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Westminster Hall

Tuesday 15 March 2011

[Jim Dobbin in the Chair]

Quilliam Foundation

Motion made, and Question proposed, That the sitting be now adjourned.—(James Duddridge.)

9.30 am

Paul Goggins (Wythenshawe and Sale East) (Lab): You will realise from my dulcet tones, Mr Dobbin, that I am struggling with my voice this morning, but I hope at least to get to the end of my introductory remarks. It is good to see you in the Chair. This morning’s debate takes us to the heart of an important issue in which I know you are interested, as are many hon. Members on both sides of the House. I am pleased that so many from both sides are already present, and am particularly pleased to be joined by my right hon. Friend the Member for Salford and Eccles (Hazel Blears). She speaks on these issues with considerable experience, as a former Minister with responsibility for police and counter-terrorism and a former Secretary of State for Communities and Local Government. She learned a great deal in both those roles and I look forward to hearing her comments later.

This debate takes us to the heart of a complex and crucial issue, namely, the need to take on the extremist ideology that underpins the activities of those who are opposed to our society and seek to destroy it. I want to keep my remarks and the debate simple, because what is at stake right now is the future of an organisation that is playing a vital role within that debate. My straightforward request, which I seek to put as constructively as I can to the Minister, is that transitional funding of £150,000 be made available to the Quilliam organisation, which will fold in the next few days unless interim support is made available. Although I realise that a debate in Parliament is not the time for line-by-line negotiation of every aspect of an organisation’s budget, I hope that, by the debate’s conclusion, the Minister will have given us cause to hope that a resolution will be found to the problem and a way forward established.

Five weeks ago, the Prime Minister made an important speech at the Munich security conference. He argued that we need to differentiate between Islam—the world religion that teaches and practises a belief in peace and a loving God—and Islamist extremism, a political ideology which is opposed to western democracy and is linked to and underpins terrorist violence. He explained that radicalisation is a process that turns non-violent Islamists into people who are prepared to kill human beings, including themselves, in pursuit of their perverted ideology. The Prime Minister pointed out that vulnerable individuals become terrorists not overnight, but as a result of the constant pressure placed on them, whether in internet chat rooms, in prisons or, indeed, on university campuses. He went on to state that we need to work with Muslim-led organisations that are willing to confront that Islamist ideology, provided that, at the same time, they defend human rights, equality and integration. He said:

“So let us give voice to those followers of Islam in our own countries—the vast, often unheard majority—who despise the

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extremists and their worldview. Let us engage groups that share our aspirations.”

I agree very firmly with what the Prime Minister said.

Quilliam is a secular think-tank that was set up in 2008 by two former Islamist extremists, Ed Husain and Maajid Nawaz. Since then, it has become a unique centre of knowledge of such extremism. It is not an exaggeration to say that its research and networking have had at least as great an influence on the debate about Islamist extremism and terrorism as any other organisation in the UK. It has gained an international reputation for its work. It is interesting that, this very morning, an important conference on counter-terrorism will be addressed by the Minister for Security, Baroness Neville-Jones. Further down the agenda, a senior spokesperson from Quilliam will speak about the same issues and agenda as a senior Government Minister.

Controversy is, predictably enough, never far away from such an organisation. It has made enemies as well as friends. Those associated with Quilliam face considerable threats and abuse as a result of the stance that they take. Quilliam was initially funded by money from private donors in the Gulf. However, that money was withdrawn when Quilliam’s founders publicly criticised Yusuf al-Qaradawi and the use of suicide bombings against Israeli civilians. After that, Quilliam began to receive money from the Home Office and the Foreign Office under the Prevent programme. Quilliam always intended to become financially self-sufficient and was close to achieving private funding on two occasions, only to lose it at the last minute—first, as a result of the credit crunch, and secondly, because of the 2009 uprisings in the middle east.

The money given to Quilliam by the Government has had an immediate and visible impact. Quilliam is one of the few Muslim-led organisations willing to confront extremism directly, to name and shame extremist organisations, and to remain unequivocal in its defence of British values, including free speech, freedom of religion, gay rights and respect for others.

Quilliam has been the most vocal Muslim-led organisation to condemn, without equivocation, suicide bombings and acts of terrorism, and to challenge extremist groups in the United Kingdom. Its bold approach has paved the way for other Muslim groups throughout the United Kingdom to follow suit. By acting as a leader within Britain’s Muslim communities, Quilliam has encouraged other Muslim groups to initiate real debates about issues such as terrorism, religious belief and secularism.

A few days ago, for example, Quilliam issued a statement publicly defending Usama Hasan—a progressive London imam who received death threats for stating his belief in evolution—and criticising the total silence of the Muslim community in the face of the threats against him. The statement encouraged more than a dozen major British Muslim organisations to issue their own statements defending Hasan and his right to free speech.

Quilliam’s staff and supporters make regular media contributions to mainstream UK programmes as well as to specialist Islamic TV and radio outlets. Their statements demonstrate clearly that not all Muslims are extremists. They also challenge Islamist extremists within their own core constituency. In my experience, no other Muslim-led group in the UK does that more effectively.

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As the middle east and Pakistan face ever greater turmoil, I believe that Quilliam can make an important contribution, both to our understanding of what is happening and the forces at work, and to the development of a narrative that counters the extremists. Quilliam can also help to challenge Islamist extremism here in the United Kingdom. It has already done much to influence the debate and get the message across to the British public that the vast majority of Muslims are also against extremism. There is particularly important work to do in that regard with young Muslims, who may be disillusioned, concerned about, and fed up with the world around them, and who may be attracted by the perverted ideology of the extremists. We have to make sure that that is countered, and organisations such as Quilliam are in an ideal position to do that.

Mike Gapes (Ilford South) (Lab/Co-op): I have known for some time some of the people involved in Quilliam. My right hon. Friend has mentioned Pakistan, and one of the things that I have found valuable is a report published by Quilliam about a year ago about the radicalisation going on in Pakistan. The organisation was prepared to go to Pakistan and engage with young people in its universities, and to explain to them the realities of British Muslim life. Very few other organisations in this country are prepared to do that, and to do it without a destructive political agenda that feeds prejudices. Quilliam was challenging prejudices, which is in our national interest. It is, therefore, vital that we continue supporting Quilliam.

Paul Goggins: I am grateful for my hon. Friend’s intervention. He is a great authority on the issues and has an association with Quilliam—as he has said, he knows some of the people involved. He has raised an important issue. In fact, Quilliam has been involved in establishing a Facebook site called Khudi, which has 40,000 subscribers in Pakistan. There are young people listening to the liberal values and arguments being made through that Facebook page. Quilliam is taking the argument into parts of the world where we would find it impossible as individual politicians or, indeed, Governments to advance arguments that would be listened to with any credibility. I pay tribute to Quilliam for doing that work and thank my hon. Friend again for his intervention.

We will soon learn the conclusions that the coroner has reached in the 7/7 inquest. Whatever findings and recommendations she makes, we cannot escape the fact that those responsible for the bombs were a part of our community. We must ensure that there is no room for retreat into denial about extremism. Like my right hon. Friend the Member for Salford and Eccles, I was a Home Office Minister when the 7/7 bombs went off. In the months that followed, she and I travelled the length and breadth of the country in a effort to engage with the Muslim community and encourage it to face up to the minority in its midst that had adopted an extremist ideology and was intent on the destruction of our way of life and the values that underpin it.

I learned a great deal from those many encounters, but the most important lesson I learned was that it would not be me who could persuade young Muslims

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away from those who would try to radicalise them and turn them into extremists; it must be people within the wider Muslim community itself who do that work. Our job—whether as Ministers, other politicians who are interested in the issue or, indeed, non-governmental organisations—is to empower and encourage people within the Muslim community to do such work for themselves. That was the most important lesson I learned.

Patrick Mercer (Newark) (Con): Like me, I am sure that the right hon. Gentleman remembers sparring over this issue in relation to the Prevent strategy and the rights and wrongs thereof. However, the Quilliam Foundation is based on not just common sense, but the historical precedent of using those who were opposed to spread the message back to our opponents. That is a very valuable tool; it is not unique but it is an extraordinary tool. I am sure that the right hon. Gentleman would agree that that must not be allowed to perish.

Paul Goggins: I am grateful for the hon. Gentleman’s intervention. He and I have sparred over many issues, including this one. I have a great measure of agreement with him when we debate such matters. Those who speak with not just knowledge, but experience do so with additional credibility and in a particularly powerful way. We cannot afford to lose the experience that is contained within the Quilliam Foundation. I hope that my remarks and arguments—and those that will be made by others later in the debate—will persuade Ministers not to give a blank cheque to the organisation, but to provide sufficient funding to enable it to survive the immediate future and provide its own sustainable funding in the long term.

I was describing the core of the important work that Quilliam does by supporting, encouraging and empowering those within the Muslim community to take this work forward for themselves. Again, I say that I am not asking for a blank cheque. Indeed, I support the strong argument that Quilliam should get out of Government funding in the longer term because that will add to its sense of independence, credibility and power within the Muslim community. In the long run, that is a sensible way forward, but we need an interim solution that will enable the organisation to survive these next few days and weeks.

Quilliam has not simply sat there and demanded money; it has taken difficult decisions in recent days to make its sustainability more likely. It has reduced staff numbers from 14 to six and has made eight staff redundant. Clearly, those are very painful decisions, but Quilliam regarded them as necessary in the circumstances. The small team that remains at Quilliam is working flat out on funding bids to charitable trusts and other funding organisations. It currently has a number of funding bids in but, as hon. Members know, charitable trusts do not deal with funding bids every day of the week; they have their own cycle and programme for deciding such things. Quilliam needs some time to allow those organisations to consider the bids and to respond, I hope, positively. Another important recent development has been the granting of charitable status to Quilliam in the United States. I hope that that will open up more avenues of potential financial support for it in the longer term.

I would also like to inform the Minister that Quilliam has actively been looking for smaller more affordable offices, which is also an important way of reducing the

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organisation’s overhead costs. Quilliam is not sitting there expecting a blank cheque from Government; it wants independent funding and it is prepared to reduce its costs. However, at the moment, it faces a real crisis. The request is simple enough. In December, Quilliam was told that there would be no more core funding in 2011-12. Three months is just not long enough for an organisation to move from core funding to project funding. We need a more flexible approach. A grant of £150,000 to cover the year ahead should be made. That is a reasonable investment in the kind of project I have been describing. After that, Government funds should be available only for specific projects that are agreed.

I hope that such an approach will find support from all parties this morning. It is certainly supported by Lord Carlile who, of course, is regarded by many as the expert in this area of public policy. He has made it clear in the media and personally to me that he supports having a transitional grant that would facilitate survival and then a path towards sustainable, independent funding. Quilliam is prepared to confront Islamist extremists. We should be prepared to ensure that it remains in business.

9.46 am

Tom Brake (Carshalton and Wallington) (LD): I congratulate the right hon. Member for Wythenshawe and Sale East (Paul Goggins), who has put forward a strong and effective case. He has made a very specific proposal that £150,000 should be provided by the Government. He made it clear that it should not be a blank cheque and specified that the funding would be for 12 months starting next month. What he did not do was to set out precisely what conditions and objectives might be attached, perhaps because he cannot conduct negotiations on Quilliam’s behalf, or he does not want to conduct negotiations here. He indicated clearly that at the end of the 12-month period, Quilliam would have to be self-financing, albeit perhaps having secured grants from Government for specific projects. However, other conditions might have to be attached if the Government were minded to go down that route.

The right hon. Gentleman made it clear that today’s discussion on the future funding of Quilliam is not just about the funding streams of that UK-based think-tank; it is about the Government’s current and developing policy stance on counter-terrorism—what we fund and why and how we should continue to move forward post-Prevent. Is our nation’s security to be based on ideology and on which groups emphasise or downplay certain aspects of Islam, or on reality and on the evidence of policies that have worked and continue to produce results?

As the right hon. Gentleman said, Quilliam’s funding streams are well documented and a loss of substantial funding early in its inception led to its being funded by the Foreign and Commonwealth Office and the Home Office, which illustrates exactly why there is a need for Quilliam to continue. It lost funding by being vocal in opposing extremism in whatever form and from whatever source. As he said, a funder withdrew support early on in Quilliam’s life as a reaction to the organisation’s stance against suicide bombings in Israel. Quilliam’s public stance on that issue was not particularly to do with Islam, but it was part of its consistent, clear and vocal opposition to all forms of terrorism. However, the

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resultant situation—Quilliam being funded largely by two Departments—clearly raises issues about bipartisanship and credibility.

Quilliam is not the only organisation that publicly and vociferously challenges extremism in all its guises, whether anti-Jewish, anti-Islam or anti-western; nor is it the only organisation in which former extremists have played an active part in educating peoples, Governments and policy makers on how to recognise and counter the type of radicalisation that results in extremist behaviours. The Street project in Brixton was previously funded by Prevent and has also experienced funding cuts. It is a non-sectarian group that works from a mosque and does measurable work in combating the kind of radicalisation that can lead to extremism. Similarly, the Cordoba Foundation has produced projects with a focus on preventing radicalism from becoming extremist action. In about a week’s time, an initiative called “Learning to be a Peacemaker” will be held in this place by an organisation called Initiatives of Change, which is also working in that field.

