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Paul Maynard (Blackpool North and Cleveleys) (Con): I welcome with inexplicable joy the announcement on the northern hub, which I have waited to see for so many years. Will the Secretary of State confirm that the amount of investment in the north-west, Yorkshire and the north-east puts to bed any notion whatsoever that the north does not get its fair share of Government funding?
Justine Greening: I absolutely think that. As someone who was born and bred in Yorkshire, I think that the sort of investment now going up to the north of our country is absolutely critical. There is so much talent up there; we just need to make sure we invest to unlock it.
Derek Twigg (Halton) (Lab): The Secretary of State mentioned small interventions that make a big difference. Do her plans include any proposal to look at the Halton curve in Cheshire, which is an important project for both Cheshire and Merseyside, and if they do not will she go away and look at it again?
Justine Greening: That is more of a local scheme, but I will certainly undertake to look at it and see whether I can get back to the hon. Gentleman with some more details.
Joseph Johnson (Orpington) (Con): I welcome the announcement of a £700 million investment for reducing overcrowding and congestion in London and the south-east. Will my right hon. Friend kindly look at the causes of overcrowding on Southeastern’s routes to Orpington, which, extraordinarily for a station of its size, has no fast trains at all during peak hours?
Justine Greening: My hon. Friend is right to raise the issue of capacity in London, particularly on his line, which I know local MPs have had real concerns about. We are looking to work closely with operators such as Transport for London to see what we can do together to improve those services over time. As I said earlier, 120,000 more people are catered for in these plans, which we have worked up very carefully. I think that it is very good news for commuters in London.
Mr Brian H. Donohoe (Central Ayrshire) (Lab): I welcome the statement, if it is not in fact one about jam tomorrow. In those circumstances, can the Secretary of State give some indication of what additional resources will be put into the railway system this side of the general election and, in particular, how much extra will be paid to the Scottish Parliament?
Greg Mulholland (Leeds North West) (LD) rose—
Mr Deputy Speaker (Mr Lindsay Hoyle): Order.
Justine Greening:
The hon. Member for Central Ayrshire (Mr Donohoe) will know that transport in Scotland is a devolved matter. He will also know that in the spending review we have committed £18 billion for the railway network, an outstanding amount of investment that can make a huge difference. Of course, today’s announcement adds further to that pipeline. I think that the certainty it will give the industry about the investment coming down the track will really help to ensure that we get the
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most out of the improvement not only for passengers and freight, but for jobs and growth, particularly in the railway industry.
Greg Mulholland: Thank you, Mr Deputy Speaker. That is probably the closest I will get to the Dispatch Box—[Hon. Members: “Hear, hear!”]—in this Parliament. In the last Parliament Labour’s contribution to tackling congestion in Leeds was cancelling the Leeds supertram and continuing to insist on a no-growth franchise for Northern Rail. Susie Cawood, from the Leeds, York and North Yorkshire chamber of commerce has said:
“The chamber welcomes government investment in the rail network…Continued investment is essential to ensure we remain competitive and continue to attract inward investment and grow our existing businesses—
Mr Deputy Speaker: Order. The hon. Gentleman should not take advantage of a situation. Many Members want to get in and this has to finish at five past 5. In fairness, we all have to get in.
Justine Greening: The hon. Gentleman is absolutely right that this investment will make a big difference to Leeds. It is not just on the back of the north trans-Pennine express electrification. He will also know that the £240 million investment in the east coast main line will also improve services for his constituents. Of course, he will be aware that in the longer term we are investing in High Speed 2, which will have a stop in Leeds.
Diana Johnson (Kingston upon Hull North) (Lab): Despite my constituents paying ever higher fares to travel by train, Hull will be the largest city in this country without electrification. Why is that?
Justine Greening: We are working our way around the UK. In fact, by the end of this decade around three quarters of passenger miles will be on electrified railways. I can assure the hon. Lady that the Government absolutely want to progress electrification—it is better for the railways overall, it has a good business case, and it is good for the environment—but obviously we still have to cut our cloth to meet the public affordability needs, which is what we are trying to do. She will know that I have taken a real interest in her area, which is one of the reasons why, while I have been Secretary of State for Transport, we have halved the tolls on the Humber bridge.
Anna Soubry (Broxtowe) (Con): This is a great day for Greater Nottingham, which has waited many years for the electrification of the midland main line. Can the Secretary of State, whom I thank from the bottom of my heart, confirm that it will give a real economic boost to Beeston in my constituency, to the enterprise zone, and to the business park which is bang opposite the station?
Justine Greening: I am absolutely sure that it will. We are developing a fantastic midland main line for what is a fantastic city.
Ian Lavery (Wansbeck) (Lab):
We have got the lines, we have got some stations; the only problem on the Ashington-Blyth-Tyne line is that we have not got any
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trains. Can the Transport Secretary explain how much of the £9 billion investment will go towards reopening the Ashington-Blyth-Tyne line?
Justine Greening: We are looking at whether there is any possibility of opening lines. Our main focus has been on whether we can improve stations, and in fact open new ones, but over time we may be able to unlock some of those local decisions through the Department’s decentralisation approach. We have just consulted on that, some very interesting responses have come through and I hope that we will make some announcements later. I take the hon. Gentleman’s point with real interest.
Dr Thérèse Coffey (Suffolk Coastal) (Con): May I say how delighted we are about the Ely North junction? It is great news for East Anglia and for unlocking freight from Felixstowe, and we commend the Secretary of State on it. What further junctions can we look forward to for unlocking freight?
Justine Greening: My hon. Friend has raised the issue tirelessly and recently had a Westminster Hall debate on the topic, and it is campaigners such as my hon. Friend who have really powerfully put the case to Ministers for looking at the issue and seeing what we can do to tackle it. The Ely junction will be done, and it matters massively, because it creates the potential for enhanced passenger services between Cambridge, King’s Lynn and Norwich, so it will have broader benefits, including freight, which, with Felixstowe nearby in her constituency, I know is close to her heart.
Huw Irranca-Davies (Ogmore) (Lab): While indeed welcoming the news that an electrified train will be heading down the tracks to Swansea, and to Maesteg, at some point in the future, we note that there is a two-year delay, so when will the train be arriving in Swansea, and when in Maesteg?
Justine Greening: I assure the hon. Gentleman that we are cracking on with the programme now, and that is precisely why it has been announced today as part of our priority for the next control period. We will work on it with the Welsh Assembly Government, and I am sure that we will be able to release more details to him shortly.
Mr Andrew Turner (Isle of Wight) (Con): Of every 100 people, a mere three travel by train. A huge subsidy is proposed for the £870 million loss that covers CrossCountry Trains and East Midlands Trains, and that does not even cover the infrastructure costs. How are we to justify such massive expenditure that will benefit so few?
Justine Greening:
Our investment proposal today is about making sure that we have a railway network that can cope with the level of demand in coming years, and that is absolutely critical for our economy, but my hon. Friend is right that we have to ensure that the railways are efficient, and a railway system that every year costs us £3.5 billion more than it needs to is not acceptable. That is why in order to address efficiency we have some difficult challenges ahead of us, but we are going to work with the industry to do that, because the points that he makes are absolutely valid. We have to tackle
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inefficiency. Well-run organisations provide a better service to their customers, and I am determined to turn the railways into a well-run organisation.
Mr George Howarth (Knowsley) (Lab): I welcome the Secretary of State’s statement, but can she assure me that the west coast main line franchise will not be determined on the basis of job cuts and a corresponding reduction in service to the travelling public?
Justine Greening: We have been very clear about wanting to see improvements in the west coast main line service, and we have actually seen passenger numbers on that franchise grow rapidly over recent years. We want to see those improvements continue and, at the same time, we want value for money for the taxpayer. I hope that some of the investment that we are putting in across the network today will help support all that, and the right hon. Gentleman will obviously be interested to see the outcome of the tender process later on.
David Rutley (Macclesfield) (Con): Unlike Opposition Members, I welcome today’s statement. Will my right hon. Friend confirm that the northern hub electrification will lead to improved journey times, more frequent trains and much better connectivity between the great towns and cities in the north-west of England?
Justine Greening: Yes, yes and yes.
Meg Munn (Sheffield, Heeley) (Lab/Co-op): I, too, welcome the electrification of the midland main line. [Hon. Members: “Hooray!”] But a letter from the Minister of State, the right hon. Member for Chipping Barnet (Mrs Villiers), arrived in my inbox shortly before this statement. It says:
“Completion of Midland Mainline electrification is proposed for 2019.”
That is seven years away. Given the increasing north-south divide, I urge the Secretary of State to bring it forward so that we get the benefits more quickly.
Justine Greening: To reassure the hon. Lady, I should say that we are looking at whether we can commence some of the investment earlier. We have had to set out our basic proposals, of course, but let us be clear: today we are setting out a statement of output—what we want to get out of the railway system. It is now for the industry to go away and look at how it can achieve the outcomes that we are specifying. The midland main line electrification is one of the key, explicit schemes that we have said we want to bring forward. If the industry has a proposal to do it faster than the timeline that we have mentioned, I have no doubt that we will be very interested in looking at it.
Sir Bob Russell (Colchester) (LD): The Secretary of State is fully aware of the east of England rail prospectus. I put it to her that for those of us served by the Greater Anglia line, her statement today is very disappointing. When might we expect the entire east of England rail prospectus to be implemented?
Justine Greening:
The hon. Gentleman will see improvements in services and capacity over the coming years. Many of the improvements that we are announcing on the network today can improve his area, too—not
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least through the potential to improve stations and see Access for All stations brought to his area. There is also investment in safety at level crossings and the general pots that we put in place to improve passenger experience and the strategic freight network. There is a huge number of different aspects to the investment, and I am sure that many of them will relate to the hon. Gentleman’s community.
Sammy Wilson (East Antrim) (DUP): Will today’s announcement have any budgetary implications for devolved Administrations through the Barnett formula? What practical measures has the Secretary of State put in the procurement provisions to ensure that her aspiration of jobs for British industry and the UK supply chain is realised by this investment?
Justine Greening: On the hon. Gentleman’s point about jobs and growth, I should say that absolutely I have looked not only at what we need on our network and the investment profile but at getting a really clear understanding of how the measures can help support jobs and growth, particularly in the railway industry.
The hon. Gentleman knows that I am keen to make sure that the money that we are spending as a Government benefits not just passengers but the industry, in creating more jobs. We will continue to look at how we can make sure that our procurement processes work effectively and I certainly hope that we can do more to support our industry than the last Government.
David Tredinnick (Bosworth) (Con): Will my right hon. Friend confirm that the journey time from Leicester to London will now be under an hour, at 58 minutes, and that we will get new electric trains? Will she be straightening out the Harborough curves, which have long been an obstacle to electrification?
Justine Greening: I can confirm those journey-time improvements for my hon. Friend’s constituents, who will welcome that, as I do. On the particular aspect of the curves, I will make sure that I write to him so that I get my facts right, but I hope and believe that there will be a positive response on that, too.
Kevin Brennan (Cardiff West) (Lab): I am glad that the Secretary of State was able to work positively with the Welsh Government over the electrification of the valley lines and the extension to Swansea. Has any financial contribution from the Welsh Government been involved?
