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19 Oct 2006 : Column 1107

We have heard a lot about enlightened shareholder value being the cornerstone of the Government’s policy for company law in the 21st century. I believe that our system limits enlightened shareholder value, as the bulk of most large companies’ shares are controlled by institutions or other large companies. The hon. Member for Rutland and Melton (Alan Duncan) dismissed problems to do with disclosure about how institutions vote, but it is a vital matter. Many of us do not hold shares as individuals, but the institutions to which I referred control our pension funds or other investments. If we are serious about ethical investment, we need to know how they deal with those matters on our behalf. One of the most important facets of the Bill is that it will give many small shareholders the information that they need to understand what is happening to their investments.

A couple of days ago, I spoke to clause 173, which was presented as a way of improving directors’ responsibilities in respect of the environment and other matters. As I said, the clause is a step forward, although it does not go far enough. We will have to revisit the matter, as the world is changing. I heard this morning that the Conservative party, like the Liberal Democrats, is discussing green taxes. I am sure that other parties will follow suit, which means that all companies will have to change. That will have a knock-on effect on how directors react and companies work.

Another strand to the argument has to do with the proposed climate change Bill. If such a Bill comes before the House, that too will have an impact on companies. It does not contradict what has been achieved with this Bill to say that the climate change legislation must place a responsibility on directors to react to environmental issues.

Finally, it has been noted that many clauses have not been discussed, although the huge number of clauses means that we would still be talking next Christmas if we had debated all of them as much as some would have preferred. However, we did not discuss the important new clause 3, which was due to be debated today. It deals with the liability of UK companies for the actions of their overseas subsidiaries.

I raised the matter on Second Reading, when I said that the legal system in many developing countries is not sufficient to allow people to gain redress for the actions of companies. The Secretary of State said that he would be very reluctant to encourage widespread litigation in UK courts simply because remedies might not be easily available in some countries. However, if we as a developed nation are not prepared to give people the opportunity to take matters to court—and only a small number of UK companies would be involved—we are failing our responsibilities to the developing world.

The Government argue that the Bill is not the place to deal with such matters, but it codifies the law affecting UK companies so, if it is not appropriate for
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the purpose that I have set out, what would be? We have been told that the Bill sets out company law in the 21st century but it has been noted often enough over the past few days that the world is changing. Companies have to change with it: issues to do with the environment and trade justice are much more to the fore, and companies need to reflect our changing times. This was the time and the place to tackle the issue, and to ensure that UK companies were at the forefront in accepting responsibility for their actions, and those of their subsidiarie overseas. The best of our companies already do that; I stress that we are not talking about the majority of companies, which act responsibly in most areas. One of the problems is that people in many developing countries cannot easily get access to the courts. We have a well developed legal system, and a massive Bill on what our companies can do. We should have taken that extra step and allowed justice to prevail for those affected by the actions of some in the third world, and it is a shame that we did not.

5.15 pm

The Solicitor-General (Mr. Mike O'Brien): I thank all Members for their contributions, particularly those who were on the Standing Committee. Britain is part of a global economy. Nobody owes us a living in that economy, so we must ensure that we modernise our industry and our tax laws. As the hon. Member for Cambridge (David Howarth) said, we must modernise the hard-wiring of the economy—the company law—and we must get it right. That is what we have done during our consideration of the Bill.

The Bill had a very long gestation—it was eight years in consideration, and the company law review looked into all aspects of company law. Initially, the legislation was the Company Law Reform Bill, and it then became a consolidation Bill. We have struck the right balance between ensuring that we build on the need for an enterprise economy and introducing the right element of regulation. We thus create fairness for shareholders and allow them better control over the companies in which they invest. Rightly, in addition to considering those issues, we looked into the subjects of animal rights and terrorism, and some of the other problems that the hon. Member for Beckenham (Mrs. Lait) identified in her contribution.

