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Sir Patrick Cormack (South Staffordshire) (Con):
As it is essential that there should be public confidence in how the disease is tackled, and as we all know that there is no situation that is not made worse by panic, will the Secretary of State assure the House that the
lorries taking the carcases to Staffordshire will not only be sealed but will be escorted by police?
Hilary Benn: I am happy to give the hon. Gentleman those assurances—in that the lorries will be escorted: there will be vehicles behind them to make sure that they are not leaking, and they will be checked before they go. The carcasses that went to Frome during the foot and mouth outbreak were dealt with in exactly the same way.
Stewart Hosie (Dundee, East) (SNP): I welcome the precautionary approach taken by the Secretary of State. I support the call for vigilance and agree that the disease is difficult to catch other than through close and prolonged contact with infected birds. The problem is on the Suffolk-Norfolk border, but the movement of wild birds cannot be controlled, and there are risks for elsewhere, particularly as the H5N1 strain is involved. Will the Secretary of State give an assurance that proper discussions are taking place with the agriculture and public health Ministers in the devolved Administrations, and that proper contact has been made with the chief scientific officers—particularly the chief veterinary officers—in the devolved Administrations as well?
Hilary Benn: The hon. Gentleman makes an important point. If it transpired that wild birds were responsible—that is an “if”, because we do not yet know—that would be a difficult source of transmission to deal with. I am extremely grateful for the support of the devolved Administrations in agreeing, in respect of those parts of the United Kingdom, to the measures that I have announced this afternoon. Yes, we are in close contact; I cannot comment on the relationships between the different Ministers in the devolved Administrations, but the Cobra meeting that I chaired at lunchtime today included representatives from the Scottish Executive and the Welsh Assembly.
Mr. Philip Dunne (Ludlow) (Con): The Secretary of State said that the vaccination programme was applicable to zoos. Will he consider whether farms with rare breeds breeding stock could also be included in that programme? I have a number of such farms in my constituency. Should the dreadful disease spread, it would pose a considerable threat to the future of rare breeds in this country.
Hilary Benn: I gladly undertake to consider that—but there are good and sound reasons, which I have explained, why the policy is as it is. Zoos are an exception because of biosecurity and the containment arrangements that they can put in place. I am sure that the hon. Gentleman would want nothing to be done that might put the control of avian influenza at risk. However, I shall consider the issue that he has raised and come back to him.
Point of Order
4.43 pm
Mike Penning (Hemel Hempstead) (Con): On a point of order, Madam Deputy Speaker. I apologise for delaying the important debate that is to follow. On 30 April this year, I asked the then Solicitor-General two questions: first, about my concerns about the leniency of sentencing, and secondly, about how many times he had referred matters to the Court of Appeal on that subject. Sadly, according to the Library today—some seven months on—there is still no reply. May I seek your advice, Madam Deputy Speaker, on how I can get an answer to those simple questions?
Madam Deputy Speaker (Sylvia Heal): I advise the hon. Gentleman that retabling the question would be one method of eliciting a response.
Orders of the Day
Debate on the Address
Order read for resuming adjourned debate on Question [6 November],
That an Humble Address be presented to Her Majesty, as follows:
Most Gracious Sovereign,
We, Your Majesty’s most dutiful and loyal subjects, the Commons of the United Kingdom and Great Britain and Northern Ireland in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament .—[Mr. Caborn.]
Question again proposed.
Health and Education
Madam Deputy Speaker (Sylvia Heal): The Speaker has selected the amendment in the name of the Leader of the Opposition.
4.44 pm
Mr. Andrew Lansley (South Cambridgeshire) (Con): I beg to move, as an amendment to the Address, at the end of the Question to add:
‘but regret the absence of measures in the Gracious Speech to empower professionals responsible for the delivery of health and education services and of measures which would make those services more accountable to patients and parents; deplore the absence of measures to improve public health and reduce health inequalities; regret the lack of a reformed legislative structure for the National Health Service which would reduce central targets and devolve decision-making closer to patients and enable health services to respond to the need for high quality and accessible care; further regret the lack of measures to deal with school discipline, raise standards in literacy, numeracy, science and languages, address under-performance in the primary sector, tackle disadvantage at its roots and provide effective support in the earliest years; and further regret the absence of measures which would deliver the real improvements needed in these and related public services.’.
Last Tuesday, I sat here and listened to the Prime Minister’s speech, but I waited in vain for him to talk about health or the national health service. Back in July he described the national health service as his priority, but in November that turns out to have come to nothing: an empty vessel—from hero to zero. I suppose that we should not have been surprised, given that last year, as Chancellor of the Exchequer, he completely ignored in his Budget speech the financial crisis that was afflicting the national health service. At the same time, he said that education was his passion. So it may be, but the passion must be for high standards in education, not just for high spending. In last week’s speech, he did not even commend doctors, nurses, social care workers or teachers—all those in our public services on whom we depend—so let me start by doing so.
