Rail services—be they services within England, the cross-border services we are discussing or services in Wales—are very much at the heart of our transport strategy. The programme of capacity expansion we are taking forward is bigger in scale than anything undertaken since the Victorian era. The comprehensive spending review allocated about £18 billion to rail, while the
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autumn statement provided further support, including £50 million for the replacement of vehicles for the Caledonian sleeper, as we heard in this morning’s debate.
As we also heard this morning, however, that is subject to co-funding by the Scottish Government. They have not yet announced whether they are prepared to co-fund the project and to match the funding the Westminster Government are prepared to provide. As we know, there are no nationalists here to defend the position of their Government north of the border, so we are, sadly, unable to question them about it directly. However, we will continue to engage the Scottish Government on this.
Mr Russell Brown: I thank the Minister for the information she has just given us. Is there a finite time for which that offer of money will lie on the table, after which she will need to say that it is no longer there? In her interaction with the SNP Government in Edinburgh, she will discover that they will prevaricate on a whole host of issues and that they tend to put one obstacle in front of another. Does she therefore have a finite time for how long that offer of money will lie on the table?
Mrs Villiers: That is a very good question. I am not aware that the Chancellor or the Department for Transport have set a time limit for the Scottish Government to respond, but rapid consideration of this important decision would be welcome, not least because of the support for sleeper services, which was mentioned by both hon. Members who have spoken. It behoves the Scottish Government to get a move on and make a decision on this. The Westminster Government have put their money where their mouth is in expressing support for the sleeper service and potentially allocating £50 million to support its long-term future. It is now for the Scottish Government to step up to the plate and decide whether they are prepared to match that funding or lose it.
Ultimately, the running of the sleeper service will be a decision for the Scottish Government, because it is part of the ScotRail franchise, which is devolved to the Scottish Government. Ultimately, Westminster will not take the decision. As I said, I recognise the concern felt north of the border about this proposal and others made by the nationalists in the Scottish Government. I hope the disadvantages of such proposals will be thoroughly considered when the Scottish Government ultimately decide whether to match the funding we have offered and include sleeper services in the upcoming ScotRail franchise.
The Government are committed to a range of other improvements on our rail network to support and improve cross-border services. As the hon. Member for Barrow and Furness (John Woodcock) said, the west coast main line was given a £9 billion upgrade under the previous Government to deliver faster and more frequent services. As he said, the delivery was somewhat painful for passengers, but real improvements have now started to be delivered. In addition, west coast passengers will benefit from 106 extra Pendolino vehicles, a number of which are already in operation, with the rest coming on stream over the next 12 months or so. The intercity express programme will provide a new fleet to replace the diesel 125 high-speed trains on services between
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London, Aberdeen and Inverness. It will also potentially replace the electric 225s on the east coast line if the franchise operator wishes to go ahead with that.
Significant improvements are being made to the infrastructure on the east coast line as part of Network Rail’s control period 4 programme, which is funded by the Government. These include major work on the joint line via Spalding and Lincoln to provide a diversionary route for freight and free up space for more passenger services. The long-awaited Hitchin flyover is also going ahead, as are major power supply upgrades to improve services for all passengers on the line, including those on cross-border services.
Those improvements will make a real difference to rail passengers travelling between Scotland and England. Although they are important, as the hon. Member for Edinburgh North and Leith outlined, they will not be enough on their own to deal with the long-term demand for inter-city transport capacity that our economy is expected to generate in the next 20 years. We expect rapidly rising demand for inter-city travel to outpace any measures we can realistically or practically take to boost capacity, given the constraints on existing lines.
That is why the Government have, this year, run a five-month public consultation—one of the biggest ever carried out—on proposals for a new high-speed rail network. The proposals would provide a step change in capacity and help bring our major conurbations much closer together. Our proposal for a Y-shaped national high-speed rail network would link London, Birmingham, Manchester and Leeds, with connections to the west and east coast main lines from the proposed new line. Those connections are crucial to today’s debate because they would allow the through-running of high-speed rail services on to the west and east coast so that passengers could reach Edinburgh and Glasgow without having to change trains.
The Y-shaped network, plus the ability for trains to run off it and on to the existing network, would, as we have heard, cut journey times between Scotland’s two biggest cities and London to about three and a half hours. That is an hour less than many of today’s services. Such journey time reductions could give significant connectivity and economic benefits to Scotland. I know that those things are important to many in Scotland, including, I am sure, the constituents of the hon. Member for Edinburgh North and Leith.
There are also benefits in relation to air-to-rail switch, which is worth mentioning in this context. Experience shows that when rail journeys come down to three or four hours, they become more competitive with air services. The coalition Government’s proposal for a direct link to Heathrow as part of phase 2 of the Y network would provide important connectivity benefits to Edinburgh and Glasgow, with a seamless and effective connection to our major hub airport.
John Woodcock: The right hon. Lady has mentioned the benefits of the Heathrow spur in the context of going all the way to Scotland. Has she not seen, for a long time, the value of going via Heathrow in the first phase, rather than building an extra spur afterwards at greater overall cost to the taxpayer?
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Mrs Villiers: I think that there is consensus between the parties that it is essential to have a connection to Heathrow. The Government’s proposal to include a spur as part of phase 2 would provide a top-class link to Heathrow, which would be great for passengers in both Scotland and England. As to the route that the Opposition have been considering, although they chose not to submit it to the consultation, I believe that others have submitted routes that are more or less identical, and I assure the hon. Gentleman now, as I have before, that all the route options presented for consultation will be rigorously assessed before the Secretary of State makes her decision on High Speed 2, and, if she goes ahead, before she makes her decision on the route.
There is a detailed process—and it is right that it is very formal—to ensure that every person who contributed to the consultation will be listened to, and that their representations will be dealt with fairly. The shadow Minister invites me to pre-empt the Secretary of State’s decision on that. He knows that that would not be a terribly wise career move. I assure him that she will announce her decision soon, but he will just have to wait for her to make the announcement. It would be unwise of me to pre-empt it with one of my own.
John Woodcock: It would be good if the Minister could say a little more about whether the proposal for a single Bill is under active consideration. There is cross-party consensus on that, so would not it make more sense, in relation to both the business case and the stability of the project, to lock in a single Bill now, and take things forward together?
Given that we have time, perhaps I may make a second point. In opposition, the right hon. Lady was in favour of going to Heathrow as part of the first phase. That must count for something, must it not?
Mrs Villiers: I always have been, and continue to be, strongly supportive of a connection between HS2 and Heathrow. I am also strongly supportive of a thorough, evidence-based consideration of all the options on routes, which is exactly what the Secretary of State is undertaking. I imagine that, as we debate, she is probably poring over the detailed submissions summarising the consultation, which provide her with all the information that she needs to take a decision on whether to go ahead with the project as a whole, and, if so, on the best route. I am confident that she will take the right decision. As I have said, the shadow Minister will have to wait just a little longer to hear that. He well knows that the coalition’s plans and proposals include a direct link to Heathrow in phase 2.
On the hybrid Bill, again, as we have had many opportunities to debate, the Government have concluded that the best way to take HS2 forward as efficiently and rapidly as possible is by two separate hybrid Bills—one for the first phase in the west midlands and one for the second phase to Manchester and Leeds. There are pros and cons about the procedures either way, but changing course now and suddenly deciding on a hybrid Bill to accommodate both phases might slow down the project. I think it would be risky. What is important is that once the Secretary of State has made a decision we should take whatever steps are needed to press ahead promptly with implementing it. I hope that the cross-party consensus
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that the shadow Minister has mentioned repeatedly will prove useful in proceeding with high-speed rail if that is the outcome of the Secretary of State’s deliberations.
