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22 Apr 2009 : Column 128WH—continued
Losing the Haverfordwest option means that testing provision, which was already inadequate, has become more so. Haverfordwest was chosen for a reason. Presumably it was to respond to demand in west Wales and to the challenges of geography. That option has now gone. As a consequence, there will be no MPTC in Ceredigion, Carmarthenshire, Pembrokeshire or Powys. That is a vast area. Although I appreciate what the DSA has said about the lack of demand in the area, there is a significant gap in coverage. I repeat that the DSA assessed that there was a need and it located Haverfordwest as a possible site, but that option has gone.
Will the Minister say what is happening to compensate for the lack of that option in north Pembrokeshire? There will be no other MPTCs in Wales to make up for its absence. I presume that the money that had been earmarked for Haverfordwest, some of which was spent on the planning process, has gone elsewhere. Some of us feel that we are being penalised by what happened in Haverfordwest. More generally, are there plans to review the number of MPTCs in future or are these proposals set in stone? There has been a downward spiral from the 90 that were envisaged originally to the current 44. The Government hope to expand on that figure, but there has been a downward spiral.
I still believe that there is a strong case for an MPTC in my constituency. I accept that that is unlikely to happen in the near future and that we must concentrate on finding a casual site. Does the Minister foresee a time when the current network will be expanded? We know that the DSA thought it was necessary to have an MPTC in west Wales, but that will not now happen. I hope that the Minister will hold out the hope for future expansion.
It seems to me that having an MPTC is the only way that we can guarantee permanently accessible testing. Casual sites by their nature will be on loan. Although they might be guaranteed for a certain time, they cannot be guaranteed permanently. Finding a casual site is not an easy process. At least five sites in my constituency have been rejected. Three sites in Aberystwyth, one in Tregaron and one in Aberporth have been examined. We are in the process of examining another site in my community of Borth. The local county councillor, Ray Quant, has been particularly active in that. To date, we have been unsuccessful.
Although the DSA has been helpful and has responded to suggestions in this ongoing process, there has been conflicting information. In my first correspondence with the DSA, it was made clear that it would not pay for the surfacing of a test site. I was later told that it would. Other costs are involved in the testing process for things such as electrical contact points and crash barriers. However, my constituents have now been told that money will not be forthcoming. If the Minister is not able to clarify the specifics of individual sites, will he say whether there is a willingness to spend money on a new site? The assertion that we can find a site without cost implications is a fallacy.
There are deep concerns in my constituency. The Under-Secretary of State for Transport, the hon. Member for Poplar and Canning Town (Jim Fitzpatrick), indicated to me in writing that he would be prepared to meet with my constituents to discuss those concerns. I hope that that will be pursued after the debate.
The fundamental principle that must be considered in any road test is safety. We expect drivers to take tests that determine their competence to avoid unnecessary accidents and deaths on our roads. We all agree with that. However, in implementing this new test without the necessary arrangements, I fear that we are unintentionally compromising that important principle. I do not think that I have come across anyone who thinks that the new test is a bad thing—anything that encourages safer riding is welcome. However, the lack of provision for the test could lead to certain hidden safety concerns. I have mentioned the difficulties involved in travelling long distances on country roads. Concern has also been expressed that due to the greater inconvenience of the testing, some riders may opt not to take the test and to remain on provisional licences or even ride illegally.
There were not enough testing sites in October. There are still not enough testing sites. I know that efforts are being made to find new sites. I implore the Government to give assurances on the finance behind this and to help us to find sites in mid and west Wales.
4.16 pm
The Parliamentary Under-Secretary of State for Transport (Paul Clark): I think that this is the first time that I have served under your chairmanship, Mr. Pope. So far it has been a delight.
I congratulate the hon. Member for Ceredigion (Mark Williams) on securing the debate, which builds on his contributions to the debate before the Christmas recess in which he raised many similar matters.
