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Those, obviously, are extremely important issues that will need to be considered, but we should also bear it in mind that Ealing has one of the fastest-growing populations in the country. It seems strange to us that anyone should consider dismantling important parts of the health infrastructure at a time when we expect to see a much larger local population.

The consultation will continue until 8 October, but, as I have said, the form is extremely long and tricky to fill in, and rather off-putting as a result. It takes a lot of time; indeed, it took me an hour and a half to fill it in, and I have spent a considerable amount of time focusing on this issue.

Naturally and unsurprisingly, in common with all other well-honed consultations, this consultation is designed to draw participants to its own desired conclusions—although with a bit of serious work and concentration, it is possible to avoid that. However, marching and filling in petitions is all very well and fine, but we must remember that it is only the responses to the consultation that legally count. The Conservatives had a stall on Ealing common last Saturday, and we handed out more than 500 consultation documents, because we felt that that was one way to help the campaign practically. We apologised to everybody in advance for the time that it was going to take to fill them in, of course.

I understand that the consultation received an award for its clarity of language, but the intention behind it is clear to us: to get its desired result, which is support for closing the four A and E services that are closest to my constituency. I hope that Ministers will resist any such recommendation.

1.41 pm

Sir Alan Beith (Berwick-upon-Tweed) (LD): I am very glad to have this opportunity to raise the important issue of the lack of maternity services in Berwick, and I hope that it will prove helpful that the Minister replying to the debate is a specialist in obstetrics and gynaecology.

Berwick is 50 miles from the district general hospital—although there is one that is slightly nearer on the Scottish side of the border, the Borders general, which we also use quite extensively. That is a long way to travel for a birth, but on 6 August all deliveries at the Berwick midwife-led maternity unit were suspended. Along with that went all overnight recovery stays for people who had given birth in the Wansbeck or Borders general hospitals. There are now no facilities to support home births in the area, which is contrary to National Institute for Health and Clinical Excellence guidelines, and no evening antenatal clinics because the unit is open only during the day.

Two reasons for the suspension of the services were cited. One was that staff were not getting enough experience of deliveries. That has been a long-standing problem, and a review was taking place to address it—and the problem could have been addressed. Reference was later made to two incidents that were seen as a reason for taking more urgent action. However, the details of those incidents have not been disclosed, probably because proceedings relating to them may still be taking place.

The announcement caused great distress to the midwives concerned, who are much respected locally, and caused fury in the local community. Plans for Berwick’s new

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hospital are being drawn up, and many people believe that the trust might be trying to avoid providing maternity services there. The trust has often assured me that that is not the case, but there is increasing suspicion. Meanwhile, these services are absent, so mothers have to travel 50 miles to give birth. That is not the only issue.

One mother told me she had been driven the 50 miles to the Wansbeck hospital and examined there, but the hospital staff said, “No, you’ve come here too soon. Go home.” She was then driven 50 miles home. Within an hour or two of arriving back, she became convinced labour was about to start, so she was again driven by car 50 miles to the Wansbeck, where she was examined and the staff said, “No, we think you should go home. There’s no need for you to be here at present.” She dug her heels in, however, and said, “No, I’m not going. I’m staying here.” Within the time it would have taken for her to return home again—taking her total journey to 200 miles—the baby was born at the Wansbeck infirmary. That story serves to illustrate that the issue is about not births alone, but all the associated journeys that may be involved. That is one of the reasons why we generally try to provide maternity services reasonably locally.

The review that is taking place should look at how we can ensure that we have maternity services in Berwick that have the full confidence of the trust and the clinical staff. The majority of local mothers initially opt for births at Berwick, but by the time of delivery, the majority of them have accepted advice to have delivery at Wansbeck or the Borders. One has to ask why that is the case. Any mother reading the NICE guidelines, which are given to mothers, will say, “Oh, ambulance transfer might happen after labour has begun!” An ambulance transfer takes two hours; that is the specified NHS time for an ambulance transfer from Berwick to Wansbeck infirmary. It is clear that doctors often feel that they do not want to take any risk at all, so they recommend that delivery should take place at the distant hospital.

Some of the problems and other characteristics of a small unit that might have led to this situation arising can be addressed. The experience issue can be dealt with by staff rotation, so giving them time in a busier hospital to maintain their experience. Having consultants on call, and ensuring they can get to the local hospital more quickly than a transfer can take place, is another necessary feature. Such matters need to be examined much more carefully. Also, there is a role for telemedicine and the practice of having a consultant at the larger centre make an early assessment of whether problems are arising that need to be dealt with. The number of births at our maternity unit have at times been very low because the majority of mothers have been advised to go elsewhere. There was an entire year in which there were only 13 births, but the numbers have increased again, and at the time when the closure took place, 40 women were booked in to have their births at Berwick.

My overriding concern is for the safety of mothers and children, but it ought to be possible for most births to be safely carried out locally. In our debates on this topic, many Members have referred to problems in transfers to hospitals 10 or 15 miles away, but I am talking about a transfer of 50 miles for every birth to a Berwick mother. The majority of mothers in the Berwick

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area want to have their babies born in Berwick, and they should be able to do so and have confidence that the necessary skills and support are in place.

At last week’s Prime Minister’s questions, the Prime Minister set out that changes in clinical services should not be made without these four conditions being satisfied: support from GP commissioners, strengthened public and patient engagement, clarity on the clinical evidence base and support for patient choice. Those conditions are not satisfied in what is happening in my constituency, and they certainly would not be satisfied by a total withdrawal of maternity services, including delivery, at Berwick. I seek the Minister’s assurance that those conditions remain relevant and that the attention of the health care and primary care trusts involved in taking decisions about maternity services in my area will be drawn to their significance. I hope that the Minister and Department will assist the trusts in any way that they can to work up a good scheme to ensure that people in my constituency can have confidence in their future maternity services at Berwick.

1.48 pm

Pauline Latham (Mid Derbyshire) (Con): May I take this opportunity to welcome the new Health Minister, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), to his post and wish him every success in his new role?

I want to draw the attention of the House and, in particular, the Minister to two key issues in relation to type 1 diabetes. Some Members may be aware that I spoke on this issue last week in a Westminster Hall debate, but today I want specifically to urge the new health ministerial team to support the artificial pancreas project that is being funded by the charity JDRF. If the Department can find any funding to assist the research, that would be very welcome.

I wish to ask the Department of Health to end the postcode lottery that exists in the NHS on access to insulin pumps. At present, there are no answers on what causes or how to cure type 1 diabetes. The only way to find a cure for type 1 is through greater investment in medical research. If additional funding can be made available to cure, treat and prevent type 1 diabetes, it will result in long-term cost efficiencies for the NHS. It will also help the UK to retain its position as a world leader in this type of medical research.

Type 1 diabetes is a chronic, life-threatening condition that has a life-long impact on those diagnosed and their families. It strikes children and adults, staying with them for the rest of their lives. It is usually diagnosed in childhood between the ages of 10 and 14, but more and more children are being diagnosed much earlier, from 18 months onwards. It is an auto-immune condition; it causes the body’s own immune system to turn on itself and destroy the beta cells in the pancreas, leaving the body unable to produce the life-essential hormone, insulin. Insulin pumps cost between £1,000 and £3,000. There are additional costs for the consumable attachments, infusion sets, batteries and pump reservoirs, for which patients might have to pay themselves. The cost of those consumables could amount to between £1,000 and £2,000 per annum for each patient.

By contrast, the Scottish Government announced in February 2012 that all eligible under-18s with type 1 diabetes in Scotland will now have access to insulin

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pumps. They have also said that the Government are committing funding of at least £1 million to help NHS boards deliver pumps to under-18s who need them, as well as tripling the amount of pumps available to all people with the condition in Scotland. That has been followed by a further boost of £1.5 million this April in Scotland to provide more young people with insulin pumps.

Type 1 diabetes is a very different, distinct condition from type 2 diabetes, as it is not linked to lifestyle issues, such as diet and exercise. People with the condition rely on a programme of finger-prick blood sugar tests and insulin pump infusions or injections up to 10 times a day to stay alive. Although these prolong life, they are not the cure. A child diagnosed with type 1 diabetes when they are five faces 19,000 injections by the time they are 18. People with the condition are at risk of devastating complications, including blindness, heart disease, amputation, strokes and kidney failure, to name but a few.

Type 1 diabetes reduces life expectancy by about 20 years and there is a small but very real chance of sudden death. The short-term complications include debilitating hypoglycaemia, which, if left untreated, can lead to unconsciousness, coma and occasionally even death. Children never escape the responsibility of checking their blood sugar level and parents never have a day off from worrying about their children, even at night, as the blood sugar level has to be checked. Parents cannot relax because one of them must get up at night to check that their child is okay—or even still alive.

JDRF has told me that about 500 people in each constituency have type 1 diabetes. Therefore, more than 26,000 children in the UK have type 1 diabetes, which is as many as one in every 700. Some 98.6% of the children and young people who have diabetes will have type 1. The incidence of type 1 diabetes is increasing by about 5% year on year.

Keith Vaz (Leicester East) (Lab): The hon. Lady is making an excellent and powerful speech. I declare my interest as a sufferer of type 2 diabetes. I wish to emphasise the importance of prevention work. She has talked about type 1, which is difficult to prevent; but in general, the more money that is spent on preventing diabetes, the less money that will need to be spent by the NHS in the future.

Pauline Latham: I thank the right hon. Gentleman for that intervention, because he is a big champion of tackling diabetes, particularly type 2, and he will speak up at every opportunity. Good care for not only the young with type 1, but for older people who can try to prevent themselves from getting type 2 diabetes will, of course, save the health service a huge amount of money.

As I mentioned, JDRF funds a large research programme to develop a closed-loop artificial pancreas, to help children with type 1 diabetes to live a life without the constant need for painful finger-prick tests and multiple insulin injections every day just to stay alive. It would give people with type 1 diabetes the freedom from those injections every day and has the potential to prevent some of the devastating complications that can arise from the condition. It would also give parents peace of mind that their children are much more likely to have stable blood sugar results, thus keeping them out of hospital.