Justine Greening:
The hon. Gentleman is right to say that we worked closely not only with the Secretary of State for Wales but the Welsh Assembly Government. I met Carl Sergeant a few times to discuss these proposals. As regards how the financing will work, the basic scheme for the valleys is £300 million. That is funded through track access charges that franchise operators will pay. It pays them to do this, because they save money through electrification, which reduces their operating costs. Once the valleys electrification has been completed, that, in essence, will electrify the line to Bridgend, which means that the final piece to Swansea becomes worth doing. It also simplifies our rolling stock procurement.
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The final piece of the Bridgend to Swansea electrification is being funded by the UK Government to the tune of £50 million. All in all, it is a good deal for Wales.
Jessica Lee (Erewash) (Con): I welcome the announcement that a fund will be made available to consider applications for railway stations to be opened. My right hon. Friend will recall a meeting earlier this year with me and representatives from Derbyshire county council regarding the Ilkeston train station project. There is a strong regeneration case for that important project, and it is well matched with the fund that has been announced today, so does she, too, hope that it can be delivered?
Justine Greening: Ultimately that will be a decision for Network Rail. Let me be clear, though, that it was the meetings I had with my hon. Friend and her local councillors that brought home to me the fact that money needed to be set aside to make sure that new stations can be opened for the communities that need them where growth is happening. I very much hope that her Ilkeston station plan will go forward to the competition bid, and I will look with real interest to see it come through.
Jeremy Corbyn (Islington North) (Lab): Does the electrification programme include the electrification of the Barking to Gospel Oak section of London overground? I had a meeting with one of her colleagues about this some months ago. It would make freight transportation from the east of England easier, improve passenger services, save a lot of money, and be environmentally sensible. Will she go for it?
Justine Greening: I take the hon. Gentleman’s point. That is not part of the electrification plans that we have announced today. Ultimately it is for Transport for London to fund it if it wants to do so, but I am sure that it will take on board the points that the hon. Gentleman has made and, if the business case stacks up, might consider it.
Sir Tony Baldry (Banbury) (Con): I thank my right hon. Friend for all that she is doing on the east-west rail link. It has been quite difficult keeping up with all the good news today. Will she therefore arrange to put in the Library a map of the national rail network as she envisages it in 2020 and in 2025 so that we can share it with our constituents?
Justine Greening: I will make sure that that is done. My hon. Friend will see huge swathes of the network being newly electrified and pockets of growth in our key cities where we are now meeting demand.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op): The Secretary of State should be congratulated on any investment for our country, for the Yorkshire region, for the northern hub and for Huddersfield, but according to the classic economic theory of Keynes, this country is in a deep recession, and we need this investment now, not in two years’ time.
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Justine Greening: To provide the hon. Gentleman with some reassurance, we are getting on with huge amounts of investment right now. Of course, if we want to be ready to get the next pipeline kicked off in 2014, we have to announce it today so that the industry can start to look at what we want and then come back with proposals on achieving it. He is absolutely right to say that projects such as the northern hub are crucial. I am very proud and pleased that we have been able to announce that investment, and I look forward to working with him as we develop these proposals.
Andrew George (St Ives) (LD): Welcome as today’s announcement is, and although I hate to rain on the right hon. Lady’s parade, I fear that they will not be dancing in the streets of Penzance by the end of the week if the Government go ahead, as we suspect, with reducing the service by a third. Will she reassure my constituents that this welcome investment in and improvement of the rail service across the country as a whole is not built on the back of cuts to the service to Penzance?
Justine Greening: I am aware of the hon. Gentleman’s concerns, which he is going to talk through tomorrow with the Minister of State for Transport, my right hon. Friend the Member for Chipping Barnet (Mrs Villiers). I assure him that no final decisions have been made. I emphasise that the HLOS investment that we are making will open up real opportunities for us to cascade rolling stock. For example, the high-speed diesel fleet that is currently on the midland main line—the Meridian stock—will be available, and we will see how we can use that effectively on other parts of the network.
Chris Bryant (Rhondda) (Lab): The people of the Rhondda Fawr will doubtless want to get out the bunting and skip for joy—[Hon. Members: “Hear, hear!”] They will doubtless want to do so when the Treherbert to Cardiff line has been electrified. What date should I put in my diary for the opening of that electrified line? Will it happen before the review of constituency boundaries and before Lords reform, or perhaps after?
Justine Greening: It is nice to know that the hon. Gentleman looks at things through such a political lens, rather than from the perspective of his local community. This investment will take place from 2014 to 2019. It will make a huge difference to communities such as his. I only wish that he could support it wholeheartedly and without reservation.
Eric Ollerenshaw (Lancaster and Fleetwood) (Con): May I add my congratulations to my right hon. Friend on how much she is doing in the north-west to deal with the neglect of the previous Government? What will she do about towns such as Fleetwood in my constituency, which had 13 years of rusty railway lines and still have no trains on them?
Justine Greening:
That is really a local matter for my hon. Friend’s regional passenger transport executive. As he will know, we are electrifying the Manchester to Blackpool railway line, which will provide real benefits. I am keen, as colleagues across the House know, to
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understand what people want next. If I know what they want next, I can set about seeing whether we can provide it.
Jonathan Reynolds (Stalybridge and Hyde) (Lab/Co-op): I am pleased that the northern hub is proceeding. It could give us six trains an hour between Manchester and Leeds, running through my constituency. Does the Secretary of State agree that it would be wrong to sacrifice local services, such as those connecting Mossley and Ashton, to make way for extra inter-city services, and that the train operating companies should use any extra capacity and infrastructure to improve services for everybody?
Justine Greening: We are careful to ensure that we understand the impacts of the northern hub. For example, today’s announcement includes increased capacity at Huddersfield station to maximise the benefits of the northern hub investment. We will continue to look at how we can do that across the whole of the network. I believe that this project will be hugely influential in unlocking economic growth across the Pennines—linking up the areas as they have always wanted.
Elizabeth Truss (South West Norfolk) (Con): I thank my right hon. Friend for her commitment to upgrade the Ely North junction. May I ask that half-hourly services to King’s Lynn be specified in the Thameslink franchise agreement in 2013 and the Norwich to Cambridge franchise agreement in 2014 so that passengers can see the benefit of that upgrade?
Justine Greening: It is too early to say exactly what will be specified in the franchise contracts, but many of the investment proposals that we have put in place today, which the industry will come back to us with more detailed versions of, allow the potential for more frequent services. I know that that is exactly what communities such as my hon. Friend’s want. We are building headroom for growth into the railway network for the communities that need it.
Jonathan Edwards (Carmarthen East and Dinefwr) (PC): I find myself in the strange position of congratulating the Government on their statement. It goes part of the way to making up for the historical underfunding of the Welsh railways. The north Wales coast line and the line west of Swansea are vital links between the mainland and Ireland, which is a major trading partner of the Welsh economy and the wider UK economy. What discussions are happening between the Department, the Welsh Government and European institutions about using Wales’s share of HS2—
Mr Deputy Speaker (Mr Lindsay Hoyle): Order.
Justine Greening: I understand the point that the hon. Gentleman is making. It is a relevant question. The Welsh Government have not raised that issue with me directly, but it is something that I am interested in considering. Perhaps he will forgive me if I reflect and get back to him as my thinking on HS2 develops.
Henry Smith (Crawley) (Con): Does my right hon. Friend agree that the reported contention of the Opposition that this significant rail investment will not create jobs is completely absurd?
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Justine Greening: It is totally absurd. Of the £9.4 billion of investment, up to half could benefit business directly. It will be massively important for local economies and for jobs and growth. Its effect will go well beyond the rail industry, for example by connecting up airports and ports. My hon. Friend’s local airport at Gatwick is receiving investment for its station. All those things are important in providing our country with a joined-up transport system that supports efficient end-to-end journeys for passengers and businesses.
Jonathan Ashworth (Leicester South) (Lab): The Secretary of State will know that there has been a huge cross-party campaign for electrification of the midland main line, so I am delighted to welcome her announcement, including what she said about the upgrade of the Leicester junction. She will know that commuters want that work to start as quickly as possible, so will she undertake that it will start closer to 2014 than 2019?
Justine Greening: It depends on the industry’s response to the outputs that we have said today we want to achieve. I can assure the hon. Gentleman that I do not generally let the grass grow under my feet. I like to get on with things and get them sorted out, so we will get on with all these projects as fast as we can.
Duncan Hames (Chippenham) (LD): What a tremendous statement! Lighter electric trains accelerate and decelerate faster, allowing for intermediary stops serving communities such as Corsham, in my constituency, as long as we are successful in winning a new station in the competition that the Secretary of State has announced today. Will any of that multi-million-pound fund be available before control period 5?
Justine Greening: I am looking at how the competition and the bids will work, and I believe we can get a lot of learnings from how individual communities and local authorities respond. We can see how the local authority major roads programme worked—it was an effective process in getting local authorities to work with local enterprise partnerships and say what their road network needed. I am interested to see how this pot of money can do the same thing for new stations in communities such as my hon. Friend’s. Once we have got those learnings, there is no reason why we cannot start to pull forward that investment.
Paul Blomfield (Sheffield Central) (Lab): I welcome the Secretary of State’s statement, but may I ask her for further clarification of her earlier answers about track improvements? In particular, will the programme include track improvements at all three bottlenecks on the midland main line—Derby, Leicester and Market Harborough —without which we will not get the targeted improvements in journey times?
Justine Greening: I will need to confirm that specific point, but I am certainly aware that track improvements will happen at Leicester. I believe that they will also happen at Derby, but I will need to find out about Market Harborough and write to the hon. Gentleman.
Mr Peter Bone (Wellingborough) (Con):
Rail passengers in Wellingborough will warmly welcome the statement, but does the Secretary of State share my concern that
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the announcement was leaked to the press in advance of being given to Parliament? Would she express her surprise that the Deputy Prime Minister was on television promoting the statement, apparently in breach of the ministerial code?
Justine Greening: I was concerned. This is obviously an important announcement, and I can understand why people would be keen to make it. I e-mailed and wrote to all Departments to emphasise to them when the announcement was embargoed until, so of course it was disappointing to see some of it leak out earlier.
Nia Griffith (Llanelli) (Lab): I thank the Secretary of State for her close working with the Welsh Government and for listening to the lobbying from south-west Wales, ably led by my hon. Friend the Member for Swansea West (Geraint Davies). I also thank her for the comments that she has just made about looking further west. Will she give special consideration to starting the project to Swansea in time for the Dylan Thomas centenary year in 2014?
Justine Greening: I believe that may be something of a stretch, but we will wait to see what the industry says about how quickly it can deliver the plan and develop the proposals. There is a lot of work to be done, but the most important thing is that we have signalled that it is going ahead. I appreciate the support of the hon. Lady and her colleagues, and I have to say that I have had a huge amount of lobbying by Government MPs from Wales as well. Together, they have made a real difference by getting across the case for investment.
Jason McCartney (Colne Valley) (Con): I very much welcome the fully funded northern hub project, the investment in Huddersfield railway station and the new station fund, which my community of Milnsbridge may go for. Will the Secretary of State confirm the importance of connectivity and local stopping services, so that people in Slaithwaite, Marsden, Lockwood, Honley and Brockholes get full benefit from this transformational announcement?
