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Our progress is backed by nationwide changes in policy and medical practice. The decision in 1999 to start recommending HIV tests to pregnant women prompted a dramatic fall in the proportion of those giving birth to HIV-positive babies. HIV tests are now standard for sexual health screening, so the proportion of those who voluntarily take such a test in genito-urinary medicine clinics rose from 77 per cent. in 2004 to 93 per cent. in 2008. That shows the benefits to which my hon. Friend referred.
I share the view that the biggest enemy of progress is stigma. HIV still has the power to define someone in a way that other illnesses do not. Too many people with HIV still experience shame and isolation because of the diagnosis, which may manifest itself in discrimination in the workplace, the community and, as was said today, even health services. It is hardly surprising that many people are extremely wary of being tested, and may react with shock or hostility if a GP or nurse suggests an HIV test.
I agree that if we want to increase testing and reduce the number of undiagnosed cases even further, we must demolish stigma and discrimination. That is one of the five goals set out in our national strategy for sexual health, which funded voluntary organisations to produce information for journalists, employers, health professionals and people with HIV. Much of the stigma surrounding HIV cannot be separated from homophobia, and we are acting to root out discrimination and prejudice against the gay, lesbian and transsexual communities. We should not forget that this Government equalised the age of consent, repealed section 28, and passed the Gender Recognition Act 2004 and the Civil Partnership Act 2004. Those are landmark achievements that have changed people's lives by giving them respect, dignity and equality on the basis of who people are, not what they are labelled as.
My hon. Friend referred to his concern about denial of treatment and the way in which treatment is given by some health professionals. People should not be denied treatment by dentists because they are HIV-positive. It is not a bar to access to the full range of NHS health care. People with HIV should be treated the same as everyone else and in the best clinically appropriate way. I assure my hon. Friend that we are raising awareness among the health community, because we know that doctors, nurses and community health teams are important in offering and encouraging more people to take HIV tests, as well as in delivering services.
Mr. Borrow: Does my hon. Friend agree that because GPs and dentists operate as private businesses and are not employed directly by the NHS, the difficulty is that individual dentists and GPs are doing their own thing? It is not as easy to pull levers to tackle such issues as it would be with doctors and nurses working in hospitals or local clinics run by the NHS.
I note that point; it is extremely useful to work with professional bodies. For example, British Dental Association guidelines say that dental practices should treat everyone the same, and that good cross-infection control applies to all of us. Our work with such bodies has been helpful, and we will continue it. The chief medical officer wrote to several royal medical colleges and faculties to highlight the role of all
health care professionals in offering HIV tests, but perhaps we could go further in getting them even more on board.
Advances in treatment may have turned HIV from a killer virus to a chronic illness, but we must maintain our vigilance, and do everything possible to reduce transmission. We must encourage safer sex among the general population, which is what our new campaign, "Sex: Worth Talking About", is all about. We must also tackle the stigma and discrimination surrounding HIV. That is vital if we want more people to come forward for testing and treatment.
I am proud to say in the Chamber that our record on HIV and AIDS over the past 12 years has made a difference, but I am deeply conscious that a lot remains to be done. I am keen to work with my hon. Friend, the all-party group and the entire sexual health community to move forward in the years ahead on something that affects us all.
Joan Walley (in the Chair): Order. Before I call the hon. Member for St. Albans, let me say to hon. Members that it might be helpful if everybody could co-operate. I think that there might be a few people who will try to catch my eye, and I would like to call the Minister by quarter to 4.
In October last year-this will come as no surprise to anybody who has been watching the news-drivers on the First Capital Connect Thameslink route, which serves my constituency and those of many other hon. Members here today, began industrial action. A virtual ban on overtime and rest-day working was imposed due to a dispute over pay. Since then, that action has been causing intense disruption and frustration for hundreds of thousands of commuters who use the route.
In early November, the company informed me that it would be introducing a new timetable that offered only 50 per cent. of the services that usually ran on that busy commuter route. It was not exactly a formal notification. I rang the company one evening and said, "Excuse me, this situation is getting so bad that I need to talk about it." The reply was, "Don't worry. It's going to improve tomorrow and there will be a much more reliable service". I said, "Oh good. How is that going to occur?" and the reply was, "We have cut the train service in half and we can guarantee that that half will be delivered." At that point, I decided that a point desperately needed to be raised about the matter on the Floor of the House.
Mrs. Jacqui Lait (Beckenham) (Con): I am grateful to my hon. Friend because my constituents have exactly the same problems as the ones she describes, and I congratulate her on securing this important debate. However, my constituents have had not only that 50 per cent. cut, but on the Crystal Palace line, City workers cannot now get to the City without using another form of transport. Does my hon. Friend agree that the situation is outrageous? To say that there is a 50 per cent. service is to exaggerate just a little.
Anne Main: I am not aware of that particular incident, but I know that commuters in my constituency are experiencing the frustrations that my hon. Friend describes. I am sure the Minister will have plenty of time today to address all points that are raised about the whole route.
