It is a pleasure to speak in favour of new clause 15 on defence statistics, which, for some, might appear a dry subject but which, after a strategic defence and security review and during an ongoing basing review, is quite important. It is especially important to those of us who have concerns that the way in which the Ministry of Defence has been managing its infrastructure, manning levels and spending is grossly imbalanced. We know all this because it has consistently provided parliamentary answers that show it to be true. It is true in Scotland, Wales and Northern Ireland, and in a number of English regions. The worrying prospect is that the result of this
14 Jun 2011 : Column 737
basing review will confirm that many of the trends that I have raised repeatedly here, in Westminster Hall and in parliamentary questions will continue.
There are reasons to be worried. For example, the Ministry of Defence has confirmed that since the last strategic defence review in 1997, 10,000 defence jobs have been lost in Scotland. We also know that between the last strategic defence review and this current review, the gap between Scotland’s population share of defence spending and the amount of money actually spent on defence in Scotland was £5.6 billion. The underspend statistics for Wales and Northern Ireland during the same period are £6.7 billion and £1.8 billion.
Gemma Doyle: The hon. Gentleman knows full well that if he had his way and Scotland was independent, the MOD footprint would be non-existent in Scotland. He may wish to come to an arrangement with England or with the MOD in an independent Scotland, but he has to assume that all military assets would be withdrawn. Furthermore, he supports the scrapping of Trident so, implicitly, the MOD spend would be less than it is now.
Angus Robertson: I am interested in the hon. Lady’s intervention. I am sorry that she did not take the opportunity to support the case I am making. The case about defence statistics is quite important, which is why the leader of her party in the Scottish Parliament, Iain Gray, put his name to a joint submission that used those very statistics, together with the leader of the Conservative and Unionist party and the leader of the Liberal Democrats in the Scottish Parliament. Incidentally, all those party leaders have hinted at their resignations, having lost in the recent Scottish Parliament elections. None the less, all three leaders, together with the Scottish National party, put their names to that submission.
The hon. Lady wishes to entice me to talk about the advantages of independence in relation to defence, which I am happy to do at any point. I note that she did not take the opportunity to apologise for the loss of 10,000 defence jobs in Scotland while her party was in power. I am more than confident that using our population share of defence spending in Scotland would provide a net increase in spending and manpower, protecting the bases that have been closed by both her party and the Conservatives.
To return to the publication of defence statistics, I would have thought it was a matter of concern to Members on both sides of the House that rather than continuing to provide statistics on these matters, the UK Government have simply stopped answering parliamentary questions and providing the important information. Members who have not looked at the issue might be asking themselves, “Are the statistics that the SNP is taking about available in other countries?” The answer is, “Yes, of course they are.” The Canadian Department of National Defence provides statistics to its parliamentarians across the range of expenditure. In the United States, members of Congress and everyone else can access information on defence spend across the communities and states of the US. Until recently, that was the case here in the UK.
On jobs, we know that when Labour left office there were 10,480 fewer people in defence jobs than there were in 1997. That leaves the current uniform contingent
14 Jun 2011 : Column 738
in Scotland at 12,000, which is significantly less than our population share. Looking at the Government Front Bench, I am pleased that the Secretary of State for Defence acknowledged when giving evidence to the Scottish Affairs Committee that there had indeed been a disproportionate reduction in defence jobs in Scotland under Labour. However, it must be pointed out that for a number of years we had consistent answers to parliamentary questions on service personnel costs, civilian personnel costs, equipment expenditure and non-equipment expenditure.
In fact, there is a complete dataset from 2002 to 2008 showing a number of important but very worrying facts. It shows that the defence underspend increased from £749 million in 2002-03 to £1.2 billion in 2007-08, a 68% increase in just six years. Between 2002 and 2008 the underspend on defence in Scotland under the Labour Government was a mammoth £5.6 billion, contributed by Scottish taxpayers to the MOD but not spent on defence in Scotland. Between 2005 and 2008 there was a drastic real-terms decline year on year in defence spending in Scotland.
I note that the hon. Member for West Dunbartonshire (Gemma Doyle) is not seeking to intervene to explain why the defence underspend was so large under Labour. There was actually a 3% cut in defence spending between 2006-07 and 2007-08, a shocking indictment of the previous Labour Government. If we widen the scope of the statistics to include Wales and Northern Ireland, we see that in the six years from 2002 to 2008 there was an accumulated underspend of £14.2 billion. In the same period in which there was an underspend of £5.6 billion in Scotland, there was a staggering £6.7 billion underspend in Wales and a £1.8 billion underspend in Northern Ireland. I point out to right hon. and hon. Members on the Government Benches representing constituencies in England that regions across England similarly have significant issues of defence underspend.
What the statistics show is shocking enough, but just wait for how the Ministry of Defence chose to deal with this! Did it make policy choices to deal with the underspend or make decisions to remedy the fact that there were these cuts in defence manpower? No, it did not. In 2009, tucked away at the end of a report, there was an “important note” entitled “Cessation of National & Regional Employment Estimates”, which stated:
“Ministers have agreed that after this year (2009) the Ministry of Defence…will no longer compile national and regional employment estimates because the data do not directly support MOD policy making and operations.”
I thought, my goodness, surely there is some mistake—that could not be the case. Then, on 6 April last year, the then Secretary of State for Defence provided what turned out to be the last parliamentary answer on defence expenditure in Scotland, confirming that it was not a mistake, and that rather than dealing with the policy challenges the MOD was going to get rid of the proof:
“Since 2008 the MOD has not collected estimates of regional expenditure on equipment, non-equipment, or personnel costs as they do not directly support policy making or operations.”—[Official Report, 6 April 2010; Vol. 508, c. 1200W.]
The information is still readily available within the Ministry of Defence, but the decision was taken not to provide it to Parliament.
14 Jun 2011 : Column 739
This has happened since the time of the last Labour Government. Given the public pronouncements about transparency, new politics and the respect agenda that we heard from the Conservatives and their Liberal Democrat coalition allies, I hoped that their rhetoric might be matched by openness. I have not been encouraged by much in the coalition agreement, but it says on page 7:
“we”—
that is, the Conservative party and the Liberal Democrats—
“are both committed to turning old thinking on its head and develop new approaches to government. For years, politicians could argue that because they held all the information, they needed more power. But today, technological innovation has—with astonishing speed—developed the opportunity to spread information and decentralise power in a way we have never seen before. So we will extend transparency to every area of public life.”
Section 16 of the agreement, entitled “Government transparency”, continues:
“The Government believes that we need to throw open the doors of public bodies, to enable the public to hold politicians and public bodies to account. We also recognise that this will help to deliver better value for money in public spending, and help us achieve our aim of cutting the record deficit. Setting government data free will bring significant economic benefits”.
There were two specific commitments. First,
“We”—
“will require full, online disclosure of all central government spending and contracts over £25,000”;
“We”—
“will create a new ‘right to data’ so that government-held datasets can be requested and used by the public”.
Aha! I was encouraged. Surely, given those commitments, we would see the information. I am delighted that the Minister for the Armed Forces is able to join us at this stage, because what I am about to say relates directly to him.
9.15 pm
I was delighted to hear similar claims of openness from the new ministerial defence team in the House of Commons debate on the strategic defence and security review on 21 June. Hansard records that the new Minister for the Armed Forces said:
“Hon. Members—and everybody else—have the opportunity to contribute and make whatever representations they wish to make. If there are hon. Members who feel that they are under-informed, and want more information to inform representations that they might make during the review, they need only let us know. Ministers have an open-door policy, and Members are welcome to any further information that they feel they need.”
