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The hon. Gentleman mentioned localism, which is something I support, so long as it is democratic localism. I do not like the notion of locally elected institutions being bypassed. People understand local authorities,
and I would like more powers to be vested in them, rather than for their current duties to pass, for example, to the voluntary sector.
My hon. Friend the Member for Leicester South (Sir Peter Soulsby) has extensive experience in local government and is highly respected in that world. He represented Leicester as the leader of the council with great credit for many years. He referred to the need for improved scrutiny, and I agree that there could be some improvements, but it is important to note that the previous Government did extend the scope of scrutiny. Part of the problem is the time required to fulfil the scrutiny role effectively, because most councillors hold down full-time jobs, so perhaps we should look at the time made available to them to fulfil that role. That comes to the thorny question of allowances, because unless people have substantial means or are retired, they will find it difficult to spend the necessary time to make scrutiny as effective as it could be.
Sir Peter Soulsby: Does my hon. Friend accept that one of the problems with the scrutiny function in many local authorities is that, frankly, it has not been separately resourced? I am not suggesting that it is easy for local authorities to find resources for anything at the moment, let alone their internal functions. Does he agree that if scrutiny is to be meaningful in local authorities, as it is meaningful in the House, it needs some degree of separate and independent support, so that it is both valued and well informed?
Chris Williamson: My hon. Friend makes a pertinent point, with which I agree entirely. In many local authorities, such scrutiny has been seen as something of a poor relation, so he is right that it is essential that it is adequately resourced. In a context of squeezed budgets, however, that can be difficult, but it is a valid point nevertheless and something that local authorities must take on board.
The hon. Member for Cleethorpes (Martin Vickers) referred to single-tier authorities. Support for the notion of single-tier authorities is growing, and I am sure that he will be somewhat disappointed by the Minister's recent decision to reject the application of Exeter and Norwich to become unitary authorities. Given his experience in local government, the hon. Gentleman probably understands better than most the benefits that flow from such an authority. His comments on extremists were well made. It is up to the main political parties to ensure, when a mayoral election takes place, that we reach out and get our message out to the general public and persuade them to support the mainstream and progressive values that we represent, certainly on this side of the Chamber. If we can get our message out effectively, we can overcome the threat posed by extremists. That threat is posed only where turnouts are low, so it is vital that we engage with people in the political process to ensure a reasonably good turnout. If we can improve turnouts, the extremists will fall by the wayside.
In my view it is abundantly clear that since the general election the Government's policy on elected mayors has turned into something of a Brian Rix farce. Earlier this month, the Minister was caught, metaphorically, with his trousers down when he told the media that current council leaders would be transmogrified into executive mayors by order of the Secretary of State. He
said that that would be followed by a "confirmatory referendum". Just a fortnight ago, he told the Yorkshire Evening Post that the referendum question would be, "We've set up these things, do you want to stick with them?"
Cue the knee-jerk intervention by the Secretary of State for Communities and Local Government. Following the inevitable backlash to this oxymoronic top-down approach to localism, the Secretary of State told the House of Commons last week that he had ruled out the possibility of imposing mayors. In fact, he said that it was "out of the question". True to form, however, he went even further later the same day and indulged his penchant for overstatement by saying that he
"had in the top left-hand drawer of my office a pearl-handled revolver with which to shoot the first person to suggest a restructuring of local government. The last time I checked, the revolver was fully loaded and waiting for such a person."-[Official Report, 21 October 2010; Vol. 516, c. 1155.]
To be serious for a moment, this past fortnight clearly illustrates that the Government's policy on elected mayors is in complete disarray. We have the Secretary of State threatening to shoot anyone who proposes any form of local government reorganisation, while the Tory leader of Birmingham city council has said:
"If anything it's a distraction to the real issues of local government."
Then, we have the Prime Minister, who has pledged to hold mayoral referendums in 12 English cities. Furthermore, before his outburst last week, the Secretary of State himself was setting out plans for local government reorganisation. On 17 August, he told the Financial Times that he was planning to introduce executive mayors in the country's 12 biggest cities by 2012. In a statement to the House, he said:
"We will put local councils in the driving seat to join up public services... We want elected mayors to trail-blaze such initiatives, not least since elected mayors in our cities will be embraced by the public".-[Official Report, 11 October 2010; Vol. 516, c. 3WS.]
The reality is somewhat different from the Secretary of State's hyperbole, however. As things stand, there does not seem to be a huge appetite for executive mayors. In fact, since 2001-the hon. Member for Carlisle set out the history-24 out of 37 referendums have rejected the idea. Stoke was one of the 13 places to vote in favour of an elected mayoral system, but even there residents subsequently voted to scrap it. Will the Minister therefore clarify precisely what the Government's latest policy position is?
John Stevenson: I am curious. I take the hon. Gentleman's point, and I commented on the fact that only one third of referendums for elected mayors had produced a yes result, but I would be interested to know the Labour party's view going forward with the idea of elected mayors. Labour Members were clearly up for elected mayors back in 2000, when the Blair Government introduced the idea. As I mentioned, they thought that it would be a great success. However, I am interested in the Labour party's view now.
The hon. Gentleman is right that there was a groundswell of support for elected mayors in the previous Labour Government. We introduced
legislation to enable elected mayors to be introduced, and we subsequently strengthened it in 2007. As we have heard from my hon. Friend the Member for Leicester South, a strong body of opinion in the Labour party supports elected mayors. However, it should be down to local people to decide, and we should not necessarily impose anything. At the very least, the elected members in an area should come to a view on elected mayors. Going forward, I think that that would remain our position, although we are now in opposition and we are looking at our policies. We will no doubt give this issue greater scrutiny as time goes by, but as things stand, it would be down to local people to decide what type of governance they wanted for their local authority, and I hope that that would remain the position.
"we will give the citizens in each of England's twelve largest cities the chance of having an elected mayor."
If the answer is yes, will he explain why the Secretary of State ruled out any local government reorganisation when he addressed the House last week? Will he give a guarantee that mayors will not be imposed in the country's 12 largest cities without a referendum? Finally, will he concede that, in the current climate, elected mayors would be placed in an impossible position because of the unprecedented cuts in local government funding that he has signed up to? Those cuts will destroy vital public services, increase unemployment and undermine economic growth.
The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill): It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate my hon. Friend the Member for Carlisle (John Stevenson) on securing a debate on this important topic. It is perhaps rather sad that the debate is so sparsely attended, because localism and the role that directly elected mayors can play in it is a significant issue for many communities, and it perhaps deserves a better audience than we have managed today.
By the sound of it, there is a bit of a contest between hon. Members over who has been in local government longest. I can only say that I spent 16 years as a borough councillor. If I am allowed to count my eight years on the London assembly, I can nearly get to the 25 or so years that the hon. Member for Leicester South (Sir Peter Soulsby)-
No hon. Member actually declared an interest in the sense of saying whether they had been a mayor. I should say at once that I have not been a mayor, although I have been the leader of an authority. The nearest I got was being a mayor's escort once, and I hope that my wife did not find me too inadequate in that role. That, of course, was under a ceremonial mayoral system.