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The project involves two pieces of equipment that are already available to people with type 1 diabetes: a continuous glucose monitor that measures blood glucose levels regularly; and an insulin pump, such as the one I am holding, that painlessly administers insulin. The main task is to develop a computer that can talk to the two components and calculate exactly how the insulin pump should react and when to administer the insulin. That would close the loop to make the device a functioning artificial pancreas. This artificial pancreas is not yet commercially available, although the research team have already completed trials of the artificial pancreas in a hospital setting and are now beginning trials where children take the artificial pancreas home to see how well it works in a real-life situation.

Will the Minister please give an undertaking to monitor this research carefully and, if possible, lend his full support to this piece of groundbreaking research, which could improve the quality of life for so many young people in my constituency and many thousands across the country—it could do more than that; it could transform their quality of life.

The second issue that I would like to raise briefly this afternoon is the inequality that exists in our NHS in getting access to an insulin pump. The Minister may be aware that the Medical Technology Group recently carried out a freedom of information survey of every primary care trust in England, publishing its findings in “Pump Action—A Review of Insulin Pump Uptake and NICE Guidance in English Primary Care Trusts”. The report shows significant inequality in the provision of insulin pumps across England and a lack of adherence to National Institute for Health and Clinical Excellence guidance, with low insulin pump usage compared to the NICE benchmark. The average rate of insulin pump provision for people with type 1 diabetes is 3.9%, compared with the 12% benchmark recommended by NICE; it is nowhere near the 33% recommended for children younger than 12.

There is, without doubt, a postcode lottery on insulin pump access. The percentage of people with type 1 diabetes using an insulin pump falls as low as 0.25% in Medway and 0.3% in Croydon. In my county of Derbyshire, the rate is 4.4%, with 120 people using an insulin pump out of the 2,746 people with type 1 diabetes in the area—that is well below the NICE guidelines. May I request that the Minister take urgent action as soon as possible to address this issue? It simply is not fair that people can be denied treatment just because they live in the wrong part of the country.

1.58 pm

Jeremy Lefroy (Stafford) (Con): May I, too, welcome the Minister to his place? Last week, two decisions were taken affecting the Mid Staffordshire NHS Foundation Trust, which covers the Stafford and Cannock hospitals. The first was the decision by Monitor to undertake a review of the trust’s finances. The second was the decision of the commissioners not to reopen the accident and emergency department at night, although the trust had said that it was in a position to do so. What is common to both decisions is that there has been no consultation so far with my constituents or those of my hon. Friends the Members for Cannock Chase (Mr Burley), for

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Stone (Mr Cash) and for South Staffordshire (Gavin Williamson). These are their health services, which is why I have established a working group specifically to look at Stafford hospital, so that my constituents can make their proposals and views clear, both to Monitor and to the commissioners.

As hon. Members will know, there has been a public inquiry into the failings of Stafford hospital, especially those in the period 2005 to 2009, although the failings go back much further. The Francis report in 2010 exposed shocking care, particularly of the elderly and vulnerable. The public inquiry, which looks at why the NHS and others failed to pick up these problems, is due to report later this year, so I will not comment on that. The time of publication will be the time for very careful and mature reflection on what happened and how the NHS must change in response. As a senior member of the Royal College of Physicians said to me, it is the most important inquiry into the NHS in two or three decades.

Standards at Stafford hospital have improved considerably in the past three years, although there is no room for complacency. The Care Quality Commission recently lifted all its remaining areas of concern and the accident and emergency waiting time target has been met for the first time in a long time. There remains a substantial financial deficit, however, with an operating deficit of some £16.5 million last year and one of £15 million predicted for this year. At this point, I thank the previous Secretary of State for Health, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), who is in his place as Leader of the House, and the former Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns), for their steadfast support for the trust as it sought to recover, as well as the staff of the hospital and those from the Ministry of Defence who helped out at A and E for a few weeks.

The financial problems facing the Mid Staffordshire trust that Monitor wishes to tackle arise, in my analysis, from three sources. The first is underuse of the estate in Stafford and Cannock. It is essential in my view, and that of my hon. Friend the Member for Cannock Chase, that both hospitals remain open, but the estate must be used efficiently as money that is needed for services is being spent on empty property.

Secondly, the consequences of the events at Stafford mean that patients who would normally attend Stafford no longer do so. Confidence in the hospital needs to return, and that confidence must be based on real progress. There are welcome signs that that is happening, but it will take time.

Thirdly, and most importantly by far, endemic problems face medium-sized acute trusts across the country. Mid Staffordshire is far from unique and that is where the Monitor review is vital as it has the chance to establish a sustainable model for district general hospitals around the country. There seems to be a view gaining currency that all medical care in the future will either be highly specialised or general, based in community hospitals, which will squeeze out the medium-sized acute hospitals. Not only does that not accord with the evidence, it goes against the wishes of the public.

I do not dispute the need to concentrate highly specialised care in larger hospitals where consultants in each specialty are available around the clock. That has happened for some time. However, there is an increasing and substantial

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need for emergency and acute care, particularly for the elderly, which is much better given as locally as possible and in close co-ordination with social care services. District general hospitals such as Stafford remain the best place for that.

Monitor therefore has an excellent opportunity to work together with the people of Stafford and Cannock to show how a medium-sized acute trust can flourish in the tough financial climate we face. Indeed, Monitor has a duty to do so under section 62 of the Health and Social Care Act 2012, which states that its main duty

“in exercising its functions is to protect and promote the interests of people who use health care services by promoting provision of health care services which…is economic, efficient and effective, and…maintains or improves the quality of the services.”

It also states that:

“In carrying out its main duty, Monitor must have regard to the likely future demand for health care services.”

The last paragraph is very important as not only is the population of the area predicted to rise substantially in the coming years, but there will be a greater demand for acute care.

It may be argued that none of Monitor’s duties requires that services be provided locally. I reject that. To provide services locally is economic, efficient, effective and an intrinsic part of their quality, so Monitor has a duty to promote health care services that are as local as possible. We also need to be very careful in the definition of the word “services”. In the debate in Committee on what was then clause 69, I said that

“it is extremely important to have clarity on what constitutes a service. Services can be salami-sliced down to very small items or, as others have said, they can be an agglomeration. One could say that, in an acute hospital, a service is not only the accident and emergency, but some—not necessarily all—of the other wards associated with it. That might constitute a block of service or, under other definitions, several services. How will Monitor interpret that word?”––[Official Report, Health and Social Care Public Bill Committee, 22 March 2011; c. 943.]

Gavin Williamson (South Staffordshire) (Con): Everyone in Staffordshire knows how hard my hon. Friend has fought on behalf of Stafford hospital. Does he agree that the closure of Stafford A and E at night will put an increasing burden on many other local hospitals, including New Cross hospital in Wolverhampton and the University hospital of North Staffordshire?

Jeremy Lefroy: I entirely agree. Of course, the hon. Member for Walsall South (Valerie Vaz) has the Manor hospital in her constituency, too, and I pay tribute to the work done by her hospital, by my hon. Friend’s hospital in New Cross and by Stoke and Burton hospitals.

So, how will Monitor interpret the word “services”? To date, as far as I am aware, we do not know the answer to that question. I want to make a very clear case that Monitor must, in the case of emergency and acute services, view the matter in the round and not engage in accountancy-based salami slicing. One cannot separate an A and E from a medical admissions unit, a surgical admissions unit, a paediatric admissions unit, an intensive care unit and the related diagnostic and therapeutic services. They must be considered as a service block. Of course, there will be a difference between the block in a district general hospital and that

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in a major specialist hospital, as the latter will cover emergency and acute events that a district general hospital cannot.

That brings me to the question of the accident and emergency department at Stafford, which has been closed between 10pm and 8am since 1 December last year. Today a petition is being presented in Downing street to urge the reopening of the department at night. Up until Sunday 16 September, 4,381 patients who would have been treated at Stafford at night have gone to other hospitals. To put that in perspective, the A and E department treated 51,000 people in 2011-2012. That is more than 4,000 patients who could not use their local acute hospital in an emergency when previously they could. We need to see them back at Stafford.

The reason given for closing the A and E department at night was that it was not safe for 24/7 reopening. Subsequent events have proved that to be the right decision as the department was close to breaking point. However, a set of criteria were given for reopening and the trust considers that, after much hard work, they have now been met, although there are concerns about sustainability. The commissioners have decided not to go ahead with night-time reopening but instead to pursue what they call a model of 24/7 emergency and urgent care. My constituents and I were very disappointed with that, because, nearly 10 months after night-time closure, we still do not have an A and E 24/7 but also because we do not have details of what that emergency and urgent care model might be. What are the similarities and differences between emergency and urgent care and A and E as traditionally understood? That needs to be made clear, not just in Stafford and Cannock but everywhere such a model is proposed.

The commissioners’ statement made it clear that even while A and E was closed, children, maternity and GP cases continued to be received at Stafford at night. They are also working on how to bring back to Stafford the 15 or so patients who currently have to go elsewhere each night. That is welcome and sounds similar to the service prior to closure. So what is different? Can we not return to an open-door 24/7 service with effective triaging to filter out the unnecessary attendances that place a strain on emergency departments everywhere?

Mid Staffordshire trust may be exceptional in the long hard road it has to travel to regain the confidence of local people—and it has come a long way down that road—but it is not exceptional in the pressures it faces as a district general hospital. The Government have a chance to show how district general hospitals can thrive, providing emergency, acute and elective services to their people, working closely with social care and with the specialist hospitals in their neighbourhood.

2.7 pm

Andrew Stephenson (Pendle) (Con): I recently spent the day out and about with the North West ambulance service and want briefly to cover my experiences with them.

The North West ambulance service is England’s largest ambulance service, with more than 5,200 staff, 109 ambulance stations and three control centres. It deals with more than 1 million emergency calls every year and although it also provides a non-emergency

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patient transport service, my day focused on the emergency medical response that it provides 24 hours a day, 365 days a year.

