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In my own patch in Wansbeck, following the most intense rainfall in living memory on 5 and 6 September 2008, a month's rain fell in 24 hours, which meant that the river Wansbeck burst its banks and the whole town of Morpeth was flooded. That was compounded by
other flooding problems including flooding from the Cotting burn, the Church burn and the Postern burn in Morpeth. There was extensive flooding throughout the town centre and nearly 1,000 properties, including many businesses on the main street, were directly affected, causing huge problems. Hundreds of residents had to be evacuated and emergency shelter was provided in the King Edward VI high school, at county hall and in the town hall in Morpeth. Iconic buildings such as the chantry and St George's church suffered considerable damage, as did landmark shops. The emergency ambulance station, the doctors' surgery, the health centre at Gas House lane, the Riverside leisure centre and the town's main library were also inundated and had to close for a considerable period.
Firefighters, ambulance crews, the RAF, the Royal National Lifeboat Institution and the British Red Cross were among the emergency services involved in the rescue and recovery operations over the whole weekend. A collection of voluntary groups and the town's churches came together to help hundreds of flood victims and the campaign was spearheaded by the Morpeth Lions club. Families were out of their homes for more than a year and businesses were closed for months, and still people from within the flood plain are not back in their properties.
Prior to the devastating flood, there was a huge flood in Morpeth in 1963, which was before I was born-people might question that. In an attempt to protect the community from further devastation in the future, I am working closely with the Morpeth flood action group, officers of Northumberland county council and the Environment Agency to try to progress the proposals for the Morpeth flood alleviation scheme. The proposed scheme for Morpeth is designed to reduce the risk of flooding from the river Wansbeck and the main burns in the town. It involves the storage of water upstream of Morpeth on the Mitford estate, the building of new defences in the town where none currently exist, and the replacement and refurbishment of some existing defences.
It is imperative that the flood alleviation scheme should be delivered to protect communities and businesses in the town of Morpeth. Local people need the reassurance that their homes are safe from the ravages of the extreme weather conditions and they deserve the peace of mind that those assurances will bring. Shops and businesses need to be assured that they will not suffer a reoccurrence of the devastation of 6 September 2008 and that they can have a secure future in Morpeth where they can build their businesses for the benefit of their employees, local communities and the local economy.
Sir Alan Beith: The hon. Gentleman presents his case eloquently. Many of the businesses he mentions are either owned by my constituents or employ them. A large area of my constituency will face the upstream flooding that is part of the alleviation scheme, but I think we all want to work together to ensure that Morpeth and Rothbury do not have to go through such an experience again.
Ian Lavery: I agree with that and understand the right hon. Gentleman's remarks, bearing in mind that his constituency is next to mine. I understand the associated problems, particularly upstream, as compared to those in the town centre of Morpeth.
In addition to the trauma and devastating personal and physical effects of the floods, local residents and visitors must now come to terms with problems obtaining buildings and contents insurance, which has been mentioned. It is a huge problem for people living on floodplains. The current agreement with insurance companies will continue until 2013, and who knows what will happen after that? It must be considered as a matter of extreme urgency. Many people living in Morpeth face huge rises in premiums and excesses. One gentleman living in the Morpeth floodplain was asked, after going to court, to pay £300 a month in insurance, and the excess was £20,000. That is not insurance. It is a massive problem. Individuals, families and businesses who have experienced the horror and trauma of flooding have had their lives turned upside down, and they should not have to face additional problems that cause them further distress and upset as well as imposing a huge financial burden on them. Those issues must be tackled as a matter of urgency.
I have not got much more to say, but I pay tribute to the men and women of the emergency services who, on all occasions up and down the country, have been absolutely fantastic when such things occur. They put their lives at risk to ensure that everyone else is safe.
"The Government should urgently put in place a fully funded national capability for flood rescue, with Fire and Rescue Authorities playing a leading role, underpinned as necessary by a statutory duty".
"take forward the findings of the Pitt Review to improve our flood defences, and prevent unnecessary building in areas of high flood risk."
Heather Wheeler (South Derbyshire) (Con): Will the hon. Gentleman pay tribute to the flood wardens of south Derbyshire, who have taken duties on themselves as part of the big society? While waiting for other things to get better, we are looking after ourselves. We get out there on horses and take out flood signs. We know that those in the community are looking after themselves. We have professionals to look after us, but it is important for our villages and communities to do their best for themselves too.
Ian Lavery: Of course I pay tribute to those people. I am not sure whether flood defences and removing water from our towns, villages and city centres should be left to the whim of some big society, as I am not too sure what that actually means, but I certainly pay tribute to anybody who volunteers to secure their community against flooding problems. I am not sure whether people in my area would have access to horses. Maybe the hon. Lady can tell me after this debate exactly how it happened. It is interesting.
Now that the Minister is in office, does he still agree with recommendation 39 on a statutory duty involving the emergency services? If so, as it is in the coalition agreement, might that take place in the not-too-distant future?
The decision today not to make funding for the Morpeth flood alleviation scheme readily available in the next 12 months is disappointing to me, the people concerned who are heavily involved in the community, the local council and many others. As the Member of Parliament for Wansbeck, I will be working tirelessly with those organisations and interested parties to ensure that the scheme is progressed in its entirety. It is important not to consider flood alleviation schemes on a piecemeal basis, because that is not effective economically or in terms of flood prevention. I ask the Minister for the third time this week-I hope that he will bear with me; I have had two assurances from him already, and I am sure he does not mind giving me a third one-to assure me that everything will be done to ensure that the Morpeth flood alleviation scheme will be completed in the near future without delay, as quickly as possible and in its entirety.
Geoffrey Clifton-Brown (The Cotswolds) (Con): I am grateful to have caught your eye, Mr Sheridan. I will speak for two minutes only, in the hope that the hon. Member for Workington (Tony Cunningham) will also be able to speak. I do not want political differences about who did what. Other than a fire, nothing worse can happen to a home than to be flooded with a mixture of water and sewage, as I saw when walking around the streets of Fairford after the 2007 floods.
I will make one or two brief remarks. In the 2007 floods, 250 buildings in the Cotswolds were flooded, including a school on which £1 million had to be spent, doctors' surgeries and so on. I am a little concerned about a letter that I received from the Environment Agency. I pay tribute to its author, Barry Russell. In my 18 years as a Member of Parliament, I do not think that I have found such a helpful civil servant anywhere else in the country. He has been to public meeting after public meeting with me to explain what the Environment Agency can and cannot do. I do not blame him at all for what I am about to quote from his letter, but I would like the Minister's observation on it.
"In previous years, the local authority projects received funding from a ring-fenced pot of money. This is not the case for next year (2011-12), and all projects are competing on a like for like basis-both local authority projects as well as our own. Ultimately the allocations were based on the OM score, and funding was allocated to projects with a higher score than those submitted by the Cotswold District Council. I share your disappointment in not receiving the funding that you were anticipating for this scheme."
It is easy to come up with statistics to show, in order of priority, which projects will give the best value for money and save the most houses. The problem in a highly rural constituency such as the Cotswolds, which has 110 villages, lots of which have flooding problems, is that it will never meet those criteria. Most of my constituency-with the exception of Cirencester, which flooded in 2000, 2007 and 2008-will never get any funding under the system. I accept that my hon. Friend the Minister has a limited pot of funding, but I ask him to look at the system of allocation.