It is true, however, that Quilliam is distinct and unique in important respects. It is the only organisation that challenges extremist views and activities by effectively straddling both the Muslim perspective and the liberal, secular, mainstream vernacular of modern Britain. It represents the swathes of British Muslims who are Muslim by birth and culture first and foremost, but who understand and adhere to the division between Church and state, which is second nature to mainland Britain. Quilliam sits within the diverse and, at times, conflicting dialogue about Islam that is both acceptable and normal practice among faith-based Muslim groups, but unlike any other organisation of its size and impact, Quilliam also sits comfortably within the traditional western liberal dialogue, which separates to a large extent the personal faith of individuals and the secular, cultural interpretation of those personal faiths.

As the right hon. Member for Wythenshawe and Sale East set out, Quilliam started life as a think-tank, but the very nature of its work—outreach in universities, and research and policy advice—is much more akin to that of an effective and proactive non-governmental organisation. Quilliam’s vocal stance against terrorism that claims to be inspired by Islam has had solid results, which are measurable. Accurately signposting Government to specific individuals with an inclination for extremist action is invaluable in our fight against terrorism. As the right hon. Gentleman said, it remains one of the few groups—occasionally the only group—that consistently challenge and publicly condemn terrorism, from whatever source. As it sits within the Muslim dialogue, it has first-hand access to, and shared understanding of, the dialogues taking place at grassroots level and online that can lead to extremist action. That position is unique and invaluable to the Government’s fight against terrorism.

However, the criticism levelled at Quilliam, and indirectly at the previous Government for funding the group, is worth examination and raises important questions that need to be addressed in relation to any decisions about funding. The first is about its perceived dominance of the mainstream view. Many individuals and organisations are discouraged by an organisation that purports to be the arbiter of what is, or is not, mainstream. That is further complicated by the coming to light of a list produced by Quilliam that seems to many to suggest

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that some other Muslim organisations, which consider themselves mainstream, are breeding grounds for civil unrest because of ideological perspectives shared to a greater or lesser extent with radical extremist groups.

Dr Julian Lewis (New Forest East) (Con): The hon. Gentleman makes a serious point. However, is it not the case that when taking part in an ideological battle, all groups describe themselves as mainstream? Indeed, even Islamist extremists describe themselves as mainstream, because they are trying to say that everyone who disagrees with them is an apostate. There is nothing unusual, therefore, about Quilliam at one end of the spectrum calling itself mainstream, while other groups at the centre of the spectrum call themselves mainstream, and groups on the radical Islamist end of the spectrum call themselves mainstream. That is not really a valid criticism.

Tom Brake: The hon. Gentleman is very experienced in these matters. Maybe on that particular point we will have to disagree on whether my comment is appropriate.

The funding of a think-tank by the Home Office and the Foreign and Commonwealth Office will inevitably contribute to a perceived lack of plurality of voices heard by Government on how best to combat extremism. Lack of funding from other agencies will raise questions about how and whether Quilliam can critically engage with Government, and will cast doubts about its credibility as an independent body with the capacity to critique Government plans and policy on tackling radical extremism. It is true to say, however, that that position conveniently forgets the numerous groups that receive funding from the Government’s Prevent strategy to undertake or continue work to counteract extremist activity. It also overlooks the many Muslim groups that are frequently invited to put their views to Government, most recently a couple of months ago at a conference I hosted here with Murtaza Shibli, when we invited Muslim organisations to share opinions and advice on how best the Government can go forward with the post-Prevent agenda.

No one can doubt the achievements of Quilliam as an NGO. The debate about funding should, therefore, rightly concern itself with levels of funding at a time of financial austerity, and not about whether we should forgo that important insight into extremist narratives. Although I support the continued funding of this much-needed organisation, Quilliam, like other NGOs and agencies working under the vital remit of social cohesion, needs to look hard at how best to make effective decisions within tighter financial constraints. Quilliam also needs to continue to pursue other avenues of funding—as it is doing—to continue, with credibility, a bipartisan relationship with Government and other Muslim groups.

9.55 am

Hazel Blears (Salford and Eccles) (Lab): It is a great pleasure to contribute to the debate. I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) not only on securing the debate, but on his thoughtful, wide-ranging and incisive contribution. It is also a pleasure to follow the hon. Member for Carshalton and Wallington (Tom Brake), who clearly has experience in these matters. He has raised some important issues, particularly on the plurality

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of voices, which we need as a society, on what are always contentious and very often sensitive matters. This debate is an opportunity not just to recognise the work that Quilliam has done, but to explore some of the complexity of this area and how Government might go forward.

We are here to highlight the situation in which Quilliam finds itself. I intend to concentrate on that in my remarks, because we need to press the Government for results as much as we need to have a general debate. In my experience, as with a number of groups working on this agenda, Quilliam has very often been brave, courageous, and willing to tread where other people have not perhaps been quite so brave. It always wants not just to highlight the threat that our country faces, but to come up with a practical response about how we can tackle that threat and develop a counter-extremist narrative and agenda to ensure that we build the resilience, particularly of our young people, to withstand extremist messages.

We are at a very important moment in relation to this issue. We had a significant speech from the Prime Minister a couple of weeks ago at the Munich security conference, which marks something of a turning point. He was very firm that the Government cannot tackle these issues alone. Government need help from a wide range of organisations from civil society, the Muslim community and communities across the spectrum. Government can do certain things, but the power to tackle an extremist narrative always comes from the community itself, which has to feel empowered, supported and backed up by Government in order to take on that task. The Prime Minister said:

“governments cannot do this alone. The extremism we face is a distortion of Islam”.

That is absolutely right. Islam is about peace, compassion, tolerance and inclusion; it is not about violence and division. The people who peddle messages of hate actually harm Islam in a way that almost nothing else can. The Prime Minister continued:

“these arguments, in part, must be made by those within Islam…let us give voice to those followers of Islam in our own countries—the vast, often unheard majority—who despise the extremists and their worldview.”

If that is our task, and we need others to help us, then it is very sad that we find ourselves having to press almost for the survival of an organisation such as Quilliam. It is that serious. Unless practical steps are taken by Government to ensure that there is some transitional funding for that organisation, I have no doubt that it will simply fold and not be able to conduct its activities. It has already made significant redundancies of a whole range of staff. From experience, I know how difficult it is to create capacity on these very difficult issues. It takes experience, knowledge and—I come back to that word—courage to stand up and be counted, and very often to make enemies, and face personal threats and intimidation. If we lose that organisation, we will lose that enormously valuable capacity that may well be able to be built up in the future. If something is destroyed, however, it is much harder to build up.

Mr Gerry Sutcliffe (Bradford South) (Lab): As an experienced former Government Minister, my right hon. Friend will know that Departments sometimes have the capacity, when they are reviewing programmes and

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trying to look at the whole picture, to let things slip through the net. Is there a danger that Quilliam could slip through the net?

Hazel Blears: I am grateful to my hon. Friend for that intervention. The debate this morning is an attempt to ensure that Quilliam does not slip through the net, and I know that Ministers in the Department are seized of the issues. We all recognise that these are difficult financial times and that difficult decisions have to be made across the Government, and I want to explore that a little with the Minister, perhaps with some specific questions later. We recognise that these are not easy times. The Home Office, which has taken a significant reduction in its expenditure, clearly needs to economise. My right hon. Friend the Member for Wythenshawe and Sale East has set out a specific proposition for £150,000 of transitional funding to enable Quilliam to pursue the other applications that it has made, which ought to get us to a reasonable position. I recognise that having an organisation solely dependent on public funds is not tenable in the long term.

Tom Brake: The right hon. Lady has been familiar with the organisation for several years. Is she aware of whether Quilliam was previously given an indication that it should go to other organisations to find funding? If it was but has not been successful in achieving self-sufficiency, the Government would have strong reservations about putting money in again.

Hazel Blears: This did not become a significant issue until we were facing the current financial circumstances which pertain across Government. I certainly was not aware of a major drive, which was unsuccessful, to press Quilliam to find funds in other sectors. Clearly, the situation now is that economies need to be made. Quilliam has been put into that pot, but I want to explore with the Minister what other organisations are funded and what cuts have been made—I shall come shortly to the Research Information and Communications Unit. We need a better, broader picture of the total resources available, and what decisions have been made about funding priorities. In a few weeks, we are expecting the Prevent review, which will give us more insight into what the balance of organisations ought to be. We absolutely need a balance.

This is not a partisan issue by any measure—it transcends party politics. It relates to the security and safety of our country, and nothing can be more important than that. My right hon. and hon. Friends and I are pursuing the matter to try to get a reasonable settlement.

As my right hon. Friend the Member for Wythenshawe and Sale East said, I was the Minister with responsibility for counter-terrorism at the time of the 7 July 2005 bombings. Even now, I can feel the sense of devastation and shock that there was across the nation when that happened. People were asking who committed the bombings, why they would want to do that to innocent men and women and their families, and what led them to be prepared to take their own life to fulfil what they presumably believed to be their mission and destiny. I do not think that any of us really understood—we still do not—the many and varied factors that lead people down such a path, that lead them even to contemplate taking such steps.

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We are better informed than we were then. Several organisations that have been active in this field have helped the Government and policy makers to come to a better analysis of the factors that lead people to extremism, but we do not have all the answers. I entirely accept that, although some of the measures in the Prevent programme were successful, some were less successful, but what we were doing in that area was innovative and, in many ways, experimental.

I have spoken to people in the United States, France, Germany and countries across western Europe who say that this country has been at the forefront of trying to drill down to determine what the factors of extremism are, and how to build resilience among young people so that they can resist such messages. My sense is that those other countries are just beginning to take the first steps. Indeed, that was reaffirmed for my right hon. Friend and me when we went to the United States just last week. Many of the Congressmen and women and Senators acknowledged that they are very much at the beginning of thinking about a counter-radicalisation strategy, whereas this country is well ahead. This country’s position has been aided enormously by the different groups that we have funded to help us. They have had programmes and have been able to develop an evidence base about the best way to counter extremism, and the Quilliam Foundation has been at the heart of that process for the past three years at least.

As everyone knows, Quilliam was formed by Ed Husain and Maajid Nawaz, both of whom had been in the grip of extremists. They had been right at the heart of Hizb ut-Tahrir and knew what it felt like to travel down that path. Therefore, their voices and the voices of others at Quilliam who have been able to set out the emotional process that happens to people on that journey have been enormously powerful and valuable in working out strategies to counter extremism. They were certainly instrumental, when I was the Secretary of State for Communities and Local Government, in my decision to set up the Young Muslims Advisory Group and the Muslim Women’s Advisory Group.

It was the first time in this country that we had people at national level who were able to advise Ministers about what it felt like to be a young person in the community with strong feelings about foreign policy and contentious issues, and with the many pressures that face them at that time of their life. What could the Government do to try to help them to grow up with a sense of this country’s values but also, of course, their important personal identity and heritage? The Muslim Women’s Advisory Group was a fabulous opportunity to find out about women’s lives, and how women could influence the young men in their families to withstand the extremist narrative. We can celebrate the huge amount that we achieved, but, obviously, we have much more to do.

Going around the country after 7/7 with my right hon. Friend the Member for Wythenshawe and Sale East was probably one of the most testing experiences I personally have ever undergone. The sense of anger, bewilderment and shock in communities was palpable, but the message that came across to me time and again was that the overwhelming majority of people in the Muslim community totally rejected the violence that had taken place, and believed that killing innocent people was never justifiable. Unfortunately, the extremism

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that leads people to contemplate and sometimes adopt violence is with us now—there is no getting away from that—and is likely to be with us for many years to come. Life has changed, and we ought to recognise that the circumstances are very different. That is why it is so important that we have the capacity to tackle that ideology and the way in which people seek to groom others to take the path of violence.

I want to mention a report which I think is relevant to this debate. “Fear and HOPE”, which was published last week by the Searchlight Educational Trust, is about the new politics of identity. Many people who are susceptible to extremist narratives are struggling with their sense of identity: who am I, where do I fit in, where do I belong, what is my value set?

The report, which was based on 5,000 interviews of people across the country who were asked more than 90 questions, provides some fascinating results and evidence. What gives me optimism and hope is that there is widespread rejection of political violence. It is interesting that the vast majority of people who were questioned considered white anti-Muslim extremists to be as bad as Islamist extremists. That tells me that a core part of our communities and population are basically saying, “A plague on both your houses. We want no part of extremism, whether far-right extremism, Islamist extremism or anti-Semitism—we reject all that.”