Of course, the goal set out in the coalition agreement is to deliver a genuinely national high-speed rail network. It is therefore a timely moment to consider the impact on Scotland. Although the Y network that we propose would bring important benefits to Scottish passengers and the Scottish economy, because of the journey time savings that we have talked about and the relief of capacity pressure that the shadow Minister referred to, we still recognise the strong support for extending the proposed new high-speed line north to Scotland in the future.
The Government share the aspiration of the hon. Member for Edinburgh North and Leith for high-speed rail one day to extend north of the border all the way to Edinburgh and Glasgow. He will appreciate that, constitutionally, the Scottish Government have responsibility for the rail infrastructure north of the border, including funding it. However, if we go ahead with HS2, phases 1 and 2, we will certainly expect to work with the Scottish Government on identifying and considering options for expanding the proposed high-speed network in the future. I assure him that there is no need to wait for completion of either phase before serious work is started in relation to potential further expansion of the network.
Mark Lazarowicz: I welcome the broad commitment that the right hon. Lady has given, but she will understand that although the Y-shaped route will clearly bring benefits to Scotland, because of the effect on rail speeds and capacity further south, it will by definition not help with capacity once the end of the Y line is reached and the journey continues on existing lines to Edinburgh and Glasgow. If anything, there might be capacity problems, because of extra trains on those lines. Can the right hon. Lady give any indication of the type of discussions that are going on with the Scottish Government? I get the impression that they are something that may happen one day, as she said; but we want more of a commitment than that. We want an indication of what work is going on now, and a commitment that preparation should start now.
Mrs Villiers: I assure the hon. Gentleman that officials from HS2 and the Department for Transport have regular discussions with Transport Scotland about high-speed rail. I have discussed it with Scottish Ministers on several occasions. The Secretary of State for Defence also discussed it, when he was Transport Secretary, with Scottish Ministers. Indeed, HS2 is already considering options further to reduce journey times to Edinburgh and Glasgow. We recognise the enthusiasm for further work on expanding the proposed high-speed rail network. As I have said, we share the aspiration of establishing a genuinely national network, which must of course include Scotland.
Mr Russell Brown:
I would like to share with the Minister and hon. Members an infrastructure-related problem—albeit not to do with rail—which my ex-colleague the former Member for Carlisle, Eric Martlew, experienced when the M6 was brought north to Carlisle. For some reason it stopped there. When he asked an official why it stopped at Carlisle, he was told the road did not go
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anywhere. In other words, there was no need to take it to the border, or even into Scotland, which fell under the remit of the Scottish Office at that time. I have to share that worry with the Minister. We have a line that comes so far north, and we have this mindset that it goes nowhere. Colleagues in Scotland will be forcing the issue with the Scottish Government to engage in a process to make sure that something is happening north of the border that ensures that we get UK coverage of this railway.
Mrs Villiers: Mr Hollobone has given us great latitude to wander far and wide in the debate, but I am afraid that I do not have a very detailed knowledge of the history of the construction of the M6. I assure the hon. Gentleman that it is always wise to learn lessons from what has gone wrong with previous transport projects. I reiterate the importance that we place on playing our part to supply a high-quality transport network for the country as a whole. As I have said, infrastructure matters north of the border are rightly devolved to Transport Scotland, but we recognise the importance of our decisions on high-speed rail taking into account fully the interests of the economy and passengers in Scotland. That is why we are happy to engage with Scottish hon. Members and the Scottish Government. We need to view, with careful scrutiny and perhaps some scepticism or reservation, the promises that Scottish Ministers are now making about high-speed rail. It is difficult to judge whether their promises on funding are watertight, but we certainly welcome the enthusiasm with which they support the principle of high-speed rail.
Before moving on to through services on the current network, I will respond to the shadow spokesman’s criticism that the Government were somehow insufficiently supportive on high-speed rail. I remind the hon. Member for Barrow and Furness that we were the first to champion the benefits of high-speed rail. Indeed, we were doing so when Labour’s 30-year strategy for the railways, published in 2007, had no place at all for high-speed rail.
One of the other key issues raised by the hon. Member for Edinburgh North and Leith was the controversial consultation document issued by Transport Scotland on the service pattern for the new ScotRail franchise to be let from 2014 onwards. As we have heard, that has posed a question on whether services north of Edinburgh should be a matter for the Scottish franchisee. As we have heard, that would mean cross-border services terminating at Edinburgh Waverley, with onward connections to Aberdeen and Inverness provided by ScotRail. That proposition has been dubbed the “Edinburgh Hub” by Transport Scotland.
As we have heard, the Scottish Government make three assertions on the effect of that change. First, they assert that it would return greater revenue to the Scottish franchisee and reduce taxpayer subsidy—that might be a controversial claim. Secondly, they claim that moving to just one operator would improve resilience—that ought to be carefully tested. Thirdly, they claim that the change would give the ScotRail franchisee more freedom and flexibility in timetabling and running services. Fourthly, they claim that there are advantages in vesting control over services north of Edinburgh in a Scottish franchisee with no reliance on services specified by the Department for Transport.
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One of my concerns is whether that is an ideologically-driven proposal motivated by a wish to control as many rail services in Scotland as possible. I would be very concerned if that was a motivating factor behind Transport Scotland’s fairly startling proposals. It is very important for the decision to be made on a clear and calm assessment of the potential effects of such a change.
The proposals generated considerable opposition and debate in Scotland. We have had discussions with the Scottish Government and Transport Scotland about the implications of such a change. As hon. Members might recollect, this issue has cropped up before. In considering whether to proceed with the intercity express programme, the Westminster Government looked at whether east coast services should terminate at Edinburgh, so that they could all be provided by electric trains. We decided against a rolling stock option that would have required passengers to change trains at Edinburgh, because we were concerned about the implications of such a change. That is the conclusion that we reached, so, as the hon. Gentleman invited me to say, I certainly would have reservations about the Scottish Government’s proposal.
If, following the consultation, the Scottish Government decide that they would like this change to take place on the east coast line, we would of course consider their proposal in accordance with our mutual respect agenda. However, hon. Members have been clear in outlining the disadvantages of such an approach, which, as I have said, would have to be very carefully considered. It is disappointing that no one is here to defend the nationalists’ position or explain why they have chosen to consult on such a controversial proposal.
John Woodcock: I appreciate what the Minister is saying, but if she feels so strongly, would it not make more sense, for good governance, to be clear now that the proposal is not a goer? We would not need to go through the consultation, wait for a response and see whether something comes through. If she made it clear that this is not something that she would accept, it would allow people to go forward with greater clarity.
Mrs Villiers: I think that that would be unwise, because the Government take devolution very seriously. We are talking about rail services provided in Scotland. It is certainly not at all unreasonable for the Scottish Government to wish to have an input in how those services are run. At this stage, it would be inappropriate for the coalition to start dictating the outcome of a consultation on the ScotRail franchise. I will therefore confine my remarks to saying that we would have reservations about a route down which we did not chose to go in relation to the IEP, but we will listen to the Scottish Government if they choose to pursue that further.