Although we can smile at the differences, some important issues arise here. Across the country, ceremonial mayors do a valuable job and are often entirely independent,
non-partisan representatives of their community. They can be forces for cohesion and fine ambassadors for, and representatives of, their communities. Whatever changes are made, one does not want to lose that element of the equation. Equally, it is perfectly fair to say that there has been considerable debate, and that there is a strong case for considering the mayor as an authority's directly elected political head and chief executive, as is the case elsewhere in the world. My hon. Friend the Member for Carlisle is therefore right to say that the issue can have a huge impact on local democratic life.
My hon. Friend raised a number of interesting points and asked a number of questions. I should make it clear that there has, of course, been some debate and consideration, and various alternatives have flown around in the air. Some are picked up and some are not, at the end of the day. The final decision on the detailed implementation of our commitment on mayors is yet to be taken, and we will announce that decision to the House in due course. However, the commitment, in principle, to the concept of directly elected mayors in England's 12 largest cities is in the coalition agreement. As has been observed many times, we have said that we will create directly elected mayors in the 12 largest English cities, subject to confirmatory referendums and full scrutiny by elected councillors. I will address those two issues as I go along.
Chris Williamson: Will the Minister clarify what he means by confirmatory referendums? As he will be aware, they have been the subject of some debate in the media. Will he confirm that there would be a referendum before any mayoral system was imposed on any local authority area or city, and that proposals will not go forward unless a majority of people voted in favour?
Having set out the policy position, let me say that our commitment recognises the positive contribution that, international experience suggests, elected mayors can make, in terms of strong local leadership and instigating real change-something that my hon. Friend the Member for Carlisle and others have observed. There are many examples of successful elected mayors, some of whom are in this country. I have had the pleasure of working with Mayors of London of both political persuasions. Other examples come from our other authorities. Clearly, there are also examples abroad. One need only look to London's best comparator city, New York, or observe the real resilience that directly elected mayors bring to the great cities of many of our continental friends and partners in France, Germany, Italy, Spain and so on, where that governance model is regarded as the norm.
That experience supports the case for mayors in our largest cities, which is founded on mayors having greater potential to achieve successful economic, social and environmental outcomes in their cities than do other forms of government. I think that that is the result of the sharper accountability, greater legitimacy and stronger leadership that direct elections bring. Mayors can both be entrusted with greater powers and be expected to
exercise them more effectively than perhaps councils generally are. In our largest cities, creating mayors and equipping them with the powers that they need will enable them to seize opportunities so that those cities can fulfil their potential as drivers of genuine economic growth.
We believe that elected mayors are an effective model-a model that can result in greater prosperity and improved social outcomes for our great cities, and a model that can restore the prestige of our cities, bettering the life of those who live and work in them. However, the decision on whether to have a mayor must ultimately rest with local people. That is why our commitment is to create mayors subject to confirmatory referendums. The timing of the referendums is important, as my right hon. Friend the Secretary of State recognised when he said in the House last week, in response to a suggestion that we would impose mayors,
"of course we will not-that is completely out of the question. The proposals will be subject to referendums."
"Once we know the views of the people in those 12 cities, we will move on to the election of a mayor if people vote for that."
Chris Williamson: I do not want to labour the point unnecessarily, but I would appreciate some clarification. There is speculation that the leaders of the councils in the 12 biggest cities in England will be, as I said in my speech, transmogrified into directly elected mayors. I should appreciate it if the Minister would clarify that that will not happen, and they will not be transferred in that way or given the title of elected mayor until such time as a referendum has taken place.
Robert Neill: The hon. Gentleman knows as well as anyone that there has been a great deal of speculation about all aspects of elected mayors and the broader decentralisation agenda. I simply repeat what the Secretary of State said, which could not have been clearer:
"Once we know the views of the people in those 12 cities, we will move on to the election of a mayor if people vote for that." -[Official Report, 21 October 2010; Vol. 516, c. 1117.]
Reference has been made to the 12 cities. Our commitment is to have mayors in the 12 largest cities, and there are different arguments about where they are. Some points have been well made in the debate about the type of city that has a sharp focus and a sense of identity. Equally there will be questions about whether cities have the size or position to take on the range of powers that may be available.
I shall not go into the argument about unitaries as opposed to two-tier authorities at this stage. It is another legitimate debate, and I do not hold a dogmatic view on it. I have experienced good authorities of both kinds. I remind the hon. Member for Derby North (Chris Williamson) that what the Conservative party has always said on the subject-and what the Secretary of State was referring to in a very catchy reference he made to his attitude to local government reorganisation-relates to the situation under the previous Government, when unitary authorities were imposed on some areas by force, without the consent of the people in those authorities. There is a difference between unitary reorganisation
and the present issue, which is about giving people in existing, well-established city authorities the choice on whether to have a directly elected mayor.
I draw the attention of the House to the Green Paper, "Control Shift", that we published in opposition, setting out 12 potential cities that might have mayors. The Green Paper is referred to again in the coalition agreement. Those 12 cities are Birmingham, Bradford, Bristol, Coventry, Leeds, Leicester, Liverpool, Manchester, Newcastle upon Tyne, Nottingham, Sheffield and Wakefield. We did that on the basis that those cities are of a particular size, which we have calculated. We did not include the city of Sunderland, which is large, but which had a vote on a mayor in 2001. The people there took a view and rejected the proposal. So there is a logic to what we have proposed, and our thinking is that we would give people the choice in those 12 cities. We shall set that out in detail in the localism Bill, which was announced in the Queen's Speech.
My hon. Friend the Member for Carlisle referred to the possibility of extending the plan to other cities, but they can already have elected mayors if they wish. Under existing legislation, councils may choose to hold a referendum on whether to adopt the directly elected mayoral model, or they may resolve to adopt the mayoral model. We do not propose to remove that option. We also intend to keep the current arrangements whereby local people can trigger a binding referendum on whether to have an elected mayor for their area by submitting a petition to the council with the signatures of at least 5% of the area's electors. I understand that there is such a petition under way in my hon. Friend's constituency.
Sir Peter Soulsby: On the point about the opportunities open to local authorities under the existing legislation, as the Minister will be aware, non-metropolitan districts, and unitaries that were non-metropolitan districts, will be required to make a choice between a strong leader or an elected mayor before the end of this calendar year. Will the Minister go a little further than he has done and encourage them to take the opportunity to consider seriously the option of an elected mayor and perhaps, when they have examined it carefully, to take the bold step of adopting the model as of May next year?
Robert Neill: As I am a localist, I genuinely do not want to impose a blueprint on those local authorities, but the hon. Gentleman, who was himself a strong leader even before the term was invented-he was a very effective leader of Leicester city council under the previous powers-will be aware that arguments can be made in that direction. There is an opportunity for the case to be made by local authorities if they wish. Equally-this is the point that we are stressing-the decision should rest with the local people.
John Stevenson: The Minister touched on the point about the petition by local people. At present, 5% of electors must sign it if there is to be a referendum, but does he think that that is a prohibitively high proportion? It is quite difficult for a group of people in a locality to get together to obtain 5% support. Would not it be better to reduce that figure and thus encourage local people to petition for a referendum?
I will consider my hon. Friend's point. I point out that 5% would be about 4,200-odd people in Carlisle, but my hon. Friend knows the area better than
I do, and I stand to be corrected. It is a moot point whether that would be an impossible threshold to reach. It is legitimate that there should be some form of threshold to provide at least some evidence of a genuine desire among the population to go down that route. There are some costs in a referendum, although that is not the biggest issue involved, so before embarking on one there should be some evidence of public support. It is possible to argue either way about the matter, and I shall think about my hon. Friend's point.