Public services are vital to our well-being and to our quality of life. We value and support the NHS and its staff, teachers and support staff in schools and colleges, and social workers and care workers. We know that while we can make promises here, it is they who deliver. However, we cannot expect the delivery that we want when morale and motivation in public services is
not high. Earlier this year, a hospital doctor carried out a substantial survey. Two thirds of the doctors who took part said that morale had fallen in the past year, while 54 per cent. said that morale in their hospital was poor or terrible. I am afraid that we need higher morale right across our public services. I therefore make no apology for repeating that one of our central intentions as a party must be to re-empower professionals working in public services so that they can deliver the service that they wish to deliver, whether to parents or to patients.
In the Gracious Speech, Her Majesty, on behalf of the Government, announced that there would be an education and skills Bill. There is something of a theme to this Gracious Speech. For all that the Prime Minister might like it to be thought that there is a change in this Government, in fact there is no change. When I listened to the speech, I thought, “Surely I’ve heard these intentions before”—and so I had. In July 1999 the Government published a document called “Bridging the Gap”—I am sure that the Secretary of State for Children, Schools and Families recalls it—in which Tony Blair said:
“staying at school or in training until 18 is no longer a luxury. It is becoming a necessity.”
Indeed, but that was in 1999. The trouble, as with all these things, is how well the Government have delivered on their intentions.
Eight years on from the intentions expressed then, the number of those not in education, employment or training has risen from 160,000 to 220,000. Connexions, which we were promised in 1999 would be one of the solutions, has come and is about to go. The Learning and Skills Council has gone through an endless succession of reorganisations without ever delivering on its intentions. However, there has not been a recognition of the fact that, as stated in “Bridging the Gap”, non-participation beyond 16 is strongly linked to the relative achievement of young people prior to 16. That is the central issue. That is why what the Government are saying feels like such a failure on their part. Extending the education leaving age is an insufficient response to earlier and continuing failings in educational achievement, particularly among those in low-income households.
Participation depends on motivation, the relevance of the education offered and the reward that young people expect from it. Young people have to think it worth while; there have to be results. If they fail to see results from a decade of schooling, why should they respond positively to more compulsory education and training? My hon. Friend the Member for Surrey Heath (Michael Gove) will explain this in more detail later, but we must tackle the roots of disadvantage, and ensure that young people in schools, including those from the poorest households, have a platform for their participation in learning through life, and see that they can secure their future position through the acquisition of standards, including basic standards in literacy and numeracy, in a disciplined environment.
Ms Dari Taylor (Stockton, South) (Lab):
Is the hon. Gentleman disputing the facts that have been produced by Stockton borough council stating that in low-income areas, the improvement in English and maths
has been between 30 and 47 per cent. during the past five years? That is an incredible improvement in primary schools, which should be celebrated. Is the hon. Gentleman really disputing that that is taking place?
Mr. Lansley: I am sure that my hon. Friend the Member for Surrey Heath will be able to elaborate on that later. All I do know is that the Government’s acknowledged statistics show that they have not met their targets for key stage 2, and we have seen some of the standards in basic literacy and numeracy pretty much flatlining in recent years.
There was nothing in the Prime Minister’s speech, or in the Gracious Speech, on the subject of public health. The Secretary of State for Health said that his priority was to tackle health inequalities, so where was that in the Gracious Speech? Where was it in the Prime Minister’s speech? It was not there at all. Just as we want to tackle inequalities in educational outcomes, we have to tackle them in health outcomes, too, because they have been widening. The Secretary of State must know, because it was in Lord Darzi’s framework for action in London—the right hon. Gentleman has of course subcontracted responsibility for policy in the Department of Health to Lord Darzi, so perhaps he does not bother to read his documents—that the spend per head on public health in primary care trusts in London is inversely related to the relative deprivation of those trusts. Frankly, that is a scandal.
The Government have been distributing ever larger amounts of money in the direction of primary care trusts that have statistics of relative deprivation, and yet what do we find in London? They spend less on tackling that problem. Why do they do that? It is not a wilful desire on their part to ignore their responsibilities. It is because, of course, in the national health service everything is focused, through the target culture, on the delivery of a small number of Government targets. Too little is focused on the necessity of understanding that we must prevent disease and improve health outcomes. That is one of the reasons why my party has made it clear during previous Queen’s Speech debates, and in our own proposals, that we should have separate funding to tackle specific public health needs.
I urge the Government and the Secretary of State, if they are serious about tackling health inequalities, to amend the structure of public health care. In the health and social care Bill, they will do a little to reform public health legislation on the control of infectious diseases, but they could do so much more to ensure that we have a strong public health infrastructure that can use dedicated resources to back up local authorities in the NHS, which are tackling those issues through local area agreements. The Secretary of State came to the Dispatch Box only a couple of weeks ago and described obesity as akin to climate change. He probably does not seriously believe that—try telling it to people in sub-Saharan African or Bangladesh. It is, however, an important issue. His response seemed to be that there should be a national debate—but that debate did not even get as far as the Queen’s Speech.
