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House of Commons

Wednesday 4 July 2012

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Oral Answers to Questions

Northern Ireland

The Secretary of State was asked—

Fuel Laundering

1. Sammy Wilson (East Antrim) (DUP): What discussions his Department has had with HM Treasury on loss of revenue as a result of fuel laundering in Northern Ireland. [114370]

The Secretary of State for Northern Ireland (Mr Owen Paterson): My Department has regular discussions with HM Treasury on a wide range of issues. Fuel fraud is primarily an excise offence and, therefore, an excepted matter that falls to Her Majesty’s Revenue and Customs, which works closely with the Department of Justice for Northern Ireland and its counterparts in Ireland.

Sammy Wilson: Despite the fact that over the past six years more than £2 billion has been lost in revenue as a result of criminal activities through fuel laundering, HMRC has taken only 28 cases to court, and there has been only one custodial sentence, which was suspended. Does the Secretary of State believe that that is an adequate response from HMRC or the court system in Northern Ireland?

Mr Paterson: I thank the hon. Gentleman for his question and I appreciate his knowledge of this subject, as Minister of Finance and Personnel. He makes a very good point, which I have discussed with David Ford, the Minister of Justice. We have agreed that we should work together so that Northern Ireland sentences can be appealed against if considered too lenient.

Mr Laurence Robertson (Tewkesbury) (Con): In the Select Committee’s recent report, we identified as a major problem the fact that a marker had not been developed sufficiently quickly. Has the Secretary of State had any discussions with HMRC about the development of that marker, which would make fuel fraud and laundering far more difficult?

Mr Paterson: I am grateful to the Chairman of the Select Committee for his question and congratulate him on a very interesting report, which showed that real progress had been made—£250 million lost in forgone revenue down to £70 million, which is a major improvement. He makes a very good point about marking. There is an HMRC strategy and there is also a memorandum of understanding that has been signed with the Irish Revenue Commissioners. We keep in close touch on this matter.

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Welfare Reform

2. Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab): What assessment he has made of the effects of welfare reform on Northern Ireland. [114371]

The Secretary of State for Northern Ireland (Mr Owen Paterson): The reforms that we have introduced give us a rare opportunity to transform our welfare system into one that is fair to all, looks after the most vulnerable in society, and above all, always rewards work.

Mr Clarke: In view of recent criticisms of the Work programme and the Prime Minister’s view that housing benefit for the under-25s should be discontinued, can the right hon. Gentleman tell us what the Government’s policy is for youngsters? Is it to create jobs or simply to tolerate their exploitation?

Mr Paterson: I think the right hon. Gentleman underestimates the fact that the issue is devolved, and we are working closely with the devolved Minister with responsibility in this area and other Ministers in the Executive on the arrangements which will be debated shortly as the Bill is taken through the Assembly. It is very important that local circumstances are taken into account so that the Bill that emerges from the Assembly suits the circumstances in Northern Ireland.

Mr Philip Hollobone (Kettering) (Con): When does my right hon. Friend expect the Welfare Reform Bill to be introduced by the Executive?

Mr Paterson: I am in regular contact with Nelson McCausland, the relevant Minister, and he is optimistic that he will stick to the schedule, which will enable Northern Ireland to come on stream, as planned, with the Department for Work and Pensions here.

Jim Shannon (Strangford) (DUP): Many people in Northern Ireland view changes caused by welfare reform with increasing concern. Northern Ireland has had 30 years of a terrorist campaign. That has led to many people suffering disability, both physical and mental; 15,000 people in Northern Ireland are on incapacity benefit and employment and support allowance, and 180,000 people are on disability living allowance. Can the Secretary of State assure us that every step will be taken to ensure that the unique position of Northern Ireland is taken into account when it comes to the benefits system?

Mr Paterson: Nobody underestimates the terrible damage the troubles did to people physically and mentally, but it is worth reflecting on the fact that high rates of DLA are not unique to Northern Ireland; Merthyr Tydfil has a rate of 13%, which is very similar to that of Belfast. What I think is important is that for the first time each person will be treated as an individual, his circumstances will be taken into account and rehabilitation, re-education and training will be offered. That has not come about before.

Ms Margaret Ritchie (South Down) (SDLP): Given that many benefit claimants in Northern Ireland have their payments paid directly into Ulster bank and, because of the ongoing debacle caused by the IT problems,

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have therefore been unable to access their only source of income and their own money, what assurance can the Secretary of State give that he has had robust discussions with RBS, his colleagues in the Treasury and the Department for Work and Pensions, and the Northern Ireland Executive, to find a long-term solution to this agonising problem for many people, which has heaped on them misery upon misery?

Mr Paterson: The hon. Lady is absolutely right to raise the very real problems that people both in and out of work are suffering due to the IT breakdown. I raised the matter with the Chancellor of the Exchequer and the Secretary of State for Business, Innovation and Skills yesterday. Sir Philip Hampton, the chairman of RBS, was in Northern Ireland on Monday and my right hon. Friend the Minister of State talked with him yesterday and is keeping in close touch. Ultimately, this is a problem for RBS to resolve internally, through Ulster bank, by getting the computer technology right, but the hon. Lady is right to raise the matter. This is causing horrendous problems not just for benefit claimants, but for those in regular employment.

Banking Reform

3. Mark Durkan (Foyle) (SDLP): What discussions he has had with his ministerial colleagues on the likely implications for Northern Ireland of banking reform and financial service regulation. [114372]

The Minister of State, Northern Ireland Office (Mr Hugo Swire): My right hon. Friend the Secretary of State and I have been in discussion with ministerial colleagues about this matter. The action plan announced by my right hon. Friend the Chancellor on Monday will drive up standards and bring much-needed and long overdue regulation to the sector.

Mark Durkan: The Minister will recognise that Ulster bank customers are currently experiencing a third-class, poor standard of care. Does he feel that there is some risk of a similar syndrome whereby Northern Ireland is only an afterthought in the hierarchy of consideration when it comes to wider banking regulation and reform? We all rightly ask about the banking of business, but should more active consideration be given to the future of the business of banking in the region, particularly given the compound implications of reform and regulation from London and the changing Irish banking landscape, including moves on banking union?

Mr Swire: The hon. Gentleman makes a fair point, as was recognised in his exchange with the Chancellor on 28 June, when the Chancellor acknowledged that

“Northern Ireland has suffered enormously from the failure of banks in the UK and in the Republic, and it has paid perhaps a heavier price than anyone else”—[Official Report, 28 June 2012; Vol. 547, c. 476.]

On the specific point about banking reform, the hon. Gentleman will be aware that there is a Banking Reform White Paper, the consultation period for which closes in September, so I urge him to contribute. On Ulster bank, I think we should be clear that this is not a failure of banking, but a failure of IT, and we should not confuse the two.

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Mr Nigel Dodds (Belfast North) (DUP): On that point about Ulster bank and the failure of IT, I have listened carefully to what the Minister has said, but is it not frankly outrageous and unacceptable that 15 days after the problem first appeared, individuals, households and businesses still cannot access their money in the normal way? Can he outline in more detail what he and his colleagues in the Treasury are doing to provide a little more flexibility for those facing cash-flow problems?

Mr Swire: I understand that the right hon. Gentleman and some of this colleagues are meeting Ulster bank and RBS this afternoon to represent the views of their constituents, and rightly so. Let us not underestimate this. There are people in the Northern Ireland Office who cannot get money either, so this is something very close to many of us. He will be aware of the press release that RBS issued this morning. It is fair to point out in my conversation yesterday with Sir Philip Hampton, the chairman of RBS, he told me that they would

“treat our customers properly and fairly”

and that the bank will

“compensate fully for financial loss”.

We shall hold the bank to that undertaking.

Mr Dodds: I am grateful to the Minister for that answer and for raising the issue of compensation, but does he agree that, as well as reimbursing customers for direct costs, Ulster bank and RBS must ensure that where financial damage and loss has occurred, whether to a customer, either an individual or business, or a non-customer who has suffered loss as a result of the crisis, compensation in full must be paid in all those circumstances? I would welcome his support in lobbying RBS on that point.

Mr Swire: The right hon. Gentleman will certainly have the support of the Secretary of State and myself in ensuring that no one loses out as a result of this IT failure. I was specific on that point to Sir Philip Hampton and I cannot do more than repeat the words he said to me, as I have just done. I will also check with him on Monday to ensure that the bank is making progress in clearing up this sorry mess, which it says it will do over the weekend.

Vernon Coaker (Gedling) (Lab): Does the Minister agree that the ongoing problems at Ulster bank underline the need to look at how banks operate? Frankly, this is a crisis. Many families cannot pay their mortgages or rent, get their groceries, buy food or put petrol in the car, and older people cannot get access to their pensions. The Minister has told us what he has done, but what is he doing to try to sort this mess out?

Mr Swire: I have a transcript of the shadow Secretary of State’s two interviews on the “Nolan” show, and I have read them carefully, but I am none the wiser as to what he is suggesting. When he was asked about the solvency of some businesses and about liquidity, he said that

“I would expect that government here in Westminster but also government at Stormont needs to consider what to do in those particular circumstances.”

Mr Nolan then asked:

“What could they do?”

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The hon. Gentleman replied:

“I don’t know the answer to that”.

If he does not know the answer, we do: it is to make sure that this sorry debacle, involving an IT problem with the Royal Bank of Scotland and Ulster bank, which, let us face it, affected the whole UK, is cleared up quickly so that people can go about their normal business in Northern Ireland.

Vernon Coaker: What we have heard there is a complacent answer that does nothing to say to the people of Northern Ireland what should be done. What the Secretary of State and the Minister should have done, and what they should be doing now, is call an emergency summit—get a summit together—of all the people who are responsible for the situation, including the Treasury, Treasury officials and RBS senior management, and to get them to recognise the seriousness of the problem, get it sorted and get a grip. That is what the Minister should do.

Mr Swire: I am not an IT expert, but I think that appearing on the “Nolan” show twice and saying absolutely nothing does not show tremendous activity. On the shadow Secretary of State’s further point about banking reform, he will be pleased that this Government have set up an independent commission on banking reform to look at the future of banking and to clear up something that his Government failed to do over 13 years—

Vernon Coaker: Complacent.

Mr Swire: It is not complacent.

This is another example of this Government walking around with a giant pooper-scooper to clear up the mess left by the hon. Gentleman’s Government.

Inward Investment

4. Julian Sturdy (York Outer) (Con): What recent discussions he has had with Ministers in the Northern Ireland Executive on attracting inward investment. [114373]

The Minister of State, Northern Ireland Office (Mr Hugo Swire): I have regular meetings with the Northern Ireland Minister for Enterprise, Trade and Investment to discuss how best we can support the Northern Ireland Executive in attracting inward investment and promoting growth. We have jointly agreed to invite ambassadors from the Gulf states, for example, to visit in the autumn in order to explore how we can promote investment and increase export opportunities.

Julian Sturdy: As with other parts of the UK, including my home city of York, Northern Ireland’s lower operational costs make it an attractive location for investment, but does my right hon. Friend agree that we must do more to promote such areas if we are truly going to rebalance our economies?

Mr Swire: Indeed. My hon. Friend makes an ingenious connection between York and Northern Ireland—the only connection that attracted investment before was probably with the Vikings, who took an early interest in both areas.

