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16 Oct 2008 : Column 979
2.44 pm

Malcolm Bruce (Gordon) (LD): This has been a useful debate and the statement we heard before it was extremely helpful. I thank the Secretary of State for acknowledging, in response to interventions from me and my hon. Friend the Member for West Aberdeenshire and Kincardine (Sir Robert Smith), that the Department will engage with the issue of domestic fuel prices. I hope that the Minister will take that forward. To reinforce that message, it is estimated that 4 million people are not on the gas mains; they are losing out because they do not have access to dual tariffs and the rebates that go with them. Many are dependent on fuel oil for their central heating, but its price has gone up hugely and it is not coming down. It is important for the Government to understand that those people simply do not have an option.

I have two further points on that. The first is about what the Government can do to ensure that fuel prices come down in a way comparable to other prices. A Library briefing shows the extent to which prices have gone up, with graphs demonstrating domestic fuel oil spiking way above all the other prices that none the less seem to get more attention. Secondly, technical innovation is important. I should perhaps declare an interest as one who, like many of my constituents, lives in a rural village and is dependent on fuel oil for central heating.

One issue of concern—it is an old one—is the gas main. Since the privatisation of gas, the extension of the gas main has almost stopped, yet a significant number of communities, villages and towns could access gas if someone were prepared to connect them to the mains. Gas companies tend to say, “Go and find us a market, and we will consider whether we will supply it”. The Government could do more to encourage the extension of the gas main.

The Government could also help people to find alternative technologies—preferably renewable energy technologies, which are much more efficient. Most people do not want oil. They would much prefer a more environmentally friendly source, but they need help to find out what it is. At the moment, the technical innovation advisory services do not provide any useful answers. I really hope that the new Department will view that as something to which it could usefully devote its attention.

The role of smart metering has been discussed in a valuable way, and I note that my hon. Friend the Member for Northavon (Steve Webb) put forward an interesting idea. I understand the issues raised in that context but, after all, competition and its effectiveness are also about information. The Secretary of State clearly acknowledged that the current system does not work very well. My hon. Friend put forward an idea that has merit, but we need to work together to try to find ways of giving people the real ability to make intelligent choices that will help them get the best fuel bills and make competition work more effectively.

I shall be brief, as I want to give the Minister time to reply, but my other main point is about fuel poverty. According to NEA, the fuel poverty group, 5.2 million households now face fuel poverty. The figures on pensioners that my hon. Friend the Member for Northavon provided from a Library analysis were also pretty startling. It boils down to this: I do not know of anyone who is not concerned about their fuel bills, irrespective of whether
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they consider themselves fuel poor. An increasing proportion of almost every household’s income is going on fuel bills.

In the long run, we need a low-carbon energy system, but we need the transition to take place in circumstances in which people are not faced with violent peaks and troughs, which make it difficult for people to adjust. I thus wholly support the objectives of the new Department and the low-carbon strategy, but I urge the Government to help the industry bring on new low-carbon technologies faster. I hope that they will be able to achieve that, as it is what many people are looking for.

I understand why the Secretary of State said that he wanted to proceed slowly, but the Government will have to look further into the law on regulation. It seems to me that if action is going to be taken to require energy companies to pass on changes to prices efficiently and to provide social tariffs, it will have to be done within the framework of new regulations for Ofgem. I do not see how the Government can achieve their objective otherwise. I also think that that would be a far better answer than windfall taxes, to which I have an inherent resistance. I believe that they damage the market in the long term, and discourage investment.

Let me issue a plea that I consider important. The Minister has been responsible for this matter in the past. I was encouraged by the Prime Minister’s comments to the Liaison Committee in July, which the Minister effectively reflected today. The Government have acknowledged—somewhat late in the day, but I welcome it—that we have passed the peak of oil and gas production from the United Kingdom North sea and that it will be more difficult to get the rest of it out. However, there is a lot of it out there, potentially nearly as much as we already have. I find it very encouraging that the Government now appear to understand that sudden tax changes and treating the industry as a revenue source is not the answer. What the industry needs is the confidence to invest in the long term in a highly competitive environment in which the North sea is very expensive.

We have built up an infrastructure—especially in my part of the country, the north-east of Scotland—that is servicing the world in oil and gas and offshore technology and that is hugely valuable to the British economy in a variety of ways. I hope that the Government, through PILOT and in partnership, will ensure that we maximise our own production at the same time as moving towards a more low-carbon economy and more diversified energy provision.

Climate change issues affect the rest of the world as well, and I hope that the Government will not allow us to adopt policies in this country that penalise the poorest countries in the world. We must recognise that what we do here must be in partnership with poor countries, and that we must enable them to cope with the real challenges that they face. In the last two weeks, the World Bank has pointed out that whereas at the beginning of the year 1 billion people were living on less than $1 a day, the figure is now 1.4 billion. Those people simply cannot cope unless we treat them as partners in the enterprise.

