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30 Nov 2010 : Column 237WHcontinued
I also hope that the Minister can reassure us about something that must be of concern to all of us: the ability of the various partners to continue to play an active part in shoreline management plans. I referred to the Environment Agency and Natural England, but the Department for Environment, Food and Rural Affairs is suffering severe budget reductions, and local authorities will have to make significant reductions as well. I am not talking only about their ability to fund capital works. It is vital that the Minister reassures us about the ability of all the partners to continue to play their part
in the management and maintenance of shorelines and about their ability to ensure that they have the expertise necessary to give advice and support to those who have an interest in the future management of shorelines, because the expenditure reductions taking place in DEFRA, the Environment Agency, Natural England and local authorities undoubtedly could result in the loss of the expertise that is essential to make the partnerships that are inherent in the success of shoreline management plans as successful in the future as they have been in the past.
The Minister of State, Department for Environment, Food and Rural Affairs (Mr James Paice): I shall begin by congratulating, as other hon. Members have done, my hon. Friend the Member for Suffolk Coastal (Dr Coffey) on obtaining the debate. I also congratulate my many other hon. Friends who participated. I apologise to my hon. Friend the Member for Suffolk Coastal for my presence and for the absence of the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Newbury (Richard Benyon). I particularly apologise if she had not been forewarned that he could not be here. He is in Brussels at a Council of Fisheries Ministers meeting. That of course also affects her constituency, so I hope that she will forgive me and understand the change. I hope that she will also accept that my background was very significantly in her constituency at one time, when I was chairman of the local authority. Without getting into the "Whose is best?" debate, I can say that I am very familiar with the parts of the beautiful area to which she referred.
Almost all the hon. Members who spoke were, of course, from the eastern side of England, where the tilt is taking place and where coastal erosion is at its worst. However, I will pick up some of the specific points that were made. Shoreline management plans raise difficult issues and cause anxiety for people who are affected, especially if those plans point to the fact that, as the hon. Member for Leicester South (Sir Peter Soulsby) said, there is some inevitability about change. Sometimes we have to accept that it is not possible to maintain the status quo. That controversy in relation to the plans is also in some ways their strength. Arguably, if we did not have shoreline management plans, we would have to invent them. They were invented by the last Conservative Government in 1994; they predate the "Making Space for Water" project.
The plans provide an opportunity for local authorities at the coast, the Environment Agency and the various other bodies mentioned to explore options for the future with local communities and to clarify what they might expect from Government and what they can do for themselves. We owe it to people to be honest and open about what we can afford. I am concerned that a number of hon. Members have referred to the consultation process and pointed out inadequacies to do with second home owners, or others who may feel that they are affected but were not consulted. The consultation ought to be pretty substantial. It should run for three months, and the local authorities are required to run a range of processes to try to reach everyone, including employing coastal community engagement officers to support them. Clearly, if that is not happening, we need to pursue that,
but it should be the case. I entirely agree with my hon. Friends that no one should feel excluded from the consultation.
When we are examining what we can afford, we must bear in mind the impact that a choice in one place may have on another. That might relate to the community or to the environment. There could even be an impact on coastal erosion, because sometimes if the sea is stopped in one place, it will vent itself in another. There is no doubt-this picks up the point made by the hon. Member for Leicester South-that the Government have fully recognised that flood and coastal defence is a priority. That is why spending on that defence has been largely protected in the spending review. We will be able to invest £2.1 billion over the next four years. We will protect the front-line services, such as forecasting and warning services and incident response, and prioritise the maintenance of existing defences.
It is worth referring to the fact that the threat is changing slightly. Coastal erosion has not changed, but there is now, probably as a result of climate change, an increasing incidence of flash flooding inland. We must also take that into account as part of our overall flood defence programmes. We expect to be able better to protect 145,000 households by March 2015. However, there is no getting away from the fact that times are tough, and it will be difficult to kick off new defence projects over the next couple of years.
I assure hon. Members that the Government are determined to proceed with those projects that are already well advanced. Schemes that are under way will continue and we shall protect the front-line services to which I have referred. However, it will not be affordable or sustainable to maintain the status quo everywhere on the coast, and I do not think that anyone expects otherwise. I entirely appreciate the point made by my hon. Friend the Member for Suffolk Coastal that erosion is permanent. It is a pertinent point for us all to remember, but we must be honest with communities about what can and cannot be done, and provide them with sufficient information to make decisions for themselves. A generation or more of politicians in different Governments have probably given assurances about coastal defences that we have not been able to live up to, and perhaps we need to be more honest. The idea that we could always hold the line on the whole of our coastline in perpetuity was probably wrong from the outset.
I fully take the point about the need to inform homeowners about what might happen to their properties, and also the point that several hon. Members have made about the impact on agricultural land. I shall return to that in a moment. However, it does not make sense do things to manage erosion or flooding in one place without regard, as I said earlier, to the impact elsewhere. Nor is it right to give people the impression that the Government-and only Government-will pay for defences, or that they will pay for those defences if there are no realistic prospects for them.
That does not mean that people cannot take measures to protect themselves with the support of the relevant authorities. My hon. Friend the Member for Suffolk Coastal referred to the visit of my hon. Friend the Under-Secretary, and to work in her constituency at Bawdsey, Thorpeness and elsewhere, where a local initiative
has created the means of self-help in erosion prevention. The coast has always been changing; my hon. Friend referred to a map suggesting that Cambridge could become a coastal town, and I can tell her that it once was. Much of my constituency, which is to the east of Cambridge, would not be there had it not been for flood defences. It probably would not be there if we had had to get planning permission for them, either, but never mind. There are villages in my constituency called Waterbeach, Landbeach and Reach-all names that show they were once on the coast. Some things come around again; though I hope they will not do so in my lifetime.
I want to respond to points made by hon. Members. My hon. Friend the Member for Newton Abbot (Anne Marie Morris) referred to issues affecting her patch, including the integrity of the sea wall and the railway line to Dawlish-which I, too, would like protected; it is a wonderful rail trip, and I am glad that that the Under-Secretary of State for Transport, my hon. Friend the Member for Lewes (Norman Baker), is supportive. My hon. Friend discussed Dawlish Warren and the fact that there is a hold-the-line defence until 2025, when the policy will be mixed. That gives me the opportunity to make the point that shoreline management plans are not cast in stone for ever and a day. There is an opportunity to review them every five to 10 years, so changes can be made, to reflect new local priorities or countless other occurrences. I understand my hon. Friend's comment about the question of who is paying, with respect to the Exe estuary, and will draw it to the attention of my hon. Friend the Under-Secretary.
My hon. Friend the Member for Maldon (Mr Whittingdale) represents another area where I spent much of my earlier life-though reaching the heights of chairmanship of the county NFU is something that eluded me.
Mr Whittingdale: I was at a meeting and saw my hon. Friend's name in impressive gold letters on a board a few weeks ago, so he is clearly held in high regard.
Mr Paice: I am very grateful for that. I think that my hon. Friend will find that I was chairman of Essex Young Farmers, rather than the National Farmers Union. In those days, believe it or not, I was young. My hon. Friend also referred to the 1953 floods and the memories of them. I am probably one of the few people in the House who remembers them-just. I was a very small child at the time, living just outside Felixstowe. The flood came close to where I was living and it was horrendous. That sort of memory lives on. People will always be frightened if they have been through that awful experience.
My hon. Friend referred to the importance of agricultural land. As a Minister with responsibility for agriculture, and coming from such a background, too, I am very concerned about it. However, I accept that against someone's home, it comes second; we must all realise that. I hope that the point I will come to in a minute about other Government proposals will reassure colleagues that it is something that we are trying to address, albeit in a different way. I take his point about the involvement of local landowners in shoreline management plans and I am very much aware of the work of Andrew St Joseph in trying to drive that forward and in generating dialogue.
My hon. Friend and one or two other hon. Members referred to the role of Natural England. Although it has a vital role to play, it is important that it adopts a more enabling and supportive role and that it recognises that other issues are involved. We are making some substantial changes to the way in which Natural England is organised and run, which I hope will make it more responsive to local needs and understanding, and I am happy to give my hon. Friend that assurance.
My hon. Friend the Member for Maldon also referred to the difficulty of landowners in doing maintenance work. I am not sure whether that happens just in his constituency, but an Essex farmer, who had better remain nameless, told me that he was given permission by the Environment Agency to do some maintenance work on the sea wall, which involved several hundred tonnes of stone. Natural England then came along and told him that the stone had to go in by helicopter, which stopped the process in its tracks.
Mobile homes, to which a number of hon. Friends referred, are included in the cost benefit analysis, although at a lower rate than a fixed building because they can be moved. My hon. Friend the Member for Lancaster and Fleetwood (Eric Ollerenshaw) referred to the issue of consultation and to the apparent priority of the habitats directive, which allows projects to go ahead, even where damage to protected sites is foreseen as a consequence. Projects that damage European protected sites can still go ahead if there are imperative reasons for overriding that public interest or if there are no alternative solutions and if necessary compensatory measures are in place.
