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Mr. Bernard Jenkin (North Essex) (Con):
Has the Minister done any analysis of the disparities in costs between different out-of-hours contracts? Is he aware of the disparities between the costs that the Ministry of
Defence pays? In one case it pays £20,000 a year for 17,000 soldiers, but in another it pays £278,000 for 20,000 soldiers, which is considerably more. Why should the Ministry of Defence pay for out-of-hours care for its soldiers when soldiers pay tax and should get that service on the national health service anyway?
Mr. O'Brien: The Ministry of Defence wants to ensure that particular facilities are available to it. Therefore, some want to fund those facilities themselves. That is, in a sense, a matter for the MOD. As for variations in cost between PCTs, that is an issue that we need to look into with care. I am satisfied that the broad run of PCTs is trying to get both value for money and a good quality of service, and that those PCTs are indeed delivering that. However, one or two PCTs are looking more at cost than at patient safety.
Mr. David Heath (Somerton and Frome) (LD): To bring the Minister back to rural areas, is not another factor the availability and accessibility of accident and emergency units? My constituency covers 900 square miles. There is not a single A and E unit in my constituency, nor is a single out-of-hours doctor based there. Do we not need better cover than the four cars that currently provide for the whole of Somerset? Should there not be an assumption that community hospitals will have at least an evening treatment centre, with a doctor available to look after people out of hours?
Mr. O'Brien: The hon. Gentleman has raised a number of issues. As for provision in his local area, the issue that we have faced over a number of decades is that power is being devolved. That means that we are very reliant on local PCTs to make local decisions. We can have minimum standards, but we cannot rewrite the entire framework in which PCTs operate-in other words, take away their flexibility to respond to local need. Getting the balance right is quite tricky, but it is important that we work on getting it precisely right.
Miss Anne McIntosh (Vale of York) (Con): I should declare an interest: my brother works for the out-of-hours service in North Yorkshire, although we have not discussed the issue. Is not the heart of the matter the fact that only in the UK has the system of family doctors and GP services developed to the extent that it has developed here? No one else is in quite the same position-or, possibly, no one else is better qualified-to judge that the PCT is not qualified to judge whether a GP here, or a medically qualified doctor in Germany or another EEA country, is fit to operate our out-of-hours service. I am not sure that what the Minister has told the House today fundamentally addresses that point.
Mr. O'Brien: We need to ensure that doctors are properly qualified. It is a requirement that PCTs should not allow anything that might mean that the GPs they employ are not capable of being GPs. Therefore, we need to ensure that we have proper induction and proper training. We must ensure that GPs are capable of doing the work that they are employed to do. It is not so much a matter of the EU; rather, it is a matter of ensuring that if someone comes into an area, the PCT and the providers have done the checks and ensured that that GP knows what they are doing and are safe.
Dr. John Pugh (Southport) (LD): Why is the Minister so opposed to specifying a minimum ratio of medical personnel to population? Surely there is a level that is clinically unsafe, and we ought to specify it.
Mr. O'Brien: This is dependent on a number of factors, including the size of the area, the amount of time it takes to get to people, and the level of demand in the area. That is why the PCTs have to ensure that proper medical issues are looked at, and that the level of cover and provision is adequate to ensure that people get the quality of service that they need. Checks should be being done now, but I still want to consider whether we need a national minimum standard. The requirements for the ratios to be right from a medical point of view are already there.
Mr. O'Brien: I do not think that it is. There is a lot of increase in demand on the ambulance service, and we are working through some of the issues relating to that increase. Much of it, however, is occurring during the daytime, rather than at night. I would need to get more research done before I could answer in depth the hon. Gentleman's question on whether that relates directly to the issues around the out-of-hours service.
Mr. Andrew Pelling (Croydon, Central) (Ind): The campaigning social issues journalist Aline Nassif revealed in the Croydon Advertiser last Friday that our population of 370,000 is covered by only three GPs between midnight and 8 am. Does the Minister really feel that that is clinically safe?
Mr. O'Brien: Decisions on clinical safety should be made by people who are clinically qualified, rather than by me as a Minister. It is a requirement for the PCT to ensure that there is appropriate clinical supervision of the provision, that there is an appropriate number of GPs for the population, and that the cover is safe. That is a legal requirement, and the PCTs should be doing that.