The emphasis in this debate has been, rightly, on flood defence. I ask the Minister to ensure that the Environment Agency budget has sufficient funds to deal with two other issues. One is maintenance. One contributory factor to the floods in west Cumbria in November 2009 was the lack of dredging and maintenance of becks, streams and rivers. We must ensure that there is sufficient funding for that.
The other issue is flood resilience measures. It is all right having flood defences and doing maintenance, but individual houses and businesses need protection, and we must ensure that funds for flood resilience measures are sufficient.
Mr Jamie Reed (Copeland) (Lab): I thank my hon. Friend the Member for York Central (Hugh Bayley) for securing this debate. He has demonstrated yet again his considerable knowledge of the issues, and I think that Members of all parties are grateful to him for securing this debate so that we can air them. I commend the Environment Agency workers who have been working around the clock, as they always do, in the north-west of England over the past few weeks, where rainfall has been high, heightening flood risks considerably.
Communities at risk of flooding require certainty from Government, and that is what I think has been at the core of everyone's argument today. As I have said, we seek to work with the Government where we can and when we agree that they are doing the right thing. Issues such as flooding and flood defences should be above the typical, tribal knockabout of this House and of British politics in general, but we will hold the Government to account when we believe that they are not doing the right thing or acting in the public interest, and when we believe that their actions are likely to hurt those most in need.
We are all agreed that flooding is a life-changing issue. It is also a complex one and its policy solutions, or the solutions that we as politicians can provide towards the problem, are not simple. Sadly, flood defence in this country, as well as the Department for Environment, Food and Rural Affairs the bodies that rely upon it, and the people whom those organisations serve, are now beginning to pay the price for what many people and independent commentators believe is the Secretary of State's fevered desire to be the first Secretary of State in the new Government to give the Chancellor what he wants-big, indiscriminate cuts, with little regard for how they could be accommodated, or for the effect that they will have on the Department's core areas of work. We cannot escape that fact.
In many ways, the debacle over forestry privatisation has illustrated what we already knew about the Government-they are riven with contradictions and lack a clear focus on issues of real concern to people in too many areas throughout the country. There is no argument about the fact that there will be a 27% cut in flood defence spending this year-it has been confirmed by the Environment Agency. I have the greatest respect for the Minister-we have a good working relationship on the whole-but he has himself confirmed to the
Environment, Food and Rural Affairs Committee that cuts are taking place. The Prime Minister, however, is apparently unaware of that, or simply disinterested in the detail of the policies that his Government are prosecuting.
The Prime Minister has told the House that it is "simply not the case" that there will be a reduction in spending on flood defences, and that the comprehensive spending review settlement is "roughly the same" as in previous years but, in fact, it is not. Cutting is not the way to deliver the savings that the country needs; it is, in fact, a false economy. I trust that the Minister will encourage the Prime Minister to correct the record.
As I have said, communities that are at risk of flooding-we are talking about 5.2 million homes, as well as business properties-require certainty from Government, not a changing of the goal posts or an abandonment or reneging on agreements. The communities of York, Thirsk, Morpeth and elsewhere feel that sense of abandonment right now as their flood defence schemes fall by the wayside. It is a fact that the Government have announced a 27% cut in capital investment for flood defence spending for 2011-12, which means that many communities will face genuine uncertainty about their futures as projects are delayed or shelved. The cuts will leave many homes and businesses at a heightened risk of flooding.
The Minister said in the main Chamber today that those are deferrals, not cancellations, but they will feel like cancellations. The statement of principles is likely to expire before any investments are made, so those areas that are today missing out on flood defence investments face the prospect of being thrown at the mercy of a bear market when trying to find future insurance. Will the Minister confirm that he will not allow the insurance premiums or excess payments of anyone in any area to go through the roof as a result of his Government's cancellations or delays? Does he agree that those areas that had expected investments, and that were told that investments would be forthcoming before the expiry of the statement of principles in 2013 have now been prejudiced? If that is not the case, how is it not the case? How much public money has been spent designing, characterising and consulting upon the schemes that will not now go ahead?
We know that York is the tip of the iceberg, that many more cancellations are in the pipeline, and that the Government's spending cuts will determine which schemes go ahead and which do not. Today is the day that the Government can finally choose to be honest with those home owners, communities and business owners who live in areas at risk of flooding, and tell all of us which schemes will be cancelled and which will go ahead, and not just for the next financial year-there is no security in that at all. I urge the Minister and all his colleagues in DEFRA not to hide behind the Environment Agency-today's announcement was by DEFRA, not the Environment Agency.
Even after today's announcement, there are many unanswered questions, an awful lot of drift and there remains a significant lack of transparency. One of the principal concerns is the expiry of the statement of principles in 2013. The statement is the agreement between Government and the insurance industry that currently
underpins household insurance provision. So far, we have heard nothing that will reassure home owners or business property owners that the Government are working in an effective way with the insurance industry to resolve the real threat of some homes and businesses becoming uninsurable and unmortgageable following the expiry of the statement of principles.
Some insurance experts have warned that when the statement of principles comes to an end, it will be devastating for consumers. Others have warned that it will be bad for consumers but a great opportunity for brokers. Does the Minister agree with that? Simon Douglas of the AA's insurance division told the Secretary of State in a letter:
"Millions of people are at risk of inundation from overflowing rivers, coasts and estuaries during extremes of weather and that risk is increasing all the time. If spending isn't maintained, it will compromise the statement of principles, which could see many homes become uninsurable."
"We are committed to the Statement of Principles, subject to spending. Now that spending has been reduced, you could say all bets are off. The Government is in breach of its side of the bargain, so if insurers wanted to stop providing cover, they would probably be able to. The problem is nobody wants to be the first and end up getting harangued in the press."
I think that all Members on both sides of the House would agree that the expiration of the statement of principles is a ticking time bomb, not just for individuals, home owners or business people, but for whole communities. It is hugely economically and socially significant.
What assessment have the Government undertaken on the impact of their budget cuts on the universal coverage of insurance provision for homes at risk of flooding? Will the Minister publish that assessment? The ongoing negotiations between the insurance industry and Government are of profound importance, so will he tell us, categorically, whether he is committed to the principle of universal insurance cover? If so, will he be transparent about his negotiations with the insurance industry and publish an update on them in the House of Commons Library? Finally on this issue, does he agree that the expiry of the statement of principles, without any meaningful system to replace it, will be a disaster for consumers, and will he seek a system of universal insurance cover for whatever follows the current one beyond 2013?
There are other critical questions for the Minister to answer. In 2010-11, the previous Labour Government allocated £35 million for Pitt and for adaptation budgets. That was outlined in the CSR for 2007-08 to 2010-11. Recently, the Minister announced that £21 million will be provided in 2011-12 to lead local flood authorities. Will he confirm that that is different money from that announced by the previous Government? Is it new money?
The Minister will be aware that local authorities were awarded £100 million for flood funding in 2010-11 through the Communities and Local Government formula grant. What contact has he had with his counterpart in CLG about the level of funding available to local authorities next year for flooding and related investment? The concern throughout the House is that local authorities have been given new responsibilities but no new money, and that local flood defence schemes in many areas face a double cut.
"Over the next 2 years we aim to offer an improved standard of protection against flooding or coastal erosion risk for 145,000 more homes".