That prompted me to intervene and ask:
“During the previous Parliament, the Labour Government provided statistics on employment and expenditure throughout the nations and regions of the UK. Will the new coalition Government give a commitment to continue producing those statistics?”
“Yes. Whatever information right hon. and hon. Members need in order to make representations to the review—”
but to be doubly sure, I interjected:
“Is that a yes?”
14 Jun 2011 : Column 740
The Minister answered, unambiguously:
“That is a yes. Hon. Members need only ask for any information that they need.”—[Official Report, 21 June 2010; Vol. 512, c. 132.]
The Minister for the Armed Forces (Nick Harvey): Our position then, as today, was that we are only too ready to share with hon. Members any information that we have and that we compile. As the hon. Gentleman knows only too well, the previous Government ceased to compile that information, and frankly for very good reason. It was unreliable information being measured against an old and out-of-date baseline. No defence decisions were being made in the light of that information. It is several years since that information has been compiled. We are happy to share with him any information that we have in this regard, but we do not have that information any longer.
Angus Robertson: I am terribly sorry, but I just do not think that is good enough. I know that the Minister has just arrived, and no doubt he has come from an important engagement, but before he arrived I was making the case that there are very good reasons to continue to have this information. It seems to me that the very good reasons in the MOD for stopping the publication of these datasets is that, frankly, they are so embarrassing.
I return to the turn of events, which it is important for Members to understand. Having received those assurances from the Minister for the Armed Forces in this Chamber, I wrote a grateful letter to him:
“I wanted to thank you personally for your unambiguous commitment during this week’s debate on the Strategic Defence and Security Review that the new Coalition Government will continue to publish both employment and defence spending statistics for the nations and regions of the United Kingdom… Towards the end of the term of office of the last government it was proving difficult to secure these important statistics and I am appreciative that you have given such a clear assurance that they will continue to be published.”
In the blink of an eye—I assume it was written as soon as my letter arrived in the Minister’s private office—I received a letter back saying much the same as he has just said from the Dispatch Box. In an instant, the Ministry of Defence reneged on a promise made in the House of Commons and in the coalition agreement that there would be openness and transparency. There are also vital clues that should concern everybody who cares about the defence footprint across the UK. Apparently, the Government think that there is
“no clear defence benefit to be gained”
from collating statistics by region and nation, and national and regional data do not
“directly support MOD policy making”.
That will come as a shock to many people, not least the Chief Secretary to the Treasury, who has said publicly in terms that economic considerations will form part of the basing review. How on earth can we have an informed debate when the Government do not even provide the statistics?
Mel Stride (Central Devon) (Con): I am not clear whether the hon. Gentleman is arguing that there is some value to the MOD in exercising its duty from collecting this dataset. Is there a value or not? If there is, what is it?
14 Jun 2011 : Column 741
Angus Robertson: I am very grateful to the hon. Gentleman because that is the crucial question. The information was viewed as essential by previous Governments. Why? Because it informed us about the impact of MOD policy making on the nations and regions of the UK. That was why the figures were collated in the first place and why the answers were provided to MPs. Members asked questions about the information because we thought it was important, and the Hansard record will show that those questions were asked by MPs of all parties.
The information is not just important in Scotland, Northern Ireland or Wales but should be a matter of concern to people throughout England, too. They need to understand what impact MOD policy making is having on their part of the country. The figures should inform us of that. Should they lead all decisions? Of course not, but they should inform policy decisions.
Mr Dodds: We are talking about the publication of information and statistics that were previously published and are published elsewhere across the world. Such statistics are published on other matters, not just defence. Surely no one can argue against the hon. Gentleman’s central theme, which is that we should know the impact that this vast area of expenditure has on the regions and nations of the United Kingdom.
Angus Robertson: The right hon. Gentleman makes a point that everybody should understand. Providing the information is not difficult. Governments here have done it, and Governments elsewhere around the world do it. Frankly, we would be in dereliction of our duty as parliamentarians if we did not try to inform ourselves of how the Department that we are trying to hold to account is spending our constituents’ tax money. How that informs our political priorities is a totally different matter, but the coalition parties made an express commitment to everybody in the United Kingdom that they would seek and deliver transparency. When it comes to defence statistics, they have reneged on that.
This is an opportunity for both Conservative and Liberal Democrat Members—and Labour Members if they have found their conscience on the issue—to understand that this is an important problem that is easily remedied. The new clause would allow that to happen, as it would force the MOD to provide and publish the statistics that we all deserve. That is why, unless the Minister agrees to publish the statistics, I will force a Division on this important issue.
Mr Robathan: Having listened to the hon. Member for Moray (Angus Robertson), I have to say that I thought his indignation was completely synthetic. What is important is how the money is spent, not how statistics are gathered, and I will put on record what we feel.
The Ministry of Defence has no plans to reinstate the publication of annual estimates of regional defence spending or the employment effects of that expenditure. The Department decided to stop the compilation and publication of those statistics three years ago. Although the statistics were valuable in giving national and regional employment context to defence spending, the data did not directly support MOD policy making and operations. Furthermore, the compilation of the series depended on external sources that had not been updated for some
14 Jun 2011 : Column 742
years. The MOD had been struggling to maintain the quality of the statistics even to a basic level. To reinstate their compilation would cost the Department about £500,000 in the next four years.
The purpose of the defence budget is to maintain the armed forces so that they can contribute to our nation’s security—a nation that includes, I am glad to say, Scotland and Northern Ireland. Every pound that the MOD spends must contribute to the security of the United Kingdom, and it gets doled out not on a regional basis but on a defence-needs basis.
Mr Dodds: I stand as a member of a Unionist party in Northern Ireland that is proud to be part of the United Kingdom, but this is not about being part of the UK. It is about the information that is available to Members of Parliament and the public. Surely the Minister should recognise that distinction.
Mr Robathan: Information on employment is quite readily available with a little bit of hard work, but I am afraid that we must consider the cost of compiling inaccurate statistics. The previous Government took their view, and we support it. Decisions on where personnel are based and which contracts are let to which firms are based solely on what is best for the armed forces and the defence of the realm. It is the duty of Government to ensure that the defence budget is spent wisely, maximising the resources available on the front line and ensuring that every pound counts.
Angus Robertson: The Minister points out that because a caveat in the coalition agreement suggests that the publication of some statistics is more expensive than the publication of others, he has a get-out-of-jail card in respect of publishing statistics on defence and the MOD.
Mr Robathan: I do not believe that the hon. Gentleman is being deliberately obtuse. The point is that the Government do not have all the statistics to publish, and compiling them would be extremely expensive—and, as I just said, they are becoming increasingly inaccurate. We do not compile statistics on everything.
Those estimates were difficult and intensive to maintain. They relied on analytical tables produced by the Office for National Statistics that have not been updated since 1995. As I have explained, the statistics did not support the MOD’s decision making. I have looked into how much it would cost to reintroduce the estimates and the cost is higher than the benefit to defence. My main focus, and our main focus, must be on doing what is best for the armed forces.
