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3 Jun 2009 : Column 86WH—continued
According to analysis by the independent Institute for Fiscal Studies, total investment spending will be cut by half across all Whitehall Departments to 2014. The Treasury’s often optimistic forecasts predict that investment spending will fall by half by 2013. Even before the proposed budget tightening, the IFS predicted that the
Department for Transport’s spending allocation would fall by 4 per cent. over the three years from 2011 to 2013. Given that a quick recovery is unlikely, will the Minister confirm the IFS numbers? In addition, the DFT will be forced to find its share of the Chancellor’s announced £6 billion efficiency savings, which are independently estimated to represent 6 per cent. of current expenditure.
Given that we are in a recession, which will clearly impact on the railways, the Minister needs to answer a number of questions this morning. What size will the overall reduction in the DFT’s budget be as a result of the 2011-14 spending plans? What size will the resulting reduction in investment spending and current spending be? What is the Department’s judgment in terms of the balance between current and capital spending? Does it have any plans—this relates directly to the point made by the hon. Member for Lewes (Norman Baker)—to review control period 4, which is being talked about in the industrial press? Electrification has also been mentioned, and I want to ask about its future because it has been widely suggested in the rail industrial press that the rolling electrification programme is one of the programmes that might, as the euphemism goes, be pushed to the right. The Government need to clarify those points, which are the direct implications for transport spending of the Chancellor’s Budget.
Another key question that the Government need to answer today relates to the implications and problems beyond 2014. The Budget’s predictions suggest a major decline in possible spending. Does the Minister realise that the Government’s spending proposals in the Budget have left considerable uncertainty across the rail industry?
Time is relatively short, but I want to put it on the record that the Government’s focus is all wrong. The Department has been working far too much on the minutiae, such as details of timetables and train specifications—on his trip, Lord Adonis even had a chance to look at the restaurant car menus. Such things should be left to the industry. The Department needs to concentrate its resources on the strategic direction. That was picked up in a Public Accounts Committee report, which said explicitly that the franchising process
“does not consider damaging side effects”
The Committee also said that the Government could have a major impact on procurement. I totally disagree with how they are going about procurement. The Committee’s report states that:
“promises of bringing 1,300 new rail carriages into service by 2014 look over-optimistic.”
Analysis in answers to parliamentary questions to the Minister shows that only 973 of those carriages are likely to be extra carriages, and that the rest are part of the Thameslink growth programme, which the Minister’s predecessor rolled out.
I agree that shorter franchises and the whole franchising process bear a major part of the blame for what has happened. Longer franchises are at least part of the remedy. Clearly, a number of passenger criteria, as well as punctuality and service levels, will need to be set out in the franchises. However, it is also clear that longer franchises must be part of the answer.
Norman Baker: Will the hon. Gentleman give way?
Stephen Hammond: I am sorry but I will not give way to the hon. Gentleman as I only have a minute left.
In the very short time remaining I want to concentrate on franchises, because it is an issue that has been raised a number of times today. Is the DFT going to stick to its mantra that it will not renegotiate franchises? If so, is the DFT, as the hon. Member for Lewes was going to say, prepared to offer fixed-fee contracts? If it does take contracts back in-house, does it intend to keep them in the public sector or to re-franchise them within six months? Finally, does the DFT recognise that the much talked about cross-default option is, in reality, not open to it, because if it takes the contract back in-house, that will not affect the holding company level, so the cross-default option will not be available to the Government?
I note, unfortunately, that my time has run out, but I hope that the Minister might answer at least some of those detailed questions about the franchising process.
10.50 am
The Parliamentary Under-Secretary of State for Transport (Paul Clark): I congratulate my hon. Friend the Member for Hayes and Harlington (John McDonnell) on securing this debate. This issue is very important to the Government in terms of ensuring that the railway system is sufficiently robust to meet the requirements of the travelling public and of the movement of goods through freight operations.
I will endeavour to cover as many of the points that have been raised as possible, but let me say first that some of the comments made and the views expressed about the railway system seem at odds with the reality. Out there, the reality is that more people are using rail services than at any time since the end of the second world war—since 1946, in fact. We have greater investment, punctuality, reliability, service, safety and operating rolling stock. Indeed, one of the pleasant challenges that we face is dealing with the fact that we have great demand for railway services. Nevertheless, of course the economic downturn is going to affect the railways, as it is affecting every other type of transport and other industries.
It is interesting that the hon. Member for Wimbledon (Stephen Hammond) wants to discuss records of investment. If I am quoting him correctly, he said that it is now “false” that only a Labour Government will invest. One only need go back to recessions of the 1980s and 1990s to see that the railways are in a far better position today than they were in those days. In 1982, the railways were at their lowest point, with the lowest number of passenger journeys, the lowest number of passenger miles travelled and the lowest passenger revenue. The conclusion of the Administration at that time was to see what report could be introduced to try to delay the terminal decline of the railways. That Administration came up with proposals that would have seen wholesale line closures and the slashing of route mileage by more than 80 per cent.