I believe genuinely that the goal of everybody present, the DSA and the Department for Transport is to ensure that the motorcyclists on our roads have the right qualifications and are safe and careful for themselves and others. That must be our guiding principle.
It might be helpful if I explain some of the provisions. In setting out how we have reached the present position, I will pick up some of the points that have been raised. The European Union legislation on driving licences that was agreed in 2000 set higher minimum requirements for driving tests. That was meant to ensure that the matters assessed in theory and practical tests were relevant to modern driving conditions. Those new EU standards support our domestic strategy for reducing road casualties, which we set out in 2000 in “Tomorrow’s roads: safer for everyone”.
The strategy set some challenging targets for reducing the number of road casualties. By 2010, we want to reduce by 40 per cent. the number of people killed or seriously injured on the roads in Great Britain. An even harder challenge is to reduce by 50 per cent. the number of children aged nought to 15 killed or seriously injured. We want to reduce by 10 per cent. the rate of slight casualties per 100,000 vehicle kilometres. All those figures are set against the baseline of the figures for 1994-98.
Because of the work that many people have undertaken, we are on target to meet the 40 per cent. target, and the other two targets have already been met. By 2007, the number of people killed or seriously injured was 36 per cent. below the baseline. The number for children was 53 per cent. below the baseline, and the slight casualty rate was 45 per cent. below it. All those achievements
were delivered by the collective efforts of many organisations and people such as Motorcycle Action Group. We welcome those achievements.
Yesterday, we launched our consultation on a new road safety strategy for the period beyond 2010. The Department recognises that motorcycling has a role to play within the whole transport set-up, and our aim is to facilitate motorcycling as a travel choice within a safe and sustainable transport framework. To that end, we published first the Government’s motorcycling strategy, and then, in 2008, a revised and updated plan, which we are taking forward in partnership with motorcycling and other interested groups.
After all the good news that I have just laid out on our achievements, there is, sadly, a downside, on which all of our decisions have to be focused. Motorcyclists still represent a large proportion of road casualties: despite making up only about 1 per cent. of road traffic, they account for some 22 per cent. of deaths and serious injuries. We must take that seriously. The road safety strategy made improvements to driver training and testing, thereby playing an important role in producing safer drivers and riders, and it identified European developments as a factor in future changes to the driving test—for example, we believe that the changes to the practical motorcycle test will contribute to a reduction in motorcyclist casualty rates.
The EU changes of 2000 included the introduction of two higher-speed emergency manoeuvres—braking and avoidance—into the practical motorcycling test. The hon. Gentleman seemed to be saying that that has always been done on the road and is therefore nothing different, but I understand that the manoeuvres required are higher-speed emergency manoeuvres. As he pointed out, they must be conducted at speeds of no less than 50 kph and they should have been included in every practical motorcycling test in Great Britain since 29 September 2008. There were overwhelming safety objections to conducting those higher-speed emergency exercises on roads, where there may be other vehicles and pedestrians. That is why those who took a position on the safety aspects for all those involved concluded that those exercises should be done off-road. Ministers therefore asked the Driving Standards Agency to explore and assess those manoeuvres at off-road testing areas that were free from other traffic.
Proposals for the implementation of the new EU requirements were the subject of a public consultation in December 2002, which offered a range of delivery options. In the consultation, contributions were made on all of those options, and undoubted preferences were shown for off-road assessments of the special manoeuvres elements and for those assessments to take place before the general on-road riding assessment process. It was considered that that arrangement would reduce significantly the health and safety risks associated with conducting the specified manoeuvres on the public highway and would answer the cost and access concerns raised by some consultees. Separating the specified manoeuvres would result in a longer practical motorcycling test and would provide an opportunity for the candidate to cover a greater distance during the on-road part of the test.