According to a written answer form the Minister on 27 July 2010, we are actually due to exceed that figure and reach "at least 160,000 households", which is a glowing endorsement of the investment that we made, and I welcome his recognition of it. The Secretary of State said of the next CSR period:
"We intend that, by March 2015, 145,000 households will be better protected"-[Official Report, 19 November 2010; Vol. 518, c. 57WS.]
The Minister said in today's announcement that 112,000 homes would be protected. Will he confirm that that 112,000 is part of the 145,000 target previously mentioned? If so, what will become of the schemes for the remaining 33,000? The Minister also mentioned the role of specialist providers in relation to the provision of insurance cover. I think that many would say that that hinted towards an end to universal coverage, but I hope that he will refute that. What does he expect specialist providers to do, and how will they keep their excess and insurance premium costs comparable with today's rates?
My hon. Friend the Member for Wansbeck (Ian Lavery) talked about the cancellation of the Morpeth scheme, which has been halted because budget cuts have changed the outcome measures via which the EA has to assess projects. Will the Minister admit that that is the reason for the scheme's delay and give the people of that town the clarity they deserve?
This is an essential point. The Minister talked briefly about value for money. Of course, anyone in his position is tasked with spending public money properly and I support him in doing that, but what is his definition of value for money in relation to public spending to protect homes? Will he acknowledge that there is a real fear that his Department's budget cuts and his changing definitions of value for money mean that particularly sparsely populated areas at heightened flood risk, such as the one I represent and those that many hon. Members here represent, are on their own and that the Government have abandoned them? Will he give a guarantee that his budgets cuts will not prejudice flood defence schemes in the more rural, disparate towns and villages that are outside the larger urban conurbations? Such a move would be a scandal and I condemn it.
Finally, will the Minister lay a copy of the full Environment Agency funding allocation in the Library, so that hon. Members from all parties can examine the detail and inform their constituents about the current state of affairs? I am proud of my Government's record in office in relation to flood defence spending: £2.36 billion over the past four years, 160,000 homes protected and the introduction of the Flood and Water Management Act 2010. I am grateful to the hon. Member for York Central for introducing the debate. We need to debate these issues urgently in Government time on the Floor of the House. I hope that the Minister will be able to give us that assurance today.
The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Richard Benyon): The hon. Member for Copeland (Mr Reed), who is excellent in so many ways, has a habit of asking me a plethora of questions and not leaving me enough time to even begin to answer them, but I will see what I can do.
As announced in the Chamber earlier today, the Government have announced £521 million to be invested in flood and coastal defences over the next year. Some 112,000 homes in England will benefit once the work has been completed. That money will help to fund 109 schemes that are already under construction, and work will begin on 39 new flood and coastal defence projects. Of those projects, 18 will provide vital repairs and safety enhancements to existing defences, and the remaining 21 will provide additional protection to 13,000 households at risk of flooding. I am sure that the hon. Gentleman will be pleased that some of that investment is taking place in his constituency.
I pay great tribute to the hon. Member for York Central (Hugh Bayley) for securing the debate and for his undoubted passion in standing up for his constituents on this important issue. One question he asked me is why his region is apparently missing out so much on the allocation of schemes this year. Yorkshire has received a smaller settlement in 2011-12 than in previous years-before he includes that quote in a press release, I ask him to listen on-but that is because a large number of flood defence projects have recently been completed in the region. Hundreds of households in Yorkshire are already enjoying better protection against floods and coastal erosion as a result of projects that have been completed-I concede-over a number of years.
That is an important point because we have to take a long-term view of the spending on flood defences. Very few schemes-almost none at all-go from conception to commissioning in one year. Some of them, particularly the one we have been talking about in Leeds, are very large schemes and run over a number of years. For example, a £2 million scheme in north Doncaster was completed in 2009, which reduces flood risk to 3,000 properties. A £10 million refurbishment of the Hull tidal surge barrier was completed in 2010, and reduces flood risk to 17,000 properties. There are many more schemes.
May I address the specific points that the hon. Gentleman and others have raised in this important debate? He asked what I would do to get the Leeman Road scheme back on track. I assure him that the Environment Agency and I will work with him at every stage to make sure that we can get some movement on that scheme, but I cannot guarantee where it will sit in any future year because of the variety of other schemes that will come forward. I can assure him that, if our payment for outcomes scheme becomes the modus operandi of taking forward such initiatives in future years, there will be much more clarity for constituents about where they stand on the issue.
The hon. Gentleman raised a rather more macro issue about the current economic climate, and how this issue sits within it. He is right: the deficit issue is a current account matter. Our national debt is about everything; it is not just current or capital account. There are siren voices that say that we must invest more
in infrastructure. We are investing in a variety of infrastructure-not just flooding schemes, but a variety of different ones. It is a question of having a balanced approach.
The hon. Gentleman talked about whether we can assist his flood defence committee in Yorkshire in obtaining European money. I assure him that he will have the full co-operation of my Department, the Environment Agency and other colleagues across Government in trying to secure any sort of funding that we can lever out of any organisation. I very much include the European Union in that. He rightly talked about the need for slow-water schemes and to think up-stream. I have been discussing the value of that with the hon. Member for Wansbeck (Ian Lavery). We recognise that the beneficiaries in one community sometimes pay for flood defences in another area, which may well affect the viability of farming businesses and the like. We have to take a large regional approach to the matter, which is why our new payment for outcomes scheme takes a much broader view. The scheme recognises where beneficiaries are and what can be done to alleviate the problems in affected communities.
I was also asked how we are protecting businesses. The economic benefits from protecting businesses from flooding are taken into account in the prioritisation schemes included in the payment for outcomes system. That has been the situation in the past and it will continue to be so. We are working with the City of York council and the Environment Agency to consider opportunities for external funding. It is crucial that there is greater local involvement at the heart of reforming the funding for flooding and coastal erosion risk management.
My hon. Friend the Member for Suffolk Coastal (Dr Coffey) made an excellent speech and raised some important issues. I was so impressed by the level of innovation from her area. From my visit to her constituency, I remember sitting in the minibus with representatives from the Environment Agency, Natural England, the local authority, local landowners and the local community. We drove along and ensured that none of them could get out, so that we could hack out some of the problems facing landowners who just want to make a small improvement and come up against two different agencies plus the local authority. The complications of the process
are, I hope, being ironed out. That was an extremely useful session. My hon. Friend is absolutely right: we need to take a longer-term view, and internal drainage boards are absolutely crucial to many of these schemes.
The hon. Member for Leeds North East (Fabian Hamilton) spoke with passion about the Leeds scheme and the cost of flooding to his community. I absolutely understand that and the commercial driver that his community-that great city-is to that region. If we follow that logical argument and consider the 5.2 million homes that are at risk from flooding, for every single one of those homes that can get protection from flooding, there will be a financial return. We have to make sure that the financial return is as high as possible. That is why work can be done on that scheme in particular. As the equally sensible contribution from his colleague the hon. Member for Leeds East (Mr Mudie) made clear, we might risk having a Rolls-Royce when a reasonably priced family car might have served some of the purpose. I cannot go into more detail about the matter now, but I will continue to look at it very closely to ensure that we get a result.
I shall quickly mention the point about the woodlands that were being built over. I cannot remember who raised the matter, but we need to understand the impact of the issue. That is why I have been totally opposed to so much of the infill development that we have seen, with building in back gardens and green spaces. The Government have a very clear policy on that which we want to take forward.