On Thursday 30 August I joined local paramedic Andy Swinburn in a rapid response vehicle that was responding to emergency calls across the Burnley and Pendle area. Although I am sure that many hon. Members would enjoy being in the passenger seat of an emergency services vehicle with the blue lights flashing, I wanted to witness the challenges faced daily by staff from the Barnoldswick, Nelson and Burnley ambulance stations.

During the shift, the vehicle I was in responded to nine blue-light emergencies, seven of which were in my constituency of Pendle. I am told that that was a quiet day, and it certainly was compared with the day before, when the air ambulance was called out twice to east Lancashire. For someone such as me, however, who had never spent any time with the ambulance service before, it certainly seemed anything but quiet.

During the day, the paramedic I was with dealt with everything from people having dizzy spells and epileptic fits to suspected heart attacks and someone who had serious-looking head injuries after falling from a ladder. In between calls and when I met other paramedics at the Nelson ambulance station, we discussed a range of issues from the classification of different emergency incidents and the value of the eight-minute response time through to problems caused locally by alcohol and drug misuse.

We also discussed the question of which hospital a patient is taken to, which has been an issue of much concern among people locally after Burnley general hospital’s A and E department was downgraded to an urgent care centre in 2007. The people involved in the calls we responded to during the shift were taken to Airedale, Burnley and Blackburn hospitals, depending on which was best placed to treat the individuals concerned.

We also discussed something of which I was previously unaware, which is that paramedics are currently unable to prescribe drugs. I would appreciate the Minister’s thoughts on that—I, too, welcome him to his new role. It seems entirely logical to me that if a senior paramedic can diagnose a problem while in someone’s home, they should be able to prescribe the required drugs rather than having to call out a GP or take the individual to hospital.

Another issue worth considering is the basis of commissioning of ambulance services. When asked about ambulance services, the public will invariably put the speed of response above all other concerns, including the quality of care. The eight-minute response performance indicator in part reflects what the public say they want. However, some of the paramedics I spoke to felt that if they were commissioned on the basis of being able to treat people with certain conditions at the scene, usually the person’s home, there could be considerable savings to the NHS. That links to my point about paramedics being able to prescribe the required drugs.

Although such a commissioning move would undoubtedly have a range of knock-on impacts, it was clear from the day I spent with the ambulance service that many people did not want to be admitted to hospital and would have much preferred to have stayed

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in their own home. I know that the Minister, given his background, will be acutely aware of not only the cost of hospital admissions, but the stress and other complications that such admissions can lead to.

Overall, I felt that the day gave me an invaluable insight into the work of our local paramedics and the ambulance service. Although I have never needed to use the ambulance service—thank God—it was hugely reassuring to see the professionalism and dedication of those who work in it. I will conclude simply by extending my thanks to the North West ambulance service, to Andy Swinburn, the senior paramedic I spent the day with, and to all our local paramedics for the remarkable job they do.

2.11 pm

Greg Mulholland (Leeds North West) (LD): I rise to make a further contribution in this House on the deeply flawed decision by the Joint Committee of Primary Care Trusts, with regard to the Safe and Sustainable review of children’s heart services, to close the excellent Leeds children’s heart unit. I know that other colleagues will also speak about that today and that many across the House feel strongly about it. I welcome the new ministerial team to their posts and hope that they will now look at the matter.

To be absolutely clear, neither we nor the campaigners in Leeds challenge the premise of the national review, but the decision to close the Leeds unit is very questionable. One of the questions that has not been adequately scrutinised is whether the decision even concurs with the premise of the review, and I believe that it clearly does not. That is most patently a matter for ministerial interest, because a flawed and wrong decision is indeed the business of Ministers, so I hope that the Minister will take that away and reflect upon it.

I will just update the Minister and the House on the current situation. A referral is being prepared by the joint health overview and scrutiny committee for Yorkshire and the Humber, and that is part of the democratic process of scrutiny of our NHS, but it is being held up by the obstructionism of the JCPCT, which has made the decision. The JCPCT is refusing to hand over all the information requested, which is absolutely disgraceful. At the same time, implementation is being forced through as if there is an attempt to avoid the scrutiny that is essential in any major decision on the health service, and especially in so sensitive a case. Professor Deirdre Kelly, who chairs the implementation advisory group, has said:

“Implementing the decision on the future of children’s heart services is a top priority and we need the work to start now so that children can benefit during 2014.”

Sir Neil McKay, who chairs the JCPCT, has said—rather outrageously, considering the strength of feeling among children and families in Yorkshire and the Humber—that:

“Children and their families have waited far too long for these vital services to be changed”.

That is patently absurd when we consider that 600,000 people from the region have said that they do not wish the service to be closed and changed in the way that he and his committee propose.

Let me go further and say that the JCPCT secretariat is denying access to key documents needed to challenge the decision while at the same time releasing reams of

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largely irrelevant material. We do not yet have enough information on the weighting methodology used or detailed scoring information and assessment forms for each surgical centre, something that is crucial for determining whether the decision is as robust as Sir Neil McKay seems so desperate to tell us it is while trying to force it through. Councillor John Illingworth, who chairs the joint health overview and scrutiny committee, has said:

“This is completely unacceptable. JHOSC is the statutory body that should scrutinise the JCPCT decisions, but we cannot complete this process without a full disclosure by JCPCT. The reluctance of the JCPCT to release this non-confidential material is delaying the entire scrutiny process.”

The simple and outrageous reality that I want the Minister to take away—he is conferring with the former Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley), but I hope that he will listen to this point—is that the JCPCT is deliberately denying the joint health overview and scrutiny committee access to the documents in an effort to block any real scrutiny of this flawed process. That is disgraceful, because that is the proper process. We need full disclosure, because this is a democratically referred renewal, as Ministers have explained from the Dispatch Box previously.

I must also bring into focus the rather unsavoury role being played by the Children’s Heart Federation. As a charity, it is being used to try to force the pace of implementation of a decision that has not yet been formally approved and ratified. Its chief executive, Anne Keatley-Clarke, has said:

“Further possible delays in implementing the planned improvements to children’s heart services across England would be extremely worrying and would also cause a great deal of further uncertainty and distress for parents right across the country.”

That is a dishonest suggestion, frankly, considering the distress that those parents and families across the country, and in our case in Yorkshire and the Humber, are already feeling as a result of the decision. To try to force it through and undermine the Leeds unit before the decision has been finalised is something that a charity should simply not be doing. It is an arrogant and insensitive thing to say and, in my opinion, brings the charity into disrepute. The reality is, to quote my constituent Steph Ward, the mother of Lyall Cookward, who has relied on the Leeds unit:

“The Children’s Heart Federation have acted in a disgraceful manner. Anne Keatley-Clarke and her organisation think it is perfectly acceptable to completely ignore the views of 600,000 people, so how dare they call themselves a national organisation when they are prepared to ignore such a large section of the country?”

Will the Minister give us a clear assurance today that implementation will not be forced through until the proper process has been followed and there has been full, proper and honest disclosure of all the material necessary to scrutinise the decision? We do not have that. I hope that he can at least give us that assurance today. In the end, we all accept that the review was commissioned. We can have an argument about the number of operations that should be carried out—incidentally, we still have the ludicrous situation in which Glasgow will be permitted to carry out only 300 operations a year but will be deemed safe and sustainable, yet Leeds, which can carry out many more operations, will not be. We have still had no word about that, but organisations, particularly the JCPCT, are trying to

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force through the decision as if it is finalised. It is not finalised, and the democratic body that is there to scrutinise the decision on behalf of us all has so far been denied the very documents it needs. If that is not sinister, I do not know what is. We must have full disclosure, we must have an open and transparent process, and we must have that now.

2.19 pm

Stuart Andrew (Pudsey) (Con): I cannot resist the opportunity in the time available to raise the same issue as that which my hon. Friend the Member for Leeds North West (Greg Mulholland) has just addressed, particularly given the fact that we now have a new ministerial team. I am delighted to see the new Minister on the Front Bench.

I realise that the Safe and Sustainable review is independent of Government, as the former Health Minister, my right hon. Friend the Member for Chelmsford (Mr Burns), told me on many occasions. It is clear, however, that there is a problem with the decision, particularly in the north-east of England, and I hope that we can try to find a solution today.

It is worth restating the issue. Despite claims by some, right hon. and hon. Members on both sides of the House, parents, the charity and clinicians are fully supportive of the review’s objectives. It has never been in doubt that safer and more sustainable units are the way ahead, but we are concerned that the outcome does not meet the review’s objectives. It goes against logical health planning, patient choice and clinical preferences. The fact is that patients in Yorkshire, Humberside and north Lincolnshire will simply be offered a poorer service.

Patient choice has been totally disregarded. A survey of patients showed that those in the major postcode areas would go not to Newcastle, but to Liverpool, Birmingham or, indeed, London instead. At the decision-making meeting, it was said that those patients would be influenced by referring doctors. The assumption was made that they would be pointed towards Newcastle, but no justification has been given for that assumption. Indeed, all of the 20 referring clinicians in the Leeds network, whose views were never sought by the Safe and Sustainable review, have said that they would not refer patients there for surgical treatment.

Greg Mulholland: It is a pleasure to carry on campaigning with my hon. Friend on this issue and we will continue to do so. Does he still agree with what we have said before, namely that the reason the Leeds unit is to be closed is the flawed assumption that that will allow Newcastle to reach the target of 400 operations, even though it will not? The unit is being sacrificed for something that will not even happen.

Stuart Andrew: I am grateful for that intervention, which brings me on to exactly that point. The review’s decision said that 25% of Leeds, Wakefield, Doncaster and Sheffield patients would go to Newcastle, when its own evidence said that they simply would not. Funnily enough, if 25% of those patients go to Newcastle, guess what? Suddenly, 403 patients a year will have surgical operations in Newcastle, which is just three more than the magic figure of 400. I do not believe that that 25% will exist, so Newcastle will miss the target of 400 operations, which is a key plank of the whole review.

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We have heard about how public opinion has been discounted. A petition signed by more than 600,000 people was brought down to Downing street. That is an enormous number for one region, yet the review counted it as just one response. On the other hand, 22,000 text messages received in support of Birmingham were counted as 22,000 separate responses, which is blatantly unfair.