However, it is important to be careful. There must be some safeguards in the process. I mention that in the context of the referendum in Tower Hamlets and the mayoral election there, which I believe everyone in this Chamber would agree was not the best advertisement for the mayoral model. The concern that I draw to my hon. Friend's attention, and to the attention of my hon. Friend the Member for Cleethorpes (Martin Vickers), who made a point about the unlikelihood of extremists being elected-I broadly agree that the electorate are generally sensible enough to see through them-is that there can be a risk of manipulation of the petition for a referendum without some proper safeguards.
In Tower Hamlets, there were some 17,000 names on the petition, easily beating the threshold, but some 6,000 were ruled invalid by the returning officer because of various blatantly fraudulent devices that had been employed to get signatures. That may not be the situation in Cleethorpes, but in some parts of the country there is a risk of pressure from individual sections of the community that may propose a petition for not entirely cohesive ends. We have to have some safeguards, but I think we can keep an open, practical mind as to the best way of dealing with the matter.
A question was raised about the important issue of mayoral powers. My hon. Friend the Member for Carlisle made a fair point on that. It is important that elected mayors have all the powers that they need to lead and enhance the prestige of their cities. Mayors need to be able to make real improvements to the lives of those who live and work in their city, and to make an impact on the city's economy and its capacity to act as an engine of growth more widely.
One of the reasons, but not the sole reason, why we proposed the 12 largest cities is that it so happens that they are all unitaries. Unitaries are not necessarily the only model, but it may be convenient, particularly at an early stage when people are not used to elected mayors, to have elected mayors in cities where the mayor has the whole range of responsibility for local government services; in that way, things could be more naturally concentrated in one person's mind. We want to strengthen mayors' powers, and my right hon. Friend the Secretary of State set out the kind of powers we meant in a speech during our party conference. The hon. Member for Derby North helpfully quoted what he said, so I need not repeat the kind of areas at which we are looking.
We envisage that mayors will work closely with neighbouring council leaders on issues such as transport, the strategic approach to planning, and wider economic priorities. Of course, it is important to remember that all the great cities do not live in isolation from their hinterland, whether in economic, social or simply spatial terms. Whatever happens, mayor or leader, there has to be a system such that cities can work sensibly with neighbouring authorities. The alternative would involve
exactly the kind of upheaval due to further local government reorganisation and changing boundaries that my right hon. Friend the Secretary of State had in mind when he referred to the armaments industry, if I can put it that way. We want to find sensible ways for mayors to work across boundaries.
My hon. Friend the Member for Carlisle is a strong proponent of decentralisation, as was evidenced in his maiden speech to this House. He argued strongly that in order to improve local economies and education, we must decentralise, take decisions back to communities and allow local people to make local decisions-in simple terms, return power to people. I endorse those sentiments wholeheartedly. They form a vital part of the Government's localism agenda. I would go further and say that creating mayors in our largest cities is a key vehicle for facilitating that much-needed decentralisation. The hon. Member for Leicester South, and my hon. Friends the Members for Carlisle, and for Cleethorpes, were hoping that the Government would endorse the idea of mayors. The Government have clearly indicated that, in the right place-it is for the people to choose what is the right place-directly elected mayors can indeed make a significant difference.
Several hon. Members raised the important issue of accountability and scrutiny. With power comes responsibility, and a crucial element of the elected mayoral model is strong and effective scrutiny of the elected mayor and his or her actions by elected councillors. Effective scrutiny will provide the means for ensuring that the electorate have detailed knowledge of their elected mayor's policies and activities. Direct accountability and scrutiny will be enhanced by stringent transparency requirements. The Government have already announced their intentions in respect of publishing online any spend over £500. Clearly, that has to apply as much to mayor-led authorities as it does to any other authority.
The hon. Member for Leicester South made a point about the role of the back-bench councillor and ensuring that scrutiny is effective. I have a great deal of sympathy with his comments about the need to give back-bench councillors a real role in the system. I have heard from councillors of all political persuasions and none that they can feel-and perhaps, in effect, be-excluded from the decision-making process. That can happen under the leader-and-cabinet model as much as it can under a mayoral model. Whatever the system, we need to find some means of addressing that.
It is important, too, that scrutiny is genuinely effective and moves beyond post-event, post hoc scrutiny, which can be rather meaningless at the end of the day. It is important that, wherever possible, we give elected members the chance to have input in the decision-making process before decisions are completed. That is why, in the spirit of localism, we are saying that local authorities should have the ability to choose whether they stick with the leader-and-cabinet model or with a committee system. That is for them to choose, but either a leader-and-cabinet or a mayoral model can be made to work, provided they properly involve councillors. My London borough of Bromley, for example, calls its scrutiny committees "policy development and scrutiny committees", which more closely mirrors what should happen, in terms of trying to involve members at an earlier stage of the process.
My hon. Friend the Member for Carlisle mentioned councillor numbers and asked whether we would seek to reduce the number of councillors in areas where elected mayors are in place. Once again, I refer to the comments of my right hon. Friend the Secretary of State in response to a question on that issue. He stated:
"Decisions on the number of councillors in any local authority are handled by the independent Local Government Boundary Commission, in which process I have no role."-[Official Report, 21 October 2010; Vol. 516, c. 1116.]
That is the case; Ministers do not have any role in setting either the boundaries or the number of councillors under our current arrangements. If councils wish to open up the matter of the number of members that they have, they can ask the Local Government Boundary Commission to review the authority's ward boundaries and number of members. They do that by direct application to the commission; the process does not involve the Government, and it is probably right that there should be independence in that regard.
Sir Peter Soulsby: On boundaries, can the Minister take this opportunity to confirm that the proposals that are likely to come forward for the 12 cities are likely to be based on the existing boundaries of those cities? There have been rumours that there may be extensive extensions of some areas. I do not expect that to be the Minister's intention, but I would like to give him the opportunity to confirm that it is not his intention.
Robert Neill: The hon. Gentleman's understanding is the same as mine. There has been debate outside this House-academics and others have suggested other things, such as regional mayors, city region mayors and so on-but I am happy to make it clear that our intention relates to the cities' existing boundaries.
The commitment remains strong. There is a real case to be made for mayors, but the people of the cities ultimately must make the choice. There can be a great advantage in having a directly elected political leader of an authority; it can mean a sharper focus, a clearer line of accountability and a greater profile for the political head of the authority, and therefore for the authority and its services.
The issue of personality was raised. I mention it because we should remember that if a community decides to go down the route of having an elected mayor, the electoral process must include proper safeguards; I largely agree with the hon. Member for Derby North on that. Although personality is inevitably part of politics nowadays, I hope that that is kept in proportion because, ultimately, values are what count. The recent election in Tower Hamlets, in which the successful independent candidate, or certainly people linked to him, launched a libellous and wholly unfounded series of personal attacks on the Labour candidate, does not help the argument. We have to keep personality in proportion, and that comes back to the need for safeguards in such circumstances-in referendums, in elections for directly elected mayors and, once they are in place, in the scrutiny process. That is not a reason not to go down the route of having directly elected mayors, but we must bear it in mind when finding the right checks and balances.
Let me reiterate our commitment to having mayors in the 12 largest cities, subject to referendums and scrutiny of the kind that I described. That commitment will
benefit those cities, helping to return them to their rightful place among the world's economic powerhouses and, ultimately, helping to improve the lives of the people of this country.