Justine Greening: We want many communities to benefit from the announcement, and frankly, the more people we can get on the railways, the more successful they will be. That means connecting as many communities as possible, which is the approach that I am taking to High Speed 2 and to the current network. That is one reason why, for the first time, I have set aside some money for new stations.
Frank Dobson (Holborn and St Pancras) (Lab): As the Member representing St Pancras, may I ask the Secretary of State whether she is really satisfied that it will be 2019 before the first electric train arrives from Sheffield at that magnificent station, which was so magnificently refurbished under the Labour Government to provide a connection for the channel tunnel link and fast trains to the Olympic games?
Justine Greening:
The right hon. Gentleman looks forward, as I do, to a time when trains that arrive at St Pancras are not dirty diesel trains but clean electric
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ones. I think that that will have a positive impact on the environment in that station. St Pancras station is an amazing building. It is impossible to walk in without gasping at the wonderful architecture, and those of us who want more members of the next generation go into design, technology and engineering should take them to St Pancras, which will get them fired up.
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. We have only five more minutes—let us try to get through as many questions as possible.
Heather Wheeler (South Derbyshire) (Con): I thank my right hon. Friend and all the Ministers and Parliamentary Private Secretaries who have worked hard with all the local MPs to make sure that this new electric spine is achieved. The point is we have a spine, and we waited 13 years for someone else to find one.
Justine Greening: I do not think I could put it better myself. My hon. Friend is absolutely right.
Geraint Davies (Swansea West) (Lab/Co-op): In 2014, we celebrate the 100th anniversary of Dylan Thomas’s birth. May I thank the Secretary of State for ensuring that in that year we can herald a new beginning to electrification to Swansea bay city region, encouraging inward investment and growth? Will she assure me that a door will be opened for more investment in transport infrastructure, including ports and roads?
Justine Greening: I understand how important this investment is. I think that it was Admiral insurance that wrote to me saying what a difference the investment could make to jobs in the area. It was precisely those sorts of representations I reflected on, which is why I know that the investment will make a huge difference.
Dr Andrew Murrison (South West Wiltshire) (Con): I warmly welcome the statement. What will the Transport Secretary do to dispel the impression that the south-west is the poor country cousin of the railway network, which will of course be underscored by HS2 and the north-south electric spine? She will want to address particularly the plight of residents west of Salisbury.
Justine Greening: I am always keen to look particularly at what we can do to improve transport infrastructure in the south-west. There is an issue of resilience for the railway and road network, but my hon. Friend will remember that we announced the electrification of the Great Western railway line, and we have announced an intercity express programme that will result in more capacity on that line and the potential for more frequent services. Perhaps less close to him, in Bristol, we have announced today substantial investment in Bristol Temple Meads station. All those things will begin to strengthen the south-west transport system, but I would like to see what we can do to go further and do better.
Nigel Adams (Selby and Ainsty) (Con):
My right hon. Friend the Minister of State, Department for Transport kindly met members of the Selby and district rail users group and me to discuss the electrification of the line from Micklefield to Selby. They will be delighted
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to hear that the scheme will go ahead. Will the Secretary of State confirm that that historic investment will contribute to the control of fare rises and will reduce overcrowding for my constituents in Selby?
Justine Greening: The Micklefield to Selby electrification opens up a second route to the north of Leeds, as my hon. Friend will be aware. It also means that potentially we can have three trains an hour serving London. He is right: electrification means that we have a lower-cost railway, which is the key to getting off the hook of having to pass on above-inflation rail-fare rises to passengers every year.
Andrew Bingham (High Peak) (Con): I welcome the investment in line speed and capacity improvement on the links between Manchester and Sheffield. The Hope Valley line through my constituency provides a vital link for freight and passengers. Does my right hon. Friend agree that investment in that line will benefit not only the two great cities but many of my High Peak constituents?
Justine Greening: Yes it will. The more freight we can get off the road, the better. The more options we can give people to get off the road, the better.
Dr Julian Huppert (Cambridge) (LD): I congratulate the Secretary of State and her team on this excellent announcement. In 13 years, the previous Government managed to electrify nine miles—a distance that a garden snail could cover in 15 days. They also allowed rail fares to go up by 66%. Does the Secretary of State agree that rail fares are too high, and that it is time to end above-inflation rail fare increases?
Justine Greening: I have to say that I did not know that snails were that fast, but I believe we need to try to get off this hook of above-inflation rail fare rises every year, which is one reason why we are looking at the efficiency savings programme that Roy McNulty first outlined. Today’s investment in electrification will be a key part of that as well.
Stephen Hammond (Wimbledon) (Con):
In my right hon. Friend’s time as Secretary of State, a new Victorian era of rail investment is not only being promised but delivered. Does she agree that removing some of the
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bottlenecks is key to capacity? Will she use some of the £700 million that is available so that users of the Wimbledon loop will gain the full benefits of Thameslink?
Justine Greening: I am sure that we will look closely at the case my hon. Friend has made. I know he has worked very hard, alongside other local MPs, to see local railway services improved. Wimbledon itself is a key railway hub for his local area. It plays a really important role, and I am keen to see what we can do to improve it.
Penny Mordaunt (Portsmouth North) (Con): I congratulate the Secretary of State on this announcement, and particularly the investment in the Portsmouth to London line and longer rail franchise agreements. If she will forgive my greed, will she consider writing into those new agreements basic passenger comfort standards, such as seat design and toilet provision, so we can ensure the quality and accessibility of these services?
Justine Greening: I have met my hon. Friend to discuss some of her concerns about the rolling stock used by some of her constituents on local lines. I take those points very seriously. That is why one of the pots of money we have set aside is to improve the passenger experience. It may seem like a small thing to have adequate toilet provision on trains, but for many people, particularly for mothers with kids, it is really important. My hon. Friend is therefore right to raise this point.
Mr Robert Buckland (South Swindon) (Con): Businesses and residents in Swindon will warmly welcome the Government’s commitment to a new rail western access to Heathrow. Connectivity is the key. Will my right hon. Friend assure me that with the extension of electrification through to south Wales and Swansea, we will see electric-only rolling stock on the cross-country Great Western line?
Justine Greening: We will move to electrify the rolling stock, too. It is one way of ensuring that we keep operating costs down. My hon. Friend’s constituents could see a 30-minute reduction in their journey time to Heathrow. That will benefit not just his area but the whole of the south-west.
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. Unfortunately, I am going to have to cut off debate on the statement now.
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Points of Order
5.12 pm
Mr Kevan Jones (North Durham) (Lab): On a point of order, Mr Deputy Speaker. At Defence questions, the Secretary of State announced that he was going to lay a written ministerial statement tomorrow on the future of Defence Equipment and Support—the equipment arm of the Ministry of Defence. He said that a decision had been taken to run the organisation by a Government-owned, contractor-operated model. This decision has been the subject of debate, delay, review and speculation over the last two years. In the light of how important this matter is—not only to those working in the defence sector but to many Members—is it right for it to be announced through a written ministerial statement rather than an oral statement and on the last day before the House rises for the summer recess, as it denies us the opportunity to scrutinise this very important decision?
Mr Deputy Speaker (Mr Lindsay Hoyle): The hon. Member has put his point on the record, and I am sure that the Secretary of State for Defence will be made aware of his comments.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab): On 4 July, the Under-Secretary of State for Education, the hon. Member for East Worthing and Shoreham (Tim Loughton), who has responsibility for children and young families, told me in a written answer that he was not aware of any individuals recruited to civil service positions in his Department who had previously been employed or elected in political positions. I am aware of at least three such appointments to senior positions— Janet Grauberg, Alexandra Gowlland and Elena Narozanski—and there may be more. I am certain that the Minister would not knowingly have misled the House, so I can only assume that he had not confirmed the accuracy of the answer he was given, despite the fact it took over a month to provide it. Mr Deputy Speaker, will you advise whether it is still the case that Ministers are responsible to Parliament for the accuracy of the information they give to it? What steps can be taken to ensure that the Minister comes to Parliament to correct the record?
Mr Deputy Speaker: As the hon. Lady knows, the occupant of the Chair is not responsible for the answers that Ministers provide. She has nevertheless put her point on the record, and I am sure it will be taken up.
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Opposition Day
National Health Service
5.14 pm
Andy Burnham (Leigh) (Lab): I beg to move
That this House regrets the growing gap between Ministers’ statements and what is happening in the NHS; notes mounting evidence of rationing of treatments and services by cost, despite Ministers’ claims to have prevented it; further regrets the increasing number of cost-driven reconfigurations of hospital services, despite the Coalition Agreement’s promise of a moratorium on changes to hospital services; further notes growing private sector involvement in both the commissioning and provision of NHS services, contradicting Ministers’ claims that the NHS reorganisation would not increase levels of privatisation; recognises that, according to the Government’s Public Expenditure Statistical Analyses figures, actual Government spending on the NHS in 2011-12 fell by £26 million, the second successive real-terms reduction in NHS spending, following a reduction of £766 million in the Government’s first year in office, in breach of the commitment in the Coalition Agreement; believes the Government’s decision to reorganise the NHS has distracted its focus from the financial challenge, with seven out of 10 acute hospital trusts in England missing savings targets in the first half of 2011-12; calls on the Government to take action to prevent rationing by cost in the NHS, based on the evidence presented; and further calls on the Government to honour pledges on NHS spending in the Coalition Agreement, and the commitment that future savings will be reinvested into the NHS front line, and to return at least half of the underspend to the Department of Health budget.
The year 2011 was the first full year of the coalition Government and the year of the biggest ever fall in public satisfaction with the national health service. As I shall set out, those two facts are not unconnected. The NHS in England is reeling from the Government’s catastrophic decision to reorganise it at a time of huge financial pressure. Warnings by Opposition Members and others during the passage of the Health and Social Care Act 2012 of a postcode lottery, of destabilised hospitals and of increasing privatisation are, sadly, beginning to materialise.
For the coalition, attention has moved to other battles—more pressing priorities—but for the NHS the moment of greatest danger is now, as the unstoppable force of reorganisation hits the immovable object of the financial challenge. That is why the Opposition make no apology for introducing this debate, or for bringing the House’s attention back to where it should be: our country’s most important public service and the struggle it faces.
I am grateful for the Secretary of State’s letter—[Interruption.] I can hear him mumbling away on the Government Front Bench. I would have thought the debate would justify his attention, as it justifies that of the Minister of State, the right hon. Member for Chelmsford (Mr Burns). The Opposition have introduced this debate to support NHS staff. We thank them for what they do. They have a huge capacity to deal with whatever is thrown at them, but they have been set mission impossible by the Government. One can only wonder how they felt on hearing the news that the Deputy Prime Minister had the chance to stop this reorganisation but chose to prioritise House of Lords reform. A million hearts will have sunk.
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It was not just the Government’s decision to reorganise that was wrong; the way they have gone about it was wrong as well.
Mr Graham Stuart (Beverley and Holderness) (Con): The right hon. Gentleman will know that the Chair of the Public Accounts Committee said that productivity fell continuously for a decade under the previous Government. Does he regret that and recognise that radical change is required to get the productivity improvements this country desperately needs if we are to be able to afford the NHS we all want?
