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The interesting and perhaps central point in the debate is the balance between the right of the public to be protected from crime and the right of individuals to live their lives without unnecessary state intrusion. That has been at the forefront of many of the speeches this morning. It has been interesting, and there have been some important contributions. I hear what my hon. Friend the Member for Shipley said about drawing a distinction between certain freedoms, which he articulated with reference to ID cards, which he sees as an intrusion, as against CCTV surveillance or the retention of DNA profiles, which he did not see as an intrusion in the same way. Clearly, not everyone shares that view, as we have seen in connection with developments in Birmingham; indeed, many cases from constituency postbags, to do with DNA profiles, for example, show that the issue is considered significant for the way the state may perceive individuals who have done no wrong. That private life interest is involved in the balance.
There have been comments about the role of the police. We have certainly discussed issues with ACPO and other police representatives and shall continue to do so as we progress with and publish our detailed proposals, so that the House can give them proper consideration. I am sure that we are only at the start of discussion of those important issues, which is why I welcome the speeches that have been made, albeit that, while it is a pleasure to continue in debate with the hon. Member for Tynemouth (Mr Campbell), he and I have probably debated the issues six or seven times in the past couple of years and I am reconciled to our not reaching complete agreement. We do, however, find agreement in the importance we place on public safety and the need for checks and balances on the retention of DNA. Although I may the other day have made a pejorative suggestion about the hon. Gentleman supporting the indefinite retention of DNA, I recognise that at the time in question that was not his position: there was recognition of a need for some restrictions on the retention period and related matters. We may not be wholly on the same page, but I recognise that there is at least some agreement about some issues.
Keith Vaz: Does the Minister accept the recommendation of the Select Committee that there should be an annual debate on the issue in Parliament, with a report presented to Parliament by the Information Commissioner?
James Brokenshire: I very much welcome the contribution made by the Home Affairs Committee on the issues of CCTV and DNA retention. I made sure that I had a copy of at least one of those reports before coming to today's debate. We shall certainly reflect on a range of issues about CCTV as we proceed with the framework for regulation, and I shall consider the recommendations in the Committee's report. Other codes of practice have been referred to and the right hon. Member for Leicester East mentioned the Information Commissioner, whose office has published a CCTV code of practice. That is important in informing the debate, as are the findings and feedback that we receive from the interim CCTV regulator, which as the right hon. Member for Don Valley pointed out was set up under the previous Government. We await the regulator's recommendations and feedback and will reflect upon it closely in relation to how we may proceed.
Emma Reynolds: Have the Minister or the Government made any assessment of the cost to businesses of increasing regulation of CCTV cameras? Many businesses in Wolverhampton North East use them to prevent and tackle business crime, which is still a massive issue.
James Brokenshire: The hon. Lady makes an important point about the nature of regulation. We are considering its ambit and scope in relation to public versus private areas, and publicly-owned versus privately-owned CCTV. Of course we are conscious of the regulatory burden and the possible regulatory impact. That will be a factor that we shall consider-and are considering-as part of the regulatory framework we shall bring to the House, so that there can be further debate.
Perhaps I should return to the central issue of the debate and the balance between the public's right to be protected from crime and individuals' right to live their lives without undue interference. I do not see that there is necessarily a conflict between the two. We are rightly proud in this country of our tradition of policing by consent. Securing the trust and confidence of the public is vital to the police, to enable them to detect and prevent crime effectively. That extends to the techniques and tools used by the police in their role. I was struck by the remarks of the hon. Member for Edinburgh West (Mike Crockart); one of his key points was about the concepts of usefulness and effectiveness. If we ensure that there is trust and confidence, and that the scientific elements are deployed so as to be more effective and so as to secure public trust and confidence in them, that in itself aids policing; it aids confidence, trust and belief in the work that the police do on our behalf to make communities safer. That is an important aspect of the debate and I welcome the hon. Gentleman's speech.
We are all aware of cases in which DNA evidence has been important in proving guilt or innocence, and several examples have been given this morning. The fight against crime necessitates the use of modern scientific techniques of investigation and identification. Indeed, this country claims a pioneering role in utilising DNA technology. As we have heard, it has proportionately one of the largest DNA databases in the world, with more than 6.1 million profiles stored on it. It has grown by more than 1 million profiles in the past two years. The use of technology must strike the right balance between the wider interest of public protection and the respecting of private life rights. That sense of proportionality is central to the debate.
James Brokenshire: I think that I touched earlier on the fact that it is a question of the way the state may perceive an individual as a criminal, when they are innocent, and the impact of that on a person. As a Home Office Minister I sign many letters to honourable colleagues who have raised that point, and I am sure that the hon. Member for Tynemouth used to do so before me.
This morning's debate is drawing to a conclusion. I look forward to continuing debate and I invite right hon. and hon. Members to engage positively in it as we
progress and as further details of our proposals are published. We have reflected on the need for and effectiveness of CCTV systems and the DNA database in helping to prevent and detect those crimes that are of most importance to our constituents, in a way that respects their civil liberties and commands their confidence and thus supports the police in making us all that much safer.
Chris Leslie (Nottingham East) (Lab/Co-op): At the outset, I wish to provide a little context to the debate. Nottingham is the 13th most deprived authority in a total of 354, according to the Government's 2007 deprivation index, with 81% of children falling within the first three deprivation deciles. In other words, the vast majority of young people form the poorest third of the population. There are some especially poor pockets of deprivation in the Nottingham constituencies. In my constituency, they can be found in the St Ann's, Dales and Arboretum wards, and in Hyson Green and Forest Fields, to name only a few places.
In September 2009, about 700 young people were not in employment, education or training, the status of another 550 was not known, and 62% of all children lived in households where no adult worked or where earnings were so low that they received benefits or other state assistance. Although I am pleased to have the opportunity to debate child health in Nottingham, it is precisely because of the concentration of problems that afflict so many young people in the city that it was necessary to spend some time on that point.
It is important to recognise that much good work is being done, not least by the NHS services in Nottingham, the city council and others. I am glad that my hon. Friend the Member for Nottingham North (Mr Allen) is here, because it would not be possible to speak on the topic for more than 60 seconds without mentioning the early intervention approach of One Nottingham, the local strategic partnership that he has pioneered and championed. Breaking the cycle of poverty and poor lifestyle, and preventing problems from worsening or even occurring is critical to ensuring that we make progress. Poor health, particularly poor child health, is not new in Nottingham.
I pay tribute to Professors Elizabeth and John Newson-sadly John passed away last Monday-for their groundbreaking work on child health and psychology at Nottingham university. In their famous and influential book of 1963, "Infant care and motherhood in an urban community", they followed 700 Nottingham families, particularly from the St Ann's ward, considering the detailed habits of their lives and so forth. I shall briefly review some of the things that affect the city to illustrate the scale of the challenge that we face.
Mr Graham Allen (Nottingham North) (Lab): I thank my hon. Friend for raising this important matter on behalf of the city. Will he tell the Minister about Nottingham's fight-back with a set of early intervention policies that try to break the intergenerational nature of these problems? There is great concern in the city that the pioneering work that we have undertaken, which may go to national level, is now under threat because of the public expenditure cutbacks. We managed 14 early intervention programmes in Nottingham on a shoestring. If that shoestring is snipped, the work that has been started will not last the generation, which is necessary if it is to have its massive impact.