I note from previous debates on this subject that the hon. Gentleman is concerned that the cessation of those statistics will mean that a gap emerges in information on defence, particularly with regard to Scotland. It should be noted that assessments of the employment effects of MOD expenditure will continue to be undertaken for individual defence projects, and as part of the regional impact assessments that are conducted to inform MOD base closures. For instance, we know how many people are employed at specific bases—that is quite straightforward—but we do not compile huge tables of statistics that are of no great value. Decisions and policy in these areas will continue to use evidence about the employment impacts.
14 Jun 2011 : Column 743
In the light of that, I hope the Committee rejects new clause 15.
Angus Robertson: I pointed out that the coalition parties made a pledge on transparency in their agreement. They said that they would provide all information on contracts of more than £25,000. I am sorry to say, however, that the Minister has suggested at the Dispatch Box that, somehow, the coalition does not have to live up to that commitment in defence matters. The commitment that the statistics would be provided was also given to me in this Chamber, but it has been reneged on. More importantly, Members of Parliament should have those statistics as a matter of course. The fact that the outcome of those statistics is unfortunate for decision makers in the MOD is no reason not to publish them. That is why I press new clause 15 to a Division.
Question put, That the clause be read a Second time.
The Committee divided:
Ayes 10, Noes 282.
[9.27 pm
AYES
Campbell, Mr Gregory
Dodds, rh Mr Nigel
Edwards, Jonathan
Hermon, Lady
Hosie, Stewart
Lucas, Caroline
MacNeil, Mr Angus Brendan
Robertson, Angus
Simpson, David
Williams, Hywel
Tellers for the Ayes:
Dr Eilidh Whiteford and
Pete Wishart
NOES
Adams, Nigel
Afriyie, Adam
Alexander, rh Danny
Amess, Mr David
Andrew, Stuart
Bacon, Mr Richard
Baker, Norman
Baker, Steve
Baldry, Tony
Baldwin, Harriett
Barclay, Stephen
Barker, Gregory
Baron, Mr John
Barwell, Gavin
Bebb, Guto
Beith, rh Sir Alan
Beresford, Sir Paul
Berry, Jake
Bingham, Andrew
Binley, Mr Brian
Birtwistle, Gordon
Blackman, Bob
Blunt, Mr Crispin
Boles, Nick
Bone, Mr Peter
Bottomley, Sir Peter
Bradley, Karen
Brake, Tom
Bray, Angie
Brazier, Mr Julian
Bridgen, Andrew
Brine, Mr Steve
Brokenshire, James
Brooke, Annette
Browne, Mr Jeremy
Bruce, Fiona
Bruce, rh Malcolm
Buckland, Mr Robert
Burns, Conor
Burns, rh Mr Simon
Burrowes, Mr David
Burstow, Paul
Burt, Alistair
Burt, Lorely
Byles, Dan
Cairns, Alun
Campbell, rh Sir Menzies
Carmichael, Neil
Carswell, Mr Douglas
Chishti, Rehman
Clark, rh Greg
Clarke, rh Mr Kenneth
Clifton-Brown, Geoffrey
Coffey, Dr Thérèse
Collins, Damian
Colvile, Oliver
Crabb, Stephen
Crockart, Mike
Crouch, Tracey
Davey, Mr Edward
Davies, Glyn
Davies, Philip
de Bois, Nick
Dinenage, Caroline
Djanogly, Mr Jonathan
Dorrell, rh Mr Stephen
Dorries, Nadine
Doyle-Price, Jackie
Drax, Richard
Duncan Smith, rh Mr Iain
Dunne, Mr Philip
Ellis, Michael
Ellison, Jane
Ellwood, Mr Tobias
Elphicke, Charlie
Eustice, George
Evans, Jonathan
Evennett, Mr David
Fabricant, Michael
Foster, rh Mr Don
Francois, rh Mr Mark
Freeman, George
Freer, Mike
Fullbrook, Lorraine
Fuller, Richard
Garnier, Mark
Gauke, Mr David
George, Andrew
Gibb, Mr Nick
Gilbert, Stephen
Glen, John
Goodwill, Mr Robert
Graham, Richard
Grant, Mrs Helen
Gray, Mr James
Grayling, rh Chris
Green, Damian
Greening, Justine
Griffiths, Andrew
Gummer, Ben
Gyimah, Mr Sam
Halfon, Robert
Hames, Duncan
Hammond, rh Mr Philip
Hammond, Stephen
Hancock, Matthew
Hands, Greg
Harper, Mr Mark
Harrington, Richard
Harris, Rebecca
Hart, Simon
Harvey, Nick
Hayes, Mr John
Heald, Oliver
Heath, Mr David
Heaton-Harris, Chris
Hemming, John
Henderson, Gordon
Hendry, Charles
Herbert, rh Nick
Hollobone, Mr Philip
Holloway, Mr Adam
Hopkins, Kris
Horwood, Martin
Howarth, Mr Gerald
Howell, John
Hughes, rh Simon
Huhne, rh Chris
Huppert, Dr Julian
Hurd, Mr Nick
Jackson, Mr Stewart
James, Margot
Javid, Sajid
Johnson, Gareth
Johnson, Joseph
Jones, Andrew
Jones, Mr David
Jones, Mr Marcus
Kawczynski, Daniel
Kelly, Chris
Kirby, Simon
Knight, rh Mr Greg
Kwarteng, Kwasi
Lancaster, Mark
Latham, Pauline
Leadsom, Andrea
Lee, Jessica
Lee, Dr Phillip
Leech, Mr John
Lefroy, Jeremy
Leigh, Mr Edward
Leslie, Charlotte
Letwin, rh Mr Oliver
Lewis, Brandon
Lewis, Dr Julian
Lidington, rh Mr David
Long, Naomi
Lopresti, Jack
Loughton, Tim
Luff, Peter
Lumley, Karen
Macleod, Mary
Main, Mrs Anne
Maude, rh Mr Francis
May, rh Mrs Theresa
Maynard, Paul
McCartney, Jason
McLoughlin, rh Mr Patrick
McPartland, Stephen
McVey, Esther
Mensch, Mrs Louise
Menzies, Mark
Mercer, Patrick
Metcalfe, Stephen
Miller, Maria
Mills, Nigel
Milton, Anne
Mordaunt, Penny
Morgan, Nicky
Morris, Anne Marie
Morris, David
Morris, James
Mosley, Stephen
Mulholland, Greg
Mundell, rh David
Munt, Tessa
Murray, Sheryll
Murrison, Dr Andrew
Neill, Robert
Newmark, Mr Brooks
Newton, Sarah
Nokes, Caroline
Nuttall, Mr David
Offord, Mr Matthew
Ollerenshaw, Eric
Paice, rh Mr James
Parish, Neil
Patel, Priti
Percy, Andrew
Perry, Claire
Phillips, Stephen
Pickles, rh Mr Eric
Pincher, Christopher
Poulter, Dr Daniel
Pritchard, Mark
Raab, Mr Dominic
Randall, rh Mr John
Reckless, Mark
Redwood, rh Mr John
Rees-Mogg, Jacob
Reevell, Simon
Reid, Mr Alan
Robathan, rh Mr Andrew
Robertson, Mr Laurence
Rogerson, Dan
Rosindell, Andrew
Rudd, Amber
Ruffley, Mr David
Russell, Bob
Rutley, David
Sandys, Laura
Scott, Mr Lee
Selous, Andrew
Shapps, rh Grant
Sharma, Alok
Shelbrooke, Alec
Simmonds, Mark
Simpson, Mr Keith
Skidmore, Chris
Smith, Miss Chloe
Smith, Julian
Soubry, Anna
Spelman, rh Mrs Caroline
Spencer, Mr Mark
Stephenson, Andrew
Stevenson, John
Stewart, Bob
Stewart, Iain
Stewart, Rory
Streeter, Mr Gary
Stride, Mel
Stuart, Mr Graham
Stunell, Andrew
Sturdy, Julian
Swales, Ian
Swayne, Mr Desmond
Swinson, Jo
Syms, Mr Robert
Teather, Sarah
Thurso, John
Timpson, Mr Edward
Tomlinson, Justin
Tredinnick, David
Truss, Elizabeth
Turner, Mr Andrew
Tyrie, Mr Andrew
Uppal, Paul
Vara, Mr Shailesh
Vickers, Martin
Villiers, rh Mrs Theresa
Walker, Mr Charles
Walker, Mr Robin
Walter, Mr Robert
Ward, Mr David
Watkinson, Angela
Weatherley, Mike
Webb, Steve
Wharton, James
Wheeler, Heather
White, Chris
Whittaker, Craig
Wiggin, Bill
Willetts, rh Mr David
Williams, Mr Mark
Williams, Stephen
Williamson, Gavin
Willott, Jenny
Wilson, Mr Rob
Wollaston, Dr Sarah
Wright, Simon
Young, rh Sir George
Zahawi, Nadhim
Tellers for the Noes:
Norman Lamb and
James Duddridge
Question accordingly negatived.