During the Gracious Speech we were promised a children and young persons Bill. Again, I am afraid that we have been here before. For a very long time, the
Government have not taken those responsibilities seriously. I was a member of the Select Committee on Health, with David Hinchliffe, in 1997-98, and we produced a report on the care of looked-after children. Why has it taken so many years to address this issue? We have waited 10 years to see legislation to avoid circumstances in which lots of young people are looked after at a considerable distance from where they live and where their friends and families may be. The gap between looked-after children’s educational achievement and that of other children has widened. It is still true that 30 per cent. of looked-after children still do not have full access to immunisation programmes. The duties of local authorities to young people and the responsibility that we take on when children are looked after must be clear.
We Conservatives understand that none of that will be possible without not only clear duties but the staff to make to it happen. That is why my hon. Friends established our commission on social workers. Lady Butler-Sloss and Lord Laming were the patrons and brought together a team without party affiliation to make it clear how we can support social workers who work with children, value their profession and help them in the process of delivering better services.
Tom Levitt (High Peak) (Lab): Clearly, if there had been a plethora of NHS legislation, the hon. Gentleman would have criticised the Government for taking panic measures and for thinking that legislation was the answer to everything. In fact, many of the issues that he talked about are being addressed through means other than legislation, not least investment. Is he trying to suggest that there were halcyon days in the health service prior to 1997? Does he not recall that at that time a quarter of a million people had waited more than six months for their operations? Now, virtually no one waits that long. Does he expect people to believe that what he has to offer is any different from what the Tories offered before?
Mr. Lansley: I am not pretending that before 1997 the national health service did not have problems. Equally, however, if the hon. Gentleman thinks that the public think that reducing waiting times to the exclusion of their safety, through the clear increase in infection rates, is an advantage, he is absolutely wrong. In the same way— [ Interruption. ] Labour Members should do as we have done, and understand from experience what will make the best policy for the future. I see no evidence from those on the Government Front Bench that they are learning at all.
The hon. Member for High Peak (Tom Levitt) is still peddling the idea that the pursuit of waiting time targets has been an unalloyed good. It has not. During the course of questions, the Secretary of State has seemed to dispute that fact, but the report on Maidstone and Tunbridge Wells NHS Trust states:
“Many staff told us about the consequences of targets, in particular the target that no patient should be in A&E for more than four hours. Some staff told us senior managers had given the A&E target much greater priority than the control of infection, including at the time of the outbreaks...One senior manager said that because of the other pressures and ‘over-heating’ in the trust, the A&E target was delivered at the price of chaos elsewhere in the system.”
I emphasise the “price of chaos”. We have had a report like that on Maidstone and Tunbridge Wells and another on Stoke Mandeville, and across the NHS people have made it clear that it was also targets—the waiting time target in particular—that led the NHS into the financial disaster that was 2004 to 2006.
Tom Levitt: Will the hon. Gentleman give way?
Mr. Lansley: No, I will not give way again. If, in the change that has occurred since 1997, the Government had understood better what they were setting out to do, they would have learned at an early stage that moving from central top-down targets to a culture of continuous improvement and performance measurement and management inside the national health service was the point. The Secretary of State gets up and says, “Sir Ian Kennedy is in favour of targets.” Well, no one in their right mind does not have the idea that a service should have performance measurement and management, but the idea that it should be done through a single set of targets dictated from the centre in a one-size-fits-all fashion is completely absurd.
The Government are now moving to the point where they want to run the whole health service on the basis of the 18-week referral to treatment target. What they do not tell anybody is that the 18-week referral to treatment target actually applies to only 30 per cent. of hospital activity, let alone whether it has any impact on people living at home with chronic conditions or on primary care services.
The hon. Member for High Peak asked what we would have said if there had been a series of health service Acts. But there has been a series of health service Acts— I am afraid that this is a constant theme of this Queen’s Speech. There was the Commission for Health Improvement, established in the 1999 legislation, which we were told would be the answer to the problem of standards in the national health service. Then the 2003 legislation abolished the Commission for Health Improvement and created the Commission for Healthcare Audit and Inspection, which we were told would solve all the difficulties with standards and problems such as infection control. Then we had the Health Act 2006, when the Government said, “Ah, well, the Healthcare Commission’s trying to do this thing, but it must have the code of practice”, but no, it turned out that that was not good enough, either.
I was here two years ago arguing that the code of practice needed to be strengthened, but that was not done; and then suddenly, in 2007, we are told, “Oh no, the Commission for Healthcare Audit and Inspection’s now going to be abolished and a new care and quality commission created in its place.” So in eight years we shall have gone through three inspectorates, all with exactly the same intentions.
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