I shall take the opportunity to pay tribute to some of Nottingham's councillors. Councillors Mike Edwards, David Mellen, Jon Collins and others have been involved in ensuring a strong early intervention approach. Partnership work needs to be supported, not undermined-particularly, in this context, the Nottingham children's partnership. That partnership's "think family" approach is holistic and integrated. Like my hon. Friend, I worry that such preventive partnership work may now be at a high water mark, going down again because of the pressures on those funds. Apart from the NHS, agencies that are not ring-fenced have hitherto put money into their pooled endeavours; now they will naturally and instinctively pull back from those activities, and it will be difficult for them to do anything more than their core work, which will endanger their crucial efforts.
I wish to review some of the key questions that need to be tackled. Sadly, there are many of them. Child mental health is important and is often hidden, but many young people can be held back by such difficulties because of the behavioural consequences. Studies suggest that as many as one in 10 young children or young people in Nottingham are diagnosable with some sort of classifiable mental disorder that might require intervention. Apparently, 10% of five-year-olds experience difficulties that cause distress or have other impacts on their lives. Nottinghamshire Community Health, along with the council, has much of the responsibility for safeguarding vulnerable children, and it does incredibly important work. Again, I am worried about the lack of ring-fencing for other less visible services, particularly social services. I urge the Minister to assure us that social services funding for mental health services will be maintained, because it is incredibly important.
On the question of substance misuse, it is estimated that 3,700 young people in Nottingham under 18 regularly use class A drugs of one sort of another, but the figure could be higher. Although the proportion of young people drinking alcohol has not risen in recent years, it is still far too high when compared with figures for the rest of the country. The number of young people whose carers or parents are involved in drug or alcohol abuse is high; it is estimated that parental alcohol abuse affects between 10,000 and 20,000 young people in the city, which is an incredibly high number.
Smoking is a widespread cause of respiratory problems among young people. The British Lung Foundation report, "Invisible lives" suggested that residents in Nottingham are 40% more likely to be admitted to hospital with chronic obstructive pulmonary disease than the UK average, and respiratory conditions are among the most commonly reported in children.
Another crucial problem is that of teenage pregnancy. By national standards, the figure for Nottingham is still very high. The latest annual data suggest that, within local authority boundaries, Nottingham had the ninth highest rate at nearly one in every 15 teenage girls. Again, that is a shocking statistic. Some Nottingham wards have an under-18 conception rate of twice the national average; 15 of the 20 wards have rates that are among the highest 20% for wards in England.
My hon. Friend is generous in giving way a second time. I would be failing in my duty as chair of the teenage pregnancy task force in Nottingham if I did
not point out that we have had a fall in eight consecutive quarters because of the sort of things that my hon. Friend has pointed out, such as working together in partnership, and having clear leadership and lines of accountability. We have fabulous people working on the front line who are pushing down the rates. We also have a family-nurse partnership which gives intensive health visiting for young mothers, and we are doing many other things. I am sure that my hon. Friend will want to pay tribute to those people, particularly the front-line workers.
Chris Leslie: My hon. Friend takes the words entirely out of my mouth. I was explaining that the problem is still significant, but thankfully some good progress has been made, particularly through partnership work. That crucial support is funded through the working neighbourhoods fund, but recent Treasury announcements suggest that Nottingham's fund will cut by £1.2 million. The name on the tin-"working neighbourhoods fund"-does not say what it will do; supporting the programmes that help reduce teenage pregnancy is one purpose. It is incredibly important that we hear about its good work as well as about the shocking statistics.
I want to take the opportunity offered by this debate to highlight the issues of poor child dental health. Although the statistics and methodology of calculating such issues change from time to time, recent reports suggest that Nottingham children have, on average, three decayed missing or filled teeth each compared with just over one in typical parts of the rest of England. Shockingly, in some schools in Nottingham, a few children have been reported to have nearly six missing, decayed or filled teeth. Fluoride in toothpaste is improving matters, but the main factors are still poor diet and nutrition and poor oral hygiene. Although programmes such as the City Smiles dental health promotion programme and community-based services have promoted good oral hygiene and the use of fluoride varnish on teeth, much more still needs to be done. I want the funding for the City Smiles campaign to be confirmed and redoubled by the PCT, and I hope that the Minister will pass on that request. Moreover, we must think about the contentious issue of fluoridation of the water supply. In areas where fluoride is naturally occurring or where it is added, there is some protection against dental decay. Although I cannot claim to be a scientific expert in this area, I none the less hope that the PCT and the east midlands health authority will speed up their review and put some options on the table within the next year if possible.
There is not enough time to address all the crucial issues, which include young people leaving care, children with learning difficulties and serious disabilities and how people can access services. I want to pay tribute to the NHS staff who work so hard in Nottingham. They have recently consolidated the children's services of City hospital with those of the Queen's Medical Centre to create the Nottingham Children's hospital at the QMC site with 15,000 inpatient occurrences and 50,000 outpatient contacts taking place annually. The hospital is very strong in renal and urology services, with 13 kidney transplants taking place last year. It is world renowned for its child integrated cancer services, with 135 children being treated there in 2009. There are also cystic fibrosis services and many others. None the less, there is still room for improvement. In particular, there is not enough
accommodation for parents whose children are in hospital. It is important that young patients have the support of their family around them. I urge the Minister to find a way to provide capital support for the PCT and the hospital to ensure that more bed space is provided.
I am also concerned to hear that Nottingham's speech and language therapy budgets, which are supported by the PCT, may be squeezed because of the financial pressures. Tragically, between 5% and 8% of pre-school children have speech and language problems, so there is a lot of concern about the loss of such resources in the Nottingham area.
I hope that the Minister will address recent policy changes. Childhood obesity and poor nutrition is one of the key underlying causal factors that come up time and again. A third of 10-year-olds in Nottingham are overweight or on the brink of the obesity category. Tragically, the free school meals pilot that had been on the cards has now been cancelled.
Lilian Greenwood (Nottingham South) (Lab): Does my hon. Friend not agree that there are concerns over the cut in the health in pregnancy grant from next January? Such a grant can be used to support breastfeeding mothers-breastfeeding is vital to children's health, and results in fewer infections and reduces the likelihood of children developing allergies. It also protects them from the very thing that my hon. Friend was talking about, which is the likelihood of people becoming obese, developing diabetes and, in the longer term, cardiovascular disease.
Chris Leslie: My hon. Friend is entirely right. It looks as if we will lose not only the opportunity to roll out greater nutritional standards through the free school meals pilot but the £190 health in pregnancy grant. To me, that was one of the most pernicious, mean-spirited decisions in the Budget. Young mums-to-be need not just warm words but financial support to back up what can be an expensive change in lifestyle. Folic acid and fresh fruit and vegetables do not come cheap. It is important that the support is there.
When we consider the other changes in the recent Budget announcement, the Minister needs to explain how young families can support some of the costs that are involved in healthy lifestyles. I am referring not only to the change in the health in pregnancy grant, but to the restriction on the maternity allowance to the first child only. Not much thought has been given to the effect that that will have on siblings. Cots, prams and children's clothes are expensive. Those are all issues affecting the decent lifestyles of young families in our city. From next year, the Government will remove the baby element from the child tax credit and reverse the settlement for one and two-year olds, which was due in 2012 and 2013. When those measures are combined with others, such as the freezing of child benefit and, as a tangent to that, the removal of the child trust fund, there is a sense that children's issues, which cover good child health, education and well being, are not as far to the front as I would hope.
