor, came to Swansea and settled in Aberdyberthi street, and the rest, as they say, is history.
I have often wondered whether it is this unique racial mix and the blood of his seafaring ancestors that have given Donald his interest and great insight in all matters foreign. I dare say that they were the seed of his diplomatic career and subsequent involvement in the Foreign Affairs Committee. In his role as Chairman of the Committee, he achieved recognition across the world and gained the respect of many diplomats and leaders. It is true to say that he always undertook his role with charm and ease.
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Donald is known to everyone in Swansea, East, and I hope to achieve a similar level of recognition and respect over the next few years. I am confident that he will continue to play a full and active role in British politics when he becomes a Member of the other place. Lord Anderson of Swansea will, I am sure, be a working Lord, contributing his huge experience of foreign affairs and a lifetime of public service to the upper House. He has been and always will be a true son of the city of Swansea, and in his new role, he will have even greater opportunity to promote Swansea and its people.
There is much that I can say about Swansea at this point. Many people are aware of its links with Dylan Thomas, but we in Swansea, East have our own poet, who, through his music and words, will be well known to many of you. Gwrosydd, the famous Welsh bard, lived and died in Treboeth, and here he wrote the words to one of the most well-known and beloved hymns in the Welsh language—"Calon Lan", "A Pure Heart", a hymn that is sung with hwyl and often hiraeth wherever Welsh people gather to celebrate their language and culture.
The history of Swansea stretches back even further. Tradition tells us that the settlement was founded by Viking raiders and grew steadily over the centuries, but it was in the 18th century that Swansea came to prominence, with the expansion of the copper smelting industry, and it exploded with the arrival of the industrial revolution. It is a city built on the wealth of its natural resources—coal, an abundant water supply, a navigable river and, of course, its greatest asset: a supply of hard-working people willing to undertake the work needed to develop industry and sustain a growing population.
Landore, Llansamlet, Hafod, Plasmarl, Morfa, Port Tennant, Danygraig and Bonymaen are areas of Swansea, East where industry flourished. The eastern side of the town grew quickly to meet the needs of those who flocked here to work. Names synonymous with the area are Morriston, Mynnyddbach, Penderry and Cwmbwria, which developed alongside industry and today are vibrant communities.
Recently, developments in the area have swept away the old traces of our industrial past. New developments such as the Morfa stadium, which is soon to be home to the Ospreys rugby team and Swansea City football club, have risen phoenix-like out of the ashes of industrial waste and now stand as beacons for the future. They are the visible signs of a new, more confident city that is able to meet the needs of future generations. The SA1 project is another flagship development. This ambitious project is transforming the old dockland area of Swansea, East into a place where business and innovation will work hand in hand, developing new ideas and providing companies with the ingredients that they need to create more jobs and generate further development in the city.
Working in partnership with local business people, the Welsh Development Agency and the Welsh Assembly have established the Technium centre, which is supporting a range of innovative local initiatives. The development has also attracted local companies, keen to take advantage of business opportunities. One of those is the Ethos project, which is encouraging a cluster approach to business support and will provide businesses with the environment that they need to succeed.
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I am proud that those projects are in Swansea, East and that our communities are yet again embracing changes that will affect them, but deliver even more security and opportunity to greater numbers of people. It is that flexibility and willingness to develop and embrace change that enabled our forefathers to establish Swansea and help develop it as one of the major ports of Wales, and it will help to ensure that we meet the challenges of the future.
I am a Swansea jack, born in the constituency and raised in the Swansea valley. Swansea has always been the linchpin of my life and it is now the centre of my working life. I am for ever linked to the city by birth and now commitment. I believe that my political career mirrors the guts and determination of the people of Swansea. From an early stage, my parents Martha and Melbourne encouraged me to stand up and be counted. I left school at 16, married and raised a family. My husband of almost 30 years, Martin, and my son Rhodri and daughter Rowena have always been there, keeping my feet firmly on the ground. My commitment to issues affecting my family and wider community encouraged my early interest in politics, but it was the miners strike of 1984 that catapulted me into direct action and got me involved with Labour party politics.
I learned valuable lessons during that strike. I learned that I was a woman, not a mother or wife; I learned that I was strong; and I learned that I could stand side by side with my husband to try to keep his pit open and our community alive. In that year of struggle, other women and I in the Neath, Dulais and Swansea valley miners support group found a new political voice that we wanted to be heard further afield than our own community.
At the end of that bitter struggle, I was chairwoman of the south Wales women's support group. I realised that I wanted to follow a different path from that of my mother and her mother, so I enrolled as a full-time university student in Swansea and, having graduated, worked for a variety of community-based organisations. My career has involved, and always will involve, working with people, particularly women and children. My most recent post was director of Welsh Women's Aid, an umbrella organisation for 35 groups across Wales that provide services for women and children who are experiencing domestic abuse.
My association with women and children nurtured my interest in women's rights, equality issues and children's matters, which are issues that are dear to my heart. As MP for Swansea, East, I intend to promote the wonderful work undertaken across my constituency by the myriad organisations dedicated to supporting the rights of women and children. Those organisations include Morriston children's centre, which was founded to work with less advantaged families on estates such as Clase and Caemawr and which encourages community participation. The Spark centre in Blaenymaes is another first-class project, and the dedication and enthusiasm of its team, which works day in and day out to support children and their parents, are an inspiration to us all. The Gap project, which is based at Cornerstone church, Portmead, provides excellent support and encouragement to disaffected young people. At Daniel James community school, the OWLS project takes young people who have been excluded from school into the community to work alongside the elderly, which helps to develop the community.
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I welcome the proposals in the Queen's Speech, particularly those that will deliver improved services to women and children. As a member of the Labour party, a community activist and, now, a Member of Parliament, I am proud of all that the Labour Government have achieved. I thank the people of Swansea, East for putting their trust in me, and I promise to work alongside them and to continue to improve the quality of their lives. I want to ensure that the issues that we all hold dear, such as community, respect and hard work, are recognised. I am committed to providing high-quality public services and ensuring that our homes and communities are safe and secure for everybody.
Finally, I want to thank an old-age pensioner who wrote to me during the recent election. In a shaky, barely legible hand, he told me why he was voting Labour and why he was telling his family and friends about our achievements. I was humbled by how positive he was about all that we have done and what a difference a Labour Government have made to him and countless others. His words reminded me what a privilege and honour it is to be a Member of Parliament.
It is possible to achieve a great deal on behalf of others, which is always the litmus test of effectiveness. When I ask myself the question, "What have I done to help others?", I want to be able confidently to answer, "As much as I can."
5.8 pm
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