Mr John Leech ( Manchester, Withington) (LD): It is a pleasure to see you in the Chair this afternoon, Mr Robertson. I start by thanking my hon. Friend the Minister for contacting me in advance of the debate for an indication of the matters that I want to raise on a wide-ranging subject. The title is particularly wide. I also thank the numerous organisations that contacted me with information for the debate and apologise to those whose issues will not be addressed this afternoon.
In this short debate, I want to make some time available to my hon. Friend the Member for Gillingham and Rainham (Rehman Chishti), who wants to say a few words, and to take the opportunity to raise two specific issues, the first of which is lack of awareness among MPs of the issues surrounding funding for the treatment of rarer cancers in general and the lack of understanding of the complex processes and institutions that make decisions about the availability of drugs, especially to sufferers of rarer cancers.
The second, related, topic is the recent health technology appraisal by the National Institute for Health and Clinical Excellence of the use of azacitidine for the treatment of myelodysplastic syndrome. That is a bit of a tongue twister, so I shall refer to it as MDS. NICE's appraisal and decision-making process for azacitidine highlights the problems and inequalities facing sufferers of rarer cancers in getting access to what are often life-saving treatments. NICE's refusal to recognise orphan drug status has created a great disparity in the treatment options for the sufferers of rarer cancers. With the move to value-based pricing not due to come into effect until 2014 and with the lack of details about how it will work, it is essential that that inequality is addressed.
The initial £50 million of funding from the cancer drugs fund has been distributed to the strategic health authorities, and today sees the opening of the consultation on the main cancer drugs fund. I suggest that today is the perfect day to restate the case for far greater funding for rarer cancers.
I start by mentioning the need for MPs to have a greater awareness of rarer cancers, and of the processes and institutions that evaluate the drugs needed to treat them. A number of patients and their family members attended the MDS UK lobby of Parliament yesterday. As part of that lobby, MDS UK launched the results of a survey, which showed that two thirds of MPs had no understanding of the term "health technology assessment", and one third had no understanding of the term "quality-adjusted life year." I confess that I was one of those people until I was contacted by MDS UK.
MPs are expected to have a broad knowledge of many subjects, but we cannot claim, or expect, to have a detailed knowledge of all subjects-some of our constituents may argue that we do not have much knowledge of any subjects. With large-scale reforms of the NHS due to be discussed and voted on, it is vital that MPs gain a greater knowledge of such subjects, and understand how those who suffer from rarer forms of cancer are currently discriminated against.
There is a need for greater awareness about how the details of value-based pricing and decisions on how to allocate the cancer drugs fund may, or may not, remove
barriers to treatment for those with rarer cancers. I do not intend to spend any more time on that aspect of the debate, other than to highlight the rarer cancers toolkit collated by MDS UK, which I hope the Minister is aware of and has seen. Although today I am concentrating on MDS, there are other rare cancers such as pancreatic cancer, ovarian cancer or mesothelioma that also struggle with either a lack of access to drugs, or with the need to raise awareness among the general public.
I want to mention the fiasco surrounding the NICE appraisal of azacitidine. The process has already taken 18 months and, as a solution is not necessarily assured until March 2011, it may end up being a two-year process in total. In the meantime, up to 1,500 patients will have missed out on the opportunity to access azacitidine during that decision-making process.
The mishandling of the evidence by the evaluation team, as highlighted by the appeals committee, has not helped. The process is long-winded and ponderous even without an appeal. More worryingly, setting aside the length of time involved, the decision-making process itself is flawed, especially NICE's refusal to recognise orphan drug status. The MDS Forum, the Royal College of Pathology and the British Society for Haematology, which collectively represent the UK's top haematologists, have all written to NICE to highlight the unsuitability of NICE's health technology assessments for considering orphan medicines. Haematologists from centres of excellence across Europe have signed a letter echoing that view. Of the 50 orphan-status drugs that are licensed by the European Medicines Agency, only three have been recommended by NICE.
There is an exceptionally strong case for further reform to the NICE process to ensure that it captures the full value of new and innovative medicines for patients with rarer cancers. It is widely accepted that there are problems with the NICE process and that it is unfair to those who suffer with rarer cancers. Extremely high costs are associated with the research and development of drugs, and the relative lack of expertise means that drugs for rarer conditions cost even more. The fact that some drugs are for small patient groups means that sales are relatively low, and the unit cost of such drugs is incredibly high. Nevertheless, the innovative value added by those drugs is great. They are not "me too" drugs, with a relatively low incremental clinical improvement to the patient compared with the drug that is replaced. Such drugs are unique and often provide the only treatment available to the patient. Azacitidine for MDS is a perfect example. The only alternative to it is usually "best supportive care", which treats only the symptoms and not the disease.
I do not know why the process cannot be adjusted to take orphan status into account, and I would be grateful if the Minister could address that question in his response. It seems that the UK is almost unique in that decision. The problems with the NICE process are not unknown, and I know that the Minister and his Department are fully aware of them. The decision to move to value-based pricing, and the introduction of end-of-life criteria and patient access schemes are recognition of such problems. However, end-of-life criteria and patient access schemes have not succeeded in making appraisals more flexible to innovative treatments for rarer cancers, especially
cancers where the small number of patients eligible to take part in trials means that there is often considerable uncertainty surrounding the data.
An interesting example of the current problems with NICE's methodology is the fact that even if azacitidine were to be given to the patient for free, its quality-adjusted life year cost would still be £20,000. I do not understand how that can be the case; perhaps the Minister will explain.
Unfortunately, value-based pricing is more than three years away. That will be too late for some patients. Furthermore, the devil will be in the detail as to how the scheme will work and how effective it will be at addressing the needs of small patient groups. In the meantime, short of further reform of the NICE process, the only option for MDS patients and similarly disadvantaged sufferers of other rare cancers is the cancer drugs fund.
Before I move on to the cancer drugs fund, I urge the Minister to ensure that value-based pricing is constructed in such a way that drugs such as azacitidine become available to UK citizens, just as they are available across the rest of Europe. Azacitidine provides a vast improvement to patient outcomes compared with current treatments, and it is therefore the very definition of "high value", which value-based pricing must be designed around.
I urge the Department of Health to ensure that the cancer drugs fund is used to help sufferers of cancers such as MDS. MDS is a life-threatening illness and it is terribly served by the NICE process. The only available treatment is currently being denied to patients, and although I hope that NICE reverses its decision, I fear that ministerial intervention may be needed to bring access to azacitidine to MDS sufferers. It is exactly the kind of treatment that the cancer drugs fund was designed to support and must provide for. Of course, MDS sufferers will have to wait even longer while NICE makes its decision, before they are even allowed to apply to the fund.
In conclusion, I urge the Minister to ensure that NICE methodology is reformed to make it more suitable for assessing medicines for rarer cancers, or that cancers such as MDS are taken out of the NICE health technology assessment process. I request value-based pricing to be constructed in a way that ensures that innovative drugs with a high benefit to patient outcome, such as azacitidine, are correctly appraised. In the meantime, I ask for the cancer drugs fund to be used to correct the inequality faced by sufferers of rarer cancers due to the disparity in the appraisal process of drugs for those rarer cancers.