Mark Lazarowicz:
I am not asking the Minister to veto the Scottish Government’s proposals, if they go along the line of a Scottish franchise that takes on board the services north of Edinburgh, because I accept that devolution exists and that the Scottish Government have the right to put forward their views. My point is that we are discussing UK services as well, and I ask her
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to take that on board. If the Scottish Government decide on such proposals, I hope that she will ask them to ensure that the new franchisee will still be required to maintain cross-border services.
Mrs Villiers: I certainly take those points on board, but closing down the debate at this stage would not be appropriate, because it would be undermining, and we respect the devolution settlement and want to pursue an agenda of mutual respect. We would consider such proposals from the Scottish Government if they chose to go ahead. As I said, we need to weigh carefully all the appropriate evidence. If the proposal were indeed motivated by some political separatist agenda, that would be a real concern. A final decision will need to be made in time for the publication of the invitation to tender for the next east coast franchise in the autumn next year.
The shadow Minister mentioned performance on the east coast line. It has certainly been disappointing; the performance of both the train operator and Network Rail has been below the levels expected. Cable theft has had a major effect, and we are discussing co-ordinated action throughout the Government, with a view possibly to increase the punishment for cable thieves and to clamp down on rogue elements of the scrap-metal industry.
The west coast main line, meanwhile, has also experienced a performance dip in recent months, mainly owing to track faults and other infrastructure delays. I am afraid that performance on the two routes has contributed to the Office of Rail Regulation’s recent warning to Network Rail, set out in a letter of 19 December, that the company is in danger of breaching its licence conditions for the long-distance sector and will miss its regulatory targets for the sector this year. The ORR made it clear that it expects Network Rail to submit robust plans for improving performance on key routes such as those on the east and west coasts. The Government, too, believe that performance needs to improve, and we are fully supportive of the action that the ORR has taken.
Concerns about fares have been expressed. The fares that people pay are of course making an essential contribution to the massive rail upgrade programme that is being delivered and to which I referred at the start of my remarks. Some cheap fares for cross-border services are available to those who can book ahead and commit to a specific service, but we recognise that it is not always possible to do that. We understand the concern about rail fares and the pressure that they put on family budgets. That is why, in the Chancellor’s autumn statement, he announced that funding had been secured to cancel the proposed increase of the retail prices index plus 3% planned for next year and to revert to an RPI plus 1% increase for the fares coming into effect in January. That covers cross-border services on the east and west coast main lines, as well as others in England.
If we are to provide a lasting solution to passenger concern about fares, however, it is vital to get the cost of running the railways down. Sir Roy McNulty’s report, referred to briefly in the debate, set out a path that he believed would achieve significant savings without cuts in service provision. At the heart of his recommendations are measures to align incentives between Network Rail and the train operators. Put simply, we need to ensure that the two sides of the rail industry, track and train, work better together, with a strong shared incentive to
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get costs down and to improve outcomes for passengers. We are determined to deliver effective savings on the railway, so that we can deliver the improvements that passengers want and respond to their concerns on value for money.
I am grateful to hon. Members for listening with such patience to my remarks on cross-border rail services this afternoon.
Mr Philip Hollobone (in the Chair): After a leisurely journey across the rail network, both north and south of the border, we have reached our destination early. I thank all Members for taking part.
3.42 pm
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Firearms Residue Testing (Criminal Cases)
3.57 pm
Damian Collins (Folkestone and Hythe) (Con): It is a pleasure to serve under your chairmanship, Mr Hollobone. I applied for this debate because a constituent has brought to my attention a case in which forensic evidence that was presented to achieve his conviction for murder has been proven to be unreliable. That constituent is Mr Paul Cleeland, who was convicted in 1972 of the murder of Terence Clarke outside his home in Stevenage. I want to address some specific issues about Mr Cleeland’s case, but I believe that it is an exemplar of problems with evidence presented in such criminal cases in the 1970s.
The matter has been raised twice in the House: in 1982 and 1988. It was pursued with persistence by Baroness Williams when she was a Member of Parliament, Mr Bowen Wells when he was the MP for Hertford and Stevenage, and Mr John Hughes when he was the MP for Coventry, North East. It is a matter of great regret that the issue remains unresolved to my constituent’s satisfaction after such a long time. Mr Cleeland is in the Public Gallery to witness the debate, a privilege he was unable to exercise in the previous debates.
When the case was first debated, it was reported that a
“prominent Queen's Counsel”
“There are a quite unusual number of blemishes in connection with the police evidence—in particular the discrepancies”
“Dr Julius Grant, Secretary of the Society of Forensic Medicine, calls the ballistic evidence ‘disturbing’ and said that it would appear to provide Mr. Cleeland with ample reasons for wanting his case re-opened and on purely scientific grounds I cannot do other than support them.—[Official Report, 29 April 1982; Vol. 22, c. 1062.]
There is a wealth of discrepancies in the evidence against my constituent, which I will not rehearse here because the purpose of this debate is to focus on the problems that his case brings to light with the testing for firearms residue. However, I want to recount briefly some discrepancies in the ballistics evidence, because they have a direct bearing on the reliability of the forensic evidence of firearms residue.
The firearm submitted by the police as the murder weapon was an antique 12-bore Gye and Moncrieff shotgun. The police claimed that it was found in the vicinity of the murder by children, and that it contained two discharged shells with a box of unused shells lying nearby. The police attested through witnesses that the gun was sold to Mr Cleeland, but that was later refuted, and it was proven that the gun had been given to the victim. Mrs Clarke, Terry Clarke’s widow, had known Paul Cleeland for 12 years before the murder, but was unable to identify him as the murderer, despite being a witness to the crime. Mrs Clarke and neighbours, who were all witnesses to the murder, claimed that the assailant discharged a gun twice at a range of not more than 6 feet—point blank range—first into Mr Clarke’s back, and secondly into his chest.
There are discrepancies between ballistics reports. Mr J. McCafferty, a principal scientific officer in the Metropolitan police forensic science laboratory on whose
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evidence the prosecution relied, claimed that the firearm would have been discharged at a minimum of 18 feet from the victim. However—I want to stress three key points—Mr Rothery, another expert, said that if the shotgun had been fired at a range of 18 feet, cartridge wadding would have remained affixed to the victim’s jacket. Mr Rothery and Mr Jennings, another ballistics expert, said that the firearm that the police claimed was the murder weapon would have to have been discharged 36 to 40 feet away to achieve the distribution on the victim. Dr Rufus Crompton, then consultant pathologist at St George’s hospital, London, provided corroboration of the evidence of Rothery and Jennings when he concluded from medical evidence that the range was about 36 feet.
If those witnesses were correct in their account of the assailant’s distance to the victim, or if Mr McCafferty’s assessment of that distance was correct, the necessary conclusion from the evidence provided by Mr Rothery, Mr Jennings and Mr Crompton is that the Gye and Moncrieff shotgun could not have been the murder weapon. It would instead have been reasonable to argue that using a shotgun at point-blank range to achieve as wide a distribution of pellets as that achieved by firing at a range of 40 feet, would have required the use of a sawn-off, 12-bore shotgun such as the one later found at a weir in nearby Harlow.