It gives me great hope for the future that if we can build, sustain and make that heart of our community strong, it will empower and give confidence to young people to say, “I reject the extremist narrative. I reject such ideologies and share the broad values of this country.” That prize is so precious and valuable that the investment of £150,000 to enable Quilliam to move to other sources of funding over the next few months is a small price to pay, considering the scale of the challenge that we face. I absolutely agree with the hon. Member for Carshalton and Wallington that we need a broad range of organisations to help with the agenda at every part of the spectrum. It is without doubt that Quilliam has been prepared to be at one end of that spectrum, to speak out, not to be intimidated, and to state the case for pluralism, inclusion and British values of democracy, tolerance, free speech, and particularly the rights of women. It has been extremely effective in doing that.

Obviously, we must support other organisations, and I will come to that, but it is only three years since Quilliam was established, and to have gained its reputation in the world within that period marks it out as a special organisation that has helped us to build that evidence base. Its report on radicalisation on campuses was extremely good and contained a series of recommendations. We know that there is a problem on some of our university campuses, and the report’s practical recommendations could help us significantly. It produced a report on the use of the internet to promote Jihad. We are now seeing preachers such as al-Maliki on the internet urging people to take matters into their own hands without having a group around them, and to carry out individual acts of terrorism. That report on the use of the internet was a good piece of work. The role of television in influencing young minds is crucial.

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Quilliam has produced excellent reports, and done project work—for example, its work in Pakistan, as my right hon. Friend the Member for Wythenshawe and Sale East mentioned, which was funded by the Foreign Office, with road shows prepared in challenging and sometimes intimidating circumstances to make the case fearlessly. It has a tremendous record. It is seeking other sources of funding. It recognises that the current situation cannot continue ad infinitum, but it must be given the chance to do that work.

I have some questions for the Minister, and if he cannot answer them during the debate, I would appreciate it if he got back to me later. The Research Information and Communications Unit was established in the Office of Security and Counter-terrorism in the Home Office three or four years ago. My recollection is that that was a fairly well resourced unit. It received contributions from the Department for Communities and Local Government, the Home Office, and the Foreign and Commonwealth Office, and it brought together a series of people with the skills to develop a counter-narrative, to publish documents, and to do research and much of the work that Quilliam has been doing.

Dr Julian Lewis: I remember a conversation I had with a senior Minister about the setting-up of RICU. My understanding is that there was an analogy between it and the operation set up at the onset of the cold war to try to counter communist subversion and propaganda. Either such organisations do the work themselves, or they do the research and support other non-governmental organisations that will go on to the front line and fight the ideological battle. I do not think I have seen anything to suggest that RICU is fighting that battle under its own banner on the front line. If it is not doing that itself, why is it not perpetually committed to the support of other organisations such as Quilliam which are prepared to go into the front line?

Hazel Blears: The hon. Gentleman makes an excellent point, to which I hope the Minister will respond. The comparison between the funding of RICU and the funding that we are asking for in this debate would be illuminating. It is clear that there is a straightforward and simple al-Qaeda narrative, which is that the west is at war with Islam with a feeling of victimhood and grievance. That must be countered, and it is my understanding that that was a core part of RICU’s responsibilities. I would be grateful if the Minister let us know what its resources are, what the product is, what it has been working on and, indeed, whether it can fund other organisations.

Mr Mark Field (Cities of London and Westminster) (Con): The right hon. Lady is making an important speech, and I entirely agree with the broad thrust of what she is saying about Quilliam’s importance. Will she go into a little detail about the discussion she might have had with that organisation about where it sees its diverse sources of funding coming from if it does not come simply from the Home Office, and a time frame for when new sources would come into play if the Home Office were able to continue some of the funding that it is planning to take away?

Hazel Blears: I am grateful for that question. Until recently, Quilliam was in a position to become self-financing in a short time. It had offers of funding, but we then had the recession, which has unfortunately affected all

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of us, including charitable donations. We have also had the events in the middle east. I understand that some support was pledged from organisations with middle east connections, but that has not been possible because of recent events. It now has a number of applications with charitable foundations that are active in building capacity, resilience and counter-narratives. It has some applications with individuals who have a long track record of support in this area. It is optimistic about being able to obtain funding. It may not be at the same level as in the past, which is why it has made some redundancies—it wants to cut its cloth according to its resources—but it is optimistic about being able to continue with a core facility and to build from there. That will depend on its reputation and the worth of its product, and rightly so. It should be out there and showing it to people.

I would be grateful if the Minister told us what the RICU budget is, what the overall budget is this year for the Prevent strategy and—I know that there will be a review—what it is likely to be, what other organisations are active in developing the counter-narrative and the counter-extremism part, as opposed to some of the good community work that goes on, and how much funding is provided to external organisations. Much of the Prevent review will be about project funding, and Quilliam absolutely accepts that that is where it needs to be in future. Will the Minster confirm that applications for project funding from the Quilliam Foundation will be considered in exactly the same way as applications from any other body-on the strength of the project that it is putting forward?

We could make decisions on such issues that we may live to regret later. It is so much more difficult to recreate something than to help it to continue to exist. I entirely support my right hon. Friend the Member for Wythenshawe and Sale East in his bid for £150,000 to enable the organisation to have an effective transition. Nothing is more important than keeping our country safe, and I believe that the Quilliam Foundation plays a major role in that objective.

Several hon. Members rose

Jim Dobbin (in the Chair): Order. I intend to call the shadow Minister at 10.40, so that gives hon. Members some idea of how much time we have left for the remaining speakers.

10.18 am

Dr Julian Lewis (New Forest East) (Con): It is a privilege to follow that outstanding speech by the right hon. Member for Salford and Eccles (Hazel Blears). Her work and that of the right hon. Member for Wythenshawe and Sale East (Paul Goggins) as Ministers on this topic excited the admiration of many of us when we were on the Opposition Benches. It continues to excite my admiration now that they are in opposition, but still fighting just as hard on this vital topic as they ever did when they were Ministers.

During the 1990s, I occasionally had the privilege of taking part in courses on public speaking, oratory and campaigning techniques with another member of the House of Commons who is now Mr Speaker. He always impressed on everyone who came to our courses that when making a speech one should have, at most, two

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main points, but preferably only one, with which to belabour one’s listeners over and over again, so that if they remembered nothing else about what one had said, they would remember that one point.

Here is my one point today. It is that countering hostile propaganda is not a commercial enterprise or undertaking. It requires sponsorship and support. It is absolute nonsense to say that people who are brave enough to put themselves in the front of an ideological battle should be selling their product on a commercial basis because that somehow means that their organisation is more vibrant.

If organisations that are fighting an ideological battle do not get support from the Government, they will need to get it from private sources. I know of no organisation during the cold war that fought these sorts of ideological campaigns—there were many such organisations; I was involved in several of them—that managed to make enough money to sustain itself as a going concern commercially. Such organisations had to find sponsorship. As I understand it, Quilliam has been rather particular about the sponsors it has sought. It could have taken money from undemocratic regimes but I believe that it turned down those offers. Although it might have agreed with those regimes on certain issues, it could not agree with the way that they rule their countries and peoples. Let us not fool ourselves into thinking that if Government funding is cut from an organisation, that organisation will somehow transform itself into a profit-making enterprise. It will not; that is not its function. The more time that activists in a counter-propaganda organisation spend raising funds, the less time they have available to do the job of countering radicalisation and extremism.

I hope that the Government will have the good sense to continue funding Quilliam because I am a little concerned about what may be going on under the surface. On the surface, as the right hon. Member for Salford and Eccles said at the beginning of her remarks, we have an excellent speech from the Prime Minister stating that we must be tough on radicalism and that we must not compromise. We must not pretend that people who speak with a double voice, as it were, and say that they are against extremism on the one hand but treat it softly on the other, are the only people with whom we should deal. Although that sort of speech makes all the right sounds, in reality Government officials are kicking away the props that support what is undoubtedly one of the most high-profile and successful organisations in the field of counter-propaganda.

I use those words deliberately because this is a propaganda war involving propaganda by those who seek to radicalise, and counter-propaganda by those who seek to defeat and undermine their campaigns. That sort of work must not be undermined by paid Government officials at a time when the head of the Government says that we ought to do more of it.

Something strange is going on and I think I know what it is. Reference was made earlier to the important conference being held today at the Royal United Services Institute. I had hoped to attend that conference this morning, but I felt that this debate was rather more important. My mind went back to a previous conference held quite a few years ago at the RUSI, and a rather impressive Government speaker on counter-terrorism. I subsequently sought a briefing from that speaker, and the Government gave permission for me to have one.

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During the course of the conversation, I made the point that one clearly had to encourage moderate Muslims to stand up against minority activists, just as in so many other fields. Particularly during the cold war and student radicalism on campuses in other decades, it had been necessary for moderates to stand up for the silent majority against the noisy activist and—above all—unrepresentative minority. I was intrigued by what the expert official said. He replied, “That’s absolutely true: there is a gap between those who hold moderate values and those who hold extreme values. However, there is another gap between those who hold extreme values and those—a much smaller group—who are willing to turn their extreme values and views into extreme and violent action.”

It seems that the Government—perhaps I should say the establishment, as that remains the same when Governments change—have primarily signed up to focusing on the division between extremist people who do not intend to be violent, and extremist people who intend to be violent. There is some value in that approach, but I do not believe that it should be exclusive. If we depend on people in the Muslim community with extreme views to stand up against others from that community with extreme views who want to be violent, we will not get a happy outcome. We must promote moderate values in the Muslim community. Therefore, we need an organisation that is prepared not only to attack violent extremism, but to counter the pernicious ideology of those who might not be planning violence, but who foster an extreme ideological environment where some people will absorb sufficiently illiberal notions and end up turning to violence.

I am concerned about this issue because there are a couple of ways in which counter-propaganda organisations can work. Some such organisations can, and should, concentrate on changing minds. If we wish to try that, it is important to persuade people who are inclined towards fundamentalism that they are wrong, and to have organisations that are perhaps tolerated more happily than Quilliam within the Muslim ideological community. Those organisations can work on trying to change the minds of those who are already radical.

There is, however, another more important element that must not be neglected. We hope, and I genuinely believe, that the majority of people in the Muslim community—I would like to think the overwhelming majority—hold moderate beliefs and are not extremist at all. The problem is that of the three sectors—the moderate community, the extreme community that is not violent and the extreme splinter community that is violent—the Government machine focuses too much on the second two categories, to the exclusion of the first. The only way we will win an ideological battle or war is by mobilising the silent majority. The silent majority is a hackneyed phrase because we use it a lot. Nevertheless, we use it a lot because it is true; it has to be true, and if it were not we might as well give up on civilisation straight away. We need groups that are not necessarily involved in trying to change minds, but rather in trying to reinforce moderate views that already exist.

Tom Brake: Does the hon. Gentleman believe that it is unrealistic to expect Quilliam to secure funds from trusts or benefactors rather than from the Government?

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Dr Lewis: It is not unrealistic and I made that explicit at the beginning of my speech. I said that if one does not get funds from the Government, one must get them from another sponsor. Ideally, one should have a range of funders, and the Government ought to be a part of that. My point is that if the Government have any sense, they will not withdraw funding in such a way that an organisation will collapse. If they believe that the organisation’s work is of sufficient value, they should ensure that it has secure funding before they begin to draw down their own funding stream. It is as simple as that.

I will conclude with one further point. It is my second point and I do not mind if hon. Members do not remember it, as long as they remember my first point. There are two types of counter-propaganda. There is counter-propaganda that is designed to persuade people to change their minds, and there is counter-propaganda that is designed to reinforce the moderate views that the silent majority already hold.

I shall give an example. When I was a youngster in the 1960s, a huge argument was going on about whether this country should continue to be defended by a nuclear deterrent. I was sure that it should continue to be defended by a nuclear deterrent, but time after time I would see people on the television and hear people on the radio saying, “No, that isn’t necessary.” I began to think, “Well, I’m only a teenager. What do I know about this?” I began to doubt my own commitment. Then one day, someone from another country was being interviewed on television and he made such a convincing case for the nuclear deterrent, and articulated so much better than I could, as a youngster, the case for what I believed already, that I thought, “Fine. I’m okay. That’s all I need to know. At least one other person in the world, brainier and more articulate than I am, has come to the same conclusion for the same reason.”

I believe that groups such as Quilliam both need to do the type of work that I have described and actually do that type of work. There are moderate Muslims who, because of the way in which radicalism and extremism dominate the narrative, will begin to doubt themselves—even though their own views are moderate. It is the job of a group such as Quilliam to show that when the extremists say, “We are mainstream and you are un-Islamic,” in fact the reverse is the case. To get that message across, people must be knowledgeable and professional, must have a huge amount of detail at their disposal and must have access to the airwaves, the printing presses and the internet.

I am very sorry that the Government, because they believe in persuading people to change their minds, are to kick away the support from an organisation that is dedicated to reinforcing people who do not need to change their minds, but need to be encouraged to speak up and need to be reassured that they are right and the extremists are wrong. This is not a commercial enterprise; it is a political fight. If the Government want to take the line that the organisation must be self-funding and self-supporting, let us ask ourselves this final question. How many Departments would be able to do their work if they had to raise the money to fund it themselves as a result of the product of their work, rather than their income stream coming from taxation? I think we would find that not a single Department—except perhaps the Ministry of fun—would survive such a proposition.