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There are clearly tremendous advantages in Northern Ireland: it is not in the euro; it is extremely good in terms of education; it is a great place to live; and it has low costs, good IT, good connections and good transport connections. Yes, we can do more, but let us just look very carefully at how well Northern Ireland has done to date in attracting inward investment.

Stephen Pound (Ealing North) (Lab): If we can move on from the battle of Clontarf, I must say that the Secretary of State is getting the reputation of being something of a one-club golfer when it comes to the Northern Ireland economy. When even yesterday’s Belfast Telegraph referred to a putative corporation tax as “an economic disaster”, one has to ask: does the Secretary of State have another driver in his bag, and will he or his caddy whip it out and show it to us?

Mr Swire: We have many clubs, and we shall use them in the same way as they were used at the Open last week—with tremendous professionalism. The whole issue of corporation tax is a key thing that the joint group has been—

Stephen Pound: It is a disaster.

Mr Swire: It is not a disaster; it is what we have been looking at very carefully.

There are other things that we need to do to rebalance the Northern Ireland economy, which both Governments over a successive number of years allowed to become far too dependent, for obvious reasons, and we will use any club available in our or anyone else’s bag to bring that about.

David Simpson (Upper Bann) (DUP): On a recent visit to my constituency, the Minister will have seen some of the inward investment there, but does he agree that it is imperative that Northern Ireland retains its 100% status for regional aid?

Mr Swire: What is key, as I saw when I was with the hon. Gentleman, is planning, among other issues, which needs to be speeded up to facilitate inward investment and private sector investment, such as in the new supermarket in his constituency. Northern Ireland had automatic assisted area status, but that is not going to continue, and people in Northern Ireland mainly agree that other areas in the UK are now worse off than Northern Ireland.

Dr Alasdair McDonnell (Belfast South) (SDLP): I inform the Minister that that is not agreed in Northern Ireland; all political parties there unanimously want Northern Ireland to retain 100% regional aid status because of the special circumstances and the poverty, under-employment, under-achievement and poor prosperity. Can the Minister assure us that he will persuade his colleagues at the Department for Business, Innovation and Skills to support that programme?

Mr Swire: I do not think that I said that regional aid was not important; I merely said that, as part of rebalancing the economy and encouraging inward investment, we need to make sure that the 2014 map covers the areas of Northern Ireland that do need assistance. We no longer believe that it is justifiable, however, for Northern Ireland as a whole to have 100% automatic coverage.

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Lady Hermon (North Down) (Ind): In evidence to the Northern Ireland Committee, we were told by one witness—I should point out that it was only one witness—that we had one airport too many and that, instead of having both Belfast International airport and Belfast City airport, we should have only one. If such a daft idea were implemented, what impact does the Minister think it would have on economic investment coming to Northern Ireland?

Mr Swire: A very negative one. The hon. Lady is absolutely right. Northern Ireland justifies two airports. They are both thriving concerns and we have had some good news on air passenger duty. [Interruption.] The hon. Member for Foyle (Mark Durkan) is saying that I should not forget Eglinton airport either, and possibly others. We should certainly have Aldergrove and George Best Belfast City airports, which should thrive. The Department of Enterprise, Trade and Investment Minister and I are very positive and optimistic; we are trying to attract more airlines to fly in and out of Northern Ireland to grow the economy. The hon. Lady is spot on.

Economic Development

5. Alok Sharma (Reading West) (Con): What recent discussions he has had with Ministers in the Northern Ireland Executive on economic development. [114374]

11. Eric Ollerenshaw (Lancaster and Fleetwood) (Con): What recent discussions he has had with Ministers in the Northern Ireland Executive on economic development. [114380]

The Secretary of State for Northern Ireland (Mr Owen Paterson): My right hon. Friend the Minister of State and I meet regularly with Northern Ireland Ministers in support of their efforts to promote economic development and to help rebuild and rebalance the economy.

Alok Sharma: What discussions has my right hon. Friend had with the Northern Ireland Executive to encourage them to set up enterprise zones?

Mr Paterson: I have regular discussions with the First Minister, Deputy First Minister and Minister of Finance. Last year’s Budget, which became the Finance Act 2011, made that facility available. There are 24 enterprise zones in England, four in Scotland and seven in Wales. They have the capacity also to have enhanced capital allowances. I am in favour of them as a benefit for Northern Ireland, but this is a devolved issue and a devolved decision.

Eric Ollerenshaw: Does my right hon. Friend agree that economic development in Northern Ireland would be much assisted by greater competition on the ferry routes in the Irish sea? A good start would be the restoration of the ferry link between Fleetwood and Larne.

Mr Paterson: I wholeheartedly endorse what my hon. Friend is doing in trying to improve ferry links across the Irish sea. I cannot think of a better place to expand to than Fleetwood.

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Dr William McCrea (South Antrim) (DUP): Does the Secretary of State accept that economic development is being hampered in Northern Ireland by the lack of willingness among the banks to assist businesses through these difficult economic times? Surely the Government can do more to force the banks to assist our economy, bearing in mind that taxpayers are the ones who helped them in their hour of crisis.

Mr Paterson: The hon. Gentleman makes a very good point. No one could have worked harder than my right hon. Friend the Chancellor and the First Secretary, who have been working with the banks ensuring that credit is freed up. Above all, let us not forget the complete mess that we inherited—the biggest deficit in western Europe. Through the robust measures that we have taken, we have kept the confidence of the international markets and have the lowest interest rates since the middle ages.

Londonderry (City of Culture)

7. Oliver Colvile (Plymouth, Sutton and Devonport) (Con): What assessment he has made of the likely effect on Londonderry of becoming the UK’s first city of culture; and if he will make a statement. [114376]

The Minister of State, Northern Ireland Office (Mr Hugo Swire) rose—[Interruption.]

Mr Speaker: Order. The hon. Member for Ealing North (Stephen Pound) aspires to be a statesman; he should not be yelling across the Chamber—yes, you!

Mr Swire: They don’t like it up ’em, Mr Speaker.

My officials have been working closely with Derry-Londonderry Culture Company to ensure that the year-long programme will have social, economic, cultural and political benefits in the short term and as a legacy beyond 2013.

Oliver Colvile: I thank my right hon. Friend for that answer. May I also ask him what lessons the city of Plymouth can learn from the city of Londonderry-Derry in its bid to be the city of culture in 2014?

Mr Swire: Of course, as a west country Member of Parliament I am hugely supportive of Plymouth. The whole issue of whether the city should be called Londonderry or Derry seems to be resolved, as we are now going to call it Legenderry. Plymouth is already legendary, not least on account of its excellent Member of Parliament. My hon. Friend should get his councillors to come over to Londonderry during its year as the city of culture, and I will introduce him to all the key players who are going to make it the most happening place in Europe.

Mr Gregory Campbell (East Londonderry) (DUP): In promoting Londonderry as the first UK city of culture, does the Minister agree that job retention and job maintenance is a crucial factor? In that context, will he speak to the Under-Secretary of State for Transport, the hon. Member for Hemel Hempstead (Mike Penning), who I assume will make an announcement on this in a written statement today, to ensure that the Driver and Vehicle Licensing Agency offices are preserved in Northern Ireland so that 260 jobs are not lost in my constituency?

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Mr Swire: On the latter point, I understand that the Minister is putting out a written statement today, and I do not want to prejudge what he might say in that.

On the longer-term economic benefits to Londonderry, yes, that is a vital issue. Of course, there will be a lot of prosperity around in the year that it is the city of culture, but that should be the building block to cement the renaissance that has gone on in the city, not least with the regeneration of the Ebrington barracks site and the peace bridge.

Security Situation

8. Nick Smith (Blaenau Gwent) (Lab): What recent assessment he has made of the security situation in Northern Ireland; and if he will make a statement. [114377]

The Secretary of State for Northern Ireland (Mr Owen Paterson): The threat level in Northern Ireland remains at “severe”. The Government remain fully committed to countering violence in all its forms and supporting the overwhelming majority of people who want to live without fear and intimidation.

Nick Smith: The Secretary of State is aware of the so-called punishment attacks by paramilitaries on young people in Northern Ireland. These attacks are increasing, particularly in Derry, by a group styling itself Republican Action Against Drugs. What every community needs is strong policing, not vigilantes. Will he proscribe this group? [Interruption.]

Mr Speaker: Order. May I remind the House that we are discussing the security situation in Northern Ireland? This is a matter of the utmost seriousness, and I think that some display of attention would be appreciated by the people of Northern Ireland.

Mr Paterson: The hon. Gentleman makes an important point. These attacks are barbaric and inhumane and have absolutely no place in a modern Northern Ireland. The only legitimate police force enforcing law and order is the Police Service of Northern Ireland, and it is for it to work with the community. On proscription, I keep all these issues under review.

13. [114383] Jack Lopresti (Filton and Bradley Stoke) (Con): The Chief Constable of the PSNI, Matt Baggott, recently said that the Northern Ireland Executive must do more to tackle disadvantage in the areas where dissident republicans hold sway. Will my right hon. Friend encourage the Executive to address this issue?

Mr Paterson: My hon. Friend makes an important point. The second layer of our strategy in bearing down on these groups is to get into those communities, but nearly all the projects are in the hands of local Ministers. We strongly support the CSI—cohesion, sharing and integration—strategy, which we want to be published as soon as possible, because we believe that the future is a shared future, not a shared-out future.

12. [114381] Mr Jeffrey M. Donaldson (Lagan Valley) (DUP): Last night we had a briefing from senior retired police officers about the threat to national security

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from evidence that is being given in inquests in Northern Ireland that opens up the whole modus operandi of our security forces and security services. What do the Government intend to do to protect national security from this threat?

Mr Paterson: The right hon. Gentleman raises a very serious issue. A whole number of legacy inquests—up to 32—are coming down the track. I would like to assure him formally that measures are in place under the existing arrangements that allow an inquest to go ahead fairly, but information that might be dangerous if released to individuals can be held back. There are measures that can be worked out, but the final decision rests with the coroner. Until now, these arrangements have worked well, and they will continue in their current guise.

Paul Goggins (Wythenshawe and Sale East) (Lab): Given that many of those historic inquests will doubtless require the disclosure of highly sensitive national security intelligence, what discussions has the Secretary of State had with the Justice Secretary about his decision not to provide for a closed material procedure in relation to inquests?

Mr Paterson: I thank the right hon. Gentleman for that question. I have regular meetings with the Justice Secretary. I talked to him on the telephone this morning. [Interruption.] If the right hon. Gentleman would wait, I treat each case individually and remain in close touch with the local Justice Minister on such issues.

Prime Minister

The Prime Minister was asked—


Q1. [114968] Fiona O'Donnell (East Lothian) (Lab): If he will list his official engagements for Wednesday 4 July.

The Prime Minister (Mr David Cameron): I am sure that the whole House will wish to join me in paying tribute to the three British servicemen who were killed in Afghanistan in the appalling incident on Sunday, Guardsman Apete Tuisovurua and Guardsman Craig Roderick of 1st Battalion Welsh Guards and Warrant Officer Class 2 Leonard Thomas of the Royal Corps of Signals. We send our heartfelt condolences to the families of the servicemen who were killed in that tragic incident. They will never be forgotten by our nation.

This morning, I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.

Fiona O'Donnell: I am sure that the whole House will want to associate itself with the Prime Minister’s remarks and to send our deepest condolences to the families of the crew from RAF Lossiemouth who were lost earlier this week.

Food prices rose by 4.6% between March last year and this year. I understand why, so will the Prime Minister spare me the lecture and tell the House what he is doing about food inflation?

