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27 Nov 2007 : Column 53WH—continued

Stagecoach never apologised for the mayhem that it caused in Darlington.

Christian Wolmar, a national newspaper journalist at the time of the Darlington incident and the first reporter to break the story, noted that Stagecoach got away with similar events in Inverness and Lancaster. He also recorded that, in the decade after deregulation, Stagecoach was referred to the Office of Fair Trading some 30 times. Of those complaints, eight resulted in MMC hearings and seven found Stagecoach’s actions to be

which forced the company either to divest or to be the subject of specific regulatory action. Of course, any action taken by the Competition Commission is welcomed, but at present it is taken painfully slowly. In many instances, punishment has been applied long after a small firm has been forced out of business, so speed of response is crucial.

Not only passengers get a raw deal out of Stagecoach’s actions; more than 1,200 bus drivers at Stagecoach in Manchester were today due to start six days of strikes. They were protesting at a pay deal that leaves them falling behind the Manchester market rate. The drivers, all members of the Unite trade union, currently earn almost 15 per cent. less than other Manchester operators. I understand that the strike has been narrowly averted. It is not surprising in such a climate that many passengers have turned to the reliability and ease of the private car.

The Government are striving to reverse declining bus patronage. Bus subsidies are at record levels, and the Transport Act 2000 improved the situation to some extent. One of the answers to the problems in Preston might be the introduction of quality contracts, which would replace open competition with a licence regime. Effectively, they are London-style franchising schemes, whereby operators bid for exclusive rights to run bus
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services on a route or group of routes. Under a quality contract, the local authority determines what services, including routes, timetables and fares, should be provided in an area.

An increase in the number of quality contracts would make bus networks more stable in that there would be less frequent changes to fares, timetables and frequencies; more reliable, because services would be monitored and there would be incentives for good performance; and better integrated, because having one brand, one network and one ticket would make fares simpler. Buses would be cleaner, because contracts could require bus operators to provide newer, cleaner buses and to maintain them properly. However, to date, no authority has ever applied for such a contract.

The Local Transport Bill addresses some of the issues that I have mentioned: it will allow greater flexibility to implement quality contracts, make it easier for those who want a quality contract to get one and replace the current arrangements with a new set of public interest criteria. The traffic commissioners will also have a stronger role in monitoring bus punctuality and a broader range of sanctions to impose on operators that are failing to deliver a punctual service. The Bill will also enable the traffic commissioners to hold local authorities to account for their contribution to punctuality performance, and it will allow the creation of an influential new bus passenger champion to represent the interests of bus passengers.

Quality contracts must strike the correct balance between cost and quality and, as I have said, take into account value for money, cleanliness, reliability, punctuality, staff training and vehicle environmental standards. Such contracts should also give local authorities powers to consider a company’s ties to the local community and thus its understanding of the community. Perhaps routes could be bid for in bundles, which could be packaged so that different routes were offered differently to meet the community’s needs.

Even more can be done. Traffic commissioners could be given more powers, not only to intervene and correct bad behaviour, but to work more closely with the competition authorities where quality contracts are not in place. The commissioners should be able to indicate to the competition authorities that the competitive commercial environment is leading to buses racing on inner-city roads and jostling for position and passengers at hotspots in our inner cities, with the consequent risks to passenger safety.

The competition authorities must be able to act quickly and must not wait until the competition has been killed of, as was the case in Darlington. It is only a matter of time before there are serious injuries or possible fatalities, because of cut-throat competition. Traffic commissioners should be able to work with the competition authorities where the competitive environment leads drivers and companies to adopt measures that are adverse to public safety, increase congestion and lead to dangerous driving of the type that I have described.

The competition authorities should be able to insist that the services that operators run reflect the true costs of the provision, rather than allowing routes in Preston to be effectively subsidised by customers in other parts of Lancashire or the country as a whole. Using the criterion of local market share, rather than national or even regional market share, in determining abuse of a
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dominant position does not take account of the true strength of a player or company in the market. Such changes are badly needed.