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I believe that Quilliam’s work is essential. I believe that it is non-commercial. It has been supported thanks to the work of the right hon. Member for Salford and Eccles and of the right hon. Member for Wythenshawe and Sale East, whom I congratulate on initiating this very important debate. It is no coincidence that more than half the House of Commons members of the Intelligence and Security Committee are here making this case today, even though we are making it in our personal capacities, not as members of that Committee. I shall leave time for the right hon. Member for Wolverhampton South East (Mr McFadden) to speak. I hope that the Government will take our message extremely seriously.

Jim Dobbin (in the Chair): Order. I know that Mr McFadden has been very patient, but I must remind him that the Front-Bench responses to the debate start at 10.40.

10.33 am

Mr Pat McFadden (Wolverhampton South East) (Lab): Thank you, Mr Dobbin. I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) on initiating the debate. We all know that the backdrop to it is the very serious terrorist threat that we face. That is not a myth; it is not something that has been made up. In the London underground bombings, 52 people were killed. Since then there has been the plot to blow up airliners, which resulted in the liquid restrictions on aeroplanes; we have had the shoe bomber, Richard Reid; and we have had the Christmas day attack on the Northwest Airlines flight to Detroit involving Umar Farouk Abdulmutallab. There have also been other incidents—some that we know about and probably some that we do not know about.

To combat terrorism, we of course need security forces to catch and punish those responsible but, as other hon. Members have said, we must also confront and challenge the ideology that feeds such acts. Quilliam is critical in that fight. It cannot all be done by Government and Government agencies. As other hon. Members have said, this is an ideological struggle that must take place within the Islamic community itself.

I have had less direct ministerial involvement in this issue than my colleagues, but of course our political interests are not confined purely to our ministerial experience. However, one issue in which I did have some ministerial involvement was extremism on university campuses. I commend Quilliam for the work and research that it has done on extremism on campuses, which is growing. One of Quilliam’s founders, Ed Husain, outlines very well in his book the expertise with which Islamic extremists use the liberal values of those who run our colleges and universities to propagate what they want to do and put the university or college authorities on the defensive.

As we have all agreed, Quilliam is an important organisation. It is important because it is unequivocal in its condemnation of terrorism. It challenges the ideology that feeds it. It condemns suicide bombings; it does not make excuses for them. It takes on arguments perpetrated by the apologists for terrorism. Quilliam is also important in another sense. It challenges the notion, sometimes spread by non-Muslims as well as Muslims, that the terrorist problem is all our fault—the conceited

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notion, ultimately, that the west is so all-powerful that it is responsible, either through its foreign policy decisions or through other means, for encouraging terrorism. Quilliam challenges that, too, so it provides a service well beyond the argument that currently takes place within the Islamic community.

Mr Denis MacShane (Rotherham) (Lab): I am sorry that I came into the debate late; that was because of a traffic problem. Does my right hon. Friend agree that he is repeating almost word for word the message of the Prime Minister both at the Community Security Trust dinner two weeks ago and in Kuwait—the message that he has constantly urged? I understand why the Liberal Democrats want to kill Quilliam, but I just cannot understand why Conservative officials and Ministers in the Home Office want to do it such damage.

Mr McFadden: I cannot speak for the Conservatives. The Minister will have a chance to do that in a few minutes.

As we have said, what Quilliam does is important because those who lead it are themselves ex-supporters of violent jihad. Therefore it is done with a level of understanding and engagement in ideological and, indeed, theological debate that is well nigh impossible for Ministers. That is important because it is extremely difficult for the state to engage in theological debate, and the argument must be won theologically as well as ideologically.

The Government have proposed to cut core funding for the organisation. That is a mistake. As the hon. Member for New Forest East (Dr Lewis) said, Quilliam has given strength and confidence to others, too. That is a very important aspect of its work. By stepping forward, people from the organisation have given strength to others who probably think these things but may not have seen other people in the debate giving voice to them.

I shall ask the Minister a direct question. I understand that the Home Office budget is under pressure—the pace and scale of cuts is an argument for another day—but is the decision purely budgetary or, as the hon. Member for New Forest East implied, is something else going on? Is there a wider disagreement with what Quilliam has advocated in recent years? I believe that the proposal made by my right hon. Friend the Member for Wythenshawe and Sale East for a grant of £150,000 to give the organisation time and space to seek alternative funding is worthy of support, even in these difficult times.

Let us just ask ourselves this question. What will the debate about terrorism be like if Quilliam folds? The hon. Member for Carshalton and Wallington (Tom Brake) said that there are other organisations. I have not really seen them. I have not seen others stepping forward with the degree of clarity and theological and ideological commitment that Quilliam has had.

There is a complacency about saying that others will simply step forward. I have long experience of seeing this ideology develop, not particularly as an MP, but as a Government staffer. I have seen some of the errors that Governments have made in the past and, frankly, I do not want to return to the situation we had 10 years ago, when we listened to many voices that we thought were representative. There is a danger of complacency in cutting Quilliam’s funding, and if the Minister thinks

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that other organisations will step forward to fill the void if Quilliam does not get the funding it so urgently needs, I would like him to name them today.

I hope that the Minister has heard the arguments that have been made today. I also hope that he will respond positively to the proposal from my right hon. Friend the Member for Wythenshawe and Sale East and tell us exactly who will speak up and make the arguments that Quilliam has made if that organisation no longer exists.

Jim Dobbin (in the Chair): Thank you, Mr McFadden, for a disciplined speech.

10.40 am

Mr Gerry Sutcliffe (Bradford South) (Lab): It is a great pleasure to serve under your chairmanship, Mr Dobbin. It is a delight to be involved in a debate that has none of the partisanship we would expect when talking about organisations’ funding.

I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) on securing the debate. I also congratulate other right hon. and hon. Members on their contributions, which they made with passion. They have shown their credibility and the experience they have gained in an individual capacity, although as the hon. Member for New Forest East (Dr Lewis) said, they also represent almost half the members of the Intelligence and Security Committee. The Minister would do well to take that experience on board. In that respect, I was impressed to hear that Lord Carlile, who has been the independent adjudicator on counter-terrorism matters, also supports Quilliam. As my right hon. Friend said, the Government have made the wrong decision—I fully understand why, given the cuts to the Home Office budget and the problems Ministers face—but they now have an opportunity to put things right.

I want to put on record my thanks to my right hon. Friends the Members for Wythenshawe and Sale East and for Salford and Eccles (Hazel Blears) for the work they did as Ministers after 7/7. As a West Yorkshire MP, I am well aware of the mood—the shock and horror—in West Yorkshire when we found out that the bombers were from our area. There was great concern in communities, and I am grateful to Members for saying that the majority of Muslim people support the state and do not agree with the atrocities that have taken place.

Paul Goggins: My hon. Friend takes my mind back to the day I visited Bradford, when he and other colleagues helped to organise an important meeting with the Muslim community. Does he remember that the central focus of our discussion was concerns about the inability of us as outsiders, and indeed of Muslim leaders themselves, to communicate effectively with young people in the community? Is that not something that Quilliam can do very effectively?

Mr Sutcliffe: Very much so. That was one of the key points. My right hon. Friend the Member for Salford and Eccles was honourable enough to say that although we got lots of things right in Prevent, we also got lots of things wrong. Communication with the community was

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one of the things that was difficult; at one point, the community felt that it was under attack by the state and that we were describing it as the enemy, for want of a better term. The reality was that we needed to get into the community, and particularly to young people who felt isolated. Quilliam can do that.

What strikes me about the debate is that Quilliam has been acknowledged as an organisation that speaks its mind. In speaking its mind, however, it can also create enemies and problems, including with officials in Departments, although I do not mean that in a critical way—that is just the way things develop and operate.

As has been said, Quilliam has set about these issues and produced important research on a complex and controversial subject. As my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) said, its research and reports on radicalisation on university campuses has been important. It has also done work in British mosques and the prison system. As a former Prisons Minister, I was interested in what Quilliam said about the radicalisation of prisoners.

Quilliam’s reports have been enlightening and important. Just yesterday, it produced a considered and thoughtful report on the situation in Libya, arguing for action by the international community. It has also done important work overseas, and my hon. Friend the Member for Ilford South (Mike Gapes) talked about the work that it did in Pakistan, challenging extremism and promoting a democratic culture. Although Quilliam is not universally popular, it is clear that many of its critics are apologists for radical Islamism.

I have listened to the debate with interest. Accepting Government funding can give rise to the thought that people are betraying themselves as Government stooges. If people rely only on Government funding and have no other funding, are they putting themselves in a difficult position? Such thoughts have undoubtedly alienated some in the Muslim community from Quilliam. It is not surprising that Quilliam is not universally popular, however, because it tackles controversial issues and it is not afraid to tell it like it is.

When we look at Prevent, it is right that we look at all the issues. This is not the time to argue about Government cuts or the timetable for the review of Prevent. However, we should recognise that Quilliam is a powerful organisation, which is supported by many Members of the House with expert knowledge of these issues. People could argue that this is special pleading, but it is special pleading for an organisation that could, as I said in an intervention on my right hon. Friend the Member for Salford and Eccles, slip through the net if nothing happens; indeed, Quilliam is already making redundancies and looking at its finances.

Ministers face difficult decisions in good times and bad times; they have to deal with budgets and other issues, and they rely a lot on support from their officials. However, if decisions are not taken quickly in this case, Quilliam will be lost, and if it is, it will not be rediscovered, as Members have said. We cannot readily call on such expertise.

I hope that the Minister will answer the question posed by my right hon. Friend the Member for Salford and Eccles in the spirit that she asked it. We need to know what is going on. Is this a political decision? Have Ministers reflected on the issue in light of the support

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for Quilliam? The hon. Member for Carshalton and Wallington (Tom Brake) is right to say that we have to look at every area of spend in these difficult times, but it is important that we do not throw the baby out with the bathwater.

I fear that the Government’s good intentions in reviewing Prevent could put an end to an organisation that has credibility and support in the UK and internationally. In that respect, I am heartened to hear that it has charity status in the US, which shows its willingness to go out and look for other funding. It is important that it retains credibility in terms of where it gets its funding. As has been said, it could get funding from many different organisations, but would that be the right funding for Quilliam, given the context of its work?

I hope that the Minister will reflect on the debate, which has been excellent, well-informed and non-partisan. I understand that difficult choices have to be made, but I hope we can make sure that this organisation does not slip through the net.

10.48 am

The Minister for Immigration (Damian Green): In congratulating the right hon. Member for Wythenshawe and Sale East (Paul Goggins), let me say how grateful I am for the constructive way in which he made his suggestions and asked his questions; indeed, I am grateful for the constructive tone in which the whole debate has taken place. I am particularly grateful to have had the benefit of the experience of the right hon. Member for Salford and Eccles (Hazel Blears), who clearly grappled with these absolutely vital, difficult and sensitive issues when she worked in various Departments.

I should say at the outset that there is no doubt that Quilliam has done important work in support of counter-terrorism efforts in this country. Various Members on both sides have quoted the Prime Minister’s Munich speech, in which he set out the course that the Government will follow on counter-terrorism, and Quilliam continues to contribute to that. The Home Office understood the role that Quilliam could play when it helped the organisation get off the ground in 2008. Officials and Ministers provided it with extensive advice and assistance at that time.

The Home Office envisaged that Quilliam would be able to work in and with Muslim communities, and particularly with young people, challenging and exposing terrorist ideology and contributing to the aim of stopping people becoming terrorists or supporting terrorism, to observe the distinction made by my hon. Friend the Member for New Forest East (Dr Lewis). The Home Office judged that, as former radical Islamists themselves, Quilliam’s founders would be able to draw on their own experiences to describe that ideology, explain why it might seem superficially compelling and demonstrate its incoherence. Quilliam subsequently developed a significant research function, and has published some papers on important issues, including radicalisation on the internet, in prisons and in further and higher education.

It is fair to say that, since 2008, Quilliam has developed a brand, a message and a clear public position. It is known not only in this country but overseas, notably in the USA. Throughout that period, both the Home Office and the Foreign Office provided Quilliam with significant financial assistance. Quilliam has received

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more Home Office Prevent funding than any other single organisation—nearly £1.2 million over the past three financial years. The Foreign Office has provided nearly £1.5 million in project funding over the same period.

Regarding funding for Quilliam and other organisations, Pakistan was mentioned and the important work that needs to be done there. Tackling radicalisation in Pakistan is clearly important but, to put it into context, there are nearly 100 organisations, large and small, supporting Prevent overseas. More than 20 of those are in Pakistan, many of them working anonymously for obvious security reasons. All of those are funded by the Foreign Office.

This financial year, the Home Office has provided Quilliam with six-figure funding. It has been invited to submit bids for project funding in the next financial year.

Dr Lewis: I wish Ministers would stop using the phrase, which has clearly been given to them, of six-figure funding. Six-figure funding can be from £100,000 to £999,000. There are big variations in it.

Damian Green: There are indeed, and I will come to exact figures in a second.