I would love to address many of the other valid points raised by, not least, the hon. Members for Copeland, for Wansbeck and others, but I see that the clock is against me. I do not want to repeat the increasingly sterile debate about where we are and whether we are comparing apples with apples or apples with pears. In the case of the hon. Member for Copeland, I suggest it is the latter.
This is a debate of immense importance for the people of Birmingham. The Birmingham citizens advice bureau is the oldest and largest in the country, dating back to 1939. Progressively, the Birmingham CAB opened five offices in Birmingham to meet great and growing demand. Last year, the Birmingham CAB provided advice and support to 56,000 people. For those who find it hard to access mainstream services, it also provides a comprehensive web of outreach services in, for example, GP practices, children's centres, hospitals, dementia advice projects and Macmillan Cancer Support.
The Birmingham CAB employs 100 full-time staff, who work with a dedicated army of 166 volunteers, including the excellent Paul Ballantyne who is here today and who is the chair of the trustees, and the excellent John Orchard, a volunteer for the CAB. Both have both devoted many years' work to the CAB in support of the most vulnerable people in Birmingham. And vulnerable they certainly are; in Kingstanding, in my constituency, we have a CAB in one of the poorest and most deprived wards in Britain-much cherished by the people who live in the ward.
Birmingham has been hard hit. The west midlands has the highest unemployment anywhere in Britain. Just when the people of Birmingham need somewhere to go for support and advice, the generalist advice services of all five citizens advice bureaux will close. Why? On the one hand, it is a combination of the callous cuts being made by the Government to local government services in Birmingham, where £170 million will come out of the budget next year alone; and on the other hand, the cruel incompetence of the council.
Steve McCabe (Birmingham, Selly Oak) (Lab): I do not know if my hon. Friend saw the Prime Minister's very helpful comment in The Sunday Telegraph, when he said that councils should look to reduce their chief executives' salaries before they cut citizens advice bureaux. Given that the chief executive of Birmingham is one of the highest-paid in the country, should he and some of his senior officers not take a cut before the CAB?
Jack Dromey: My hon. Friend makes a powerful point. The last thing that should be cut is advice to the people of Britain from citizens advice bureaux. If there are to be reductions, they should start at the top in Birmingham city council.
The CAB had been planning for some council cuts for some time, going back to March 2010, but suddenly, out of the blue, the bureaux were told in December just before Christmas that they would lose all their funding from March 2011. The CAB then made repeated approaches to the council to try to find a way forward. What have they been told? "Sorry, you will have to close by March, but you can reapply for a fresh funding stream in August this year." That means that the CAB's generalist advice services will close down for five months, with no certainty whatever that there will be support afterwards.
John Hemming (Birmingham, Yardley) (LD): Does the hon. Gentleman not accept that the city council is in fact offering interim funding to maintain the service, and that the CAB had not actually made proposals for any savings whatever?
Richard Burden (Birmingham, Northfield) (Lab): This is an intervention on my hon. Friend, but before I start it I think the answer to the question asked by the hon. Member for Birmingham, Yardley is no.
"Central Government has not been notified of the closure of any citizens advice bureaux since the spending review settlement 2010. The Government are aware that local authorities that fund citizens advice bureaux are facing tough decisions but do not expect them when making those decisions to pass on disproportionate cuts to other service providers, especially in the voluntary sector."-[Official Report, House of Lords, 26 January 2011; Vol. 724, c. WA166.]
Jack Dromey: My hon. Friend is absolutely right. It is proof positive, once again, that the Government are simply out of contact with the consequences of their actions. What is happening in Birmingham is clear beyond any doubt. The question that we will be asking today is what Ministers intend to do about it.
On the point about the council, the hon. Member for Birmingham, Yardley asked whether the CAB had explored alternatives. It has explored alternatives repeatedly. I have seen the correspondence going backwards and forwards. The CAB has tried to find a way forward, but what has it been met with? Among other things, abuse from the cabinet member concerned, councillor Ayoub Khan. Just when the CAB was looking for a co-operative approach to try to find a way forward, including making economies consistent with protecting the service to the community, it ran up against a brick wall.
John Hemming: Earlier, the hon. Gentleman claimed that there was no proposal for any funding from April onwards. In fact, there is a proposal to make interim funding available. That, to be fair, is something that I have discussed with the CAB.
Jack Dromey: There will be a crucial meeting on Monday next week. As things stand, the CAB will have no alternative but to close down its generalist advice services-no alternative. If as a consequence of today, the Government say, standing by previous statements, that they mean what they say and that CABs should not close, and if the council sees sense, not only will the CAB celebrate, so too will the people of Birmingham.
If there is no change, let us bring home what the consequences will be for the people of Birmingham. All Members who represent Birmingham can give examples-the kinds of problems that my hon. Friend the Member for Coventry South (Mr Cunningham) sees as well-but I shall give the House three. First, a quote:
"I didn't know what sort of help to get regarding family difficulty with breach of custody agreement. I was terrified that I may lose my son to a hostel and wouldn't know who to go to about my rights as a father if it wasn't for the CAB."
Secondly, a client of the CAB, disabled and living alone in an empty flat on a low income with no furniture, had no idea about the support available-social tariffs for utilities, community care grant or budgeting loans for furniture. Thanks to the CAB, that disabled woman now lives in comfort and is properly supported. Thirdly, there is the case of a client with cancer, who without the help of the CAB would not have been able to challenge successfully a decision not to award her benefits.
The consequences for people like them, and for the people of Birmingham more generally, will be severe indeed. Where will they turn at their time of need, and just at a time when demand is increasing?
Jim Shannon (Strangford) (DUP): The issue for a great many of us as elected representatives and as MPs is that we recognise the good work that CABs do, but we also recognise that with the changes the coalition Government are putting forward on benefits, demand for CAB services will increase and concerns will increase. Homelessness, loss of benefits and loss of income will be critical issues over the next four to five years.
Jack Dromey: The hon. Gentleman makes a very powerful point indeed. I suspect that all Members of Parliament, let alone advice agencies, are seeing the same trend of growing demand for support from us: advice on housing, advice on homelessness, advice on benefits and advice on debt. A whole range of issues is coming to us because there is growing demand when the economy is in difficulties and at the same time the Government are cutting back vital services to the people of Britain and Northern Ireland.
Yvonne Fovargue (Makerfield) (Lab): Does my hon. Friend agree that CABs and other advice agencies are facing a double whammy because of the cuts? The closure of the financial inclusion fund will leave 100,000 people who were served last year with nowhere to turn in the future, and more than 500 skilled and trained advice workers are currently serving their notice.
Jack Dromey: My hon. Friend is absolutely right. She brings to this debate the wisdom and experience of her many years in the CAB. Her contribution is welcome, and she is right to bring home once again the consequences of what the Government are doing.
On the folly of the cuts, interesting independent academic research has demonstrated that every £1 invested in advice yields a return of up to £10 because early intervention produces the best results. What will happen-it is as simple as this-is that the CAB and other advice services will be run down and closed, and there will be greater risk of debt, homelessness, poverty, mental health problems and relationship breakdown simply because tried and tested services upon which people depend at a time of need have gone.