14 Jun 2011 : Column 744
14 Jun 2011 : Column 745
‘(1) In preparing policy, public bodies and Ministers must have regard to those matters to which the Secretary of State is to have regard in preparing an armed forces covenant report, under subsection (2A) of section 359A of AFA 2006.
(2) In preparing policy, public bodies and Ministers must consider whether the making of special provision for service people or particular descriptions of service people would be justified.’.—(Gemma Doyle.)
Brought up, and read the First time.
Question put, That the clause be read a Second time.
The
Committee
divided:
Ayes 213, Noes 291.
[9.41 pm
AYES
Abbott, Ms Diane
Abrahams, Debbie
Alexander, rh Mr Douglas
Alexander, Heidi
Ali, Rushanara
Allen, Mr Graham
Anderson, Mr David
Ashworth, Jon
Austin, Ian
Bailey, Mr Adrian
Bain, Mr William
Balls, rh Ed
Banks, Gordon
Barron, rh Mr Kevin
Bayley, Hugh
Beckett, rh Margaret
Begg, Dame Anne
Benn, rh Hilary
Benton, Mr Joe
Berger, Luciana
Blackman-Woods, Roberta
Blenkinsop, Tom
Blomfield, Paul
Bradshaw, rh Mr Ben
Brennan, Kevin
Brown, Lyn
Brown, Mr Russell
Bryant, Chris
Buck, Ms Karen
Burden, Richard
Burnham, rh Andy
Campbell, Mr Alan
Campbell, Mr Gregory
Campbell, Mr Ronnie
Caton, Martin
Chapman, Mrs Jenny
Clarke, rh Mr Tom
Coaker, Vernon
Coffey, Ann
Cooper, Rosie
Corbyn, Jeremy
Crausby, Mr David
Creasy, Stella
Cruddas, Jon
Cryer, John
Cunningham, Alex
Cunningham, Mr Jim
Cunningham, Tony
Curran, Margaret
Dakin, Nic
David, Mr Wayne
Davidson, Mr Ian
Davies, Geraint
De Piero, Gloria
Denham, rh Mr John
Dobbin, Jim
Dobson, rh Frank
Docherty, Thomas
Dodds, rh Mr Nigel
Donohoe, Mr Brian H.
Doran, Mr Frank
Doyle, Gemma
Dugher, Michael
Eagle, Ms Angela
Eagle, Maria
Edwards, Jonathan
Efford, Clive
Ellman, Mrs Louise
Esterson, Bill
Evans, Chris
Farrelly, Paul
Field, rh Mr Frank
Fitzpatrick, Jim
Flello, Robert
Flynn, Paul
Fovargue, Yvonne
Francis, Dr Hywel
Gapes, Mike
Gilmore, Sheila
Glass, Pat
Glindon, Mrs Mary
Goggins, rh Paul
Goodman, Helen
Green, Kate
Griffith, Nia
Gwynne, Andrew
Hain, rh Mr Peter
Hamilton, Mr David
Hamilton, Fabian
Harris, Mr Tom
Havard, Mr Dai
Healey, rh John
Hendrick, Mark
Hepburn, Mr Stephen
Hermon, Lady
Heyes, David
Hilling, Julie
Hodge, rh Margaret
Hodgson, Mrs Sharon
Hoey, Kate
Hood, Mr Jim
Hosie, Stewart
Hunt, Tristram
Irranca-Davies, Huw
James, Mrs Siân C.
Jamieson, Cathy
Jarvis, Dan
Johnson, Diana
Jones, Graham
Jones, Mr Kevan
Jones, Susan Elan
Joyce, Eric
Kaufman, rh Sir Gerald
Kendall, Liz
Lammy, rh Mr David
Lavery, Ian
Lazarowicz, Mark
Leslie, Chris
Lewis, Mr Ivan
Lloyd, Tony
Long, Naomi
Love, Mr Andrew
Lucas, Caroline
Lucas, Ian
MacNeil, Mr Angus Brendan
Mahmood, Shabana
Mann, John
Marsden, Mr Gordon
McCabe, Steve
McCann, Mr Michael
McCarthy, Kerry
McClymont, Gregg
McDonnell, John
McFadden, rh Mr Pat
McGovern, Alison
McGovern, Jim
McGuire, rh Mrs Anne
McKechin, Ann
McKinnell, Catherine
Meacher, rh Mr Michael
Mearns, Ian
Michael, rh Alun
Miliband, rh David
Miller, Andrew
Moon, Mrs Madeleine
Morden, Jessica
Morrice, Graeme
(Livingston)
Morris, Grahame M.