The issue of how cost benefits are calculated, to which my hon. Friend also referred, are addressed on the DEFRA website. I will write to him with more detail, because I fully appreciate that people have a right to know. My hon. Friend the Member for Great Yarmouth (Brandon Lewis) referred to the solidarity fund promoted by the hon. Member for North Norfolk (Norman Lamb). I know that the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Newbury, is, in principle, supportive of that, but it is a matter for local people to take forward. Although the comments from my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart) cover a devolved issue, I appreciate his point about the liability aspect.
As the hon. Member for Leicester South said, no two places on the coast are the same, which is one reason why greater local involvement is necessary if we are to get this job right. The powers of consent for work rest with the local authority, except where there are certain European obligations to achieve, and then the powers rest with the Secretary of State. The House is aware that the coalition Government are determined to be the greenest Government ever, and that includes protecting and enhancing the natural environment. None the less, we need to be more creative in the way in which we serve those interests as well as meeting our international obligations and protecting agricultural land wherever possible.
Greater local involvement is at the heart of the Government's proposed "payment for outcomes" funding approach, which we launched for public consultation last Wednesday, alongside the joint consultation with the Environment Agency of the national flood and coastal erosion risk management strategy. The consultation
suggests changes to the way in which Government funding is allocated to flood and coastal defence projects. That follows recommendations by Sir Michael Pitt in his review of the 2007 flooding. The reforms aim to provide improved transparency and greater certainty over potential funding levels from the general taxpayer for every flood and coastal defence project. They will also allow local areas to have a bigger say in what is done to protect them. Over time, local ambitions on protection no longer need be constrained by what national budgets can afford, and the reforms will encourage innovative, cost-effective solutions in which civil society can play a greater role. This is about saying what the Government think the cost-benefit analysis is and, therefore, what funding might be available from Government. If that is not enough to do the work, the local community has the option to find funding to enable it to happen.
Dr Thérèse Coffey: One of the criticisms that sometimes comes out is about over-engineering and, therefore, the high costs of work. That is a constant refrain from landowners who believe that they could do a lot of the work at a much lower cost.
Mr Paice: I am grateful to my hon. Friend; she makes a point that has been made many times. I know that the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Newbury is conscious of that issue and is working with the Environment Agency to see how we can alter the situation, which I do not think necessarily means reducing the specification of what is done. I am grateful to my hon. Friend for raising the matter.
The proposals to which I have just referred are subject to consultation and final decisions will be made in the spring after the consultation closes on 16 February 2011. I hope that this will mark a significant step forward in how we go about things. I think I have referred to most of the issues that hon. Members raised; if I have not or if I have answered their concerns inadequately, perhaps Members could let me know.
Sir Peter Soulsby: I referred, at the conclusion of my remarks, to the loss of staff and expertise from Natural England, the Environment Agency and local government. The Minister referred to the role of Natural England as enabling and supporting Government. Will he provide reassurance that the Department is aware if that role is to be played, Natural England needs experts to offer the support that is fundamental to making a success of the plans?
I cannot give the hon. Gentleman assurances about individuals for obvious reasons. Although, as he says, we are making significant savings across all the arms-length bodies, and within DEFRA, there is no reason why they should not retain the element of expertise to which he refers. We are trying to ensure that those arms-length bodies retain the ability do what they have to do and what Government need them to do, which includes giving scientific advice. Natural England is, after all, the statutory adviser to the Government on such issues, and it will retain that role. Where there are functions that the private or third sector can perform, we should try to make that happen. I know that the hon. Gentleman is not suggesting otherwise, but those bodies have taken their fair share of the reduction in
funding that we have had to make as part of dealing with the overall public deficit. I hope that I have addressed most of the issues raised by hon. Members, but if not, I am happy to write to anyone who wishes to raise an issue with me.
Pat Glass (North West Durham) (Lab): Breast Cancer is the UK's most common cancer. It affects thousands of families every year. Almost 48,000 people were diagnosed with breast cancer last year: 47,000 women and 277 men, and 125 women will be diagnosed with breast cancer today. Breast cancer incidence rates among women have increased by 50% over the past 25 years-5% in the past 10 years-and, because of lifestyles changes such as increased obesity and drinking in young women, those incidence rates will continue to rise, particularly for those under 50. Eight in 10 breast cancers diagnosed are in women aged 50 or over, but that means that two in every 10 are diagnosed in younger women, who may have young families. For young women the disease can be particularly virulent and aggressive, and the chances of survival are less good as a result.
Ian Lavery (Wansbeck) (Lab): Does my hon. Friend agree that the time between the mammogram and the results is critical, and that the length of that period depends on the area and district a person lives in and the hospital they attend? It could be between a week and up to four weeks, depending on the hospital, which could mean the difference between life and death. At the same time, those with money have the opportunity to have a mammogram in the morning and receive the results in the afternoon.
Pat Glass: That is incredibly true. I am particularly concerned about young women, and in many cases the younger they are, the more virulent the disease is and the chances of survival are less good as a result, so that is particularly crucial. Every family in this country will be touched by this awful disease. Within my family, four close relatives have died of breast cancer in recent years, all aged well under 50; and a cousin, also under 50, is currently battling the disease for a second time.
However, it was an inspirational woman, Trish Greensmith, who runs the Chyrelle Addams breast cancer appeal trust in my constituency, who first brought home to me the number of young women who are being diagnosed with, and having to fight, breast cancer today. She told me that when she first visited an oncology clinic she was struck by the number of young women in the waiting room-young women who were trying to deal with virulent and aggressive cancers while bringing up young families. Under the current system, they would never be offered the opportunity for routine screening, which might have detected their cancers early and saved their lives. More women are surviving breast cancer than ever before, and the survival rates have steadily improved over the past 30 years, but 12,000 women and 70 men in the UK died from breast cancer last year.
Alex Cunningham (Stockton North) (Lab):
I congratulate my hon. Friend on securing this important debate. Few people will not have a friend or relative who will suffer from breast cancer and who would benefit from earlier diagnosis and improved information. I understand that Cambridge university has developed a computer programme called "Predict", which allows any patient-or doctor-to go online and enter their symptoms and the kind of cancer they have, and it will predict their life
expectancy and the likelihood of survival. Does my hon. Friend agree that that would be another useful tool to help inform and reassure women and men who are diagnosed with breast cancer?
Pat Glass: I am aware of the "Predict" computer system, which is an incredibly useful tool in the hands of clinicians, but I do not think it should be generally available for people to use in their own homes to calculate, using their symptoms, how long they have to live. I think they would find that very worrying. However, it would be incredibly useful for their doctor.
Of the women who died last year from breast cancer, 1,300 were under 50 years old. We know that women with a mother, sister or daughter who have been diagnosed with breast cancer have almost double the risk of being diagnosed themselves. We know that the risk increases with the number of first-degree relatives diagnosed, but even so, eight out of nine breast cancers occur in women with no family history of cancer whatsoever.
Natascha Engel (North East Derbyshire) (Lab): A woman in Derbyshire, Wendy Watson, runs the national hereditary breast cancer helpline. What is my hon. Friend's view on getting national funding for that helpline, which is a lifeline for many women suffering from hereditary breast cancer?
Pat Glass: I am aware of Wendy and the fantastic work she does; I also know that she is struggling to secure funding. Perhaps the Minister might look at that as a result of today's debate. I thank my hon. Friend for making that point.
We know that obesity presents a risk, as do hormone replacement therapy and the use of oral contraceptives. In the binge capital of Europe, we are now told that as little as one alcoholic drink per day increases the risk of breast cancer by about 12%.
Neil Carmichael (Stroud) (Con): Breakthrough Breast Cancer, which is an excellent organisation, has rammed home the point that awareness is important and that we should all do all we can to remind women of that. We should make women aware that they need to be aware.
Pat Glass: I absolutely agree.
Going back to the risk factors-obesity, HRT, oral contraceptives and alcohol-all of them are likely to affect women under 50 more than women over 50, and yet women under 50 are not routinely offered screening of any kind. About 1.5 million women in the UK are screened for breast cancer each year, and we must congratulate those involved in the routine screening programme on the many lives they save. The previous Government extended the screening programme so that from 2012, all women aged 47 to 73 will be invited for routine screening. That extension will save many more lives, but it will do nothing to help identify breast cancer in younger women.
Concerns have been expressed that wider screening could lead to over-diagnosis, but recent research is showing that the benefits of mammographic screening in terms of lives saved are greater than the harm caused by over-diagnosis. Those same arguments about over-diagnosis were used in the past to argue against extending screening for womb cancer and cervical cancer, but the
response to those arguments has always been that it is better to be safe than sorry, and that, in the case of breast cancer screening, between two and two and a half lives are saved for every over-diagnosed case. Despite that, however, women under 50 are not currently offered routine screening.