I thank all those who have contributed, particularly my noble Friend Lord Sainsbury and my right hon. and learned Friend the Attorney-General, who spoke in another place. I thank my right hon. Friend the Minister for Industry and the Regions for the way in which she piloted the Bill through its stages. It is a major reform that modernises Britain’s company law, and it will make our economy stronger. In no small part, that is thanks to her dedication and effort in ensuring that the Bill becomes law.

Question put and agreed to.

Bill accordingly read the Third time, and passed, with amendments.


19 Oct 2006 : Column 1109

Health Care (Suffolk)

Motion made, and Question proposed, That this House do now adjourn. —[Mr. Heppell.]

5.17 pm

Mr. John Gummer (Suffolk, Coastal) (Con): I wish to discuss national health service provision in Suffolk as a whole, and in my constituency of Suffolk, Coastal, in particular. I begin by making two points to the Minister. First, I recognise that additional funds have been put into the national health service—indeed, I not only recognise the fact, but support it. Secondly, I recognise his good faith and the fact that he has shown competence and directness in handling the issues of the national health service since he took over the job. For that reason, I hope that he will not take some of the hard things that I will say personally, or as a comment on what is happening across the country.

My case is that Suffolk has particular problems that are clearly not of our own making, or the making of the people whom the Government have put in charge of our national health service. The key figures are simple. In the pecking order of 304 primary care trusts that, until recently, were in operation, Suffolk Coastal was 210th, receiving 91.5p against a standardised average of 100p. However, if we look at the number of over-65s in the 646 UK constituencies, we see that my constituency ranks 16th. My Suffolk, Coastal constituency and Suffolk Coastal PCT are not entirely coterminous but, to all intents and purposes, that is a perfectly reasonable comparator. As age is the biggest determinant of need in the health service, one would expect a rough correlation between areas with a higher proportion of old people—22 per cent. of my constituents are over 65, many of them are very old indeed, and a high proportion live in single-person households—and areas where the NHS receives an above-average sum from central Government.

The correlation would not be exact, as there are other issues to take into account, but there is a serious mismatch between my constituency, which is ranked 16th of 646 constituencies, and the PCT, which is ranked 210th of 304. That is neither right nor sensible. The fundamental problem is not one of spending but of under-resourcing. The way in which the Government hand out money makes it impossible to provide even an average service, as we receive less than average per head. The figures are even tougher for Suffolk as a whole, as the county receives 82 per cent. of the average funding, even though the average age of the people who live there is at the upper end of the spectrum.

The Government’s own quango, the Countryside Agency, which is responsible for dealing with the countryside, has pointed out that rural provision costs 70 per cent. more than urban provision. The cost of health cover in rural areas is 74 per cent. greater than it is in most urban areas. As the area is almost entirely rural, the funding arrangement is not sensible. On the Government’s own figures, it ought to receive a higher than average sum, not a below average sum. It is not just one PCT or one hospital that has overspent its budget over many years but every PCT and hospital.


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To misquote Lady Bracknell, for one PCT to overspend might be thought an accident but for every PCT and hospital to overspend must be considered carelessness. The question is, whose carelessness? It is not, I submit, the carelessness of the heterogeneous collection of people appointed by the Government to run our local services—it is the Government’s carelessness in a number of specific instances. The amount of money accorded to those institutions is unsatisfactory. Every indicator suggests that we should receive more than average, but the Government have decided to give us less than average. Every indicator suggests that it is more difficult to provide services in that part of the country, but the Government have decided that it should receive less than other areas.

Everybody knows that old age is the major indication of need for help by the national health service, but the Government have decided that it is not suitable as a proper reflection of the situation when it comes to deciding what the resources shall be. They have changed the way in which they measure by reference to a deprivation index. I am all in favour of that, except that that it is what is necessary for a preventive health service, yet we have an acute health service. Perhaps the Minister would like to have something different, but that is what it is. That means that we have to try to determine the real measure of the need for acute services: again, it is age that really matters.

