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I turn to capacity. Milton Keynes continues to expand. Unfortunately, we have had to give up the battle of trying to get the Virgin trains that stop in Milton
Keynes to allow passengers on. At the moment, they can only get off during peak hours, despite empty carriages. That seems ludicrous. I understand the arguments that in future there will be greater capacity for more northern towns, but why can we not allow passengers on the trains at the moment, as Milton Keynes continues to expand?
We are also concerned that for every one of its two high-speed links to the City, London Midland, which provides the commuter service, could be holding up slots for seven Virgin Pendolino trains. As pressure increases in years to come, the slots may well be lost. I seek assurances from the Government that Milton Keynes will continue to get its fair share of slots for commuter trains.
I also want to raise the issue of compensation from train operating companies. In the past, automatic compensation was paid—in cash, directly to affected passengers and season ticket holders—when major disruptions occurred. Such incidents were classified as “void days”. Today there is no such classification; it is left to the individual to claim from the train operating company. It is up to the individual to prove their inconvenience by having to keep detailed records of their potential journey. That is inconvenient to the point of being unworkable, as few passengers have the time or resources to record in detail every problem that they encounter. Under a supposedly simplified system recently announced by the Government, there is no provision for strike-day compensation for season ticket holders. What the individual train operating companies do is up to them and even if alternative transport arrangements are provided, they are often inconvenient and the passenger suffers extra journey time and financial hardship.
Although there is no legal requirement, the train operating company can, at its discretion, pay compensation, although of course it invariably chooses not to. Many of my constituents feel that that is unacceptable. Even if compensation is paid, it is now done in vouchers, not cash. Although those vouchers can be used against season ticket renewal at a future date, if the person does not use the train for other journeys, it is months before they can use the vouchers. My constituents are clear about what they would like to be done: for lost days, a return to the old system of automatic cash compensation; for strike days, an automatic refund, the same as for lost days; and for the payment to be in cash, not vouchers.
Mr. Robert Goodwill (Scarborough and Whitby) (Con): Will my hon. Friend give way?
Mr. Lancaster: I am afraid that I have no time—I am sorry.
In the final few moments that I have, I want to raise the issue of the British grand prix moving from Silverstone to Donington park. Although Silverstone is not in my constituency, much motor racing activity is, and it would have a severe impact on my constituency should it move—on the hotel business, for example, because many people going to Silverstone stay in hotels in my area. Although I realise that this is not a matter directly for the Government, the Minister concerned has recently had meetings with Bernie Ecclestone. All I ask is that we perhaps move to a system whereby the British grand prix can alternate between Silverstone and Donington park.
4.45 pm
Anne Milton (Guildford) (Con): I echo many of the comments made by my hon. Friend the Member for North-East Milton Keynes (Mr. Lancaster). The “South East Plan” was published last week amid an unnecessary degree of secrecy. I phoned the office of the Secretary of State for Communities and Local Government on several occasions last week and was told by her staff that they did not know when it would be published. In fact, they clearly did know because there was a ministerial statement on Thursday. I cannot see why it was felt necessary to keep it secret. That does not inspire confidence in my constituents, who will now be involved in the public consultation that will continue until 24 October.
The changes to the draft visions of the regional spatial strategy will see an increase in the original housing numbers of 31 per cent. for Guildford and 9 per cent. for Waverley, and of note to my constituents will be a 25 per cent. increase in Woking. That will clearly lead to the green belt around Guildford being destroyed. The plan says:
“In order to meet regional development needs in the most sustainable locations, selective reviews of Green Belt boundaries are required in the following locations:
In the Metropolitan Green Belt to the north east of Guildford and possibly to the south of Woking”.