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The Prime Minister: First, I join the hon. Lady in what she said about the Tornado aircraft accident at RAF Lossiemouth. She is right that our thoughts should be with the friends, families and colleagues of those involved. The circumstances remain uncertain, but it was clearly a serious incident. The investigation is ongoing and more details will be released by the RAF in due course. It is a reminder of the risks that our service personnel take, not only when they are on active service, but when they are undergoing vital training for that service.

On food inflation, I would first make the point that inflation is now falling in our country, which is extremely good news. It is vital that the food prices in our shops are not too hard on people’s budgets, but the way to keep inflation down is to have a responsible monetary policy, which is what we have in our country.

Nicholas Soames (Mid Sussex) (Con): Does my right hon. Friend agree that although the serious banking difficulties must be dealt with, it is vital that we retain the central importance of the City of London, and that any reforms must be proportionate and not damage such a brilliant asset for our country?

The Prime Minister: My right hon. Friend makes an important point. We have to get to the bottom of what has happened and we have to do so quickly. In doing that, we should bear in mind the remarks of Richard Lambert, who ran the CBI very successfully for many years, who carried out an investigation for the Labour party and whom I respect a great deal:

“the Libor scandal means that the required changes have to be tougher…that is the argument for a short, sharp inquiry. Going back to square one would, to put it mildly, be a serious mistake. The economy cannot recover in the absence of a stable banking system: nothing can be more urgent than that.”

That is not the only consideration. We must get to the truth, but we should listen to such expert opinions as well.

Edward Miliband (Doncaster North) (Lab): I join the Prime Minister in paying tribute to Guardsman Apete Tuisovurua, Guardsman Craig Roderick of 1st Battalion Welsh Guards and Warrant Officer Class 2 Leonard Thomas of the Royal Corps of Signals, who died in the most tragic of circumstances. Our hearts go out to their families and friends. I also join the Prime Minister in his remarks about the incident at RAF Lossiemouth.

The banking scandals of the last week have revealed traders cheating and the mis-selling of insurance products to small businesses, and come on top of other scandals in the banking system and the continuing multi-million-pound bonus merry-go-round. How can the Prime Minister convince people that a parliamentary inquiry is a better way of restoring people’s confidence than a full, independent, forensic and open judge-led inquiry?

The Prime Minister: On the substance of the issue, there is no disagreement between us. This banking scandal is appalling. It is outrageous, frankly, that home owners may have paid higher mortgage rates and small businesses may have paid higher interest rates because of spivvy and probably illegal activity in the City. People want to know that crime in our banks and financial services will be pursued and punished like

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crimes on our streets. As well as people being held accountable, the public want rapid action to make sure that this cannot happen again.

In my view, the most important thing about an inquiry is that it is swift and decisive, is set up as fast as possible, gets going as fast as possible, reports as fast as possible and is transparent and open at every stage. That is why I favour a public parliamentary inquiry rather than a judge-led inquiry. I want us to legislate on this, starting next year.

Edward Miliband: I do understand the Prime Minister’s concerns about speed, but there are concerns also that the inquiry that has been talked about is far too narrow, focused solely on the scandal of LIBOR when we know that the problems go much wider, to the culture and practices in the City. I believe, however, that there is a way forward that we could agree upon—that we have a two-part, judge-led inquiry that is instructed to report by Christmas on the scandal surrounding LIBOR, which is his timetable. The second part of the inquiry should look, over 12 months, at the much wider area of the culture and practices of the industry. That would satisfy his requirement of speed but also the necessary requirement to look at the wider culture and practices in the City. Will he agree to my proposal?

The Prime Minister: I always listen carefully to proposals from all parts of the House. Let me make three points in response. First, on the structure and future of banking, we set up the Vickers inquiry. It reported, and we are going to implement that inquiry, which will for the first time separate investment banking from retail banking. That is a major step forward. Secondly, the parliamentary inquiry that we are proposing is wider than the right hon. Gentleman says. It will look at the culture of banking, as my hon. Friend the Member for Chichester (Mr Tyrie) confirmed this morning.

My third point—all these points need to be considered—is that the Serious Fraud Office is still considering whether to launch a criminal investigation. While that is happening, there are dangers in opting for a judge-led inquiry, which might not be able to get under way. If we want to do this as fast as possible and get action as fast as possible, I think the way we have suggested is right. There was a vote last night in which the House of Lords voted against a public inquiry, and we have made time available on Thursday—this has not happened before—for an Opposition motion and a Government motion to be debated and voted on. Frankly, what matters more than the process is the substance and getting on with it. I hope we can accept the results on Thursday.

Edward Miliband: We were in exactly the same position a year ago, when the Prime Minister initially rejected the idea of a judge-led inquiry into the press scandal and then rightly changed his mind. In justifying that decision, he said:

“I don’t believe there is any better process than an inquiry led by a judge”.

He said that would happen with

“the whole thing…pursued…by a team of barristers who are expert at finding out the facts”.—[Official Report, 30 April 2012; Vol. 543, c. 1251.]

Why is it right to have that judge-led approach to the scandal in the press but wrong for the scandal in the banks?

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The Prime Minister: I think there is a very profound difference between the circumstances of the Leveson inquiry and the circumstances of this inquiry, because of course the Leveson inquiry followed a whole series of unsuccessful and failed inquiries. On this occasion we have had a very successful inquiry by the Department of Justice in America and the Financial Services Authority, which has uncovered the wrongdoing. Now what is required is swift inquiry, swift action and swift legislation. That is what you will get from this Government.

Edward Miliband: I do not think the Prime Minister has understood the depths of public concern and the depths of the lack of confidence. He says both that the inquiry that he proposes can be completed within essentially four months and that it can go as wide as it likes. That is simply not realistic. I have listened to his concerns and proposed a way forward. I ask him again for a two-part inquiry, with a judge, to complete the part on LIBOR on the Chancellor’s timetable—by Christmas—and then to look at the wider issues about the culture and practices of the City, of which there are many.

The Prime Minister: I understand the public concern about this issue, which is why I want us to get on with it. Frankly, it is this Government who are legislating to split the banks, as Vickers suggested; who are scrapping the tripartite agreement that failed so badly under the last Government; who have introduced the bank levy so that the banks pay their taxes properly; and who have introduced the most transparent regime for pay and bonuses in any financial centre anywhere in the world. As evidence that the House of Commons is getting on with it, we are going to see Bob Diamond questioned upstairs by the Treasury Select Committee this afternoon. I say to the right hon. Gentleman that we are having a vote in the House of Commons tomorrow—a vote on his motion and a vote on the Government motion. Clearly, if the Opposition motion wins, there will be a full independent public inquiry. I urge him to say now that if the Government motion is carried, he will co-operate with a full parliamentary inquiry.

Edward Miliband: I do not think the Prime Minister gets it about the depth of public concern. I hope that he will reconsider his position. He says that the Government are implementing the Vickers inquiry. On a very important issue that has come out in the past two weeks—high street banks selling dodgy products to small businesses—the Vickers commission said that it should never be allowed to happen again, yet after lobbying by the banks the Government rejected this basic recommendation of Vickers. In the light of the recent scandal, with small businesses damaged, will he now U-turn and implement the Vickers recommendations in full?

The Prime Minister: First, I will not take a lecture on getting it from a party that was in office for 13 years when all these things took place. On his specific question about the Vickers inquiry, let me repeat that it was set up by this Government and will be implemented by this Government—something that had not happened before. Under the inquiry, complex derivatives will be included in the investment bank ring fence, not in the retail banks, which we want to make safer. But let me just say this to the right hon. Gentleman: if he wants a quick

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resolution, he must accept the outcome of a vote in the House of Commons. I am prepared to do that. Why is he not?

Edward Miliband: Mr Speaker—[Interruption.]

Mr Speaker: Order. Government Back Benchers who have been here for some years ought to have grasped by now that it is not the responsibility of the Leader of the Opposition to answer, so they should pipe down and try to be good boys, if they can.

Edward Miliband: If the Prime Minister wants a history lesson, let me repeat what he told the City of London on 28 March 2008:

“As a free-marketeer by conviction, it will not surprise you to hear me say that”

the problem “of the past decade” is “too much regulation”.

Does that not say it all about the double standards of this Prime Minister? Whenever these scandals happen, he is slow to act and he stands up for the wrong people. The question people are asking is, “Who will act in the national interest, rather than the party interest?” His is a party bankrolled by the banks. If he fails to order a judge-led inquiry, people will come to one conclusion: he simply cannot act in the national interest.

The Prime Minister: Everybody can see what is happening here. [Interruption.]

Mr Speaker: Order. Members must calm down. I said it to Government Back Benchers and I am now saying it to Opposition Back Benchers: let the answer be heard.

The Prime Minister: The party opposite want to talk about absolutely everything apart from their record of 13 years in government. I have to say that we may have found the Higgs boson particle, but Labour has not found a sense of shame.

Esther McVey (Wirral West) (Con): Today is a hugely significant day for British scientists with the announcement of the Higgs boson discovery. Some 6,000 scientists worked on it worldwide—700 from the UK—and there was a major contribution from the north-west. A constituent of mine, Professor Phil Allport, head of particle physics at Liverpool university, led the ATLAS experiment. Will the Prime Minister confirm this Government’s commitment to science and to institutes in the north-west?

The Prime Minister: My hon. Friend is absolutely right to raise this issue, the immense British contribution there has been to this extraordinary breakthrough—not least that of Higgs himself—and the extraordinary work that, as she says, is done in the north-west of England. It is a very big step forward and we should congratulate everyone involved. This Government’s commitment to the science budget is without any doubt, not least because although we have had to make difficult cuts, we have preserved the science budget.

Q2. [114969] Jim Shannon (Strangford) (DUP): The last 15 days have witnessed absolute chaos in the Ulster bank. Direct debits continue to be removed and wages have not been put into accounts. Ulster bank is owned by RBS. We, the people, have an 82% share in RBS, so the Government have a major say in what happens in the Ulster bank in Northern Ireland. Will the Prime Minister give an assurance to the 100,000 Ulster bank

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customers that the Prime Minister and the Government will have a direct input in addressing this issue, and that normal banking will resume immediately?

The Prime Minister: I can quite understand why the hon. Gentleman raises this on behalf of his constituents. What happened is not acceptable. Clearly, it is an operational matter for the bank, but the Financial Services Authority has been monitoring this very closely. My right hon. Friend the Secretary of State for Northern Ireland spoke yesterday to the chairman of RBS. The lessons must be learned, but I can tell the hon. Gentleman that RBS has said that it will reimburse any customer for penalty charges or overdraft fees—anything that is incurred because of these difficulties.

Q3. [114970] Eric Ollerenshaw (Lancaster and Fleetwood) (Con): To be blunt, my constituents and businesses are losing faith in their banks. What they need from the Prime Minister is a reassurance that there will be no more political skeletons in the cupboard left by the Labour party.

The Prime Minister: What matters for my hon. Friend’s constituents and, frankly, for everyone in this House is that we get to the bottom of what happened as quickly as possible. We have had a vote in the House of Lords; we will have a vote in the House of Commons; and then we need to get on with it. We are sent to this House to hold these inquiries, to find these facts, to pass these laws. Let us get on with it.