The funding provided to Quilliam has been unique, not only in its scale but in its scope. It has been used not just for projects and programmes but, exceptionally, for significant overheads and running costs. The Government agree that Quilliam deserved some support in the past, and we continue to believe that Quilliam is capable of useful work. However, following a review of all the organisations, projects and programmes supported as part of the Prevent strategy, Home Office Ministers have taken the decision to end funding for Quilliam’s running costs from the end of this financial year. Clearly, that is the heart and purpose of the debate.

I say to the right hon. Member for Wythenshawe and Sale East that there is an offer on the table to Quilliam of tens of thousands of pounds to cover the next few months of basic operations. He and the array of distinguished ex-Ministers on the Opposition Benches will recognise that this not the place to conduct detailed financial negotiations. I want to assure him and everyone who has attended the debate that there is an offer. It would be foolish for me to start negotiating here; I will merely gently observe that the £150,000 transitional money referred to by several right hon. and hon. Members is actually more than the total Home Office money given to Quilliam over the past 12 months, as decided by the previous Government. I would not want anyone to leave the debate with the thought that £150,000 is a small percentage of what Quilliam might have expected to receive. It is actually more than the total budget received from the Home Office in the past year.

Hazel Blears: Will the Minister give an indication of when Quilliam was first told that it would need to replace the Home Office funding with funding from other sources?

Damian Green: In December. My hon. Friend the Member for New Forest East asked for specific numbers. The trajectory of Home Office direct funding for Quilliam is quite clear. In 2008-09, it was £665,000; in 2009-10, it was £387,000; and in 2010-11, it was £145,000. There

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was a clear trend in the direction agreed with by everyone who has spoken in the debate: that is, that Quilliam does good work but that a think-tank of that kind should not be reliant for its core running costs on Government funding.

Dr Lewis rose—

Damian Green: If my hon. Friend will excuse me, I need to make some progress, because others have asked interesting “in principle” questions, which I need to address. He himself gave the impression there was some kind of conspiracy afoot, and I wish to reject that.

Home Office Ministers have taken the decisions they have for three reasons. First, Quilliam has, as we all agree, evolved into a think-tank; it is no longer fulfilling the role for which it was originally funded by the previous Government. Secondly, Quilliam has continually committed to broadening its sources of funding and to becoming more self-reliant, and I think we agree that that needs to happen. Thirdly, Home Office Ministers believe that the Department can no longer make an exception for Quilliam by paying for its ongoing running costs as well as funding specific projects. The Home Office does not support any other think-tank on that basis, a point well made by my hon. Friend the Member for Carshalton and Wallington (Tom Brake).

Let me deal with each of those points in turn. As I have already said, the original purpose for which Quilliam was funded by Government was to work in and with Muslim communities to challenge the ideology of terrorism and extremism. In some cases, that has not been done as successfully as Ministers originally hoped. Since 2008, Quilliam has progressively engaged in a different and rather broader range of activities consistent with its declared intention of being a think-tank. It publishes work on a range of security issues, not confined to the narrower and hugely important issue of countering radicalisation. In doing so, I emphasise again, Quilliam makes important contributions to the overall debate.

Mr McFadden: I appreciate the pressure of time. I am not sure that I accept the distinction the Minister makes between think-tank work and countering extremism. The publication of the reports is important in countering extremism. To get to the point, can the Minister say who he thinks will step forward and do this if Quilliam folds?

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Damian Green: I am trying to come to that point. The principle we want to uphold is that Quilliam should be free to contribute to the wider debate, but not depend on Government funding to do so. The other think-tanks that have also published on radicalisation—including Demos, the Policy Exchange and the Centre for Social Cohesion—all operate on that basis. It is the way that all successful think-tanks need to operate. The right hon. Member for Wolverhampton South East (Mr McFadden) asked a reasonable question about whether think-tank work can contribute to countering radicalisation. That is done by a number of think-tanks. There is an important point of principle about whether think-tanks should continually depend on direct state funding for their core activities to continue their work year after year.

Paul Goggins: I am grateful to the Minister for giving way: all of us who have been Ministers recognise that the timing of winding-up the debate is a fine art, and there is much ground to cover.

The Minister has recognised the contribution that Quilliam has made. He talked about an offer running into tens of thousands of pounds. We have argued for £150,000. If there is good will, a real interest in making sure that the organisation can survive, will the Minister agree to meet me and other colleagues to pursue that, to see if what may be a narrow gap can be closed?

Damian Green: I am always willing to meet the right hon. Gentleman. I know he met the Home Secretary yesterday, and the situation on the subject has not changed radically in the 12 hours since he met her.

Let me address the issues. The Foreign Office and the Home Office fund a number of small organisations, charities, civil society organisations and faith communities to deliver the Prevent programme, overseas and in this country. There are more than 130 such organisations. To protect them and their credibility we do not disclose their names. I am sure everyone will recognise that they are sometimes working in high-risk environments. Their credibility needs protection because research that appears to be British Government-inspired will inevitably have less credibility.

The right hon. Member for Salford and Eccles asked about RICU. It has clearly received staff and resources from the Foreign Office, from the Department for Communities and Local Government and from the Home Office, recognising the challenge of producing a coherent narrative overseas, nationally and among local communities. I will write to her on the details.

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NHS (Essex)

11 am

Priti Patel (Witham) (Con): I am grateful to Mr Speaker for granting me the opportunity in Westminster Hall to draw directly to the Minister’s attention a number of important issues regarding the performance of NHS services in my constituency and in the county of Essex. I suspect that the matters that I shall raise and the constituents’ cases that I shall mention are by no means unique to my constituency or the county. However, the Government are developing the most important and, in my opinion, long-overdue changes to the NHS, and I want to ensure that the problems and challenges faced by my constituents are thoroughly and fully considered.

Throughout the endless reforms and reorganisations undertaken by the previous Government, the health needs of patients were never afforded the same priority as the expanding tick-box bureaucracy suffered by my constituents. One consequence of the waste that was created is that the money put into the health service never achieved the true outcomes that my constituents deserved and needed. That has led in part to my constituents suffering poor patient choice and health care services. However, we cannot change everything about the past.

The Minister, the Government and, most importantly, my constituents want an effective NHS for the British people; it should deliver value for the taxpayer, ensuring that the mistakes of the past are not repeated and that all receive the care and front-line services that are their due. It is therefore essential that as the NHS is reformed, the needs of local communities in my constituency of Witham are not overlooked or ignored. That is why this debate is so timely.

By way of background, I shall give the Minister some details about my constituency and some of the health care challenges faced by my local community and me that are specific to the area, and the nature of current NHS services there. I shall then highlight the excessive and overblown bureaucracy that affects the NHS globally, which demonstrates the scale of taxpayers’ money that is increasingly and wrongly being taken from front-line services. I shall also draw attention to some of the most serious and heart-breaking cases that I have come across in the 10 months since I was elected, which show that the NHS too often fails the most vulnerable. I shall conclude my remarks by putting the case for new NHS services being delivered locally under the Government’s planned reforms.

Witham is a new constituency, so I forgive Members for not knowing much about it. It is not far from the London commuter belt, and lies within the heart of Essex. We have tremendous public transport and road links to London. The ports of Felixstowe, Harwich and Tilbury are not far away, and we have some major industrial towns and centres. It is not surprising, therefore, that Witham has experienced significant population growth in recent years. It is an attractive area to live in.

The three local authority areas in my constituency are Braintree, Colchester and Maldon. Under the previous Government, they were required to build more than 27,000 new homes in the 20 years to 2021, and 60,000 new homes between 2011 and 2031. Throughout Essex, the current population of 1.4 million could easily grow by 14% over the next 20 years. Members will be aware

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from their own areas that population growth inevitably puts more burdens not only on infrastructure but on the local NHS.

The local plans, particularly those that affect my constituency, unfortunately give no serious consideration to ensuring that the quality and quantity of local health services can keep pace with projected population increases and changing demographics. Although top-down targets are being scrapped by the present Government, the attractiveness and desirability of my constituency inevitably means that more people will move to the area, so we can expect to see a significant increase in the local population. That will put demands on local health services that are already struggling to cope.

It is not simply the sheer quantity of people that NHS services will need to support; they will also need to adapt to the changing demographics of the area. Because our local communities attract young families, we need stronger maternity services and paediatric provision. However, the most significant demographic change will be an acceleration of the number and proportion of residents over the age of 65. In that respect, my constituency and the county of Essex are not unique, as health services across the country are responding to an ageing population. By 2021, the NHS in Essex, along with its partners in local government, will need to accommodate the health needs of 45% more people in the county living beyond the age of 65, and 75% more people living beyond the age of 85.

Some of the most significant increases in Essex are expected to be in the Maldon district, part of which falls within the Witham constituency. It is worth noting that about 10% of the Essex population provides assistance, caring for family, friends or neighbours, with higher than average rates in Maldon, where the number of working-age people available to care for older persons will have nearly halved by 2029. These demographic changes present serious challenges to the front line of the NHS in my constituency and in the county.

I am pleased to report that Essex county council is taking a strong lead in implementing the Government’s reforms to deal with the challenge. It has already established a health and well-being board, and the Department of Health recognises it as an early implementer. I would welcome the Minister’s reassurance that the Government, unlike the Labour party, which has made no commitment to NHS funding to support this work, will continue to increase resources when necessary to support the health needs of my constituency and Essex. I shall emphasise throughout the debate the need for the money to be spent on front-line care, not bureaucracy.

That brings me to NHS bureaucracy in Essex and my constituency, and specifically to our local primary care trusts. The Minister will be aware that the medical needs of my constituents are served by a number of NHS trusts and by the East of England strategic health authority. There is no general hospital in my constituency; local residents usually use the Broomfield hospital run by the Mid Essex Hospital Services NHS Trust, which is based in the neighbouring constituency—that of the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns)—or the foundation trust hospital in Colchester for acute care services. Mental health services are provided by the North Essex Partnership NHS Foundation Trust.

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My constituents are served by two of the five primary care trusts in Essex. Those who live in the Braintree district council or Maldon district council parts of my constituency fall within the area covered by the Mid Essex NHS trust, whose budget for 2011-12 has increased to just under £520 million. Those who live in the wards covered by Colchester borough council find themselves being dealt with by NHS North East Essex, whose budget for 2011-12 has risen to just under £547 million.

Later, I will give examples of cases in which constituents have faced unacceptable problems with those health trusts. In the meantime, it is worth looking at the obscene levels of bureaucracy, administration and management that have taken hold of those organisations. The number of managers and senior managers employed by the East of England strategic health authority doubled under the previous Government from 1,300 in 1997 to more than 2,700 in 2009. At Mid Essex Hospital Services NHS Trust, more than £10 million is spent annually on 29 senior managers and 79 managers. In the North East Essex PCT and its three predecessor trusts, the proportion of administrative staff rose from 19% to 33% between 2001 and 2009. The number of managers and senior managers increased from 25 to 84.

Finally, Mid Essex PCT, which serves the majority of my constituents, and its four predecessor trusts, saw administration and staffing levels rise from 17% to 33%, and the number of managers go up from 10 to 102. When we consider that those two PCTs were formed from seven predecessor organisations, it is fair to say that the growth in management and administration over eight years is quite shocking. The PCT now spends almost £13 million on management costs alone. That money, which my constituents and I view as hard-pressed taxpayers’ money, has been taken away from essential local medical care to staff a bureaucracy. Mid Essex PCT is also experiencing slippage in progress on its quality, innovation and prevention plan and, as a result, could now miss its year-end target by £2.7 million. On 16 November, the minutes of its remuneration committee, which have not been disclosed fully, indicate that performance bonuses were to be paid to the chief executive and its executive directors.

What concerns me is not just the vast sums of money increasingly flowing into the pockets of bureaucrats and managers, but the way in which the PCT is behaving and functioning since it embarked on its reorganisation. It seems to have no real idea as to what it is reorganising into. That is a cause for alarm. I hope the Minister is aware that last autumn, North Essex PCT and Mid Essex PCT decided to form a cluster with West Essex PCT under a new chief executive. The first I heard of that change was when I received a press release last September. In a massive blaze of glory, it was announced that the chief executive of the strategic health authority would form closer working arrangements with the PCT.

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): The hon. Lady has spoken at some length and with real passion about money being poured into the appointment of bureaucrats and managers. In her mind’s eye, a hospital bureaucrat is a man in a bowler hat with a brief case, but is she aware that many people who are dubbed managers in the health service are actually

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former senior nurses, such as her colleague, the Minister, who bring much of their clinical background and expertise to bear on their role? Nurses in particular get a little pained when politicians talk about managers and discount the fact that many of them are people with a very solid clinical background.

Priti Patel: I recognise that NHS managers have a range of health care backgrounds and bring a number of skills to the table. Of concern to my constituents though is the fact that we are dominated by managers who tend to have administrative rather than clinical backgrounds, and they are making key decisions about patient treatment, and even about medical care and access to drugs. None the less, I thank the hon. Lady for her comments and her valid point.