I draw attention to the report commissioned by the Government—I will be interested in the Minister’s comments—from experts Roger Tym and Partners, who warn of the effects of imposing unsustainable building targets on the south-east. They say that the building plans will
“have a negative effect in all sub-regions on the objective to reduce the risk of flooding...A number of trunk roads are likely to be unable to cope with the predicted traffic demand...There is some over-loading on most routes into London and all sub-regions adjoining London would therefore likely be under stress under the higher growth forecasts...Increasing the provision of housing under all our scenarios will result in a regional deficit in water supply, with many areas in severe deficit of water resources”.
Last July, the Prime Minister said:
“I assure the House that we will continue robustly to protect the land designated as green belt.”—[ Official Report, 11 July 2007; Vol. 462, c. 1450.]
In a No. 10 lobby briefing on 10 July, he said:
“Green belt land will stay as green belt land. Yes we can give you an assurance that we will not build on the green belt land. We are not proposing any changes to our very robust protection of the green belt.”
Yet the green belt is specifically mentioned in the “South East Plan” and my constituents will see the potential for its being built over. Can the Minister explain how those statements square with the proposals in the plan?
I pay tribute to East Guildford Residents Association, and particularly to the chairman, Dr. Graham Hibbert, who has long worked to improve the local environment in Guildford. EGRA, as it is known, includes Abbotswood, Burpham, Chantry View road, the Cranley road area, Downsedge, Holy Trinity, Merrow, Shalford and Tyting farm. More than 2,500 people are represented through that organisation. EGRA says:
“The plan is bad news for Guildford...Guildford will undergo major expansion which will irrevocably damage its heritage and compromise its future. The scale of growth proposed is not primarily targeted at helping current Guildford residents who
want to buy and live here. We seriously doubt that, as a gap town in the Surrey Hills, Guildford can be an economic and housing hub”.
I would also like to pay tribute to the Guildford Society. Many market towns have similar societies, and they do a huge amount in their own time, spending hours going through planning proposals. As it points out, Guildford
“is in a gap in the Downs and is surrounded by Green Belt on all sides and by Areas of Outstanding Natural Beauty. The town lies within the 5 km buffer zone of the Thames Basin Heath Special Protection Area. Significant areas lie in the River Wey flood zone. The constricted roads are already at capacity...If we expand on the scale proposed Guildford will grind to a halt.”
All those associations, and all my residents, are extremely concerned about these proposals, and it is not at all clear how, when or if the Government will deliver the infrastructure improvements necessary.
While we are on the subject of infrastructure, I would like to say a little about Guildford, its funding and our roads. We are a significant contributor to the Treasury coffers. Local residents pay a heavy price for economic success in terms of congestion and traffic, but that is not recognised in our funding settlements. As one county councillor said to me, we have double the amount of car usage and half the amount of money. Indeed, the Government’s settlements show that in 2008-09, Surrey received a minimal increase in Government grant of 2 per cent.
Total Government funding equates to just 18 per cent. of the annual budget. The remaining 82 per cent. has to be funded through council tax. Government funding represents approximately £205 per head for Surrey residents, compared with an England average of £595, and £856 in Manchester, but we are one of the few areas that contributes to the Treasury.
Turning to police funding, only 42 per cent. of Surrey police’s budget is funded by the Government, but Northumbria and Greater Manchester only have to find somewhere in the region of 10 to 15 per cent. We pay a heavy price. The Government want us to take more houses, but they are not prepared to give us the money to ensure that Guildford keeps moving or to ensure that local business remains a success.
As time is so short, I would like to finish by mentioning Cranleigh and Milford hospitals. Local residents have fought for a long time to keep Milford hospital open; my hon. Friend the Member for South-West Surrey (Mr. Hunt) played a significant part in that. On Cranleigh village hospital, the decision made two years ago by the former Guildford and Waverley primary care trust to proceed with the so-called option 1 has finally been shelved as a result of a damning independent panel report. The decision made by the former Guildford and Waverley PCT was taken up and run with by Surrey PCT, and if the Deputy Leader of the House has some time in the recess and wants a little holiday reading, I can recommend the report of the independent panel. It is outstanding. I am now at a loss to know how to reassure my local residents that Surrey PCT can fulfil its obligations and duties. The report contains comments such as:
“‘no apparent links to social care’; ‘Workforce plans are not developed’; ‘no evidence of how the proposals will increase the availability of day care surgery’; ‘Not possible to assess whether more OPD services will be available’”.