The new test centres were to be based on the updated design that we intended to use, with appropriate facilities to conduct all the specified manoeuvres off-road, whilst offering improved accommodation and facilities for customers and staff. As well as being fully compliant with disability discrimination legislation, the new centres were to support the Government’s wider sustainability agenda. In order to maximise our investment in those centres, the DSA decided that, wherever possible, they would be multi-purpose test centres, which the hon. Gentleman mentioned. In addition to the practical motorcycling test, the centres were to deliver practical tests for learner car, lorry and bus drivers, and their off-road test facilities were to be made available for training purposes when not being used by DSA.
The results of the consultation were published in 2004, and included a stated intention that most motorcycling test candidates should be able to reach an MPTC within 45 minutes, or should be within a 20-mile radius of one, as was laid out in the response to the consultation. On that basis, the DSA estimated that 66 MPTCs would be required across Great Britain to meet demand and to enable the majority of people to attend one and to fit within those criteria. On those estimates, 83 per cent. of the population would have fallen within the criteria. The DSA would have had 38 MPTCs fully operational by 29 September 2008, and it intended to offer, in addition, motorcycling tests from nine part-time Vehicle and Operator Services Agency centres and three casual hire sites. That would have meant that 70 per cent. of the UK population would have fitted within the criteria that I have mentioned.
The hon. Gentleman said that, because there has been no change in those six months, he did not see why there should not be another six-month delay. I must respectfully point out that there has been an improvement in the position in that time, because we have been able to increase the number of centres available. Let me spell it out in this way: instead of 50 being available, there are now 66 sites that would be available. When that time was requested in September, on that basis, we agreed to that six-month delay and we informed the EU Commission accordingly. To give greater flexibility, further consultation was then undertaken about splitting the test into modules 1 and 2, which the hon. Gentleman has mentioned.
Mark Williams: I thank the Minister for his answers to some of my points so far, but I have an eye on the clock. The situation has moved on since then and one of those important sites down in Haverfordwest has subsequently gone, and so has been taken out of the equation. He mentioned the VOSA sites, but most of those are on the other side of Offa’s dyke and so are not of particular assistance to my constituents. What compensatory news can the Minister give people in west Wales, given that the MPTC for Haverfordwest has now gone, and given that we are still exploring casual sites and that Monday’s deadline is fast approaching? My constituents would be very grateful for some specific news on west Wales.
Paul Clark:
I understand the hon. Gentleman’s concern and I shall come to where I see our way forward. As he has said, a number of sites have been considered, but it is not easy to find a route through that is suitable to meet the required standards for the new test, which is of
benefit in making sure that we have good standards of training and good test sites available for those whom we want to make sure are safe drivers and motorcyclists. We have taken the opportunity, in the past six months, to increase the number of facilities available and to increase from 70-odd per cent. to 88 per cent. the percentage of the population now falling within the criteria that we laid out. However, I recognise that we have difficulties and that the situation is nowhere near ideal for his constituents and constituents in some other areas.
We have to strike a balance. Some £71 million has been invested in MPTCs, as the hon. Gentleman has recognised. He has said on his website that he hopes that Ministers will find a sensible way forward. I think that way forward is to continue to introduce sensible reforms to cycle and test provisions, because we want safer cyclists and we want them and others on the road to be better protected. We continue to work together and with county councils to take forward the various sites that have been identified, of which some have been too small and some too large.
Sexual Health (Middlesbrough)
4.30 pm
Dr. Ashok Kumar (Middlesbrough, South and East Cleveland) (Lab): I thank Mr. Speaker for granting me this debate, which is important to my area. I want to put on record the contribution that health service staff are making in dealing with sexual health matters in Middlesbrough, and to highlight some of the good practices that are being followed. Given that it is Budget day, I will not ask the Minister for any more money—she can put herself at ease on that subject—but I shall demonstrate what good practice is being followed and express one or two concerns that I have for the future.
Securing improvements in sexual health and well-being will continue to present a real challenge to all of those charged with that responsibility nationally, locally and regionally. Sexual health services have been required continually to adapt to changes in the communities that they serve. That was evident in the most recent Department of Health document on the issue, which was entitled “Progress and Priorities—Working for High Quality Sexual Health”.