Ms Gisela Stuart (Birmingham, Edgbaston) (Lab):
Does my hon. Friend, as a fellow Birmingham MP, share my experience? The two agencies that I rely on most heavily when constituents come to my advice surgeries are the CAB and the Immigration Advisory
Service. The CAB is a source of reliable, independent advice, and there is no alternative. If we lose it, our people will lose.
Jack Dromey: My hon. Friend speaks from her great experience in Birmingham, Edgbaston. She is absolutely right: these services, including the one for immigration, are vital. The question then arises-Ministers will have to answer it-of where people will go if the fabric of our advice services is torn apart. As I shall say in a moment, it is not just the CAB; a total of 13 services will close in Birmingham.
John Hemming: I agree with the hon. Gentleman that the CAB is a vital service, but does he agree that it should not take an all-or-nothing approach but be willing to compromise with the city council and aim to maintain a service at a lower cost?
Jack Dromey: The hon. Gentleman is, to be frank, wrong. The CAB has made it consistently clear that it is prepared to do precisely that, but dialogue with Birmingham city council has proved to be a dialogue with the deaf. If he will speak out today and call on Birmingham city council, and join the Labour MPs of Birmingham in hoping that good sense will break out next Monday, that would be very welcome indeed.
Mr Mahmood: The hon. Member for Birmingham, Yardley (John Hemming) is not dealing with the real issue. I have two CABs in my area-one in my constituency and one just outside-which serve some of the most deprived people in the area. Those people have real issues in respect of health, housing and mental health. An organisation called COPE: Black Mental Health Foundation, which provides advice on mental health issues, will close in the next two months because the city council is not providing any support. The Asian Resource Centre is also closing. As my hon. Friend the Member for Birmingham, Erdington says, there will be huge issues around support for the most vulnerable in our society, but there has been no dialogue at all with the city council on that.
Jack Dromey: My hon. Friend is, of course, right; it is not just the CAB. Some of the 13 organisations that are threatened are the Afro-Caribbean Millennium Centre, Age Concern in Birmingham and Perry Barr, the Birmingham Asian Resource Centre, the TUC Centre for the Unemployed and the Chinese Community Centre. A whole range of advice services catering for the needs of the various communities of Birmingham are all facing closure. In total, between 80,000 and 100,000 people seek advice from those 13 advice services each year. That is one in 10 of Birmingham's citizens, or one in four families. Such is the scale of need that those admirable institutions meet at present.
It would appear that the cuts are not just cruel and callous; they may be unlawful as well. The National Council for Voluntary Organisations, an admirable organisation, has written to Birmingham city council to raise concerns over the legality of the cuts in relation to consultation and equality impact assessments. Many of us will give evidence in any proceedings that are held because we know from our experience that there was no proper consultation in advance, and that no serious impact assessments were conducted. The council made the decisions just before Christmas, and it has gone hell for leather to implement the next stages without proper consultation or impact assessments.
It is essential that the Government and the council act. If a solution is to be found that will secure the long-term future of these admirable organisations, there will need to be at least interim funding while we seek a long-term solution.
Andrew Percy (Brigg and Goole) (Con): I thank the hon. Gentleman for his comments. The situation is the same across the country. In my constituency, the CAB in Goole is facing a similar threat. I want to reinforce the point that he has just made. There has to be a long-term solution, because this is not something that has not happened before. CABs are constantly battling for various funding streams, but what we really need is something that puts their vital service on a proper, long-term footing. I entirely agree with what he has been saying.
Jack Dromey: I am grateful to the hon. Gentleman. He makes a powerful point based on his experience. The current arrangements mean that this admirable institution, the CAB, lives from hand to mouth, never quite certain that it can count on the next funding round or stream, which makes it difficult to plan. John and Paul, who are here today, are outstanding at doing precisely that, but it is impossible for them to plan if they are told in December that they will have to close in March but they might or might not get money in August. That is, to be blunt, an absolute farce and something that requires urgent action by the Government to put right.
Let me close on exactly those points. Clear views have been expressed on both sides of the Chamber that we need action by Ministers. I say this with the greatest of respect to the Minister: Ministers cannot wash their hands of responsibility. If the big society means anything-they proclaim that the CAB and advice agencies are a key part-what do the Government intend to do about the situation? Will they call on Birmingham city council to think again? That is precisely what we hope for-that Birmingham city council will think again-when the meeting takes place on Monday next week.
I pay tribute to Citizens Advice. It is an outstanding institution with outstanding employees and volunteers. It needs to be able to serve the people of Birmingham well for the next 70 years, as it has for the past 70.
The Parliamentary Under-Secretary of State for Business, Innovation and Skills (Mr Edward Davey): I congratulate the hon. Member for Birmingham, Erdington (Jack Dromey) on securing this debate on what I agree is an important subject. I would like to thank the Members who intervened in the debate.
Like other hon. Members, I have advice surgeries in my constituency every week. In fact, I have two every week, and have done so every week since 1997: every Monday morning at 8 am in my office, and on Thursday or Friday night, or Saturday morning. I spend between five and six hours-sometimes even nine hours-face to face with constituents every week, so I see many of the kind of cases that the hon. Member for Birmingham, Erdington spoke about, whether about benefits, debt, housing or antisocial behaviour.
My staff and I work with the CAB in Kingston. We work with organisations such as Kingston Churches Action on Homelessness and several others to help the most vulnerable in our society, and we do that willingly, as does every Member in this Chamber. We understand the importance of the CAB. I understand the importance that it has in our society, whether it is called the big society or something else. I am afraid that the hon. Gentleman will have to get behind me in the queue to praise the work of the volunteers and professional staff of CABs in every community in our country and the work of the national organisation. I hope that when he hears my remarks, he will understand that the Government do support CABs.
John Hemming: It helps to put the history on record. Yes, the decision was taken in November that money needed to be saved in this area, but the objective was to maintain services, and, therefore, interim funding was made available. The CAB took the view that it was all or nothing; it wanted to continue interim funding at the same rate at which the funding was being withdrawn. To be fair, since then I have met with the chief executive of Citizens Advice, and although the meeting started with the position that it needed to maintain interim funding at the same rate, it has now agreed to look for savings, but that is far too late. I have a meeting with Councillor Ayoub Khan about the matter on Friday, and let us hope that the CAB, rather than issuing threats of legal action, is willing to co-operate to maintain services. I ask the CAB to co-operate to maintain-
The information that my hon. Friend provided then and in other interventions backs up the information I received-in no way has there been a final deal. People locally, both on the council and in Birmingham CAB, are talking to each other. Local MPs such as my hon. Friend are trying to help to resolve the issue, and are working hard on behalf of local people in Birmingham. That is exactly how it should be.
Richard Burden: May I gently put it to the Minister that those of us who have experience working with Birmingham city council know that all too often it is like trying to knit fog? Unlike the hon. Member for Birmingham, Yardley (John Hemming), rather than get my knitting needles out, I would rather get rid of the fog. If the Minister has looked into the issue, will he answer the following question? Has he taken a view on whether Birmingham city council's actions so far in dealing with this are compact-compliant?
Mr Davey: The hon. Gentleman will not be surprised to hear that it would be wrong for a Minister to second-guess every action of every council in the country. I hope that he will agree with that. If he agrees with localism, I hope that he will agree that local authorities, and the councillors who are elected to serve, should take responsibility and be accountable to their local electors. It is important that local councillors of all parties play their role in sorting out local problems in their areas.