Mr. Mark Harper (Forest of Dean) (Con): On a point of order, Mr. Speaker. I know how much importance you place on timely answers being provided to questions posed by Members of the House. Could you give me some advice on how I might ensure that the Department for Work and Pensions does a little better at answering its questions? I have tabled 30 questions that have now passed their due date without being answered. To be fair, most of them are due to be answered in February, but the worst instance dates back to 30 November last year. The most embarrassing example is from 14 December, when I asked the Secretary of State how many and what percentage of questions tabled for written answer on a named day had had a substantive answer. Every other Department has managed to answer that question in a timely manner, but I suspect, given that I have not had an answer from the DWP, that its response will be "Not very many". What can I do to get more timely answers?
Mr. Speaker: I am grateful to the hon. Gentleman for his point of order. I understand why he feels disquiet about this matter. I wondered for a moment whether we were going to get a Cook's tour of his questions to which Ministers had so far failed to respond. He is right to say that I attach a premium to prompt and informative answers from Ministers to questions from hon. Members, whether those questions are written or oral. He is a keen student of these matters and a regular and substantial tabler of questions, and he will also be aware of the developing system of transparency, whereby it can readily be seen at a glance whether a question has been answered or not.
I would like to say, perhaps a little speculatively, to the hon. Gentleman that I have found, over the years, that when a Member complains about an unanswered question or letter, either through a further question on the Order Paper or by raising a point of order on the Floor of the House, that often serves speedily to concentrate the minds of Ministers. There are a number of Ministers on the Treasury Bench at the moment, and I feel sure that they are listening attentively to the point that the hon. Gentleman has just made. I hope that that is helpful.
Mr. Martin Caton, supported by Colin Challen, Mr. David Heath, Mr. Michael Meacher, Dan Rogerson, Alan Simpson, Dr. Desmond Turner and Joan Walley presented a Bill to set targets relating to energy generation and consumption; to make provision for the sectoral targets to be met; and for connected purposes.
That leave be given to bring in a Bill to require local authorities to supply regular data to the Environment Agency on their response time to incidents of fly-tipping; and for connected purposes.
Fly-tipping blights communities; it causes pollution and destroys wildlife; it attracts vermin and can encourage arson; and it is also just plain unsightly. We all want to feel proud of where we live, but too often problems such as fly-tipping and litter and graffiti and vandalism make people's lives a misery.
The Government have taken tough action to tackle fly-tipping. Much has been done to increase the powers available to local authorities in taking action against fly-tippers. We have substantially increased the penalties available to courts to punish those convicted of fly-tipping, but for too many people in too many places, fly-tipping still scars our communities and the extent of the problem is shocking, if not-sadly- entirely unsurprising.
Last year, there were more than a million incidents of fly-tipping-1.16 million to be exact, and the clean-up costs come in at somewhere between £100 million and £150 million. Even those figures, however, are likely significantly to underestimate the true extent of the problem. For one thing, they include only the reported cases of fly-tipping, while many incidents go unreported. For another, only fly-tipping on public land is counted so the figures do not include incidents of fly-tipping on private land, which is the responsibility of the owner of the site. The conclusion, though, is clear: fly-tipping is a widespread and serious problem-one that degrades our environment, costs our economy and damages our community.
Enfield suffers from particularly high levels of fly-tipping. The average local authority deals with about 250 incidents of fly-tipping a month. In Enfield, in November 2009 alone, there were nearly 1,400 reported cases of fly-tipping; and over the course of a year, we face not far off 10,000 reported incidents of fly-tipping. That gives us a sense of the scale of the problem we face with fly-tipping in Enfield. Open spaces, alleyways and even beauty spots are often disfigured by rotting black sacks, discarded tyres and a mixture of almost every conceivable household item. The need for further action, then, is obvious.
Since 2004, local authorities have been required to supply information detailing the number of incidents of fly-tipping, the number of enforcement actions, such as prosecutions or fines, and clean-up costs to the Environment Agency-but not how quickly the rubbish is actually removed. The residents I meet in Enfield are not really interested in the type of mattresses that have been dumped down their street or the number of black sacks that block their drive. They just want them removed-and they want them removed quickly.