It is also argued that film mammograms are not as effective for pre-menopausal women as for post-menopausal, as the greater density of breast tissue in pre-menopausal women makes it more difficult to detect problems. That is absolutely right. Screening of women under 50 may not be as effective as screening of women over 50, but it can still be effective, certainly in the absence of any other screening programme.
It is also argued that routine screening of women under 50 is not necessary, because the incidence of breast cancer is lower in that age group. I would say, "Tell that to the hundreds or thousands of young women battling this disease", who say that any arguments about numbers are outweighed by the increased virulence of the disease in the young.
We are told that, because breast cancer is less common in women under 50, research trials have shown that regular screening of young women does not help to save lives. It is even argued that in other trials, regular mammogram screening is more of a risk than not screening. However, I say to the Minister, "Tell that to the young women currently undergoing chemotherapy".
It is absolutely clear that mammogram screening is most effective among women who have gone through the menopause, but recent research shows that it can also be effective among those aged 35 to 50 and that, despite all the counter-arguments, there is now increasing evidence that there are significant gains to be made by routine screening of women from the age of 35 upwards.
Grahame M. Morris (Easington) (Lab): I compliment my hon. Friend on securing time for this important debate. On routine screening and the value of targeting a particular age group, I, too, have received information from Breakthrough Breast Cancer-an excellent organisation-pointing out that 1,400 lives a year are saved by routine breast screening. However, Breakthrough Breast Cancer also says that any woman aged 70 or over is not routinely invited to attend for breast screening. It may well be advantageous, in terms of improving the health outcomes of those women, if a screening programme targeted them, too, in view of the high incidence of breast cancer among post-menopausal women.
Pat Glass: I thank my hon. Friend for that intervention.
I ask the Minister to consider the arguments that have been put forward and the increasing weight of medical evidence calling for routine screening from the age of 35 onwards. In his response, I ask him not to pull out the one argument that the coalition Government seem to have for everything: that there is no money. If we could set aside £9 billion last week to build more trains to make commuting more comfortable, surely we can consider routine screening. If we can find £9 billion to lend to the Irish in their hour of need, surely we can find the money to save young lives.
I understand that the Minister is unable to announce that routine screening for breast cancer will start tomorrow, but he could consider a long-term plan-over five years,
for example-to reduce the age of screening to 45 in year one, 42 in year two, 40 in year three, 38 in year four, and to 35 within five years. Such a policy would be universally welcomed and could save precious lives.
I am aware of the Breakthrough Breast Cancer campaign. In particular, it seeks early breast screening for women from the age of 35 where there is a history of breast cancer. We must learn lessons from the highly successful cervical cancer screening programme. Early intervention is cost-effective-it saves the country money in the longer term, and it saves lives.
The Minister of State, Department of Health (Paul Burstow): It is a delight to serve under your chairmanship, Mr Betts, and I congratulate the hon. Member for North West Durham (Pat Glass) on securing this important debate. As others have said, it is important that we do everything possible to increase awareness of breast cancer so that people are more aware of signs and symptoms and are able to present themselves at an earlier time and thus make the chances of survival much greater. I also congratulate the hon. Lady on the work that she does in raising funds and increasing awareness of the issue, as she has done today. I note the personal experience that she draws on.
Around 40,000 women a year are diagnosed with the disease-that is a third of all cancer diagnoses in women. The hon. Lady made a good speech setting out a powerful case that needs proper consideration. It is a shame that she made the point about Ministers trotting out certain lines about coalition funding and so on, as that added nothing to the debate. I was certainly not intending to go down that line because I want to try to give a substantive response to her remarks.
Breast cancer can strike women of all ages, although a person's risk of developing it rises dramatically after middle age, with cases peaking among women in their early 60s. The prognosis for a person with breast cancer has transformed over the last 40 years. It has gone from a consistently lethal killer, to the second-least deadly form of the disease, if judged by five-year survival rates.
The NHS breast screening programme has played a major part in that success. Since it began in 1988, the programme has made a huge difference to a woman's chances of surviving breast cancer. Around 83% of all women with breast cancer are still alive five years after diagnosis, and among those whose cancer is detected through screening, that survival rate increases to over 96%. That is a striking demonstration of the power of detecting cancer early on-that point has rightly been made in the debate-and that is why we will make earlier detection a key part of our forthcoming cancer reform strategy.
Experts believe that the current breast screening programme saves 1,400 lives a year among the 50 to 70-year-old age group on which it focuses. That point was made by the hon. Member for Easington (Grahame M. Morris). Therefore, the hon. Lady asks a fair question about whether there is scope to widen the net and whether that would be appropriate. Should we be looking to extend the programme to cover other age groups?
Under the current programme, women aged between 50 and 70 are routinely invited for screening, and women over 70 can request to be screened every three years. The hon. Lady suggested that women as young as 30 should be invited for screening. When it comes to health care, our priority is simple-to have outcomes that compare with the very best in the world. We will achieve that by handing power to front-line professionals and basing decisions on the best available evidence. That is where there is a debate. I am interested and I listened carefully to what the hon. Lady said about the emerging evidence. However, when it comes to extending screening to all women older than 30, as far as I can see, the evidence is not there.
Pat Glass: May I just clarify that I am talking about women between the ages of 35 and 47 rather than 30? That is the point at which screening would be most helpful.
Paul Burstow: I am grateful to the hon. Lady for that clarification. In 2006, the Institute of Cancer Research published the results of a 15-year study of the benefits of screening women from the age of 40. The study invited about 53,000 women to receive annual breast cancer screening over nine years and then compared them to a control group of women who received standard NHS treatment. The study found that the reduction in deaths due to screening was not statistically significant. I understand that, for the individual, it is 100%; I understand the hon. Lady's powerful point. She might say that, if such measures save a single life, they are worth doing. However, the study pointed out, as she seemed to guess, that early screening had significant disadvantages. Almost one in four women in the study had at least one false positive, with all the resulting distress, anxiety and unnecessary follow-up, including invasive biopsies. Currently, there are about 7 million women aged between 30 and 49 in England. I accept that she wants to screen from 35 onwards, but if the take-up rate among that population were 75%, we would be screening about 5 million more women a year. Even if the minimum age were 35, it would create the issue of false positives.
Ian Lavery: Does the Minister agree that there is still a huge diagnosis problem, involving the time between mammogram and results, based on what is classed as a postcode lottery? We need to look at that and ensure that each patient, regardless of wealth or where they reside, gets her mammogram results within days, not weeks.
Paul Burstow: Yes. It is entirely right for the hon. Gentleman to make that point. That is why this Government will publish the first ever NHS outcomes framework, which will focus much more clearly on how we ensure that the system delivers the right outcomes in terms of cancer survival. We will publish that shortly, along with a new cancer reform strategy in due course that will say even more.
The Government's view at present is that the risks of the change proposed by the hon. Lady outweigh the benefits. However, I want to ensure that the evidence that she has discussed is properly evaluated by officials in the Department. We will consider those points and her representations carefully, and I will write to her after we have had an opportunity to do so. However, the
Department's view and the Government's view about maintaining the status quo is shared by most countries in Europe, as well as the Council of Europe, which recommends a breast cancer screening age of 50 to 69. The United States recommends screening every two years for women aged between 50 and 74. The position that this country has adopted for a considerable time is based on international practice and the best available evidence. One must be open to changes in evidence; that is important in an evidence-based approach to developing policy.
Grahame M. Morris: On best practice and targeting available resources, the figures suggest that in some areas, as many as one third of women within the target group aged 50 to 70 do not attend routine screenings. There are various reasons for that. It might have to do with misconceptions about the nature of the screening test. In some urban areas, it might have to do with the fact that there is a large transient population. In my area, where we also have the problem of people failing to turn up for routine appointments, they may be reluctant or poorly educated, or a number of-
Mr Clive Betts (in the Chair): Order. Interventions are meant to be brief.
Grahame M. Morris: I apologise. The Minister will see the point that I am trying to make.
Paul Burstow: I understand fully. Today, the Secretary of State will make a statement in the House setting out this Government's new commitments on public health and the clear lines that we are drawing on tackling health inequalities. Some of the issues clearly involve a social gradient that we must address, and we will address them in our new cancer reform strategy and public health White Paper.
Pat Glass: I appreciate what the Minister says about considering new evidence. Will he also take into account-this relates to the remarks by my hon. Friend the Member for Easington (Grahame M. Morris)-the issues that affect younger women and the cohort that those younger women are likely to come from? It is about obesity, hormone replacement therapy and alcohol. It is younger women from low socio-economic backgrounds who are likely to be hit hardest by those things.
Paul Burstow: I am grateful for those points, and I am coming to them, which is why I was smiling-it was not because of the subject, which is very serious.