Members of Parliament from all parties are deeply frustrated that their constituents have so little influence over the state of their bus services. After 20 years of chaos, now is the time to allow local authorities to reclaim their streets and stop the “Wacky Races” that we see now. Only then will we put an end to bus barons blatantly disregarding passengers and public safety in favour of profits.

1.13 pm

The Parliamentary Under-Secretary of State for Transport (Jim Fitzpatrick): I congratulate my hon. Friend the Member for Preston (Mr. Hendrick) on securing a debate on a subject of such importance to his constituents and others. I hope that my remarks respond to the issues that he has raised, but if omit any, I assure him that I will write to him with further information.

Buses play a vital role in our transport system. Two thirds of all journeys on public transport are made by bus. It is important to the public—particularly those who rely on public transport—that buses work well, which for the most part means their offering a reliable and punctual service at a reasonable price. Where buses operate to their full potential, with the local authority and bus operators often in partnership, they offer a significant contribution to meeting national and local objectives. However, there are examples where, for whatever reason, bus networks are not fulfilling their potential and some communities are missing out. That is one reason why we introduced the Local Transport Bill, about which I will say more later.

Before moving on to discuss the situation in my hon. Friend’s constituency, it is perhaps worth giving a bit of the background to put it in context. As my hon. Friend has said, bus services outside London have been deregulated for more than 20 years. The majority of such services are provided on a commercial basis, without subsidy. Bus operators, most of whom are in the private sector, can register services on routes on which they wish to operate, subject to fulfilling some basic requirements, such as being licensed to operate a bus service and providing a timetable.

In general, bus services are open to competition from other companies. Such competition can benefit consumers through lower prices and improvements in the quality of the services being provided. There is no rule prohibiting big companies from competing with smaller companies: that happens in many markets. In some cases, a larger company’s ability to offer lower prices may simply be due to its being more efficient. Competition legislation—the Competition Act 1998—prohibits conduct that amounts to the abuse of a dominant position, although it does not in itself prohibit the holding of a dominant position.

I will now turn to the situation in my hon. Friend’s constituency: the so-called bus wars between Preston Bus and Stagecoach.

Mr. Hendrick: Will my hon. Friend the Minister respond to my point? Does not the current situation
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whereby the share of the market locally, rather than regionally or nationally, is considered in terms of a dominant position give a disproportionate strength to a national company at the expense of a small local company, even though the local company might have a greater share of the market in a single town, as in Preston?

Jim Fitzpatrick: My hon. Friend makes a straightforward, logical point about market distortion, which may be subject to elements that are outside the local environment. A company’s minor market share locally may not, as he says, mean that they are the smaller of the two operations, because it may be part of a much larger—indeed, a national—combine. I will return to that later.

There have been similar situations before—for instance, in nearby Manchester, as my hon. Friend the Member for Manchester, Blackley (Graham Stringer) mentioned. Whether in respect of retail business or buses, we have to determine whether competition rules are being abused in such circumstances. That is the job of the Office of Fair Trading, to which allegations of anti-competitive behaviour should be directed.

From my understanding of the local situation, the launch of new Stagecoach services in Preston around June 2007 represented, perhaps, the first large-scale competition in the Preston bus market for some 15 years. Stagecoach introduced high-frequency services with new low-floor buses and offered new ticket deals. Preston Bus responded by introducing low-floor buses of their own and began operations on traditional Stagecoach routes. On the face of it, that seems like good news for the consumer, but I recognise that there can be repercussions associated with intense competition for bus markets. Over-bussing routes, poor co-ordination of services and the absence of co-operation between operators can be detrimental to passengers, as my hon. Friend the Member for Preston said. That can also cause road safety and congestion problems.