Yet one of the most common complaints I receive is the time it takes to deal with fly-tipping. Residents tell me that they can be waiting weeks for rubbish to be cleared-and I doubt that the problem is confined to
Enfield-so we need to make local authorities more responsive to local residents. We need to encourage them to tackle the scourge of fly-tipping with the urgency it deserves.
I believe that making local authorities publish their response times, as my Bill seeks to do, would reduce the time it takes them to remove fly-tipping. Every local authority would be able to see how well they performed and how much better they could do. No local authority would want the dubious title of "the slowest council in Britain to deal with fly-tipping", and no voter would tolerate a council that dragged its heels in removing rubbish. Just as we ask schools to publish their exam results and hospitals to disclose their waiting lists, and just as we require train-operating companies to report the number of delays and cancellations, so, too, we should ask local authorities to publish their response time to incidents of fly-tipping.
Since 2004, local authorities have been required to report the number of incidents of fly-tipping and their enforcement actions-and rightly so, in my view, as since this requirement was introduced, councils have taken tougher action to combat fly-tipping. As a result, the amount of fly-tipping across the country has gone down and the number of enforcement actions, fines and prosecutions has gone up. In the last year alone, there has been a 9 per cent. decrease in fly-tipping throughout the country. Sadly that is not the case in Enfield, where since the closure of the Carterhatch recycling centre in 2006-against which I campaigned, along with thousands of local residents-fly-tipping has increased threefold, just as we said it would.
If making local authorities publish information about fly-tipping has encouraged them to take tougher action, we might assume that making them publish the time that it takes to respond to reports of fly-tipping would make them quicker at cleaning up the results. Publishing response times is not just about getting councils to remove rubbish more quickly, important though that is; it is also about reducing the amount of fly-tipping in the first place. Removing rubbish quickly would also act as a deterrent to fly-tippers.
It is easy to see what happens. One black bag that is not removed quickly attracts another. I observe that for myself when I am out and about in my constituency, and I am sure that the same applies to other Members. The three black bags dumped at the end of a row of houses become four the next day, and five the day after that. Not removing fly-tipped rubbish sends others the message that fly-tipping is tolerated, that rubbish can be dumped, and that no one cares about the area. It also has a snowball effect: small acts of fly-tipping encourage more fly-tipping and larger amounts of rubbish, which attract vermin and become a public health hazard. The more rubbish is dumped and the longer it is left, the more likely are acts of vandalism and graffiti, which in
turn attract even more damage and other more serious crimes, making the whole problem more difficult and more expensive to solve. As with so many problems, it is cheaper and easier to nip it in the bud than to allow it to grow.
It is an extremely simple change that I seek: one that has little or no cost implications, and does not place any extra burden on local authorities. Authorities are already required to provide the Environment Agency with extensive information about fly-tipping in their areas. They must tell the agency how much fly-tipping takes place, how they deal with it, and how much it costs to clear it up. My Bill would simply ask them to submit information on their response times to the agency, alongside the data that they are already obliged to give it.
It is inconceivable that local authorities do not already maintain records of some kind or other of their response times. This is, after all, what residents are most concerned about. Surely local authorities must already log the time when a report of fly-tipping is received, and when some sort of action is taken. If they did not, how would they know whether they had dealt with a particular case? If they already have that information on file, why can it not be given to the Environment Agency at the time when all the other fly-tipping data are supplied?
That is the simple change that my Bill seeks to achieve-a simple change which I believe could prove hugely positive for the residents whom I represent and the community that I serve. The residents whom I meet out and about in Enfield tell me that all they want is to live somewhere decent and to be able to feel proud of where they live. Is that really too much to ask? I do not think so, and for that reason I commend the Bill to the House.
That the Order of 18 January 2010 (Crime and Security Bill (Programme)) be varied as follows:
(1) Paragraph 2 shall be omitted.
(2) Proceedings in the Public Bill Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 25 February 2010.- (Kerry McCarthy.)
That, for the purposes of any Act resulting from the Constitutional Reform and Governance Bill, it is expedient to authorise the payment out of the Consolidated Fund of sums required by the Electoral Commission to meet-
(a) the charges payable to counting officers in connection with a referendum held on the voting system for parliamentary elections; and
(b) sums payable in respect of increases in superannuation contributions required to be paid by local authorities in consequence of fees paid as part of those charges.- (Kerry McCarthy.)
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