Let me talk briefly about partial age extensions, which is another issue worth airing. The last cancer reform strategy committed the Government to extending the NHS breast screening programme to women between the ages of 47 and 73. Beyond 73 years of age, patients would still be able to self-refer. That extension will ensure that all women are invited for screening before their 50th birthday. The June revision to the NHS operating framework confirmed that the extension will begin this year-in 2010-11. By the end of March next year, we expect 60% of screening programmes to be screening that wider age group, and we obviously want to go as far and as fast as we can.
Our updated cancer reform strategy will focus on outcomes and on improving cancer survival rates. Although the one-year and five-year survival rates have improved in recent years, we still lag behind other European nations. If we could match the five-year survival rates of the best countries in Europe, we could save up to 10,000 lives every year in England. As has been said, therefore, early diagnosis is essential. In September, I announced funding for a new £9 million campaign to get people to recognise and, importantly, to act earlier on the signs and symptoms of cancer. We are talking not so much about a campaign as a series of 59 local campaigns, which will focus on the three big killers: breast cancer, bowel cancer and lung cancer. The campaigns will raise public awareness of symptoms and encourage people to talk to their GP at the earliest possible opportunity. We will target those populations that the hon. Member for Easington talked about, which are often harder to reach.
Our approach will also encourage GPs and others in primary care to act appropriately. The tragedy of these cancers is that they are preventable. As has been said, lifestyle-eating too much, drinking too much and not getting enough exercise-plays a big part. That is why the coalition is determined that public health will become a far more important part of overall public policy and practice nationally and locally. We will make sure that we treat and prevent cancer in that context. That is why we will, as I said, publish a White Paper later today to set out how we will provide the right leadership and the strategy to improve people's lifestyles and to reduce their risk of getting cancer in the first place.
Natascha Engel: Will the Minister briefly outline his opinion regarding national funding for the hereditary breast cancer helpline? It is a national service and it needs national funding, but the Department of Health has said that it is more appropriate to fund it locally. This incredibly important service provides information and advice and helps women up and down the country. What does the Minister think needs to be done about it?
Paul Burstow: I am grateful to the hon. Lady, and I certainly pay tribute to the work that the helpline does, but it is important to stress that NHS organisations and commissions are responsible for such funding, so it is perfectly possible for them to collaborate to make the resources available.
The hon. Lady rightly refers to inherited cancers. It is perhaps important to stress that about 5% of women will contract breast cancer simply because it runs in the family. National Institute for Health and Clinical Excellence guidance published in 2004 recommends that women with a moderate or higher risk of familial breast cancer should receive annual screening. However, across the NHS, delivery is patchy, and we have heard examples of that patchiness in the debate. Women deserve better than that; they deserve a consistent service wherever they happen to live. For that reason, the NHS breast screening programme will soon take responsibility for ensuring that familial screening is regularly and routinely carried out.
In conclusion, I very much respect the points that the hon. Member for North West Durham has made, the passion with which she delivered them and the commitment that she clearly has to improving our ability to detect
these cancers early and prevent them. We must do everything we can to improve survival rates and to improve the quality of life for those living with cancer. We will do that by focusing resources on what works and where the evidence demonstrates the risks are outweighed by the benefits. In this instance, the evidence at the moment is clear: extending annual breast cancer screening to all women over the age of 35 would not improve their chances of surviving the disease. However, it would mean that we would need to ensure that we did not place women in a situation where they felt unnecessary anxiety as a result of false positives. We will always act on best evidence, which is why I make the undertaking to take away the evidence that the hon. Lady referred to. At this time the evidence does not lead us to conclude that there is a case for change. But we will keep it under review.
I thank the hon. Lady for raising these matters today. The Government are determined to achieve the best possible outcomes for people with cancer through our public health strategy and our cancer strategy. We are committed to ensuring that the resources are there to avoid the postcode lottery that some hon. Members described, an inheritance that we are determined to deal with.
Andrew Selous (South West Bedfordshire) (Con): It is a great pleasure to serve under you this afternoon, Mr Betts. I am particularly grateful to Mr Speaker for granting me this debate on the position of Christians in Iraq. It follows on from the very well informed debate initiated by my hon. Friend the Member for Gainsborough (Mr Leigh) almost exactly two years ago on 16 December 2008. At that time my hon. Friend told the House that back in 2003, there were some 1.2 million Christians in Iraq and that that number had been reduced to around 600,000 because of the persecution they had suffered. Sadly, since then things have continued to be even more difficult for Christians in Iraq.
It is worth putting on the record the fact that there have been Christians in Iraq since virtually the time of Christ, when doubting Thomas stopped off in what is now modern day Iraq. There are Christians in Iraq who still speak Aramaic, the language that Jesus himself would have spoken, and the tomb of the Old Testament Prophet Nahum is in Iraq with the inscription from Nahum chapter 3 verse 18:
"Your people are scattered on the mountains with none to gather them"-
words which, unfortunately, have an eerily accurate ring to them for Christians in and from Iraq today.
Last week I met in my office in the House of Commons an outstanding member of the Iraqi Government-the Minister for Human Rights, Mrs Wijdan, who is herself a Chaldean Catholic, and Canon Andrew White, the Anglican vicar of St George's in Baghdad. Andrew is a long-standing friend and one of the most inspirational Christian leaders I have ever met. I learnt from Canon White that in this month alone more than 100 Christians have been killed in Iraq, and 58 were killed in one massacre during evening mass in the Syrian Catholic church of Our Lady of Salvation in Baghdad on 31 October. Since that atrocity many more Christians have also been targeted, blown up or told that they no longer belong to Iraq and should leave now or be executed. This violence has gone on for many years.
Back in August 2004 there was a series of bombings targeting five churches, and 11 people were killed. In October 2006 an Orthodox priest, Boulos Iskander, was snatched in Mosul by a group demanding ransom. Despite payment of the ransom, the priest was found beheaded, with his arms and legs cut off. In June 2007 Ragheed Ganni, a priest and secretary to Archbishop Paulos Faraj Rahh, was shot dead in his church along with three companions. In January 2008 bombs went off outside three Chaldean and Assyrian churches in Mosul, two churches in Kirkuk and four in Baghdad. In February 2008 the Chaldean Catholic Archbishop, Paulos Faraj Rahh, was kidnapped. His body was found in a shallow grave two weeks later. In April 2008 Father Adel Youssef, an Assyrian Orthodox priest, was shot dead by unknown assailants. In February 2010 at least eight Christians died in a two-week spate of attacks in the northern city of Mosul. So it is a pretty sorry state of affairs.
I am well aware that Iraq is still in the process of forming a Government, some eight and a half months after its general election earlier this year. I would request,
however, that both British and American Ministers raise these issues with the newly appointed Iraqi Ministers as soon as they can after the formation of the new Government. I also hope that able Iraqi Christian MPs are not held back from Government positions merely because of their faith. When I met Mrs Wijdan last week, she told me that a lot of her requests were very practical ones to do with preventing terrorists from outside Iraq entering her country to kill and injure. She also requested help with counter-terrorism and intelligence to prevent such future atrocities.
I have concerns about aspects of the Iraqi education system regarding what is taught about minority faiths in Iraqi schools. Canon Andrew White told me last week that children in his church are being abused at school because they are Christian, and we know that when such prejudices are taught to the young, they can be very hard to shift. I am of course conscious of the recent media reports that some part-time schools in the UK have textbooks that inflame religious prejudice, so we should acknowledge these issues in our own country as well.
In the debate two years ago on this subject, there was discussion of the possible formation of a 19th province in the Nineveh plains, where there would be a Christian majority which would have control over the police and local militia. It is not for foreign countries to advise Iraq how to organise its internal affairs, but I hope that a major middle eastern country such as Iraq can do better than to opt for any form of segregation or ghettoisation of different faiths. I was impressed by the views of Yonadam Kanna, a prominent Member of the Iraqi Parliament, who is a Christian and was reported on the BBC as saying:
"This is our home, we have been together with Muslims for centuries, this is our destiny, and we will stay together".
Mr Edward Leigh (Gainsborough) (Con): I obtained a debate on this subject two years ago because, as my hon. Friend knows, I visited Iraq and went to the tomb of Prophet Nahum. More importantly for the purposes of the present debate, I heard some heart-rending stories from mothers who had lost children and husbands. We have a responsibility in this country because, for all Saddam Hussein's horrendous faults, there was some sort of protection for the Christian community in Iraq. We invaded Iraq and since then the situation for Christians has become deplorable, frightful and murderous. Our Government have some responsibility with respect to the 19th province to make representations and encourage the Government of Iraq to protect that ancient Christian community.
Andrew Selous: I am grateful to my hon. Friend who has gone one better than me in going to Iraq and seeing things for himself. I was able only to meet an Iraqi Minister last week, in Parliament. I bow to my hon. Friend's experience, and thank him for his presence here and his continuing interest in the subject.
