| Previous Section | Index | Home Page |
3 July 2007 : Column 212WH—continued
Mr. Bradshaw: I will write to my hon. Friend to try to reassure him on that point. I have not seen the advertisement myself and have not had a chance to discuss the details of it with my officials, but I will do so and if he is not satisfied with the reply that he receives, I invite him to come back to me.
My hon. Friend also raised concerns about product availability.
Dr. Pugh: Can the Minister confirm what the proceedings of the product councils will be? Presumably, they will have meetings, debates and input from a variety of sources. Will there be public documents in any shape or form that we can access?
Mr. Bradshaw: I am afraid that I do not know, but I will find out and let hon. Members, including the hon. Gentleman, know.
On product availability, the contract with DHL enables the Department of Health to instruct DHL to list specific products in the catalogue and evaluated products will be made available. On range, because the catalogue will need to expand to achieve targets, more rather than fewer products will be available to the NHS. I hope that that will be of some comfort to my hon. Friend as he mentioned a company in his constituency that manufactures dressings for wound care. The question was asked whether, if a product is not listed in the supply chain catalogue, the NHS will still be able to obtain it. The answer was helpfully given by the hon. Member for Southport (Dr. Pugh): yes, people will still be able to obtain it because trusts are not mandated to use DHL and can purchase direct if they chose to do so. The second point is that it will not be in DHL’s interest to limit products, as it is driven by volume and growth, so it will work with the NHS to secure what clinicians want and need.
My hon. Friend the Member for Merthyr Tydfil and Rhymney and the hon. Member for Eddisbury raised the issue of value versus price and whether there is an inherent conflict between a price-driven approach and what real value is considered to be in a health context. We accept that there have generally been problems with public sector procurement in relation to that because it tends to be price focused. That is exactly why we established the health care industry task force, where we have been working with industry to do two things. The first aim is to create a centre for evidence-based purchasing to devise a common definition of value and to assess products from a value perspective, not simply a price perspective. Secondly, we will create a new integrated procurement framework that will ensure that value, rather than price, is properly assessed in the procurement process. Part of that framework is the development of a new benefits framework that will look at broader value issues, rather than simply price.
On the relationship between the DHL and the NHS, the DHL must partner trust to deliver the contracted service. It has recognised that clinical engagement is
essential to that process. The contract is only nine months old and, as I have mentioned, product councils will build on existing consultation mechanisms, such as the clinical nurse specialist group that already exists.
Mr. Stephen O'Brien: It is perfectly reasonable that we should not expect the Minister to give us definitive answers, but it is, at last, very helpful for us to put these issues in his inbox. Perhaps he would like to reflect on why there was such a rush to get the whole thing going before the product councils were established, whether that was entirely wise and whether there might have been a more useful way to ensure that the process was kicked off in the right way.
Mr. Bradshaw: I hope the hon. Gentleman will forgive me, but I have only been in this job in working terms for less then 48 hours and have not yet become an expert in what has gone on with this issue in the past two years. I have done my best to grasp the bare essentials of this subject in the last day and a half and to do all the other things that one has to do in the first day and a half in a new job. I will endeavour to come back to this issue, and I offer an invitation to him, my hon. Friend the Member for Merthyr Tydfil and Rhymney and the hon. Member for Southport to come and have an in-depth briefing in my Department. If they still have outstanding concerns, they are welcome to come back and talk to me about them.
Mr. Havard: I thank the Minister for that invitation, and I am sure that we will find a way to take it up, because this important issue will roll forward over some time and will need monitoring; it does not just relate to a single incident. He mentioned the process of how the supply chain will involve itself with the NHS, and I will remind him of something that I said that he may have missed. As I understand it, the director of procurement of the supply chain says that he will be under no obligation to take notice of the guidance and technology appraisals of the National Institute for Health and Clinical Excellence or the recommendations that come from CEP, which is the organisation that he says has been established to do that.