One of the most important issues is the co-location of services. What has impressed me about the Leeds unit is that it is part of the Leeds children’s hospital. All other surgeons get there within minutes, if needed. We are asking our patients in our constituencies to go to Newcastle, where all other services are some 3 miles away from the heart surgery unit. That is simply not acceptable and goes against the advice of the key recommendation of the Bristol inquiry, which was backed by the British Congenital Cardiac Association. The inquiry said:

“For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

It is important that we do not forget that.

The fact is that, allowing for patient choice and without the flow of patients from the populous areas of Yorkshire, as evidenced by the PricewaterhouseCoopers research, Newcastle will not reach the target of 400 surgical procedures. In 2010-11, Leeds delivered 336 procedures against Newcastle’s 271.

The impact assessment also showed that the options that included Leeds would have fewer negative impacts and that option B, which included Newcastle, would be particularly damaging for paediatric intensive care in Yorkshire and Humber.

It is also important to ask why Birmingham was chosen because of its density of population and Leeds was not, given the fact that we have a high south Asian population who, statistically, are more likely to need the service. As we have said time and again, doctors should go where the patients are, not the other way around.

Sheffield parents whom I have met at the unit travel three times a day to visit their children in hospital, because they have other children at home. We have to think about the impact this has on families.

Martin Vickers (Cleethorpes) (Con): I congratulate my hon. Friend on his work on this issue. His point about distance is particularly relevant to my constituency. Cleethorpes is about 85 miles from Leeds and the parents will not travel to Newcastle, so it will not reach that figure of 403.

Stuart Andrew: I am grateful to my hon. Friend for the support that he has given to the campaign by meeting his own constituents who, he is right to say, will not travel to Newcastle. His comments further highlight the ludicrous nature of the decision.

I have presented the problem, so what is the solution? I recognise that the review is independent of Government, but we have to tackle the problem—it will not go away, because we as Yorkshire, Lincolnshire and Humberside MPs will not let it. Our view is that the review could happily be implemented elsewhere, that both Leeds and Newcastle should be kept open and that a decision on their future should be delayed until April 2014. That would provide an opportunity for patients and parents who require the services to exercise their constitutional

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right to patient choice and to determine which centre they wish to access. By the end of that period, each centre would have to demonstrate that they were fully compliant with all the standards set by the Safe and Sustainable review.

This solution would amount to only a one-year pause. Given that legal proceedings are likely to take place, there will be a one-year pause in any case. The reconfiguration of all children’s heart surgery centres in England is not due to commence until April 2014 and a decision taken at that time on Leeds and Newcastle could be implemented in 2015. The definition of a centre that delivers a sustainable service is that it should have a minimum of four surgeons, so if, after the one-year pause, commissioners did not think that the Newcastle unit had a sufficient work load, the Leeds unit could explore how it could provide support in conjunction with Newcastle.

If either of the centres did not meet the standards, it would, frankly, let itself down. This solution gives them the opportunity to provide the services that families are so desperate to keep. There are many benefits to the solution: it would avoid the risk of a costly judicial action from supporters of either unit, which could sink the review in its entirety; it would give Leeds and Newcastle the opportunity to demonstrate their compliance with the safe and sustainable standards, which is what we all want; it would allow the less controversial decisions made by the JCPCT to proceed elsewhere in the country; and it would show, frankly, that the Government are listening to the concerns of the 600,000 people who signed our petition, and I am sure that the public would respond accordingly.

I know that this is not an easy decision, but there is a great deal of concern and anxiety in our region. I hope that the Government will not just give us the line that this is a review independent of Government, but acknowledge that there are serious concerns and great anxiety among our patients and families, and that it is time to look at the issue in detail, to listen and to act.

2.29 pm

Iain Stewart (Milton Keynes South) (Con): I am grateful for the opportunity to speak about community health services in Milton Keynes. Before I outline the issue that is causing concern locally, I will set out the background.

Milton Keynes council, the primary care trust and Milton Keynes Community Health Services have a 12-year history of working collaboratively to deliver jointly commissioned and provided services to the citizens of Milton Keynes. That has been possible because the three organisations share a common vision and common values, and are committed to the principle of local services for local people. The collaboration has supported a transformational approach, which has delivered financial efficiencies and good quality outcomes for people. There is a single joint management structure, which manages combined budgets and resources, and works to a single operational policy.

The collaboration covers mental health and learning disability services, intermediate care services for older people and community equipment. Additionally, there is an integrated pathway involving adult community nursing, end-of-life care, community matrons and social

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workers. I put on the record my deep appreciation of the invaluable role that those dedicated professionals play in our communities. They often go unsung, so I would like to take this opportunity to record my gratitude.

To achieve such a locally tailored, integrated model is one of the admirable aims of the Government’s health and social care reforms yet, oddly, our successful local model may be at risk because of administrative factors. I hope that common sense can prevail.

Last year, it was hoped that there would be a managed transfer of the community health services to Milton Keynes Hospital NHS Foundation Trust. However, that was not achievable within the required timetable and the PCT enacted a temporary divestment to Bedford Hospital NHS Trust, in full agreement with the strategic health authority and in full knowledge of the anticipated later divestment to the foundation trust. That is an acceptable hosting arrangement that will allow the integrated model to continue.

On 14 December last year, the PCT wrote to the foundation trust, inviting it to submit a proposal for the managed transfer of the community health services, which was to be considered by the PCT board at the end of February this year. However, on 22 February, the cluster PCT received e-mail communication from the head of provider development at NHS East Midlands, which advised that it should follow an open tendering process.

On 11 April, following strong representations from the council and local health partners, a positive meeting was held with Bob Ricketts at the Department of Health, where it was indicated that a managed transfer of the community health services to the hospital would be possible, subject to SHA assurance. However—the situation gets more complicated—a letter from Sir Neil McKay, of NHS Midlands and East, advised that the transfer was no longer possible and that the PCT should proceed towards a competitive tendering process for NHS providers only.

On 12 June, my hon. Friend the Member for Milton Keynes North (Mark Lancaster) and I raised questions in the House on this issue. In response, the then Secretary of State for Health urged the PCT and the SHA to ensure that any decision was in the best clinical interests of patients. He stated that it must meet the views of clinical commissioners of the future and those of the public, not least as expressed through the local authority.

Following that, NHS Midlands and East met Milton Keynes council and its partners to discuss the position adopted by the SHA. It was agreed that a meeting should be convened to assess the case for an integrated care organisation. However, it was also agreed that the cluster PCT should continue with a twin-track approach, including an expressions-of-interest process.

Finally, on 11 September, NHS Milton Keynes and Northamptonshire cluster PCT received advice from the NHS Midlands and East SHA to progress with an NHS-only competitive procurement for the services currently provided by Milton Keynes Community Health Services. There has, therefore, been a sequence of contradictory advice from different parts of the NHS, which has thwarted the ambitions of the council, local health partners and patients’ representatives to achieve the best local solution for our citizens—an integrated care organisation in Milton Keynes.

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All that is happening at a time when the NHS landscape is changing. The SHA and PCT will be wound up next year, and there is an acute services review that may change the configuration of the local hospitals. My call, and that of my hon. Friend the Member for Milton Keynes North and many local people, is quite simple: the temporary hosting arrangement should continue for the time being, until the new NHS landscape is settled and a sensible permanent arrangement can be found. My hon. Friend and I have raised this matter with the Secretary of State. In welcoming the Minister to his new role, I hope that he will ask the Department to intervene in any way that it can to achieve the common-sense solution, for which there is much local appetite.

2.35 pm

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): I thank hon. Members for their kind comments. A lot of ground has been covered in this debate and many good points have been raised about local NHS services. I hope that hon. Members will forgive me if I cannot give comprehensive answers about everything that has been raised, but I will do my best in the time that is available.

It was clear from all the points that were made in the debate that every hon. Member sees the NHS through the prism of the patient. That is the right way to regard how NHS services are delivered. Patients are the priority for our NHS services and for the Government, and they were the priority for the former Secretary of State, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), in his decision to push ahead with the NHS reforms. The basis of the “No decision about me without me” policy is that patients are the most important thing. They are why doctors and nurses do their work and why all Governments endeavour to fight for a better NHS.

I turn now to the concerns of individual Members. I believe that I am right to wish my hon. Friend the Member for Milton Keynes South (Iain Stewart) a happy birthday. A number of hon. Members have concerns about the competitive procurement processes for community health services in Milton Keynes. He mentioned the concerns of my hon. Friend the Member for Milton Keynes North (Mark Lancaster). Our policy is clear that it is for the local NHS, and the primary care trust in particular, to look at the options for different procurement procedures and to decide what is best for local people. The local strategic health authority has played an important role in assuring the PCT’s decisions. Whichever option is chosen, it must be possible to put it in place before 31 March 2013, to avoid the continuing and damaging uncertainty for staff. I am happy to meet my hon. Friend the Member for Milton Keynes South and other hon. Friends to discuss the matter further.

My right hon. Friend the Member for Berwick-upon-Tweed (Sir Alan Beith) talked about maternity services, which is a matter close to my heart. This morning, I visited Newham university hospital, which faces different challenges in maternity care. I looked at the fantastic new unit that has been opened at Newham, which will meet those challenges and provide high-quality maternity care to that part of London.

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My right hon. Friend was right to point out that the challenges for maternity services—indeed, for all health care services—in more rural areas such as Berwick-upon-Tweed are different from those in more urban parts of the country, such as London. Women and families in Berwick, like women and families everywhere, deserve maternity services that focus on improving the delivering of high-quality health care for women and babies, and on improving women’s experience of care.

The decision temporarily to close the midwifery-led maternity unit and in-patient post-natal services at the Berwick infirmary, to which my right hon. Friend alluded, was difficult for the local trust to make. He is right to say that in making such decisions there should be regard to the rurality of the area. He made good suggestions about the potential for rotating staff to support rural maternity units. I understand that the decision was made to protect the quality and safety of maternity services in the area and, in particular, to protect the quality of care and safety of women in labour.