Some foreign countries, and Iraqis in exile, have called for greater provision to be made for Christians in Iraq to leave and settle overseas. Again, the view of Canon Andrew White and his congregation at St George's, Baghdad, is that they wish
"to stay and to be safe"
where they are. That should not be too much to ask for. One issue of concern is the fact that traditionally, churches have been protected by Christian police and military personnel in Iraq. As the persecution of Christians has intensified there have been fewer Christian police and military personnel, at a time when they are most needed. The new Iraqi Government will need to examine that issue, to ensure that all minority communities can be protected, even when there are dwindling numbers of police and military personnel from the faith concerned.
An initiative that has done a lot of good in recent years in promoting tolerance and dialogue between the different faiths in Iraq is the High Council of Religious Leaders in Iraq. It was funded by the United States but I understand that the funding has been stopped. Denmark has now agreed to continue funding the group. Parliament should pay tribute to the Government of Denmark for stepping in to provide funding for that organisation. One of the fatwas produced by the group said:
"Therefore religious and ethical duty calls us as Shia and Sunni religious leaders to announce that all killing must be stopped now whatever the reasons and the cause and the motives between Muslims. We must start reconciliation and tolerance and make them the only way to solve the conflicts between the brothers in our country."
It goes on to urge all people of faith in Iraq
"to reject and forsake all violence, killing and provocation"
"achieving peace and living together under the rule of law is the demand on all Iraqi people and is the religious and ethical duty of everybody to abandon all violence."
I am sure we would all say amen to that.
In the debate two years ago concern was also expressed about Christian-owned land being taken in the Kurdish north of Iraq. The then Minister of State at the Foreign Office said that he would
"endeavour to discuss it with him"-
the Kurdish regional Government Minister for extra-regional affairs-
"at the earliest opportunity."-[Official Report, 16 December 2008; Vol. 485, c. 44WH.]
Sarah Newton (Truro and Falmouth) (Con): It is excellent that my hon. Friend has secured the debate today. Does he agree that it was a very brave commitment by the coalition Government to maintain levels of funding for overseas aid? Does he also agree that the stated intention of helping post-conflict areas of the world to build tolerant, sustainable communities is a vital aim, and that the Government could be looking at the situation in Iraq with a view to investing resources to ensure the safety of the Christian community there and help them in their larger role of building a peaceful and sustainable Iraq?
Andrew Selous: I thank my hon. Friend, who makes an excellent point; I hope my hon. Friend the Minister will take it back to his colleagues at the Department for International Development to see what can be done. I would be grateful to hear from him whether such conversations with his predecessor took place, and what the result of them was. It would be good to understand how the British Government intend to handle the future protection of all minorities, including that of Christians in Iraq.
We who sit in this Parliament have the immense privilege of having a voice in the mother of Parliaments. It is our duty to use our voices to speak for those who are suffering for their faith in Iraq.
Ian Paisley (North Antrim) (DUP): Has the hon. Gentleman had any discussions with the British Council, which has done similar work in other conflict areas in promoting tolerance and trying to get a greater understanding of diversity, about what it can do in Iraq? Would he welcome that mechanism as a way in to Iraq to promote Christianity?
Andrew Selous: I am grateful for that intervention, which builds very helpfully on the point that was made earlier. I do not know the exact position of the British Council in Iraq. I raised that question with Canon Andrew White when I met him last week. I will leave the hon. Gentleman's question on the table, as it were, and if the Minister can pick it up in his response, that would be helpful. The hon. Gentleman is right to pursue that line of argument and I am glad the Minister has heard what he had to say.
Whatever our views on the war in Iraq-there are people in this Chamber today from both sides of that debate-there is no question but that this country has an ongoing responsibility and obligation to the people of Iraq and the Christian minority within it. They need to know that they are not alone. Even though our forces on the ground have stopped fighting, we must show that we have not forgotten them and that we have a continuing obligation. I am incredibly grateful to colleagues today for supporting this debate. We have made it clear to our Christian brothers and sisters in Iraq that we stand with them, and that we will continue to ask these questions of our own Government and of the international community.
In its quest to improve human rights around the world, the United Nations has produced for Governments, in relation to the suffering of their own peoples, a new doctrine of responsibility to protect. What engagement have the British Government had with the United Nations and other international organisations to undertake the hard and difficult work of reconciliation and of instilling tolerance, to ensure that these ancient peoples who have lived together in peace for many centuries can do so again, and that Christians are not forced to flee Iraq and many other parts of the middle east? I look forward to the Minister's reply and thank him for his time this afternoon.
The Minister of State, Foreign and Commonwealth Office (Mr Jeremy Browne): I am grateful to have this opportunity to respond to this important debate. I pay tribute to the many Members who have attended and contributed. By so doing, they have indicated and demonstrated their interest in this important matter. I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on securing this debate. He raises an important issue that enables me to set out not only the Government's policy towards the protection of Christians in Iraq but our firm position against religious persecution worldwide.
Let me start by saying that the Government utterly condemn all attacks against Iraqi citizens, including Christians and other minority communities. We were appalled at the attack on the Our Lady of Salvation church in Baghdad on 31 October, which killed more than 50 people. The further attacks on 10 November targeted mainly Christian areas across Baghdad, killing six and wounding more than 30 people.
On 1 November, the Under-Secretary of State for Foreign and Commonwealth Affairs, my hon. Friend the Member for North East Bedfordshire (Alistair Burt), spoke to Canon Andrew White, the vicar of the Anglican church in Baghdad, St George's, to express his sadness about the attacks on Christians and the need for all religious minorities to be resilient in the face of such violence. He also issued a statement on behalf of the Government, which I think is worth briefly quoting from. He said:
"I utterly condemn the attack against Our Lady of Salvation Church in Baghdad. My thoughts are with the families and friends of all those that have been killed or injured in this tragic event. I urge the Iraqi authorities to do all they can to bring to justice those who are responsible for this attack on innocent worshippers, and all Iraq's politicians and diverse communities to work together to tackle the threat of violent extremism."
That is the position of the British Government. We remain in close contact with the Iraqi Government and we are committed to doing all we can to support them where possible.
On 10 November, my right hon. Friend the Foreign Secretary met the visiting Iraqi Minister of Foreign Affairs, Mr Zebari, and he specifically raised the issue of Iraqi Christians with him. Mr Zebari acknowledged that the protection of Christians was the Iraqi Government's responsibility.
My right hon. Friend and colleague the Prime Minister also discussed the attacks on Christians in Iraq, as well as the wider security situation, in a phone call to Iraqi Prime Minister al-Maliki on 15 November, just two weeks ago. The Prime Minister made it clear that the Iraqis had the UK's full support and in turn Mr al-Maliki expressed his concern at recent developments in his country. Mr al-Maliki said that the Iraqi Government were doing everything possible to tackle the terrorist threat and that UK support-including support for efforts to persuade Christian minority groups to remain in Iraq, which is an issue that has been raised in this debate-would be most welcome.
During a visit to the Our Lady of Salvation church on 9 November, Mr al-Maliki said his Government worked for
"justice and equality among all citizens, noting that Christians are part and parcel of a civilization all Iraqis are proud of."
I was encouraged by the emphatic nature of the Iraqi Prime Minister's statement with regard to Christians in Iraq and the part that they have to play.
I noted the comments by my hon. Friend the Member for South West Bedfordshire regarding the dwindling number of Christian police and security guards in Iraq. The Iraqi police service plays a fundamental role in ensuring that Iraq has a strong rule of law that protects all Iraqis regardless of their religious affiliation. We will continue to encourage the Iraqi Government to improve the professionalism of their police and security forces.
My hon. Friend may be aware that the Under-Secretary of State for Foreign and Commonwealth Affairs, who is the Minister with responsibility for Iraq, visited Iraq
between 22 and 25 November. On that visit, he met a number of senior Christian figures and he raised the plight of the Christian community with the Foreign Minister, the new Speaker of the Council of Representatives, and the President and the Prime Minister of the Kurdistan regional government. The central Government in Iraq are taking responsibility for improving security for Christians, while the Kurdish leadership offered protection to Christians coming to the Kurdistan region from elsewhere in Iraq.
Mr Leigh: It is not only the appalling violence against Christians in Iraq that is of concern but the constant intimidation and encroachment that they face. I must say that a lot of the problems in northern Iraq come from the Kurdish community. I hope that the Minister, before he sits down, will say something about this "19th province". I know that he probably cannot give a commitment one way or another, but the reason the campaign for a 19th province has arisen is that the Christian community in Iraq feels that it is the only way that it can have some sort of protection, including its own militia and its own legal system.
Mr Browne: I am grateful to my hon. Friend for his intervention and for his long-standing interest in the subject. I hope that he is reassured by the very hands-on interest that the Minister with responsibility for Iraq is taking in this matter, including, as I have said, the number of meetings that he held only a week ago in Iraq to discuss it specifically.
The concern that the Government have about going down the track that my hon. Friend the Member for Gainsborough (Mr Leigh) suggests is that we would not wish to see Iraq divided up into provinces based on religious affiliation. We want Iraq as a whole to be a hospitable country for people of all faiths, which is why my hon. Friend the Under-Secretary made a particular point of meeting representatives of the Kurdistan regional government when he was in Iraq a week ago-it was not with a view to segregating Iraq into different religion-based districts.