I have mentioned some exceptionally serious issues and complex health problems. I have run over the key issues that need real action. In particular, I am referring to the partnership working that my hon. Friend the Member for Nottingham North discussed about. It is all very well suggesting that there will be increases in
real terms for front-line health services, but health inflation goes far and above the retail prices index plus 0.5%. There will undoubtedly be pressures affecting hospital and ancillary services as well. The cuts in funding for local authorities and other public services-25% over the next four or five years-are unnecessarily fast and steep. Alternative strategies could be used. I fear that we will jeopardise some of the inroads that we have made into these problems. I hope that the Minister will do better than his other colleagues in government. There is a whole range of serious issues affecting child health in Nottingham, and I urge the Government to take them seriously.
The Minister of State, Department of Health (Mr Paul Burstow): It is a delight to serve under your chairmanship today, Mr Amess; I know you have taken an interest in health debates over the years. I congratulate the hon. Member for Nottingham East (Chris Leslie) on securing this debate. He is right to say that he has brought a serious range of issues to the attention of the House. I applaud him for ensuring that the concern that he and his hon. Friends share about improving children's health in Nottingham is kept on the agenda both here in the House and in Nottingham.
I am delighted to have the opportunity to respond to this debate and to acknowledge some of the work that has already been done by hon. Members in Nottingham. In particular, the hon. Member for Nottingham North (Mr Allen) has been a staunch advocate on the subject, and has a good track record both in the House and in the local area. The hon. Member for Nottingham East should pay tribute to his leadership, particularly in respect of the teenage pregnancy taskforce, which has done important pioneering work on early intervention that has started to make a significant difference. The Government are determined to do everything they can to ensure that the lessons learned from the taskforce are embedded and sustained as we go forward.
I also want to thank the hon. Member for Nottingham East for his positive remarks about the work of local NHS staff. They are keen to build on the equally strong relationship they have with him and other hon. Members in the area by extending to me an invitation to have discussions with them. A lot of what the hon. Gentleman has said today was concerned with how we ensure that local services are better aligned with each other and collaborating effectively, and that the culture is right to promote effective joint working. Members have a key part to play in that process as local community leaders, and we already have an exemplar in that regard: the hon. Member for Nottingham North.
The hon. Member for Nottingham East cited a lot of statistics on this subject that are compelling and in some ways quite depressing. He pointed out that there is a significant concentration of deprivation and poverty indicators in parts of his constituency, and across the city of Nottingham more generally. Sadly, the map of poor child health aligns all too readily with the wider issues of social and economic deprivation. Clearly, there are challenges to be faced in that regard.
The local NHS should be congratulated on the progress it has made, because significant improvements have been made in some areas during the last decade. Those
areas show that strong, well integrated, well resourced and well targeted mainstream services can indeed make all the difference.
We know that there is much more to do in Nottingham-a point that the primary care trust emphasised when I spoke to its representatives yesterday, ahead of this debate. For example, it reassured me that children's health, particularly in the poorest communities, will remain a strong priority for the future and that it will continue to invest in local health services as well as contributing strongly to the children and young people's plan, which is important. I understand that that plan, which is very important in driving delivery on the ground, will go to the city council in a few weeks' time.
That culture of strong partnership working is particularly important: we need much more in the way of joined-up planning, commissioning and delivery in the future. The PCT has reassured me that its priority is continuity, and I hope that that reassures the hon. Members for Nottingham North and for Nottingham East. We want to ensure that we are pushing ahead in areas where progress has been made-there has been progress-and quickening the pace of improvement elsewhere. The Government intend to support such efforts and to ensure that the work that has been started on early intervention and prevention is not lost or thrown aside, but is seen as an essential investment. In truth, that work is not a waste of resources but unlocks resources; to stop it would indeed be a false economy. Therefore, we want to ensure that the poorest communities can get the well targeted services, run by confident and assertive staff, that they need.
Reference has been made to spending pressures. Those pressures existed before this Government came into office; indeed, the last Government acknowledged that the deficit presented a significant challenge to the public sector, including the health service. Indeed, they mapped out the challenge that would have to be faced. Through our first, emergency Budget, the new Government have recognised that not to act promptly would be to fail to deal with the difficulties and the legacy we inherited. In failing to reduce the deficit, we would not only endanger the whole economy but some of the most vulnerable people in our communities, through an inability to secure sustainable public investment in key services. So the decisions we have made, some of which have undoubtedly been painful, are absolutely essential if we are to deliver the sustainable economy and growth that we all need, and the support that is essential to ensure that services continue to develop.
However, as part of making those tough choices, the Government took the decision to protect the NHS and to secure real-terms increases each year for the duration of this Parliament. The hon. Member for Nottingham East was right to say that that does not mean it will all be plain sailing from now on; there will be difficulties and challenges ahead, and there are real pressures on the NHS budget. However, we do not believe that the sick should pay the price for the debt crisis, and this funding will enable the NHS in Nottingham to continue improving services.
That does not necessarily mean "more of the same". One of the lessons that I took from last week's National Audit Office report on health inequalities is that success
is not all about spending more money. In many cases, it is about spending money more wisely, and the type of schemes the hon. Member for Nottingham North has led in Nottingham are a case in point. In that way, big differences can be made with relatively small amounts of investment.
We need a fresh approach, with a health service that is more preventive, more integrated, more answerable to local communities and more responsive to local needs. We will say more about that approach in the health service White Paper that will be published in the near future, and which will clearly have an impact on the way that health and social care services are delivered in the Nottingham area.
Mr Allen: My hon. Friend the Member for Nottingham East pointed out that one way we can make small amounts of money go a long way is through inventive use of the working neighbourhoods fund or its predecessor, the neighbourhood renewal fund, for example. Sadly, however, as my hon. Friend pointed out, those funds are the first things to go when an organisation starts looking at its core operation and contracting inside its own silo, rather than reaching out in partnership with others. That is a problem and the Minister really must address it.
Mr Burstow: It is a challenge, and one that both the Government and local organisations understand. When we publish the White Paper, I hope the hon. Gentleman will see that we are addressing that challenge in a very direct way, to ensure that every pound the taxpayer invests in our health service really delivers the maximum possible benefit for the communities it is meant to serve.
The hon. Member for Nottingham East raised a number of specific points and I want to address as many as possible in the time remaining. On child and adolescent mental health services, he said that up to one in 10 young people in Nottingham are diagnosed with mental health problems. Clearly, deprivation, isolation and exclusion are often the harbingers of poor mental health, and children living in poverty are frequently the worst hit. That carries a cost of the sort the hon. Gentleman talked about-one borne not only by those children personally but by the wider community. The hon. Gentleman was therefore right to talk about the vital role that children's mental health services play. The children and young people's plan is focused, rightly, on greater prevention and earlier intervention. I can therefore assure him that this Government attach a very high priority to early intervention, preventive mental health services and public mental health services; they are very important to us.
The children and young people's plan also aims to stop young people experiencing behavioural problems, mental illness, substance misuse and low educational achievement. Again, that requires a confident and well equipped work force who bring together skills across the statutory and third sectors. I understand that the local NHS and the local council plan to improve the training and development of staff in dealing with such behavioural problems.