This brings me to the overall efficiency and effectiveness of the reorganisation. I have been told that reorganisation will lead to a significant step forward in delivering greater efficiency for the people of north Essex. None the less, I constantly have to ask the PCT, “What does this mean? What will this look like? What are the costs of the reorganisation?” I was told last autumn that the PCT could not quantify the cost of reorganisation as the process of reconfiguration had only just started. I have been asking for updates, but as yet, have not received any. Each time I ask anything, I am told that my question cannot be answered “at this time”.

There is far too much uncertainty. I welcome reorganisation, efficiency drives and reductions in management and bureaucracy costs, but there are major implications for front-line services. The language of the PCT is constantly about reorganisation producing greater efficiencies, which I would not dispute, but the PCT still has no detailed plans to show what the greater efficiencies will look like and what the formation of the new cluster will mean for local services.

The merging of back-office functions to save money is to be welcomed and I have no issue with that. In this case, however, I have discovered that there is no forward plan in the form of a route map and details of how things will operate. I have been asking questions for six months, but I have not received any substantial details about the new cluster, the staffing arrangements and what it will all mean for patient choice locally. I have sent written questions to the Secretary of State about the reorganisation but, again, I have not had a response.

Will the Minister examine this reorganisation and ensure that more information is made available to the public so that they have some sense of what kind of decision making is taking place locally within the new cluster and the PCT, and what it will mean to them in terms of access to health care and local services? It appears that many of the decisions have been taken behind closed doors, with very little accountability and transparency. It is in the public interest to know what has transpired within the reorganisation, and what the new arrangements will look like as well as the costs and the benefits.

As the PCT should rightly be beginning its winding-down process prior to its abolition, I would like to hear from the Minister about the redundancy arrangements for senior PCT managers. I am sure that that is a matter that is naturally in their minds right now. In view of the colossal levels of waste caused by PCTs, my constituents will be very disappointed to see PCT chief executives

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and other senior directors receive golden goodbyes to boost pension pots or huge redundancy pay-outs. In the interests of accountability and transparency, all constituents across the country will be looking, during the NHS reforms, for some encouragement from the Government on that issue.

Before I move on to some individual cases, let me just say that I make no apologies for being critical of NHS bureaucracy. In my limited time as an MP, I have seen endless examples of red tape standing in the way of my constituents getting the best health care that should be available to them. I am overwhelmed by the whole culture of tick-box management that has pervaded my local NHS. It is something with which I have been battling, day in, day out, on behalf of my constituents. It is an alarming state of affairs.

Let me now draw to the Minister’s attention a couple of cases. I have been in touch with the Minister and the Department about the issue of Sativex. There have been two cases in my constituency in which the PCTs have refused to treat patients on the NHS with the drug Sativex despite their doctors’ recommending its use to help with multiple sclerosis. In both cases, the PCTs have been able to afford to pay more to their managers and to spend more on red tape and bureaucracy, but have refused to provide vital medical treatment to my constituents.

First, Mr Shipton from Tollesbury was recommended Sativex by four doctors, to help his condition. Those doctors are medical experts who have been treating him and who are aware of his condition and medical needs. However, last September Mid Essex PCT, acting through officials sitting on its area prescribing committee, thought that it knew best and decided that it would not accept a request for Sativex to be prescribed to Mr Shipton on the NHS. That left him in considerable pain and distress. It then took more than a month for the chief executive of the PCT to respond to my request for copies of minutes of the meeting at which that decision was made. The minutes stated that the PCT declined to prescribe Sativex to Mr Shipton

“due to a lack of evidence of significant long-term benefit. Clinical trials are of very short duration and do not compare with current treatment.”

Despite that, however, Sativex is already licensed—in fact, it was licensed last June—for use to improve symptoms in multiple sclerosis patients with moderate to severe symptoms, clearing the way for the PCT to prescribe it. Indeed, the PCT itself had made 31 previous prescriptions of Sativex in 2009-10.

My constituent, Mr Shipton, ended up sourcing Sativex privately, at the cost of £125 plus VAT per bottle, which is a course of treatment that lasts for only two weeks. Contrary to the conclusions of the area prescribing committee, the drug is having a hugely beneficial effect on Mr Shipton. If the bureaucracy of the PCT had not stood in the way, he could have received that treatment at a much earlier date and he would not have had to endure extreme suffering and pain, as well as what I would describe as an unnecessary bureaucratic process.

I have another constituent, Mr Cross from Tiptree, who has also experienced horrendous problems. In fact, his wife, Mrs Cross, is on the phone to my office on a weekly basis, updating us about the terrible position that her husband is in and the suffering that he is experiencing. He has had horrendous problems receiving

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a prescription of Sativex, although in this instance the obstacle has been dealing with North Essex PCT. Mr Cross is wheelchair-bound and in terrible pain, experiencing constant spasms. In fact, he has recently been in hospital. Given his condition, any treatment would be a welcome relief for him. There is double suffering for his wife, as it were, because she is now effectively his full-time carer. Once again, getting access to this drug has been terrible. He has had his consultant neurologist battling for him and making his case, and I too have battled for him and made his case. But North Essex PCT, despite issuing 16 prescriptions for Sativex in 2009-10, still refused to prescribe this treatment for Mr Cross and gave him a highly dismissive response.

When I took up Mr Cross’s case from September 2010 onwards, I began a process of constant correspondence with the PCT. All I received were evasive non-responses and the odd reference to Mr Cross’s “medical needs”, which were then just dismissed. I found that totally unacceptable. Mr Cross’s condition has since deteriorated and he has been in hospital again. There needs to be a recognition of the endless stress and strain that this process puts on his own domestic set-up, especially his dear wife who is now his constant carer.

There is a compelling case for action in both of those cases, to press the PCTs to provide this drug. Also, both of my constituents have made the point that they have spent their lives working hard, doing the right thing and contributing to society. They felt that in their hour of need the NHS would be there for them, but now they feel that it has not been there for them. That is unacceptable. Although I appreciate that the Minister cannot intervene in individual cases, I ask her at least to examine these cases if she possibly can.

There are two other cases that I want to touch on briefly. The first is that of my constituent Mrs Emily Wetherilt, and again I would welcome the Minister looking into it. It is another example of a local PCT failing to perform adequately to meet the medical needs of my constituents. Mrs Wetherilt is 96 years old and requires 24-hour care. However, despite her case meeting the published criteria for NHS continuing health care funding, Mid Essex PCT has refused to provide any care whatsoever. So there has been no support for her from the PCT. Mrs Wetherilt’s daughter has taken up this matter directly with the PCT’s panel twice and she has been declined on both occasions. The PCT categorically refuses to look into this matter again, because an appeal had not been lodged within the two-week window that was available to Mrs Wetherilt’s daughter.

Many of us recognise that in cases such as this one, when a constituent’s family is caring for them, the family’s priority is looking after their family member and it is not to follow an appeals process within a two-week window. People become very emotional and providing care takes precedence. That care is the priority. Consequently, the tone and the attitude adopted by the PCT are utterly bureaucratic and deeply unhelpful.

Mrs Wetherilt’s daughter has also offered to work with the PCT to find out whether it is possible for the PCT to part-fund her mother’s care, but that suggestion was dismissed by the PCT without even being addressed. That is another example of the inflexible bureaucracy that fails to put patients’ care and needs first. It is more about the process—ticking boxes and filling in forms—and that is wrong.

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I have a final shocking case to highlight. It is one that I have raised previously in the House and it is that of my constituent, 14-year-old Bethanie Thorn. Last October, Bethanie was struck down with a terrible illness and left bed-ridden. She literally went from being a healthy teenager one day to being completely bed-bound two days later. The cause of her symptoms was unknown and she became unable to eat as her condition deteriorated. Nevertheless, she faced lengthy delays to get an MRI scan and the other vital checks that were needed to diagnose her condition.

It was only last November, when I raised this matter on the Floor of the House, that the Secretary of State looked into Bethanie’s case and appointments were made for her to have an MRI scan. People in urgent need of an appointment should not have to rely on the Secretary of State, local newspapers or their constituency MP to raise their case and sort appointments out. It shows how serious this case was that, shortly after her scan and check-up, Bethanie was admitted to hospital and she was only able to return home two months later, at the end of January. Her mother has effectively become her full-time carer and her family have had to battle at every single stage for care, appointments and treatment, which is appalling. I must say that, if Bethanie had received the appointment that she needed straight away, she would probably be in a better state of health today. The Minister will appreciate that this has been terribly distressing for Bethanie and her family.

When the NHS was pressed about this case, the only explanation given for the delays was something described as a “broken pathway”. I have no idea what a “broken pathway” is in NHS management talk, but the case has highlighted just how damaging poor performance and failures in NHS services can be to individuals. This girl’s life has changed beyond all recognition now. This case also demonstrates what can go wrong when there are endless layers of bureaucracy in the NHS; it was unclear throughout whether it was Bethanie’s GP, the PCT or the hospital services who were actually responsible for ensuring that Bethanie received the care that she needed. There was to-ing and fro-ing constantly—there really was.

Like all Conservatives, at the last general election I was absolutely proud to stand on a manifesto commitment to cut the waste and bureaucracy in the NHS, so that we could invest in the front-line services and give more powers to doctors and patients. I want to reiterate that in my short tenure—10 months—as a Member of Parliament, all I have seen are examples of how bureaucracy has got in the way. If nothing else, I will continue to battle to get the services for my constituents, in the face of adversity—that is, in the face of bureaucracy.

I welcome the measures that have been announced by the Government about the reforms and plans for the NHS. The purpose of mentioning these cases now is to highlight the fact that in Essex we have seen more of the non-medical side of the NHS in action locally than we have of the medical side, which shows the need for reform of patients’ treatment.

Finally, I want to draw attention to the fact that there is some hope for my constituents. That is the hope that they have placed in Government legislation to reform the NHS. As the Minister will recall from Health questions

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last week, Witham town is the most urban part of my constituency and Witham town council and others have put forward a very strong case for there to be more health care specialist services in our town. Although Colchester, Braintree and Chelmsford all have significant health facilities, including general hospitals and community hospitals, there is nothing for the people of Witham in our town, and there is nothing for the people from the surrounding villages. That gives the impression locally that there is a two-tier health system.

I mentioned at the start of my remarks that the Witham area includes some pockets of serious deprivation and has a growing population. Unfortunately, the PCT has not taken enough action to close the gap created by the changing demographics and local needs. Maltings Lane is a new housing development in Witham town. It has evolved over a number of years, and many more new homes and other facilities will be built there over the next 10 years, but it was begun with no plans whatsoever for additional health care services. That issue needs to be addressed in the long run, and I hope that the Minister can help my town council, along with our district and county councils, to work with the PCT and the forthcoming GP consortia to develop additional local services that seek to meet local needs. The issue is one of supply and demand, and there is a crying need but no provision.

As a starting point, the town council, to its credit, is working cross-party locally with all our councillors, and has put together a list of services that Witham needs, including an additional surgery, an out-of-hours walk-in clinic, minor injury, oncology and out-patient clinics and a diversity of medical-testing facilities. By adding some of those services to Witham and the surrounding communities, we will naturally see real benefits in the form of health care provision, choice and diversity, and we will enjoy the convenience of more local NHS services.

I am conscious that I have spoken for a considerable time and that many other Members wish to speak, so I shall conclude by saying that although I could raise many more health-related issues, I hope that I have given the Minister a real insight into the challenges that we face in Mid Essex, where we are surrounded by a lot of health activity but have had this bureaucracy that has stifled both the delivery of front-line care to patients, and the choice aspect of health care provision locally. I thank the Minister and colleagues for their patience in listening to my remarks, and I look forward to the Minister’s response.

11.32 am

Mr David Amess (Southend West) (Con): I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing this debate, and particularly on how she has raised concerns on behalf of her constituents. Witham is very fortunate to have her as its representative.

I served on the Health Committee for a decade; in fact, I was on it for so long that towards the end of that time we were repeating inquiries. We travelled to a number of countries and when we returned home, we always concluded that our health service was the best in the world. We did wonder, however, how on earth we would fund the service if we were starting it from scratch.

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Since I first became involved in health matters, the needs and demands of the health service have changed dramatically. I am in a very good position to comment on such matters because when Ann Widdecombe was shadow Secretary of State for Health I was one of her troops, serving on the Committee on the Bill that brought into force primary care groups and primary care trusts. Although the right hon. Member for one of the Southampton constituencies got slightly irritated with my endless questioning and long speeches, if anyone is very sad and wants to read Hansard I recommend the speeches that I made then because everything that I forecast would happen, sadly, has happened. It has taken the present Government to reverse what happened 13 years ago.

I am very familiar with four hospitals: Newham General, the King George in Ilford, Basildon and Southend. I will not share my views of my experiences at those hospitals, because I was there not just as a politician but as a user, along with my family. I shall simply say that the experiences were very different from one another, and they are ongoing.

Let there be no doubt that I agree with everything that my hon. Friend the Member for Witham said. I have to be slightly partisan; I have to tell my hon. Friends who were elected last year that I feel very strongly that during the 13 years of Labour Government the word “deprivation” was not on the register at all for the south of England. There is no doubt that resources shifted from the south to the north. All I say to the Minister, who has a wonderful background, is that I hope we will now be treated fairly. I am confident that that will happen.