(Easington)
Munn, Meg
Murphy, rh Mr Jim
Nandy, Lisa
Nash, Pamela
O'Donnell, Fiona
Onwurah, Chi
Osborne, Sandra
Owen, Albert
Pearce, Teresa
Perkins, Toby
Phillipson, Bridget
Pound, Stephen
Qureshi, Yasmin
Raynsford, rh Mr Nick
Reeves, Rachel
Reynolds, Emma
Reynolds, Jonathan
Riordan, Mrs Linda
Robertson, Angus
Robertson, John
Robinson, Mr Geoffrey
Rotheram, Steve
Roy, Lindsay
Ruane, Chris
Ruddock, rh Joan
Sarwar, Anas
Seabeck, Alison
Sharma, Mr Virendra
Sheerman, Mr Barry
Sheridan, Jim
Shuker, Gavin
Simpson, David
Skinner, Mr Dennis
Slaughter, Mr Andy
Smith, rh Mr Andrew
Smith, Nick
Smith, Owen
Spellar, rh Mr John
Straw, rh Mr Jack
Stuart, Ms Gisela
Sutcliffe, Mr Gerry
Tami, Mark
Thomas, Mr Gareth
Thornberry, Emily
Timms, rh Stephen
Trickett, Jon
Turner, Karl
Twigg, Stephen
Umunna, Mr Chuka
Vaz, rh Keith
Vaz, Valerie
Walley, Joan
Whiteford, Dr Eilidh
Whitehead, Dr Alan
Wicks, rh Malcolm
Williams, Hywel
Williamson, Chris
Wilson, Phil
Winnick, Mr David
Winterton, rh Ms Rosie
Wishart, Pete
Wood, Mike
Woodcock, John
Wright, David
Wright, Mr Iain
Tellers for the Ayes:
Lilian Greenwood and
Angela Smith
NOES
Adams, Nigel
Afriyie, Adam
Alexander, rh Danny
Amess, Mr David
Andrew, Stuart
Bacon, Mr Richard
Baker, Norman
Baker, Steve
Baldry, Tony
Baldwin, Harriett
Barclay, Stephen
Barker, Gregory
Baron, Mr John
Barwell, Gavin
Bebb, Guto
Beith, rh Sir Alan
Beresford, Sir Paul
Berry, Jake
Bingham, Andrew
Binley, Mr Brian
Birtwistle, Gordon
Blackman, Bob
Blunt, Mr Crispin
Boles, Nick
Bone, Mr Peter
Bottomley, Sir Peter
Bradley, Karen
Brake, Tom
Bray, Angie
Brazier, Mr Julian
Bridgen, Andrew
Brine, Mr Steve
Brokenshire, James
Brooke, Annette
Browne, Mr Jeremy
Bruce, Fiona
Bruce, rh Malcolm
Buckland, Mr Robert
Burns, Conor
Burns, rh Mr Simon
Burrowes, Mr David
Burstow, Paul
Burt, Alistair
Burt, Lorely
Byles, Dan
Cairns, Alun
Campbell, rh Sir Menzies
Carmichael, Neil
Carswell, Mr Douglas
Chishti, Rehman
Clark, rh Greg
Clarke, rh Mr Kenneth
Clifton-Brown, Geoffrey
Coffey, Dr Thérèse
Collins, Damian
Colvile, Oliver
Crabb, Stephen
Crockart, Mike
Crouch, Tracey
Davey, Mr Edward
Davies, David T. C.
(Monmouth)
Davies, Glyn
Davies, Philip
de Bois, Nick
Dinenage, Caroline
Djanogly, Mr Jonathan
Dorrell, rh Mr Stephen
Dorries, Nadine
Doyle-Price, Jackie
Drax, Richard
Duncan Smith, rh Mr Iain
Dunne, Mr Philip
Ellis, Michael
Ellison, Jane
Ellwood, Mr Tobias
Elphicke, Charlie
Eustice, George
Evans, Graham
Evans, Jonathan
Evennett, Mr David
Fabricant, Michael
Foster, rh Mr Don
Francois, rh Mr Mark
Freeman, George
Freer, Mike
Fullbrook, Lorraine
Fuller, Richard
Garnier, Mark
Gauke, Mr David
George, Andrew
Gibb, Mr Nick
Gilbert, Stephen
Glen, John
Goldsmith, Zac
Goodwill, Mr Robert
Graham, Richard
Grant, Mrs Helen
Gray, Mr James
Grayling, rh Chris
Green, Damian
Greening, Justine
Griffiths, Andrew
Gummer, Ben
Gyimah, Mr Sam
Halfon, Robert
Hames, Duncan
Hammond, rh Mr Philip
Hammond, Stephen
Hancock, Matthew
Hands, Greg
Harper, Mr Mark
Harrington, Richard
Harris, Rebecca
Hart, Simon
Harvey, Nick
Hayes, Mr John
Heald, Oliver
Heath, Mr David
Heaton-Harris, Chris
Hemming, John
Henderson, Gordon
Hendry, Charles
Herbert, rh Nick
Hollobone, Mr Philip
Holloway, Mr Adam
Hopkins, Kris
Horwood, Martin
Howarth, Mr Gerald
Howell, John
Hughes, rh Simon
Huhne, rh Chris
Hunter, Mark
Huppert, Dr Julian
Hurd, Mr Nick
Jackson, Mr Stewart
James, Margot
Javid, Sajid
Johnson, Gareth
Johnson, Joseph
Jones, Andrew
Jones, Mr David
Jones, Mr Marcus
Kawczynski, Daniel
Kelly, Chris
Kirby, Simon
Knight, rh Mr Greg
Kwarteng, Kwasi
Lancaster, Mark
Latham, Pauline
Leadsom, Andrea
Lee, Jessica
Lee, Dr Phillip
Leech, Mr John
Lefroy, Jeremy
Leigh, Mr Edward
Leslie, Charlotte
Letwin, rh Mr Oliver
Lewis, Brandon
Lewis, Dr Julian
Liddell-Grainger, Mr Ian
Lidington, rh Mr David
Lopresti, Jack
Loughton, Tim
Luff, Peter
Lumley, Karen
Macleod, Mary
Main, Mrs Anne
Maude, rh Mr Francis
May, rh Mrs Theresa
Maynard, Paul
McCartney, Jason
McCartney, Karl
McLoughlin, rh Mr Patrick
McPartland, Stephen
McVey, Esther
Mensch, Mrs Louise
Menzies, Mark
Mercer, Patrick
Metcalfe, Stephen
Miller, Maria
Mills, Nigel
Milton, Anne
Mordaunt, Penny
Morgan, Nicky
Morris, Anne Marie
Morris, David
Morris, James
Mosley, Stephen
Mowat, David
Mulholland, Greg
Mundell, rh David
Munt, Tessa
Murray, Sheryll
Murrison, Dr Andrew
Neill, Robert
Newmark, Mr Brooks
Newton, Sarah
Nokes, Caroline
Nuttall, Mr David
Offord, Mr Matthew
Ollerenshaw, Eric
Paice, rh Mr James
Parish, Neil
Patel, Priti
Percy, Andrew
Perry, Claire
Phillips, Stephen
Pickles, rh Mr Eric
Pincher, Christopher
Poulter, Dr Daniel
Pritchard, Mark
Pugh, John
Raab, Mr Dominic
Randall, rh Mr John
Reckless, Mark
Redwood, rh Mr John
Rees-Mogg, Jacob
Reevell, Simon
Reid, Mr Alan
Robathan, rh Mr Andrew
Robertson, Mr Laurence
Rogerson, Dan
Rosindell, Andrew
Rudd, Amber
Ruffley, Mr David
Russell, Bob
Rutley, David
Sandys, Laura
Scott, Mr Lee
Selous, Andrew
Shapps, rh Grant
Sharma, Alok
Shelbrooke, Alec
Simmonds, Mark
Simpson, Mr Keith
Skidmore, Chris
Smith, Miss Chloe
Smith, Julian
Soubry, Anna
Spelman, rh Mrs Caroline
Spencer, Mr Mark
Stephenson, Andrew
Stevenson, John
Stewart, Bob
Stewart, Iain
Stewart, Rory
Streeter, Mr Gary
Stride, Mel
Stuart, Mr Graham
Stunell, Andrew
Sturdy, Julian
Swales, Ian
Swayne, Mr Desmond
Swinson, Jo
Syms, Mr Robert
Teather, Sarah
Thurso, John
Timpson, Mr Edward
Tomlinson, Justin
Tredinnick, David
Truss, Elizabeth
Turner, Mr Andrew
Tyrie, Mr Andrew
Uppal, Paul
Vara, Mr Shailesh
Vickers, Martin
Villiers, rh Mrs Theresa
Walker, Mr Charles
Walker, Mr Robin
Walter, Mr Robert
Ward, Mr David
Watkinson, Angela
Weatherley, Mike
Webb, Steve
Wharton, James
Wheeler, Heather
White, Chris
Whittaker, Craig
Wiggin, Bill
Willetts, rh Mr David
Williams, Mr Mark
Williams, Stephen
Williamson, Gavin
Willott, Jenny
Wilson, Mr Rob
Wollaston, Dr Sarah
Wright, Simon
Yeo, Mr Tim
Young, rh Sir George
Zahawi, Nadhim
Tellers for the Noes:
Norman Lamb and
James Duddridge
Question accordingly negatived.