My hon. Friend the Member for South West Bedfordshire may know that the Iraqi authorities are carrying out a thorough investigation into the attacks, which has, we believe, led to the arrest in the past few days of individuals who may be linked to attacks against Christians. The Iraqi Prime Minister has called on the armed forces and the security forces to be on maximum alert and to secure mosques, churches and other places of worship.
The Iraqi Parliament-the Council of Representatives -has also been active in calling for the Government to do more. It has formally requested the Prime Minister to issue a statement condemning the attacks and to dedicate more resources to stopping them. It has called for the increased recruitment of Christians into the Iraqi security forces. A parliamentary committee, under the leadership of a Christian MP, has been set up to address the official reaction to the attacks. The British Government regard all those as promising steps in the right direction.
I reassure my hon. Friend that the Government will continue to urge the Iraqi Government to protect all communities, especially vulnerable minority groups, and to prosecute those who are found responsible for any acts of violence and intimidation that are carried out
against people because of their political, ethnic or religious affiliation. As my hon. Friend will know, the UK has also discussed the current security situation in Iraq with EU partners, including at the Foreign Affairs Council on 22 November.
We are encouraged by responses from the Iraqi authorities suggesting that they take this matter very seriously, and we are pleased to see the renewed commitment to protecting all Iraqi citizens, including Christians. Prime Minister al-Maliki has said that his Government are ready to take whatever measures are viewed as necessary by Christian leaders
"to assure all citizens in general and the Christians of Iraq in particular so that everyone enjoys stability and safety".
Some Members attending the debate may feel that it is one thing to express those good intentions, but another to deliver on them, and I accept that. However, the fact that they have been expressed in such emphatic terms is an encouraging development. I also hope that I have been able to indicate to those attending the debate that concrete actions are being taken, and we will continue to try to ensure that they go as far as possible and lead to desirable consequences.
We are aware of requests made by the Iraqi Human Rights Minister, Mrs Wijdan Salim, for support in developing some of Iraq's counter-terrorism capabilities. Where appropriate, we will work with the Iraqi authorities to consider where our support is best applied. However, Prime Minister al-Maliki has publically committed to improving the security situation.
My hon. Friend may be aware of comments from the exiled archbishop of the Syriac Orthodox Church suggesting that Christians should leave Iraq. The Iraqi Christian community has made it clear that emigration is not the answer, and the British Government agree. Christians are one of Iraq's indigenous populations, and all the religious leaders we have spoken with have reiterated that driving Christians from their homes is the goal of terrorists and not one that we should facilitate with offers of asylum.
During his recent trip to Iraq, my hon. Friend the Under-Secretary, who has responsibility for the middle east, met a number of senior Iraqi Christian figures. The clear sense was of a community that was vulnerable and under threat but determined not to allow the attacks to threaten the continued existence of Christians in Iraq. Prime Minister al-Maliki has commented that
"The countries that have welcomed the victims...of this attack"-
"have done a noble thing, but that should not encourage emigration".
At this point, I would like to pay tribute to the work of Canon Andrew White, who has been mentioned in the debate, and other religious leaders. We support initiatives that bring together different faith groups to promote tolerance, and I am pleased to hear that Denmark is supporting such initiatives with funding. I join my hon. Friend the Member for South West Bedfordshire in paying tribute to the Danes for their commitment in that regard.
It is important to remember that Iraq has made a long-standing commitment to protect all its minorities. During the universal periodic review of Iraq carried out by the UN Human Rights Council in February 2010, the Iraqi authorities revealed that minorities, including Christians, had been subjected to grave violations at the
hands of terrorist groups and militias. The Iraqi Government made a commitment to support the rights and freedoms of all minorities, in keeping with the guarantees set out in their constitution, and they restated their commitment to protect religious institutions and places of worship.
Jeremy Lefroy (Stafford) (Con): I am most grateful for the support that the Government are showing on this issue. Does the Minister agree that, in some ways, the actions and words of the Iraqi Government set an example to other surrounding countries about the way that religious minorities should be treated?
Mr Browne: I do up to a point. The level of willingness to respond to the problem, rather than to conceal it, is encouraging. We all share the concerns. There will be hon. Members who are not Christians but who nevertheless share the concerns about the persecution of Christians and other religious minorities in Iraq. We want a country where people are free to practise their faith without interference, and we are keen to work towards that. We are encouraged that the Iraqi Government, and other senior figures within the Iraqi political environment, share that ambition. It would be extremely worrying were that not the case. There are Christians who hold prominent positions in Iraq, including, as I have said, roles in Parliament chairing a relevant committee. The fact that Christians are institutionalised in Iraq and not pushed to the fringes should encourage us. However, as other hon. Members have said, the situation remains far from desirable, and I hope that the progress is in the right direction.
The UK recognises the importance of protecting and defending the rights of religious minorities, not just in Iraq but worldwide. I will conclude the debate with a quote from the Foreign Secretary, which I hope will provide a wider context to our deliberations. During a recent speech in London on the subject of values he said,
"religious persecution is unacceptable to us at any time in any place."
That is the position of the British Government. It applies to Christians just as much as to any other religious group, and it applies to Iraq just as to any other country. We will pursue a foreign policy in line with those objectives.
Mr Dave Watts (St Helens North) (Lab): I am pleased to have the opportunity to raise this important matter on behalf of my constituents and of SIGOMA-the special interest group of municipal authorities. There is great concern among MPs in the SIGOMA group that we are facing one of the worst spending reviews ever experienced. It is likely to have a massive impact on every part of our public services, whether in education, health or any other area. I am pleased that so many of my colleagues have attended the debate, and I will try to give way to as many of them as I can. I know they will have major concerns about the impact of the spending review on their constituencies.
I believe we are likely to see massive and devastating cuts in our communities, and that the general public have no idea about the scale of the cuts heading their way. When people see the level of cuts, they will be concerned about their implications and the way that the Government are going about them. From day one, both I and the rest of the Opposition have accepted that there must be cuts in public services. We accept that local government must play its part in reducing the deficit. However, we are concerned about the speed of those cuts, the way in which they are being implemented and the unfairness of the cuts to the SIGOMA authorities.
My constituents accept that there needs to be a reduction in public spending and that local government must play its part in the cuts, but they have every reason to feel aggrieved that, at a time when they face massive cuts in their public services, the Government have cut tax for the bankers, who caused the problem, by £1 billion and have already turned their back on doing anything, realistically, about the massive bonuses that continue to be paid to bankers. They have now decided that they will not even publish the size of the bankers' bonuses so that people can hold them accountable for their actions.
The least that my constituents should be able to expect is that any cuts are fair, that they protect the most deprived parts of our communities, that they take into account the unfair cuts that have already taken place, in May, and that they allow time for councils to adjust their budgets. That is one of our major concerns-that the cuts are front-loaded.
Barbara Keeley (Worsley and Eccles South) (Lab): I want to ask my hon. Friend about that. The worst aspect of the cuts that people are seeing is the front-loading-the lack of time that there will be between the settlement and implementation. Does my hon. Friend think, as I do, that it is difficult to see any fairness, as was promised in the comprehensive spending review, in a situation in which some councils, in the most deprived areas, will see reductions in their budget next year of, it has been suggested, up to 25, 30 or 38%, whereas other councils, in the south, will see increases of an equal size-25 to 37%? It is hard to see how there has been fairness. The other promise in the CSR was that those parts of the country that depend on public sector jobs would not be hit the hardest. It is very hard to see those things. I wonder whether my hon. Friend can see them, because I cannot.
Mr Watts: It is very difficult to see any fairness in the system so far. We know that more cuts are on the way. We hope that they will be introduced more fairly and will take into account the unfairness of the last set of cuts, which hit the most deprived communities.
Mr George Howarth (Knowsley) (Lab): My hon. Friend is being generous in giving way. Does he agree that this is not just a question of fairness? It is becoming increasingly apparent that there is a built-in unfairness in the system. Some authorities, of which Knowsley is one, as part of the SIGOMA group of local authorities, are likely to be disproportionately affected. Does he agree that in those circumstances it is important that damping be kept in place, so that the losses we will experience can to some extent be mitigated?
Mr Watts: We would hope, in relation to any massive cuts, that some damping would be introduced to ensure that local authorities do not face the full loss of grant, as they did under the previous Tory Government, who cut millions of pounds from local authorities overnight. The previous Labour Government, when they made changes, put in mechanisms to ensure that local authorities did not suffer in the same way as they had done with the Tory cuts. I hope that the situation will be fairer, that there will be some damping and that local authorities will have an opportunity to adjust their budgets.