Those points are important because the doubts about the ballistics evidence submitted by Mr McCafferty underline the unreliability of his forensic evidence. At the time of Mr Cleeland’s trial, Mr McCafferty was a principal scientific officer in the Metropolitan police forensic science laboratory. He had no formal academic qualifications, but he had been in charge of the firearms section of the forensic science laboratory since January 1964. At the time of the trial, he had 25 years of ballistic experience as an examiner of firearms and ammunition.
Given his long-standing position at the forensic science laboratory, it is perhaps unsurprising that Mr McCafferty was frequently relied on in trials as an expert forensics and ballistics witness for the prosecution. That included the trial of James Hanratty, who was hanged in 1962 for the murder of a Government scientist, over which there has been great and long-lasting doubt. Were the competence of Mr McCafferty as a forensics and ballistics expert to be brought into question, so too would the safety of the convictions of those in whose trials he gave evidence. That is why the results of the forensic tests used to convict my constituent have implications far wider than the case under discussion today.
During the original investigation, Mr McCafferty carried out a sodium rhodizonate test on Mr Cleeland’s clothes. The results of that test were relied on by the prosecution as evidence that Mr Cleeland had discharged a firearm. It has since become apparent, however, that the sodium rhodizonate test is suitable only as a preliminary, screening test. It is not capable of specifically detecting firearm discharge residues, but only the presence of lead or lead compounds. Despite the fact that the sodium rhodizonate test was not suitable for establishing the presence of firearm discharge residue, Mr McCafferty clearly considered that to be the purpose of such a test,
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as is clear from statements that he made during the 1977 investigation into allegations of perjury made by my constituent:
“On the 17th November I received from Mr Chaperlin in the laboratory exhibits…which were all items of Mr Cleeland’s clothing for the examination principally for firearms residue…On the completion of my examination of all the items received including the items of Mr Cleeland’s clothing I made a further statement which covered my chemical test for the presence of possible firearms residue.”
McCafferty’s evidence clearly impressed the judge at the time, who said when summing up the case that the clothes had been examined for
“traces of this lead residue”—
—a reference to the powder residue from the discharge of a firearm. The test carried out was the sodium rhodizonate test that we now know is unreliable for establishing the presence of firearm discharge residue.
In the early 1970s, forensic science was not as developed as it is today; the expertise and tests available were more limited, even if we could reasonably have expected the scientific rigour to have been the same. If we ask ourselves, however, whether other tests available at the time were suitable for establishing the presence of firearm discharge residue, the answer is yes. Other chemical tests would have supplemented the sodium rhodizonate test, and they were available to the prosecution at the time of the original trial. In particular, the atomic absorption spectroscopy and neutron activation analysis were available, and those sophisticated modern analytical methods were adopted to improve the sensitivity of the testing process. Neither test was used on Mr Cleeland’s clothes, however, even though, according to an expert witness who has gone unchallenged throughout my constituent’s appeals, they
“could have helped in ascertaining whether the elements on the clothing of Mr Cleeland came from the discharge of a firearm or were present as a result of completely innocuous activity.”
The fact that Mr McCafferty was seemingly unaware of the existence of those tests at the time of the original investigation casts doubt either on his expertise or his integrity. Some reassurance could perhaps be gained if it could be established that in his investigation into the murder of Mr Clarke, Mr McCafferty was incompetent but honestly so. Such a conclusion would perhaps cast less doubt on the evidence that he has given in other trials, as it would rely on him being unaware of the availability of those more specific tests.
Was Mr McCafferty aware of those tests? In 2006, my constituent came into contact with Professor Marco Morin, a ballistics expert who was involved in the high-profile case of Barry George, the man incorrectly convicted of the murder of television presenter Jill Dando. The prosecution in that case relied heavily on evidence of what it claimed was firearm discharge residue on Barry George’s clothing. Professor Morin referred my constituent to the training manual prepared by the Metropolitan police forensic science laboratory, dated November 1980. That manual explicitly recognised that the sodium rhodizonate test, carried out by Mr McCafferty, was unreliable for the purposes of establishing the presence of firearm discharge residue, and it refers to the test as:
“Simple. Not specific. Useful for lead distribution on a target eg bullet wound.”
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It later confirms that the presence of lead and barium particles—those detected by the sodium rhodizonate test—is “not reliable” as an indicator of firearm discharge residue.
It was known, therefore, during Mr Cleeland’s many appeals that the forensic test presented to the court as evidence of firearm discharge residue was not really evidence at all. However, that manual was prepared in 1980 and Mr Clarke was murdered in 1972. For how long was the Metropolitan police forensic science laboratory aware that the sodium rhodizonate test was not a suitable test for the detection of firearm discharge residue?
During my inquiries into my constituent’s case, and following a written parliamentary question to the Home Office, I was kindly assisted by Martyn Ismail of the Forensic Science Service, with which the Metropolitan police forensic science laboratory was merged in 1996. Mr Ismail provided me with three papers from the archives relating to the sodium rhodizonate test, dated 1943, 1959 and 1965. All those papers were useful, but especially that by G. Price in the 1965 edition of the Journal of Forensic Sciences, which describes the use of the sodium rhodizonate test—which we now know to be inappropriate—for the identification of firearm discharge residue on hands. The paper’s penultimate paragraph states:
“In the case of firearms where the breech remains closed after firing, such as shot guns and rifles, it has not been possible to detect traces of lead by this method.”
In other words, lead residue is released when the breech is opened following discharge of a weapon.
At the beginning of my speech, I said that the firearm submitted by the police as the murder weapon was an antique 12-bore Gye and Moncrieff shotgun, which police claimed was found in the vicinity of the murder, and which contained two discharged shells. Two shots were discharged in the murder; two discharged shells were found in the breech of the double-barrelled shotgun. We know that the breech of the shotgun had not been opened, because if it had been the shotgun would have discharged the shells. Therefore, in this murder case, where the shotgun’s breech was not opened to eject the shells, the Metropolitan police forensic science laboratory has known since 1965—some seven years before the murder of Mr Clarke—that it was not possible to detect “traces of lead” with a sodium rhodizonate test.
We know that more specific tests were available to the Metropolitan police forensic science laboratory at the time of the investigation, and that Mr McCafferty should have been aware of them. Mr McCafferty should also have been aware that the sodium rhodizonate test was unsuitable for the detection of firearm discharge residue, and that given the circumstances of the murder, it had
“not been possible to detect traces of lead”
using the sodium rhodizonate test.
It seems to me obvious that Mr McCafferty was an unreliable expert witness, and the very grave problems with his evidence in my constituent’s trial must surely cast doubt on every other trial in which he has given evidence. It may also cast doubt on the trials of others whose convictions resulted from the evidence of the Metropolitan police forensic science laboratory where the presence of firearm discharge residue was alleged.
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We are dealing with a case that took place in the 1970s, and my concern when looking at the evidence is that it sounds almost like something from “Life on Mars”, where the crime has been fitted to the person but not necessarily to the evidence available to the police.
Reflecting on those grave matters, is the Minister prepared to consider a review into cases where the sodium rhodizonate test was used to establish the presence of firearm discharge residue? With particular reference to Mr Cleeland’s case, I ask whether an independent review of all the papers relating to his case in the Home Office and with the police could take place. The Boothby report was commissioned in the 1970s to examine the case in detail and also the evidence prepared by Mr McCafferty. Conclusions of that report have been referred to in previous debates in the House. Mr Cleeland has never seen a full copy of the report. Could the Boothby report be published in full, including any supporting documentation and notes used in its preparation? If it is not possible to publish the report in full, could it be given to an independent expert outside the Home Office to examine in detail?