The hon. Gentleman asked about smoking, which I acknowledge is an important issue that we need to keep a clear focus on. I understand that work is progressing in that field that is targeted at reducing smoking during
pregnancy. He also talked about the work that has been done on teenage pregnancy in Nottingham. He is right to say that we should applaud the fact that the teenage pregnancy rate in Nottingham has fallen for eight consecutive quarters. The rate in Nottingham was among the highest not only in the UK but in Europe. Clearly, the rate is now going in a different direction-one secured by the integration of services and effective leadership on the ground. However, the figures remain stubbornly high, and we need to ensure that there is more effort and focus on reducing them. The local PCT has reassured me that a number of schemes it is taking forward, such as the C-card scheme and various other initiatives involving sexual health services, are being maintained. By way of reinforcement, reducing teenage pregnancy will be a feature of the joined-up working produced by the children and young people's plan.
The hon. Gentleman cited statistics on dental health that were even more stark than those I was presented with by my officials, including on schools that reported having pupils with six teeth that were either missing, decayed or filled. In fact, the latest figures show a slightly different and hopefully better picture. They suggest that five-year-olds in the Nottingham city area have, on average, 1.73 decayed, missing or filled teeth. That places the city's PCT as the 31st worst performer on that indicator, whereas it was the second worst the last time such figures were published. That figure of 1.73 compares with an average figure of 1.11 for five-year-olds for the whole country. The hon. Gentleman is therefore right to say that more needs to be done about oral health and hygiene in Nottingham. The City Smiles programme will certainly continue to play an important part in that work. On the direct provision of dental health services in Nottingham, the hon. Gentleman will be pleased to know that two new dental practices will open in October, in Bulwell and Bilborough, which will obviously improve access to such services. He also talked about fluoridation. Clearly, such matters are to be decided upon locally, but I will pass his comments on to my ministerial colleagues.
The hon. Gentleman also spoke about funding for speech and language therapy. When I talked to representatives of the local PCT yesterday, they certainly gave no indication of any intention or plan to cut those services. I can assure him that I asked the PCT a lot of questions in preparation for this debate. However, if I am misinformed on this subject, I will certainly write to him to give him further details.
You, Mr Amess, will know about the importance of the issue of obesity, as we both served on the Health Committee when it produced a report on obesity some years ago. Again, the local PCT has told me that it will continue its work on the active schools programme, which encourages more children to take up sporting activities.
I am afraid I will probably run out of time shortly, but the hon. Gentleman has certainly given us a run-around the important issues that this Government will continue to maintain a clear focus on. We see delivery on those issues being provided by effective local leadership, effective integration of commissioning and provision, and good leadership from politicians nationally and locally. By doing that, we believe we can improve the nation's health.
Patrick Mercer (Newark) (Con): I am most grateful that you are chairing this important debate, Mr Amess. Nottinghamshire is getting a good outing this morning. I hope that the local press appreciate it; it is not at all laid on for their benefit. I thank the Minister for being here. It shows a degree of commitment from his Department as well as from him personally. Not only did he give up his time to make his first ministerial visit to Newark hospital when I asked him, he is also here today. I thank him personally for the great interest and acumen that he is showing. I also thank the hon. Members who are here in support. My local paper, the Newark Advertiser, is interested in the issue and has been supportive, and the "Save Newark Hospital" campaign has been immensely helpful.
This subject is extremely important in my constituency. I will not say that it divides public opinion, because it does not. It is quite simple: I cannot find a single person in Newark who does not support the development and further expansion of the services of a vibrant and successful hospital in a town due to grow by many thousands over the next five to 10 years. The issue does not divide the town; everybody agrees that we need a proper, developing and expanding hospital.
A health care review began 18 months ago, entitled "Help to shape the future of Newark's NHS". As a sitting Member, I realised that the three elements involved-Nottinghamshire County primary care trust, Sherwood Forest Hospitals NHS Foundation Trust and the East Midlands ambulance service-needed my responsible and sensible support if we were to improve health service in a town that is growing exponentially.
The process made good progress, but recently we have run into trouble. The subject, quite rightly, became extremely contentious and difficult during the election campaign, and is now attracting more and more energy as people become more concerned about what is going on. One or two mendacious suggestions that the hospital would close were made during the campaign. I do not believe that the hospital will close under this Administration or any other, nor should it, so we can put that suggestion to one side. Those in the town of Newark who hope to frighten individuals with it are both irresponsible and mendacious, but things become difficult when one sees the health care review document-it also says that Newark hospital will not close, which is fine-which says:
"Some services will change, some will be added."
If we pitch against that the changes that have occurred, we can understand the perception in my constituency. First, we are going to lose our accident and emergency ward. I know that and accept it, but it is alarming to the people of Newark. I will return to that issue in a moment. We have already lost the Friary ward; I will return to that in a moment as well. The blood classification service has been alienated. Pharmacy services have been closed. All sorts of dilemmas exist about the protocols under which ambulances work: for instance, if a child is knocked over within sight of Newark hospital, the ambulance that picks up that child will not take the child to Newark hospital. Nor should it-Newark hospital cannot cope with injured children-but it is hard for a
parent who can see the hospital not to wonder why his or her child is being taken to Lincoln, King's Mill or Mansfield hospitals or to Sutton in Ashfield, for instance. It is a difficult matter of perception. Furthermore, we were recently told that another ward would be closed. I think that my constituents feel that they have been misled rather than informed by the process.
We have had a healthy debate among the three different factions and various town campaigns, but if the Minister will bear with me for a few moments, I would like to apply to what is happening in Newark the four crucial tests laid down by the Health Secretary for the improvement of health services throughout the country. I repeat that a lot of it is a matter of perception. Ambulances were never going to take children to Newark hospital. However, why that has not been properly explained to my constituents, who continue to think that ambulances could do so, is a wholly different matter. I have no doubt that the Minister, who is nodding in agreement, understands that as well as I.
The first of the four crucial tests is that changes should have the support of GP commissioners. Let us test the closure of the accident and emergency ward at Newark hospital. Anybody who bothers to lift the stone and look underneath will understand that Newark has not had an A and E ward for as long as I can remember. There is no debate about whether it should; it meets none of the criteria. Therefore, the sign is clearly misleading and unhelpful, and it must go. However, Newark sits at an extremely important point on the A1, near the dualling of the A46 and the east coast railway line, where there is massive potential for large-scale injuries. If the Potters Bar crash happened in Newark, as it might, Newark hospital could not cope with that many accident and emergency cases.
However, we need something better than what is proposed. I am told-although I treat this with a certain amount of scepticism-that GPs are strongly behind the idea of having a minor injuries unit-plus rather than an A and E ward. I cannot describe how irritating that is, not only to me but to the people of Newark. Most will accept that A and E has no place at Newark hospital, but most believe, and indicated during the consultation process, that we need an urgent care centre, ward or similar at Newark hospital where people can go to receive the care that they need. I believe that that will be provided, so it does not matter much; we are really arguing about what the notice should say. However, I say to the Minister that if we do not get an urgent care ward, centre or whatever, it will spread unnecessary alarm and despondency in Newark. The title "minor injuries unit" suggests cuts and bruises or coughs and sneezes, which is unacceptable and similarly misleading to the public.
"the provision of an 'urgent care, minor illnesses and minor injuries service' at Newark Hospital, as agreed by local clinicians and supported by the majority of local people during the formal consultation process"
"to ensure that the name of the new unit clearly describes the breadth of services provided and ensures that patients access services in the right place, at the right time, first time."