Michael Dugher (Barnsley East) (Lab): I am grateful to my hon. Friend for securing this important debate and for the work he has done over many years on behalf of local government. I wonder whether he is aware of a question that I raised yesterday at oral questions to the Secretary of State for Culture, Olympics, Media and Sport. Along with a number of other hon. Members on both sides of the House, I raised the issue of the threat of library closures in many communities because of the cuts to local authorities. I was trying to explain to the Under-Secretary of State for Culture, Olympics, Media and Sport, the hon. Member for Wantage (Mr Vaizey), that the financial realities are different in different parts of the country. As my hon. Friend has said, in an area such as Barnsley, which has very low council tax receipts but high social needs, the pressures on the budget are hugely disproportionate compared with more wealthy areas in the south. The Minister replied that councils needed to show "a little imagination", which I think demonstrates-
Mr Clive Betts (in the Chair): Order. Interventions are supposed to be brief and to the point.
Michael Dugher: Does my hon. Friend agree that that shows how oblivious Ministers are to the financial realities in areas such as Barnsley and St Helens?
Mr Watts: I do. I am pleased that the Minister here is not the Secretary of State, because it is clear from the Secretary of State's comments that he has no idea of the implications of the cuts he is advocating. The idea that the cuts can be dealt with through efficiency savings or by councils using their imaginations as they have not done in the past is ridiculous. I point out that many of the authorities facing the biggest cuts, including my own, are the most efficient and effective already.
My council is a five-star council that provides excellent education, social services and other council services. It has kept its council tax below inflation rates for the past 10 years, and it runs an effective partnership with the voluntary and private sectors, yet it faces up to £12.7 million in cuts in 2011-12 and up to £24 million in cuts by 2014-15, on top of a previous cut of £5.6 million from the working neighbourhoods fund. We also face the potential loss of enterprise growth funds, which have helped regenerate my area; the money is spent in partnership between the private, public and voluntary sectors. Clearly, it is not inefficient councils that face the biggest problems but councils that are well run and well managed and provide good services.
As colleagues and I have said, the Government's record on the matter is not good. So far, cuts have hit the most deprived communities the hardest. They have been front-loaded, and the cuts to the working neighbourhoods fund have hit the most deprived communities in Britain. The record so far is not good.
George Hollingbery (Meon Valley) (Con): Does the hon. Gentleman agree that the councils in the south to which he refers so freely as exceptionally well funded by wealthy local populations suffer exactly the same problem as those in the north? The cuts are fair and proportionate and carry on across the country. The level of funding in many northern councils is considerably higher per capita than in the south. I understand, of course, that the level of need is higher, but does he agree that pain is being felt all over the country and that the cuts are in fact fair?
Mr Watts: I accept that not all deprived communities are in the north. There are certainly deprived areas in the south, and they have been hit hardest as well. They have not been exempt. I do not say that there are no deprived councils in the south, because there certainly are. We need not go farther than Southwark to see major problems, as there are in many other parts of the country.
However, the tax base in most southern areas puts them in a much better position to deal with cuts than areas where the tax base is low, such as St Helens and the SIGOMA authorities. So far, the south-east has lost 13%, the south-west has lost 12% and the north-east and north-west have lost 16%. That demonstrates how unfair the cuts are. I recommend that the Minister read the SIGOMA document "All in this together", which dispels the lie that we are in this together by showing that, and supporting the argument that, local authorities in the most deprived areas are being hit hardest.
George Hollingbery: I am sorry to interrupt again, but that goes to the heart of what I was saying. The level of subsidy per capita in Sedgefield, for example, is five to six times higher than in Hampshire county council. That means that the cuts can, to some degree, be more easily borne by those with much higher per capita funding. The proportion being removed in this element is right at the margin down in the south, and it hurts.
Before it was changed by the new Government, the system of allocating resources was based on deprivation. A number of factors were to be taken into account, and an academic research document indicated where the grant should go. Unfortunately for many authorities,
the Labour Government did not introduce all those changes but left money in some of the southern areas that should have been passed to the north. The changes were not fully implemented.
We would have no problem if an academic study was undertaken on the need to spend that took account of deprivation, if that is what the Government wanted to do. However, the Government are not doing that. Instead, they are finding ways to cut budgets for the most deprived councils without an academic study, and with no research documents to back their actions. Frankly, we think they are gerrymandering the system to ensure that their councils are not hit as badly as ours.
Mr Marcus Jones (Nuneaton) (Con) rose-
Mr Watts: I give way first to my hon. Friend.
Barbara Keeley: Will my hon. Friend comment on this, as I know he is concerned about the matter and knows the information for SIGOMA authorities? My local authority of Salford is to have a 13% cut, taking only the cuts being inflicted by the Government, but the loss of the working neighbourhoods fund will take it up to a cut of 18% or 19%. The hon. Member for Meon Valley (George Hollingbery) is referring to councils that do not have unemployment problems of the sort that would need the working neighbourhoods fund-problems that the SIGOMA authorities definitely will have.
Mr Watts: My hon. Friend is right. That funding has made a tremendous difference for some of the country's most deprived communities. The cuts will be a massive loss to them. The Government should be ashamed. If they are going to cut, they should do so in a way that protects the most deprived communities, not doing as they are and making cuts in the most deprived areas.
Mr Marcus Jones: Does the hon. Gentleman not accept that areas such as Nuneaton in Warwickshire were particularly underfunded under the Labour Government? He mentioned gerrymandering, but that seems to have been the case for many years when comparing the funding for shire counties such as Warwickshire with that for the Labour heartlands in the north, and particularly those in the north-east.
Mr Watts: That argument is put forward by many councils. They say that everyone should get the same; if everyone does not get the same because deprivation is taken into account, they say that that it is unfair. The grant system took account of the ability of local councils to raise local tax and of the deprivation within their communities. The hon. Gentleman suggests that everyone should get the same, regardless of deprivation. As I said before, I would have no problem if the Government were going about the job by doing some academic work and producing a study that people could consult, taking account of existing need and deprivation. That is not happening, and the Government should be ashamed of their proposals.
The Government cuts will go so far as to hit the most deprived communities, and they are front-loaded. We have lost the neighbourhoods fund. As I said before, the south has been protected but not the north. I was saying that the Minister should read the SIGOMA document,
which goes into far more detail about the unfairness of the proposed cuts. He should also read "Hard Times", a document produced two weeks ago by the Industrial Communities Alliance. Hard times is what our communities are in for. That document shows the devastating effect that the cuts in public spending will have on our areas. Anyone who reads it could not help but understand the deprivation that will exist as a result of the cuts.
We fear that the cuts are heading our way. We could lose 33% of our grant in 2010, and a further 22% by 2011. We hope that that is not the case, but we know from what the Government have done so far that that is the likely impact. There is no way in which efficiencies can stop the wholesale closure of libraries, and we will also have fewer policemen and firemen, and fewer social workers, if that level of cuts is introduced in our communities.
On top of that, the Government have top-sliced the council block grant to pay for the freeze on council tax. That will make the situation even worse in communities such as mine, as they will be less able to provide services. Those communities will lose as much as another £500,000 of grant, which they would have received, had the grant not been top-sliced. We understand that SIGOMA authorities may face cuts of up to £44 million over the next few years.
The new homes bonus scheme, which is also hitting local authorities, is intended to provide resources to encourage new homes to be built. Again, I do not think we will do well out of that. It is not that local authorities such as St Helens and the SIGOMA authorities do not want to provide new homes; but given the devastating effect that the Government's cuts will have in our areas, I do not think there will be much of a market for building new homes. Where we have real deprivation in our housing, we will have fewer resources with which to provide homes for our constituents.
Simon Danczuk (Rochdale) (Lab): I thank my hon. Friend for securing the debate. He is absolutely right about housing, for which there is a great demand in Rochdale. Another problem with the cuts being inflicted is that local authorities are cutting the money they give to local charities that support homelessness services. Petrus community trust and the Sanctuary trust in my constituency are losing thousands of pounds as a result of the cuts, and now cannot even provide for homeless people. It is vulnerable groups in deprived communities who are feeling the effects.
Mr Watts: Most local councils and MPs will know that the voluntary sector is very much supported by local government. It cannot exist without funding and support from local government. I worry that not only will we have cuts in council services, but the voluntary sector will be hit as a result. I fear for the safety net of services that are now provided by the voluntary sector, but which will disappear if the cuts are made.
What are we trying to get from today's debate? We would like an assurance from the Minister that any further cuts will be fair, that more help will be given to the most deprived parts of the country, rather than less, and that any cuts will be transparent so that it can be easily understood how the Government are making the changes to ensure that those in the most deprived communities get the most support. We would like an
assurance that any cuts that are introduced will take into account the cuts that are already disadvantaging us. Any future cuts we face should take into account the fact that we have lost more than anyone else.