Mr. Bradshaw: Again, if my hon. Friend is not satisfied that his questions have been dealt with, I will have to clarify the issues that he has raised in writing, following a briefing in the Department. I apologise to hon. Members for being unable to answer all their questions. I have endeavoured to answer as many as I possibly can, but it would helpful—not least for my own knowledge of this subject—if they were to have a full briefing with officials in my Department. They are welcome to bring any further questions to me for clarification.
12.26 pm
Public Services (Gloucestershire)
12.30 pm
Mr. Mark Harper (Forest of Dean) (Con): It is pleasure to serve under your chairmanship, Mr. Hood. Before I start, I would like to welcome the new Minister in what I believe is her first parliamentary outing. I am sure that she will do very well and, hopefully—from her point of view—follow in the path of her predecessor’s meteoric rise.
The subject of my debate is the funding of public services in Gloucestershire and the comprehensive spending review. My objective is straightforward. A number of the public services in Gloucestershire, ranging through local government, health, policing, education and transport, are funded either directly or indirectly by central Government. Gloucestershire tends to appear at the bottom of funding league tables in most cases. In some cases, one would expect it to be towards the bottom, owing to the nature of the area relative to others, but in some cases one would not. I wanted the opportunity, therefore, to put my constituents’ concerns on the record prior to the Government’s conclusion of the comprehensive spending review in the autumn, in the hope that they will be addressed, at least in part, and that the disparities between Gloucestershire and other authorities will not get worse, even if we do not expect rapid improvement.
It is not always clear to people locally exactly what the Government spend in particular areas. If the Sustainable Communities Bill, which is currently in another place, gets through Parliament, central Government will be required to make clear how much they spend on local services in each area and, as my right hon. Friend the Leader of the Opposition said, it would
“significantly alter the balance of power in favour of local councils and local communities”
because the amount of money spent by central Government in each area would be much clearer. People would be able to see exactly how much of their tax was coming back to their local area.
Given that that Bill has not passed into law yet, it is difficult to assemble all the data. However, I shall put some figures on the record and hope that the Minister can respond. I shall deal, first, with health, which I know is a matter close to her heart; in her constituency of Burnley, she has been involved in a number of local campaigns, as I have, to save local hospitals, and busloads of her constituents have come down to Westminster to protest about cuts in local services, which indeed has happened in my constituency. As a constituency Member, as well as a member of the Government, she will know how much such matters concern local people.
Gloucestershire receives about 90 per cent. of the national average for health care funding, which, were we to receive it, would amount to an extra £66 million. Over the last few years, we have been facing cuts in services at community-hospital level—I am pleased to say that we saved the hospitals at Dilk and Lydney in my constituency—and currently are trying to fight off cuts to mental health services. In part that is down to deficits and a lack of funding that does not represent properly the health needs in my constituency and Gloucestershire more widely.
In this debate and the comprehensive spending review, I hope that the Government will address the health
allocation formula, which divides health spending around the country. One of the reasons that Gloucestershire does rather poorly is that the current formula focuses more on deprivation than on rurality or the age profile of areas. However, I noticed a piece of good news in the constituency health profiles just published: given that, in the Forest of Dean, female life expectancy, as well as that for males, has risen, women now live longer there than in England as a whole. Although those two pieces of news are very welcome, they mean that the population is ageing, and older people use more health care than younger people. The overall prevalence of disease in my constituency and Gloucestershire will rise with that higher age profile, which will push up the cost of health care. The current formula does not represent that adequately, which will give us a problem in the future.
On policing, again, the bulk of funding for our local force, the Gloucestershire constabulary, comes from central Government. This year, the Government grant will give our police force the equivalent of £97 per head of population, whereas across the country, that figure is £122. That difference would equate to an extra £14 million for our county’s police. Even if we exclude the large metropolitan forces from that equation, we are still being underfunded to the tune of about £7 million, which means in Gloucestershire that the police authority has had to put up the council tax precept rather higher than the rate of inflation.