Rehman Chishti (Gillingham and Rainham) (Con): It is a pleasure to speak under your chairmanship, Mr Robertson. I thank and congratulate the hon. Member for Manchester, Withington (Mr Leech) on securing this debate on such an important and sensitive issue. Applying the basic principle that brevity is a virtue, not a vice, I shall keep my submission short. I place on the record my thanks to organisations such as Macmillan Cancer Support, which have been very helpful in providing information for me to consider and base my submission on.
My first point is that representations have been made to me that people who suffer from rarer forms of cancer should be given priority in the Government's proposals
for the new drugs fund, on the basis that they are the ones who are the most disadvantaged by the current NICE drug appraisal system.
Secondly, the services available through the clinical nurse specialist system are very unlikely to be given to people with rarer forms of cancer. I urge the Minister to consider extending that system and ensuring that people with rarer forms of cancer have access to it. That is especially important because new research shows that clinical nurse specialists save the NHS money by co-ordinating services more effectively, along with significantly improving the patient experience and outcomes.
Thirdly, I seek an assurance from the Minister that the full maximum of the money allocated in the coalition agreement to the cancer drugs fund will be available. It is vital that we ensure that people who need those drugs get them at the earliest opportunity.
The Minister of State, Department of Health (Paul Burstow): I am grateful for the opportunity to respond to the debate. I congratulate my hon. Friend the Member for Manchester, Withington (Mr Leech) on securing it and I particularly thank him for giving me notice of the focus of the debate, because, as he rightly says, the range of issues that could be covered in a debate on rare cancers is very wide. I hope that my remarks will therefore address his particular concerns.
The argument that my hon. Friend makes about the iniquities facing people with rare cancers is a clear riposte to the challenge posed by those who say that the NHS needs no reform because it works perfectly. That is often said to me, but my hon. Friend has set out a compelling case why there are areas in which scrutiny, change and reform are undoubtedly necessary. In fact, there are significant failings in the current system of drug pricing and access. The Government are determined to put them right so that we can help more people to get fair access to drugs and treatments that will help them.
In that regard, my hon. Friend rightly draws attention to today's launch of the cancer drugs fund consultation. It is an important moment for the 27,000 people diagnosed with rarer cancers each year. The £200 million a year investment that we shall be making from 1 April 2011, on top of the £50 million that started to go into the system from 1 October this year, means that the NHS will be in a position to provide more support than it has been able to in the past. We will ensure that more patients get drugs and treatments not otherwise available on the NHS.
The Rarer Cancers Foundation has said that our interim funding for the cancer drugs fund will benefit more than 2,000 cancer patients this year alone. Clearly, the £200 million investment that we are making from next April will benefit thousands more. My hon. Friend-
My hon. Friend is right to stress that we need to ensure that the fund and the eventual value-based pricing approach are accessible and intelligible. He is right to challenge all of us to test our own understanding of QALYs and technology appraisals. My officials did supply me with a plain English version of what QALYs are, but I will not detain hon. Members by reading it out today. My hon. Friend is right to say that MPs need to understand the detail of how the new cancer drugs fund will work in practice, so that they can advise constituents effectively and their constituents can make the maximum use of it.
The rarer cancers toolkit, which my hon. Friend described, contains a lot of useful information to help MPs to understand cases brought to them by their constituents. I place on the record my gratitude to MDS UK for taking the time to develop it. I hope that it is a successful toolkit that is widely taken up and used by colleagues in the House.
In addition, today's consultation launch is an ideal opportunity for hon. Members to interrogate the proposals, offer constructive challenges and add their own thoughts on how we can take the issue forward. I certainly encourage my hon. Friend and the hon. Member for Gillingham and Rainham (Rehman Chishti) to consider it in more detail and be prepared to comment in more detail. I will ensure, however, that the comments made about it today are fed into the consultation.
I was asked a specific question about the role of clinical nurse support. Every cancer patient should have access to appropriate care, support and information. We are considering the evidence to see whether one-to-one nurse specialist support can improve care for cancer patients, as well as ensuring that there is efficient use of NHS resources. We shall say more about that as we publish our NHS cancer reform strategy review later this year.
My hon. Friend rightly highlighted value-based pricing as one of the ways in which we can address a number of the issues. The cancer drugs fund provides us with a bridge to that more sustainable system, which we hope to have in place from 2014, when the current pharmaceutical price regulation scheme ends. Our intention is to develop a system that makes a much closer link between the price that the NHS pays and the value that a new medicine delivers. That is the key to securing better access to medicines for patients and a better deal for the taxpayer.
Developing a new medicines pricing system is clearly not a simple task. It is important to ensure that when the new system comes in, we get it right. There is international experience on which we can draw, but it will be groundbreaking work and we shall want to engage with stakeholders to ensure that we get it right. I agree with my hon. Friend that the new pricing system must be carefully designed so that it provides fair outcomes for all patients, including those with rarer forms of cancer.
There is, though, a balance to be struck, as I am sure my hon. Friend would acknowledge. The pricing model needs to support innovation in the pharmaceutical sector; it needs properly to reward research and development in respect of new treatments. We need to ensure that the
incentives are there to encourage firms to invest in the future treatments that will fulfil unmet needs and save and improve people's lives. However, we also need to deliver better value for the taxpayer. In the current financial climate, that is even more the case.
My hon. Friend makes valid points about the unit costs of drugs for rarer conditions and how we tally up the development costs with the relatively low sales of those drugs. I will ensure that his comments about those matters are fed into the future discussions about the design of and consultation on value-based pricing of drugs. Later this year, we shall publish a consultation document, setting out our plans in detail. I hope that he and people from the many charities representing those with rarer cancers take part in that consultation and help us to shape the system in a way that makes a difference for those whom they represent.
My hon. Friend made comments about the treatments available for MDS; indeed, he said that none was available. I am informed by officials that some people with low or intermediate-risk MDS and no symptoms may not need treatment, but they will be monitored. Most MDS patients will have treatment to control or improve the symptoms. That is called supportive treatment. Chemotherapy may be helpful for some people, depending on the type of MDS that they have. A small number of patients may benefit from stem cell transplants, and the aim in those circumstances is to cure the disease. There are things that are done, but I accept my hon. Friend's general point about the need to have access to appropriate drugs as well.
Let me answer the points that my hon. Friend raised about NICE. NICE performs a very difficult but essential job. Its independence is a key strength in the system. It should not be subject to micro-management and meddling by Ministers on a case-by-case basis. For that reason, I will not be able to give my hon. Friend the comfort that he wants-a ministerial intervention to direct NICE to behave differently with regard to the particular treatment under discussion. However, I note my hon. Friend's criticism of the way in which the appraisal has been handled. That is the very reason why we have to have within it the appeal mechanisms that exist. That appeal mechanism has allowed some of those issues to be flagged up and reconsideration to take place.
I appreciate what my hon. Friend has said and his frustration, which I suspect is shared by many hon. Members and, more importantly, by those hoping for access to the drugs, about the length of time that it can take to get an appraisal through. NICE has attempted to streamline its appraisal process in recent years and, in many cases, is now able to start work before a new drug is licensed. For the majority of new cancer drugs, NICE aims to publish draft or final guidance within six months of licensing.
The process tends to be more protracted when there is an appeal against the decision, as there was in that case, or when there are particularly complex issues surrounding the drug in question. While we would welcome greater speed, none of us would advocate dispensing with the vital features of NICE's work, such as public consultation and an independent appeal stage.