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The Deputy Speaker resumed the Chair.
Bill to be considered tomorrow.
Business without Debate
European Union Documents
Motion made, and Question put forthwith (Standing Order No. 119(11)),
That this House takes note of European Union Document No. 16348/10, a Commission Communication on the Common Agricultural Policy towards 2020: Meeting the food, natural
14 Jun 2011 : Column 750
resources and territorial challenges of the future; supports the UK Government’s response to this Communication, calling for ambitious reform that will enable farmers to adapt to future challenges; and notes that detailed legislative proposals are set to emerge by the end of 2011.
—(Miss Chloe Smith.)
Petition
McMillan Daycare Nursery (Hull)
9.53 pm
Diana Johnson (Kingston upon Hull North) (Lab) rose—
Madam Deputy Speaker (Dawn Primarolo): Order. Will Members leave the Chamber quickly and quietly? There is more business for the House to deal with.
Diana Johnson: I beg leave to present a petition signed by Kerry Stansfield and Abigail Flavell, both of whom are constituents of mine, and by more than 440 other people who oppose the closure of the McMillan day care nursery, which has been rated outstanding by Ofsted and which is managed by Andrew Shimmin, the excellent head teacher of McMillan children’s centre and nursery school.
Declares that statements made by Ministers of the Crown to the effect that Sure Start children’s centres across the country have sufficient funding to continue providing the level of service that they have attained in recent years, appear to be contradicted by the reductions that are happening across the country; further declares that the petitioners believe that the resulting reduction in the affordable childcare in children’s centres will discourage some parents from seeking employment and will prove damaging for the long-term development of children.
The Petitioners therefore request that the House of Commons urges Ministers to review the funding arrangements for children’s centres to ensure that the valuable investment in the future that they represent is protected.
And the Petitioners remain, etc.
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Hospital Food
Motion made, and Question proposed, That this House do now adjourn.—(Miss Chloe Smith.)
9.55 pm
Joan Walley (Stoke-on-Trent North) (Lab): I am very grateful to Mr Speaker for granting me this Adjournment debate on hospital food. As you, Madam Deputy Speaker, and many Members will know, I have long been interested in this issue and have pursued it in Parliament, so when I was fortunate enough for my name to be drawn in the private Members’ Bills ballot at the beginning of this parliamentary Session, I was clear about the Bill I wanted to draft. I wanted it to introduce minimum nutritional, environmental and ethical standards for the food procured by the public sector and served in our hospitals, care homes, armed forces institutions and the rest of the public sector.
The Bill gained widespread support from industry and from more than 60 health and environmental groups, including organisations as diverse as the caterer Sodexo, the women’s institute, the Chartered Institute of Environmental Health, and the Royal College of Paediatrics and Child Health. These organisations have witnessed years of failed attempts to improve public sector food through voluntary initiatives, and have seen first hand the damage caused by bad food in our public institutions, and they are united in the belief that the only way to improve public sector food is to ensure that all public bodies buy food according to national minimum standards. Despite that, the archaic parliamentary procedure that applies to private Members’ Bills means my Bill has still not received its Second Reading debate, and without Government support it is very unlikely to proceed.The Procedure Committee is conducting an inquiry into parliamentary sitting hours, and I hope it takes seriously the inadequate procedure relating to private Members’ Bills and proposes reforms that allow MPs the opportunity to introduce a Bill and proper parliamentary time for the consideration of its merits. My experiences in that regard have led me to seek an Adjournment debate to address this general issue from the perspective of health and the procurement of sustainable food in so far as that affects the Department of Health.
The procurement of sustainable food by the public sector is a cross-cutting issue. The Department for Environment, Food and Rural Affairs has lead responsibility for cross-cutting sustainable development issues, and I expected it to have been more decisive and to have taken an effective initiative in exploring how progress can be made. I wish to bring to the attention of the House a letter from the DEFRA Minister with responsibility for food, which basically said there was an ongoing review and he hoped to have the opportunity to report to the House by March, but we still have not had that opportunity.
Tonight’s debate arises at a timely moment given today’s announcement on the Health and Social Care Bill, and I want to link the issue of sustainable food and procurement with health and healthy food in hospitals. If, indeed, the stated aim of our NHS is to have excellent care for all, we need to address the issue of hospital food, so I am very grateful for the opportunity to raise the issue of the procurement of sustainable food in hospitals as well as the equally important issue of the quality of hospital food—
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10 pm
Motion lapsed (Standing Order No. 9(3)).
Motion made, and Question proposed, That this House do now adjourn.—(Angela Watkinson.)
Madam Deputy Speaker (Dawn Primarolo): I am sorry for the interruption, but the procedure caught up with us. Please, continue.
Joan Walley: I am most grateful for the explanation, Madam Deputy Speaker. I was confused by the fact that this Adjournment debate started before 10 o’clock. That might explain some of my slight nervousness, as I was unsure about whether I was speaking in order with the proceedings of the House. I am grateful.
Sustainable food procurement links to health and to hospital food, too. I want the Government to set out the role that food plays in patient pathways and the priority I believe that hospitals should give to ensuring that, where required, patients are assisted to eat the food that is served. We have heard too many shocking accounts of malnutrition and dehydration as well as the plain criticism that hospital food is bad and unappetising. We should be doing something about that.
At the core of this debate is a central contradiction. The Government are happy to rail against regulation and boast about their bonfire of red tape, but they are equally proud—and rightly so—of their standards for the procurement of sustainable food for the Olympics and of their intentions for there to be a Government buying standard for food. They promote their localism agenda aggressively, leaving choice to those at a local level, but the net effect, I believe, is that no overall quality standard applies to the food served in hospitals. I do not see how such a postcode lottery can be justified and I want to consider that in more detail.
Let me turn first to malnutrition. It is not just a matter of having appetising food for patients; this can literally be a matter of life and death. In its 2009 report submitted to the Department of Health, the Nutrition Action Plan Delivery Board showed that in the region of 47,800 people had died with malnutrition while in English hospitals in 2007. Of those, 239 patients died directly because of malnutrition—that is an important distinction to make. In the report, the delivery board recommended as a key priority that the Government should clarify nutrition
“standards and strengthen inspection and regulation”
to address this problem. The issue is being flagged up.
In its recent report, “Still Hungry to be Heard”, Age UK found that the number of people leaving hospital malnourished is on the increase. A recent answer to a parliamentary question from my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry), placed in the Library of the House of Commons, acknowledged that from 2006-07 to 2009-10, instances of malnutrition increased in total from 2,581 to 3,773 and, as regards discharged episodes, from 2,883 to 4,412. That inevitably leads to further serious consequences, including longer stays in hospital, the need to take more medication and an increased risk of infection and even death.