Fortunately for us today, that view did not prevail. However, railways were still not invested in, which remained the position when we came to the 1990s and a further recession, which meant further problems. It is against that backdrop that we must view the situation. We then had a botched privatisation process, which continued the legacy of under-investment. We have had to deal with that legacy since 1997 in trying to address the problems on the railways. Now, we have had
a growing railway system for more than a decade, with increasing performance, reliability and customer satisfaction.
However, there are still challenges to be met and they must be met within this recession period. Of course, that is why we have continued to invest—to ensure that we have a robust railway system within the existing framework. That is also why we have announced £10 billion of investment to increase capacity for the next control period, for an extra 183 million passenger journeys between 2009 and 2014. Let us recognise the substantial investment that has been brought into the system by both private and public resources.
Mr. Drew: I will not talk about Swindon and Camborne because I know that that is outside this debate. However, can the Minister confirm that that £10 billion is on track? I apologise for the pun there. Obviously, that £10 billion is a key counter-cyclical factor in extending the network, including opening up new lines and improving existing ones.
Paul Clark: The Government’s actions, such as bringing forward fiscal stimulus packages at the pre-Budget report to invest in public transport, including the railway programme, show our commitment to ensuring that that investment continues at this time. My hon. Friend the Member for Islington, North (Jeremy Corbyn) said that it is at exactly this time that we should keep such investment going, and we would not disagree one iota with that view. Actions speak louder than words, but we have put on the record our commitment to bringing forward and continuing with investment to address the immediate issues relating to capacity on our railways. That is in contrast with the proposal of the hon. Member for Tatton (Mr. Osborne), the shadow Chancellor, who would have lopped some £840 million off the transport budget from April 2009. So we take no lessons about investment—
Stephen Hammond: Will the Minister give way?
Paul Clark: I will not give way because I only have four minutes left and I want to cover some of the points that have been made.
I want to talk about the issue of franchises, which was raised by my hon. Friend the Member for Hayes and Harlington and the hon. Member for Lewes (Norman Baker). The hon. Gentleman asked whether we were going to play “hardball” with the operators to ensure that they deliver on their franchise requirements. That is our position exactly: we will ensure that the operators meet the franchise requirements. That is also why I say,
as Lord Adonis has already said, that we are not in the game of renegotiating franchises.
Having said that, however, there is the question of a management contract, if required. What happened with Great North Eastern Railway is on public record, and there is nothing different in what I say now. There was a management contract, and as I am sure hon. Members are well aware, under section 30 of the Railways Act 1993, which was amended by the Railways Act 2005, there is a requirement on the Secretary of State to operate as “operator of last resort” if need be. However, the issue is ensuring continuity of the services that are required. We see that as being the important point—making sure that customers are put first when there are problems.
It has been said that only in the bad times do we have to bail out the companies, while they reap all the benefits in the good times. That is not how it works. In fact, in the good times the taxpayer shares in any revenue increases, and in the downturn there is a requirement for us to make up a percentage of the revenue gap. However, that provision applies only in the last year of a four-year franchise.
Opposition Members have talked about longer franchises. Having longer franchises would also mean having to predict revenues over 15 to 20 years, which makes matters extremely difficult.
John McDonnell: Will the Minister give way?
Paul Clark: I will not give way.
In addition, longer franchises would also raise further questions about our ability to ensure that we hold operators to account over any difficulties.
We recognise that the issue of fares, including getting the balance right between the fare payer and the taxpayer, is absolutely critical. The hon. Member for Lewes quoted from what Lord Adonis said to the Transport Committee about sticking by the RPI plus 1 per cent. formula. Of course, Lord Adonis went on to confirm that we are going to take away the flexibility that allows regulated fares to increase by up to a further 5 per cent. Furthermore, he said that, with negative RPI, we will expect rail operators to reduce their prices and not just freeze them from January 2010.
There was a lot of speculation about what the scale of job losses might be, and I recognise the issues that will be faced. On investment and renewals, everyone is well aware of Network Rail’s investment commitment. The package for 2009-10 is similar to that for 2008-09, but it is designed to achieve improvement in productivity by, for example, using modulus point sets so that we can get better turnaround. That is why there has been a re-profiling.
Other issues were raised that I would have liked to deal with, but I was not given the time to respond. We continue to invest in the industry and we will continue to invest for passengers.