It is worth pointing out, however, that people can access the new funding for cancer drugs before NICE makes a final decision. Let me be absolutely clear: in
other words, people do not need to wait for NICE to say no before they can apply to the cancer drugs fund. We have also made it clear to primary care trusts that they should not refuse to fund a drug locally simply because no NICE guidance is yet available.
I am also aware of the problems about providing drugs for which there might be limited evidence of effectiveness. Again, today's consultation is asking about and seeking comments on that, to see how the fund is developed and what advice we give to the members of the panels that make the decisions. We are open to ideas and, through this debate, I put to my hon. Friend and others the idea of participating in the consultation.
Turning to orphan status drugs and drugs appraisal, my hon. Friend rightly drew attention to the fact that NICE has recommended only three of the 50 orphan drugs licensed by the European Medicines Agency. I understand his point, but we need to put his point into context. NICE has issued final guidance on, I believe, only seven drugs that have a current orphan designation, recommending only three of them, including one drug for more than one indication. NICE also issued positive guidance on the drug Sutent, which was an orphan drug when designated, but has since had that designation withdrawn.
My hon. Friend asked why NICE approval processes could not be adjusted to take into account orphan status. I point out, as he rightly mentioned, that the end-of-life criteria give NICE flexibility in appraising life-extending drugs for patients with terminal cancer. One of the criteria that must be satisfied for NICE to apply those extra flexibilities is that the treatment must be licensed, or otherwise indicated, for small patient populations. He suggested that such flexibility has not been helpful with orphan drugs, but it has helped make a number of drugs available to patients, including orphan drugs such as Yondelis for soft-tissue sarcoma and Revlimid for multiple myeloma.
I know that NICE is always open to ideas and I encourage my hon. Friend to engage directly with it, along with MDS UK, about their concerns. I will certainly ensure that a transcript of the debate is passed to NICE, so that it can see for itself the concerns of my hon. Friend.
To sum up, such issues are incredibly difficult and emotive. I know that from my own constituency mailbag and from constituents who come to see me, battling to get the medication that they think is appropriate for them on the advice of clinicians. The cancer drugs fund begins to transform and unlock new opportunities in that regard. Decisions concerning treatments often affect patients' chances of beating their cancer. That and the possibility of patients having more time with their families are the very motivation behind the drugs fund.
The Government are clear. We need a system that treats people with rarer cancers in a fairer way, as my hon. Friend said today. He offered us a helpful and insightful spur to ensure that we have a clear focus as we progress in developing policy in the area. The fact is that many thousands of people have lost out over the years, owing to how cancer drugs are priced and funded. Starting with the £50 million already made available this year, and continuing with the £200 million cancer drugs fund from next April, we want to end that unfairness. More people will be able to get the drugs that they want to extend or improve their lives.
I hope that my hon. Friend has found the debate useful. We must ensure that the system works around the needs of patients and is evidence-based and properly accountable. I look forward to continuing the discussion. I hope that he and others will respond properly to the cancer drugs consultation and our work around designing the value-based pricing system to come.
Kate Green (Stretford and Urmston) (Lab): I am grateful, Mr Robertson, that time has been allowed for this afternoon's debate, and I am pleased that my hon. Friend the Member for Edinburgh East (Sheila Gilmore) and my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) are present. My right hon. Friend is here because his constituency neighbours mine and will be impacted by the proposed power station that is the subject of today's debate. My hon. Friend the Member for Edinburgh East faces similar problems in her community.
I shall start by setting out a little of the background to the subject. Peel Holdings proposes building a biomass renewable energy plant at Barton in my constituency on the banks of the Manchester ship canal. The plant would primarily burn recycled wood-for example, wood that had been treated with paint or varnish-and some virgin timber. I understand that other plant-derived material will also be burned. According to the applicant, the plant will handle 200,000 tonnes of material per annum, have an operational life of 25 years and provide renewable energy for approximately 37,000 homes. A planning application to the local authority, Trafford metropolitan borough council, is expected to be made soon.
No one questions the wish to make more use of renewable energy sources, but since I was elected in May the proposed plant is without doubt the single biggest issue in my postbag. Hundreds of local people have contacted me about it, the majority being opposed. Local campaigners have established the Breathe Clean Air Group to oppose the building of the power station. A public meeting earlier this month in my constituency attracted hundreds of local residents, and the vast majority of them oppose what is planned.
The concerns being expressed by campaigners and local people fall into three groups. First, there is concern about emissions from the plant and whether the technology that is to be employed will be adequate to clean them satisfactorily, and there is concern about the impact of the emissions on public health. Secondly, there are concerns about the monitoring processes in relation to the emissions. Thirdly, people have a range of concerns about the effect of the plant on local amenities-on local housing, businesses and transport-and problems resulting from congestion. I appreciate that many of those are local planning matters.
I note that the area is already spectacularly unfavoured, as the site of a planned methane plant and a sewage works, and is located right next to an already busy motorway junction. I was interested to note that Peel Holdings has suggested that the materials bring brought to the plant for incineration and the waste being removed could be transported on the canal in due course. I hope that the company will provide more details when the proposal comes to the planning stage, which I expect to happen in the next few weeks.
I wish to refer today to the level and monitoring of the emissions, and I invite the Minister to respond to those concerns. I am pretty confident that Peel Holdings will seek to show that the plant will comply with minimum legal emissions standards. The consensus in the debate
initiated in Westminster Hall yesterday by the hon. Member for Congleton (Fiona Bruce) seemed to be that Ministers believe that the Health Protection Agency has convincingly failed to establish any link between emissions from incinerators and public health. However, significant concerns remain among my constituents. I ask the Minister to expand on that analysis.
My constituents point to the latest European Union directive on air quality, incorporated into the UK's air quality strategy, and to EU directives on waste that require member states to use the best available technology to achieve maximum emissions of no more than 1 to 5 mg per cubic metre, but they also say that the United Kingdom has allowed a limit of 10 to 15 mg per cubic metre. Campaigners tell me that each additional milligram worsens health outcomes and mortality rates. The worry is that although the Barton plant may fall within the UK limits-indeed, I expect that it will-it does not represent the best in technology and that the risk of adverse cardiac, respiratory and other health conditions could result.
Paul Goggins (Wythenshawe and Sale East) (Lab): My hon. Friend explains the concerns of her constituents with her customary skill and brings to the Minister their real concerns on the impact on public health. Of course, these issues are a trouble not only to her constituents, but to many of mine, particularly those who live in the Sale area. Does my hon. Friend agree that it is vital that we have an accurate assessment of the risks involved, so that decisions are made in light of the full facts?
Kate Green: Steam vapours are of course no respecters of constituency boundaries. Indeed, the Breathe Clean Air Group has shared with me a footprint plan suggesting that the effect of the emissions would be felt across much of Greater Manchester, as far south as Manchester airport and well into the city centre.
There are significant anxieties about the health analysis that has been made. It is not sufficient for my constituents, who are very concerned about the proposal, or for others in the Manchester vicinity, simply to be told that the Health Protection Agency has reviewed the available evidence. I hope that the Minister will be able to help this afternoon by giving much fuller information on that aspect.
Will the Minister explain how the ongoing review processes on the latest evidence about the health impact of emissions will be maintained following the Health Protection Agency's abolition, which was announced the other day? My understanding is that local public health directors will take a significant role, and I would be grateful for any information that the Minister provided about where they could obtain the most up-to-date evidence, research and advice necessary to inform future debates.