Andy Burnham: I am afraid the hon. Gentleman is out of date, because the figures cited by the Government are wrong. NHS productivity was improving by the time Labour left office. The independent and authoritative Commonwealth Fund pronounced the NHS the most efficient health care system in the world in June 2010. That was the legacy of the Labour Government, which the Conservative party is putting at risk.
As I have said, it was not just the decision to reorganise that was wrong; the way the Government have gone about it is also wrong. Before the ink was dry on their White Paper, Ministers set about dismantling existing NHS structures before the new ones were in place. That is a dangerous move at any time, but disastrous at a moment of financial crisis.
We have therefore had drift in the NHS: a loss of focus at local level and a loss of grip on the money just when it was most needed. At a stroke, the Government demoralised the very work force who would be crucial to managing the transition, with primary care trust managers dismissed as worthless. Experienced people left in droves. Those who stayed hoping for jobs in the new world were issued with scorched earth instructions: “Get on and do the unpopular stuff now—the rationing and the reconfiguration—so the new clinical commissioning groups don’t have to.”
We can now see the consequences across England: brutal, cost-driven plans for hospital reconfiguration being railroaded through on an impossible timetable without adequate consultation; walk-in centres being closed left, right and centre; and people left in pain and discomfort, or facing charges for treatment, as PCTs introduce restrictions on 125 separate treatments and services.
Mr Andy Slaughter (Hammersmith) (Lab): On the subject of brutal closures, did my right hon. Friend have a chance to look at the authoritative report by David Rose in The Mail On Sunday yesterday about the “Beeching-style” closure of major casualty units? Four out of nine of the units to be closed are in west London, leaving my constituents and 2 million people in west London without adequate health cover.
Andy Burnham: I have no idea how Ministers expect west London to cope with service reductions on that scale, nor do I know how they square them with the moratorium on hospital closures and changes which they promised at the last election. Perhaps we will hear some justification later today, although I will turn to reconfigurations shortly.
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Stephen Pound (Ealing North) (Lab): Further to the previous question, the hon. Member for Ealing Central and Acton (Angie Bray) has said that this is all about finance, and she may well be right. However, bearing in mind the fact that Ealing hospital not only came in under budget but produced an operating surplus last year, what possible justification can there be for ripping this crucial and much-needed service from the heart of our community?
Andy Burnham: My hon. Friend makes his point powerfully. With some reconfigurations there is a clinical case supporting change, such as the changes I introduced in London before the last election to improve stroke services. We reduced the number of centres from 12 to eight. That was a difficult decision for many London Members at the time, but it was the right thing to do because lives are being saved. However, there is a world of difference between those changes and the crude, cost-driven reconfigurations in the NHS that those on the Government Benches said they would not allow.
I spent my weekend reading a very entertaining book entitled “Never Again? The story of the Health and Social Care Act 2012: A study in coalition government and policy making”. It is a very interesting book and offers a new, detailed account, by Nick Timmins, of the Government’s NHS reorganisation—or, as it says on the blurb, the inside story of a “car crash”. I particularly enjoyed the quotation from the Minister of State—I gather that he has not read it, but there he is, up in lights at the very beginning of the book. He made this comment about the then Bill, which the author thought worthy of special attention:
“You cannot encapsulate in one or two sentences the main thrust of this.”
He should know that better than anybody, as he toured more media studios than anybody, and used more sentences than anyone, in a vain attempt to sell the technocratic and dense plans that made sense to his boss and nobody else.
Mrs Anne Main (St Albans) (Con): Given that the biggest strain on most health authorities is staff pay, does the right hon. Gentleman regret the fact that Labour doubled the remuneration of GPs, allowing them to opt out and thus putting huge stresses on many health care authorities, which then had to buy in additional services? Does Labour not regret allowing doctors to be paid more for doing less?
Andy Burnham: I am interested in the argument that the hon. Lady is beginning to develop, which is that she wants to deliver pay cuts to NHS staff across her constituency. Presumably she wants the same as people in the south-west are getting. Is that what she is calling for? It is an interesting argument, and I would be interested to hear her expand on it later.
Barry Gardiner (Brent North) (Lab): Will my right hon. Friend give way?
What I found most useful about the book is that it answered a question that has been nagging away in my mind for some time. As a former Health Secretary, I remember clearly the warnings I received from senior
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civil servants about the sheer scale of the £20 billion efficiency challenge. “It would be a major undertaking,” they said. “The NHS would need to focus all its energy on that alone. To be negotiated safely, new policy initiatives would have to be put on hold.” Over the months that have followed, I have often had cause to recall those words, as I watch the Secretary of State add to the financial challenge with the biggest ever reorganisation in NHS history. Did the same civil servants issue the same apocalyptic warnings to the incoming Secretary of State as they did to me? Finally I have my answer, in a quotation in the book from an unnamed senior civil servant:
“The biggest challenge was trying to get the secretary of state to focus on the money—the £20 billion and the sheer scale of the financial challenge”.
According to that civil servant, however, the Secretary of State’s attitude was:
“I am going to do these reforms anyway, irrespective of whether there are any financial issues. I am not going to let the mere matter of the financial context stop me getting on with this”.
Another civil servant is quoted as saying:
“We did point out to him that his plans were written before the big financial challenge, and didn’t that change things? He completely did not see that at all. He completely ignored it”.
Then the question is asked: was the Secretary of State presented by the Department with alternatives to inflicting legislative upheaval on the NHS? A senior civil servant said that
“it was clear that having posed the question of did he want to see other options, that Andrew was not very interested at all in us presenting alternatives.”
A picture is emerging of a Secretary of State with an inability to listen, take advice or heed warnings, who is going to have his Bill regardless of the upheaval that it will cause to the national health service.
Barry Gardiner: I am grateful to my right hon. Friend for giving way, although I fear that the moment might have passed. I simply wanted to ask him to reflect on the challenges that the hon. Member for St Albans (Mrs Main) issued to him about doctors and pay. Does he agree that those doctors are now the very people who are in charge of commissioning the services of which they are also the providers? I wonder whether the hon. Lady thinks that that is a good thing or a bad thing.
Andy Burnham: At the heart of the defective legislation that the Government rammed through the House of Commons is an unresolved conflict of interest, in which commissioners can also be providers who can remove services from hospitals and then provide them themselves. Under pressure in the other place, the Government came up with a requirement for a statement of such interests, but without introducing any mechanism for enforcement to ensure that decisions in the NHS are being made for the right reasons. I fear that that conflict of interest will return to haunt the Government.
Andrew George (St Ives) (LD):
The right hon. Gentleman knows that I share his critique of the Health and Social Care Act 2012. He mentioned the fact that civil servants had given him warnings and cautioned him about the consequences of his decisions during his time in office.
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Was he warned about the changes in regulations that have resulted in the decision of the south-west consortium to suggest changes to the terms and conditions and pay of staff in that area? That was a direct result of regulations brought in by his Government.
Andy Burnham: No, it was not. Agenda for Change was one of the proudest achievements of our Government, and we always staunchly defended national pay arrangements. The hon. Gentleman talks about warnings, but I have just read out the explicit warning that was given to the current Secretary of State that this was the wrong time to reorganise the NHS. It was unforgivable to proceed in those circumstances. This was the single most reckless gamble ever taken with the NHS, and patients and staff are already proving to be the biggest losers.
Steve Brine (Winchester) (Con): I was not reading the book that the right hon. Gentleman has mentioned at the weekend, but I was listening to Radio 4 last night while I was doing the washing up, as I do. I heard one of his colleagues, the hon. Member for Wigan (Lisa Nandy), say that Labour was committed to repealing the Health and Social Care Act in its entirety. Will the shadow Secretary of State tell me whether, when I am in Winchester over the summer recess, I should tell the clinical commissioning groups that are getting on with their work that all that work would be undone, and that the Hampshire primary care trust and the South Central strategic health authority would be recreated if Labour were to form the next Government?
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. We are short of time, so may I request short interventions, please?
Andy Burnham: There is a simple answer: yes, we will repeal the Act. It is a defective, sub-optimal piece of legislation and it is saddling the NHS with a complicated mess. The hon. Gentleman should listen to the chair of the NHS Commissioning Board, whom his Secretary of State appointed. He has called the legislation “unintelligible”. In those circumstances, it would be irresponsible to leave it in place.
Mr Stephen Dorrell (Charnwood) (Con): Will the right hon. Gentleman give way?
Andy Burnham: I will give way to the Chair of the Select Committee in a moment.
Wherever we look, we see warnings of an NHS in increasing financial distress, yet according to Ministers everything is fine. The gap between their complacent statements and people’s real experience of the NHS gets wider every week. They are in denial about the effects of their reorganisation on the real world. That dangerous complacency cannot be allowed to continue.
The Minister of State, Department of Health (Mr Simon Burns): In the light of what the right hon. Gentleman has just said, will he clear up this confusion? His leader, the right hon. Member for Doncaster North (Edward Miliband), has said that he would keep clinical commissioning, yet the shadow Secretary of State has just said that he would repeal the Act in toto, which would include the provisions on clinical commissioning.
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Andy Burnham: One of the great tragedies in this book is the Secretary of State’s admission, during a statement in the House in which he announced the “pause”, that he could have done most of what he wanted to do without legislation. The former Secretary of State, the right hon. Member for Charnwood (Mr Dorrell), is quoted as muttering to a colleague, “Why on earth are we doing it, then?” Well, why on earth did he do it? Because he wanted his Bill, regardless of other people.
Mr Dorrell: A moment ago, the right hon. Gentleman told my hon. Friend the Member for Winchester (Steve Brine) that Labour was committed to repealing the Act in its entirety. Does that not mean that an incoming Labour Government would be committed to precisely the kind of pre-cooked reorganisation of which he has just accused my right hon. Friend the Secretary of State?
Andy Burnham: No, it does not. This is what Government Members do not understand. It is not about the organisations, but about the services that they provide. The existing organisations can be asked to work differently, and I would ask them to work differently. I do not want NHS organisations to be in outright competition, hospital versus hospital; I want them to work collaboratively. So yes, we will repeal the Act, but no, there will not be a pointless top-down reorganisation of the kind that we have seen the Secretary of State inflict on the NHS.
This complacency is dangerous, and it cannot be allowed to continue. We had two clear purposes in initiating today’s debate. First, although we cannot stop the Government’s reorganisation, we can hold them to account for promises that they made to get their Bill through. I shall shortly identify five such promises in respect of which we are asking Ministers to live up to their words. Secondly, we wanted to give the House a chance to help the NHS by voting to hold the Government to account and enforcing the coalition agreement’s commitments on NHS spending.
Let me first deal with Ministers’ claim that there is no evidence of rationing of treatments by cost. They have promised to act if any evidence is presented. In fact the evidence is plentiful, and it is simply not credible for Ministers to deny it. The postcode lottery of which we warned is now running riot through the NHS. We have identified 125 separate treatments that have been stopped or restricted in the past two years, in some cases in direct contradiction of guidance from the National Institute for Health and Clinical Excellence.