Derek Twigg (Halton) (Lab): I congratulate my hon. Friend on securing the debate and on his excellent speech, in which he is trying to be fair to the Government. Halton, which has one of the most outstanding councils in the country, has already had £1.2 million cut from its education budget, compared with £600,000 from Cheshire East and Cheshire West, which are more affluent boroughs. It has lost massively and disproportionately as a result of the cancellation of the Building Schools for the Future programme and the education maintenance allowance cut, which has also hit other deprived communities. Given their track record, how can we expect the Government to be fair to deprived communities such as Halton, St Helens, Knowsley and others? The Government somehow believe that a 28% average cut will not hit the most vulnerable.
Mr Watts: My hon. Friend has made an excellent contribution. Our concern is not just about cuts in local government services, because we have already had cuts right across the board and face even bigger cuts in welfare. As the "Hard Times" document demonstrates, many of our communities are not in a position to fight back and will go to the wall. We are throwing those communities into abject poverty, which will have serious implications for our communities and the country as a whole.
I advise the Minister, before those draconian cuts are made, to take into account all the losses of grant that are taking place. A substantial amount of money is already being taken out of the local economy, which is having an impact on the private sector in our communities. Many of the shops, retailers and suppliers already face major problems. I spoke recently to a gentleman in the construction industry who told me that all his orders have now run out and that within six months he would be laying off hundreds of workers as a consequence. The economy cannot generate itself; it needs the support of the Government. That is why all our previous policies took into account deprivation and the need to spend.
What do we want? We certainly want any changes that are made to take into account the tax base and the ability of local government to raise money. We have already seen some scandals, such as the fact that Westminster council's ability to raise millions of pounds every year from car parking charges is just ignored and not taken into account, which allows it to provide good services at a low cost to local taxpayers. It is a scandal that that has been allowed to continue for many years. I hope that when the Minister is looking at any change, he takes into account that some very wealthy councils are in a much better position than my authority and the SIGOMA authorities to deal with the levels of cuts that we have seen.
Barbara Keeley: Yesterday the Chancellor was optimistic about the recovery. So would my hon. Friend, like me, like DCLG Ministers to approach the Treasury about re-phasing the cuts to local government budgets, so that they will not be so front-loaded? That would help.
As I understand it, most-in fact, all-local authorities believe that the way the Government have front-loaded cuts is wrong and does not give them time
to adjust their budgets. The Government could have switched it round and had the most severe cuts in the latter part of the period. We know why they are doing this: frankly, we are seeing all sorts of political shenanigans going on because they want to make all these draconian cuts now, so they can have some tax cuts in the run-up to the general election. That is a short-term view, given the problems that will be created. The Government's view of the economy as a whole is very optimistic, and what we fear will happen with local council spending will shove most of our economy into recession, if not depression. There are areas around the country that may take 50 years to recover from the cuts that are on their way-places such as Barnsley and some of the north-east councils. They will have a dramatic effect for a very long time.
I hope the Minister will take those things into account when he responds. I hope he can give us some assurance that, when he makes changes, they will be fair and transparent, will take into account deprivation factors and will put resources where they are most needed; and that he will look at the tax base to ensure that those who can afford to pay a bit more council tax and can afford to receive less grant than they are receiving do not continue to receive higher levels of grant. There was a time when-and I do not think things have changed from when I was council leader many years ago-if we received the sort of income Westminster gets from grants, car parking and all the other things, we could have had no council tax at all and sent every one of our constituents on a holiday to Spain every year. That is the level of fiddle that has gone on with the system, and it needs to come to an end. Fairness needs to be put back into it.
The Parliamentary Under-Secretary of State for Communities and Local Government (Robert Neill): It is a pleasure to see you in the Chair, Mr Betts, and a pleasure to respond to this important debate initiated by the hon. Member for St Helens North (Mr Watts), to whom I am sure we are all grateful. It is an important topic. It arises at this time of year every time the local government finance settlement is coming up. Inevitably, there are debates in advance of the settlement and, understandably, hon. Members seek to get the Minister to say things about the detail of the settlement. The Minister, regardless of party, says, "You'll have to be a bit more patient because the detail as far as it affects local authorities is set out in the settlement itself, which will be laid before the House shortly". I say that because that is the factual position. I want to respond to some of the matters raised, but I am sure that you, Mr Betts, and hon. Members who have participated in the debate, who are well experienced in local government matters, know that I am not in a position today to set out the individual impacts of the funding settlement on particular local authorities. However, I can make it clear that the provisional settlement will be done in the usual way. It will be announced shortly, and we will provide as much information as we can to enable local authorities to set their budgets.
This debate gives us a chance to look at the overall position. It is a position that arises, first, in relation to the financial situation, but it is actually broader than that. It is unfortunate that the opportunity has not been taken to put what has to be done on local government
finance in the context of the Government's broader agenda of handing more power and flexibility to local authorities. I agree with the hon. Member for St Helens North: the fact is that we need to reduce the deficit. Reductions in spending have to be made, and local government, as a significant part of the public spend, has to play its part. That much is common ground, but we are seeking to reduce spending constructively, and there I have to part company with the hon. Gentleman.
With respect to those on the Opposition Benches who have participated in the debate, there has been almost a competition-dare I say it-to come up with the most overcooked, overheated and exaggerated language possible. Frankly, it does no justice to the seriousness of the subject. Opposition Members have chosen to adopt a regrettable approach. It will make cheap headlines in a press release, but it does not advance the argument.
Barbara Keeley: The Minister must know-and if he does not, he should know-that councils in the north-west are now looking at having to make cuts of £35 million, £40 million and £50 million. If he thinks that that is fair and balanced, we will all be very upset next week. Last night, Stockport council, a Lib-Dem council, announced the cutting of 400 jobs, and the Local Government Association has suggested that the number of job cuts will be 140,000.
Robert Neill: I have seen those figures. I have also seen the SIGOMA document, which I read with interest. I have met SIGOMA representatives and I am happy to continue to do so. I want to take the hon. Lady to task a little. She referred to the reduction in funding for the working neighbourhoods fund. Yes, absolutely right-and who decided to do that? Her Government. The Labour Government made it clear that the working neighbourhoods fund was a three-year fund due to end in March 2011. The previous Government-the Labour Government-were committed before the general election to cutting it, so I am not taking any lectures from anyone on the impacts of that.
Mr Marcus Jones: Will the Minister give way?
Mr Watts: Will the Minister give way?
Robert Neill: I shall make a little progress before I give way. Neither will I take lectures from Opposition Members about the need to reduce the deficit and how we should do it. The simple fact is that, thanks to their Government's policies, about which I have not heard a word of apology, we are paying £120 million a day just to pay off the interest on their debts. That money is lost for ever to council services on the front line. If we carried on down the Opposition's route, the pressure on local authorities would be all the greater because we would be paying up to about £100 million more by the end of the Parliament in debt interest. I am not taking lectures from the Labour party about our attempting to balance the nation's book, when it is its prodigality that has placed local authorities under such pressure.
Mr Watts: The Minister must get off the rant that we hear regularly from the Front Bench. There has been a world recession caused not by the Government, but by banks. At a time when the general public face such draconian cuts, they want to know why the Government have given the bankers a £1 billion tax cut, refuse to act on the bonuses and are now refusing to publish the size of the bonuses that bankers are receiving. The real enemy is not the previous Labour Government. They were faced with a meltdown of financial systems in this country and throughout the world, so it is not good enough for the hon. Gentleman to blame the financial crisis on that Government. As he knows, the crisis is worldwide and it is one that has been caused by the bankers, not the Government.
Robert Neill: That is as discredited an alibi as we hear nowadays, but I credit the hon. Gentleman for his loyalty in still trotting it out.
Council tax payers throughout the country know that their council tax doubled during the 13 years or so of the Labour Government. That was not anything to do with the world crisis. It was to do with mismanagement of the economy and, ironically, the sometimes perverse workings of the system of local government finance which that Government put in place.
Mr Marcus Jones: We are certainly seeing a lot of synthetic rage from Opposition Members. Does my hon. Friend agree that, under the previous Labour Government-and had they formed this Government-local authorities such as Nuneaton and Bedworth and Warwickshire were looking at 20% cuts in Government funding?
Robert Neill: That is entirely right, which is why the rage is synthetic, and why I hope that hon. Members, including Opposition Members, will welcome £650 million of additional money that the Government have put in to support the council tax freeze and which will be embedded in the base budgets of those authorities. I hope that they recognise the steps that we have taken specifically to protect services for the most vulnerable, such as £1 billion of grant funding for social care by 2014-15 within the £2.4 billion that we have rolled into formula grant. By rolling more money into formula grant, we give local authorities more flexibility to reflect their own priorities and demands.
Barbara Keeley: Will the Minister give way?
Robert Neill: I shall make a little more progress. An extra £1 billion of extra funding has gone in through the NHS budget to break down the barriers between health and social care. As I said, we are fully funding the council tax freeze and embedding it into the base. We will make £200 million of capitalisation available in 2011-12 to deal with restructuring costs. Those are positive things.
It being Two o'clock, the sitting was adjourned without Question put.