Stroke Services (Ealing and Southall)
11 am
Mr. Virendra Sharma (Ealing, Southall) (Lab): I am grateful for the opportunity to raise the important issue of stroke services in my constituency in Ealing and Southall. I will come quickly to the point and say that my concerns centre on the recent Healthcare for London proposals for stroke services in London. If proceeded with, those proposals will result in the closure of Ealing hospital’s stroke unit. I hope today’s debate will give the Minister good reason to get Healthcare for London to think again about those proposals, and designate Ealing hospital as a local stroke unit for patients to return to after treatment at a hyper-acute stroke unit.
During the consultation on Healthcare for London’s proposals that ended in early May this year, it became clear that there was significant local opposition to the closure of the unit. Many constituents, local health practitioners, local councillors, clinicians and the hospital management contacted me with serious concerns about the impact of such a closure on the local community. Of particular concern were the extra journey times that my constituents would face both as patients and as visiting relatives. That was because under the new proposals, patients would be treated in the first instance at either Northwick Park or Charing Cross hyper-acute stroke units, or subsequently at Hillingdon or West Middlesex stroke unit, which I understand is in the Minister’s constituency.
The recent early-day motion that I sponsored highlighted the fact that 170 people died from strokes in Ealing in 2006-07. In the same year there were approximately 1,600 admissions to hospital for stroke-related conditions, with admissions from wards in Southall running at twice the national level. There are 4,000 people in Ealing who have had a stroke at some time.
It is well known that people of south Asian and Afro-Caribbean origin have a higher incidence of stroke, and both those groups are well represented among my constituents. The figures also show that the correlation between age, ethnicity and the incidence of stroke is disproportionately high among south Asian, Afro-Caribbean and other non-white ethnic groups, regarding people who have a stroke before the age of 60. Given those figures and trends, it seems unwise not to have a stroke unit at Ealing hospital, which is geographically positioned in the middle of my constituency. Stroke is a major killer in this country, disproportionately so among my constituents. Major improvements in the treatment of strokes have been made in recent years, and Ealing hospital has invested in better facilities to treat stroke patients. The latest independent assessments of stroke services at Ealing hospital show that in the main categories of stroke treatment, it is in the top 25 per cent. of the country. The hospital also stands ready to work with Healthcare for London to ensure that it can reach the highest standards that a designated stroke unit would need to attain by 2011.
If there is no stroke unit at Ealing, residents from Ealing and Southall will be sent from the hyper-acute stroke unit to Hillingdon or West Middlesex hospitals for stroke unit care, even if they have had no previous contact with those hospitals. The proposed HASUs at Charing Cross and Northwick Park have already expressed
concerns about their ability to repatriate Ealing residents in a timely fashion if there is no stroke unit at Ealing hospital. If patients cannot be moved from the HASUs efficiently, the hospitals might have to close to new admissions and the London ambulance service would have to take patients to HASUs in other parts of London.
The Healthcare for London consultation document states that the patient capacity supplied by Ealing hospital is “not required”. Healthcare for London has indicated at recent meetings that final decisions on capacity have not yet been made, and that designated stroke units will be asked to provide information on how many beds they will provide. I am concerned that the current plans will not have the capacity to deal with Ealing’s stroke patients.
If there is no stroke unit at Ealing, that will have serious implications for the running of other local services in the hospital and in the community. There are specialist acute services and procedures available at Ealing hospital trust that will be under threat if the stroke unit is removed. Those include acute surgery and coronary angiography. Patients undergoing those procedures have an increased risk of stroke, and the removal of an on-site stroke unit means that if they suffer a stroke as a complication of their treatment, optimal subsequent management might be compromised. If a patient has a stroke while in hospital, they will be unable to access immediate stroke care, which would significantly worsen the outcome. They would have to be transferred away from Ealing for further management. Access to key therapists, such as speech and language therapists, physiotherapists and occupational therapists will also be impaired, as they will not be available on site.
I and many of my constituents are deeply concerned about the proposal to close the stroke unit at Ealing hospital. I ask the Minister to work with Healthcare for London to find a way to provide those services for my constituents at their local hospital. The preferred option, which I believe is viable, would be to keep the stroke unit open under the management of Ealing hospital. If that is not possible, it is essential that a stroke unit is on the Ealing site under the management of one of the other designated stroke service providers.
I am sure that there is a positive way forward on this vital issue for the health of my constituents and I ask the Minister to do all she can to help to find a solution. I thank her for coming today and look forward to her reply.
11.9 am
The Parliamentary Under-Secretary of State for Health (Ann Keen): I congratulate my dear friend the hon. Member for Ealing, Southall (Mr. Sharma) on securing this debate. It is also a particular pleasure to serve under your chairmanship this morning, Mr. Bayley.
I know that for many years, even prior to his well-earned election to Parliament, my hon. Friend has shown a great interest in the welfare of his local health services and the future of stroke services at Ealing hospital. I commend the dedication with which he serves the needs of his constituents.
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