The next test, however, is that proposed changes must strengthen public and patient engagement. I seek an assurance from the Minister about patients, members of the public, all local GPs and particularly the staff of Newark hospital, who have been enormously supportive, helpful and loyal to their organisation. A horrible rumour circulated in town that staff had been gagged from talking to the press or the Minister. I am sure that the Minister would agree that during his visit last Thursday, not only did we hear some extremely articulate individuals but members of staff were not restricted at all. They and their opinions are terribly important. Will staff at Newark hospital be included in all decisions on the future of the hospital? I ask the Minister how we can achieve that, because clearly we are anxious to help with the process.
The next question I ask the Minister comes under the same heading of strengthening public and patient engagement. I absolutely accept his point that the process has to be led from the bottom up-it must be led from the grass roots and must not be top down and dictated from the top. I know that the Government are committed to maintaining front-line services, but will the Minister assure me that services at my local hospital will not be reduced or diminished for acute and sub-acute patients? I understand that change has to occur-I am not being a stick-in-the-mud about this; I am trying to be as helpful as I can-but that question is crucial. As I have said, not only has the Friary ward been closed, but there is word that another 30 beds will be taken away. That is the equivalent of another ward. If we lose that number of beds, my worry is that very shortly Newark hospital will become nothing more than a cottage hospital. That is the last thing I want, so I ask the Minister to deal with that question.
Mr Mark Spencer (Sherwood) (Con): Does my hon. Friend recognise that Newark hospital is important to not only his constituents, but the constituents of Sherwood and Bassetlaw? It is particularly important to people who live in villages to the east of the A614, many of whom prefer to use the services at Newark rather than travel to the Queen's medical centre or to King's Mill hospital.
Patrick Mercer: I am grateful to my hon. Friend for that intervention and I congratulate him on his tremendous success at the election, although I regret the departure of his predecessor, who was a close friend of mine. I completely agree: the hospital's influence extends far beyond Newark. Once the A46 is dualled-heaven help us if that is cancelled-it becomes even more important that the hospital can provide a quick and urgent service to people in the Sherwood constituency. I absolutely accept his point.
The third crucial test is that of greater local clarity and the need to have a clinical evidence base for any proposals that will be made. In the light of that, it is proposed that patients are treated at Lincoln hospital's accident and emergency department instead of Newark's. The patient safety record at Lincoln hospital is worse than at Sherwood Forest Hospitals NHS Foundation Trust. Can the Minister shed some light on the matter of patient safety, because I want my constituents, or anyone who is injured, to go to the best possible place? If such a situation exists, can we have some explanation for that proposal?
The last test is that proposals should take account of patient choice. Many in the town of Newark would say that the consultation process was faulty and was not properly delivered. A number of proposals were clearly supported by everybody who responded to the process and therefore my fourth, and almost my last, question to the Minister-I am sorry if I am burdening him with tedious matters-is whether he will investigate the closure of the Friary ward, which is our local psycho-geriatric ward, and consider whether it might be reopened in the future. We have been told that the Friary ward has only been closed temporarily and that we will get psycho-geriatric services back in the near future. It is crucial that that happens.
I respect and understand those four points. The difficulty is that Newark lies right on the edge of Nottinghamshire and Lincolnshire. In theory, we have excellent communications in all four directions, but if we have a national health service based on centres of excellence in places such as Lincoln, Sutton-in-Ashfield and Nottingham, we obviously need communication from Newark to those centres of excellence. I understand that we cannot have one of the several hospitals in Nottingham inside Newark, but we must have an ambulance service that is capable of getting our injured or routinely sick to centres of excellence quickly, efficiently and calmly. I have received a number of reassurances from the ambulance service that those improvements are in hand, but I would be grateful to the Minister if he could dilate upon that a little more. Can he reassure me that we will have an ambulance service that is fit for the 21st century, which can deal with the increasing number of people who live inside the town?
You will be relieved to hear that I have almost finished, Mr Amess. I understand that we must have demonstrably better outcomes for patients and that we must ensure they receive the highest-quality specialist care in specialist centres. I understand that, in many cases, it is better to treat people at home rather than in hospitals. I am not being narrow minded or reactionary about this, but so much of the process has been badly presented to the public, to health care professionals and to patients. If only we could have some clarity on the matter and I could see clearly that the four tests set by the Secretary of State were being met, I would be a lot happier. The matter is crucial to Newark, which sits on the edge of two different local authority areas, and I am extremely grateful to the Minister for the time he has taken to visit the town. However, a strong and vibrant outcome from this process would assure Newark that it does not just sit on the edge of everything; it lies in the heart of the east midlands, which is exactly where it ought to lie.
The Minister of State, Department of Health (Mr Simon Burns): I congratulate my hon. Friend the Member for Newark (Patrick Mercer) on securing this important debate on the future of Newark hospital. As he said, I was fortunate enough to visit the hospital last week. I was extremely grateful to have the opportunity to do so and I was particularly struck by the enthusiasm and dedication of all the staff and management I had the privilege of meeting during that visit. I fully understand my hon. Friend's desire to ensure his constituents have the best possible health services. My visit last week proved extremely useful in understanding the issues there.
I would like to take this opportunity to outline briefly the Government's approach to service reconfiguration. We believe that the best decisions are local decisions, and that change should be driven by local clinicians, not imposed by politicians or decided by managers behind closed doors. The Secretary of State has identified four crucial tests that all reconfigurations must now pass. First, they should have the support of GP commissioners; secondly, arrangements for public and patient engagement, including local authorities, should be strengthened; thirdly, there should be greater clarity about the clinical evidence base underpinning any proposals; and fourthly, any proposals should take into account the need to develop and support patient choice.
To ensure the long-term future and sustainability of health service provision in Newark, a range of NHS services in the area have been reviewed. Those include unplanned and emergency care as well as in-patient dementia care. I understand that clinicians from primary and secondary care are in unanimous agreement that Newark hospital cannot provide a full accident and emergency service-I am grateful to see my hon. Friend nodding in agreement to that. They have concluded that, for the sake of patient safety, the hospital should no longer care for patients with acute medical conditions. The hospital should also be named more accurately to avoid public confusion, ensuring that patients go to the right place first time and are not put at additional and unnecessary risk by going as a first destination to a unit that is not able to look after their degree of injury.
The main reasons for that are as follows. First, every tier 1 accident and emergency department needs an intensive care unit, emergency operating theatres and 24/7 anaesthetics to provide back up for the A&E and acute medical conditions. Unfortunately, Newark does not have those and has not had them. Secondly, acute emergencies require specialist skills, which are not and have not been available in Newark. Thirdly, doctors agree that avoidable transfers are associated with poorer health outcomes and worse patient experiences. In 2009/10, the PCT reports, a significant number of patients had to be transferred, many due to a deterioration in their condition.
The local NHS ran a consultation exercise earlier this year to garner the views of local people. The majority were in favour of changes to urgent and emergency services at Newark hospital. I know that there is a view, expressed by some campaigners, that the consultation was rushed, too small to be properly representative of the local community's views and that the full implications of the review have not been sufficiently drawn out. The NHS must not take local support for granted and must continue to engage fully with clinicians, the public and the council's overview and scrutiny committee. If a consultation is inadequate, it must be improved and should provide as much relevant information as possible. The overview and scrutiny committee continues to review the implementation of planned changes, which is essential to help to ensure democratic scrutiny.
The strategic health authority has told me that Nottinghamshire County PCT engaged with the overview and scrutiny committee throughout the Newark review and that evidence of that engagement was presented at the PCT board meeting on 17 June. Yesterday, the PCT met with the overview and scrutiny committee to decide the next steps. I understand that it does not intend to refer the proposals to the Secretary of State.