I have been assured that the trust is working closely with commissioners to look at the future of maternity services in Berwick. The review will be completed in the coming months. My right hon. Friend may be aware of the recent birthplace study, which discusses good and bad practice in supporting smaller maternity units. I am sure that the commissioners will have regard to that study in making decisions about the future of the unit in his area. He should be assured that I will take a close interest in the matter and support his advocacy on behalf of his constituents.

My hon. Friend the Member for Ealing Central and Acton (Angie Bray) made some points about the service reconfiguration of health care services in London. The hon. Member for Mitcham and Morden (Siobhain McDonagh) also mentioned that issue, and I am sure she would like to pay tribute—as I do—to my right hon. Friends the Members for Carshalton and Wallington (Tom Brake) and for Sutton and Cheam (Paul Burstow), for their work over the years campaigning for services at St Helier hospital.

Key tests must be passed to ensure that clinical services are suitable for reconfiguration. First, there must be support from local clinicians, and, secondly, arrangements for public and patient engagement and consultation—including with local authorities—must be strengthened and put in place. Thirdly, we need greater clarity on the clinical evidence bases underpinning proposals, and, finally, any proposals should take into account the need to develop and support patient choice.

The reconfiguration of front-line health services is up to the local NHS, and no decisions will be taken until there has been a full public consultation. St Helier hospital is part of the south-west London reconfiguration scheme “Better Services, Better Value”, which is in its pre-consultation stage and is led by local GPs, nurses, acute clinicians, other health care professionals and patient representatives. Under “Better Services, Better Value”, the number of accident and emergency and maternity units will be reduced from four to three, and the likely recommendation is for St Helier to become a local hospital with an urgent care centre.

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Ealing hospital is part of the “Shaping a healthier future” scheme in north-west London. Proposals for that scheme include centralising A and E units, and having maternity facilities on fewer sites. However, I reassure my hon. Friend the Member for Ealing Central and Acton that there are no plans to close any hospitals, and certainly not Ealing hospital. As she said, a full public consultation began on 2 July this year and will finish no earlier than 8 October, and I encourage my hon. Friend and her constituents to continue engaging with that process. She outlined the good campaign that she has been running to encourage local engagement, and I am sure she will continue with that so that local voices can be heard when health care decisions are made in the area.

The issue of children’s congenital heart surgery was raised by a number of hon. Members, including my hon. Friends the Members for Leeds North West (Greg Mulholland) and for Pudsey (Stuart Andrew). My hon. Friend the Member for Sittingbourne and Sheppey (Gordon Henderson) spoke passionately about Jacob, the son of one of his constituents.

A number of hon. Members are concerned about the “Safe and Sustainable” review of specialist paediatric services, and particularly its focus on the reconfiguration of heart surgery services. However, as was made clear in a number of contributions, its findings were based on Professor Kennedy’s review of paediatric heart services at Bristol after the heart scandal there, and the “Safe and Sustainable” review is independent of the Government, as it should be. In those circumstances, and given the notice of legal proceedings and referrals to the Secretary of State, it is not appropriate for me to comment further on that review or its outcome, and that stands for my statement on the Floor of the House as well as for my correspondence with constituents. I know that my hon. Friend the Member for Leeds North West has written to the Department on this matter, and the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry), replied with details of how anyone who wishes to raise concerns about the review can get their voices heard.

Greg Mulholland: I commend the Minister for his professionalism in both his previous career and his current role. Although I accept what he says, does he agree that our statutory process must be allowed to look at whether this review is, as we believe, a dodgy decision, or, as the Joint Committee of Primary Care Trusts contends, a fair one? Does the Minister at least agree that such scrutiny should take place, and that the fact that it is being prevented because documents have not been released is wrong and must be rectified? That is all I ask him to say today.

Dr Poulter: As my hon. Friend is aware, there is a process for scrutinising all decisions and, as I have outlined, if the correct procedure has not been followed, decisions are open to judicial review. To reassure hon. Members, we have accepted, from a medical perspective, the principle that fewer units deliver better care for patients and better surgical results for children. Therefore, this review is not about closing units in any particular hospital, but about specialist surgical services. Day-to-day

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care of patients and paediatric care for those who have had surgery will continue locally even after this review, and that should reassure local patients.

Mr William Cash (Stone) (Con): Will the Minister give way?

Dr Poulter: I will give way again, but I am mindful of the time.

Mr Cash: On that point, and in the light of the way this legislation has been redressed over the past year and half, does the Minister accept that before the legislation was introduced, and now, ultimate responsibility and accountability for all matters affecting the health service turned on the duties, accountability and statutory responsibilities of the Secretary of State? That is why the Minister is now at the Dispatch Box, just as the Secretary of State would be in other circumstances.

Dr Poulter: I accept that the Secretary of State has always had responsibility for the health service, and that was implicitly made clear in the Health and Social Care Act 2012. It is, however, important that we no longer have a system in this country that micro-manages the delivery of local health care services. We must listen to local doctors and nurses, and put them in charge of the configuration of local services because they are often the best advocates for the needs of local patients. Reconfiguring local services should be led—as per the four tests I outlined previously—on good clinical grounds where there is a clinical case for reconfiguration and where local communities have been consulted. That is something we should listen to and we must move away from the Whitehall micro-management of local health care delivery.

Gordon Henderson: Will the Minister give way?

Dr Poulter: I will give way one more time, and then I will make some progress.

Gordon Henderson: Does the Minister accept that local people wanted Royal Brompton hospital to be kept open, and that the decision to remove the intensive care unit was not taken by local people? The Minister is arguing against himself.

Dr Poulter: The initial process for the reconfiguration was started, I believe, by John Reid when he was Secretary of State in 2002, after listening to evidence at the time. We should remind ourselves why we are discussing congenital heart services. All speakers have accepted the principle that there is good clinical evidence—acknowledged by doctors and specialists—that having fewer units actually delivers better care for patients. That was accepted by my hon. Friend the Member for Pudsey. I am not going to go into the rights and wrongs of individual units as that is under judicial review and I will not be drawn further on that point today.

Stuart Andrew: Will the Minister give way?

Dr Poulter: I have been very generous and indulgent but I must make some progress. The process was led by doctors and nurses, and there is an ongoing consultation

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to engage with, review and reflect on decisions at a local level. That came out clearly in comments by my hon. Friend the Member for Leeds North West, but some of those processes are under judicial review and I will not, therefore, be able to comment further. I hope that my hon. Friend the Member for Sittingbourne and Sheppey will accept my reassurance that these reviews are carried out on good clinical grounds that take into account local factors such as whether local health care services are well designed. The important thing is that they are being led and developed by local doctors and nurses. We need such clinical leaders in the NHS, because they are the best advocates of patients’ needs.

My hon. Friend the Member for Stafford (Jeremy Lefroy) has been a strong advocate of the needs of his constituents and the staff of Mid Staffordshire NHS Foundation Trust. I know that we will be meeting tomorrow to discuss his concerns further, and I will also meet my hon. Friend the Member for Stone (Mr Cash), who has sadly now left the Chamber. We will talk about a number of issues, and I reassure my hon. Friend the Member for Stafford in advance of that meeting that I and other Ministers will continue to do all that we can, as our predecessors did. He rightly paid a full tribute to my right hon. Friend the Leader of the House for all the work that he did as Secretary of State for Health to support staff of that trust and ensure that there are good outcomes for patients. On behalf of all members of the Health team, I commend my hon. Friend the Member for Stafford for his work as a strong advocate of the needs of local patients, and I look forward to meeting him tomorrow.

My hon. Friend the Member for Pendle (Andrew Stephenson) rightly raised the issue of paramedic prescribing. He talked about the need for more flexibility in urgent and emergency care services, on the basis that it is better to have prevention than cure. We know that paramedics do a great job every day of looking after people and providing essential care on the spot and in the ambulance that saves lives before people get to hospital. The more we can do to support paramedics in providing preventive care in the community, the better for patients.

As well as allowing flexibility in urgent care services, paramedic prescribing would allow eligible paramedics to deliver more treatment in the home and the community where appropriate. That should prevent hospital admissions and reduce demand on the system. At the moment, paramedics can administer a range of medicines, but they cannot write prescriptions for patients. A new system of paramedic prescribing should benefit both patients and the NHS. Due to resource and capacity issues it has not been possible to take forward that work yet, but it will be considered within the new architecture of the NHS Commissioning Board along with other work programmes on resources and capacity. I shall certainly raise the matter, and the good points that my hon. Friend made, with ministerial colleagues.

My hon. Friend the Member for Mid Derbyshire (Pauline Latham) talked about diabetes care, particularly for type 1 diabetes. It is commendable that a lot of her focus was on younger people with diabetes. The number of patients with type 1 diabetes and known to be on insulin pumps has increased. At the moment, at least 3,700 children and more than 10,000 adults are on

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insulin pumps, and they are particularly important for younger people who may find it more difficult to control their diabetes. However, they are important for all people who have difficulty with their insulin and their diabetes control.

We want people to lead more independent lives, and we want to support people with long-term conditions to enjoy the same life as anybody else, so it is right that we do more to support people with type 1 diabetes. Those with difficult diabetes control have to be mindful of their disease on a daily basis, and if we can do more to ensure that their diabetes is not a factor in how they live their lives, that has to be a good thing.

The NHS operating framework for 2011-12 highlights the need to do more to make insulin pumps available. The NHS Diabetes insulin pump network is promoting good practice, but as we have discussed, pump therapy is not suitable for everybody. We are waiting for the conclusion of the first ever national insulin pump audit early next year, which will give us a clearer picture of the number of pumps provided and the services that are available. Importantly, it will also include the first investigation of how services are provided compared with the guidance issued by NICE in 2008 and updated in 2011, which my hon. Friend outlined.

My hon. Friend also raised the issue of artificial pancreases. There is small-scale use of them in children, but the clinical trials are not yet conclusive as to their effectiveness and ease of use and there are currently no NICE guidelines on the subject. We need to use the commissioning process to address the disparities in NHS care and better reflect good medical practice, and nowhere is that more true than in diabetes care. We need to ensure that where there are NICE guidelines on good practice, that practice is carried out.