Q4. [114971] Mr David Hanson (Delyn) (Lab): Yesterday, 117 manufacturing jobs were lost in my constituency on a rising trend of unemployment in north Wales. Will the Prime Minister confirm to the House that last week’s GDP figures showed that his Government’s performance was worse than he expected and requires change, and that the cause is his Government’s policies?

The Prime Minister: I very much regret any loss of jobs, including in the right hon. Gentleman’s constituency, particularly as, since the election, we have seen 800,000 extra jobs in the private sector. I am very concerned about the economic performance in Wales, which over the last decade or more has actually fallen further behind the rest of the United Kingdom. We need to work very hard with the Welsh Assembly Government to try to make sure that we are making Wales more competitive.

Stephen Lloyd (Eastbourne) (LD): A key part of the Health and Social Care Act 2012 is that clinical change must be led by clinicians and patients. In my own hospital, the Eastbourne district general hospital, the majority of consultants have said that they have no confidence in the trust’s proposed clinical change, and the vast majority of the public in Eastbourne share that lack of confidence. Will the Prime Minister confirm that the local trust has to listen to the Act, the clinicians and local people in Eastbourne?

The Prime Minister: I can absolutely confirm that. Clearly, changes should not go ahead unless there is proper listening to local clinicians and local people. That is how our health service should operate. My right hon. Friend the Health Secretary will be making an

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announcement shortly. The good news is that across the health service in-patient and out-patient waiting times are down, and we have the best ever performance for patients waiting for longer than 18 weeks to be treated. Added to that, the number of mixed-sex wards is down and rates of infection are down; the health service is doing well.

Q5. [114972] Anas Sarwar (Glasgow Central) (Lab): The Prime Minister will be aware that the Crown Office in Scotland has confirmed that it has been carrying out an investigation, led by the serious crime division, into allegations that several banks, including state-owned RBS, have provided false information to financial markets. Does the Prime Minister back that investigation? Given the scale of the crisis and the scale of public anger, will he back a full, independent, judge-led inquiry and, crucially, will he give us a free vote in the House tomorrow?

The Prime Minister: There are two important things here. First, we should allow all the investigative authorities to carry out their investigations and take them wherever the evidence leads them. That is true for the Serious Fraud Office, and it is true for the Financial Services Authority—we need to ensure that they have the resources necessary to do that. Then we have to consider the nature of the inquiry. The problem with the suggestion the hon. Gentleman makes is that as these investigations are ongoing, it is actually easier to hold a rapid investigation within Parliament than to set up an investigation outside Parliament.

Q6. [114973] James Wharton (Stockton South) (Con): What message would the Prime Minister send to the emergency services, local authorities and communities across the north-east, which swung into action so effectively when the region was hit by flooding last week?

The Prime Minister: The first thing I would say is huge congratulations and thank you to the emergency services. I saw for myself—not in my hon. Friend’s constituency, but when I was in West Yorkshire—the incredible work that was done. The other thing to note is that whenever these things happen, there is an incredible coming together of community and social action to help people who have been flooded out of their homes. I am sure that everyone, in all parts of the House, will want to thank people for what they have done on others’ behalf.

Q7. [114974] Ian Lucas (Wrexham) (Lab): On the question of a European referendum, is it the policy of the Prime Minister to be indecisive, or is he not sure?

The Prime Minister: I wonder how long in front of the bathroom mirror that one took. The point is this. There are two things that would not be right: the first would be to hold an in/out referendum now—I do not think that is the right approach—and the second would be to rule it out for all time. I have no idea what the hon. Gentleman’s party’s policy is.

Mr Julian Brazier (Canterbury) (Con): Does my right hon. Friend agree that central to any reforms of banking must be, from the point of view of ordinary punters,

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two things: first, the proposals which we are already working up to ensure that people can move their accounts quickly, cheaply and easily; and secondly, an absolute guarantee that Governments will never again bail out banks?

The Prime Minister: My hon. Friend makes two very important points. On the first point, about people being able to move their bank accounts, that will be in place later this year. On the issue of bailing out banks, we need to put in place mechanisms so that banks can fail without calling on taxpayers to support them. That resolution regime, which for 13 years was left untouched by Labour, has been dealt with by this Government.

Q8. [114975] Graham Stringer (Blackley and Broughton) (Lab): The euro now has a solid record of destroying jobs and democracy throughout Europe. The Prime Minister is failing to repatriate any powers or resources to this country. When is he going to stop dithering and allow the electorate in this country to have a referendum on the European Union to decide whether to stay in or get out of that mess?

The Prime Minister: We have repatriated one power, which is that we have got out of the bail-out that the last Government put us into, and that is saving us billions of pounds. If the hon. Gentleman takes that view, he should be sitting on this side of the House rather than that side.

David Morris (Morecambe and Lunesdale) (Con): I want to draw my right hon. Friend’s attention away from banking for one moment—[Interruption]—and the Opposition’s attention—to more important matters: children’s lives in my constituency. Five children in my constituency have been involved in an accident on a crossing outside St Peter’s school in Heysham. I know this is a county council matter, but I would like the Prime Minister to assist me in trying to get a crossing outside St Peter’s school.

The Prime Minister: My hon. Friend is entirely right to raise a constituency case such as this, where so many people have lost their lives and where there is such a threat to safety. I will certainly look at what he says. As he says, it is a matter for the county council, but if I can help him to put his case, I will be pleased to do so.

Q9. [114976] Jonathan Ashworth (Leicester South) (Lab): Leicester is bearing the brunt of the Prime Minister’s double-dip recession, with the sad news today that yet another business is going under, resulting in the loss of local jobs. In that context, was he as disappointed as I was at the figures released last month showing that lending to small businesses was down by £1.7 billion? Is it not clear that the Chancellor’s credit easing policies are not working?

The Prime Minister: The credit easing policy—the national loan guarantee scheme—is going to make available £20 billion of extra loans; some of that money is already available. The Merlin scheme saw lending to small businesses go up in 2011. It is difficult when the banks are nervous about the economic situation, but the Treasury and the Bank of England are doing all that

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they can, including through the Merlin agreement, to get money out of the banks and into hard-pressed businesses.

Sir Peter Tapsell (Louth and Horncastle) (Con): If, as a result of this shameful banking crisis, bank executives are dismissed or forced to resign, and the boards of their banks fail to act appropriately, will the Government do their best to ensure that the delinquents are not able to walk away with their bonuses and severance payments?

The Prime Minister: The Father of the House makes an extremely good point. It would be completely wrong if people who were leaving in those circumstances were given some vast pay-off. It would be completely inexplicable to the British public, and it would not be right. I very much hope that it does not happen. In terms of what the Government can do, we are going to legislate so that all pay deals are put to shareholders with a binding vote, and those deals should include any severance payments. The party opposite had 13 years to do that; we are going to do it in two.

Q10. [114977] Mr Michael Meacher (Oldham West and Royton) (Lab): Given that the richest 1,000 persons in Britain made gains of £155 billion in the past three years of austerity, why will the Government not charge those gains at the capital gains tax rate, which would bring in about £40 billion? That would be enough, without any increase in public borrowing, to generate 1 million or more jobs. It would be far better to cut the deficit in that way—through growth, rather than through the Chancellor’s failed slump.

The Prime Minister: I hate to remind the right hon. Gentleman, but he was a Minister in the Government whose capital gains tax rules meant that people in the City were paying less in tax than their cleaners were paying. We have lifted the rate of capital gains tax to 28% so that we have a fairer system.

Q11. [114978] Duncan Hames (Chippenham) (LD): The pupils I met recently at Corsham primary school told me, in their own creative ways, that they liked to learn together. They know, however, that many children in other countries never get that chance. How will the Prime Minister, as chair of the United Nations high-level panel on the millennium development goals, restart efforts to ensure that all girls and boys around the world go to school?

The Prime Minister: My hon. Friend raises an important point. Many of us will have seen the “Send my Friend to School” campaign in our own constituencies; it is a brilliant way of teaching young people the importance of showing responsibility for those on the other side of the world who do not have the advantages that they do. Our aid is currently supporting 5.3 million children in primary education, and we hope to up that to 9 million people by 2014, so the Government are playing their part, but we want all of civil society—schools, parents and teachers—to join in that magnificent effort.

Mr Nigel Dodds (Belfast North) (DUP): In addition to what the Prime Minister said earlier about the Ulster bank crisis in Northern Ireland, in which households, individuals and businesses are being denied even basic

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banking facilities, will he and the Chancellor talk to Her Majesty’s Revenue and Customs to ensure that some flexibility will be shown towards the liabilities of those households, individuals and businesses so that they can be helped through the cash-flow problems that are the result of problems that they did not create?

The Prime Minister: I will certainly look at what the right hon. Gentleman says. As I said, RBS has said that it will ensure that people do not lose out through banking charges, but I will discuss his point about HMRC with the Chancellor.

Q12. [114979] Margot James (Stourbridge) (Con): I welcome the Government’s commitment to women and girls at the heart of their development policy. As this weekend’s Tokyo conference on the future of Afghanistan approaches, will the Prime Minister consider making aid to Afghanistan conditional on the protection of the hard-won rights of women and girls, which, as he knows, are under attack?

The Prime Minister: My hon. Friend makes a very important point. Whereas in 2001 fewer than 1 million children—and, of course, no girls—were attending school in Afghanistan, today 6 million children regularly attend school and 2 million of them are girls. I will reflect carefully on what she says about our aid programme and discuss it with the Secretary of State. It is important that we attach conditions and have real transparency and proper results from our aid. I think that is the only way we can take people with us as we continue to expand our aid budget at a time of economic difficulty at home. My hon. Friend is absolutely right to raise this issue because if we want a stable and prosperous as well as a safe Afghanistan, we need an Afghanistan where the role of women is properly respected.

Q13. [114980] Mr Michael McCann (East Kilbride, Strathaven and Lesmahagow) (Lab): May I give the Prime Minister the opportunity to answer the question put to him a few moments ago by my hon. Friend the Member for Glasgow Central (Anas Sarwar)? If the Prime Minister believes in the sovereignty of Parliament, will he confirm that there will be a free vote across the House tomorrow?

The Prime Minister: There was a vote last night in the House of Lords when Labour peers were heavily whipped to vote for the Labour position. I have a clear view, the Government have a clear view and the whole of the coalition Government have a clear view about the right way ahead. There will be a motion for the Labour party, which they can vote for, and a motion for us, which we can vote for. Let me put this one more time to the Leader of the Opposition: I will be bound by a vote for a full public inquiry; will he be bound if the House votes for a parliamentary inquiry? If he cannot answer that question, people will take a very dim view of an

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Opposition party that stands in the way of an inquiry because they do not want their dirty washing done in public.

Q14. [114981] Andrew Stephenson (Pendle) (Con): The Olympics provide a great opportunity to bring our nation together. Does the Prime Minister therefore share my dismay at the plans of some union leaders to disrupt this summer’s events?

The Prime Minister: My hon. Friend makes an important point. The Unite union is encouraging strikes on our buses in London. The Leader of the Opposition likes to talk about standing up to vested interests, but what have we heard from him on the trade union movement? Absolutely nothing, and the whole country will be listening to that. We want a strike-free Olympics, and Labour should talk to its paymasters about it.

Q15. [114982] Pat Glass (North West Durham) (Lab): We all witnessed last week’s storms across the country. My own village of Lanchester hit the headlines because of the floods. We are all grateful to the police, the fire brigade, Durham county council and the Weardale mountain rescue service, but will the Prime Minister confirm that the Government will be there with real money to support these people and these agencies, and not offer just nice warm words?