I know that the trustees of Cranleigh village hospital, Cranleigh parish council, the League of Friends in Cranleigh and the GPs in Cranleigh have a superb plan that will deliver all the Government’s objectives for providing care close to where people live. I urge the Deputy Leader of the House to apply any pressure she can to ensure the successful delivery of that project.
4.53 pm
Dr. Richard Taylor (Wyre Forest) (Ind): The best invitation I can offer to the House is to my party conference—the conference of independent health concern. It will take place in my garden, after a very good buffet lunch, on 7 September. We will be discussing my own manifesto for the national health service. I shall share it with the House for a few minutes now, because I am sure that there are a lot of votes in it for all parties.
My manifesto for the NHS contains seven points, and a lot of them support and add to Lord Darzi’s review. The first, which does not appear in the review but which I consider incredibly important, is the abolition of prescription charges. We know that they are unfair, and that an inquiry is being carried out at this moment. The Secretary of State for Health told us today that the result would be produced shortly, but he then said that it was some months away. The process has been going on for months and months, which just shows how difficult it is to make any sense out of prescription charges if they remain.
We are told, in an attempt to reassure us, that only 13 per cent. of people pay the charges. However, they include people with long-term conditions—for instance, young people with cystic fibrosis—who a few years ago would not have survived. One young lady told the Select Committee on Health that she was taking 85 tablets a day. Those with long-term conditions such as Parkinson’s are not exempt, yet those who are lucky enough to have thyroid disease, which is easily put straight, are exempt from charges for every medicine that they might need in the future. The people most affected are working adults whose incomes are just above the income support level.
We are told by the Government that abolishing prescription charges would cost £450 million a year. That is a fraction of the national health service budget, and about a quarter of last year’s NHS surplus. However, even if the Government desperately want to find another source of funding, I think that this is one of the occasions on which a tiny hypothecated tax on the super-rich would be borne by everyone concerned.
The second point in my seven-point manifesto is, of course, quality. I have four Cs. The first is care, which includes safety, avoiding errors and using the best treatment protocols. The second is compassion, which includes dignity and kindness. The third is communication: communication between clinical staff and patients and their relatives at home and in hospital, and communication between hospitals and GPs and between GPs and hospitals. An article in this week’s British Medical Journal asked:
“Can we call this failure of information transfer care at all? Isn’t the truth that this institutional behaviour of non-communication is just carelessness and neglect?”
“High-quality care is care where patients are in control, have effective access to treatment, are safe and where illnesses are not just treated, but prevented.”
Darzi recognises both the difficulty and the importance of measuring quality, but it must be measured. Until we have a better way of measuring it, surely complaints about quality, particularly those that come to Members of Parliament, should be passed on.
The third of my seven points is competition. Obligatory reading for everyone involved in it is an article in the Journal of the Royal Society of Medicine by Richard Smith, a recent editor of the BMJ. He has reluctantly come to see that competition may be essential. As I have supported the NHS so intensely throughout my life, it goes against the grain for me to realise that it is like a great big juggernaut or tanker which cannot easily be turned around. Perhaps we must appreciate that there is something in competition, but if we do, we must bear in mind some of the criticisms of the experience in the United States—worded very well—that appeared in the BMJ at the end of last year. The authors observed:
“Extensive research shows that its for-profit health institutions provide inferior care at inflated prices... commercialisation drives up costs by diverting money to profits and fuelling growth in management and financial bureaucracy.”
The New England Journal of Medicine said in January this year:
“The extreme failure of the United States to contain medical costs results primarily from our unique, pervasive commercialization.”