The traffic commissioners have powers to impose traffic regulation conditions, where requested by a local authority, to prevent danger to road users or to reduce severe traffic congestion. Where a TRC is in place, all bus operators in the area must comply with it. In this case, Lancashire county council, as the local highway authority, monitored the operation of the increased bus services and felt that the situation presented potential dangers to road users. In view of that, the council applied to the traffic commissioners to introduce a TRC to prevent buses from stopping other than to pick up or set down passengers at a number of locations in Preston. That TRC came into force on 30 July.

Essentially, the aim of the TRC is to prevent buses from exceeding waiting times at bus stops in an attempt to get more passengers or block other buses. However, despite that TRC, I understand that the traffic commissioner is still receiving complaints regarding the operation of buses in Preston. The situation is being monitored. For instance, a recent survey was undertaken to assess compliance with the TRC. The commissioner is considering those complaints and whether regulatory action should be considered at a public inquiry. The county council is also holding regular meetings with representatives from both Preston Bus and Stagecoach to discuss the implications of the increased service on certain routes. There have
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also been complaints about the actions of some bus drivers. The traffic commissioner announced an inquiry into that matter, although it has been adjourned until the format of the hearing can be agreed.

Action is being taken locally to look into the Preston situation. We are also taking action nationally to help to prevent such occurrences from becoming more widespread. A large part of the Local Transport Bill involves giving local authorities a better range of options to improve local bus services in their area. The Bill will provide more opportunities for quality partnerships, allowing them to specify minimum frequencies and maximum fares. Operators would have to be willing partners in that, but the negotiating hand of local authorities would be strengthened.

In particular, the potential for partnership between local authorities and multiple bus operators would be improved, and experience shows that bus services work best when there are good relations between operators and local authorities. If the provision of bus services in local markets can be improved through partnership—to the benefit of consumers—the potential for future bus wars should be reduced. Bus wars might generate benefits in the short term, but they do not generally benefit consumers in the longer term.

When there is a strong case for quality contracts—the system adopted in London—we are making them a more realistic option. Local authorities must still demonstrate that the public benefits will be large enough to justify considerable influence in the market.

The Bill will also help to address some of the consequences associated with bus wars. Some stakeholders have commented that the current legislation does not provide sufficient flexibility for traffic regulation conditions to be applied until after problems have actually arisen. We have concluded that it would be useful for traffic commissioners to have the power to impose TRCs in anticipation of future safety or congestion problems, rather than having to wait for such problems to occur before taking action. As now, a TRC would still have to be requested by a local authority. In addition, we have determined that the time is now right to provide a more visible and influential voice for the bus passenger. As my hon. Friend said, the Bill includes provisions to take that forward. We plan to issue a consultation paper shortly that will outline the detailed options.

Competition between bus operators should bring benefits to consumers. However, when there are concerns about anti-competitive behaviour, the OFT should be informed. When there are concerns about the performance of buses on the roads, the traffic commissioners can take action, and they are continuing to investigate the situation in my hon. Friend’s constituency.

In conclusion, my right hon. Friend the Minister of State, Department for Transport is due to meet the chief executive of Stagecoach tomorrow, and I am sure that she will bring the debate to his attention, as I am sure that my hon. Friend the Member for Preston and I will bring it to her attention later today.

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Macular Degeneration

1.23 pm

Sir John Butterfill (in the Chair): Order. As both the initiator of the debate and the Minister are present, we shall commence the debate early.

Mr. Peter Bone (Wellingborough) (Con): Thank you, Sir John. I am pleased to open a debate on an issue that is important to my constituents, and I am grateful to Mr. Speaker for having granted permission for it. I thank the Minister for attending; she is well known for her compassion and her understanding and for her knowledge of the NHS. I hope that the debate will be constructive, and I certainly do not intend to make any party political points.

I have been contacted by a significant number of people in my constituency who suffer from wet eye age-related macular degeneration and who have been told that they must either pay thousands of pounds for sight-saving treatments or go blind. Age-related macular degeneration is the most common cause of sight loss in the UK and accounts for 57 per cent. of all certificated visual impairment and blindness in this country. Of the two types of age-related macular degeneration—wet and dry—wet eye is the most virulent and can cause blindness in just a few months. There are some 250,000 people in the UK with wet AMD, and 24,000 new cases are diagnosed each year.