My constituent feels very strongly that previous Ministers may have inadvertently given misleading information to the House, based on guidance that they gave about what was contained in the Boothby report, which asserted that the evidence presented by Mr McCafferty was correct and that the conviction was sound. I would like that to be reviewed by an independent person, if not Mr Cleeland himself and his lawyers. If it is the case that assertions based on the Boothby report that were made to the House were not valid, a formal note should be placed on the record to confirm that, but obviously that requires an independent review of those papers and documents.
My constituent has raised a number of very important and fundamental questions about his case and the nature of his conviction. This is not a court of law—it is not a court of appeal—but I believe that the Home Office, if it is in possession of the Boothby report and any supporting notes and documents, should seek to make those available for independent scrutiny. That would certainly help my constituent in preparing for his case and shine some light on the way in which forensic evidence of this kind was presented in court cases in the 1970s.
4.11 pm
The Parliamentary Under-Secretary of State for the Home Department (Lynne Featherstone): It is a pleasure to stand before you this afternoon, Mr Hollobone. In case I forget, I wish you a merry Christmas now.
Let me turn to the serious nature of the case in front of us. First, I congratulate my hon. Friend the Member for Folkestone and Hythe (Damian Collins) on securing the debate. It is important that Members of Parliament can raise in this way matters that are of concern to their constituents. My hon. Friend has set out the grounds on which Mr Paul Cleeland disputes his conviction for murder. I listened very carefully to what he had to say, because allegations of miscarriages of justice are very serious matters. My hon. Friend went over the ground in this case. The conviction has been the subject of much scrutiny and debate. It is worth reflecting on the
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fact that, to my knowledge, this is the third time that the matter has been debated in Parliament. As my hon. Friend said, the previous debates took place in 1982 and 1988. He referred to the many right hon. and hon. Members who over the years have tried to raise these issues.
However, as my hon. Friend the Member for Folkestone and Hythe said, it is of course the criminal justice system, not Members of Parliament or Ministers, that decides on guilt or innocence. Terence Clarke was murdered in 1972, and Mr Cleeland was convicted of his murder by a jury the following year. The Criminal Cases Review Commission has been engaged with this matter over time since the first application to it in 1977. In 2000, the case was referred to the Court of Appeal, which upheld the murder conviction in 2002.
Of course, I listened carefully to the arguments about discrepancies in the ballistic evidence. My hon. Friend makes the case very well. He raised the issue of forensics and the reliability or otherwise both of the sodium rhodizonate test and of Mr McCafferty himself. Notwithstanding all that has happened with regard to this case, as set out in section 13 of the Criminal Appeal Act 1995, the Criminal Cases Review Commission can always refer a case back to court on the basis of information or an argument that has not previously been raised—at trial, on appeal or with the Home Office—and which creates a “real possibility” that an appeal would succeed. I assume—I hope that my hon. Friend will correct me if I am wrong—that many if not all those points were made in the appeals, and those issues have been raised previously.
Damian Collins: As I said in my speech, the Metropolitan police manual for 1980 has come to light only recently and subsequent to some of the appeals; and, indeed, the evidence that I have obtained via the Home Office, which cites academic papers dating back to the 1960s, has not previously been presented and, I think, certainly undermines the evidence presented by Mr McCafferty.
Lynne Featherstone: On the case itself, I would then make this suggestion—I am not able to give legal advice; I am not a lawyer in any sense. I would have thought that if there is new evidence, the Criminal Cases Review Commission is the body that should seek another judicial stage, if that were to be sought. In that sense, this is not, as we have said, a matter for Members of Parliament or, indeed, Ministers.
In terms of the alleged miscarriage of justice, the use of a forensic test in the case is questioned. That goes to the heart of my hon. Friend’s request for a review by the Home Office. Forensic science is an essential tool in the armoury of criminal justice. Forensic service suppliers in England and Wales provide some of the quickest turnaround times and highest-quality forensic science in the world. The Government have recently reappointed Andrew Rennison as the forensic science regulator to provide strong, independent regulation of quality standards, and it is right that the Government set the direction for and expectations of the quality standards to be used in the criminal justice system.
I want to be clear in that context that, as a test for the presence of lead, the sodium rhodizonate test is not fundamentally flawed. It is the case, however, that forensic
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science techniques are available today that would provide considerably more information than those in use in the 1970s. That does not mean that convictions from that time are unsafe or that a court has not properly relied on the scientific evidence available to it at the time.
Damian Collins: I am grateful to my hon. Friend for giving way again; she is being very generous. What I said was not that the test is unsound for detecting the presence of lead, but that it is not a safe test for detecting firearms residue.
Lynne Featherstone: Indeed, but I notice that in terms of the specific case, the forensic test was one of the 20 grounds of appeal considered by the Court of Appeal in 2002, when Mr Cleeland’s conviction was upheld. The understanding was that electron microscopic testing had not then been developed within the Metropolitan police laboratory to be in use. Also, whether or not that was correct, there was no evidence as to what such testing might or might not have demonstrated at the time or with the benefit of hindsight.
Damian Collins: My concern is that there was knowledge of the limitations of the test, yet evidence was presented from it in a court that suggested that there was no ambiguity at all and that it could be safely relied upon, whereas academic papers that were in the possession of the Metropolitan police cast doubt on that.
Lynne Featherstone: My hon. Friend is saying that since the relevant time, new evidence has come to light that casts doubt on all this, and has requested a review. What I can offer is this. I can ask the forensic science regulator, Andrew Rennison, to consider this type of evidence. I cannot give an answer on whether there will be a review, but I will ask his opinion of whether there should be a review.
In terms of the Boothby report, my hon. Friend has requested that a report on the allegations of police misconduct in connection with the case made by Mr Cleeland be made available. The Court of Appeal ordered the disclosure of that report in 2001 to seek to allay concerns raised by the appellant at the time about that. We therefore understand that his solicitors from that time may have a copy of the report.
Damian Collins: Mr Cleeland has confirmed to me that they do not have possession of the report. They never have had possession of it, despite what was said at the Court of Appeal. Certainly the report is not in his hands at all. Therefore if the Minister could deliver that report—make it available to him—we would be very grateful.
Lynne Featherstone: It was brought to my officials’ attention yesterday that the issue would be raised. The whereabouts of the report was discussed with the Hertfordshire police. We understand from them that Mr Cleeland’s solicitor has requested the report and that they are trying to locate a copy so that they can consider whether it would be appropriate to disclose it. The Home Office will also carry out the same process to see whether we can find the report, but I cannot guarantee that it was or will be found.
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My hon. Friend has made an excellent case today in laying out why he believes that there should be a reconsideration, presumably both of the case and in looking at forensics and residues in that context. I cannot give answers on that or on the actual case; as I said, it is for the criminal review board to decide whether there is enough new evidence to take the case back to any sort of judicial process.
I thank my hon. Friend. I have sought to be as helpful as I can possibly be.
Damian Collins: I appreciate that the Minister is drawing to her conclusion. Would it be possible for her to write to me, following the debate, on the points that she has raised about the review of the test, the location of the Boothby report and whether that can be made available, so that I am able to share that information in writing with my constituent?
Lynne Featherstone: Hansard will do it for me, but I am happy to write to my hon. Friend on those particular points that he has raised.