The Prime Minister: Of course we will be there to do that. We are investing around £2 billion in future flood defences. Of course, all the emergency services have done an excellent job, and they remain ready to carry out further work if necessary. I also think the Government should lend a very sympathetic ear to the local councils and local organisations that are setting up hardship funds to help families, perhaps those that do not have insurance or cannot afford the excess when it comes to dealing with their problems. I have said to the Department for Communities and Local Government that we should be generous in helping people to get their lives back together again.

George Freeman (Mid Norfolk) (Con): Will the Prime Minister join me in welcoming the news that over £1 billion has been raised in the last six months for start-ups in our life science sector—more than in the last three years combined? Does he agree that this is a massive statement of confidence in our innovation economy and in our policies to make Britain a place to do business?

The Prime Minister: My hon. Friend has a close interest in life sciences and pharmaceutical industries, and knows a lot about what he says. One of the successes with part of the EU patent court coming to London is that the patents that cover life sciences, pharmaceuticals and similar industries will be in London as well. That means many, many jobs and tens of millions of pounds of investment in this industry and in our capital city.

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NHS Annual Report and Care Objectives

12.34 pm

The Secretary of State for Health (Mr Andrew Lansley): With permission, Mr Speaker, I would like to make a statement about my first annual report to Parliament on the health service, published today alongside the report on the NHS constitution and the draft mandate to the NHS Commissioning Board.

This year the NHS has made major progress in the transition to a new system: a system based on clinical leadership, patient empowerment and a resolute focus on improving outcomes for patients. In a year of change, as the annual report shows, NHS staff have performed admirably. Waiting times remain low and stable, below the level at the election, and the number of people waiting over a year is the lowest ever. Today only 4,317 patients are waiting more than a year for treatment, dramatically fewer than in May 2010. Nationally, all NHS waiting time standards for diagnostic tests and cancer treatment have been met. The £600 million cancer drugs fund has helped more than 12,500 patients to gain access to drugs that were previously denied to them.

We have extended screening programmes, potentially saving an extra 1,100 lives of sufferers from breast and bowel cancer every year by 2015. More than 90% of adult patients admitted to hospital—about a quarter of a million every week—are now assessed for venous thromboembolism, or blood clots, in what is a world-leading programme of its kind. In 2011-12, 528,000 people began treatment under the expanded improving access to psychological therapies programme—up from just 182,000 in 2009-10—and almost half have said that they have recovered. Following the success of the telehealth and telecare whole system demonstrator programme, which included a 45% fall in mortality, we are on course to transform the lives of 3 million people with long-term conditions over the next five years.

The NHS is also improving people’s experience of care. Patients are reporting better outcomes for hip and knee replacements and hernia repairs. In the latest GP patient survey, 88% of patients rated their GP practices as good or very good, and the result of the out-patient survey shows clear improvements in the cleanliness of wards and the number of patients reporting that they were treated with respect and dignity. MORI’S independent “Public Perceptions of the NHS” survey shows that satisfaction with the NHS remains high, at 70%. Mixed-sex accommodation breaches are down by 96%, MRSA infections are down by 25%, and clostridium difficile infections are down by 17% in the year.

Real progress is also being made in public health. More than 570,000 families have signed up to Change4Life, and our support for the School Games and Change4Life sports clubs in schools is helping to secure the Olympic legacy. The responsibility deal has seen the elimination of artificial trans fats, falling levels of salt in our diets, and better alcohol labelling. By the end of the year, more than 70% of high street fast food and takeaway chains will show the number of calories on their menus. To drive forward research in key areas such as dementia, I have announced a record £800 million for 11 National Institute for Health Research centres and 20 biomedical research units.

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All that, and a million more people have access to NHS dentists; every ambulance trust is meeting its call response times; 96% of patients are waiting less than four hours in accident and emergency departments; quality, innovation, prevention and productivity—QIPP—savings across the NHS were £5.8 billion in the first year of the efficiency challenge; and NHS commissioning bodies delivered a £1.6 billion surplus, carried forward into the current financial year. All that, and a new system is taking shape. The NHS Commissioning Board has been established; health and wellbeing boards are preparing to shape and integrate local services; 212 clinical commissioning groups, which are already managing more than £30 billion in delegated budgets, are preparing to lead local services from April next year; and we are starting to measure outcomes comprehensively for the first time. Far from buckling under pressure, NHS staff—with the right leadership and the right framework—are performing brilliantly.

As well as the NHS annual report, I am today publishing a report on the NHS constitution. The Health and Social Care Act 2012 strengthens the legal foundation for the constitution, and includes a duty for commissioners and providers to promote and use it. This report—the first by a Secretary of State—will help commissioners and providers to assess how well the constitution has reinforced the principles and values of the NHS; the degree to which it has supported high-quality patient care; and whether patients, the public and staff are aware of their rights.

I am grateful to the NHS Future Forum and its chair, Professor Steve Field, for their advice on the effect of the NHS constitution. I have asked them whether there is further scope to strengthen the principles of the constitution before a full public consultation in the autumn. Any amendments would be reflected in a revised constitution, published by April 2013.

Rooted in the values of the constitution, we will drive further improvement across the NHS through a set of objectives called the mandate to the NHS Commissioning Board. I am publishing the draft mandate today. The mandate will redefine the relationship between Government and the NHS, with Ministers stepping back from day-to-day interference in the service. Through the mandate, we will set the board’s annual financial allocation and clearly set out what the Government expect it to achieve with that allocation, based on the measures set out in the NHS outcomes framework. Those include both measures of quality, such as whether people recover quickly from treatment, and the experience of those cared for, including whether they are treated as well as they would expect, and whether they would be happy for family and friends to be cared for similarly. The mandate will promote front-line autonomy, giving clinical commissioners the freedom and flexibility to respond to local needs—freedoms balanced by accountability.

Each year, the board will state how it intends to deliver the objectives and requirements of the mandate, and it will report on its performance at the end of that year. The Secretary of State will then present to Parliament an assessment of the board’s performance. If there are particular concerns, Ministers will, for example, ask the board to report publicly on what action it has taken, or ask the chair to write a letter setting out a plan for improvement.

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Today’s publication of the draft mandate marks the beginning of a 12-week consultation. I look forward to working with patients, clinicians, staff and other stakeholders to finalise the mandate in the autumn.

These documents show how a new, exciting chapter is opening up for the NHS. Starting with strong performance and robust finances, we are driving towards integrated services and community-based care. This heralds a new era for the NHS, based on openness and transparency and focused on what matters most to patients: health outcomes, care quality, safety and positive experience of care. It heralds an era in which every part of the NHS—the Secretary of State, the NHS Commissioning Board, clinical commissioning groups and health-care providers—is publicly held to account for what is achieved. For the first time, Parliament, patients and the public will know exactly how the NHS is performing locally, nationally and by way of international comparison. This will be a new era in which patients are more in control, where clinicians lead services, and where outcomes are among the best in the world.

I commend this statement to the House.

12.42 pm

Andy Burnham (Leigh) (Lab): The Secretary of State today presents his first annual report—an annual report on a lost year in the NHS. Just when the NHS needed stability to focus all its energy on the money, what did he do? He pulled the rug from underneath it, with a reorganisation no one wanted and that this Prime Minister promised would never happen.

In fact, we have had not one, but two lost years in the NHS, as this Secretary of State has obsessed on structures and inflicted an ideological experiment on the NHS that made sense to him but, sadly, to no one else. It was his decision to allow the dismantling of existing structures before new ones were in place, which has led to a loss of financial grip at local level in the NHS. He mentioned QIPP savings. The truth is that two-thirds of NHS acute trusts—65%—are reported to have fallen behind on their efficiency targets. So we see temporary ward and accident and emergency closures, a quarter of walk-in centres closing across England, panic plans to close services sprouting up wherever we look, and crude, random rationing across the NHS, with 125 separate treatments—including cataracts, hip replacements and knees—being restricted or stopped altogether by one primary care trust or another. This is an NHS drifting dangerously towards trouble, or, in the words of the chief executive of the NHS Confederation,

“a supertanker heading for an iceberg”.

Let us remember that even before the added complexity of today’s mandate, the Secretary of State has already saddled his new board with an Act of Parliament that even the chair of that board, whom he appointed, calls “unintelligible”. Listening to the Secretary of State today, one could not but conclude that he cannot be looking at the same NHS as the head of the NHS Confederation. The statistics he just reeled off do not include the people who give up waiting in A and E, who have their operation cancelled, who cannot get a GP appointment for days or who cannot get into hospital in the first place because his Government are restricting

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access to operations. Perhaps that explains why the year that he hails as a great success was the same year that saw the biggest ever fall in public satisfaction with the national health service according to the British social attitudes survey.

Let me challenge the Secretary of State on this growing gap between Ministers’ statements and people’s real experience of the NHS. He has said that there will be no rationing by cost, but I have news for him: it is happening on his watch, right across the system, with a whole host of restrictions on important treatments and a postcode lottery running riot. Where is the instruction in the draft mandate to stop it and deliver on the promise that he and the Minister of State, the right hon. Member for Chelmsford (Mr Burns), made to patients? It is not there.

Let me turn to bureaucracy and targets. First, the Government said that they would scrap the four-hour A and E and 18-week targets; then they brought them back. Now they have gone further and adopted Labour’s guarantees, but they have gone even further today and have added a whole new complex web of outcomes and performance indicators for the NHS. The NHS needs simplicity and clarity, but what it has received today from this Secretary of State is a dense document with 60 outcome indicators grouped within five domains. I hope it is clear to him, because it will not be clear to anyone else. Will he treat the House again to his explanation of the difference between an outcome indicator and a target? The fact is there is not one and he is loading a whole new set of targets and burdens on to a NHS that is already struggling to cope with the challenges it is facing.

It will not have escaped people’s notice that today the Secretary of State was silent on the biggest issue of all: the unfolding crisis in adult social care. Out there in the real world, councils are not coping, services are collapsing and that is placing intolerable pressure on hospitals. He promised a White Paper soon on service change, but nothing on funding. Has he given up on the Dilnot proposals and the challenge of finding a fairer and more sustainable funding system?

Before we let the Secretary of State go today, the House needs to ask to whom this mandate is being given. We are witnessing the democratic responsibility and accountability to this House for the organisation that matters more to our constituents than any other being outsourced and handed over to an unelected and unaccountable board.

Another major announcement is taking place today on the review of the arrangements for children’s heart surgery. It will not have escaped people’s notice, however, that the Secretary of State did not mention that review in his statement. He said that Ministers are stepping back, and I think people in this House know what that means—it is now nothing to do with him. All these changes will take place and he will not be responsible.

What assurances can the Secretary of State give to right hon. and hon. Members that his new board will listen to their concerns? Who are the people on that board? With trademark catastrophic timing, we learn that he has given a leading role in the running of the NHS to—yes—the vice-chair of Barclays, none other than Mr Diamond’s right-hand man and someone who

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has given £106,000 in donations to the Conservative party. If that does not sum up this Government, I do not know what does.

We know the real mandate that the Secretary of State has given his new board—and that is a mandate for privatisation. He promised it would not happen, but it is happening with community services being outsourced. No wonder there is a crisis of leadership, with one third of directors of public health not planning to transfer to local authorities. Is it not the simple truth that the Secretary of State inherited a successful, self-confident NHS and, in just two years, has reduced it to a service that is demoralised, destabilised and fearful of the future? The man who promised to listen to doctors has completely ignored them, and now they are calling for his resignation. Despite all his claims today, the supertanker is still heading towards an iceberg. He gave us a new mandate when what we really needed was a change of direction and a change of personnel.