2.51 pm

Mr. Mike O'Brien: We have had an enormously useful debate, featuring some very helpful speeches. In the time that remains, I shall try to deal with some of the helpful points that were raised, as well as some of the less helpful.

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My hon. Friend the Member for Barnsley, Central (Mr. Illsley) referred to the windfall tax. I share his concern about price and fuel poverty, but it should be borne in mind that we have just asked the energy companies for £910 million for the package recently announced by the Prime Minister. Admittedly the amount was to be provided over three years, but the energy companies responded, and I am not sure that this is the right time to go straight back to them and say “We now want some more”. Moreover, as we all know from the headlines, there are financial issues in the world today. There are times when it is right to do this sort of thing, and times when it is not. Having said all that, I should add that matters of taxation are matters for the Chancellor.

I was struck by an interesting point raised by my hon. Friend the Member for Southampton, Test (Dr. Whitehead). He questioned the idea of taxing companies that would then increase charges, suggesting that it was difficult to ensure that the increases were not passed on to customers. In the long term, we must ensure that we secure investment from those companies, which will want to receive a fair return. We also need to create an environment in which we attract overseas investment: that will be particularly important.

In that context, I should tell the House that this morning I had a meeting at No. 10 Downing street with E.ON and Masdar, a company from the United Arab Emirates, which have joined forces on the London Array offshore wind farm project. When built, the wind farm will be the world’s largest offshore scheme, and the partnership between oil-producing and oil-consuming countries will help to develop new energy sources and technologies. The sheer scale of this ground-breaking project, involving 1,000 MW makes Britain a world leader in offshore wind technology. I welcome that, and the foreign investment that will ensure that it happens.

The hon. Member for Kettering (Mr. Hollobone) kindly invited me to his constituency and put up a very good case that it was well worth a visit. I would like to see the innovation, particularly that by the local authority and E.ON. I would also be interested, having come from a portfolio that dealt with pensioners, to see how the local authority is dealing with the elderly person, perhaps over 80, who suddenly gets all this information about how much money they are spending and decides to cut down on their heating. We want to ensure that people are properly informed, but we also want to ensure that we do not create a killer. That will be important. How we deal with that in terms of smart metering is something that I want to be sure I am entirely satisfied with. However, he makes a good case and I will consider his kind invitation.

I know the speeches of the hon. Member for Northavon (Steve Webb) well from the pensions portfolio. He always comes up with a raft of good ideas, and some not so
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good, but they are always interesting. I was particularly struck by some of the points that he made, and I will take up some of those issues. He and the right hon. Member for Gordon (Malcolm Bruce) raised the need to get connected and rural gas contracts. I face that problem in my constituency. In the town of Kingsbury, we managed to get a group of local people, both householders and tenants of the local authority, to create a market and to get the local authority to work with them to get connections put in through Transco. We are now on a much bigger project. I went to the local authority and suggested that we do that and it has responded, albeit there has been something of a delay. However, it has managed to start the project of getting gas connected to large areas of a very rural constituency. Local authorities have a role, therefore. If we can get enough people together to create a market, it is possible to get those connections done, but I assure both Members that I will look into the matter.

On North sea oil and gas, the right hon. Member for Gordon is right. Those resources are more difficult to access but they are important none the less and we must work to see whether we can create the right environment for them.

I am concerned by the case raised by my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh). Perhaps I can deal with it in more detail on another occasion, but those who install prepayment meters under the terms of their supply licence must take into account customers’ ability to pay. She might be aware of that. Customers on benefit may be able to pay by fuel direct. That may be another point that is worth canvassing.

The contribution of the hon. Member for Wealden (Charles Hendry) was extraordinary. Pensioners throughout the country will now be concerned by the position of the Conservative party in relation to winter fuel payments, and the refusal to say that there would be any winter fuel payments. That puts in grave doubt the winter fuel payments and any help with fuel payments for those who are still facing quite high fuel bills. Despite his protestations in relation to nuclear power, it is the case that his party leader said that nuclear energy was “a last resort” and that the then shadow energy Secretary, the hon. Member for Rutland and Melton (Alan Duncan), specifically denied that it had been Conservative policy to support nuclear power. He said:

We need more clarity from the Conservative party about that. Can we also get some clarity in relation to wind turbines? Calling them wind blenders is not a policy and we need—

It being one and a half hours after the commencement of the proceedings, the motion lapsed, without Question put, pursuant to the Temporary Standing Order (Topical debates).