Mr George Howarth (Knowsley) (Lab): Last week I was at Whiston hospital, which, as my right hon. Friend will know, covers Knowsley and St Helens. The net effect of all the changes is that its staff, particularly the nursing staff, are thoroughly demoralised. Does my right hon. Friend accept that any commitment that he makes to changing the system will be welcomed by NHS staff?
Andy Burnham:
I have heard the same from staff throughout the system. Morale has never been lower. People have been badly let down by a Government who promised them no top-down reorganisation, a moratorium on hospital changes, and real-terms increases. None of those things has been delivered. During the run-up to
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the general election the Conservatives cynically used the NHS to try to gain votes, and they will pay a heavy price for breaking the promises that they made then.
Clive Efford (Eltham) (Lab) rose—
Andy Burnham: I will give way to the Minister one more time, and then to my hon. Friend the Member for Eltham (Clive Efford), but after that I must make some progress.
Mr Burns: I am grateful to the right hon. Gentleman. Although he did not answer the question that I asked him earlier, he did spread more confusion. If he were ever in a position to repeal the entire Act and did so, given that the strategic health authorities and the primary care trusts will have long since gone, how does he envisage care being commissioned for patients?
Andy Burnham: The Minister seems to equate removal of the Act with bringing back PCTs and SHAs. I do not have a problem with clinical commissioning, and I said as much during the Bill’s passage. I introduced it myself. I do not have a problem with clinical commissioning groups; my problem is with the job that they are asked to do, and the legal context in which they are asked to operate. We reject the Secretary of State’s market, and that is why we will repeal his Act.
Clive Efford: Clinicians in south-east London presented proposals for the reorganisation of our health care provision in “A picture of health”. It was all agreed by local commissioners, but when the Tories took office, they imposed a two-year delay that cost our health care trust £16 million a year—and that is the same trust that the Secretary of State has just put into administration.
Andy Burnham: This is what happened: when they came into government, they had a cynical policy of a moratorium, and they went up to Chase Farm hospital to announce it, saying, “There will be no cuts and no closures at this hospital.” They traded and touted for votes in that constituency for years on the back of that issue, and now that hospital is going to close. They delayed the reconfiguration and then they delayed the savings that came to the NHS. It was disgraceful, and people will have seen through it.
Mr Dave Watts (St Helens North) (Lab): I wish my right hon. Friend well in trying to hold this Government to account. The NHS is paying consultancy fees all around the country: hundreds of thousands of pounds are being wasted, and the Government are refusing to publish the information. They are also bullying many of the trusts. How are we going to get the information out when the Government are doing this?
Andy Burnham:
My hon. Friend is absolutely right about the waste of money the Government have brought into the NHS through this reorganisation. The total is over £3 billion. That is simply unjustifiable at this time. Staff who had been working in primary care trusts are either being re-employed as consultants or are going
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into clinical commissioning groups. This is such a waste of money at a time when the NHS needed every penny to maintain standards of patient care.
I was talking about rationing, and let me focus on cataract surgery. GP magazine has found limits on cataract surgery in 66% of PCTs. The Royal National Institute of Blind People found that 58% of PCTs are using visual acuity thresholds to restrict surgery. This is the evidence, so the Secretary of State had better start listening. What has happened since those restrictions on cataract operations have been introduced? Unsurprisingly, the number of cataract operations in England fell by over 12,000 between 2010 and 2011. That is a direct result of the new restrictions. There is no less need, however. Thousands of older people need such procedures, but they are now being forced to live with very poor sight.
This is truly a false economy. Cataract surgery is one of the most cost-effective procedures carried out by the NHS. It helps people live independently and have a quality of life, and research has shown that in the last two years poor vision has been a factor in 270,000 falls by people aged 60 or over. This is the rationing by cost that Ministers have repeatedly denied is happening. So let me ask the Secretary of State again: does he agree with these restrictions on cataract surgery? If he does not, will he take immediate action to lift them?
Frank Dobson (Holborn and St Pancras) (Lab): Will my right hon. Friend confirm that under the last Labour Government the number of cataract operations carried out by the NHS rose from 160,000 a year to 310,000 a year, as a result of the commitment of the staff? What will the staff in the south-west think about all this if they have their pay cut?
Andy Burnham: For staff who are trying to hold things together through the chaos the Government have brought about, what a kick in the teeth it must have been to read in the Sunday newspapers that unless they accept pay cuts, they will be made redundant. My right hon. Friend says the staff made those improvements, but so did he. As the incoming Secretary of State, he made improvements to waiting times for cataract surgery, which, if I remember rightly, were commonly about a year in the late-1990s. We brought those waiting times right down. Now what do we hear? We hear that under this crowd people with two cataracts are being told, “You can have one done, but not both.” That is what the NHS has been reduced to under this Government. The Secretary of State has promised action, and I have given him the evidence. He now must take action.
The second area on which the Government need to be challenged is privatisation. As the debate on the Bill drew to a close, the Secretary of State made this clear statement:
“The legislation is absolutely clear that it does not lead to privatisation, it does not promote privatisation, it does not permit privatisation and it does not allow any increase in charges in the NHS.”—[Official Report, 27 March 2012; Vol. 542, c. 1335.]
It is hard to know where to start, but how about the NHS walk-in centre in Sheffield, which is managed by a private company and has just started charging patients with whiplash injuries £25 for treatment, or the NHS
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hospitals now marketing private treatments for in vitro fertilisation, cancer screening or bone screening since the cap was lifted? How about the letter sent to all PCTs requiring them to identify three or more services for tendering under the “any qualified provider” measure in 2012-13? How about the 100 or so tenders for a range of services that have been offered to the private sector on this Secretary of State’s watch, with a total value of more than £4 billion? So let me ask the Minister and the Secretary of State today: will they now at least be honest about their true intentions for the level of private sector involvement in the NHS?
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab): Is my right hon. Friend as concerned as I am about the exponential rise in the number of private health care ads that we see on our television screens and in our newspapers every day? These ads had almost disappeared under the previous Government. Advertisers advertise only when they know that there is a market.
Andy Burnham: This is really important; it is where all of what the Government are doing comes together. They have put in place restrictions in treatments— 125 separate treatments, as I have just mentioned— and at the same time they have given a 49% cap to NHS hospitals to do more private work. So as the NHS decommissions services, hospitals are then free to start offering those services. That is why my hon. Friend is beginning to see the changes that she is noticing, and this is the clear agenda of the Conservative party.
Huw Irranca-Davies (Ogmore) (Lab): Does not the fragmentation that my right hon. Friend is describing raise the crucial question about when the national health service ceases being a national health service under this Government?
Andy Burnham: The Bill that the Government brought through is an attack on the N in the NHS; that is what it was designed to do. It was designed to break national standards; to break national pay; to break waiting time standards; and to allow primary care trusts to introduce random rationing across the system. That was the intention of the Bill that they brought through; they wanted an unfettered market in the health service, and my hon. Friend is absolutely right. That is why we are saying that we will repeal this Act and restore the N in NHS at the earliest opportunity.
Andrew Percy (Brigg and Goole) (Con): On 28 June, in response to misinformation put out by Labour councillors, the medical director of my local hospital trust, a doctor of 30 years, wrote an article in my local paper under the headline “NHS faces greatest challenge”. She talked about staff costs, treatment costs and the 2008 Nicholson challenge. She said that the trust’s problems date “back to 2008”, and she continued:
“Having been a doctor for nearly 30 years, the 2008 Nicholson challenge is, by far, the greatest challenge the NHS has ever faced”.
What should we believe: the picture being presented by the right hon. Gentleman or this article?
Andy Burnham:
The hon. Gentleman is making my point; if he was listening to what I said at the start of my speech, he would have heard me say clearly that
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the £20 billion Nicholson challenge, which I set, was always going to be a mountain to climb for the NHS. Let us be clear that it was. What was unforgiveable was combining that Nicholson challenge with the biggest ever top-down reorganisation in history, when the whole thing was turned upside down, managers were being moved or made redundant and nobody was in charge of the money. That was what was so wrong, and that is what the hon. Gentleman should not be defending if he is defending staff in the NHS.
The third area where we need action from Ministers is on protection for staff. The Deputy Prime Minister said recently:
“There is going to be no regional pay system. That is not going to happen.”
But we heard yesterday that a breakaway group of 19 NHS trusts in the south-west has joined together to drive through regional pay, in open defiance of the Deputy Prime Minister. They are looking at changes to force staff to take a pay cut of 5%; to end overtime payments for working nights, weekends and bank holidays; to reduce holiday time; and to introduce longer shifts. We even hear that if staff will not accept this, they are going to be made redundant and re-employed on the new terms. So let us ask the Secretary of State and the Minister to answer this today: do the Government support regional pay in the NHS and the other moves planned by trusts in the south-west? If they do not, will they today send a clear message to NHS staff in the south-west that they are prepared to overrule NHS managers?
Fourthly, I shall deal with reconfigurations. The House will recall the promise of a moratorium on changes to hospitals and the Prime Minister’s threat of a “bare-knuckle fight” to resist closure plans. In 2010, the Secretary of State set out four tests that all proposed reconfigurations had to pass. They related to support from general practitioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice. He said:
“Without all those elements, reconfigurations cannot proceed.”
So let me ask the Minister: does he think that the A and E units closing at Ealing, Hammersmith, Charing Cross and Central Middlesex pass that test? How about St Helier, King George, Newark and Rugby? Is it not clear to everyone that the Prime Minister’s bare-knuckle fight never materialised? Is it not also clear that no one told the Foreign Secretary, the Work and Pensions Secretary or even the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is responsible for care and older people and who has launched a campaign against his own Department? What clearer sign could there be of the chaos in the Department of Health and of the chaos engulfing the NHS? Will the Secretary of State now take action to stop reconfigurations on the grounds of cost alone?
That brings me to my fifth and final area for action, which is NHS spending. The coalition agreement said:
“We will guarantee that health spending increases in real terms in each year of the Parliament.”
That is health spending, not the health allocation. Official Government figures show that actual spending has fallen for two years running and the underspend has been clawed back by the Treasury. Of all the promises the coalition has broken, people will surely find that one
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the hardest to understand given that the Prime Minister appeared on every billboard in the land, on practically every street in the land, promising to do the opposite just two years ago.
Gordon Birtwistle (Burnley) (LD): Will the right hon. Gentleman advise me who he consulted before he closed the A and E unit in Burnley?
Andy Burnham: I was prepared to make difficult decisions and be honest about them. I am not proposing the reversal of that decision and I note that clinicians in his area recently said how it had improved outcomes for his constituents. What I will not do—what I will never do—is go to marginal constituencies, as the Secretary of State did, and make false promises that I will reopen such units. The Secretary of State did that before the last election; no wonder he is looking shifty in his seat right now. He went to the hon. Gentleman’s constituency and said that he would reopen that unit. Has he done that? I do not believe that he has.
Clive Efford: On that very point about turning up in constituencies just before general elections promising to save A and E services, the Tories pledged to save 999 services at my local hospital, Queen Mary’s, Sidcup. They pledged to keep that A and E open—the Secretary of State did so himself. Where is the A and E?