Mr. Andrew Pelling (Croydon, Central) (Ind): I am grateful to the hon. Lady for giving way as I know she wants to make progress. She has been leading the campaign not only in this debate but elsewhere, and she should be congratulated. Does she agree with my constituent, Colin Withey, and with the hon. Member for Sutton and Cheam (Mr. Burstow), that the franchise should be removed? A 50 per cent. reduction is absolutely appalling.
Anne Main: I will talk about whether the franchise should be removed or whether it should stay with the company later in my speech. I hope the hon. Gentleman will bear with me and I thank him for his warm congratulations.
The new timetable with the 50 per cent. reduction resulted, needless to say, in chaos. Many passengers at St. Albans and further down the line spent hours trying to get to and from their workplaces in central London. Trains often arrived late, or already full so that people could not get on them, or they were cancelled at a moment's notice. Platforms were changed at a moment's notice, meaning that people could not board a train. The situation only worsened last month, with adverse weather conditions causing some of the older trains to become frozen; motors and doors became inoperable and further cancellations occurred over a period of weeks due to the poor weather, as well as the problems with the drivers.
The original problem stemmed from the company's heavy reliance on staff good will to ensure that it could run its services. The drivers were not contracted for enough hours to run a full service, and their contracts did not include Sunday working. The model was bound to come to grief at some point.
Andrew Selous (South-West Bedfordshire) (Con): I am extremely grateful to my hon. Friend for giving way, and I offer my apologies that I cannot stay for the whole debate because I have a meeting on child poverty shortly.
My hon. Friend has put her finger on the nub of the question. Does she agree that it is up to the Department for Transport in future not to award franchises to companies that rely on good will for overtime to run a scheduled service on which our constituents rely to get to work?
Anne Main: I thank my hon. Friend for his valuable contribution and I will touch on that point later in my speech. I want to know how much Ministers and the Department were aware of that model, as it was bound to lead to failings.
Stephen Hammond (Wimbledon) (Con): Perhaps I can help my hon. Friend and my hon. Friend the Member for South-West Bedfordshire (Andrew Selous). It is not only the company that was relying on good will-the franchise model given by the Government specified that and allowed the company to do it. When the specification was written, there was an innate failure in the Government's franchising model.
Anne Main: My hon. Friend answers part of the question that I will put to the Under-Secretary of State for Transport later-he might like to agree on whether that was a good decision. I was unaware of it, and it is frankly shocking.
Mr. Paul Burstow (Sutton and Cheam) (LD): I congratulate the hon. Lady on securing the debate. I know that she does a lot of work on behalf of her constituents on the matter. On the franchising process, together with other hon. Members, I have tabled early-day motions to ask questions about termination of the franchise, as many of my constituents feel that the only option is to get a fresh start with a new provider. Ministers have been vague about how much longer they are prepared to tolerate the catastrophic failure of the service before they will terminate it. Is that a question that the Under-Secretary should answer today?
Anne Main: I thank the hon. Gentleman for that intervention and I shall certainly ask the Under-Secretary exactly what he is considering doing. I have heard some strong words from Lord Adonis in the other place about the ultimate sanction of stripping the franchise. I would like to know if those are empty words, and whether, if that were done, it would provide a better option for commuters in my constituency. I am not interested in punishing train companies. I am interested in commuters in my constituency having the service they have paid for and getting to work on time. Ultimately, that is what they want. They do not want bits and pieces of compensation or empty words, threats and promises. They want the commuter services that they have paid for and that First Capital Connect undertook to deliver. I will come to that in a moment, but the hon. Member for Sutton and Cheam (Mr. Burstow) is right. The Minister needs to discuss the matter in this forum so that people know what is going on.
The bad weather caused faults in trains that were already in need of work and replacement by newer units. I do not have time to add this issue to the debate, but the delivery of the newer units from Bombardier was subject to delays that were apparently due to the recession and the laying-off of workers. Four-car trains were operating when there should have been eight-car trains, which increased the problems along the route, and at some points, people were unable even to get on the trains.
Answers to my parliamentary questions have revealed that the Secretary of State for Transport knew about the action by drivers on the route as early as 26 October 2009. However, the news did not reach the public domain or Parliament. I was not informed about the change of timetable until my conversation that fateful evening of 11 November with the manager of First Capital Connect.
Between 26 October and 11 November, my constituents were thinking that the problems might have been due to swine flu or that there was some other reason why the drivers were unavailable to work. However, Ministers knew about it. I lodged an urgent question to the Under-Secretary and raised the issue of the First Capital Connect service in the House the next day, 12 November. It is rare for a Back Bencher to get an urgent question-I do not know whether the public are aware of that-and I am pleased that the Minister came before us. However, the response was that the Department was "monitoring the situation daily". I must say that watching the situation did not do any good. It was chaotic.
The Secretary of State for Transport, who has since been criticised for not intervening earlier, did not give a statement on the matter in another place until after my urgent question. Even then, he only repeated the answer that had been given by the Under-Secretary-needless to say, "looking" at the situation.