Mr Lansley: At no point did the shadow Secretary of State express any appreciation for what the staff of the NHS have achieved in the past year. A party political rant populated with most of his misconceptions and poorly based arguments does not get him anywhere.

The right hon. Gentleman went around the country trying to drum up something he could throw at us about things that he believed were going wrong in the NHS. Do you know what he ended up with, Mr Speaker? He ended up by saying the NHS was rationing care. What was the basis for that? That parts of the NHS have restrictions on weight-loss surgery, because people have to be obese before they have access to it. That is meaningless. I wrote to the shadow Secretary of State this morning, and went through his so-called health check. There is no such ban on surgery as he claims. Time and again, he says, “Oh, they are rationing.” They are not, because last year, the co-operation and competition panel produced a report that showed where there had been blanket bans on NHS services under a Labour Government. We introduced measures to ensure that that would not happen in future across the service. Not only is he not giving the NHS credit for the achievements that I listed in detail in my statement but he is now pretending that the NHS is somehow in chaos or financial trouble. It is complete nonsense. Across the NHS, only three primary care trusts out of 154 were in deficit at the end of the year. The cumulative surplus across all the PCTs and strategic health authorities is £1.6 billion carried forward into this financial year.

That means that the NHS begins 2012-13 in a stronger financial place than anyone had any right to expect, because it is delivering better services more effectively, with GP referrals reduced, and reduced growth in the number of patients attending emergency departments. The right hon. Gentleman asked, “What about patients who leave A and E without being seen?” Under the Labour Government, no one ever measured whether patients left A and E without being seen. For the first time, we are measuring that, and we publish the results in the A and E quality indicators. There was a variation between about 0.5% and 11% of patients leaving without being seen when we first published that, but since then the variation has reduced. The average number has gone down, and it is now at 3%, so he ought to know his

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facts before he stands up at the Dispatch Box and begins to make accusations. We published those facts for the first time.

I will not reiterate the A and E target, because I mentioned it in the statement, but 96% of patients are seen within four hours in A and E. The right hon. Gentleman should withdraw all those absurd propositions that the NHS is not delivering. He should get up when next he can and express appreciation to the NHS for what it is achieving. Patients do so: last year, 92% of in-patients and 95% of out-patients thought that they had good or excellent care from the NHS, which is as high as in any previous year. That is what patients feel. Staff should be proud of what they achieve in the NHS, and the Labour party should be ashamed of itself.

David Tredinnick (Bosworth) (Con): My right hon. Friend’s statement, which is very positive, will be widely welcomed, particularly what he said about low waiting times. He said that patients in future will be more in control. Is he referring to the personal health budgets in the Health and Social Care Act 2012, and does he expect a greater range of treatments to be available on the health service in future?

Mr Lansley: I am grateful to my hon. Friend. There are many ways in which we can improve the control that patients can exercise, including greater opportunities for patients to exercise choice. In my announcement today, that includes the opportunity for patients to choose alternative providers of NHS care if, for example, the standard of 18 weeks that the constitution sets is not met. I might say that, at the last election, 209,000 patients were waiting for treatment beyond 18 weeks. That number has been brought down to 160,000.

My hon. Friend makes an important point about the exercise of control on the part of patients, who have an opportunity to access clinically appropriate care through the NHS. We will make sure that that is available and, as he knows, in relation to homeopathic treatments, for example, we have maintained clinicians’ ability across the service to make such treatments available through the NHS when they think that it is appropriate to do so.

Mr Kevin Barron (Rother Valley) (Lab): I have not been able to read the annual report in the last few minutes, but may I ask the Secretary of State for Health whether it gives any information on the benefits of high-street pharmacy companies taking over the running of hospital pharmacies?

Mr Lansley: No, the annual report makes no reference to that. It refers—I hope, for the first time—in detail to the performance of the NHS over the past year. If the right hon. Gentleman wishes to raise any issues about that, I shall be glad to respond to him separately.

Alun Cairns (Vale of Glamorgan) (Con): I welcome the statement from the Secretary of State and the annual report. Is he aware that the National Audit Office published a report last week on variations in the NHS across the United Kingdom? It specifically reported that life expectancy in Wales was lower than in other parts of the UK; there were fewer GPs per patient; longer hospital stays in Wales; and longer hospital waiting lists. Will he reassure me, in the light of his

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statement and of the NAO report, that he will not take any lessons from the Labour party, because it is responsible for running the health service in Wales that my constituents have to put up with, sometimes tragically?

Mr Lansley: My hon. Friend makes an excellent point—in fact, an excellent series of points. On his behalf I am glad to send to the Minister for Health and Social Services in the Labour Government in Wales a copy of the annual report for England, perhaps inviting her to publish a similar report in Wales. As the NAO said, and, indeed, as the Wales Audit Office said, only 60% or, on the latest data, only 68% of patients in Wales waiting for treatment accessed it within 18 weeks—the right under the NHS constitution—whereas in the NHS in England, the figure is 92%.

John Healey (Wentworth and Dearne) (Lab): NHS staff and patients simply do not have the same rosy view of the NHS as the Secretary of State. When a Government-commissioned survey asked people last summer what they thought of the NHS, why had satisfaction with the NHS plummeted from 70% to 55% in just a year under the Secretary of State?

Mr Lansley: The right hon. Gentleman makes an interesting point, because MORI conducted an independent survey last December after the survey conducted on behalf of the King’s Fund. The survey said that 70% of people were satisfied with the running of the NHS; 77% agreed that their local NHS provided a good service; and 73% agreed that England had one of the best national health services in the world—the highest level ever recorded in that survey.

Andrew George (St Ives) (LD): I am pleased and reassured by the comments from the Secretary of State on outcomes, which he said were among the best in the world. In view of that, would he perhaps reconsider whether it is wise to press ahead with such disruptive and damaging reforms?

Mr Lansley: One reason why the NHS continues to deliver such significant improvements in performance is that through the transition, we are increasing clinical leadership, which will make an important, positive difference, and can already be shown to have done so. For example, we are managing patients more effectively in the community, and reducing reliance on acute admission to hospital. The number of emergency admissions to hospital in the year just ended went down, which is a strong basis on which to develop services in future, and that is happening not least because of leadership in the primary care community. I hope that my hon. Friend from Cornwall, along with other Members, supports the assumption of clinical leadership through clinical commissioning groups by those clinicians.

Valerie Vaz (Walsall South) (Lab): Like my right hon. Friend the Member for Rother Valley (Mr Barron), the former Chair of the Select Committee on Health, I have not had sight of the report, but will the Secretary of State say what the cost to the public purse of the pause and the reorganisation will be?

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Mr Lansley: I think that the hon. Lady knows that the figure is in the order of £1.2 billion to £1.3 billion. She also knows that, during this Parliament, we will deliver, as a result of the changes, reductions in bureaucracy and administration costs across the NHS, which cumulatively will be of the order of £5.5 billion.

David T. C. Davies (Monmouth) (Con): Is the Minister also aware that the National Audit Office report shows without doubt that deep and damaging cuts are taking place within the national health service, but that they are all happening in Wales? Does he agree that the last thing we need is to see that repeated in England by allowing these people control of our NHS?

Mr Lansley: My hon. Friend is right. There is only one part of the United Kingdom where the health service is being run by a Labour Government—in Wales, and that is the only part of the United Kingdom where the Government are deliberately cutting the budget of the NHS. We should not be surprised. The right hon. Member for Leigh (Andy Burnham), the shadow Secretary of State, at the time of the last election and afterwards, told people that they should cut the budgets, and Labour in Wales did it.

Several hon. Members rose—

Mr Speaker: On the whole, if at all possible, and it is not always possible, I prefer to avoid sibling rivalry so I shall now call Mr Keith Vaz.

Keith Vaz (Leicester East) (Lab): May I declare my interest as a type 2 diabetic and say how disappointed I am that the Secretary of State did not mention diabetes in his statement today? Fifty per cent. of adult diabetics have not had the nine care processes that are necessary. Will he ensure that commissioning groups are asked to ring-fence resources to help with diabetes prevention?

Mr Lansley: There are many conditions from which patients suffer that I did not mention in the statement because the purpose of the draft mandate to the NHS Commissioning Board is to improve the quality of services across the board, and the objectives we are looking for are about improvement across the whole service, rather than trying to isolate and identify individual conditions. But the NHS Commissioning Board will indeed go about the task of doing so. In recent years we have increased the proportion of patients with diabetes who have access to the nine recommended processes, and I know we will increase the number in future. I draw to the right hon. Gentleman’s attention, among the figures reflected in the report, the fact that, at the end of 2011-12, 99% of people with diabetes had been offered screening for diabetic retinopathy in the previous 12 months—an increase from 98.6% in the preceding quarter.

Dr Sarah Wollaston (Totnes) (Con): I particularly welcome the inclusion of the patient experience in the outcome framework. May I urge my right hon. Friend to make sure that commissioners and communities can clearly access the patient experience data so that they can see the real value that communities can place on community hospitals, and may I urge him to set out a clear database of community hospitals across England so that it can be much more readily available?

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Mr Lansley: I am grateful to my hon. Friend. I agree that measuring patients’ experience of care is very important. Although there was and continues to be an NHS patients survey, there are many areas of patients’ experience that it did not reflect. For example, we received yesterday the first of the VOICES—views of informal carers for the evaluation of services—a survey of the experience of bereaved families of the quality of end-of-life care that their family member received. That is part of the process of ensuring that for the future we understand, measure and respond to the views of bereaved families about the quality of care they received. That is just one illustration. Another is for the very first time measuring the experience of care reported by young people below the age of 16. There is a complex inter-relationship with the specific benefits of community hospitals in individual locations, but I hope that one of the things we will be able to do is look at the data, which will be disaggregated across the country, and increasingly see what most contributes to the high levels of patient experience in different parts of the country.

Derek Twigg (Halton) (Lab): I join the Secretary of State in congratulating NHS staff on their hard work and dedication, which is even more remarkable given the disastrous reorganisation they are having to work through at present. The Secretary of State talks about the new era. Can he today in Parliament rule out any additional charges anywhere in the NHS for patients who use the NHS in the next few years?

Mr Lansley: I am grateful to the hon. Gentleman. I said during the passage of the Health and Social Care Act 2012 that it had been intensively considered in its every aspect. The Act expressly rules out the introduction of any charges across the NHS, other than by further primary legislation, and there is no primary legislation to permit such a thing. So I reiterate the point: there will be no additional charging for treatment in the NHS.

Chris Skidmore (Kingswood) (Con): Many of my constituents are concerned that under the Labour Government £11 billion of PFI contracts were signed, which will cost the NHS over £60 billion to pay back. They are concerned that PFI, Labour’s toxic legacy to the NHS, has the potential to bankrupt many health trusts. Can my right hon. Friend reassure my constituents about possibly renegotiating some of these contracts?

Mr Lansley: My hon. Friend makes an important point. When the shadow Secretary of State was attempting to suggest that there were trusts in trouble across the country, he might have had the humility to admit that the hospital trusts in the greatest difficulty are the ones that were saddled with unsustainable debt by the Labour Government’s poorly negotiated PFI projects. He might have instanced Peterborough and Stamford Hospitals NHS Foundation Trust. Monitor wrote to him and his colleagues, telling them that that PFI project should not have proceeded. The Labour Government went ahead with it anyway and it is now unsustainable.