Andy Burnham: I do not know how the Secretary of State justifies what has been done. Even in my own patch, Greater Manchester was going through a children’s and maternity services review and some constituencies were benefiting from the changes—Bolton, for example, was getting a bigger maternity unit—but some were not and this Secretary of State went both to Bury, where he said that he would defend the maternity unit, and to Bolton, for a photo call celebrating the new investment. If anything illustrates the sheer opportunism of the Secretary of State in opposition, surely that is the example that does.
Andy Burnham: I will give way to the hon. Member for Totnes (Dr Wollaston) before I conclude.
Dr Sarah Wollaston (Totnes) (Con): I hope that in his conclusion, the right hon. Gentleman will address a point raised by the King’s Fund. It said that the greatest policy failure of the previous Administration was the failure to tackle health inequalities. He says that he wishes to appeal the whole of the Health and Social Care Act 2012, but does he accept that shifting public health back to local authorities gives us one of the greatest opportunities to tackle health inequalities? Will he seriously put public health back where it was before and, by so doing, continue to fail to address health inequalities?
Andy Burnham:
The hon. Lady mentions the Act, and I seem to remember that she called the Bill a hand grenade thrown into the health service. She seems to have changed her tune since then. We made huge progress on tackling smoking and improving the public health of this country, progress of which we are very proud. We can always say that we could have done more, but
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I remember putting through measures on smoking towards the end of our time in government that were opposed by those on the Government Front Bench. I am not sure how she could justify that.
The budget cut combined with the distraction of reorganisation means that six out of 10 hospitals in England are now off target for their efficiency savings. That brings me back to where we started: this is the wrong time to reorganise the national health service. In conclusion, the House cannot reverse tonight the damage of the NHS reorganisation, but we are not powerless. There are things we can do to help the NHS at one of the most dangerous moments it has faced. Our constituents will expect us to hold Ministers to account for promises made on rationing and reconfigurations. They will want us to do the right thing by NHS staff facing pay cuts and redundancy. Our constituents have a right to expect that one of the central pledges in the coalition agreement—not to cut the NHS—will be honoured. That is the simple call of our motion this evening which, we hope, can unite all sides of the House. A vote tonight for the motion would be a positive vote for an NHS under siege and a message of appreciation for NHS staff facing uncertain times. I commend the motion to the House.
5.50 pm
The Minister of State, Department of Health (Mr Simon Burns): The motion that we are debating today is typical of the Opposition. Rather than praising the NHS in a year of change, they seek to denigrate it. Rather than commending the hard work and dedication of NHS staff, they undermine their efforts and belittle their results. Rather than supporting the parts of the NHS that are dealing with long-term financial challenges—challenges that were partly of the own making of the right hon. Member for Leigh (Andy Burnham)—they attempt to scaremonger.
In truth, this has been a year that has tested the NHS, which has dealt with significant financial pressures as well as the transition to the new system, but it is also a year in which the NHS has proven its mettle. Far from the meltdown that some gleefully predicted, we have seen a robust and resilient NHS delivering better care for patients.
Mr George Howarth: Will the Minister give way?
I know that waiting times mean a great deal to the right hon. Member for Leigh, so let us have a look at the numbers. Despite what he peddles around the country, waiting times remain low and stable—in fact, below where they were at the last general election. In May 2010 more than 18,000 people waited more than a year for treatment. Today that figure is just 4,317. Today 55,335 people wait more than six months for treatment—almost half the figure of 100,979 at the last general election. There are 149,912 people now waiting more than 18 weeks, compared with 209,411 in May 2010. The median wait for admitted patients has fallen in that time from 8.4 weeks to 8 weeks, and for non-admitted patients from 4.3 weeks to 4 weeks. Across the country, all NHS waiting time standards for diagnostic tests and cancer treatment have been met.
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Mr Slaughter: The Minister talks about scaremongering. For seven years my constituents put up with scaremongering from his party that Charing Cross hospital was going to close. The services there expanded. After two years of his Government, the hospital, 500 beds, and the accident and emergency department are closing and being replaced by an urgent care centre, which will treat only minor injuries. What will that do to his statistics?
Mr Burns: I am slightly surprised that the hon. Gentleman made that intervention because it rather proves my point about scaremongering. He said that is going to happen. The truth is that the local NHS has determined locally what it believes is the best reconfiguration of services. That is going out to public consultation and so far no decisions have been taken because the consultation process has only just started. It will last for 14 weeks and then the results of that consultation will be considered.
Mr Burns: I will now make progress.
To return to waiting times and the record as a fact, rather than the fiction that Opposition politicians like to peddle, 96% of patients wait for fewer than four hours in accident and emergency, and every ambulance trust in England meets its core response times.
Andy Burnham: On accident and emergency waiting times, let us be clear. In the 2013 year to date, has the NHS met the 95% target or not?
Mr Burns: Yes; 96% of patients wait for fewer than four hours in A and E, and as the right hon. Gentleman knows, the percentile is 95%.
Valerie Vaz (Walsall South) (Lab) rose—
Mr Burns: I shall make a little more progress.
Let us not stop at waiting times. The £600 million cancer drugs fund that has helped more than 12,500 patients to access the drugs previously denied to them, the screening programmes for breast and bowel cancer, potentially saving an extra 1,100 lives every year by 2015, the world-leading telehealth and telecare whole systems demonstrator programme, which saw a stunning 45% fall in mortality and is set to transform of 3 million people with long-term conditions over the next five years—
Mr Burns: I will give way to my hon. Friend the Member for Crawley (Henry Smith), then I will give way to the right hon. Member for Knowsley (Mr Howarth) and the hon. Member for Walsall South (Valerie Vaz), then I will stop giving way for a time to make progress.
Henry Smith (Crawley) (Con):
Earlier this year I was delighted to be able to open a new digital mammography unit at Crawley hospital, a hospital which under the previous Government saw its accident and emergency unit closed down. Does my right hon. Friend find it
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odd that the Opposition refuse to match the spending commitments on the NHS that this Government are delivering?
Mr Burns: My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.
Valerie Vaz: The Minister is very fond of statistics. Can he say whether GP referrals have gone up, and whether A and E admissions have gone up or down?
Mr Burns: The hon. Lady will know that GP referrals have gone down slightly, but the referrals to A and E have risen slightly.
Mr George Howarth: The Minister said in his opening remarks that Opposition Members are denigrating NHS staff and their achievements. Does he accept that if he has any conversations with NHS staff, he will find the reverse—they feel that they are being denigrated by this Government and their reforms?
Mr Burns: I do not like to contradict the right hon. Gentleman, but I will. What I said was slightly different from what he accused me of saying. What I said was that rather than praising the NHS in a year of change, the Opposition denigrate it. That is slightly different.
To pick up on a point that the right hon. Member for Leigh mentioned from a sedentary position, GP referrals for 2011-12 were 1% lower than in the previous year, but outpatient referrals were, as I said, slightly higher.
Andrew Percy: Will my right hon. Friend give way?
Mr Burns: If my hon. Friend will allow me, I would like to make some progress. If the opportunity arises, I will give way to him then.
I could stop after reporting all that good news, but I do not see why I should when there is so much more to praise the NHS for. It gets little praise for its performance from the Opposition. I want to praise the fact that patients are reporting better outcomes for hip and knee replacements and for hernias, and the fact that the latest GP patient survey showed that 88% of patients rated their GP practice as good or very good. MORI’s independent public perceptions of the NHS survey shows satisfaction with the NHS remaining high at 70%.
In the patient experience survey, 92% of patients who had used the NHS in the past year rated their care as good, very good or excellent. Mixed-sex accommodation breaches are down an incredible 96% since we came to power, although of course the Opposition often claimed to have eradicated that problem—not so, alas. MRSA infections are down 24% in the year, and C. difficile infections down 17%. More than a million more people have an NHS dentist. No reasonable person could look at the performance of the NHS over what has been a challenging year with anything but admiration and
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pride. I, too, would like to take this opportunity to praise NHS staff for their hard work and dedication and the excellent results they are delivering for patients.
Angie Bray (Ealing Central and Acton) (Con): Will my right hon. Friend give way?
Mr Burns: I promised to give way to my hon. Friend the Member for Brigg and Goole (Andrew Percy).
Andrew Percy: Will the Minister condemn Labour party representatives in Goole who, despite the fact that under Labour we saw ward closures and mental health in-patient beds go, recently gave the media incorrect waiting list times, and will he confirm that in North Lincolnshire 93% of patients are seen within 18 weeks, which is far ahead of the national target? The Labour party needs to stop talking down our local hospital.
Mr Burns: I am extremely grateful to my hon. Friend and certainly condemn any misrepresentation, misinformation or talking down of the NHS in any of my hon. Friends’ constituencies.
Mr Burns: If hon. Gentlemen and Ladies will bear with me, I would like to make some progress, because this is a short debate and many hon. Members would like to participate, but I will give way later.
The motion, like the right hon. Member for Leigh, mentions a fall in spending on the NHS of £26 million in 2011-12. I will give him one statistic: £12.5 billion. There will be £12.5 billion extra for the NHS in this Parliament, £12.5 billion that would never have been made available had he had his way, as he said that to do so would be irresponsible. That is exactly what his party is doing in Wales, where it is in control of the NHS. It is cutting the NHS budget in Wales by 6.5% in real terms from 2011-12 to 2014-15. His motion talks about a £26 million underspend, but what he does not understand is that there has been a real-terms increase in funding for the NHS this year. Because we are no longer wasting hundreds of millions of pounds on a bloated bureaucracy and the national programme for IT, we have been able to save an extra £1.1 billion in real terms from the back office and put it into front-line care.
Andy Burnham: So that there is no confusion, because this is a very important matter, I will quote from a Department of Health press release of Friday 6 July:
“PESA figures released today show that in real terms NHS spending has reduced slightly by 0.02%.”
For the record, will the Minister say whether NHS spending rose or fell over the last financial year?
Mr Burns: What I was saying that the right hon. Gentleman—[Interruption.] He must wait one minute, because I will answer him. What I said, which is correct, is that, in keeping with our commitments, we have increased funding on the NHS in real terms—
Andy Burnham: It is your press release.
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Mr Burns: Just wait. But, as he has said, and as I have said about the £26 million—[Interruption]—there was an underspend in the NHS and that money, as he will know, because of the financial arrangements his party put in place for the NHS in 2004, will be ploughed back into the NHS over the next three or four years as extra spending. We will put in more money for front-line clinical staff, including more than 4,000 doctors—more money for doctors and treatments and for improving patient outcomes. Spending on front-line NHS services has increased by £3.4 billion in cash terms, or 3.5%, compared with last year.
Angie Bray: Will my right hon. Friend give way?
The motion states that seven out of every 10 acute hospital trusts in England missed their savings targets for the first half of 2011-12, referring to their cost improvement plans. Not only did the right hon. Gentleman use out-of-date figures—figures for the whole year are now available—but he again misrepresented what they mean for the performance of the NHS. Across the NHS, acute NHS trusts plan to save £1.3 billion during 2011-12. In the end, they saved £1.2 billion. More than half—57%—of the shortfall was concentrated in just 10 NHS trusts in significant financial difficulties— 10 NHS trusts that he ignored when he was Health Secretary but that we are getting to grips with. I would point him instead to the £4.3 billion of efficiency savings made in 2010-11 and the further £5.8 billion of efficiency savings made in 2011-12. Primary care trusts and strategic health authorities have reported a surplus of £1.6 billion in 2011-12, money that is being carried forward and made available for 2012-13 and thereafter.