I will turn now to one of the problems with the reconfiguration: the naming of the unit that will deal with injuries, which my hon. Friend mentioned. It is of course important that the facility at Newark hospital is appropriately named. I know that some people would prefer it to be known as a minor injuries-plus unit, while others would prefer to call it an urgent care centre. As he will appreciate, it is not for me to intervene in that issue in a top-down manner. The choice of a name must be agreed locally and should clearly reflect the nature of the facility, so I hope that the matter can be resolved locally through ongoing discussions.
On A and E services, I understand that Newark hospital has never had a full A and E department. Confusion has arisen in part because there is an A and E sign outside the building, but that does not reflect the nature of the services provided inside. Having a local A and E department on one's doorstep can feel reassuring, but the reality is that receiving the best care does not always mean being taken to the nearest hospital. Some patients might be treated at the scene and others might be taken to Newark for treatment, but those who have suffered major trauma will be best served by being taken directly to specialist units, receiving care en route to the hospital that has the most suitable facilities.
The proposed changes aim to solidify the existing protocols on diverting acute patients to more appropriate hospitals, ensuring that patients go to the right place the first time and are not put at additional and unnecessary risk. I understand that the parents of a young child recently turned up at Newark hospital A and E, incorrectly assuming-understandably-that it was a full A and E department, and the child's care was delayed as a result. I stress my earlier point about the importance of naming the unit correctly so that local people can understand easily what it does and does not do. I am pleased that during October and November there will be a public education process in Newark to explain exactly what the unit does and where patients should go in the first instance, either to Newark or to another hospital, for appropriate treatment when injured.
Patrick Mercer: Would the Minister be kind enough to inform the relevant authorities that I would very much like to be involved in that work? The whole process has been marred by poor communication and bad consultation, so I would be happy to help in any way I can.
Mr Burns: I am extremely grateful to my hon. Friend and am sure that there is a role for him to play in helping his constituents in the education process and explaining fully the role of the unit so that it receives appropriate admissions in future.
On the running down of services at Newark, we must be careful not to do the local NHS a disservice through idle talk about the future of the hospital. The proposals focus on giving patients access to safe care for urgent conditions. The people of Newark will continue to access Newark hospital if that is the most clinically appropriate place for their treatment. There will be an increased availability of same-day or next-day outpatient appointments for patients who GPs believe require urgent assessment. If a diagnostic test such as an X-ray is required, that will be done at the same time.
There is also scope for Newark hospital to undertake more planned surgery, such as hip and knee replacements. I know that that is being explored by the Sherwood Forest Hospitals NHS Foundation Trust and the PCT. It is also important to note the important role that Newark hospital plays in rehabilitating patients who are well enough to leave the facilities at Lincoln and Nottingham and can continue their care closer to home. Those proposals would also see an out-of-hours GP service available on site, which I hope my hon. Friend will welcome, as patients who wish to see a GP after midnight currently have to travel up to 20 miles to see one in Mansfield.
I am aware that the local press have reported that Newark hospital is being downgraded. The trust has made it clear that there are no plans whatever to downgrade the hospital. Rather, the plan is to make it fit for purpose and safe for patients. The trust also assures me that it is fully committed to Newark hospital and has no plans to close it. Rather, it sees the hospital as an integral part of local health services. I hope that that goes some way towards reassuring my hon. Friend and his constituents.
He also mentioned Friary ward, which was temporarily closed by Nottinghamshire Health Care Trust to assess how it can best be used in future. I gather that demand for the ward, which has 15 beds, had dwindled to two patients. More people need to be cared for in their own homes, as I suspect many patients would prefer, if that is medically and clinically feasible. I will certainly write to him with more details on what is happening at Friary ward and what will happen as a result of the trust's assessment of the future of that part of the hospital's activities.
On the concerns about the public consultation, the evidence I have been given indicates that there was a full engagement with the local community about the proposals that were put out to consultation prior to decisions being reached, although there will always be differences of opinion. I have no evidence to show that that was not a satisfactory and wholehearted consultation, even though I accept that some people remain unconvinced by the proposals before the trust.
In conclusion, local health services will need to evolve and become more efficient, in line with current Government policy. If we want to take people with us, we must ensure that they have full confidence in the decisions being taken and feel that their voices are properly heard. That is what the new arrangements are about. That will not always be easy, but if it is clear, transparent and led locally by clinicians, and if it listens and responds to the voices of local people, it will help to reduce the anxiety my hon. Friend has spoken about today and on which he has so eloquently campaigned over the past few months for the people of Newark. The commitment and tenacity he has shown in fighting for local health services is commendable, and I know that he will continue to engage constructively with the local NHS to ensure that his constituents' concerns are properly heard.
I trust that something can be done through continued dialogue between all parties, including my hon. Friend, to resolve satisfactorily the differences of opinion on the name of the unit so that there is no confusion about where his constituents should go if they or their family members are involved in an accident and that they get the quickest and finest health care possible in the most appropriate setting.
Ian Lucas (Wrexham) (Lab): It is a pleasure as always to appear before you, Mr Amess. I welcome the Minister, the hon. Member for Arundel and South Downs (Nick Herbert), and congratulate him on his appointment.
Ian Lucas: I do beg his pardon-the right hon. Member for Arundel and South Downs. In that case, I will congratulate him even more. He has always been civil in his dealings with me. I am sure that we will cross swords, if not today then in the future, but I welcome him and congratulate him on his elevated status.
I try to keep it quiet in this place that many years ago I was a solicitor in private practice. It is often not a good idea to advertise the fact that one is a lawyer. I worked as a solicitor in criminal law in north Wales in the late 1980s and the 1990s and, as policing is one public service that has improved beyond all recognition in the past ten to 15 years, I regret that in those days I considered that it was not of the standard that it should have been.
Chris Ruane (Vale of Clwyd) (Lab): I congratulate my hon. Friend on securing this debate. Does he agree with me that North Wales police is one of the most successful police forces in the country, and has the lowest crime rate?
Ian Lucas: My hon. Friend is already stealing some of my speech. He is well aware of the vast progress that has been made in north Wales, through an effective, successful and engaged police force. When I was first elected to this House in 2001, it was not unusual for councillors to have very little contact with their local police service. There were certainly no structures in place to enable local communities, through councils, to work effectively with the police service. I am pleased to say that the Crime and Disorder Act 1998 put in place the building blocks for that to change, and local authorities and police services now work together to combat crime. It is extraordinary that before that date there was so little engagement between those two large public sector organisations, at a time when criminal behaviour issues were one of the most common reasons for constituents visiting my office.
The establishment of community safety partnerships-as we call them in Wales-created a forum within which the general public, councillors, police officers and others involved in the criminal justice system could work together, identifying problems of concern to the local community and devising actions to address those problems. One major step was the establishment of a system of community beat managers. I seem to recall that north Wales was ahead of the game on that, establishing community beat managers responsible for council wards. The managers were identified police officers, who, it was hoped, would stay in place for about three years and get to know the area they were policing very well. When I was first elected, if a crime-related issue was raised in my surgery I often had difficulty finding a point of contact in the local police. That all changed with the establishment of the community beat manager system, and I now have a
list of community beat managers for particular wards on my wall and know who to contact directly when an issue arises.
Community beat managers do not, of course, operate on their own. The Police Reform Act 2002 introduced police community support officers, who have also been extremely effective in helping to improve policing on the ground. I think that that Act is inspired legislation because I see exceptional police community support officers operating in Wrexham, individuals whose commitment goes way beyond that which is set out in their contracts. They are now an essential component of a successful criminal justice system. They function as an early warning system and as a community service, working as a team to safeguard the communities within which they operate.