I am more concerned now about management generally, particularly that of our hospitals. Why is a school considered good? Because it has leadership from an excellent head. Why are transport facilities good? Again, because there is good leadership. Why is a country successful? It is because of a great Prime Minister. I am challenged on a number of fronts by leadership in our hospitals. I will not go on about matrons, but when people are anxious and have health problems, with which they need to go to A and E for example, they want to know who is in charge. It is not rocket science. Nor is cleanliness and all the rest of it. Leadership is so important, and I do not care if a leader is seen as a bossy boots, like Hattie Jacques. I am fed up with managers who have endless meetings. What are they meeting about? As MPs, we have to take full responsibility for how we represent our constituencies, and if something is not right it is down to a hospital’s chief executive—it is no good their blaming the troops.

My hon. Friend the Member for Witham touched on some matters concerning Essex, for example the demographic pressures and shifts. The council and the NHS have developed, and are continuing to develop, joint commissioning arrangements there. That is very good. In Essex, we are working hard to implement the White Paper, and are progressing well with putting into practice the Government’s flagship reforms. The Secretary of State has been criticised in some areas for rushing the reforms, but in my time in the House I cannot remember a shadow Secretary of State who was in post for as long as my right hon. Friend was, so he had a lot of time to think about the reforms. This is the only job that he wanted, so the idea that he is rushing is wrong.

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In Essex, commissioning with the independent voluntary and community sectors is going extremely well, as is the scrutiny of health functions. As the changes—some of which are controversial and challenging—go through, will the Minister reflect on how our hospitals are managed? That is so important. In my previous constituency the fullest age profile was for young people and in my present one we have the most centenarians in the country, so the challenges are very different in different places.

I want to raise a number of quick points. I will not cause the Minister angst, but she will be aware that there is an issue locally with the Essex Cancer Network and the proposal for an increase from seven to 10 linear accelerators. I hope that any increase is in Southend, and that we do not look further afield. The Minister would expect me to say that, and I do not want to put her in a difficult position.

For the past nine months, all health and social care partners and representatives of patients, carers and care homes have been working in a formally governed partnership to deliver an innovative and integrated model of care for the elderly locally. Will my hon. Friend the Minister look at how we are dealing with that? Over the past year, partners have worked together to open a new “step up” intermediate care facility on the Southend hospital site. I wish that many years ago, managers had considered more carefully when deciding to close Rochford hospital. Unlike Basildon hospital, which has plenty of land around it, Southend hospital is landlocked and has nowhere to expand, and we are paying the price.

Demand for care of the elderly is increasing, and I am not entirely convinced that we have a solution at the moment. Children’s services in south-east Essex are doing well. We have been recognised as baby-friendly by UNICEF and have received a certificate of commitment. We are launching a new service for children and young people with disabilities and we are opening a new diabetes rehabilitation suite. Southend hospital has secured a patient safety award. Many good things are happening.

GPs are being asked to deliver health care reforms. When Bernard Ribeiro, who has now been made a peer of the realm, was the lead consultant at Basildon, it was clear where the leadership of consultants was. I am puzzled to know who leads groups now. Endless meetings are held, but we need ownership and someone to take responsibility for what happens when a patient arrives at hospital. Who sees them first? When they go to accident and emergency, are they seen quickly by triage? Who deals with their case afterwards?

We have many wonderful GPs in Southend— Dr Husselbee, Dr Pelta, Dr Lawrence Singer, the Zaidis; the list is endless—and they are all working hard to deliver what the Government want. I believe that my constituency has the only GP pathfinder consortium in south-east Essex, and it has one of only seven partnerships in the east of England announced during the first wave. The group covers a population of nearly 80,000 patients, mainly in the west of Southend.

The practices have been working well together for the past three years and have managed to set up out-of-hospital ear, nose and throat, gynaecology and urology services, which give rapid access to specialist care at less cost to the NHS than at present. The group has implemented a clinical gateway that enhances GP referrals, reduces waste and ensures that patients get to the right specialist first time, which is critical to reducing the amount of

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money spent and the stress caused to patients waiting for referrals. Practices co-operate closely, with patients attending other surgeries for minor surgical procedures.

As a result of such close working for the past three years, the group is moving forward and seeking to become a sub-committee of the primary care trust, which will not exist within 18 months, and to take greater control of the budgets delegated to it by the PCT. The group has ambitious plans to improve care for the elderly, which I salute, as well as the health of patients with long-term conditions.

When local authority work begins, close working relationships will be vital to align the health and social care budgets to enable—colleagues might be puzzled by this phrase—more integrated working. That will be better for patients and lead to greater efficiencies. Similar joint working is happening between community and mental health programmes. The Health and Social Care Bill clearly puts patients at the centre of the NHS. This is controversial, but when budgets are stretched it is vital that the public are part of the process for deciding how the commissioning budget will be spent. We must take people with us if they are to accept that resources are scarce.

I am delighted to say that our local group has a grant from the Department of Health to define what public involvement should look like. A successful meeting was held recently involving a wide range of stakeholders—that awful word—including patient voluntary organisations, special interest groups and representatives from the local involvement network, Southend and Essex hospitals and the community. It is expected from the initial meeting that an agreement will be reached on how the public can best be involved, both at strategic level and in making decisions about specific projects. One possible outcome involves forming a group of health champions who have received training on commissioned health services.

I will not take up any more of the House’s time, as it is not fair to the colleagues who are waiting to catch your eye, Mr Dobbin, but I say to my hon. Friend the Minister that it would be good for the Department of Health to take seriously any representations made by hon. Members for the great county of Essex.

11.45 am

Robert Halfon (Harlow) (Con): I, too, congratulate my almost-neighbour and hon. Friend the Member for Witham (Priti Patel). She made an incredibly powerful case about the individual against the state and the powerlessness that people feel against state agencies, which is why we need to return power to the people. I thank her for securing this important debate. I am sorry that my hon. Friend the Member for Southend West (Mr Amess) has been to all the hospitals in Essex apart from Princess Alexandra hospital in Harlow. I strongly recommend it; it is a good place.

As has been mentioned, Essex is a large county, with five primary care trusts and more than 1.4 million people, which is roughly the same population as Northern Ireland’s. Some variation in such a large area is natural, but sadly, my constituency contains serious health inequalities, despite the best efforts of local staff and

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the Princess Alexandra hospital. Addressing them is not just about health and a stronger work force; to me, it is also about social justice.

I have three points. First, we suffer from significant health inequalities, as I said. Secondly, Harlow has a good hospital; it has its problems, but I strongly support its bid for foundation status. Thirdly, we have a history of funding problems, particularly in west Essex—I am glad to move from north Essex to west Essex—and they must be addressed.

On health inequalities, sadly, more men die from alcohol-related causes in Harlow than in any other district in Essex. The latest statistics show that there are 45 such deaths in Harlow every year, double the rate in nearby Uttlesford and about 50% more than the east of England average of 30 a year. I accept that Harlow is a major town, but families there are struggling with a particular problem, and the rate is higher than in similar towns in Essex such as Colchester and Basildon. Harlow also experiences some of the worst rates of child and adult obesity in Essex. Government statistics show that one in five 11-year-olds in Harlow is obese before leaving primary school. Some 55% of 15-year-olds in Essex drink alcohol, 19% are regular smokers and 13% use drugs, but the problem is particularly acute in Harlow. The rate of adult drug abuse in Essex is 4.8 per 1,000, but in Harlow it is nearly double, at 8.3 per 1,000.

I do not want to paint a negative picture of Harlow. I am proud of my town and constituency. There is some good news. Local faith and charitable groups are aware of the challenges and are responding to them. The organisation Open Road runs an SOS bus and does other anti-drug work, helping people access advice, information, support and more formal treatment if needed. Some other remarkable drug rehab charities do essential work behind the scenes. There are many walking groups, and I have been to a number of events organised by the Harlow athletics club, which is one of the most distinguished groups in the region. Projects such as Kickz work with young people, providing football, boxing and other fitness pursuits.

In that context, Princess Alexandra hospital has had problems, but hopefully it will become a foundation hospital. With a new chairman and chief executive, the hospital is making a strong bid for foundation status, which I support. I have found the chairman of the hospital, Mr Coteman, to be open, honest and straight-talking about the difficulties that we face in Harlow. He is also dedicated. On Christmas day, I visited the hospital wards with Harlow hospital radio and was astonished to see not only that the chairman was going around visiting patients, but that he had brought his whole family with him after travelling from Cambridge for the day. That shows a lot of commitment to the hospital.

It is not just Mr Coteman. I visited the cancer ward at Addison House with Robert Duncombe. The ward is very well run. We have talked a lot about waste and bureaucracy, and of course, we have those problems, but it is a completely different story at Addison House, where five staff share a small office, and when I say small, I mean really small.

The Princess Alexandra hospital is at the cutting edge of research, with its cellular pathology laboratories, for which I hope NHS support will continue. Having visited the laboratories, I know that the genius of their people and their technology is remarkable and bests anything

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in the private sector. However, the difficult environment means that the Princess Alexandra hospital needs the foundation status for which it has applied in order to take its work to the next level.

I want to touch upon the history of the funding problems in west Essex, which are all the more serious given the health inequalities that I have described. Under the previous Government, West Essex primary care trust struggled with the 20th worst deficit in the UK, and the black hole for 2009-10 was nearly £2 million. I welcome the coalition Government’s commitment to increase health spending in each year of this Parliament, but it is a question not only of getting the right resources, but of spending the money wisely.

When I was a parliamentary candidate, I found out, via a freedom of information request, about a £700,000 cut in funds to the NHS walk-in centre in Harlow. Finances had been mismanaged, so much of the investment was wasted. There have been serious problems with health management, as well as health inequalities, which we must address under the new ways of devolving purchasing power to GPs. I particularly welcome the pledge to remove strategic health authorities, because they seem to be a complete waste of resources and an unnecessary tier of bureaucracy. That money would be much better ploughed into the work of nurses, doctors and health visitors on the front line. I think that the Health Secretary said at the Conservative conference that managers have so far been cut by 2,000 and that front-line staff have been increased by 2,700. I am sure that the Minister will want to clarify that.

On NHS fuel and petrol allowances for workers, I was astonished to discover when I visited my mental health trust that NHS mental health professionals who use their cars all day for their work—this is not just about commuting, but about visiting patients—get tiny fuel allowances, some just 12p a mile. I have tried to investigate the issue, but there seems to be a spaghetti junction of authorities that decide what the rate is. It is unfair, when petrol is at £1.35 a litre, that their fuel allowances are so low. I urge that dedicated NHS professionals who use their cars all day for their work should get a decent fuel allowance.

We must deal with the health inequalities in Harlow. To coin a phrase, we must be tough on health problems, but tough on the causes of health problems, too. Ultimately, the evidence is that we need more early intervention and preventive work, but the cause of many health problems is social deprivation. It is jobs, a stronger economy, higher employment, and opportunity for the many and not the few that will give us a healthier society, which is why I welcome the Government’s economic reform, with lower taxes for lower earners and deficit reduction. It is about not just pure utilitarianism, but social justice.

We must do more. We need more partnerships with grass-roots community groups, such as the local Harlow branch of the Alzheimer’s Society and the Harlow athletics club, which I have mentioned. Hospitals should be the first, not the last resort, which is part of the problem that we face in the NHS today. To do that, resources must be directed towards prevention, and the best people at prevention are the small community and faith groups already in our estates, working with people. When we open up NHS contracts, we must make it easier for small charities and firms to bid for them, as well as the larger, “Tesco” charities. There is fear in

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some parts of my constituency that our health reforms will be monopolised by vast health conglomerates. I very much hope that we see more co-operatives. I understand that the PCT in Kingston has become a co-operative. If that is the case, I hope that it will be a model that other PCTs and GP commissioning bodies can follow.

I have always said that the big society will only work if we build the little society, too. We must bring real localism to our NHS. We have to give patients meaningful choice. Harlow struggled for years with top-down cuts under the previous Government. For example, the North Essex trust, which, as has been mentioned, supplies mental health services, suffered a £5.3 million cut in 2007.

Finally, why is it that whenever the previous Labour Government cut our services in Harlow, it was presented as a fact of financial management, but whenever the coalition Government are forced to cut spending, it is seen as an ideological outrage? That double standard must be addressed. I am glad that our NHS budget is guaranteed to rise in real terms every year in this Parliament, and hope sincerely that Harlow patients and residents will get their fair share. I look forward to the Minister’s forthcoming visit to Harlow to see for herself the NHS in operation.

Jim Dobbin (in the Chair): Before I call the final speaker, I remind hon. Members that the wind-ups normally start at 10 past 12.

11.56 am

Jackie Doyle-Price (Thurrock) (Con): Thank you, Mr Dobbin. Like my hon. Friends, I should like to congratulate my hon. Friend the Member for Witham (Priti Patel) on securing this debate and on giving an articulate exposition of the inherent tension between process and outcomes. I think that one thing that we are all looking forward to from the Government’s health reforms is a greater focus on achieving outcomes and rather less on the processes that she has outlined.