Alistair Burt (North-East Bedfordshire) (Con):
I, too, offer an apology as I need to leave before the end of the debate. Before my hon. Friend leaves the incidents of 11 and 12 November, does she recall that on the Great Northern line there were no trains on the Sunday, so my constituents who wanted to attend Remembrance day services in London were unable to do so? Notwithstanding the fact that the trade union supported a yes vote on the ballot, is there not a joint responsibility during the drivers dispute? Drivers also played their part, and if
the service is to work in the future, unions and management must co-operate in the interests of the public to provide a better service.
Anne Main: I concur completely with those sentiments, and I want to touch on my hon. Friend's point. We are only too well aware that drivers unions have been pressing for full nationalisation. If we are to think of doing that, we must discuss what the possible reaction would be.
Kelvin Hopkins (Luton, North) (Lab): Does the hon. Lady accept that the state railway systems in continental Europe run much better than our system, and that fares are much cheaper, with lower public subsidy?
Anne Main: I thank the hon. Gentleman for that rather rosy view of life on the continent, but I must say that one of the few rail services that have been repatriated to state control has actually got worse. That is why I am nervous about even suggesting that Ministers get their hands on another rail service.
I wrote to the Under-Secretary on 16 November, after the statement, to urge him to do more than just "monitor" the situation and to ask him to meet the company urgently to discuss its apparent failure to meet its franchise obligations. On 26 November, at business questions, I requested a debate in the House of Commons from the Leader of the House to discuss the problems. In response to a parliamentary question, I was told that the Secretary of State met management in mid-November, but I have no idea what was said. If he has any recall of that meeting, I would quite like to hear about it today. The Under-Secretary did not agree to my request and no debate was granted. This is the first time that we have had a chance to debate the matter in the House.
The overwhelming impression was that the Government were unwilling to take action about the catastrophic delivery of services, which were deteriorating daily. On 9 December, I called a meeting with Mary Grant, the group rail manager at FirstGroup, and all hon. Members affected, so that our concerns about the ongoing problems could be discussed. At that meeting, I urged Mrs. Grant to act swiftly to implement a lasting resolution to the ongoing problems and, importantly, to compensate adequately all passengers affected.
However, commuters experienced even more extreme disruption over the Christmas period, which was very taxing for families, given all that was going on with the weather. Because of the deterioration in services during the period of poor weather and the apparent lack of progress on the reinstatement of a full timetable, I raised the issue again in the House of Commons on 11 January with the Minister of State, Department for Transport, who promised to look at ongoing problems. Looking, monitoring, watching and thinking seem to be all the Government have been doing on this matter. My constituents and thousands of others along the route had completely lost patience with First Capital Connect by that stage.
The list of the many things that the hon. Lady has done shows that I was right to say at the beginning just how much she has been working on behalf of all of us. Does she think that if the Government decide no longer to be asleep at the wheel, an alternative approach might be for them to allow other franchises to provide other services? Perhaps there could be additional stops. The Gatwick express is often very empty on the
southern part of the route that we are discussing. Perhaps it could be allowed to stop at East Croydon station. That might be a way of at least trying to put some additional competitive pressure on First Capital Connect.
Anne Main: The hon. Gentleman anticipates the later part of my speech. I thank him for his warm words. He is absolutely right. It does not have to be an either/or option. We can have alternative models, and I should like to raise that later.
"as a matter of urgency"
to discuss the way forward. I have a copy of that letter with me. I am staggered to say that despite all the chaos, I still have not received a response nearly a month later, so despite the supposedly stiff words uttered to the media by Lord Adonis and harsh pronouncements in the Chamber, it appears that all that is only bluster. The reality is that precious little has been done to avoid the situation or even to deal with it. According to the Minister's own officials, his response to my letter is overdue according to the Department's guidelines, yet there is no sense of urgency.
I hope that the commuters who use this beleaguered service take on board the fact that the present Government did not even care enough to try to bring about a satisfactory and early resolution when I gave them numerous opportunities to do so. It appears that they were waiting for the train drivers to make up their minds.
Mr. Nicholas Soames (Mid-Sussex) (Con): I congratulate my hon. Friend on her vigorous and energetic campaign on behalf of all our constituents, which is much appreciated. My hon. Friend the Member for Arundel and South Downs (Nick Herbert) and I met the management of First Capital Connect on Monday to complain about this wholly unacceptable service, about which she is so eloquently expounding. Does she agree that one of the most important things is not just punctuality and all the rest of it, but the flow of information to the poor commuters who spend enormous sums of money trying to get from A to B and are then stranded without any information? In the age of the mobile telephone, that is unforgiveable. Will my hon. Friend add that grotesque lack of information to the litany of very effective charges she has laid against the company's door?
Anne Main: My hon. Friend is absolutely right. That litany of charges has come through my post box and those of other hon. Members. There has been a lack of communication. As I said, it was through a happenstance phone call that I found out on 11 November that the timetable was to be cut by 50 per cent. The Minister knew and he still cannot be bothered to communicate with me and my office, so I do not think that there is any better communication coming from the Government on the matter. My hon. Friend is right to say that passengers have been treated appallingly. I can only say that through the "Meet the Managers" sessions-I am having one in St. Albans on Friday-managers are becoming fully aware of how absolutely fed-up the travelling public are. I encourage residents in St. Albans and commuters to go along and give their 10 penn'orth, because the managers certainly deserve to hear it.
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