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Finally, I wish to reflect on service reconfiguration and social care, which my hon. Friends the Members for Pudsey and for Milton Keynes South raised. Social care reform is important, and we need an integrated approach to health and social care. We must ensure that we reflect the health care needs of local populations and do more to support people with long-term conditions. That is a key driving force behind the vision for the NHS that my right hon. Friend the Leader of the House outlined in 2010 when he was Secretary of State for Health. It drives what should happen, and what does happen, at local level every day as doctors and nurses look after their patients.

Decisions about integration and what it means to have good joined-up care, particularly for older people and those with diabetes, chronic obstructive pulmonary disease, asthma, dementia and other long-term conditions, need to be made at local level, drawing on the best of local health care provision. The Government will ensure that the NHS Commissioning Board’s mandate includes guidance on what is good commissioning. I am sure that from 2013, when the Government’s reforms have gone through and we have an NHS that is truly locally led, there will be properly joined-up and integrated care that better looks after people with long-term conditions, focuses on prevention rather than cure and particularly focuses on looking after older people better.

Several hon. Members rose—

Madam Deputy Speaker (Dawn Primarolo): Order. Before I call the first Back Bencher in the general debate, I inform Members that the time limit is going to change to 12 minutes, as the number wanting to participate has reduced. May I ask that if you do not need 12 minutes, you do not take it? That time limit will probably enable us to get everyone in in the time that we have.

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General Matters

2.57 pm

Valerie Vaz (Walsall South) (Lab): I am grateful to the Backbench Business Committee for granting this debate. I wish the Deputy Leader of the House very well in his new post, and I hope that will be able to understand what Members say and reply appropriately. I had hoped that the relevant Minister would be here, but all good wishes to the Deputy Leader of the House.

I wish to set out why the Government’s recent statement on relaxing the planning laws was wrong and how it will affect my constituents. In most societies, certain freedoms are restricted for the public or common good, and the long-term use of land should be in the long-term interests of the whole community. I welcome the new planning Minister, the hon. Member for Grantham and Stamford (Nick Boles), to his post, but I have to say that sadly he has got it wrong. Hot on the heels of the statement made by the Secretary of State for Communities and Local Government on 6 September came a report by the very organisation that Ministers had set up. Surprise, surprise, it said that the Government should allow building on the green belt.

The Secretary of State’s statement should have given us clarity, not ambiguity, but I will give some examples of how it will confuse a lot of people, including planning lawyers. First, planning inspectors will be allowed to decide on applications, instead of the local authority. However, the problem is not the speed with which planning officers have to deal with applications, but the lack of properly qualified staff. In most councils, cuts are affecting the number of staff who can make proper decisions on planning issues.

Having worked for the Treasury Solicitor’s Department and acted for the Planning Inspectorate, I know that the people there are capable and committed public servants, but the Minister is going to have to increase their numbers. There cannot be an increase in their work without an increase in the number of those who carry it out.

The Government are looking for options to speed up planning appeals. Here is one easy remedy: more judges should be appointed to the High Court to deal with judicial reviews and appeals. Having dealt with planning litigation, I know that there was a pretty robust system between the judges’ clerks and the planning barristers’ clerks, and time estimates for cases were well adhered to. The problem is not about cases getting to court but the fact that we need more judges to deal with them.

What of the other controversial issues such as allowing extensions of up to 8 metres? My constituent, Mr Arnold Pate, has already had to suffer from this. A law-abiding citizen, who has worked hard all his life, is reduced to sitting in his back garden with a large two-storey extension blocking his light. The officers recommended refusal, but the planning committee allowed it. No weight was attached to Mr Pate’s views. Under the new planning statement proposals, the voice of the electorate—my constituents, such as Mr Pate, and other Members’ constituents—will continue to be ignored.

What of the flexibilities in the national planning policy framework to tailor the extent of the green belt? There is already encroachment in Walsall. In the case of

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the Three Crowns pub, officers advised the planning committee that the proposed development would constitute an unacceptable development on green belt land. The majority of residents were against the proposal, but the planning committee passed it anyway, even though there were no special circumstances to outweigh building on the green belt. A substantial amount of time was spent arguing in favour of the proposed development, while those who were against it were allowed only three minutes to make their case. Construction has not yet started, apparently due not to planning but to financial issues. Despite previous decisions that the Three Crowns school site should remain in the green belt because of its elevation and the trees, the council plans to build eight detached houses, after a short consultation period that did not necessarily include all the residents.

Walsall South already has land to build on for housing on the former Servis factory site in Darlaston. Outline planning permission has already been given for housing development. The residents in the area want housing, but the owners of the site would like another retail development. I have mentioned Woodside close in a previous debate. The same application has been refused six times by the Planning Inspectorate. The residents association said that officers gave no weight to its views. How would repeat applications be covered under the new regime? Would residents have to put up with multiple applications? Will section 43 of the Planning and Compulsory Purchase Act 2004 apply to inspectors when they have to deal with the new work that might come their way? Another constituent of mine had to face the construction of a dormer bungalow on the garden next door. Despite guidance that people are not supposed to build in gardens, this was still allowed.

Walsall South is at terrible risk from these proposals. As other Members know, it is situated at the confluence of many motorways; it is a key area. The Local Government Association has given us figures, which are well known, showing that there are 400,000 plots across England and Wales with planning permission for work to start. The figure is about 25% higher than previously thought. Building work has only started at half those plots, so it would take developers three and a half years to clear the backlog. I fear that because the Government have lost the argument on the planning reforms and have had to rethink the national planning policy framework, they are trying to change the rules through a different route.

With the greatest respect to the Minister, I do not think that he has undertaken litigation in planning, as I have. I am no Luddite and the people of Walsall South are not Luddites. What they are concerned about—from the residents to the builders—is that the precious green belt in Walsall, particularly in the south of the town, should not be eroded to the point where there is an unbroken urban sprawl from Staffordshire in the north to Warwickshire in the south. As one of the planning consultants, Malcolm Griffiths, told me, people already suffer from large-scale extensions to properties in this part of Walsall, with little if any control over oversized extensions and no enforcement by the council.

I am reluctant to say this, but the Chancellor is right: it is an economic problem. The economics are not working; the lenders are not lending. A condition should

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be attached to any money that is given to the banks under quantitative easing whereby some of that money is given back to the people by, for example, relaxing the need for them to have large deposits when they want to purchase a house.

If the Minister wants to build homes on existing sites, he needs to harness the imagination and creativity of architects who propose interesting developments. Paris can have an innovative building such as the Pompidou centre that is in keeping with the skyline, but we have to have the Shard, which dominates our skyline. I am sorry; I had to get that in because I really do not like that building.

There is no need further to relax the planning rules, but there is a need to protect the countryside. As Beatrix Potter, the great protector of the countryside, might have written: “This is the tale of the bad policy.” I hope that it ends happily.

3.6 pm

Mr Ian Liddell-Grainger (Bridgwater and West Somerset) (Con): It gives me no pleasure to rise to talk about a failed procurement project that has cost every citizen in Somerset a great deal of wasted money and time. Southwest One is a joint venture between Somerset county council, Taunton Deane council, Avon and Somerset police and IBM—one of the world’s biggest IT firms. It is a classic example of how not to do public procurement.

At 2 o’clock in the morning five years ago, an unlikely cast of characters were gathered. The county councillors were red-eyed, the IBM executives passed round a pen, and everyone signed. It was done out of office hours and in total secrecy, even though it involved hundreds of council staff and hundreds of millions of pounds of taxpayers’ money. Somerset’s chipper little chief executive, Alan Jones, said afterwards: “In five years’ time, people will look back on this agreement and say it’s the best thing we’ve ever done.”

I was, I admit, suspicious from the word go. IBM, as most people know, is no charity; it prides itself on fat profits. The joint venture was never equal anyway; IBM owned 75% of the business. However, it has taken five long years to get to the ghastly truth. I have now obtained a copy of the original IBM bid. There were only two serious contenders: IBM and BT—British Telecom. They were asked to do some blue-sky thinking, and IBM came up with some bizarre extras: pure fairy dust; total fiction; a romantic dream of our county and its wildly ambitious chief executive strutting the world stage hand in hand with IBM. Here are some of the promises: “We will increase the economic wealth of Somerset by £600 million every year!”; “We will create 400 new jobs—instantly!”; “We will build a new industry of environmental science!”; “We will provide the infrastructure for a new university!”; “We will deliver broadband to Somerset within a single year!”; “We will build an iconic headquarters!” I think that that is what my Spanish friends would call a load of cojones. Yet Councillor Jill Shortland, the then leader of the Liberal Democrats, and her pea-brained sidekick, Councillor Sam Crabb—once a banker, funnily enough, or so he claims, but more likely a junior clerk—swallowed the story hook, line and sinker.

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One needs to be seriously stupid not to spot the holes in IBM’s bid. IBM pledged to get Somerset wired up for broadband within a year—impossible without the help of BT, and BT, quite rightly, was far too sensible to suggest it. In fact, Somerset is still negotiating with the Government for a multi-million-pound grant to wire up both Devon and Somerset, which is moving along. I am afraid that IBM was telling a huge porky. Councillors have highly paid officials to help them to spot pitfalls, and they should have been doing so, but these councillors were at best dim, if not reckless. The only other explanation is that palms were being greased.

So who recommended that Somerset should go with IBM? The project leader was appointed by the then chief executive, Alan Jones, and she was a lady called Sue Barnes. Ms Barnes, as it happens, was married to the chief constable of Avon and Somerset, Mr Colin Port. Six months after the secret contract, the police joined the venture—dare I say it?—funnily enough, on more favourable terms. The police received an enormous bung from Ms Barnes’s employers, Somerset county council. There is hard evidence that Somerset provided a subsidy to the force. I have seen e-mails from the assistant chief constable confirming it. Somerset’s former director of resources, Roger Kershaw, was given executive power to negotiate the arrangement. Apparently, no councillors were told. The payment to the police was deliberately concealed in the county’s accounts 2008-09. I am calling on the Secretary of State to reopen those accounts for inspection, because I am afraid that there is a can of worms in them.