We have been very clear. We have gone through a process of identifying where trusts can manage, not least with us assisting them. In the latter part of last year we identified seven trusts that we will step in and support if we believe that they are otherwise unable to restore their finances to good health. It will entail about

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£1.5 billion of total support for them to be able to pay for their PFI projects. Where there are opportunities for renegotiation we will exercise them, but unfortunately it is in the nature of coming into government that we inherit what the previous Government left us. We were left with 102 hospital—


The shadow Secretary of State says from a sedentary position that they were our PFI schemes. No NHS PFI scheme was signed before the Labour Government took office in 1997. Two years ago we inherited 102 hospital projects with £73 billion of debt, yet the Opposition thought that in the years before they had used taxpayers’ money to build these new hospitals. No, they did not. They saddled the NHS for 30 years with that debt.

Mr Dave Watts (St Helens North) (Lab): Talking about waste, will the Secretary of State explain why his Department has wasted hundreds of thousands of pounds on consultancy fees looking at my acute trust, and why his Department refuses to publish the reports? Could it be that they are a complete waste of time?

Mr Lansley: In the year before the election the Department of Health spent about £110 million on consultancy and we reduced it to £10 million. I will tell the hon. Gentleman about waste. In the past two years we have already racked up £1.4 billion of administration savings across the NHS—money that goes straight back into the front line. The Department is having to do work in relation to the hon. Gentleman’s hospital at Whiston only because of the PFI deal that his Government signed before the last election. We will have to help St Helen’s and Knowsley trust deal with that debt in the future.

David Rutley (Macclesfield) (Con): Will my right hon. Friend join me in welcoming the progress that East Cheshire clinical commissioning group is making in building a collaborative approach to delivering health care in the Macclesfield area? Does he believe that other areas could benefit from observing the constructive approach being taken there?

Mr Lansley: Yes. I am grateful to my hon. Friend. He is absolutely right. I had the pleasure of meeting Dr Paul Bowen from his clinical commissioning group when I visited Blue Coat school in Liverpool. Leaders of clinical commissioning groups from across the north-west came together and many of them are already exercising 100% delegated responsibility for local commissioning budgets and showing how they can improve services using that. We know that in a financially challenging environment reducing cost is important, but redesigning services to deliver care more effectively with the resources available is even more important, and that is precisely what the clinical leadership in those groups is doing.

Gloria De Piero (Ashfield) (Lab): In Ashfield in the past year the number of people waiting in accident and emergency for more than four hours has almost doubled, we have lost our NHS walk-in centre, and there are now proposals to close our community hospital. Why does the Secretary of State think these things are happening?

Mr Lansley: As I made clear in my statement, according to the latest data 96.5% of patients in A and E are assessed, treated and discharged within four hours. The

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right hon. Member for Leigh (Andy Burnham) asked about the difference between a target and an outcome, but the point is that it is not enough to measure whether a patient has been seen and treated within four hours; the issue is the quality of treatment they receive, which is why our A and E quality indicators go further. The hon. Lady and I have had correspondence on this—I will be glad to look back and ensure that I have kept it up to date—so she knows that there has been a review of walk-in centres and that there is a need for people to have access not only to emergency departments, but to urgent care in a way that does not entail having to wait for a long time in A and E. I do not remember all the details, but I recall that some of the services offered in one walk-in centre in her constituency were being transferred to another that was adjacent to the A and E.

John Pugh (Southport) (LD): I welcome the statement. In order fully to fulfil the NHS mandate, we need to raise NHS staff morale. What plans does the Secretary of State have for doing that?

Mr Lansley: I think that what most gives staff a sense of motivation and morale, in any organisation in any walk of life, is being more in control of the service they deliver. That is evidenced across many areas of economic and service activity. That is what we are doing for the NHS. Whether in foundation trusts or clinical commissioning groups, staff will feel that they have more control over the service they deliver. Consequently, I believe that as we see the figures improve it will be less a case of politicians interfering, or even trying to take credit, and much more a case of NHS staff taking credit for the services they deliver.

Hugh Bayley (York Central) (Lab): Last week the board of the NHS North Yorkshire and York primary care trust cluster received a financial position statement that identified the need for cuts of £230 million, plus unfunded costs pressures of £55 million a year, and noted that

“the risks would grow even greater as it moved from a single organisation…to five much smaller clinical commissioning groups.”

Many treatments are already not available to patients in North Yorkshire and York, even though they are available to those in neighbouring areas. Bariatric surgery, for example, is available to people elsewhere with a body mass index of 40, but people in North Yorkshire and York have to be much more obese, with a body mass index of 50, to get it. Will the Secretary of State look at that report, make a thoughtful response and put both in the Library of the House so that Members can see how this financial crisis in the North Yorkshire and York primary care trust is being dealt with?

Mr Lansley: Identifying cost pressures and risks is, of course, a necessary part of the process of managing those risks, but I am afraid that the claim by the outgoing primary care trust that the risks cannot be managed by the incoming clinical commissioning groups is contrary to the experience of everybody in the hon. Gentleman’s part of the world, as he must know from the experience of the primary care trusts in North Yorkshire. The primary care trusts of the past did not cope, and it is up to the new clinical leadership in

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Yorkshire to make these things happen more effectively. The PCT did not finish last year in deficit; only three in the whole of England did—Barnet, Enfield and Haringey. I will make sure—




If he listens to my answer, he will hear that we, along with the NHS Commissioning Board, intend all the new clinical commissioning groups across England to start on 1 April 2013 with clean balance sheets and without legacy debt from primary care trusts. That will give them the best possible chance of delivering the best possible care. On bariatric surgery, he must know that the NICE guidance recommends that it should be available to those with a BMI index of over 40, depending on their clinical circumstances.

Hugh Bayley: So why is it 50—

Mr Speaker: Order. The hon. Gentleman should not keep shouting out. He has asked his question and had the answer. We will now move on.

Neil Carmichael (Stroud) (Con): Does the Secretary of State agree that one of the lasting achievements of the Health and Social Care Act 2012 will be the integration of health and social care, which will be excellent news for people recovering from strokes or meningitis?

Mr Lansley: My hon. Friend is absolutely right. The Labour party completely ignores the fact that one of the central points is that the creation of health and wellbeing boards—I pay credit to my Liberal Democrat friends in the coalition for that—the involvement of democratic accountability and the opportunity to create joint strategies that integrate public health, social care and the NHS and impact additionally on the wider and social determinants of health will be absolutely instrumental in the improvement of services and health in future.

Seema Malhotra (Feltham and Heston) (Lab/Co-op): Will the Secretary of State confirm that shortly after taking office he downgraded the standard that the NHS should see A and E patients within four hours from 98% to 95% and that many A and E units are now failing to meet even that relaxed target? Does he believe that that was the right move, and does he have any other plans to change it again?

Mr Lansley: I did indeed reduce the standard to 95%, on clinical advice, and currently the NHS is achieving 96.5%.

Nigel Mills (Amber Valley) (Con): On a recent visit to observe the excellent work of my local ambulance station in Alfreton, I was shown the widely different times it takes certain hospitals to admit patients arriving by ambulance, which leads to ambulances being off the road for longer than they need to be. Is there anything the Secretary of State can do to strengthen the guidance on how hospitals should handle this process to avoid the problem?

Mr Lansley: My hon. Friend makes an important point. Part of the measurement of the performance of ambulance trusts, together with their hospitals, is to record the number of occasions when ambulances wait more than 15 minutes before discharging their patients into the service. The Minister of State, my right hon.

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Friend the Member for Chelmsford (Mr Burns), is very concerned and pursues precisely those issues, so I will ask him to look into the matter further and respond to my hon. Friend.

Bill Esterson (Sefton Central) (Lab): The Secretary of State told us earlier that every ambulance trust was meeting core response times, but I have to tell him that that is not the experience of my constituents, including Mrs Taylor, who had to wait 90 minutes after falling down stairs. Is not the truth that this is the result of reorganisation and the resulting cuts are making it impossible for ambulance trusts up and down the country to hit the times he says they are hitting, because they are not actually doing it?

Mr Lansley: No, and I do not think that the staff of ambulance trusts will appreciate the hon. Gentleman generalising from the particular. I have not said that ambulance trusts reach every case in the time we intend, but the figures show that all ambulance trusts across England have met the category A target for responding consistently at a level they have not previously achieved.

Andrew Bridgen (North West Leicestershire) (Con): I welcome the reforms and improvement to the NHS that the Secretary of State is delivering. However, the NHS paid out £1.3 billion in compensation claims last year, a rise of almost 50% on the year before. A spokesman has said that that is partly due to aggressive marketing by no-win, no-fee lawyers. Does my right hon. Friend agree that the current level of compensation claims in this country, in both the public and private sectors, is completely unsustainable and that it is now time to curtail the out-of-control compensation culture?

Mr Lansley: My hon. Friend makes an important point. From our point of view, the legislation that passed through this House in the last Session, led by the Under-Secretary of State for Justice, my hon. Friend the Member for Huntingdon (Mr Djanogly), will be important and will help us in relation to some of these matters, not least on the use of no-win, no-fee arrangements. From time to time it has been deeply frustrating for us all to see that, of the money paid out by the NHS as a result of negligence claims, sometimes more is paid in fees, not least to lawyers, than is provided in compensation to those who have suffered harm. In the NHS we recognise the need to provide compensation when harm has occurred. It is extremely costly. The costs have risen and we want to minimise them. Reducing harm in the NHS will be important, but ensuring that we respond to complaints and offer redress more openly will also help us to manage the extent to which people resort expensively to the courts.

Chris Ruane (Vale of Clwyd) (Lab): Of the 150 lines in the Secretary of State’s statement, only six referred specifically to mental health, despite the fact that between 1991 and 2011 the number of antidepressant prescriptions increased from 9 million to 46 million, a 500% increase. In 2004 NICE recommended mindfulness, a non-drug self-help therapy with no side effects, as better, more efficient and less costly than drug therapy, but it has not been taken up. I am not blaming him, but will we have an inquiry into the reasons for the massive increase in the prescription of antidepressants and the reason why mindfulness has not been taken up?

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Mr Lansley: I reiterate to the hon. Gentleman and to the House that the purpose of reports across the NHS is not to isolate individual conditions and to report on all of them, because if we attempted to do so the resulting document would be not the size of the one before me, but 10 times that. The object is to improve outcomes across the board.

Let me make two points. First, one thing that the NHS did achieve last year involved 528,000 people having access to talking—psychological—therapies, and that in itself should substantially reduce dependence on medication for depression. Secondly, and I think importantly, of the 22 overall objectives established in the NHS Commissioning Board’s draft mandate, the ninth is about making mental health as important as physical health—creating a parity of esteem between the two. The measure is in the Health and Social Care Act 2012, it is being carried through into the objectives of the NHS Commissioning Board and it will, in itself, be important when carried through into practice.

Bob Blackman (Harrow East) (Con): I warmly welcome the improvements in screening, diagnostics and treatment for those suffering from cancer, but patient outcomes are wildly different. For some, 10% of treatment will be successful, for others, 85% will be, and this means that we need more research to highlight which drugs and treatments should be introduced. May I make a bid for part of the surplus to be directed to the expensive equipment that is required to make such research happen, so that treatment and outcomes can be improved?