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab): Will the Minister give way?
Unlike the right hon. Member for Leigh, who championed cuts to the NHS, this Government are investing more in the NHS, more in front-line care, more in staff and more in treatments.
Angie Bray: As my right hon. Friend is aware, the proposal is to downgrade four accident and emergency departments across London that are all right beside my constituency. Does he agree with my constituents that losing four accident and emergency departments is disproportionate and will mean a significant loss of service for them locally?
Mr Burns:
What I will say to my hon. Friend is similar to what I said to the hon. Member for Hammersmith (Mr Slaughter): that is a reconfiguration that is in progress and has been put together locally by the local NHS. It has just gone out to consultation and, obviously, when the process is complete the responses will be considered before any final decisions are made on the best way to provide care for her constituents and those of Opposition Members so that they can get the quality of care and the relevant care in their area. At the moment, when there is a consultation process going on, it would wrong of me to comment on a local decision,
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but I certainly urge my hon. Friend, her constituents and others to get involved in the consultation so that all views can be considered.
Mr Burns: I will now make some progress.
The motion seeks to give the impression that NHS care is being rationed. That is worse than inaccurate: it is scurrilous nonsense and scaremongering on a grand and somewhat desperate scale. [Interruption.] I will come to cataracts in a moment. We did some rudimentary checking of our own into the veracity of those claims, which were originally made as part of the Labour party’s NHS health check. It was not long before it became abundantly clear that that was not worth the press notice it was printed on. It claimed that there was a blanket ban by NHS Hull on the removal of risk ganglia. We spoke with NHS Hull and found that there is no such ban. It claimed that 11 out of 100 PCT clinical commissioning groups restrict laser revision surgery for scars, but such cosmetic surgery has never been routinely available on the NHS, under either this Government or the previous Government, when the right hon. Member for Leigh was Secretary of State. It claimed that weight-loss treatment is restricted, stating that
“patients generally have to be over 18 and have a BMI over a certain level to receive weight loss surgery”.
Amazing—people actually have to be overweight to be entitled to weight-loss surgery. I would have thought that that was startlingly obvious, but obviously the right hon. Gentleman does not think so.
Mr Burns: I will give way to the right hon. Gentleman and then to my hon. Friend, but then I will make some progress.
Andy Burnham: Is the Minister aware that the National Institute for Health and Clinical Excellence guidance recommends that bariatric surgery should be offered only to people with a BMI of 40? Is he also aware that numerous PCTs all over the country are restricting access to that surgery by introducing their own arbitrary limits? That is evidence of the rationing I am talking about. He will know that the NHS constitution guarantees people access to NICE-approved treatments, so why does he not take action on those PCTs that are standing outwith the NICE guidance?
Mr Burns: What the right hon. Gentleman rather cunningly does not mention—[Interruption.] I am answering the question, if the hon. Member for Copeland (Mr Reed) can just keep quiet for a second. The right hon. Gentleman says that the NICE guideline refers to a BMI of 40, and that is absolutely correct, but I point him in the direction of one area in central London that does not go by that guideline, because it uses a BMI of 35, which is lower.
Mr Graham Stuart:
Is my right hon. Friend as confused as I am by the Labour party’s policy? The right hon. Member for Leigh (Andy Burnham) could not explain
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where public health would go; he wants to repeal the Health and Social Care Act 2012, although he wants the services to be shaped as the Act says; and on funding he said in June 2010:
“It is irresponsible to increase NHS spending in real terms”.
That is the Labour party’s policy: it is chaotic and makes no sense. Can my right hon. Friend please tell us whether he sees more sense in it than I do?
Mr Burns: I am afraid that I cannot help my hon. Friend, because the policy is contradictory and does not make sense.
The right hon. Gentleman talks about repealing the 2012 Act, which includes the clinical commissioning groups, but if he abolishes them there will be no other mechanism from 1 April next year to commission care for patients, so there will be no one available to commission care for patients, which seems stunning.
The right hon. Gentleman talks about funding, and his quotations—my hon. Friend the Member for Beverley and Holderness (Mr Stuart) mentions one—are quite clear: he disapproves of giving real-terms increases in funding to the NHS. In Wales, the Welsh Labour Government have taken him at his word and are cutting spending, which we are not very enthralled by.
Mr Burns: I will now make progress.
Treatments available on the NHS are based on clinical need. There should never be any arbitrary rationing based on cost either locally or nationally—[Interruption.] The right hon. Member for Leigh shouts from a sedentary position, “There is”, and waves a piece of paper a little like Chamberlain on his way back from Munich, but if the piece of paper that the right hon. Gentleman is waving is his NHS health check, which officials in my Department have looked at, it is as worthless as the piece of paper that Chamberlain brought back from Munich.
If the right hon. Gentleman has any genuine evidence based on the cost of care, I and the Department of Health will certainly investigate it. Such practices are totally unacceptable, and we will take them very seriously indeed, but until then, although the motion talks about “the evidence presented”, the truth is that there is none.
The right hon. Gentleman claims that the number of cataract operations has fallen significantly since we came to power, but the reason for the fall is that clinicians have advised that the surgery is inappropriate in many cases—on clinical grounds. Surgery is available, however, for those patients who are clinically eligible, and they will receive it when there is a clinical reason.
Barbara Keeley (Worsley and Eccles South) (Lab): Will the Minister give way?
Mr Burns: No, I am making progress.
The motion notes the growing involvement of the private sector, insisting that it represents evidence of growing privatisation. Not only is that unadulterated tosh, but I personally find it offensive to be accused of seeking to privatise the NHS, when in my political philosophy one of my core beliefs is in an NHS free at the point of use for all those eligible to use it.
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Not only does the right hon. Gentleman have some difficulty understanding the meaning of “privatisation”, but he forgets his own record in government. The only plan to increase the private provision of NHS services came under the previous Government when he was Minister, when his hon. Friend the Member for Leicester West (Liz Kendall) was the special adviser and when Patricia Hewitt was Health Secretary. In May 2007, the right hon. Gentleman said:
“Now the private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate.”
Those are his words. It was his Government who saw private companies paid 11% more than NHS providers for doing the same work, and who wasted £297 million on operations that never happened at independent sector treatment centres. Given that he may have forgotten, I must tell him that the Labour party manifesto in 2010, when he was the Secretary of State for Health, stated:
“Foundation trusts will be given the freedom to expand their provision into primary and community care, and to increase their private services—where these are consistent with NHS values”.
That suggests that, as Secretary of State, he was prepared to have in his own party’s manifesto a policy allowing and encouraging foundation trusts to attract more work from the private sector.
This Government’s Health and Social Care Act 2012 specifically prohibits the Secretary of State, Monitor or the NHS Commissioning Board from favouring any type of provider, be they from the NHS, the charitable sector or the independent sector. It does so because this Government understand something that the right hon. Gentleman’s never did—it is not the nature of the provider, but the quality of the outcomes that matters most to patients.
Kate Green (Stretford and Urmston) (Lab): Will the Minister give way?
“increasing number of cost-driven reconfigurations of hospital services”.
The reconfiguration of NHS services must always be led by a desire to improve patient care and patient outcomes. As lifestyles change, as needs and expectations grow and as technology develops, the NHS must respond. This Government are very clear that the reconfiguration of services is a matter for the local NHS, and that the best decisions are those taken closest to the front line and tailored to the needs of the local population. But, when making those decisions, it is imperative that the NHS carries the support of local people, patients, carers and clinicians.
The principle is enshrined in the four tests that my right hon. Friend the Secretary of State set out in 2010: all local reconfiguration plans must demonstrate support from clinical commissioners, strengthened public and patient engagement, clear clinical evidence and support for patient choice.
John Woodcock (Barrow and Furness) (Lab/Co-op) rose—
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Mr Burns: The right hon. Member for Leigh equates the coalition agreement’s promise of a temporary moratorium on changes to hospital services, with a commitment to hold the NHS in a permanent state of suspended animation. The moratorium was needed to put a stop to the arbitrary reconfigurations that his Government instigated—reconfigurations that lacked the support of local clinicians, lacked a clinical evidence base and lacked basic democratic legitimacy. This Government and the Secretary of State have put that right.
Now I turn to another issue that the right hon. Gentleman raised and which is of considerable importance, given what has—
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. Hon. Gentlemen, the Minister has given way quite a bit, and I am sure that if he wishes to give way he will let you know. You do not need to keep standing and hovering for so long.
Mr Burns: Thank you, Mr Deputy Speaker. Because I want to make progress so that other people can contribute, I will not accept any more interventions.
On the South West Pay Consortium—[Interruption]—an issue on which I hope the right hon. Member for Leigh will listen, given that during his speech he seemed keen to hear the Government’s response—the Government’s position is clear: it is for employers, not for the Government, to lead negotiations on the terms and conditions of their staff, and to do so with the agreement of staff.
This Government are committed to the principles of “Agenda for Change”, a national framework. The ongoing negotiations on “Agenda for Change” are about ensuring that patients and taxpayers get the maximum value for money from every penny spent on the NHS, and that it is spent efficiently and effectively. The negotiations are not about a pay cut, and we would not support one.
The Health Act 2006, brought in by the previous Government when the right hon. Gentleman was the Minister of State in the Department of Health, gives NHS trusts the power to set their own terms and conditions. Although they are free to opt out of the national pay framework, they cannot do so unilaterally; they must consult and seek agreement with their staff and representatives.
Almost all trusts have until now chosen to stay on national terms and conditions. I believe that most still want to, but that has to be fit for purpose and fit for the future. Only one trust—Southend—has opted out of “Agenda for Change”. [Interruption.] The hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) may be a Whip, but he is rather foolish to fall into the trap that I have just set. That trust opted out of “Agenda for Change” under the last Labour Government. Perhaps he would like to apologise.
Pay is the largest element of NHS costs, and pay systems must evolve. The trusts in the south-west wish to work and negotiate with the trade unions to agree changes, not to dismiss and re-engage staff.
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Kerry McCarthy (Bristol East) (Lab) rose—
Mr Burns: The hon. Lady only recently walked in. She has not been here from the beginning.
I call on the unions to respond positively to the issue and the national discussions on “Agenda for Change”. I also hope that the Opposition will support the policies that they put in place when in government.
The Opposition have used this debate to make yet another sorry attempt to paint a distorted picture of the NHS. That is wrong. The shadow Secretary of State pours scorn on the performance of the NHS, while we admire the excellence of the staff; he belittles their achievement while we laud them; he scaremongers, while we present the truth more transparently than at any other time in the history of the NHS.
The accusations in the motion are simply wrong, and I ask my right hon. and hon. Friends to join me in the Division Lobby at the end of the debate to defeat the motion.
Mr Deputy Speaker (Mr Lindsay Hoyle): Order. I inform hon. Members that there is now a five-minute limit on speeches.
6.21 pm
Grahame M. Morris (Easington) (Lab): Thank you for calling me early, Mr Deputy Speaker. I am delighted to be able to participate in this important debate just before the recess.