So who is being careless? First, the Government are being careless because their method of sharing out the money detracts from the ability of anyone in Suffolk to deliver the service that should be delivered. Secondly, the people whom the Government have put in charge are being careless. I do not know what the strategic health authorities do for their money. When one asks them whether their purpose is to represent to the Government the needs of their areas, they say no—that is down to Ministers. If one asks them whether it is to keep the PCTs within their spending limits, they say no—that is down to the PCTs. When we ask Ministers what their purpose is, they tell us that they are supposed to keep the local PCTs, hospital trusts and the like within their spending limits. Why the blazes, then, was the PCT overspending with no reference to the strategic health authority?

Mr. David Ruffley (Bury St. Edmunds) (Con): I am enjoying my right hon. Friend’s contribution, as will all patients in Suffolk. He may remember that it was said of the Holy Roman Empire that it was neither holy, nor Roman, nor an empire. Does he agree that the strategic health authority is neither strategic, nor about health, nor an authority on anything?

Mr. Gummer: My meetings with those at the strategic health authority, which were wrung out of them—their incapacity to respond to Members of Parliament is legendary—led me to be even more depressed than I had expected due to their inability to answer any of my questions.

Irrespective of the Government’s carelessness in not reforming the method of handing out the money, if the strategic health authority had been doing its job it would have stopped the overspending of all PCTs and hospital trusts—that is what it must be there for.
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The fact that it did not beggars belief. But do the Government fine it? Are they placing on it the responsibility for paying the debts? No—not at all. It is still there, hectoring, except that it now has an even bigger remit—a larger area to fail to administer and to be an authority for.

It is of course unfair to ask PCTs to provide 100p-worth of services for 91.5p-worth of resources—although it is not really 100p-worth because it should be providing what would cost 72 per cent. more, according to the Government’s own figures from the Countryside Agency.

Primary care trusts should therefore probably provide 110p or 115p-worth of services and it is hard to ask them to work on the basis of 10, 15 or 20 per cent. below the resources that they should have. Even so, that is their job. It is why they are paid and why they are there. They are accountable to no one except the Government.

The Government appoint PCT members, although there is an arm’s length organisation that finds hitherto unfindable people who serve on the boards—most of them unknown to the people whom they represent. None of the non-executive members of our strategic health authority comes from Suffolk or Norfolk, which are two of the largest affected counties. None of them knows about our specific problems. However, they are appointed by the Government. If the appointments commission proposed someone unsuitable, such as me, I doubt whether the Government would confirm the appointment. I have some names that I would like to suggest to the Minister but he will not accept them because the Government want people who kowtow first to the authority and then to them.

The Government, having got the sort and class of people they want—those who do what the Government demand and do not stand up for local people—find that their appointees cannot deliver the goods. Do they fine them? Do those people have their salaries reduced or removed? No. The Government reappoint them and fine my constituents. They say that, because people had more money spent on them in the past than the figures suggest should have been spent, present and future generations must pay.

Waveney PCT was close to paying all its debts and was in credit on a year-on-year basis. However, the Government decided that, far from helping it with the extra money that they promised, it will be fined to help pay for other people whom the Government have failed to control.

The Government are fining my constituents—what is the result of that? It means that NHS provision in my constituency is worse than it was 25 years ago when I was first elected. If the Minister finds that surprising—and it is surprising, given all the extra money—let me explain. In November, the Bartlet hospital, which is a community hospital—the Government have decided to find £300 million to increase the provision of such hospitals—will be closed. The building was presented to the people of Felixstowe through the honourable work of doctors who wanted to provide beds for those who came out of hospital and needed to convalesce. It was especially important for people who live in rural areas and find it difficult to go back to their homes, which are often unsuitable for those who are disabled, at least for a time. Many of them are elderly. People in
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that part of Suffolk, which I did not originally represent, will no longer have the Bartlet hospital. Some refurbishment will occur in Felixstowe general hospital but there will be a lack of beds for rehabilitation and aftercare, which has existed for all those 25 years.