Mr Lansley: My hon. Friend makes a very important point, and I was happy to announce earlier this year that in response to the report by Professor Sir John Bell and his colleagues we will now put resources behind the establishment of genetic testing centres throughout the NHS, which will enable us to undertake what is known as stratified medicine. This means that, by identifying when medicines have particular benefits for patients with certain genetic characteristics or phenotypes, we will be able to target such treatments, as we will be much more certain of their effectiveness and be able to reduce, as my hon. Friend rightly says, the many cases in which medicines are prescribed but turn out not to be effective in a particular patient’s circumstances.

John Woodcock (Barrow and Furness) (Lab/Co-op): If the Secretary of State really believes that people will accept Ministers standing back from the consequences of their decisions, will he hear from families in my constituency, who are going to be devastated if, after all the turmoil—of which he is well aware—and after the forthcoming review, they are forced to travel for an hour and for 50 miles to receive consultant-led maternity services?

Mr Lansley: I do not construe what we are doing as Ministers stepping back from the consequences of our decisions. The Secretary of State will continue to be responsible for the comprehensive health service, and I fully expect, in the same way as I am making a statement today on the first annual report, that I and my successors will make statements in years to come on annual reports and be held to account for the performance of the service.

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The point is that delivering the best possible care is not achieved by Ministers interfering on a day-to-day basis in how the NHS goes about its task. We have been very clear, through today’s mandate, about what we are looking for the NHS to achieve: consistently improving outcomes. We are not trying to tell the NHS to do so.

Any particular service change, such as the one the hon. Gentleman describes, has to meet four tests: being of clear clinical benefit; responding to the needs and wishes of local service commissioners; responding to strong patient and public engagement; and maintaining and protecting patient choice. If there are any questions and objections, stating that such a service change does not achieve those aims, his local authority has the right under legislation to refer the matter to the Secretary of State for its reconsideration, so I am not taking the Secretary of State out of the process completely.

The safe and sustainable review was set up independently by his right hon. Friend the Member for Leigh, and it has been conducted completely independently, but, in the same way as I have just described, if local authorities have grounds for objections, they have also a mechanism, if they wish to use it, for referral.

Guto Bebb (Aberconwy) (Con): I applaud my right hon. Friend for his statement today and the publication of the annual report, from which I note that 12,500 patients in England have been able to access specialist cancer treatment as a result of the cancer drugs fund. The corresponding figure in Wales is zero, because the Labour Government in Cardiff refuse to put in place a similar scheme in Wales. Does my right hon. Friend agree that cancer patients in Wales deserve access to the same treatment as cancer patients in England?

Mr Lansley: Yes, I could not agree more. It was precisely because Professor Sir Mike Richards undertook an inquiry and produced a report identifying a lack of access in this country to new cancer medicines in the first year after their introduction that we instituted the cancer drugs fund. It is a matter of considerable regret to many of us that that example was not followed in a similar way in Wales.

Mr Andy Slaughter (Hammersmith) (Lab): What message does the Secretary of State have for the 2 million people in west London, four of whose nine major hospitals are set to lose their A and E departments, including both Hammersmith and Charing Cross, in my constituency? That is the Secretary of State’s policy. He cannot pass the buck to the NHS on this or, indeed, on the threat to the Royal Brompton hospital’s children’s services; he has to answer for it.

Mr Lansley: No. Let me reiterate to the hon. Gentleman the point I have just made, because what he describes is not my policy. If there are proposals, they are proposals that have been generated in north-west and west London, and the safe and sustainable review is an independent review. It is not establishing the Government’s policy; it is an independent review in the NHS, looking at how services can be improved.

The review was not in any sense about costs; it was entirely about how we sustain the highest quality of excellent care for patients. The same will be—needs to

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be—true in relation to services in west London for emergency care. I will not go through this all again, but I reiterate that, if people object and say that such an aim will not be achieved, it is open to a local authority to refer the matter to a mere Secretary of State on the basis that the tests I have set down have not been met.

Simon Hughes (Bermondsey and Old Southwark) (LD): I welcome the encouraging and successful results of the work of our NHS staff in delivering the outcomes that the Secretary of State has reported in this first annual report. A vox pop in one of our local papers last month showed that everybody bar one thought that the NHS was doing a good job. The only complaint was that one person had to wait a little too long to be seen by their GP.

One thing that would encourage people also is to know that, if there ever are proposals to discontinue NHS services or to transfer them from NHS management to private or voluntary sector management, they will always be subject to consultation and proceed only with the consent of the public.

Mr Lansley: I am grateful to my right hon. Friend. Let me just separate those two parts. First, when there are changes in a service, such as when there is a proposal to change the provider of community services from, for example, an NHS-owned provider to an independent sector provider, they will be a subject for local consultation.

Secondly, the right hon. Gentleman will recall that, when there is any proposal not to provide a service, the Secretary of State is responsible under legislation for the provision of a comprehensive health service. It is not open, as I have made clear to the right hon. Member for Leigh, to the NHS to discontinue the provision of NHS services. It has to—[Interruption.] He says from a sedentary position, “It is doing so,” but he is completely wrong. I wrote to him this morning.

We have stopped precisely the things that he said used to happen under the Labour Government, and it is precisely the case that trusts and future commissioners will have to maintain a comprehensive health service. They can apply clinical criteria and judge certain treatments to be of relatively poor value, but they must always maintain a service and show how they are responding to the clinical needs of their patients.

Mr Peter Bone (Wellingborough) (Con): Ever since I was elected to Parliament, I have campaigned for an urgent care centre in a hospital in my constituency. Labour took NHS provision out of my constituency, but with the new Nene Valley clinical commissioning group we are going for the first time to have that urgent care centre. So I should welcome the Secretary of State to Wellingborough, but I must warn him that he would be carried shoulder-high through its streets—with people cheering him.

Mr Lansley: I cannot resist the enticement of such an invitation from my hon. Friend. It will reiterate what I found a year or so ago when I visited the nascent Nene Valley commissioning organisation. People there are really taking hold of things and showing how they can improve services in Northamptonshire.

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Tessa Munt (Wells) (LD): Over the past year, the Department of Health has made statements about the fact that radiotherapy is eight times more effective than drugs. It is said that the cancer drugs fund is £100 million underspent and the figures of £150 million and £750 million have been mentioned in connection with new radiotherapy and radiosurgery services. Will the Secretary of State consider transferring at least that underspent funding into radiotherapy and radiosurgery services so that new services in the south-west do not depend on charitable funding?

Mr Lansley: I am grateful to my hon. Friend. The issue is important. In the cancer outcomes strategy, we responded positively to the recommendations of the National Radiotherapy Advisory Group. There was a £400 million programme for the support of radiotherapy; more recently, I have added to that a commitment to build two new centres for proton beam therapy. From about 2015, patients requiring such therapy will not have to go abroad to access it.

My hon. Friend makes an important point. In the early part of this year, we made additional resources available to the NHS supply chain so that more radiotherapy machines could be readily available for purchase or lease through the NHS without costs being incurred over the same period. I will look at what my hon. Friend has said. I think that in the cancer outcomes strategy we have set out all the investment in radiotherapy that we think is clinically indicated, but I will continue to review it.

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Point of Order

1.31 pm

Hugh Bayley (York Central) (Lab) rose—

Mr Speaker: Order.

Hugh Bayley: On a point of order, Mr Speaker. I am sorry; I let my indignation get the better of me.

I have a point of order that I hope you will consider, Mr Speaker. I went twice to the Vote Office this morning to see whether I could get a copy of the NHS annual report so that I could read it before we heard the statement. I was told that it would not be available. Could we change our procedures so that when a Minister is presenting a document to the House, the document itself is circulated around the Chamber as well the statement? Even better, the document could be put in the Vote Office under strict embargo, say, an hour beforehand. Could that be considered?

Mr Speaker: I am grateful to the hon. Gentleman for his point of order. Of course, what he has mentioned is not a matter of current practice and the fact that it is not is what the hon. Gentleman judges to be unsatisfactory, and he seeks a change. It seems a perfectly reasonable subject for consideration by the Procedure Committee, and I doubt whether the hon. Gentleman will require much further encouragement to take the matter up with the right hon. Member for East Yorkshire (Mr Knight).

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Town and Country Planning (Control of Advertisements) (England) Regulations 2007 (Amendment)

Motion for leave to bring in a Bill (Standing Order No. 23)

1.32 pm

Mr Nicholas Brown (Newcastle upon Tyne East) (Lab): I beg to move,

That leave be given to bring in a Bill to amend the Town and Country Planning (Control of Advertisements) (England) Regulations 2007 to limit the display of external advertisements concerning lettings; and for connected purposes.

My Bill is designed to deal with the overuse of estate agents’ “To Let” signs. It has supporters from each of the three main parties. Following the last constituency boundary changes, I represent, for the first time, the mixed residential area of Jesmond in Newcastle upon Tyne. As well as being home to long-term residents, the area has a large population of students and young graduate professionals. The attractiveness of the area is spoilt by a plethora of “To Let” estate agent signs—signs that seem to me to be permanent display items, regardless of whether the flat in question is actually to let or not.

Whatever the justification for the signs in the past, there is not much of a case for them now. Students and young professionals do not use “To Let” signs to find vacant flats; they use the internet, the lettings columns of Newcastle’s The Journal and Evening Chronicle and estate agents’ offices, and students can use the services provided by the universities and student unions.

The situation, of course, is not unique to Newcastle; the same problem occurs in a slightly different guise in seaside towns and other cities—and for the same underlying reason, I suspect. It seems likely that the real reason the estate agent signs proliferate and stay up much longer than for their stated purpose is that they serve as a form of advertisement for the estate agent. In a competitive market, each agent feels the need to have signs to advertise their presence, because rival estate agents have them.

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My Bill has four clauses. The first disapplies schedule 3 to the Town and Country Planning (Control of Advertisements) (England) Regulations 2007 in so far as it applies to “To Let” signs. It deletes the phrase “or letting” from the Act. Thus “For Sale” signs would remain, while lettings signs would not.

Clause 2 enables local authorities to make byelaws regulating “To Let” signs for all or part of the local authority area. That seems to be in keeping with the Government’s desire to shift responsibility for purely local matters to local government.

It would therefore be possible for different rules to apply in different parts of the country according to the wishes of local people, as expressed through their local representatives. Local authorities enjoy day-to-day responsibility for housing policy, as well as local planning issues, so that seems a proportionate and appropriate way of dealing with the issue.

Clause 3 makes it clear that when local authorities have not made rules for “To Let” signs, the default is that the signs should be banned. Clause 4 is a penalties regime on conviction of committing the offence, on the appropriate county court scale, with rising penalties for repeat offenders. I accept that it is currently possible for local authorities to apply to the Department for Communities and Local Government for permission to take steps to deal with the problem. However, the present procedures are cumbersome and disproportionate. My proposal is a much neater and more clear cut way of dealing with the problem, and is rooted in our commitment to local democracy. I commend the Bill to the House.

Question put and agreed to.


That Mr Nicholas Brown, Roberta Blackman-Woods, Frank Dobson, Mrs Sharon Hodgson, Ian Mearns, Miss Anne McIntosh, Catherine McKinnell, Mr George Mudie, Chi Onwurah, Sir Bob Russell, Mr Andrew Smith and Bob Stewart present the Bill.

Mr Nicholas Brown accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday, 7 September 2012 and to be printed (Bill 56).