Lynne Featherstone: Am I misunderstanding my hon. Friend?
Damian Collins: The Minister said that both Hertfordshire police and the Home Office will try to locate a copy of the Boothby report and see if that can be made available to Mr Cleeland. I would appreciate it if the Minister could write to me following the search for the report to confirm whether it has been found and what has happened to it. If it is decided that it would not be appropriate, despite what the Court of Appeal said, to give that document to Mr Cleeland, will an independent expert be able to scrutinise it on behalf of Mr Cleeland and form an opinion about its contents?
Lynne Featherstone: I am more than happy to write to my hon. Friend following our search; I do not know about Hertfordshire police’s search. We will do whatever we can. I cannot go ahead of that, before we understand whether we have it, but I am happy to write to my hon. Friend in that regard. I congratulate him again on securing this debate and on bringing such an important issue to Parliament.
Mr Philip Hollobone (in the Chair): I thank both hon. Members for taking part in that interesting debate; I think that Mr Collins’s constituent has been well served today. I wish both participants a happy Christmas.
4.22 pm
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Stafford Hospital
4.24 pm
Jeremy Lefroy (Stafford) (Con): It is a pleasure to serve under your chairmanship, Mr Hollobone. It is also a pleasure to see the Minister in her place. I am expecting my colleagues from Staffordshire to come into the Chamber during this debate and to intervene if they so wish.
On 1 December this year, Stafford hospital started a temporary night-time closure of the accident and emergency department from 10 pm to 8 am. That happened principally as a result of a shortage of A and E specialists and the need to maintain a safe service. The hospital has been unable to recruit such specialists, partly as a result of a national shortage and partly owing to problems that Stafford has experienced. I wish to set out why it is important for the hospital’s A and E department to return to full-time working and to draw out some more general conclusions.
The hospital is part of the Mid Staffordshire NHS Foundation Trust, which also runs the non-acute Cannock hospital. Stafford serves a population of some 250,000 to 300,000 people in the middle and south-west of the county. As my intention is to highlight the importance of A and E, I will dwell only briefly on the Francis public inquiry, which is completing its work and will report next year. The inquiry is considering the lessons that can be learned from what happened. Certainly, lessons learned from the initial Francis investigation into the hospital have largely been put into practice. There continue to be major improvements, though clearly there is no complacency. It has been very encouraging to hear from constituents about the quality of care that they receive and their praise for staff.
I have heard some say that the Francis inquiry is not necessary, but I disagree profoundly. Let me simply report the words of a senior member of the Royal College of Physicians who said that that is the most important inquiry into the NHS in a generation. I am most grateful to the Government for their support for the hospital and the trust through a particularly difficult time for Stafford and the whole surrounding area. I ask for that support to continue, as the trust develops its plans to provide high-quality and financially sustainable services.
The importance that people in Stafford, Cannock, Rugeley and beyond place on the A and E department is shown by the more than 18,000 people who have signed petitions that support it. Stafford borough council has also shown strong support by passing a unanimous resolution at full council. Since the temporary night-time closure, a number of people have told me how concerned people, particularly the elderly, are that they no longer have a night-time emergency service relatively close to hand. We need to remember that, across the country, A and E departments not only treat people in medical need and save lives, but provide reassurance, whether to parents with a child who becomes sick in the middle of the night, or elderly people who have no transport of their own and are worried about imposing themselves by calling out an ambulance and overburdening the service. For them, an emergency service that is as local as possible is essential.
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Let me make it clear that the closure was necessary. The decision was not taken lightly, but was made in the interests of patient safety. The temporary night-time closure is giving the hospital time to recruit the necessary staff and to improve training, which is difficult when one is overstretched.
I should like to thank the Minister and the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), as well as the Secretary of State for Health and the Department of Health for their help and support. I also thank the Ministers and staff of the Ministry of Defence for providing armed forces medical staff to assist for some 12 weeks. They have been invaluable both in providing additional cover and in helping with training.
I should like to thank the leadership and staff of the University hospital of North Staffordshire, New Cross hospital in Wolverhampton, Manor hospital in Walsall and Burton hospitals for taking the strain of additional patients during the temporary night-time closure. I also thank the staff of the West Midlands ambulance service for providing the necessary additional cover.
I should now like to turn to the reasons why Stafford requires a 24-hour A and E department. First, the population of the area is growing. Stafford itself is a growth point and expects to see another 15,000 to 20,000 people settle in the area in the coming 20 years, with 2,000 to 3,000 from the armed forces returning from Germany to MOD Stafford between 2015 and 2018. Cannock and Rugeley are also growing.
Mr Aidan Burley (Cannock Chase) (Con): I congratulate my hon. Friend on securing this debate. He mentions Cannock, which is my constituency. Does he agree that the answer to all the problems that we have seen in Stafford is not to close Cannock but to impose a two-site solution, with services both at Stafford and at Cannock and an improved and more vibrant Cannock hospital? That is the only way forward and a solution on which we both agree as neighbouring constituency MPs.
Jeremy Lefroy: I entirely agree with my hon. Friend. It is essential that we have services both in Cannock and Stafford. Both hospitals are vital to their local communities, although they perform different services.
Secondly, we have an increasing elderly population who rely on local accident and emergency services. Increasing life expectancy is welcome, but when the elderly become ill, they tend to be more acutely ill. The combination of population growth and more elderly people will inevitably lead to more demand for emergency and acute services. Successive Governments have tried, with varying degrees of success, to persuade people who are not seriously ill to use alternatives to A and E. That is important—I welcome the Government’s moves in that direction—but it will only relieve a small part of the pressure on these departments.
Thirdly, Stafford’s accident and emergency department is extremely busy. The admissions for the past 12 months, up to November 2011, numbered 52,255. That is some two thirds of the number of admissions to Manor hospital in Walsall and slightly more than half of the admissions to the University hospital of North Staffordshire and New Cross hospital in Wolverhampton.
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Gavin Williamson (South Staffordshire) (Con): I congratulate my hon. Friend on securing this debate. He touches on an important point, especially at this time of peak demand for hospitals. New Cross hospital and hospitals in Walsall and Stoke-on-Trent are under a lot of pressure. It is vital that we ensure that this closure is only temporary and that we resume full-time, 24-hour accident and emergency services.
Jeremy Lefroy: I am most grateful to my hon. Friend for making that point. I reiterate my thanks to those hospitals for taking on the extra patients in the night-time hours during this difficult time in the winter. Stafford accounts for 14% of the entire number of A and E admissions for the whole region, which includes Staffordshire, Wolverhampton and Walsall.
Fourthly, with Stafford being shut at night, most patients have to travel considerably further for emergency care. The University hospital of North Staffordshire in Stoke is 19 miles away, New Cross in Wolverhampton is 18 miles away, Manor hospital in Walsall is 19 miles away and the hospital in Burton is 27 miles away. The absence of Stafford, even for 10 hours at night, leaves a very large hole in accident and emergency provision for the region. It is a matter not only of distance, but of the amount of traffic on the roads. Night-time travel is usually reasonable in the area, but congestion can be substantial during the day, particularly when the M6 is closed between junctions 12 and 14 and all motorway traffic is diverted through the middle of Stafford.
It has only been possible to cope with the temporary night-time closure with the use of several additional ambulances and increasing staff cover. Such facilities are expensive. Indeed, they are more expensive than keeping the A and E department open 24/7, which emphasises the fact that the decision was taken for reasons not of cost but of patient safety.