Most members of the public in my constituency will remember that, a few years ago, in 2003-04, there was a 51 per cent. rise in the police precept in order to create a large number of detective posts and firearms officers for the level 2 policing that the Government talked about in their review of the attempted mergers of police authorities. That was tackled locally in Gloucestershire. However, that huge increase was driven largely by the lack of funding from the centre. Dr. Timothy Brain, our chief constable, who is also the finance spokesman for the Association of Chief Police Officers, has been warning, both nationally and locally, that there will be a squeeze on the number of police officers in the coming years as costs rise ahead of Government grants. That will be a particular problem in Gloucestershire because of our relative lack of funding compared with other parts of the country.
The Conservative county council that gained control in 2005 promised broadly in its manifesto an extra police officer in each electoral division, which is being paid for by the council tax part of the overall council tax, rather than by the police precept. There are now a significant number of officers. In fact, all the increases in the number of police officers since 1997 have been funded, not by central Government, but either by the county council or the local precepts. We have more police officers, but the credit needs to go to the police authorities and local taxpayers, rather than central Government.
I shall move on to education. It is extremely well known, in Gloucestershire and elsewhere, that our county is in the F40 group of education authorities, which are the worst funded in the country—Gloucestershire is the 11th worst funded. Our children get about £315 less per head than the national average, which equates to £25 million over the year, or about £750,000 for a large secondary school. Clearly, governing bodies and head
teachers in those schools would see the tremendous difference that they could make, if that funding were applied more evenly.
On transport, there is a small specific issue, of which I gave the Minister prior notice, concerning the changes to taxi licensing in the Road Safety Act 2006, which will lead to higher costs for the county council in providing public transport. In Gloucestershire, there is a great deal of use of private hire vehicles on long-term contracts to transport children to school, particularly those with special educational needs. Drivers working on those long-term contracts used to be exempt from the licensing regime, but that is no longer the case. That will drop a cost straight on to the council that will not be covered by central Government funding. Again, that is just another example of how financial pressures hit constituents in my area and the county as a whole.
It would also be helpful if the Minister could address the amount that local government is expected to get. For example, this year, Gloucestershire received an increase in its grant of only 2.7 per cent. when inflation was running at 4.2 per cent. The county council’s allocation from central Government is £163 per head, compared with the national average of £170—a difference of £4 million. If the county council got the national average grant, no rise in council tax would have been needed this year, which would have been very welcome, particularly for pensioners and hard-pressed families who find the council tax a real burden.
The Government’s changes to supported borrowing have hit the county council’s funding as well. As the Minister will know, supported borrowing is a method whereby councils can borrow money to build and refurbish schools and to repair and develop roads, for example. The Government used to give the council a grant to cover the interest and repayment charges, and the charges therefore did not hit council tax payers. That grant has now been cut on future borrowing, meaning that councils will have to spend less capital, or they can continue borrowing the money but will have to meet the full cost of the interest payments, which will push up council tax, hitting local council tax payers. That is of particular concern to those in the community who have the most difficulty in paying the council tax.
Despite all those financial pressures, the county council in Gloucestershire should be praised for its efforts in keeping the council tax down. That was the top priority in its 2005 manifesto and it kept the increase down to 3.4 per cent., which was excellent news for those on low incomes and pensioners, but it required a huge focus on efficiency savings, which are obviously easier to achieve in the initial stages and cannot be carried on for ever.
It is worth noting that in the current year the Government have cut the funding for flood protection in the midlands. For the purposes of flood protection, my constituency is in the midlands, although it is in the south-west for all other purposes. Given the events of the past few weeks and the fact that my area and areas like it are very vulnerable to flooding, I hope that when the Treasury is examining flood protection in the future, it will ensure that those short-term cuts—frankly, they are short-sighted cuts—do not take place again.
I touched on rurality—rural areas and the cost of delivering public services in those areas. Few of the funding formulas that are used to dish money out across the country take adequate account of that. Delivering
services in a rural area is more expensive due to the costs of transport, a dispersed population and the time, and number of people, needed to deliver the services. That is not reflected adequately in those formulas, particularly for health. It is worth noting that the formulas used by certain devolved nations in the United Kingdom for distributing that money take more account of rurality and the difficulties of delivering services in rural areas than the formulas do in England. Perhaps the UK Government could, on devolved matters such as health and education, more adequately recognise that.