Funnily enough, Mr Kershaw once worked for Warwickshire county council. Mr Port was a senior officer at Warwickshire constabulary. This is where the IBM data centre for Somerset is, and where its records are stored. Warwick—I do not need to tell anybody in this honourable House—is in Warwickshire. Mr Port went on to join the board of Southwest One, an obvious conflict of interest if ever there was one. It took substantial publicity before it dawned on the chief constable that his position on the board was untenable. By then the credibility of Southwest One was even more untenable. It promised to save taxpayers £200 million over 10 years, but the savings are minimal and the losses of Southwest One run close to £50 million.

Somerset was forced to chuck out its own computer systems and spend £30 million of taxpayers’ money on IBM kit and software called SAP. That dreadful system refuses to pay clients, double pays others, mucks up police rotas and puts sensitive information at risk. I am afraid that it is Mickey Mouse software. IBM used its Indian division to design the software to save money. When SAP ground to a halt, IBM flew in a contingent of Indian IT workers who stayed in Taunton, the county town, for months trying to fix it. Guess what? They failed.

Alan Jones claimed things were all going swimmingly. Roger Kershaw went to Canada at IBM’s expense to address a conference entitled “Successful Outsourcing”. Sam Crabb and Jill Shortland—both still councillors, both Liberal Democrats—tried to blame me and the trade unions for rocking the boat. The trade unions—would you believe it? The truth was crystal clear: no other local authority or police force has joined Southwest One, ever. It is a rubbish venture.

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In May 2009, the voters removed the Liberal Democrats from control of Somerset county. The new administration got rid of Alan Jones, the chief executive, and it cost the taxpayer £341,000 to do so, but at least he was gone. Roger Kershaw, the finance director, quit before he was pushed. The new team started to renegotiate the awful deal with IBM. Many of the staff who transferred to Southwest One are, I am glad to say, back at Somerset county. Much of that work has returned to the county, but the ghost of this ghastly contract haunts us.

When the economic crisis arrived, public spending was cut, which meant less work for Southwest One. Unfortunately, there is a booby-trap in the contract that forces Somerset to compensate IBM if spending falls. Last week, the county council had to take the decision to take £2.7 million from contingency funds to pay the company off. If spending remains at the current level, which it probably will, Somerset will have to fork out £2.7 million every year for the next five years. That is £13.5 million pounds, plus a £5 million subsidy to the Avon and Somerset force. That vastly outweighs any mythical savings that Southwest One claims.

Just to rub salt into the wound, Southwest One is trying to extract more money from Somerset by suing. The marriage is over—that reminds me of another marriage that we are in at the moment—but there is no escape. On 27 September, five years to the day since the contract was signed, Somerset could legally terminate the whole mad thing, but the price of quitting is so high that we are stuck.

The blame lies fairly and squarely with Alan Jones, Roger Kershaw, Sam Crabb and—dare I say it?—other second-rate councillors. Al Capone would be rather proud of them in a bizarre way. They behaved as though they were working for IBM.

This is a national, not a local, scandal. The district auditor gave Southwest One glowing reports. The Audit Commission whitewashed the lot. There is now overwhelming evidence to prove that the auditors were grossly negligent. Southwest One should be—must be—examined properly by the National Audit Office. Only then can I see a happy ending to this ghastly fairytale.

3.14 pm

Mr John Denham (Southampton, Itchen) (Lab): I wish to speak about the marking of the English and English language GCSEs this summer.

At the beginning of the school term, I was asked to visit one of my local secondary schools, which had been confidently predicting 58% A* to C grades in English and English language. The students have been marked down at 32%. At the same time, stories started to appear in the local newspaper, the Daily Echo, about schools in neighbouring Hampshire. Some schools that have regularly had 84% to 90% A to C grades achieved just 60%. It became clear to me, as it did across the country, that something had gone enormously wrong in the marking of GCSE exams this summer.

I wanted to speak in the debate because I believe that a huge injustice has been done to that group of students who sat the exams this summer. It is an injustice that has a real effect on their lives: I have heard already of students who have been denied access to the college or the course that they wanted, or who have not been

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allowed to go on to the apprenticeship that they had been promised, or who are worried about the future impact of having low grades when they might come to apply, for example, to selective universities.

Equally importantly, there are those students who, from the beginning of their school career, needed considerable support, inspiration, nurturing, cajoling and confidence building just to stay the course. They left school in June confident that they would achieve a reasonable result, but they now feel so bitterly let down that they say they are turning their backs on education altogether.

This is not the time for wider debate on education standards; that will take place another time. I want to focus on the marking of those exams this summer. I believe that the students are innocent victims, caught in the crossfire of a wider and sometimes highly partisan debate about education. We need to focus on the position that they are in, but up to now Ministers—and, I am afraid, the Secretary of State—do not seem to have understood the injustice that has been done. The concerns of students are being brushed off, like so much dandruff from the Secretary of State’s collar.

Why am I so convinced that an injustice has been done? First, because the students, however we look at it, fulfilled every expectation of their teachers and, in turn, of the exam boards. Students look to teachers to guide them on what they need to know—the skills and the aptitude that they need to demonstrate—but there is simply no evidence that, peculiarly this year, they were catastrophically let down by their teachers.

Let us look at the schools involved. It is not as though this is poor performance concentrated in schools that had traditionally been weak or had struggled to achieve decent results. As is very clear, the unexpectedly poor results occurred in schools that had traditionally been among the best-performing in the country. It defies belief that so many teachers in so many schools should, collectively, turn into poor teachers in that one month of June this year.

Those teachers were supported by the exam boards. In the school that I visited, because the controlled assessment was new, there were regular checks with AQA on the way the work was being moderated and to ensure that the approach to the teaching was in line with the exam boards’ expectation. The school was told that it was in line with expectations—a school that had been praised for the excellence of its moderation and the quality of its predictions.

We got the Ofqual interim report, but it really does not convince in any way that Ofqual has, clearly and transparently, got to the bottom of why the results turned out the way they did in so many schools.

One reason for my participation in the debate is that I am one of the architects of Ofqual. It was my joint decision with my right hon. Friend the Member for Morley and Outwood (Ed Balls), when he was Secretary of State for Children, Schools and Families and I was Secretary of State for Innovation, Universities and Skills, to establish Ofqual as an independent regulator. The truth is that the guarantee of independence that we delivered has not turned out to be a guarantee of competence. Ofqual has failed to deliver the quality of service that is needed to inspire confidence among students and teachers.

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The interim report that Ofqual published failed to provide a convincing explanation of what happened; indeed, as the General Secretary of the Association of School and College Leaders said to the Select Committee on Education, in the one exam that we are talking about there has been extraordinary variation: 26.7% of those sitting it got a C grade in June last year; 37% got a C grade in January; and 10.2% got a C grade in June 2012. As he said,

“there is no evidence that those papers had any difference in the level of challenge in those examinations”.

In other words, it is all down to the extraordinary way in which the exam was assessed.

Ofqual tried to say that the problem related to January, but its figures do not tell a convincing story that gives a full explanation. In any case, students have the reasonable expectation that if they deliver what they were asked to deliver by their teachers and the exam board, that will be reflected in their result. For them to fail their exam, as they will be seen to have done, is deeply unfair; it will have a lasting impact on them.

Last week, the Secretary of State said, or is reported to have said, the following to the Select Committee—the transcript is not yet on the website—about the Welsh decision to reopen the question:

“the children who suffer are children from Wales who, when they apply for jobs in England, will hand over certificates that profess to be good passes, and English employers will now say, ‘I fear, through no fault of your own…that I cannot count your exam pass as equivalent to this other exam pass.’”

As with many of the Secretary of State’s statements, there is absolutely no evidence for that. Indeed, if it were true, we would be seeing schools, colleges and employers turning down children with the January qualifications, on the grounds that those qualifications were not good enough.

Ofqual says—I have given a health warning about its report—that performance overall is down by just 1.4%. Perhaps we should treat that statement with caution, but if that is the case, it can hardly be claimed that re-grading to around the expected levels would invalidate the whole set of qualifications this summer. It would, however, make a massive difference to the students affected. Allowing the injustice to remain uncorrected will do far more damage to the students than any possible consequences of allowing a re-grading consistent with the January results to go ahead.

Why did the Secretary of State not consider that course of action, or, given the questions around the Ofqual report, set up an independent inquiry? I am convinced that a re-grading is the only fair way forward, but I can understand that a necessary first step is an independent inquiry into what happened. I fear that the real reasons do not reflect well on the Secretary of State. He is a highly political, highly partisan Minister who wishes to play every issue for his personal promotion and party advantage. When the issue came to light, he thought, I am sure, “This is a party opportunity.” After all, Labour had introduced controlled assessments, and Labour—indeed, I, as Minister—had introduced Ofqual. He thought it was an opportunity to attack Labour’s record and burnish his credentials as a defender of standards; that is what he set out to do.

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However, surely there has to be a limit to the amount of damage that we are prepared to do to innocent students just to promote a Secretary of State’s career and political stance. We are all in politics, and we all make partisan speeches at times, but none of us has the right to make others the victim of our politics.

I am convinced that an injustice has been done to thousands of students; they worked hard and did what they were asked to do. I am convinced that many of them will suffer as regards their careers, academic qualifications and job opportunities. This situation cannot be allowed to last, and the issue must not be lost in the wider, legitimate debate about educational standards. I hope that the Government will, at this late stage, agree to an independent inquiry, so that we can get to the bottom of what went wrong and make sure that the students concerned are treated fairly.

3.24 pm

Mike Crockart (Edinburgh West) (LD): I wish to tackle the important issue of nuisance calls. Like many Members, I am fed up with receiving nuisance calls on my mobile and home telephone, and unsolicited texts sent to my mobile. It is a real problem for many of my constituents, much as cold-calling in person was many years ago. It was mainly energy companies who indulged in cold-calling in person, but thanks to many local campaigns across the country, most of the big six energy companies have stopped the practice. It is time to turn our attention to the issue of nuisance calls and texts.