I turn to the arrangements for monitoring the emissions. I acknowledge that Peel Holdings has been very forthcoming in its responses to my questions. It has indicated that it will be putting in place sophisticated computer monitoring systems, and it says that the Environment Agency will have the power to make regular and unannounced checks. I hope that the Minister will confirm that the agency will continue to fulfil its inspection function,
and that there will be no slackening of the inspection regime following the announcement the other day of a redefinition of its functions. That is important to my constituents, and I look forward to what the Minister has to say. I also wish to know how as much as possible of the data that are captured and monitored can be made transparent to the public, especially to my constituents, and how the Environment Agency will ensure that they cannot be suppressed if standards are not met.
Let me refer to the issue that was at the heart of yesterday's debate on incinerators that was initiated by the hon. Member for Congleton. It was said that Government policy, both in relation to incineration and renewable energy sources, will be reconciled to empowering local communities to make decisions about their local areas.
Sheila Gilmore (Edinburgh East) (Lab): One concern that has been raised by my constituents about the proposed construction of a biomass plant nearby is that the concept of renewable energy as a good thing is being used to cover up, or to disguise, practices that are by no means environmentally friendly. Does my hon. Friend agree that there is a danger in that? Only 30% of the fuel for the plant proposed in my area would come from recyclable elements, which might be polluting, and up to 70% will be from virgin wood, some of which may be sourced from South America, which does not sound very environmentally friendly. Does she not agree that, because of greenwash, there is a danger that things will be agreed that are by no means green?
Kate Green: I thank my hon. Friend for that helpful intervention. There is a sense that a number of proposals, many of them very different in their detail, are being branded with a collective greenwash, as she so eloquently describes it, which is, perhaps not intentionally, serving to brush aside debate. The Breathe Clean Air Group and Peel Holdings have supplied me with a considerable amount of scientific information, very little of which I can make sense of. I strongly suspect that that will be the case for many of my constituents who are closely attending to this debate. It would be helpful if we had the fullest possible public information in terms that are easy to access and understand, so that we can have a genuinely well informed debate about renewable energy sources and their green impact.
I am particularly interested in an issue that has been raised by the Breathe Clean Air Group about the European requirement to make use of the best available technology. Its view is that the best available technology may not be represented, even in the context of energy renewables, and I should very much like to understand more about that, as would many of my constituents and those of my hon. Friends.
I am keen to understand how the information and the wider context will be played out in relation to the role of local communities in making decisions about the issues that directly affect them. Yesterday, in responding to the debate initiated by the hon. Member for Congleton, the Minister said that where applications were made for such plants-he was talking at that time about waste incineration-the Government wanted to ensure proper, informed and vigorous debate in the community. I very much welcome that. In Trafford, such a debate is already
taking place. None the less, it seems that there could be a tension between Ministers' avowed commitment to localism and the assertions about health standards and emissions that were being made by the Minister yesterday. Perhaps the Minister will expand on how he expects the will of local people to be properly taken on board in planning decisions and in any potential planning appeal.
I ask such questions in advance of a planning application being submitted in relation to the Barton renewable energy plant, because local people are very concerned that the decision has been stitched up. What guarantees will the Minister give my constituents that that is not the case and that local concerns about the proposals will be given appropriate weight?
The Minister of State, Department of Energy and Climate Change (Charles Hendry): It is a huge pleasure to serve under your chairmanship, Mr Robertson. We worked closely together on the Energy and Climate Change Committee before the last election. I know that you have a great personal interest in all these energy-related matters, and I am delighted that we have a chance to debate them in front of you this afternoon.
Let me begin by thanking the hon. Member for Stretford and Urmston (Kate Green) for securing the debate and for the way in which she has introduced it. Her constituents will feel that she has done them a very important service by initiating a debate in this Chamber, raising their concerns and giving us the chance to debate them broadly. I also welcome the constructive contributions from other hon. Members, who adopted exactly the right tone for such a debate.
I hope that the hon. Lady understands that I am not in a position to comment on individual planning applications. There is a legal process for applications to go through, and it would be wrong for Ministers to intervene in individual matters which quite properly fall under the control of local authorities. None the less, I am keen to respond to some of her points, and to set out the importance of biomass and the safeguards that are needed to reassure her constituents about the role that it might play.
I agree with the hon. Lady about the importance of a well-informed debate. Her constituents need to feel that they can understand the issues that are being addressed. Plain English should therefore be used in all documentation. I recognise that the subject requires quite technical information, but everyone has an obligation to put that forward in the most straightforward way possible. The only way that we can gain public acceptability is if people can understand exactly what is being proposed and feel that they can genuinely have their views heard. I will seek to reassure her, in my contribution, that that is absolutely the intention of our planning changes.
Our objective as a Government is to see that there is constant upward pressure on standards. Such an objective does not stand still; we do not lock it in at any particular point in time. Standards must evolve over time. The types of technology being introduced now are of an infinitely higher standard than those of the past, and that is a process that we want to see taken forward.
Biomass has a very important part to play in our commitment to develop renewable energy. Bioenergy more generally has an important role to play in that
regard. Biomass offers a significant opportunity for this country. Energy crops, wood and municipal waste play a vital role in that process, and we encourage people to consider that. I understand the point that the hon. Member for Edinburgh East (Sheila Gilmore) made when she said that such materials should come from sustainable sources. We are considering the right standards that we must put in place in that respect, and we will introduce new mandatory sustainability standards next year. People have to be reassured that we are pursuing this in a way that is globally sustainable. We are not just looking at a particular local issue without understanding the wider implications.
Our challenge is to ensure our energy security and to reduce our carbon emissions. We want to rebuild our energy infrastructure in a way that creates green jobs and helps to build economic prosperity. The efficient use of sustainable biomass will play a key role in meeting that challenge. We want Britain to be a global leader in the transition to a low-carbon economy. We are committed to producing 15% of our energy from renewable sources by 2020 and to reducing our carbon emissions by 80% by 2050. Sustainable biomass is the single most important contributor to our renewable energy ambitions. Heat and electricity from biomass can provide nearly a third of UK needs from renewables by 2020-about 4.5% of overall energy demand.
Today, biomass provides around 3% of UK electricity and 0.6% of heat demand. Bioenergy offers the rare benefit of being a renewable technology that it is not intermittent. It can generate electricity or heat on demand at any time of the day or night. We welcome the security of supply that that brings. We also recognise that delivering our ambition for renewables will not be easy. Substantial changes will be required as the UK moves away from the familiar technologies that are used today. Decisions taken now will shape the country's energy future for many decades to come, and it is vital that we make the right decisions and carry people with us.
I recognise that the investment challenge is large, not only for renewables but for all the types of low-carbon generation that the UK will need. We will require local communities and the private sector to work together to deliver the right energy development if we are to achieve our aims of energy security, climate security, and green growth. That is why we have committed so strongly to devolving decision making from central to local level as much as we can. We want to see communities and individuals having a stake in our collective low-carbon future, and we want them to choose the technologies that work for them in their neighbourhoods. The Minister with responsibility for planning, my right hon. Friend the Member for Tunbridge Wells (Greg Clark), will publish detailed proposals about how that process will work, but the involvement of local communities and their right to determine how they evolve is absolutely at the heart of the process.