Ms Gisela Stuart: I am grateful to the Minister for giving way. Given that six out of the 10 Birmingham MPs are here, and they have considerable experience of working with the council, will he say whether in his view Birmingham is compact-compliant? It is a very important point.
Mr Davey: I am afraid that I am not going to give the hon. Lady an answer to that question. It is important that, as this is being settled and as the meetings we have heard about-the one that has happened, the meeting on Friday, and the meeting on Monday-try to resolve the matter, they will ensure that any regulatory demands from central Government are met.
Mr Davey: This is a wider point that applies beyond Birmingham. I certainly agree that it is important that local authorities and citizens advice bureaux in these difficult times try to work together. I will talk about that in a moment, if I can make some progress.
I can give a view from the heart. A few years ago in my constituency, my local council signed up to a three-year strategic partnership with Kingston CAB to ensure that it had stability of funding. That is one issue discussed in
the debate. I understand that local authorities are under serious pressure at the moment, as are Government, Whitehall Departments and all those across the public sector. We have some difficult funding times, which is hardly a secret, and such long-term deals need to be seen in that context. From my local experience, I can recommend that strategic partnerships with key voluntary players, such as the CAB and the local council, can resolve such problems more easily.
Steve McCabe: I simply wanted to ask the Minister whether he is responding as part of a double act with the hon. Member for Birmingham, Yardley (John Hemming). Will he ask the hon. Gentleman why there was no mention of transitional funds in the council report in November? That seems to have emerged when the hon. Gentleman made his contribution today.
Mr Davey: When I eventually get to that point in my speech, I will say that prior to today I was aware that there was transitional funding. I do not think that it has emerged in the past few minutes. [Interruption.] Labour Members need to hear this, because there is a backdrop to the debate, which is the record deficit that the Administration inherited.
We have had to take very difficult decisions. One of the most difficult decisions I have had to take as Minister meant telling the chief executive of Citizens Advice that his budget-this was before Gillian Guy took over-had to be cut in-year by a significant percentage. I did not like having to deliver that decision, but I knew that we had to take tough decisions because we have such a difficult spending climate. It is exceedingly important that those tough decisions are taken fairly and are implemented. Local authorities will have to face up to that issue-Birmingham city council, Kingston council and other councils as well. I shall give way to my hon. Friend, but I hope that he realises that I need to make progress after his intervention.
As a result of the financial difficulties, all councils must re-examine how services are organised and run-finding efficiencies and unlocking savings. We have sought to make that task easier by scrapping most ring-fencing constraints on councils' funding, so they have greater freedom to manage resources in the best possible way. That involves joining up back-office functions, sharing chief executives and other senior managers, and cutting out the duplication and waste associated with procurement. Where possible, that should not mean cuts to front-line services. We say that not only to Birmingham city council, but to all local authorities.
It is worth noting that, although all citizens advice bureaux are members of the national umbrella organisation, Citizens Advice, they operate independently. I am sure that the hon. Member for Birmingham, Erdington will admit that at least. Their funding is determined locally. That is not new, but has been the case for many years under the previous Administration and the Administration
before that. Funding is determined by the relevant local authority. That is how it should be, because the need for advice and such services varies dramatically across the country. I am sure that the needs of Birmingham are different from the needs of Kingston. There should not be any doubt about the fact that these should be local services.
Yvonne Fovargue: Does the Minister agree that funding from the local authority often acts as seed-corn funding for the other funding that citizens advice bureaux get? For every £1 that the local authority puts in, £10, on average, from other sources is gained by bureaux.
Jack Dromey: We are getting close to the end of the debate, and it is of the highest importance that a clear message be sent to the people of Birmingham. A meeting is scheduled for next Monday and we hope progress will be made. In the event of progress not being made next Monday, will the Minister be prepared to meet a delegation from the Birmingham CAB-the admirable people who work for it, the admirable people who volunteer and some of the people who depend upon it?
Mr Davey: I would not want to prejudge the meetings that will happen over the next few days. It is up to individual councils such as Birmingham to work with partner organisations to sort out some of the difficulties. I understand that Birmingham city council has reviewed advice provision within the whole city and will be moving towards a new commissioning process in the summer. All the independent advice providers will be eligible to apply, and that will, of course, include the bureaux.
I also understand that the council recognises that there may be short-term problems for some of the independent advice providers during the period until new contracts are awarded. I believe that it has a transition fund, to which my hon. Friend the Member for Birmingham, Yardley referred, which might be used to help those organisations through that period. The meeting, scheduled for Monday, will focus on discussing that.
Those are positive developments, which the hon. Member for Birmingham, Erdington did not touch on his speech, and it is worth putting them on record because I hope they will result in a successful outcome. I am concerned that hasty decisions taken by councils now could lead to the unnecessary loss of important CAB services not only in Birmingham, but in other areas. I trust that, when local authorities work carefully with their citizens advice bureaux to strike up the strategic partnerships I talked about, that will not happen.
Daniel Kawczynski (Shrewsbury and Atcham) (Con): This important debate is on the reconfiguration of hospital services in Shropshire, and in almost six years as Member of Parliament for Shrewsbury, I have never received so many letters, e-mails and telephone calls from concerned constituents over a single issue. Many of those calls have been emotional, and even though the consultation process is still ongoing, I feel it is my duty to use the platform that I have in the House of Commons to highlight a few of the concerns to the Minister.
Part of the reconfiguration proposals would involve maternity and paediatric services moving from Shrewsbury to Telford. I want the Minister to imagine the geography of Shropshire and mid-Wales. The Royal Shrewsbury hospital covers not just the whole of Shropshire, but the whole of mid-Wales-a vast expanse just across the border. I am pleased that my hon. Friend the Member for Montgomeryshire (Glyn Davies) is present in the debate today.
Picture the wheel of a bicycle, and at the centre, the spokes coming into the middle. That is where Shrewsbury is in the area. Now imagine moving paediatric and maternity services right to the edge of the wheel. How would that wheel function? Telford is at the edge of the area, on the extreme eastern border close to Staffordshire. What is the sense in moving services so far away from the rest of central Shropshire and mid-Wales?
I am so passionate about this issue that I raised it during Prime Minister's Question Time last week. The Prime Minister referred to the importance of public engagement and consultation, which he said was a fundamental aspect of any reconfiguration proposals. Therefore, I have asked the chief executive and the primary care trust for a public meeting to be held in Shrewsbury on 11 February at the football stadium in our town. I believe that hundreds and hundreds of people will attend. I intend to make a transcript of that meeting and of all questions put to the PCT and the chief executive, and I will be sending that transcript to the Minister.
Glyn Davies (Montgomeryshire) (Con): My hon. Friend knows that I also have a huge interest in this issue as I represent Montgomeryshire over the border. Does he agree that the meetings that will be held in Montgomeryshire on 18, 23 and 24 February are of equal importance, and that it is crucial for the health board and PCTs to take notice of them? We also depend on the services in Shropshire.
Daniel Kawczynski: I agree with my hon. Friend. We are cognisant of the fact that his constituents, the citizens of mid-Wales, do not have facilities across the border and are dependent on the Royal Shrewsbury hospital. The people of Wales must be listened to equally, in the same way as the people of Shropshire.