I refer hon. Members to part of the Opposition motion:
“That this House regrets the growing gap between Ministers’ statements and what is happening in the NHS; notes mounting evidence of rationing of treatments and services by cost, despite Ministers’ claims to have prevented it”.
I would like to highlight one specific example. The Minister, who is not paying attention at the moment, may wish to make note of the issue, because it matters to cancer patients in my area and across the country. I am talking about the lack of access to advanced radiotherapy.
By way of background, I should say that the national cancer action team told NHS commissioners that radiotherapy is involved in 40% of cases in which cancer is cured. Furthermore, radiotherapy by itself now cures 16% of cancer patients. By contrast, cancer drugs are the main cure of only 2% of cancer patients. We can draw the conclusion that I hope the Department of Health and Ministers would accept: radiotherapy cures far more cancer patients than drugs. They should issue instructions to commissioners to reflect that and make money available for radiotherapy.
The current allocations are inadequate and arguably paltry. The radiotherapy budget for the current year is just £350 million, while the cancer drug budget is close to £1.5 billion. Within that sits the Government’s flagship cancer drugs fund, which, according to information that I have received, was underspent by £150 million. Despite that underspend, an additional £200 million is going into the cancer drugs fund. My concern is that that money is not for cancer patients but for cancer drug companies.
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The whole idea is becoming discredited—so much so that, as has been reported in the newspapers, even Mr Clive Stone, the Prime Minister’s constituent who originally inspired the fund, has asked for less money to be put into the fund. Why? He now needs advanced radiotherapy for his cancer and there is no money available for him.
The cancer drugs fund cannot be used to fund advanced radiotherapy, and that is a real concern. I have no doubt that during the winding-up speeches we will be told that the Government are putting in an extra £150 million into new radiotherapy treatments over the next four years. The Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow), keeps telling us that, but when I ask him where the first and second year allocations—£13 million and £22 million—are being spent, he tells us that he does not know.
I thought I would try to help out the Minister, so I sent freedom of information requests to every strategic health authority asking how much of the money they had received and how their PCTs had spent it. I have good news for the Minister, who is not in his place. It is that he is not the only one who is in the dark when it comes to that £13 million and £22 million; the SHAs do not know either. I have the replies with me. I was going to read them out, but unfortunately I do not have time.
The stark truth is that under this Government no new money is going into providing the latest radiotherapy technologies for the NHS. In March last year, the Secretary of State commended some of the new facilities, including the new CyberKnife system at St Bartholomew’s hospital in London. Members, some of whom have also been to see the system, are concerned that charities are having to be used to raise money to buy that vital equipment. When I raised that issue in this Chamber, the Minister disputed that, but I have furnished him with a list of areas where it is happening. The Minister should accept his responsibility, get a grip on the situation and ensure that cancer patients needing advanced radiotherapy have access to the service that they need. I support the motion.
6.26 pm
Mr Stephen Dorrell (Charnwood) (Con): It is a pleasure to follow the hon. Member for Easington (Grahame M. Morris), who is a member of the Health Committee. I hope he will forgive me if I do not follow him down the specialist course of radiotherapy services.
I want to address my remarks primarily to the shadow Health Secretary and to begin with an echo from a different era. When I first came to the House, there used to be something called “Whitelaw’s law”, which, obviously, referred to the late Willie Whitelaw. “The more he blusters,” we used to say, “the less he believes it.” The shadow Health Secretary gave us an Olympic-class demonstration of the principle of Whitelaw’s law. He blustered from the Dispatch Box and got himself into several dead ends. It became clear that he did not really believe that he had answers for the challenges facing the NHS.
I refer the right hon. Gentleman to a point that he made and which I agree with. The most important statement about the current state of the health service was not made by him as Secretary of State—and, with great respect to my right hon. Friend the Secretary of State, it was not made by him either. It was made by
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Sir David Nicholson in his annual report to the national health service in May 2009, and it was endorsed by the right hon. Gentleman. Sir David said, looking forward to the period of this Parliament:
“we must be prepared for a range of scenarios, including the possibility that investment will be frozen for a time. We should also plan on the assumption that we will need to release unprecedented levels of efficiency savings between 2011 and 2014—between £15 billion and £20 billion across the service over the three years.”
I agreed with what the shadow Secretary of State said about the importance of what we, in the Health Committee, dubbed “the Nicholson challenge”. I believe that that is the central challenge facing the national health service. The sadness in this debate was that the right hon. Gentleman gave us no hint as to how he believes the health service should address that central challenge about which he and I agree.
Mr Graham Stuart: Meeting that challenge, and dealing with the challenges in the NHS generally, would be all the more difficult if one believed, as the right hon. Member for Leigh (Andy Burnham) does, that real-terms increases in investment in the NHS are irresponsible.
Mr Dorrell: I agree with my hon. Friend, but let us not go down that route. At the time when Sir David Nicholson was writing, the Labour Government were contemplating the possibility not of a real-terms freeze, which is in effect what is planned under the coalition, but of a cash freeze, which would have been substantially more difficult to achieve.
The main issue now is how we deliver services that meet the demands placed on the system against the background of a resource allocation to the health service that was always going to be dramatically less generous than it was during the earlier years of the Labour Government. We heard from the right hon. Gentleman a commitment that an incoming Labour Government would go through a clean-sheet-of-paper redrawing of the map—
Andy Burnham indicated dissent.
Mr Dorrell: The right hon. Gentleman shakes his head, but he said that he would repeal the Health and Social Care Act 2012, the result of which would be to commit the health service to precisely the kind of reorganisation—or re-disorganisation—that he accuses the Government of introducing.
The challenge for the Opposition is to show that they are willing to map a future for the health service, in much more constrained financial circumstances, that allows it to meet the demand for services that is going to be placed on it and to fulfil the aspirations that we all have for improved quality of service. That becomes increasingly difficult in the light of motions such as the one that the right hon. Gentleman has put down for the House to consider. He invites us to regret
“the increasing number of cost-driven reconfigurations of hospital services”
“growing private sector involvement in both the commissioning and provision of NHS services”.
Yet when he was Secretary of State and bore my right hon. Friend’s responsibilities for meeting this challenge, he made it clear that service reconfiguration was precisely
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how the health service needed to meet the challenges that it faced, and that the private sector had an important role—of course, not an exclusive role—in introducing the solutions to the challenge that Sir David Nicholson articulated in May 2009. The same approach was taken in the Labour party’s manifesto for the 2010 general election.
The challenge that the right hon. Gentleman has to address if he is to discharge his responsibilities as shadow Health Secretary is to move on from party political ding-dongs, of which we have had too many. [Interruption.] The right hon. Member for Holborn and St Pancras (Frank Dobson) is commenting from a sedentary position. I have always been aware that he, at least, does not agree with the commissioner-provider split that the shadow Health Secretary operated as Secretary of State and has always said that he is in favour of considering.
Frank Dobson: Would the right hon. Gentleman care to confirm for the House that in the last year when he was Secretary of State, NHS hospitals carried out 5.7 million operations and at the end of the Labour Government’s period in office it was carrying out 9.7 million operations?
Mr Dorrell: I am grateful to the right hon. Gentleman for drawing attention to the fact that throughout the history of the health service, under Governments of all political complexions, there has been a growth in the level of services, and improvement in the quality of services, provided to patients. It happened under the Tory Government of whom I was a member and under the Government of whom he was a member. Of course, that is delivered not by the politicians but by the doctors and nurses who work in the health service.
The challenge faced by the current generation of policy makers, including the shadow Health Secretary, is how to meet the rising demands and the requirement for improved quality in much more constrained financial circumstances than I or he faced as Secretaries of State. He signally failed to meet that challenge today.
6.34 pm
Mr Nick Raynsford (Greenwich and Woolwich) (Lab): This debate comes less than a week after the Secretary of State’s announcement that he is putting South London Healthcare NHS trust into administration. He will therefore not be surprised, and nor will the House, that I intend to focus on that issue.
Not surprisingly, this announcement has caused massive alarm and concern across south-east London. Staff working for the NHS in all three affected boroughs—Greenwich, Bromley and Bexley—are all worried about whether they will continue to have a job. Patients and their relatives are worried that the NHS services on which they have depended for years may no longer be available, as rumours abound about potential cuts and closures affecting hospital services. What is most regrettable is that all this is utterly unnecessary. Indeed, there is a strong suspicion that the whole process of putting South London Healthcare into administration is driven by politics—by the Government’s wish to send a message about being tough with trusts in deficit rather than by a rational assessment of what is most likely to help the trust to improve its clinical and financial performance.
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Let us look at the facts. At the time when the Secretary of State made his announcement, briefings appeared in the media about South London Healthcare being a failing trust with poor standards of clinical care. On the contrary, the trust has shown significant improvement in clinical performance. It is one of the top five trusts in the UK in terms of low mortality, hospital infection rates are three times lower than the national average, and the four-hour target for A and E patients has been met month on month since February. For those of us who have been working with South London Healthcare to raise its performance, it is particularly galling to see the Secretary of State dismissing those achievements and incorrectly claiming, as he did on 28 June in a communication to MPs, that patients at the trust
“experience some of the longest waits for treatment”.
That is simply not true of South London Healthcare today. It may have been true a year ago, but, as I said, there has been improvement, and the Secretary of State has ignored that. Indeed, he himself appears to realise that his criticisms were wide of the mark, as just one week after he made that statement I received a letter from him, as did many other London MPs, starting with the following memorable words:
“Dear Colleague,
I wanted to write to you with a summary of the excellent performance of the NHS in your area”.
You couldn’t make it up; talk about the left hand not knowing what the right hand is doing.
What about the deficit? Yes, there is a deficit—about £70 million last year—but South London Healthcare has been implementing a series of service changes designed to reduce it over the next four years while at the same time improving the standards of health care. Ironically, its task has been made much more difficult by the Secretary of State, who knows only too well that two years ago, in summer 2010, he intervened to halt the implementation of a clinically led plan to reconfigure services in south-east London entitled “A picture of health”, which, after six months’ delay and a review that he imposed, was judged to meet all four of the necessary tests. His intervention merely delayed a reconfiguration process that was going to improve services and save money. Now, after a wholly unnecessary and costly delay, the plan is proceeding, with the consolidation of A and E services on two, rather than three, sites and similar moves to concentrate specialisms: stroke at Bromley; elective surgery at Queen Mary’s, Sidcup; and maternity at Queen Elizabeth, Woolwich. All those changes have helped to improve performance and have made savings. Ironically, the same Secretary of State who delayed the implementation of these improvements is now blaming the trust for the deficit without acknowledging his own part in the process.
South London Healthcare has been in existence for just three years. It came into being as a merger of three trusts, all of which faced deficits and needed support and help to get out of their problems. As the trust’s ex-acting chair, who was removed from office today, said in his letter to the Secretary of State on 9 July,
“We have been prepared to take strong action—we are the only Trust in London to successfully close an A and E department and move maternity services…What we have not been prepared to do is to promise more than is within our capacity to deliver; nor to mask structural issues that need to be addressed.”
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It is a tragedy that, rather than supporting the trust in its really good work in improving patient care and reducing the deficit, the Secretary of State has acted in an arbitrary and unfair way and is trying to blame the trust for a problem for which he has a large measure of responsibility.