Something that, to be fair, the Conservatives did to some extent when we were in government, but which the present Government have become past masters at, is loading extra responsibilities and costs on to local government and not adequately meeting those through central funding. The admittedly small example of taxi funding was an example nevertheless of a change in legislation leading to a direct cost on local government with no change in local government grant.
I hope that in the comprehensive spending review the Minister will note the points that I have laid out and that action will be taken on some of the formulas that allocate funding across the whole range of public services. One does not realistically expect them all to be changed hugely overnight, but it would be helpful if the Government said what work they were doing on them, explained the extent to which the rurality of an area—the difficulty of delivering public services in rural areas—will be taken into account, and assured us that all the factors that drive cost, such as the age profile of the population, will be better taken into account in the future. If the Minister does that, the people of Gloucestershire and the Forest of Dean will have much more confidence when the Government finally announce their public spending proposals for the next three years when they publish the comprehensive spending review in the autumn.
12.43 pm
The Economic Secretary to the Treasury (Kitty Ussher): It is an honour to make my Commons ministerial debut under your chairmanship, Mr. Hood.
I congratulate the hon. Member for Forest of Dean (Mr. Harper) on securing the debate and representing so eloquently the views of many of his constituents and, indeed, the wider interests of the local authority. He raised some interesting issues, not all of which, I am delighted to say, are my ministerial responsibility, but the manner in which he raised them has shone a spotlight on the need for the Government to think in a cross-cutting, cross-departmental way when considering such issues. I am grateful to him for that and for the constructive way in which he approached the debate, which has allowed my officials time to provide some answers that I hope his constituents will find useful. I should like to make a couple of observations as a general response to the points that he raised. I shall then deal with the specific points, and if I have any time remaining, I shall perhaps make some observations about how this debate fits into the comprehensive spending review.
The hon. Gentleman was right to say that many of the issues are perhaps best discussed in the debate taking place on the Sustainable Communities Bill, which is going through Parliament. One of its provisions would place a duty on the Secretary of State to provide a local spending report, which would consider the net
effect on a certain geographical area of the various spending decisions that are taking place. That may not lead to a change in those decisions, but it will shine a spotlight on whether there are any anomalies that local communities may want to lobby about or may consider unfair. The hon. Gentleman raised a valid point, and it is interesting to consider the effect of a number of different decisions on a particular geographical area.
A number of points that the hon. Gentleman rightly raised will be considered as part of the routine negotiations that take place between every local authority and the Department for Communities and Local Government in relation to the always intense and strongly argued representations that are made as each annual funding process is gone through. Like every other MP, in acting as a constituency MP I have made strong representations. It almost seems to me that we get into more trouble if we do not. MPs who do not make representations may be subject to a cut, as opposed to those who do make representations being subject to something favourable. The hon. Gentleman is right to raise these issues, but they will be considered as part of that routine process.
As part of the CSR, my Department and other Departments in Whitehall are engaged in more blue-sky, root-and-branch consideration of the demands that currently apply to local authorities due to pressures that have arisen from elsewhere, and the implications for local government finance of the way in which Government policy has evolved elsewhere. I am thinking, for example, of the new obligations that we are taking on in respect of waste. The Government are considering that and I urge the hon. Gentleman’s council and others to make their views known strongly as part of that process, because our intention is certainly to listen.
It may be helpful if I outline the basis for determining the level of local government grants. Perhaps the difference between us is that the hon. Gentleman emphasised, rightly, the level of funding in terms of input—I disagree with some of his numbers—but the process that the Government go through involves considering the effect of that spending. The amount allocated to Gloucestershire is not determined arbitrarily; the amounts are determined through a clear and rational process based on the needs of each local authority. I shall not bore the House by explaining the funding formula in all its detail, not least because, thankfully, it is not my responsibility. If there were a great clamour, I could try, but I am not sure that there is. However, it is important to realise that it takes account of a large number of characteristics of each authority, including demand for key service areas, such as adult social services and children’s services. That is calculated on the basis of the area’s population: the number of people employed and unemployed, the number of children and so on.
| Next Section | Index | Home Page |