This issue is of great importance to my constituents in Thurrock. Frankly, considering recent years in particular, the performance of our local health services needs to be better. I pay tribute to the staff involved in the care and treatment of patients—they discharge their efforts with the best of intentions and commitment—but, as my hon. Friend the Member for Southend West (Mr Amess) has pointed out, what is often lacking in the health service is leadership. In south-west Essex in particular, poor management at a number of levels has resulted in too many people being failed and in local people’s confidence in the local health provision being too low. We all need to work hard to improve that and give people the health services they deserve.

I shall give some clear examples. My constituents rely on services provided by Basildon hospital, and the primary care trust responsible for delivering them is South West Essex PCT, which is currently implementing a severe programme of cuts, following a significant overspend. I shall deal with the hospital first, but as hon. Members will realise from my remarks, the ongoing issues at Basildon are interlinked with the overspend in the PCT. Dealing with that overspend will have implications for the hospital, too, so there is a great deal of uncertainty among my constituents, and a serious lack of confidence in local health services at present.

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Basildon hospital has had a difficult recent history. In November 2009, the then Secretary of State, the right hon. Member for Leigh (Andy Burnham), made a statement in respect of Basildon hospital, following concerns about excessively high mortality rates there, which my hon. Friend the Member for Southend West will remember extremely well. The then Secretary of State said:

“There is still considerable variation in standards throughout the NHS, from one hospital to another, and in some cases the variation is unacceptably wide. That is the case in respect of Basildon and Thurrock University Hospitals NHS Foundation Trust.”—[Official Report, 30 November 2009; Vol. 501, c. 855.]

[Hywel Williams in the Chair]

Since that time and despite various programmes to tackle poor performance at the hospital, my constituents and I are concerned that such variation is unacceptably wide. The hospital management tell me that things are improving, but my postbag tells a very different story. Although many constituents report excellent treatment at the hands of the hospital, simply too many do not. As I say, week in and week out, there are reports in the local press of new things that have gone wrong. The impact on my constituents is that they simply do not have confidence in the hospital and they do not want to be treated there.

It is true to say that there has been some improvement since 2009 but, returning to the then Secretary of State’s statement, that has happened from a very low base. The Care Quality Commission continues to find that there are serious deficiencies in patient care. Most recently, the CQC’s February 2011 report states that of 16 measures taken into account, four needed action and six received suggestions for improvement. Criticisms include a lack of consistent nursing care, a failure to check that equipment is safe, the need for improvements to care for patients with dementia, and issues with poor nutrition and weight loss going unreported.

The hospital’s management are taking rather too much satisfaction from the improvements reported by the CQC. It does no one any good that the reputation of Basildon hospital remains so low. However, there is an opportunity to achieve real change. The current chairman is due to depart and I hope that the Minister will take steps to ensure that the opportunity is taken to provide some decisive leadership to the board, so that the real challenge to improve performance can be dealt with.

On the state of NHS South West Essex, many treatments have recently been cut by the PCT—including in vitro fertilisation—and restrictions have been put on cataract operations. As a Government, we have promised to protect the NHS budget from cuts and we have held to our promise. However, in south-west Essex, people just do not believe us because they are faced with a cost-cutting programme to fix a black hole of some £50 million. How did the PCT get into such a mess? In the past two years, it has taken on 100 extra backroom staff. Those people were not involved in front-line delivery; they were working in the PCT headquarters. The PCT also spent money building a community hospital in Brentwood that is far bigger than required. When I visited that hospital, I went around switching on lights in redundant facilities. That service was commissioned under the

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private finance initiative, so it will be an enduring cost to the NHS budget. It is a classic example of complete incompetence in managing the commissioning of a service.

A further reason for the overspend brings me back to what has happened with Basildon hospital and the impact that that is having on the wider health provision in south Essex. As confidence in Basildon fell, patients were desperate to be treated elsewhere, which meant that the PCT had to buy services from other hospitals in Essex, London and Kent. The hospital was faced with a loss to its income because of the decline in demand, and it dealt with that by routinely booking additional out-patient appointments in the knowledge that the PCT would pick up the bill. Such a situation added to the financial pressure.

No one has been held to account for the PCT’s overspend. Patients therefore perceive what has happened to be a direct result of the Government’s programme. I cannot emphasis enough that that is not the case. The responsibility for that overspend rests firmly with the PCT’s management. It is disappointing and bad for public confidence that no one has taken responsibility. Unless someone is held accountable, how can we ensure that our constituents regain confidence in the system and trust what we say? When we say that we are ring-fencing the NHS budget, that sounds pretty hollow to my constituents. I pay tribute to Andrew Pike, the newly appointed chief executive of the PCT. He has grasped the nettle and is making the necessary painful decisions to turn the situation around. The price of that is an accelerated programme of redundancies and carefully managed demand for services. That means patients are not getting seen as quickly as they would have done, and my constituents are not getting the same standard of service they would if they lived elsewhere. It also means that the new hospital planned for Grays is likely to be delayed as we fill the black hole, which will lead to much disappointment locally.

I look forward to hearing the Minister’s comments on those issues. Too often, poor performance in the NHS goes unchallenged. While ever-senior NHS managers continue to draw hefty salaries, the least we can expect is that when things go wrong, someone steps up to the plate and takes responsibility. It is galling for members of staff to receive redundancy notices when the people who are responsible for that overspend remain on the NHS payroll. I hope that the Minister will take action to improve accountability among senior management because that will go a long way towards rebuilding confidence.

12.5 pm

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): The hon. Member for Witham (Priti Patel) is to be congratulated on obtaining the debate. Many of my constituents move to Essex as a kind of upward trajectory, so I listened with great interest to what she had to say about a part of the world with which I am not as familiar as I probably should be. The week after the Lib Dems have turned savagely against the Conservative-led coalition’s health care policies—the British Medical Association is debating them today and, as we know, doctors are very worried about what is proposed—hon. Members will expect me to touch on the health reforms generally and how they will affect the people of Essex.

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I listened with some sympathy to the complaints of the hon. Member for Witham about bureaucracy. As I have been a Member of Parliament for 20 years, I have tangled with more bureaucrats than I care to remember. However, I always like to stop short of sounding as if I am dismissing people who work for the health service as a whole. My mother was a nurse. She was one of that generation of West Indian women who helped to build the health service after the war. We have to remember that however frustrating it is as Members of Parliament or even as members of the community to deal with bureaucrats in the health service or elsewhere, there are thousands and thousands of people without whom the health service could not work or function. They will tell us that they have survived more reorganisations than they care to remember. They are still there, getting their heads down and trying to provide a service for our constituents.

The hon. Member for Witham made an important point about the proportion of elderly people in our population. We do not have time to deal with that matter fully, but people are living longer and they are suffering from ailments such as Alzheimer’s and other things. Elderly people make up an increasing proportion of the population. A few weeks ago, I went to a nursing conference and a senior nurse said to me that, when she was on the wards, the mean age of elderly patients was about 80. The mean age of elderly patients is now 90 or 100. Elderly people now pose very different problems from those that the elderly posed a few years ago. It is important that we consider the question of how we secure high-quality care—I am reminded of that awful ombudsman report that was published a few weeks ago—how we pay for it and how health care interconnects with the issues of public health and social care. I hope that we will have a chance to return to those matters.

I remind the hon. Lady that, despite her letters to bureaucrats and her undoubted frustrations on behalf of her constituents, when my party left office, satisfaction with the health service was the highest it has ever been. Hon. Members can say that the population was deluded on that, but I do not think that that is correct. We are talking about massive MORI polls. People’s satisfaction was higher than ever. There had also been massive levels of investment, not least in Essex. She will be aware of the new unit at Colchester general hospital, which includes an updated children’s ward. It is fully open and operational, and that £20 million project marks the biggest investment in the hospital’s facilities since it opened in 1985.

Apart from general frustration with bureaucracy, there are specific issues in relation to health care in Essex that are worth mentioning in this short debate. The hon. Lady mentioned Broomfield hospital. She will be aware that, just a few weeks ago, it was highlighted that although the hospital takes more than £1 million a year in car parking charges, its car parks still lose money because it is spending £1.2 million on running costs, including on CCTV, attendants and capital investment—they must be extremely well paid attendants. We also know that the hospital’s move into its £148 million PFI wing was delayed twice before finally opening in late 2010. The opening day was pushed back because staff were trapped in faulty lifts. We also know that the same hospital spent £400,000 on art for its new wing, which was commissioned as part of the development and funded through PFI. PFI is expensive enough—we may

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debate that at another time. To spend the money on art, when we know how ridiculously expensive PFI can be, seems quite strange.

There have been all sorts of care warnings about hospitals in Essex, such as Queen’s hospital in Romford. We know that the Romford project will be the first of a number of pilot reviews of PFI contracts to see if the costs can be brought down, and anyone who cares about the health service must welcome that. We know that the Braintree community hospital has defended itself after paying out nearly £20 million in damages for clinical negligence. If we are focusing on bureaucracy, we have to focus on how those things happen. We know that the Southend University Hospital NHS Foundation Trust, with which hon. Members will be familiar, has had to respond to concerns about safety, which were raised by the Care Quality Commission. We know that the West Essex primary care trust risks not being able to give an 18-week referral-to-treatment time. We know that NHS South West Essex has a very large overspend—its deficit has been improved, but it still has an overspend—in relation not to bureaucrats, but to acute hospital activity.

We also know, which I find alarming, that the Basildon and Thurrock University Hospitals NHS Foundation Trust is now trying to make savings by allowing waiting lists to extend. That implies a 14-week wait on first appointment, which is why an hon. Member on the Government side said that, when ordinary residents and voters are told that money on the health service is being ring-fenced, it rings rather hollow. Up and down the country, not just in Essex, they can see waiting times lengthening, and new hospitals and new health care facilities that have been promised being delayed. It is for the Government, who have made much of their protection of health care spending, to explain that. The real issue is this. The hon. Member for Witham spoke glowingly about the reforms, but sadly I have news for her. She seems to believe that those reforms will help with the issues that she has raised. As she would know, however, if she had followed the Health Committee, there is a real challenge involved in trying to introduce those reforms, whatever we think of them, while at the same trying to achieve unprecedented savings in health care. The Health Committee doubts whether that can be done.

No one argues with the notion that GPs could have a lot to offer in the commissioning of care, but as the president of the Royal College of General Practitioners has said, there are other ways to do that without subjecting the health service to a top-down reorganisation. I do not want to be unpleasant, but the Government promised, all through their time in opposition, that they would not subject the health service to any top-down reorganisations.

Priti Patel: Will the hon. Lady give way?

Ms Abbott: Time is against me, because I want to give the Minister plenty of time to respond. That is what we were promised—no more top-down reorganisations. As for waste of money, one problem with letting all those PCT bureaucrats go is that they have to be paid redundancy. The hon. Lady said that she hopes that they will not be paid big redundancy packages. I am afraid that they will be, and many will be re-employed. GPs will be less accountable to patients and the danger that many people,

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including GPs, see is that the big American health maintenance organisations will be able to get inside and act as commissioners for GPs, who, after all, joined the health service to heal and not to be managers.

I feel sorry for Government Back Benchers. They believe that the issues that they find so challenging about bureaucracy, cuts and patient accountability will be solved by the reorganisation. I can say with complete confidence that, if anything, the reorganisation, which is too fast and at the wrong time, will make those problems worse. It gives me no pleasure to say that, but anyone who has analysed the so-called reforms can see that they are a car crash in slow motion.

12.14 pm

The Parliamentary Under-Secretary of State for Health (Anne Milton): It is a pleasure to serve under your chairmanship, Mr Williams. I do not believe that I have had the pleasure before. I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing the debate. The fact that she has attracted so many of her fellow Essex MPs is a testament to the importance of the issue. The health services in any MP’s constituency are always of major concern and it is fantastic to have an opportunity to raise some of those issues in the Chamber.

I must add to the comments made about the staff in the NHS. The staff in Witham, and across Essex, should be congratulated on their work. I trained as a nurse, like the mother of the hon. Member for Hackney North and Stoke Newington (Ms Abbott), and worked in the NHS for 25 years. I understand, therefore, some of the complexities of their job, and their dedication and expertise in driving benefits for my hon. Friend’s constituents on a daily basis is valued greatly. As a Government, we want to ensure that we support all staff and give them the framework to provide the highest standards of care for everybody they treat.

Before I go further, the hon. Member for Hackney North and Stoke Newington need not feel sorry for Government Back Benchers at all. She does them a disservice by suggesting that they do not see the reforms for what they are. They are an opportunity, for the first time, to bring patients and their clinicians closer together in shaping the services that they need. She is right to say that the previous Government put untold investment into the NHS. Spending on health doubled, if not more, in the time that they were in government. It is important to realise, however, that just chucking money at services does not mean that they will get better—we need to have value for money. Taxpayers expect and deserve that, and for every pound of taxpayers’ money that goes in, £1-worth of services needs to come out at the other end, and that is central to the debate.