We recognise, however, that with choice comes responsibility. It is important for local communities carefully to consider proposed projects in their neighbourhood. Each planning application should be judged on its merits, and not all sites will be considered suitable. A vigorous debate over the pros and cons of all projects is essential to ensure that all the issues are teased out.
In recognition of the important role that communities play in hosting renewable energy developments, we will bring forward proposals to allow communities to retain the business rates associated with renewable energy projects. The hon. Member for Stretford and Urmston talked about the impact on communities of traffic and related issues, but the benefit from those business rates could significantly help to address those issues locally. We believe that the communities that host developments for the wider, national good should be recognised through the retention of business rates for the contribution that they have made.
I will now look more directly at some of the issues that the hon. Lady raised about public health. A great deal of concern has been expressed about the effect on air quality, the natural environment and the health of communities in the vicinity of an incinerator. I recognise that those are absolutely crucial concerns, both for the hon. Lady's constituents and for people elsewhere around the country, and I can reassure her that all modern waste incinerators and biomass incinerators are subject to the most stringent pollution controls. Emissions from waste incinerators are more strictly regulated than emissions from coal, gas or any other form of power generation from combustion.
The proposer-that is, the company bringing forward the plan for the Barton plant-must produce an environmental statement covering transport and social and environmental issues. In addition, modern incinerators must comply with the waste incineration directive, which sets strict emissions limits for pollutants. It is in that regard that the best of class and the best of kind must be considered. The Environment Agency will not grant the permits required for an incinerator to operate if a facility is not compliant with the waste incineration directive.
It might be helpful if I set out the extremely rigorous process that a 20 MW facility-that, I believe, is the scale of the plant proposed at Barton-that primarily uses wood waste must go through. Such a facility would be likely to be subject to the environmental permitting regulations and, as I have mentioned, the waste incineration directive. Both the regulations and the directive are regulated by the Environment Agency. The legislation sets strict environmental standards for all plants burning waste, including waste wood, and standards relating to a range of pollutants, such as nitrogen oxides, sulphur dioxide, heavy metals and dioxins.
If the Environment Agency were to issue a permit, it would need to cover issues such as: the limits on emissions to air, water, sewers, land and groundwater; the disposal of ash; operating conditions, such as temperature, oxygen and polluting gas concentrations; conditions on the fuel that can be burned; monitoring and reporting requirements; conditions to achieve control of noise emissions; and energy efficiency.
The Environment Agency would then regulate the plant by: requiring continuous monitoring of the main pollutants for which limits are set and periodic monitoring of other substances; making regular announced and unannounced inspections; investigating non-compliance with any condition of the permit, and taking enforcement action if needed, including by issuing notices, prosecuting serious breaches or, potentially, revoking the permit.
The hon. Member for Stretford and Urmston also raised her concern about data suppression. There are absolutely extraordinary powers in that regard, so regulatory bodies such as the Environment Agency can be absolutely certain that nothing was being suppressed. That is an integral part of the process, and we believe that the monitoring of these issues is central. We also believe that if there is to be public acceptance of the green agenda, which we are very keen to pursue, the public must believe that standards will be rigorously enforced.
Sheila Gilmore: One of the difficulties for local communities is that this is a highly technical area, and a lot of the detail of what is required is also highly technical. I wondered whether the Minister had any proposals about how information on these issues can be made available in an accessible manner to local communities, so that they can judge what is happening. I say that because obviously one of the difficulties is that this area is so highly technical that people feel almost suspicious of what is going on. Are there ways in which public education could be carried out by the Government to assist local communities?
Charles Hendry: The hon. Lady raises an extremely important point. There is a very important role in that regard for the green non-governmental organisations-people who are trusted in this area. I suspect that the power companies would give rise to a question mark, in terms of public trust in the message that they are giving, and I think that the Government come with that health warning, too. The green NGOs therefore have a very important contribution to make, and if their representatives could come to community meetings, put information on their websites or produce materials saying, "We have looked at these issues-the health matters and the environmental issues-and we are satisfied that these plants meet the criteria and can make a positive contribution towards the development of the green, low-carbon economy," that would help to reassure people. However, I will reflect on the hon. Lady's point and see whether there are things that we can do through our departmental website to point people in the right direction towards independent sources of information, so that they can gain the reassurance that the hon. Lady is seeking on their behalf.
I also want to talk about some of the concerns that have been expressed generally about the emissions from biomass waste. Emissions from energy from waste plants have fallen considerably in recent years as a result of the stringent standards that have been applied. Biomass burning actually causes only a small fraction of air quality impacts in the UK; the majority of those impacts are caused by transport.
Studies of the health of communities living in the vicinity of energy from waste plants have failed to establish any convincing link between emissions and adverse effects on public health. Indeed, the latest scientific evidence on the health effects of modern municipal waste incinerators has recently been reviewed by the Health Protection Agency. Its report, published in September 2009, concluded that modern plants that are well run and regulated do not pose a significant threat to public health.
The hon. Member for Stretford and Urmston asked about the future of the work of the HPA. At this stage, a significant amount of work is being carried out by my
ministerial colleagues to ensure that the critical work of organisations such as the HPA will be continued by different organisations. The decision to remove and get rid of some of the public bodies involved in this area does not in any way demonstrate that we do not value the work that they do; rather, it shows that we think that very often that work can be better done elsewhere. My ministerial colleagues are bringing forward clear proposals about how the work of organisations such as the HPA can be continued. Although it is clearly not possible to rule out completely adverse health effects from incinerators, any potential damage from modern, well run and well regulated incinerators is likely to be so small that it would be undetectable.
The hon. Member for Edinburgh East raised the issue of the sustainability of biomass, which I also want to touch on. We believe that biomass that is grown, harvested, processed and transported sustainably can be a very important low-carbon energy source. However, we recognise the critical importance of taking action to ensure that rapid growth in bioenergy does not result in the loss of important habitats, either at home or abroad, or in the release of more carbon than it is saving. That is why we will introduce sustainability criteria to ensure that the biomass power generation supported by the renewables obligation is sustainably sourced. All solid feedstocks used by generators that are above 1 MW capacity will be required to make greenhouse gas savings of 60% compared to fossil fuel and to avoid deforestation or impacts on diverse habitats and high-carbon stock resources, such as peat. Similar standards will be introduced for biomass that is used for heat.
I understand that the proposed Barton biomass plant intends to use waste wood as its main source of feedstock. I am aware that the wood panel industry prides itself on the use that it makes of wood, but there are still considerable amounts going to landfill currently, and we are keen to reduce those amounts. More generally, we think that waste should be considered more as a resource than as the problem that it is seen as today. Too much wood continues to go to landfill, and landfill itself is a blight that affects many communities. Our constituents are rightly concerned about ensuring that the amount of wood going to landfill is reduced, ultimately to nothing. As I say, we must see waste as a resource and, where it cannot be recycled, we must see how it can be reused, including as an energy source. In that respect, we believe that biomass has an important contribution to make.
This has been a constructive and helpful debate. If people in the constituency of the hon. Member for Stretford and Urmston have further issues and concerns, notwithstanding the fact that I cannot comment on individual applications, I will be more than happy to receive correspondence from the hon. Lady or her constituents. However, I hope that my comments have been helpful in putting in context the role that we believe biomass can play in the future, and in outlining the very stringent controls that are in place regarding emissions from, and the health consequences of, biomass.