Let us consider Ipswich hospital. I am glad that the hon. Member for Ipswich (Chris Mole) is present. We have had little support from him in our battle for Ipswich hospital and that is sad. If Ipswich were represented today by Jamie Cann, Ken Weetch, Dingle Foot or Richard Stokes—four fine former Labour Members of Parliament—they would have been battering on the Minister’s door. The Minister would hardly have been able to move without their saying, “Do something about Ipswich hospital.” Perhaps the hon. Gentleman has conducted a secret battering, but we have had no support for our fight for Ipswich hospital. I am pleased that he is here because I can give him the figures—I do not think that he knows them. He has certainly not protested about them in our local newspapers. There are going to be 357 redundancies at Ipswich hospital. That figure was confirmed this morning by the hospital’s chief executive, and it represents 10.1 per cent. of the work force.

Hon. Members who have listened to the Leader of the House try to explain away the redundancy figures in the national health service will realise just what that means. It is no good the Minister looking through his papers to try to explain how they will not be compulsory redundancies. It is funny how redundancies are no longer called that. All sorts of other phrases, such as “readjustment of staff”, are used.

Mr. Richard Spring (West Suffolk) (Con): Redeployment and modernisation.

Mr. Gummer: Exactly.

Mr. Ruffley: Service redesign.

Mr. Gummer: Indeed. So far as my constituents are concerned, however, this is going to be a 10.1 per cent. reduction in the work force, and that will include 31 nurses. There are 100 job losses at Ipswich for every nine in Peterborough. That shows the pressure on Ipswich hospital, which serves my constituency and those of my hon. Friends the Members for West Suffolk (Mr. Spring) and for Bury St. Edmunds (Mr. Ruffley), who have fought a noble battle in the absence of any support from the Member of Parliament who ought to be out there on the streets with us.

There are problems not only in Ipswich but in Aldeburgh, a town of some 2,500 people—a bit more if we include the villages round about. Five hundred of those people are over 65 and living on their own. The Aldeburgh cottage hospital—now the Aldeburgh community hospital—is exactly the kind of community hospital that the Secretary of State is supposed to be in favour of. Aldeburgh has halved the number of beds, even though people in the locality have raised a considerable amount of money in recent years to
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provide them. Those beds were serving the community; now they are not. Of course, we are told that this is because of a redesign of services.

That redesign of services is based on the premise that there will now be carers in the community, and that the social care system will be able to go out there and look after people. This illustrates what I mean about the decline in the service that is being provided. Any sensible reorganisation would have put the care in the community in place first, and reorganised the hospitals second. If this had not been a matter of saving money, that is how it would have been done. When I talked to people in Ipswich hospital today, as I have done over many months, they made the point that they were happy to move to new frameworks and systems, but that they did not want to move to the new one after the old one has been closed. We should keep the old one until the new one is seen to be working.

The Minister is unfortunate in that he does not spend much time in my beautiful constituency. It has 74 miles of coastline and more than 100 communities, it is very lovely and it is a long way from anywhere. That is a very good thing. In my constituency, however, there are very few carers. The Minister’s whole argument is based on the premise that enough carers can be found, but I have to tell him that people who pay for carers with their own money cannot find them. There are not even enough carers to meet the present demand, although there is still the full number of beds in the Bartlet and at Aldeburgh.

My neighbour, my hon. Friend the Member for Central Suffolk and North Ipswich (Sir Michael Lord), is not able to participate in this debate because of his position as Deputy Speaker, but he has exactly the same problem in the Hartismere hospital, which I used to represent. That hospital is also under threat, and it will certainly not continue as it is. It will probably be put out to some kind of privatised arrangement, and it might be closed altogether. The fact is that, yet again, we are discussing another community hospital serving an area where carers are almost impossible to come by.

If one in five of the population is already over 65, it is not surprising if it is quite difficult to find carers. That is why the situation is worse today than it was 25 years ago. Of course, it is worse too because then people could go to All Hallows hospital in Ditchingham, just over the border, where Anglican nuns have been caring for people in the most exemplary manner for a very long time. That is to be stopped: the respite and palliative care for the terminally and incurably ill is funded partly through the primary care trust and partly through contributions, but the PCT is withdrawing funding. That threatens the whole service.


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