In Wrexham, we go even beyond the people who get paid to police. We have an unusual, albeit developing, group of people, who work hard to assist the criminal justice system. We have special constables, as do many other places, but we also have a group called street pastors. I am not sure if the Minister is aware of these individuals. In Wrexham, they are a group that is linked to local Churches and which has functioned for about three years. They work particularly at weekends, when the town centre gets a little livelier than even the Strangers Bar does on occasions. There must be about 30 street pastors operating with the police in Wrexham, and their calming influence is effective in taking the heat out of incidents that could lead to the commission of crime.
As I was preparing for this debate, I looked at the national Street Pastors website and saw an example of exactly the type of thing that happens. Someone posted a thank you on the website, and happened to refer to Wrexham. Sometimes these things are meant:
"My 20-year-old daughter is in her 3rd year at Chester Uni, training to be a Children's Nurse. Last night she went out into Wrexham with 3 of her friends to celebrate passing all her exams and assignments and to look forward to her last and final year of training. On leaving the nightclub in the 'early hours', the 4 girls were all 'shoe-less' from dancing and celebrating all night, and all a little 'worse for wear'! This morning she presented me with a pair of purple flip flops. She told me that when the girls left the club they were greeted by some Christians, who gave them the flip flops to walk to the taxi rank, fastened their shoes around their necks and were 'very kind'. I am writing to say THANK YOU SO MUCH. Your Street Pastor Scheme is fantastic."
Much of the credit for the success of community policing in Wrexham should go to a recently retired inspector whom I would like to mention by name: Inspector Chris Beasley. He worked extremely hard in Wrexham and was always very open to new ideas, such as flip-flops and street pastors. He was receptive and imaginative in his policing, and as a result established a tremendous reputation in the town. We are very proud of the police service that we have built up over many years in Wrexham, and also more broadly in north Wales.
My hon. Friend rightly sings the praises of his constituency and his county. Is he aware that Denbighshire, where my constituency is located, is the third best of the 376 crime and disorder reduction
partnerships in England and Wales? That is partly down to the legislation that our Labour Government introduced, partly down to the funding, and partly down to the excellent co-operative working that we have in Denbighshire.
I have set out the excellent work that has been done, but my concern is about the future. The extension of community policing has taken place against a backcloth of increased investment in our police service, including an increase in the number of police officers, the introduction of community support officers, and Home Office support for the street pastors scheme. Unfortunately, under the Tory-Lib Dem Government, that support has already been reduced.
Today the newspapers in north Wales carry details of an interview with the local chief constable, who talked of the £1.4 million reduction in this year's budget, which has already happened for north Wales. He says that
"the suggestion from David Cameron is that this could be increased to 40 per cent over the next four years. This would mean cuts of £30 million coming out of our budget."
"Eighty-two per cent of our money is spent on staff so even if we stopped using computers and walked everywhere we would have to cut staff numbers."
Those staff are the community beat managers and community support officers that I mentioned. Those individuals have achieved the progress in policing and in making safe the communities that I represent over the past decade. I am, therefore, extremely concerned to hear my chief constable saying that he cannot deal with the proposed reductions in expenditure without getting rid of some of that staffing.
That is a major concern, but not just from me-I am already receiving representations from councillors in my constituency. My good colleague Councillor Michael Williams of Gwersyllt has told me that good work in combating antisocial behaviour in his ward is under threat. He tells me that already community beat managers are not being replaced. He represents a community of up to 10,500 people who now have only one community beat manager, whereas previously they had two.
Mike Weatherley (Hove) (Con): Would the hon. Gentleman agree that, if we reduce some bureaucracy, we might get more time on the beat? The expenditure might not, necessarily, have the impact he suggests.
Ian Lucas: The hon. Gentleman makes what is always an important point: no one wants to create bureaucracy. However, the chief constable tells me that he will have to let staff go because of the proposals and that is why I quoted him directly. Of course we want to create less bureaucracy-no one enjoys bureaucracy-but we need to take the professional opinions of chief officers seriously or we will threaten the way in which policing has developed so successfully. We do not want to undermine what is, essentially, a success story.
What I would like from the Minister is an assurance that the Government believe in community policing. A statement to that effect, at the outset, would be useful. The budget reductions floated at the present time-whether 25% or 40%, or even if they are less than 25%-will clearly have a major impact. That chief constable's statistic about more than 80% of his budget being spent on staffing is very relevant. How does the Minister see the budget being reduced to the extent discussed by the Government without a reduction in the number of police officers? Also, what is the Government's view of the future of community support officers? Do the Government anticipate a reduction in the number of CSOs? If so, who will be responsible for dealing with them and who will make the decision to make them redundant, if that is to happen?
We have heard that there has been major progress in policing in north Wales. Through the Crime and Disorder Act 1998 and community safety partnerships, we have established effective structures that have led to a diminution and lessening of crime in the communities that we represent. A major impact has been not just on the commission of crime but on the social atmosphere in an area.
One of the best ways of creating cost in the criminal justice system is to allow criminality to rise. A rise in crime means a strain on prison budgets, effectively increasing the cost of crime. More pressure will be put on Government budgets if the successful anti-crime strategy pursued in the past is jettisoned.
I therefore appeal to the right hon. Gentleman, the Minister, who is a sensible man and who knows a good success story when he sees one, to fight his corner against the Treasury, and to say to them, "Let's look at the effective way of reducing cost in the criminal justice system." The most effective way, I venture, is to reduce crime in the first place-something achieved under the Labour Government since 1997. The reduction of crime has meant that fewer people are causing more cost to the system. Effectively, progress in the creation of community policing-one of the great success stories of the last Labour Government-should be continued, so that the people that I represent feel safe in their communities and so that we do not go back to the bad old days when no one knew who the local constable was and no one knew where to go when crime was committed.
The Minister for Police (Nick Herbert): I congratulate the hon. Gentleman on securing the debate and thank him for his kind words. I appreciate his long interest in policing matters, as a constituency Member of Parliament and generally, and the passion and commitment with which he talked about community policing. I welcome the opportunity to respond to him specifically and to set out in more general terms the Government's approach to community policing and to the considerable challenge that we must face.
The hon. Gentleman spoke first about the importance of partnership in tackling crime-how the police are involved in a partnership approach and the value of his local community safety partnership. I am very happy to agree entirely with him. I believe that one of successes of the past few years is that local partnerships can be effective in helping to fight crime and in dealing with offenders.
Challenges for us include ensuring that, at a time of fiscal retrenchment, local partners continue to accept their responsibilities and engage with those partnerships, and that, at a local level, they are operating without bureaucracy, are action-oriented and problem-solving, and are not make-work organisations. At their best, the community safety partnerships have helped in the fight against crime.
I would be interested to hear more from the hon. Gentleman, formally and informally, about the effectiveness of his local partnership and how he thinks it might be improved. I am very much looking at such matters at the moment, as part of our police reform agenda. I appreciate and value the contribution of partnerships, recognising that the police cannot fight crime alone-the engagement of other agencies at the local level is required.
Secondly, the hon. Gentleman talked about the value of community beat managers and about longevity-people knowing who their local police officers are and having constables out on the beat, with such officers staying in their communities and not moving on. I know from my own constituency how much attachment people have to that. If there is one thing that the public ask for-it is the people's priority-it is to see police officers out on the streets. We have to recognise that front-line policing is broader than just community policing-the police do other important things, such as response policing-but the North Wales police currently receive £3.3 million specifically for neighbourhood policing.