To put it in purely financial terms, the estimated cost of malnutrition to the NHS in 2006 was £7.3 billion a year. Although we do not have an accurate figure for how much it costs the NHS today, given the fact that
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malnutrition is on the increase it is likely to be higher still. I believe that the Department of Health should have up-to-date figures on the cost of malnutrition, and I urge the Minister to look into the matter and give us an indication of what the costs are.
Dealing with malnutrition in hospitals is not simply about making food taste better. Even if we could do that, a whole range of other issues must be addressed. First, hospital staff must be aware of what food patients can and cannot eat. They need to be able to identify which patients need help with eating their meals and to be willing and able to provide that help or, if they cannot provide it, to have a robust system of volunteers to assist. Age UK has produced a seven-step guide to eradicating malnutrition in hospitals, to which I urge the Minister to give his attention. There is also an issue with dehydration and it is important to make sure that patients in hospital have proper access to water. That simply cannot be taken for granted.
It is not only nutrition and malnutrition that need to be addressed. There must be recognition by Government of the role that healthy food plays in healthy lives. The Government estimate that 70,000 preventable deaths each year in the UK are caused by diet-related ill health. One simple thing that the Government could do to tackle that problem is to ensure that the food served to patients in hospital is nutritious. That sounds simple but the issue is how it will be done. It is also important that the Government prioritise the role of public health.
I also want to mention the dignity and nutrition reports—[ Interruption. ] I am most grateful. Talking of dehydration, it is important that I refer to the dignity and nutrition reports recently published by the Care Quality Commission.
Madam Deputy Speaker (Dawn Primarolo): Order. If the hon. Member wishes to take a seat and take some more water so as not to strain her voice, I am sure that the Chamber will not mind waiting a few seconds more.
Joan Walley: I am most grateful Madam Deputy Speaker.
The first tranche of what will be 100 dignity and nutrition reports into individual hospitals found that in four of the 10 hospitals investigated, the nutritional needs of patients were not being met. The reports also stated that the quality of hospital food remains a long-standing concern. This highlights both the extent of the problem and the importance of the Care Quality Commission’s role in monitoring and reporting on hospital performance in relation to nutrition. I believe that its resources should be increased so that it can carry out more such checks and fulfil the delivery board’s recommendation of strengthening inspection and regulation. I also believe that the CQC should be made fully accountable for how that work is done.
I want to discuss regulation because that is ultimately the best means of improving hospital food. It is remarkable that there are still absolutely no legal standards governing the quality of the 330 million meals served in the NHS each year. In its report, “Yet more hospital food failure”, published earlier this year, Sustain’s “Good Food for Our Money” campaign surveyed dozens of Government-backed initiatives to improve the quality of hospital food. Alas, it found that those initiatives have cost at
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least £54 million of taxpayers money and have achieved improvements in only very few isolated cases. The reason is simple: they have all been voluntary, so except in those few isolated cases they have been largely ignored. Let us contrast that with the successful attempts to improve the food served in schools, where meals have to meet legal nutritional standards. A survey by Consensus Action on Salt and Health—CASH—in October 2010 showed that most meals served to children in hospital could not legally be served in a school because they contained too high a level of salt and saturated fat. The reason for the success in schools is simple: minimum nutritional standards in schools are legally binding, but in hospitals they are purely voluntary.
To date, successive Governments have failed to send a clear message to hospital caterers that the quality of their food is critical to patient health and the sustainability of our food system. It is not asking for the impossible. For many years, the Royal Brompton hospital in Chelsea has practised a progressive approach to its food procurement, providing nutritious and appetising meals prepared from fresh ingredients, which enables patients to recover faster.
Unfortunately, the Government’s ideological commitment not to introduce more regulation, regardless of its merit, is a serious block to improving hospital food. I return to Government buying standards. The coalition Government have at least recognised that voluntary initiatives have limited effect; they do not work across the board and over time. As a result, they will introduce Government buying standards that set compulsory minimum standards for food served in central Government institutions. I hope it will be soon, as the standards were promised for March 2011, and we have waited for more than a year. They were promised by the Conservative party pre-election; they were welcomed by the coalition Government and were the subject of a great deal of Department for Environment, Food and Rural Affairs civil servant attention throughout 2010. The work also involved the Department of Health to integrate badly needed health standards for food served in central Government institutions. The integration of health and sustainability standards for food bought with public money was an innovative and much needed approach, and should act as an inspiration for the wider catering sector to follow suit. Tackling health, ethical and environmental issues together should save the country money and be of great benefit to food producers and the environment.
The real issue for me is that even when the Cabinet Office home affairs committee signs off the Government buying standards, they will not apply to hospitals and hospital food. That is the heart of the concern. On the day the Government are revising the Health and Social Care Bill and recommitting it to further scrutiny, should the Health Minister not be exploring with colleagues at DEFRA and in the Cabinet how the long-promised Government buying standards can be extended to hospital food? If that is ruled out, surely there should be urgent discussions with the NHS Future Forum, the National Audit Office and expert groups, such as Age Concern and Sustain, which have a track record on this matter, with a view to tabling amendments to the Bill so that we have minimum standards for nutrition in hospital food.
Tessa Munt (Wells) (LD):
There is another part to the equation. I have worked in further education colleges and it would seem logical that when we train chefs they
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should take a module on the specifics of nutrition for people in hospital. That is a different element. Does the hon. Lady think we could focus on that to improve standards?
Joan Walley: I am glad to take that intervention. It is an extremely important point. Basic minimum standards should be applied to schools and in future to hospitals, but that will not happen by accident. It will happen only if we put in place all the necessary education, training and skills. Whoever is responsible for providing the food needs to be trained. I agree that that is a third dimension to the issue.
I apologise to the House for having lost my voice because of my cold. In conclusion, surely there is no other institution where it is more vital to serve healthy, wholesome food than in our hospitals. That is important in so many ways—for the recovery of patients, staff morale, and the atmosphere that fills the wards. When hospitals serve good nutritious food, everyone benefits. I therefore call on the Government to introduce minimum nutritional, environmental and ethical standards for hospital food that will radically improve the quality of food served, reduce costs to the NHS and improve the health of the nation.
10.16 pm
The Minister of State, Department of Health (Mr Simon Burns): I congratulate the hon. Member for Stoke-on-Trent North (Joan Walley) on securing this debate on hospital food. I hope she gets better swiftly. I have considerable sympathy with her as she was clearly suffering through no fault of her own, and I wish her a speedy recovery.
I know that food and nutrition is a subject dear to the hon. Lady’s heart, and that she has done a considerable amount of work in her constituency, bringing together schools, primary care trusts, the city council and others, Prue Leith not least among them, to see what can be done locally to improve the diet of her constituents. I pay tribute also to the many NHS staff who have worked so hard to push nutritional care up the agenda, and who continue to make it their priority.
Good food—nutritionally balanced, clinically appropriate meals that taste good— are right up there with good hygiene and good clinical care when it comes to a patient’s experience of the NHS. They are all things that we should be able to take for granted while being cared for by the NHS. Good food contributes directly to recovery from illness and it adds structure to a day that can be all too long and featureless. Although I agree with much of what the hon. Lady said, there are some details on which we may not have such close proximity of views.
As the hon. Lady mentioned in the course of her comments, we will shortly publish the Government buying standards for food. Developed by DEFRA and the Department of Health, they will support and encourage public bodies to provide a healthy balanced diet for public sector workers. They will also help to reduce the environmental impact of food and catering in the public sector. However, as the hon. Lady said, within the NHS, these standards will be voluntary, not mandatory. Government buying standards are already promoted through the NHS operating framework for 2011-12 and through the Boorman review of health and well-being
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on the NHS, now being implemented by NHS Employers. We will promote the Government buying standards through training and materials developed to help NHS organisations to procure more sustainably.