That document shows us, for example, how the shape of HIV in this country has changed significantly, particularly in relation to increases in the diagnosis of heterosexual people infected overseas and the undiminished levels of newly acquired infections in gay men. Despite the availability of more effective drug treatments and expanded testing opportunities, too many people are still diagnosed too late. Overall, diagnoses of sexually transmitted infections have continued to increase. Other social changes also impact significantly on sexual health, such as the frequent use of alcohol and other drugs.
One subject that has not been well reported or analysed is the need for sexual health services for older people. Sexual behaviour research in that group is minimal, but recently, in a large survey of almost 8,000 people over 50, two thirds said that they were sexually active and more than one in 10 said that they did not use contraception with their current partner. They also did not know about their partner’s sexual history. The document concludes:
“Whilst progress has been encouraging in some areas, overall the picture is one of worsening sexual health”.
That is the case in Middlesbrough and Teesside, too. Middlesbrough, Redcar and Cleveland, and Hartlepool primary care trusts, as well as Stockton-On-Tees teaching PCT, have developed proposals for the improvement of local sexual health services as part of a Teesside-wide investment. That is an example of best practice in collaboration across geographical boundaries. Flowing from that, a Teesside-wide sexual health reorganisation is taking place to help to facilitate a fully integrated sexual health service.
A tendering process is under way in the area to appoint a lead provider, which will be responsible for organising the delivery of an integrated sexual health service. That will include genito-urinary medicine—GUM—contraceptive and sexual health services, and teenage pregnancy. It is intended that such a future pattern of integrated sexual health services will start to address the issues that I have mentioned. Those developments will support the changes needed to take a radical step forward
in service delivery on Teesside. That vision of sexual health services sets out an ambition for everyone across Teesside to have access to comprehensive sexual health services, and to promote sexual health and well-being. Our providers say that that
“will be delivered through high quality, fully integrated care pathways, that will be both holistic and client focused”.
That is, and will be, delivered through PCT primary services at street and clinic level, and the James Cook university hospital in my constituency. The South Tees Hospitals NHS Trust GUM services are currently meeting Government targets on the number of patients seen and appointments offered. In fact, South Tees GUM services were recent finalists in the Nursing Times GUM service awards.
On HIV, approximately 300 patients attend South Tees services—the majority attend the department of infection and travel medicine. Patients are usually seen by the department of infection within 48 hours of referral. Medical, nursing, psychological, dietary and social input gives holistic care to patients with HIV.
For too long, our area has had to suffer poverty and health inequalities, and it has long been recognised that there are serious health inequalities in the Cleveland area. More than 16 per cent. of the population have health problems and that is significantly higher than the national figure of 13.1 per cent. Standardised mortality ratios are higher than national averages for all causes of death—for example, standardised mortality ratios for coronary heart disease show that, in some wards, levels of heart disease are more than 50 per cent. higher than national rates.
The same is true of sexually transmitted infections. Across the Tees area, the four primary care trusts have the highest levels of teenage pregnancy and sexually transmitted infections in the country. The evidence collected by the four PCTs shows a clear picture of an increasing trend in sexual risk-taking behaviour, with the resultant increase in sexually transmitted infections. That is often exacerbated by alcohol and drug taking.
The first priority is to deal with these infections at the sharp end, both in clinics and in hospitals, as I have mentioned. However, a longer-term view is also needed. So, alongside the need to manage the growing demand, the PCTs are acutely aware that they must have a better understanding of social causes and provide better education and prevention. The PCTs have recognised that, although they commission a range of sexual health services, there is not a comprehensive approach to the issue. They also acknowledged that strong, strategic leadership was needed to build on a vision and strategy for this delicate but crucial area of service. As a result, there should be a strong, robust, patient-and-public-involvement focus to address the needs of vulnerable groups.
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