I have slight concerns about the lack of sufficient engagement by the authorities with local people. I pay tribute to the chief executive and his colleagues. There have been public meetings, and the chief executive has met some of my constituents who have serious questions to ask on a one-to-one basis. Nevertheless, many letters
and e-mails have not been answered in a timely way or to the degree that people wished for. Some people who have written in are retired senior consultants and experts in the field. I hope that all their questions will be answered.
I am also concerned about the dates of the public consultation. In began on 9 December and will finish on 14 March. I find 9 December a rather strange time to start a public consultation. We all know how stressful Christmas is at the best of times, and we would have been gearing up to buy the Christmas tree and presents and get our homes ready for festivities. A lot of people in Shropshire will not have been thinking about the consultation as intently and with as much time and focus as they might have done, because they were distracted by the coming festivities. If we are to have a public consultation, it must be held at the right time of the year and there must be sufficient time for people to make their views heard.
David Wright (Telford) (Lab): I am grateful to my hon. Friend-I use that phrase pointedly-for giving way. There will be a consultation in Telford next week, and I hope that people will come to it. It is important that people across Shropshire express their opinions. Does my hon. Friend accept that under the proposals, both hospitals have to give something in order to sustain health services in Shropshire? Acute surgery would move to Shrewsbury, and some elements of paediatric and maternity services would move to Telford. There will be a balance between the two hospitals. We do not want to see services move out of the county, and if we are to sustain services in Shropshire, I think this is the best plan we are going to get.
Daniel Kawczynski: I will reciprocate by referring to the hon. Gentleman as my hon. Friend. We are from different parties but we are colleagues. We get on well, and across the parties we have a passion for Shropshire. I will come later to the importance of retaining services in Shropshire. However, constituents do not pay attention to services that come to their area; they are focused on those that are leaving. That is why they are pressing me to highlight these issues in Parliament.
My other concern is that there is no plan B. This is a consultation process in which the chief executive and the board come forward with proposals. However, there are no shades of grey-it is take it or leave it. I speak purely as a layman, but if there is only one option, it is difficult for a large group of people, many of whom do not have medical experience, to scrutinise that proposal. Surely, if we are to genuinely engage with local people, differences and alternative options could be put forward so that the community as a whole could come together, debate them and make recommendations.
Mark Pritchard (The Wrekin) (Con):
Does my hon. Friend accept that in an ideal world, both hospital sites would have all-singing, all-dancing acute and clinical services? However, we do not live in an ideal world, but in a time of constrained public finances. Does he accept that the current consultation recognises the importance of having an accident and emergency ward at both Shrewsbury and Telford? That is a breakthrough from
the original consultation process and shows that the hospital trust has listened to Shrewsbury and Telford on that important point.
Daniel Kawczynski: I concur with my hon. Friend and with the point that he makes in his usual eloquent way. I have been told by the chief executive, and others, that if we do not go for the proposals, we will potentially put our foundation trust status at risk. If we put that at risk, there is the possibility of losing services-and the management of those services-out of the county. Again, I speak without medical experience, but I do not understand how we could enter into a consultation process but be told that if we do not go for the proposals, services will be lost from Shropshire.
I cannot envisage a time when we have no maternity or paediatric services in the whole of Shropshire. That is unthinkable to me, so I do not understand the logic of the trust. It is saying, "Take it or leave it, but if you leave it, that's it. We won't get our foundation trust status and you'll lose your services." That position needs to be clarified because many people see it as a gun being pointed at their heads and are therefore frightened to challenge the proposals.
Glyn Davies: I am grateful to my hon. Friend for his tolerance in allowing me to make a second intervention. The point that he has just raised is key. Everyone, including, I am sure, my hon. Friend, recognises that there must be a reconfiguration of services. The points that have been made are crucial. However, that does not necessarily mean that the reconfiguration of services that is before us has to be the case. The argument is not about whether there should be a reconfiguration of services, but about how that should take place. In the interests of the people of Montgomeryshire, I think that services are best placed not where it is convenient for a balance in Shropshire, but where they are accessible to the people who will use them.
I shall briefly relate a couple of specific cases. I have been inundated with hundreds of letters on this issue. My own daughter was born at the Royal Shrewsbury hospital, and it was the proudest day of my life when my daughter was born within the community that I represent. She is not just a Salopian; she is a Shrewsbury girl and she will have that with her for the rest of her life. For us in Shrewsbury, being a Salopian is important, but being a Shrewsbury girl? Now that is something special. I feel so passionately about that.
One constituent's family is directly affected by the proposals, as her three-year-old son needs 24-hour open access to the children's ward at the Royal Shrewsbury hospital because he suffers from severe haemophilia. He needs treatment to be administered every other day and any additional treatment on demand if he should cut himself. I was told that it was vital for my constituent's son to be admitted immediately to the children's ward via A and E and not to be sent down the motorway to the Princess Royal hospital. How can that mother of a son with haemophilia empower herself to make her views known if the overview and scrutiny committee is not minded to refer this issue to the Minister?
The issue has also been raised with me by the father of a child who was previously a cancer patient treated at the Royal Shrewsbury hospital. He talks about the appeal in 2003 for a designated children's cancer unit at the Shrewsbury hospital. It raised £500,000 and the unit was completed in 2005. My constituent told me that
"many people across Shropshire and Mid Wales donated or gave up many hours to fundraise, only to now find that the purpose built unit will...stand unused as Children's services are being moved to Telford with no provision for this desperately needed unit which provides an essential service to families facing unimaginable turmoil whose children are being treated for cancer."
I have been told of the severe disruption and anguish that will result from the need for seriously ill patients to travel from Shrewsbury if it is left with no consultant-led surgery, which may result in a catastrophic delay in emergency treatment.
I also want to mention Joshua, a young boy in my constituency who has chronic lung disease. His mother, Hayley Corfield, wrote to me about him. He has had bronchial problems since birth and is now 14 and constantly in and out of hospital. I have been given the most extraordinary list, which I will send to the Minister, of the medications that this poor young boy is on. He lives in Shrewsbury. His mother tells me that there have been many near misses in the last few years in terms of saving his life-resuscitating him. She is desperately worried about the impact on her son and the chances of his survival if, suffering from this chronic disease, he has to travel for an extra 20 minutes to Telford. I am therefore raising these issues with the Minister today.
"to ensure views from that meeting are fed back to the local NHS via the consultation mechanism, so local concerns are fully taken into account."
"The Department will be watching the outcomes from the consultation exercise with interest."
I have today written to all the general practitioners who practise in Shrewsbury and Atcham. Again, the Prime Minister stated at Prime Minister's questions, and it was reconfirmed to me by my right hon. Friend the Secretary of State for Health, that the views of local general practitioners would have to be taken into account before any reconfiguration process could occur. I wanted an independent assessment of their views, rather than it being handed to me by the PCT or anyone else. I have therefore written today to all the general practitioners in my constituency and I urge my hon. Friends to do likewise if they so wish. I will compile the results of the views of local general practitioners in Shrewsbury and will share their views anonymously. I will not refer to specific people, but I will share their views with the Minister.
I am extremely grateful for the 15 minutes that I have had and for the constructive way in which we have debated this issue. It is extremely emotive. I do not want to get into a Shrewsbury-Telford pillow fight. We have
had enough of that over the years. I want to work constructively with my colleagues and with the trust to come up with the best possible solution for our beautiful county.