It is essential that Stafford hospital has a full-time accident and emergency service, but not every emergency can be treated there. Given the advances in medical science and treatment, it makes sense for some of the most serious emergencies to be treated by top specialists who will only be in the largest hospitals. Patients with major trauma, severe strokes or major heart attacks already go to regional centres such as UHNS. That is understood and generally accepted. However, a district general hospital should be able to respond safely to a number of emergency conditions and provide a minimum set of services, such as acute medical, including rheumatology and geriatric; acute surgical and orthopaedic; paediatric; maternity; and mental health, particularly for overdoses. In some cases, hospitals may have to stabilise a patient before they can be transferred to a specialist centre.
Retaining a core set of emergency services in district general hospitals is important to protect their viability. As John Donne said:
“No man is an island.”
That can equally be said of many acute services. It is not possible to retain acute medicine, which provides the lion’s share of the income of an acute hospital, without having access to surgical opinion on the spot. Any emergency service also needs the full-time support of critical care units and radiology, to name but two. That is not to say that there can be no change—there must be changes to make district general hospitals
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financially sustainable in a difficult climate—but we must not put so much pressure on them that their only option is to close their doors to emergencies from the communities that they serve, forcing people to travel considerable distances for all but minor injuries.
Changes must be thought through and discussed openly with those communities. There should be no sudden changes and nothing hidden in the small print. The NHS is paid for by the British people and is a service that gives us great reassurance, even if we are fortunate enough rarely to need it.
I have set out clearly why Stafford hospital needs a full-time accident and emergency service. I am making the argument from the point of view not of the hospital itself, the bricks and mortar, but of the patients—my constituents and those of my hon. Friends the Members for Cannock Chase (Mr Burley), for Stone (Mr Cash) and for South Staffordshire (Gavin Williamson), many of whom rely on its services.
Stafford hospital provides a first-class service to many people in our area. The management, the staff, my parliamentary colleagues and I are not complacent; we recognise that there is more to be done. None of us will be satisfied until our hospital is known nationally, as I believe it will be, for its high-quality treatment and care and it has the confidence of all those whom it serves.
4.37 pm
Mr William Cash (Stone) (Con): I will be fairly brief. I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on securing this debate. Since becoming the Member of Parliament for Stafford, he has transformed the attitudes and policy towards Stafford hospital. I pay tribute to the work that he does on behalf of the hospital and all his constituents. The issue has a direct bearing on my constituency, as well as those of my hon. Friends the Members for Cannock Chase (Mr Burley) and for South Staffordshire (Gavin Williamson). Indeed, it also has a bearing on other parts of Staffordshire where the hospital is used by constituents from neighbouring areas.
I endorse everything that my hon. Friend the Member for Stafford has said, but I should like to add another factor, which is highly relevant to a constituency such as mine. The Stafford part of my constituency has some deeply rural areas, such as High Offley, that are very much more remote than the streets of Stafford and other towns with good arterial connections to the M6. I have heard figures quoted about how quickly people can get to UHNS and other hospitals. I simply make the point that somebody might have a stroke, or a farmer might be caught in some dreadful tragedy in a dark field in a remote area.
My hon. Friend is completely right when he says that we need a full accident and emergency service. At the moment, we are going through a hiatus, but let it not remain long because we need a proper full service, especially for those deeply rural areas, as well as for the more built-up areas in the urban parts of Stafford and the adjacent areas.
Mr Philip Hollobone (in the Chair): Order. This debate is clearly important for Stafford and the surrounding area. I call the Minister to respond.
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4.39 pm
The Parliamentary Under-Secretary of State for Health (Anne Milton): Thank you very much, Mr Hollobone, for calling me to respond to the debate. It is a pleasure to serve under your chairmanship today; I do not think that I have done so before.
I congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on securing this debate and of course I join him in paying tribute to the staff of Stafford hospital, the staff of the local ambulance service and indeed the staff of the neighbouring hospitals for all that they are doing to provide local people with good accident and emergency services. I particularly pay tribute to them at this time of year. When many people will be enjoying their Christmas lunch, there will be many NHS staff working over the Christmas period and it is always important to acknowledge their contribution and the work that they do.
My hon. Friend raised a number of issues about the overnight closure of the A and E department at Stafford hospital, which is a measure that will naturally be a cause for concern for his constituents. I know that all of them have been through quite a tough time, but I also know that he will agree—in fact, he did agree—that the safety of patients must always come first. However safety can be protected, that is always the best course of action, so I must support clinicians at Stafford hospital in their request for the overnight closure, which they made so that standards of care in the A and E department can be kept high.
My hon. Friend mentioned A and E staff, but it is also important to note that this issue is not always about numbers. A certain number of staff are needed in an A and E department, but that department also needs expertise; it not only needs staff in the right quantity but staff with the right skills and competencies.
I also want to remind hon. Members who are in Westminster Hall today—it is a pleasure to see so many of them here—that for some time now the NHS at Stafford hospital has been routinely diverting all of the most critical patients, including those suffering from major trauma, heart attacks and strokes, to the larger hospitals to the north and south of Stafford. That is not because of the suspension of overnight A and E at Stafford but because the larger hospitals in the area are better able to cope with life-threatening emergencies. My hon. Friend pointed that out, but it is worth repeating it for the record.
The change at Stafford A and E is down to staffing levels; I understand that financial pressures do not come into it. Mid Staffordshire NHS Foundation Trust has the funding for the posts that it needs to fill, but it has found it difficult to find the staff to fill them. My hon. Friend mentioned the importance of reassuring the local community. The available health services need to reassure people; that is one of their important roles. They must also engender trust among those people who they are there to serve. That is a very important role that the NHS must play.
Since the summer of 2010, permanent staffing—both medical and nursing—at Stafford A and E has been low. The trust and the wider NHS in the midlands have been trying to get enough medical cover to keep standards at the right levels. It is also important to acknowledge the support from the neighbouring University Hospital of
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North Staffordshire. Without it, the situation would have been considerably worse. However, that regional support could never be kept going indefinitely. To buy some time to work out longer-term solutions, Sir Bruce Keogh, the NHS medical director, arranged the short-term loan of four members of staff—two doctors and two nurses—from Defence Medical Services to help at the trust. My hon. Friend paid tribute to those staff and it is always good to see organisations working together to deliver the best possible solutions for patients. As my hon. Friend pointed out, that arrangement started on 17 October and it is now coming to an end; again, it could not be kept going for an indefinite period of time. However, let us place on record our thanks to the members of staff involved and to the DMS for providing them. I know that everyone at the trust welcomed the expertise that the DMS staff brought with them.
In October, the Care Quality Commission issued a warning notice regarding the quality of care provided by the Stafford A and E department. The CQC’s concerns centred on nursing staff levels, which at the time of inspection were badly depleted because of staff sickness and the overall difficulty of filling vacancies. On 9 November, the trust decided to close its A and E department overnight, starting from 1 December. That decision was not made lightly. As my hon. Friend pointed out, people want A and E facilities close to where they live, so, as I say, such decisions are never made lightly, and they need to be taken locally; it is not appropriate for the Department of Health to interfere with them. It goes without saying that the trust is paying the closest possible attention to the situation at Stafford A and E. It believes that that situation cannot be improved quickly, however frustrating that is for hon. Members.