The hon. Gentleman also talked about the importance of community support officers, as part of the mix of the available and visible policing in communities. At 30 September 2009, there were 158 police community support officers in the north Wales area. I believe that PCSOs have been an important innovation which has extended the police family. I disagree with those who reject the contribution that PCSOs can make. In my constituency, but also around the country, I have seen the added value that they can bring: a police presence and offering reassurance in neighbourhoods, well supplemented by the wider responsibilities that a neighbourhood policing team has to fulfil.
The fact that PCSOs are not fully empowered is far from being a disadvantage, and can be an advantage in keeping them with a near-permanent presence out on the streets, rather than being tied up by other duties. The hon. Gentleman asked me about PCSOs. We certainly want to see PCSOs continuing as part of the policing family.
PCSOs are not the only members of the policing family. The hon. Gentleman could have mentioned special officers and their contribution as volunteers. There is still untapped potential in the recruitment of specialists. Significantly, in the 1950s, there were more than 67,000 specials nationally, partly as a legacy of the war-now there are 14,000. Steps have been taken to improve the recruitment of specials in recent years, but the number is still far lower than it used to be. As part of our big society agenda we should consider how to encourage volunteering to a greater extent. I have talked to a number of specials. I gave the awards at the National Policing Improvement Agency specials awards ceremony a few weeks ago, and it really came home to me just how much specials can add to the mix of policing. There is potential for expansion in that regard.
The hon. Gentleman asked whether I knew about Street Pastors. Yes, I do. I have seen them in action. I went out with Portsmouth police a couple of weeks ago to look at the problems that they have policing the so-called night time economy. Street pastors were engaged with police officers as part of the presence on the streets, doing an important job dealing with people who needed help and preventing the police from being diverted from law enforcement duties. As part of the volunteering mix, and as part of the wider police family, street pastors play a real and important role, which I understand the hon. Gentleman values locally.
The hon. Gentleman mentioned the importance of local leadership and singled out Inspector Beasley for having led the increase in confidence in neighbourhood policing in his constituency. I understand how important it is to find local leaders like that, who commit to neighbourhood policing and build confidence in the local community. Last week I met a highly motivated inspector in Greater Manchester police who has been involved over a long period in building neighbourhood policing in a difficult part of Greater Manchester-the Gorton estate-where crime has been a significant problem. Much has flowed from his commitment and enthusiasm, his dedication to the area and his determination to bring policing partners together, get people around the table and get the community involved. It is important to ensure that such motivation is encouraged. It is a challenge for chief constables to ensure that they are retaining and recruiting such talented police officers.
Ian Lucas: Does the right hon. Gentleman agree-I think he does-that one failing of politicians in the past is that we have not promoted sufficiently the good work done in community policing? There was a time when community policing was not regarded as being at the forefront of policing work. I am glad to hear that the Minister thinks that that has changed.
Nick Herbert: I agree. There was a move away from community policing in the past and we forgot the fundamental principles on which policing in this country was founded. We have now returned to an understanding of the importance of neighbourhood policing, backed with significant resources. I commend the previous Government for moving in that direction, which was a return to the kind of policing that the public want to see, although it sometimes took a certain amount of time for opinion in policing circles to follow. Neighbourhood policing was regarded by some as a kind of add-on-an accessory that did not necessarily help in the fight against crime, or something that they felt they ought to do. It is important that we value neighbourhood policing, and important that effective neighbourhood policing is celebrated.
The hon. Gentleman is concerned about funding. I understand that. There are two main issues to do with ongoing funding. First, the Government have had to announce funding changes in-year as part of the contribution to reducing the fiscal deficit and to paying down the deficit by £6 billion. The Home Office took a disproportionate share, in terms of the savings that we made in the Home Office centrally and in the central policing bodies. Nevertheless, police forces, which represent the lion's share of the Home Office's spending, had to play some part, so we asked them to reduce their
spending in-year. The reduction is less than 1.5% of what police forces are spending this year, but it is a challenge because they have to make an in-year saving. However, most chief constables-I have discussed this with them collectively, including the chief constable of North Wales-understand that it has to be done. We have been urging them to do everything possible to protect the front line and to make the savings in efficiencies of the kind that we have made in the Home Office: cutting wasteful expenditure and bearing down on things that do not need to have money spent on them, so that they can retain recruitment and protect those front line services that are so important.
North Wales police had a £1.2 million cut in revenue and capital spending, but the force will still receive £900,00 more than it received last year and its overall estimated revenue expenditure-the total amount that it will be spending-last year was £157.7 million. As a proportion of that overall revenue spending, the amount that it is being asked to cut in-year is 0.8% of expenditure. I think that most of us would conclude that an organisation ought to be able to make savings of 0.8% of the total amount that they spend by finding the kinds of savings that I have suggested.
The second concern about funding relates to the Chancellor's announcements in the Budget about spending and the savings that are required to be made in Departments in the four-year period of the comprehensive spending review. The Chancellor has indicted savings in the non-protected Departments, including the Home Office, of 25% in real terms over four years. None of us doubts that that would be a challenging figure. Again, as the major component of spending, policing would have to play its part. We do not know what the outcome of the CSR will be. Therefore we do not know what share policing will have to bear.
Last week at the Association of Chief Police Officers conference in Manchester we discussed extensively the kinds of things that we want to see happening to protect the front line. For instance, we want greater sharing of services between the 43 forces, where I believe there are significant savings to be made through centralised procurement and greater collaboration. The Government will play their part by doing everything possible to cut bureaucracy to ensure that there is less paperwork for police officers to do, so that they are not tied up in police stations. We want the police to be crime fighters, not form writers, so we scrapped the remaining central target in relation to policing and the central pledge. We
will look again at the police performance framework, which is administered by Her Majesty's inspectorate of constabulary, to ensure that police officers can be free to do the job that we want them to do, and we want to reduce costs, which are considerable, in terms of compliance with all the top-down targetry that exists.
Considerable savings can be driven out of police forces and they can make savings individually and collectively. We are working with ACPO to look at how that will be possible and what role the Government can play in securing those savings. I assure the hon. Gentleman that, although policing is entering challenging times, we are committed to ensuring that, as far as possible, police officers will remain visible and available in their communities. We understand that that is what the public want.
Nick Herbert: The hon. Gentleman knows that we cannot give guarantees about numbers. The previous Government could not do so. During the general election, on "The Daily Politics", the previous Home Secretary refused to give a guarantee on numbers. We can no longer play the numbers game. The test of an effective force is not just the numbers of people working in it. We have to consider how we might ensure that front line availability is increased by considering what roles civilian officers could perform in police forces-for example, whether they could do not just bank-room jobs, but policing jobs, such as contributing to detective work that does not necessarily need sworn officers. We will be able to promote innovative working practices as well.
We cannot give any guarantees about numbers, but I can assure the hon. Gentleman that we will do everything possible to create the conditions that enable chief officers to protect the front line. We understand that that is what the public want and that that is their priority. We understand the value that the public attach to visible and available policing and, from the Government's point of view, we will do everything that we can. However, it is for chief constables to decide on the right work-force mix in their forces and it is for them to take decisions and ensure that they are delivering effective value for money, given the available resources. There are not limitless resources for policing-there never were-and the situation is tough.