The Minister of State, Department of Health (Mr Simon Burns): I congratulate my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) on securing this debate on hospital services in Shropshire. I am sure that his constituents will be pleased to know that he has raised an issue of such great importance to his local community. I also pay tribute to the staff of the NHS across the whole of the county of Shropshire, who do such an incredible job caring for the constituents of my hon. Friend and the hon. Member for Telford (David Wright). They deserve and will receive the Government's full support.
Before I come to the specifics of Shropshire, I shall set out the Government's general approach to the reconfiguration of health services, as my hon. Friend referred to the answer that he received from my right hon. Friend the Prime Minister last week. The Government passionately believe that local decision making is essential to improve outcomes for patients and to drive up quality. We do more than just talk about pushing power to the local level; we are doing it.
In May 2010, my right hon. Friend the Secretary of State for Health identified four crucial tests that all reconfigurations must pass. First, they must have the support of GP commissioners. Secondly, arrangements for public and patient engagement, including local authorities, must be further strengthened. Thirdly, there must be greater clarity about the clinical evidence base underpinning any proposals. Fourthly, any proposals must take into account the need to develop and support patient choice.
I understand that NHS West Midlands has given an assurance that the case for change is underpinned by those tests. Let me be clear what that means. Hospital closures that do not have the support of GPs, local clinicians, patients and the local community should not happen. There should be ample opportunity for patients, local GPs and clinicians and local councils to have a far greater role in how services are shaped and to ensure that these changes will lead to the best outcomes for patients.
It is important to remember that local public consultation is the vehicle through which to ensure that everyone with an active interest in proposed changes to their local health service gets their say. In this case, local consultations began on 9 December 2010 and are scheduled to conclude on 14 March 2011. My hon. Friend mentioned it, but if it is any consolation to him, Christmas and the new year holidays came during that period. The normal consultation time is 12 weeks, and if my maths is right this consultation process will take 13 and a half weeks including the holidays.
It should be stressed that consultation is by no means a fait accompli. It is a democratic process that allows full and open participation in considering all the options for service change. If an overview and scrutiny committee is not satisfied that adequate NHS consultation has taken place, or decides that proposals do not meet the needs of the local community, it may refer the matter to the Secretary of State for Health.
I understand that there has been a long history of debate on the best way to organise hospital services in Shropshire. A previous review failed to provide a lasting way forward for the county. Local organisations are now taking this review forward, and they believe that changes need to be made in the near future to ensure that services continue to be provided safely. Over the last decade, the NHS in Shropshire has identified a number of services, including accident and emergency, acute surgery, maternity, neo-natal, in-patient, paediatrics and urology, that face an increasing challenge in trying to provide 24-hour cover by senior medical staff at local hospitals.
As the public consultation document explains, there are five main reasons for that. First, the increasing specialisation of staff means that fewer consultants are able to provide general emergency cover. That is a particular problem in general surgery if it is split between two sites. Secondly, out-of-hours arrangements mean that some consultants have to cover a number of services and sites at the same time. That places unrealistic pressure on staff, and it can put patients at risk. Thirdly, the European working time directive limits the time that medical staff are allowed to work to an average of 48 hours a week. Fourthly, due to the relatively spread-out nature of the Shropshire sites and the area's rurality, it can be difficult for junior doctors to see the wide range of patients necessary for their training. Fifthly, those factors collectively could make it difficult to recruit high-quality medical staff, particularly consultants.
The current configuration of services results in duplication between the Royal Shrewsbury and Princess Royal hospitals. It also limits the ability to develop the more specialised services that could be provided in Shropshire, Telford and The Wrekin. That is not sustainable.
This is the opportunity for all those with an interest in making changes to local health services to become involved. My hon. Friend has called for an additional public meeting in Shrewsbury; that takes place on Friday 11 February. As I said in my letter, I strongly encourage my hon. Friend to note the views raised at the public meeting, so that they can be fed in to the consultation process. Before a final decision is made following the conclusion of the consultation process, those views will have been heard and considered.
The consultation document explores four options. Option 1 is to do nothing. That is not considered feasible by the local NHS. A second option is to concentrate all major and emergency activity on the site of one or other of the existing two hospitals, with planned activity at the other. That has been looked at carefully, and I understand that that is not considered feasible either. A third option is to build a new hospital, but that has been discounted because of the financial climate. A fourth option, the preferred local NHS option, means moving services between the two sites to make the most effective use of staff, equipment, and buildings.
Mr Burns: As I was saying when we broke for the Division, the consultation document suggests that this is likely to mean that the bulk of in-patient, children and maternity services will be provided at the Princess Royal hospital in Telford. A range of acute surgery, including trauma and orthopaedic surgery, and various surgical and other services would remain at, or move to, Shrewsbury. Both sites would continue to provide midwife-led maternity units, with improved accommodation provided for the midwife-led unit at the Royal Shrewsbury hospital site. All pregnant women who are assessed as being likely to have a low risk of complication in the later stages of pregnancy would still have the opportunity to choose to have their baby in a midwife-led maternity unit or at home.
Gynaecological services and antenatal out-patient and day care services will continue to be available at both sites, as will children's out-patient services. It is proposed that a number of specialist surgery services, whether for planned or emergency operations, would be concentrated at the Royal Shrewsbury hospital: vascular surgery; colorectal surgery, and upper gastro-intestinal surgery. I also understand that funding will be made available so that the Royal Shrewsbury hospital will gain phase 3 status as a specialist aortic aneurism centre.
The consultation states that most surgery for life-threatening trauma is already carried out by surgeons at the Royal Shrewsbury hospital and that would continue to be the case under these proposals. Also, 24-hour accident and emergency services will remain at both hospitals. Therefore, proposals in the consultation document appear to point to a vision of both hospitals providing a diverse range of services that complement each other.
This review has been led by clinicians. Proposals are based on work led by senior doctors, nurses and other health care professionals in the county, working with partners from local authorities, community and voluntary organisations, and patient and public representatives. I understand that the local NHS has involved a number of clinical staff in its local assurance process, including clinical experts from outside Shropshire, such as the director of nursing from Leicester Royal Infirmary and a consultant paediatrician from Manchester, as well as a number of clinical staff with related experience who work within the trust but who had not been involved previously in developing future options.
I am assured that NHS West Midlands will consider results of the public consultation, as is appropriate, before any results are presented to the local NHS boards. I also understand that the local NHS is keeping all local MPs briefed on the consultation process.
I know that my hon. Friend the Member for Shrewsbury and Atcham has campaigned vigorously in the past for retaining services at his local hospital. May I assure him that I fully appreciate his desire for a process that is open and transparent, one that does not end with decisions made behind closed doors after only a derisory nod to public consultation? His constituents, like those of all right hon. and hon. Members, deserve local health services that have the confidence of local GP commissioners and of local people themselves.
I also point out to my hon. Friend that because we are in the middle of a consultation process it would be totally inappropriate for me to seek to influence or compromise that process by becoming directly involved. There are avenues open through the consultation process, as my hon. Friend knows well, and I know that he is working vigorously, as demonstrated by his holding a meeting in Shrewsbury on 11 February, to make sure that the voice of his constituents is heard and considered
as part of what is a very important consultation process for the whole county of Shropshire, to ensure the right configuration of services in local hospitals to meet the needs of local people.