If there is to be competition in the NHS, it must be regulated. That means a fair and level playing field, open to NHS providers as well as non-NHS consortiums. An example of unfairness is where out-of-hours care is put to tender, but where there is no definition of how the service is to be provided, so that the non-NHS providers can come in with a reduced skill mix and thus offer it more cheaply.
Fourthly, all providers—hospitals, GP conglomerates and mental health providers—should be able to go for foundation trust status, because it means that they can engage with Members, keep their surpluses and, by so doing, have money for quality awards.
Fifthly, we should accelerate the work of the National Institute for Health and Clinical Excellence, as recommended by Darzi. That would be part of the answer to co-payments.
Sixthly, patient and public involvement in commissioning is crucial. We have to strengthen local involvement networks and overview and scrutiny committees.
My final point is about health care rationing—we are scarcely allowed to use the term; we have to use “prioritisation” instead—which is essential. I quote again from The Journal of The Royal Society of Medicine:
“The final recurring theme, present throughout the last 60 years and no doubt into the next 60, is the thorny question of rationing health care...The future of rationing health care will provide a key battleground for the NHS.”
Mr. Deputy Speaker: Order. Before I call the next hon. Member to speak, may I say to the House that if everyone now takes their full eight minutes, we will probably not get everybody in, but that if they reduce it a little, we might? Perhaps hon. Members will bear that in mind.
5.2 pm
Mr. Michael Moore (Berwickshire, Roxburgh and Selkirk) (LD): Thank you, Mr. Deputy Speaker, I will seek to honour what you have just said.
As the right hon. Member for Leicester, East (Keith Vaz) said, we have had a tour of Britain. We have heard a lot about the different experiences in England and Wales, and I should now like to draw Scotland into that picture, too. There is a theme linking many of this afternoon’s speeches, which is essentially that the Government are failing in particular areas. That is generally the case in rural Britain and, as I see it, particularly so in my constituency. Some key decisions will be made over the summer by the Government and the agencies acting on their behalf. Currently, I fear that they will make the wrong kinds of decisions.
One issue is that the Government are failing to understand the realities of rural Britain and the extra pressures of the increases in the cost of living, particularly in fuel and, as was mentioned earlier, the changes to vehicle excise duty. Local businesses in my constituency, whether in the fishing communities or the textile industry in Hawick or elsewhere, are struggling with the extra costs that have been imposed on them in the past few months.
Like many others who have spoken, I face the prospect of post office closures in my constituency being announced in a few weeks. There are 3,500 pensioners who go to post offices each week to get their pensions and 3,500 other people who collect their benefits there. They depend on a network of post offices spread across the vast, beautiful constituency that I represent. I rather fear that, as others have said, the criteria are not designed to ensure that we get a sustainable network that services the local community in the way required. Thousands of my constituents have signed postcards, and thousands have also signed the sub-postmasters’ campaign on the Post Office card account. I hope that the Government will hear what has been said throughout the country about that.
A related matter is puzzling for many of my constituents and must be dealt with—the issue of the Royal Mail and its address database. A number of communities in Berwickshire—for example, the villages of Foulden, Hutton, Paxton, Lamberton and Mordington—have a Berwick-upon-Tweed postcode. I have no wish to cast aspersions on the good people of Berwick-upon-Tweed, but my constituents are very firmly in Scotland, even though they have an English postal address. It can be plain irritating for the people concerned, but it can also have serious consequences for official documentation about which country they live in, for example. It can affect insurance premiums in areas where small villages are linked to nearby towns and it can also affect deliveries to those areas. A community such as Fountainhall, a full 15 miles from Galashiels, has a Galashiels postal address, which can cause utter confusion, particularly when people try to buy or sell a house. The Royal Mail has frankly refused to accept that it has any responsibilities in this matter. It has refused to accept that the commercial database that it sells has consequences for people such as my constituents, who are the consumers in this case. I hope that the Government will look further into this issue and force the Royal Mail to rethink.
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