16 Oct 2008 : Column 983

Primary Care

2.59 pm

The Minister of State, Department of Health (Mr. Ben Bradshaw):

I beg to move,

Even before the NHS was born 60 years ago, Nye Bevan recognised that, for it to stay relevant and to retain public support, it had constantly to change and improve. Primary care, as the gateway to the NHS and the upholder of its values, is in the vanguard of that change. I would like to share with the House the ways in which the Government are reshaping primary care for the 21st century: how we are listening to patients and letting them lead the way; how we are pushing power down to local level to primary care trusts, giving them the freedom, finance and support to transform primary care; and how we are doing more than any previous Government to improve access to primary care so that the hard-working men and women who pay for the NHS through their taxes can benefit from it at a time and place convenient to them.

In the 11 years since this Government came to power we have put unprecedented investment into primary care, supporting a massive increase in new staff and modern premises and improved services. Funding has more than doubled. Investment in GP services has increased from just £3 billion in 1997-98 to £7.86 billion in 2006-07. There are 5,300 more GPs and 4,500 more practice nurses. The average length of a GP consultation has risen by 50 per cent., from 8 to 12 minutes, and outcomes for patients have improved, and patient satisfaction in England with GP services has risen. In 1997, fewer than half of all patients could expect to see a GP within two days of asking for an appointment; now, more than 87 per cent. of patients say they see their GP within 48 hours.

Mr. John Horam (Orpington) (Con): Appointments are an important issue because they are the first point of access between doctor and patient. In most circumstances, it is sensible for a person to make a phone call, and they will then get an appointment for that day or the following day. However, patients who telephone are increasingly finding that they are placed behind others who make appointments through the internet. As a consequence, elderly people who do not have a computer are at a disadvantage in getting appointments. Is the Minister aware of this, and what can be done about it?

Mr. Bradshaw: I am certainly aware that some GP practices are introducing the option to book appointments electronically, and I welcome that as it provides a greater range of means by which people can make appointments; the complaint has often been made in the past that is rather difficult at some surgeries to make appointments via the telephone. However, the hon. Gentleman is right to highlight the potential danger of people who do not have access to the internet, or who do not use e-mail and rely on the telephone, being disadvantaged. I hope that GP surgeries and primary care trusts will do what they can to ensure that that does not happen.

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Mr. Andrew Lansley (South Cambridgeshire) (Con): Can the Minister explain why the GP-patient survey said that 87 per cent. of those asked whether they were able to get through to their surgery on the phone said yes, but in a report published by the Healthcare Commission just a couple of months ago on urgent care, the patient experience survey found that 55 per cent. of people always or sometimes had a problem getting through to their GP practice or health centre on the telephone. Why is there a discrepancy between those two results?

Mr. Bradshaw: If the hon. Gentleman will bear with me, I will come on to deal with the discrepancies that have emerged between those two surveys and the Healthcare Commission report.

Dr. Howard Stoate (Dartford) (Lab): In some parts of the country there is still access to GP surgeries via 0844 numbers, and I consider that to be an unfair tax on those patients who have to pay a higher charge to get through to their GP—and where the GP effectively revenue-shares with the phone company, perhaps through how they pay for the phone system. This practice damages access, and I would like to learn what the Government might do to stop it, as it disadvantages patients, particularly in poorer areas.

Mr. Bradshaw: I can reassure my hon. Friend that we are looking closely at this. We have repeated on a number of occasions that the public should not be charged more than the cost of a local call for contacting their GP surgery. Some surgeries have introduced these more expensive phone systems, but we are looking at whether we can introduce a system where that would not be the case without disadvantaging surgeries.

Mr. Michael Ancram (Devizes) (Con): I wrote to the Minister’s Department on the following matter in the summer. We are all keen for access to primary care to be encouraged and promoted, and we are also keen to encourage people to go to their GPs. However, a pharmacy White Paper is currently out for consultation, and for an area such as my constituency unless the first option outlined in it is adopted, which is the option of no change, it will be less likely that people will go to their GPs and more difficult, particularly for elderly people, to obtain the prescriptions they get at present from their dispensing doctors. Will the Minister take into account the fact that if we are serious about encouraging better access to primary care, moving in a direction other than that proposed in the first option will severely damage that aim?

Mr. Bradshaw: I reassure the right hon. and learned Gentleman that we are listening very carefully to the representations that he and other Members have made on dispensing GPs. No decisions have been made yet, but we recognise the value in their work that he describes. At the same time, we want pharmacies and pharmacists to play a greater role in the provision of primary care and we need to address some of the distortions that have been in the market for rather too long.

Many of the improvements that I described a moment ago have resulted from the much, and unfairly, maligned new GP contract. The contract was vital to prevent the haemorrhaging of GPs from the service, but that does not mean that it cannot be improved. Since its inception we have been improving it in relation to the quality of service from GPs and value for money for the taxpayer.

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