Wet AMD not only directly affects the vision; in the early stages it takes its toll on the ability to drive, read and see faces. It is the latter stage that causes blindness. However, it also restricts independence in the elderly. In fact, only arthritis and heart disease cause greater functional impairment in the elderly in this country. The difference in the case of wet AMD, however, is that it can be treated in a way that allows sufferers to continue to enjoy their independence and their sight.

Two licensed drugs for treatment of wet AMD are currently available on the market: Lucentis and Macugen. Those drugs are called anti-VEGF, and they work by neutralising the agent that causes abnormal blood vessel growth and by reducing the fluid leakage from blood vessels that causes wet AMD. Avastin is another drug used to treat wet AMD. In cases in which the local NHS provides treatment, it is the drug most commonly used. Avastin is licensed for treatment of some cancers but is also effective “off-label” in treating wet AMD, and is cheaper than Lucentis or Macugen.

The National Institute for Health and Clinical Excellence is the Government body that rations health care in England and Wales. Its soul aim is to ration or deny treatment within a nationalised health care system. None of the treatments that I have mentioned has NICE approval, although a decision on Lucentis and Macugen might be made in the spring of next year. However, NICE has been dragging its feet in providing guidance, and its delay is allowing people to go blind. Primary care trusts have an excuse not to prescribe anti-VEGF drugs as a course of treatment because they can hide behind NICE. That is where our problem lies.

The Northamptonshire Association for the Blind has stated that 80 per cent. of patients with wet AMD in this country will be denied sight-saving treatments on
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the NHS. The other 20 per cent. of sufferers will have to go blind in the first eye and start losing sight in the second before receiving treatment. If there is a drug to cure people, they should be treated on the NHS. After all, the elderly people whom the disease affects have paid taxes all their lives to fund the NHS.

Mrs. Linda Riordan (Halifax) (Lab/Co-op): It is true that the disease affects older people. However, one of my constituents, Lynne Smith, is just over 50, and is not receiving treatment. She has been told that she must start to go blind in her second eye before the treatment is available. Does the hon. Gentleman agree that that is totally unacceptable?

Mr. Bone: The hon. Lady’s intervention is very positive. She is correct in what she says, although I shall explain later that that policy is not universally applied across the country. There are different ways to treat wet AMD.

I should like to read a passage from a letter I received from the Northamptonshire Association for the Blind. It says:

The letter refers to the crux of the problem that we have in parts of this country: cost and funding of the local NHS. My constituents go to see their GP who then refers them to a consultant who diagnoses wet AMD. The good news that they tell patients is that the patients can be treated and cured. The bad news is that treatment cannot be done on the NHS in their area, but if they go to the private hospital two miles down the road, they can be treated at £1,100 per eye per injection and their sight can probably be saved.

I do not blame the consultants; they are right to tell patients that the drugs are available privately, rather than telling them that there is no treatment at all. However, we are talking about elderly people who do not have thousands of pounds spare to save their sight. In any case, why should they have to fork out their hard-earned savings when other areas of the country prescribe anti-VEGF drugs freely? If my constituents lived in Southampton, Sheffield or Liverpool, they would be treated with sight-saving drugs on the NHS. Of course, if they lived in Scotland, I would not need to have this debate at all. The Scottish Medicines Consortium—Scotland’s equivalent to NICE—has already approved the use of Lucentis and Macugen. Indeed, Lucentis and Macugen are approved for use and reimbursement across much of mainland Europe.

My local Northamptonshire primary care trust runs a second-eye policy. That means that patients with wet AMD may be treated with photodynamic therapy in the first eye, which is a less effective treatment, if they meet the stringent criteria. Patients will not be treated with anti-VEGF drugs until they start losing their sight in the second eye. Again, they have to meet the east midlands’ exceptionally stringent regional criteria.

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