Mr Cash: Does the Minister agree that there is also a question that may be a national issue, of which Stafford may or may not be an example? That is the need to ensure that consultants are always available, as and when necessary, because I think that that issue is all part of the hierarchy of the problem.
Anne Milton: Yes, and I thank my hon. Friend for raising that important issue, which is one of delegation and cover. It is of concern to the Department of Health; I think that there have been a number of newspaper articles and some television programmes about it. It is important at all times that care is delivered safely. That sometimes requires cover, but it also requires appropriate levels of delegation. However, what must be uppermost in everybody’s mind is that patients’ safety is always preserved, and the Department of Health will obviously work with the NHS to ensure that nationally we have schemes to ensure that patients’ safety is maintained.
For that reason, it would be unwise to return to 24-hour opening at Stafford A and E department before it is safe to do so. To minimise risk, I understand that the trust has set criteria that must be met before overnight operating can resume, and I also understand that there are regular staff meetings to check progress against those criteria. Those meetings are an important means of reassuring staff and those criteria will become critical.
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They mean that staff will be aware of the current situation and fully up to speed with the progress that is being made.
At present, I understand that patients needing A and E treatment are being diverted by ambulance to A and E departments in Wolverhampton, Walsall, Burton and Stoke, every one of which has been fully involved in planning for the overnight closure at Stafford. West Midlands Ambulance Service has established a divert policy to deal properly with patients coming to the trust, and to alternative A and E departments, at night. To help to manage those arrangements, the trust has appointed a “repatriation co-ordinator” to ensure close co-operation between Mid-Staffordshire NHS Foundation Trust hospitals and the other hospitals affected. The thing that struck me as quite extraordinary is the amazing job titles that the NHS can come up with at times. However, that “repatriation co-ordinator” will be important, to ensure close co-operation between hospitals.
To date, very few patients have turned up at Stafford A and E at night, which is a testament to how well the trust has publicised the current arrangements. That is another important point; explaining the reason for the closure, and how and where to get help when Stafford A and E is closed, is vital. My hon. Friend the Member for Stafford mentioned older people in his speech. As I say, the fact that few people are turning up at Stafford A and E at night means that the message that the department is closed overnight has got through, even to older people, who of course often attend A and E departments.
Mr Cash: On a purely practical level, diversion signs are important. My hon. Friend is referring to the importance of getting the message through, but however much we try to get the message through, I suspect that people will still turn up anyway. Therefore, the most important thing at that point is to know that the signing system—as provided by the highways authorities, or whoever—will actually provide the right information to help people to get to the other hospitals. Does my hon. Friend agree?
Anne Milton: I agree entirely, and I am sure that my hon. Friends the Members for Stone (Mr Cash) and for Stafford are in touch with the local authorities, because it is extremely important, as my hon. Friend the Member for Stone rightly pointed out, that diversion signs are clear to people and that people do not turn up at an A and E department that is closed. It is actually quite extraordinary how resilient people are to those diversion signs. Information needs to be given to people in words of one syllable, so that they are quite clear that the A and E department is not open for business at the moment.
Stafford is taking, and it will continue to take, GP-referred maternity, paediatric and medical patients 24 hours a day, seven days a week, which will be of some reassurance to local people. I know that my hon. Friend the Member for Stafford has visited Stafford A and E department several times since the overnight closure came into effect, and I am pleased to hear that he is satisfied that the measures that have been put in place will ensure patient safety and good access to A and E services. I know that some of his constituents are concerned about the impact of increased demand on neighbouring A and E departments. The situation is being closely monitored and the local NHS is content that the arrangements are working well.
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Of course at this time of year, the pressure on A and E departments gets greater. We have not suffered particularly severe weather in the south of the country, but some places have done so. Such weather always takes its toll on the NHS, and therefore the monitoring of how things go is very important.
As I have said, the closure took place on the advice of clinicians with the aim of ensuring patient safety. The trust continues in its efforts to recruit additional staff, and patients can be assured that it will not reopen its A and E department full time before it is safe to do so. The trust, the Staffordshire PCT cluster, emerging clinical commissioning groups and others are looking at a range of options to achieve a clinically safe and financially sustainable service, and will present their report on the way forward to the NHS Midlands and East strategic health authority cluster at the end of January next year.
I will say a word about emergency medicine nationally. The number of emergency medicine consultants has risen by more than half in the past five years, but we agree that it must continue to increase and we are working with the College of Emergency Medicine on how best to make that happen. In the short term, some trusts have been employing more GPs in A and E. GPs are primary care experts, so their presence in A and E allows emergency specialists to concentrate on the cases for which their skills are needed. We are, however, looking at a number of areas, because this matter is of national concern. We are considering revising the person specification for training in emergency medicine to make entry more accessible, and redirecting into emergency medicine some of the doctors who cannot secure other higher specialty training posts.
My hon. Friend the Member for Stafford pointed out the importance of specialist services, and what I have said about the national situation highlights exactly why they are so important. As my hon. Friend the Member for Stone mentioned, the particular needs of people in rural communities, for whom travelling long distances causes additional problems, must also be taken into account. It has long been the case that specialist services need to be provided in specialist centres, and during my own working life as a nurse we had regional neurosurgical centres for the specialties that required highly skilled and specific care. That is important, because we are always balancing patient safety with the accessibility of local services.
Jonathan Lord (Woking) (Con):
I join colleagues in commending the thoughtful leadership role that my hon. Friend the Member for Stafford (Jeremy Lefroy) has taken. May I ask the Minister two things? Can we be reassured that the awful lessons of Stafford have
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been learned nationally? If I may crave the indulgence of my Staffordshire colleagues, I have happy memories of fighting with the Minister during the previous Parliament, when I was chairman of her association, to save the A and E at the Royal Surrey, so perhaps she would care to extend her warm words to all the medical staff who will be working there over Christmas and the new year holiday, just as she did to those at the Stafford hospital and elsewhere in Staffordshire.
Anne Milton: I thank my hon. Friend for his imaginative use of this debate to point out that I joined with him to fight a long, hard battle to save our hospital in the Guildford constituency. It is important, of course, to extend our thanks and tributes to staff working not only in our own constituencies, but across the country. On the first question, there is no doubt that lessons need to be learned, and I think that we sometimes feel that the NHS is slow to learn the lessons it should.
Work is being carried out nationally to address the skills mix, by developing non-medical roles within A and E departments. Enhanced nursing roles have genuine potential, and in countries with very remote populations, such as Canada and the USA, they are an extremely important part of the general skills mix. Emergency nurse practitioners who can look at the minor injuries and illnesses that in most departments account for 40% of the work load can be a major contribution to ensuring that A and E services remain available for local people, and advanced clinical practitioners, such as nurses and paramedics, can therefore treat many more of the major conditions.
I thank my hon. Friend the Member for Stafford for securing this debate, and other hon. Members for attending on the last day before recess. A number of Staffordshire MPs have met with the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), and I know that he will continue to keep in close touch, but should any new concerns arise I am sure that my hon. Friend the Member for Stafford will raise them with him. That leaves to me just to wish you, Mr Hollobone, and all the House of Commons staff a very happy Christmas and a prosperous and safe new year.
Mr Philip Hollobone (in the Chair): I thank all Members for taking part in this debate and I, too, wish everyone a very merry Christmas.