The Government believe in giving far greater responsibility and control locally to NHS providers. NHS trusts must be allowed to determine their own procurement policy. Hospitals need to find out the wants and needs of their local population and then work out how to meet them efficiently. Government’s role is to set the direction and the policy, but it is for local experts to deliver the food locally. This is not to say that the NHS is on its own. There are a number of resources available, including guidance on reducing food waste, sustainable procurement and developing menus and food services.
No health care catering manager need feel unsupported. If hospitals wish to increase the proportion of locally-sourced food, there is guidance to help them do that. If they have a problem with food waste, there are resources that can help them to tackle it. This is the way we should tackle problems—with assistance and support, not restrictive legislation and diktat. It is wrong for Government to meddle in the detail and to attempt to micro-manage the NHS from on high. Our job is to create the right environment, to set standards and to lead, and that is what we are doing.
Joan Walley: Is not there a contradiction in having minimum standards in schools but not having minimum standards that would apply in the same way to patients in hospitals?
Mr Burns: No, I do not think so, for the reasons that I have already given and because of our ethos that the modernised NHS should respond through local decision-making rather than top-down diktat from Whitehall or Westminster. However, as I have outlined, we are prepared to, and we have and we will, provide the guidance to enable local deliverers to seek advice and take decisions based on the best needs of their patients.
We should also bear in mind that the food needs of patients are already regulated and checked by the Care Quality Commission, through the choice of suitable food, the food and nutrition to meet reasonable needs and the support to enable patients to eat and drink—a subject that I will come on to because I feel very much, as the hon. Lady did, that that is an essential part of the care of patients in a hospital setting.
I share the hon. Lady’s concerns about poor standards of nutritional care. In too many cases, food has slipped off the menu of some NHS providers, and that is not good enough. Of course, proper nutritional care is a multidisciplinary affair. There are many links in the chain from field to fork. Food must be well sourced and properly cooked by well-trained catering staff, delivered efficiently by the porters, and properly presented on the ward. The chain is a long one, and if any single link breaks, the good work that went before it is undone. Of course, the best food is of no value if it is not eaten, and many people, particularly older patients, will need help, and they must have it. Stories of food left out of reach, or taken away before a patient has had the chance to eat it are shocking and, sadly, too common, as are stories of those unable to feed themselves left without the assistance they require.
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The latest in-patient survey found that less than two thirds—64%—of patients always got the help they needed to eat. But that sadly meant that 36% did not always get the help, which, frankly, is unacceptable. That is something that hospitals must concentrate on to ensure that we quickly and dramatically raise those figures. In a civilised society, in this day and age, that is unacceptable as part of patient care, particularly for elderly people.
That is why we asked the CQC to inspect 100 hospitals, focusing on issues of dignity and nutrition. The CQC has begun to publish reports on individual hospitals, and we expect a final report in September. In most cases so far, the care was every bit as good as one would expect. There were many examples of high-quality nursing and of people enjoying healthy, nutritious meals. Indeed, in a number of cases, the quality of food was actually complimented. But the inspections also identified a number of hospitals that were failing to provide the nutritional care their patients need. In one damning example, a doctor was forced to prescribe water on a patient's medicine chart to ensure they got enough to drink. That, again, is unacceptable, and something that one would find hard to believe if it had not shown up in the inspection. Where there are deficiencies, the CQC has demanded that improvements are made. Progress against these demands will be followed up and, like everyone in this House, I expect such follow-up to be rigorous and complete.
The CQC's inspection programme is just one example of how we are shining a light on all aspects of the performance of NHS providers—in this case on hospital food. There are also the annual patient environment action team inspections, the CQC's in-patient survey and patient feedback through NHS Choices, along with any local surveys that trusts choose to undertake. This information is crucial if patients are to make informed choices about their care and if pressure is to be brought to bear upon providers to improve.
Improving the patient experience of care is vital to drive up standards. Providers need to listen to patients’ complaints and suggestions and to change and improve in response. This will be one of the main ways in which the NHS will improve in coming years. Our information revolution will mean that patients are better placed to understand and influence the NHS, and we expect to see standards increase as performance becomes more transparent.
When it comes to hospital food, people know what they want. They expect good-quality, wholesome meals that are attractively served, arrive on time and taste good. They want to receive the food they ordered, not what is left over. They want to be able to eat it in comfort, they want sufficient fluids to drink, and they want the help they need when they need it. That is hardly asking the earth, so we owe it to them to be clear about what they can expect in their local hospital, however good or bad it may be.
I understand the hon. Lady’s concerns about hospitals that are built without kitchens. However, there are many ways to provide food in hospitals. Excellent meals can be delivered ready-made, either chilled or frozen, and poor-quality food is not an inevitable consequence of being made off-site. Although the quality of the food at the University Hospital of North Staffordshire has
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been rated as among the poorest 20% in the country, that is not simply because it is not made in a hospital kitchen. Other hospitals, such as those in Papworth Hospital NHS Foundation Trust and Dorset County Hospital NHS Foundation Trust, also have meals brought in and maintain in-patient survey scores that are among the highest in the country. In fact, for a small hospital, delivered meals can combine a wider choice of food and more accommodating meal times, with economies of scale and greater flexibility.
Delivered meals can also help hospitals to meet high sustainability standards, because although on-site kitchens might at first seem more likely to be sustainable, that is not necessarily the case. Larger off-site kitchens are often more efficient because, by utilising economies of scale, they can reduce the amount of energy they use. What is important is the quality of the finished product and whether it meets the specific needs of patients, not where or by whom the food is produced or prepared. If the best solution for a particular hospital is to do that on site, that is what should happen. However, the service should be contracted out if that is in the best interests of the individual hospital and its patients. We should reject any knee-jerk reaction that says doing it in one way will automatically be a disaster, or vice versa. With food, as with all aspects of NHS care, it is the outcomes that are important to patients, not the process. We need to remember that whoever provides the food, the trust management retains the responsibility for its quality. If the provider does not meet the standards that the trust has set, it must take action.
Of course, efficiency and value for money are also important. We have to find ways of producing excellent food at manageable cost. For some hospitals, that will certainly mean looking at delivered meals. This is sensible and prudent management, but it need not and should not mean poor quality. As long ago as 2002, the Audit Commission found no relationship between the amount of money spent on meals and their quality, and the Department of Health’s more recent internal analysis backs this up. Across the country there are trusts that provide great meals at low cost, which is precisely what all providers should aspire to. The Queen Victoria hospital NHS foundation trust is in the top 10% of NHS organisations rated by patients for having good food, but in the lowest 5% for production costs.
As ever, improving patient experience is central to the Government’s vision of the NHS. Good food is not only a vital element of that experience, but vital for improving clinical outcomes. However, I do not accept that the answer to these problems is to impose ever more controls that would prove expensive to administer, undermine local accountability and stifle the innovation and flexibility that hospitals need to tailor improvements to their specific local needs and constraints. Where food services are not as good as they should be, we should highlight the fact in order to improve care for patients. I do not pretend that making improvements will be easy or fast. Although there is much to do, I am confident that we now have the right approach and that the real winners in all of this will be patients.