There were 650 million silent calls made in the UK last year, and 45 million spam texts sent in Europe last year and every year. Some 3 million UK adults will be scammed out of £800 each this year by fraudulent marketing calls. It is clear that we have an industry in crisis and a country under siege. People should not have to put up with this menace, which puts many vulnerable and elderly people at just as much risk of fraud as if the crook or pushy salesman turned up at their door unannounced. Yet the two Departments responsible for various aspects of the industry—the Department for Culture, Media and Sport and the Ministry of Justice—do not seem to think that there is a need for any change in legislation.

In response to a letter that I sent him, the Under-Secretary of State for Culture, Olympics, Media and Sport, the hon. Member for Wantage (Mr Vaizey), said that although the Government do not believe that sweeping changes are necessary to the regulatory framework, the Ministry of Justice continues to keep the Information Commissioner’s Office powers under review. Thousands of people disagree and are backing my campaign to restrict this nuisance. They say that their experience shows that the current situation is simply not good enough. Many people have shared their horror stories with me. I would welcome the chance to meet Ministers from DCMS and the Ministry of Justice to discuss the issue.

The Sunday Post in Scotland has helped to promote my campaign nationally, and a spokesman for the newspaper recently told me:

“It's clear from the overwhelming response we have had from our readers this problem plagues our daily lives.

And yet regardless of asking for them to stop—and sometimes taking steps to halt them—the onslaught continues.

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The will is there from people to put on an end to this once and for all. Now is the time for the Government to act on that will and strengthen existing legislation.”

I could not agree more.

Since launching my campaign only four weeks ago, over 10,500 people have signed the campaign petition at no2nuisancecalls.net—sorry for the plug. Like many others, I know that I have not had a fall in the last five years and am not entitled to any more payment protection insurance compensation, and I certainly do not want a payday loan. Nevertheless, I am continually contacted by text and phone by companies offering me those things.

I am registered with the Telephone Preference Service for both home and mobile numbers, but even that does not stop the onslaught. According to Ofcom figures, complaints to the TPS about unwanted marketing calls jumped to almost 10,000 for the month of July. That compares with just over 3,000 in December last year. In an online poll of 4,000 individuals for Which? magazine, 76% of respondents said that despite signing up to the TPS, they still receive many nuisance calls. Only 1% rated the service as excellent and said that they no longer received nuisance calls. Once again, the Under-Secretary seemed to miss that point; he said that the TPS was generally successful in reducing the number of unsolicited marketing calls received. That is not the experience of the majority of people registering with it.

Ofcom suggests that increased activity by PPI and accident claims companies is partly to blame for the rise. The problem is partly the result of the fact that PPI calls are not classed as sales calls but as a service or marketing calls. On texts, the law says that there must be an unsubscribe option such as “Reply STOP to this number”. However, there are two problems with that. First, there are serious worries about how much it would cost to send such a text. Secondly, such a reply tells the sender that the number is genuine and in use, which might merely engender further contact from that company and from others.

Recent research by the Association of British Insurers has found that more than three quarters of people—78%—have been contacted by a claims management company asking if they have been involved in an accident or mis-sold payment protection insurance. The ABI found that 92% of those who received such a message from a claims management company said that it was not relevant to them.

Complaints about abandoned or silent calls trebled in 2012, rising from 957 in December 2011 to 3,390 in July 2012. That is probably only the tip of the iceberg. In May 2011, the Information Commissioner’s Office was given powers to fine companies up to £500,000 if they broke the rules on unsolicited texts and phone calls. To date, however, the ICO has failed to prosecute any company for breaking the rules, in spite of the fact that it has received more than 7,000 complaints this year—a 43% increase on last year, when fewer than 5,000 complaints were received for the entire year.

I understand better than most the difficulties involved in carrying out complex police investigations, but we must understand what prevents those investigations from leading to prosecutions and fines. Until an example is made, those companies will carry on unfazed. The ICO has done great work on fining companies that fail

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to look after their data properly, but the strongest action so far on breaking of the legislation governing unsolicited calls and texts was a strongly worded statement in July this year which talked of the ICO “baring its teeth”.

All of that points to a huge problem that is on the increase—indeed, it is out of control. Some companies offer a service to help protect people from unwanted calls, but it can be costly—anything from £35 to £100—and often those companies are not up front about the charges. To be frank, why should we have to pay for such a service anyway? I believe, as do the 10,000-plus people who have signed up to my online campaign, that we have the right to be free from such calls without having to pay for the privilege.

As I have said, the problem is out of control, and requires urgent action. The Information Commissioner desperately needs to have the power to end this menace. I am therefore calling for the Information Commissioner’s powers to be strengthened to take in all forms of unsolicited contact, and for a single point of contact for any individual wishing to protect their privacy and block unwanted calls, texts, faxes and e-mails. That express wish should be taken seriously and acted upon.

I simply do not understand why we continue to allow this to happen, and why we are so permissive about our telecoms contact. If Barclays or HomeServe—two companies that, between them, were fined £5 million for silent calls—were knocking on our vulnerable granny’s door every day, then running away before she answered, we would be appalled. Instead, we tell those companies that they can do that only one day in 20: 5% of their calls are allowed to be silent. If claims management companies were knocking on her door, then bullying her into making PPI claims or taking payday loans, we would be up in arms. Instead, we hide behind the claim that those are merely surveys. If, because of all of that, we had to hire a doorman at significant expense to filter all the unwanted people at the door and only allow real visitors in, that would be completely unacceptable, yet that is the awful, frightening telecoms reality for many older, vulnerable members of society. It simply cannot continue. It simply must stop.


3.33 pm

Barbara Keeley (Worsley and Eccles South) (Lab): May I, too, welcome the Deputy Leader of the House to his post and to the debate? I once replied to 400 speeches—40, not 400—in a pre-recess Adjournment debate, so I understand the task that faces him.

Last week, I said at Culture, Media and Sport questions:

“The all-party group on women’s sport and fitness wants to see our fantastic women athletes in the media, inspiring girls and women of all ages to take part in sport. However, outside the Olympics, women’s sport gets 5% of the media coverage and less than 1% of the commercial sponsorship.”—[Official Report, 13 September 2012; Vol. 550, c. 413.]

I asked the Minister whether he agreed that the situation must change. I was surprised at how effective my question was, because on Saturday the Secretary of State for Culture, Media and Sport wrote to all national broadcasters telling them to reassess their coverage of women’s sport. I agree with that action, because the lack of media coverage for women’s sport is a vital issue.

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Across our leading newspapers there are no female sports editors. Only 2% of the articles and 1% of the images in the sports pages of the national newspapers are devoted to female athletes and women’s sport. Earlier this year, the Women’s Sport and Fitness Foundation reviewed the sports pages across all national daily newspapers to assess the level of coverage given to women’s sport. I am indebted to the Women’s Sport and Fitness Foundation for the authoritative reports and statistics that it produces on women’s sport. Over the three days of the review, those newspapers published more than 1,500 articles on sport, yet only 2% were on women’s sport. TV sports schedules were also reviewed. On one Friday, of the 72 hours of sport broadcast on three Sky channels, only three were devoted to women’s sport. I am sad to say that the online coverage of women’s sport reviewed was little better—although I should mention the Sportsister website, which is dedicated to women’s sport. However, apart from that exception, on the 10 sports news internet sites that were reviewed on one day in April, only 1% of the links were to articles on female sports, and there was not a single image of a female athlete on the front page of the top 10 websites.

That is the normal situation outside the Olympics, but if that level of coverage had applied during the Olympics, we would have missed a great deal. Team GB women athletes won 22 of our 65 medals, 10 of them gold. If our women athletes had received only 1% or 2% of the news coverage during that time, we would possibly have seen some of Jessica Ennis’s gold in the heptathlon, but what would we have missed? We would have missed Nicola Adams winning the historic first gold in the boxing; Victoria Pendleton’s individual gold; the team gold for Dani King, Laura Trott and Joanna Rowsell, and Laura Trott’s gold in the omnium; the rowing golds—won when we had got hardly any gold medals—of Heather Stanning and Helen Glover, Katherine Grainger and Anna Watkins, and Katherine Copeland and Sophie Hosking; Charlotte Dujardin’s magnificent gold in the dressage and her gold in the mixed team dressage; and Jade Jones’s gold in the taekwondo.

If women’s sport in the Olympics had received only 5% of media coverage or three of the 72 hours of broadcast coverage, we would definitely not have seen Gemma Gibbons’s silver in the judo or her emotional response, which for many ranks as one of the high points of the Olympics; Christine Ohuruogu’s magnificent defence of her earlier performance, with a silver in the 400 metres; Rebecca Adlington’s bronzes in the 400 and 800 metres swimming; the women’s team bronze in hockey; Samantha Murray’s silver in the modern pentathlon; the bronze for Beth Tweddle—a wonderful gymnast at the end of her career—on the uneven bars; or even Lizzie Armitstead’s race for silver in the pouring rain, our very first medal for Team GB.

It would have been ridiculous if we had not seen those moments in the women’s events, yet that is what happens all the time outside the Olympics, with very few exceptions. There is netball coverage on Sky and some coverage of women’s football on the BBC, albeit not enough—although I should mention that BBC2 is showing the England women’s game against Croatia tomorrow, an important qualifier for Euro 2013. There was

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even some live coverage of the England women’s cricket team in the T20 recently, but there should be so much more coverage of women’s sport.

Let us take women’s rugby as an example. The Rugby Football Union feels that there are great opportunities for growth in women’s rugby. The numbers of those playing are up 91% since 2004, with more than 13,000 women and girls currently registered as playing rugby each week across 533 clubs. England hosted the 2010 women’s rugby world cup, which was deemed to be the most successful world cup to date. The legacy of that event was a much greater increase in the number of women taking up rugby than in ordinary years. However, although the RFU feels that there are great opportunities for growth in the women’s game, I feel that they will be hard to achieve at the current levels of media coverage, which I outlined earlier.

Jim Shannon (Strangford) (DUP): Does the hon. Lady agree that this is not only about encouraging women’s sport through the media of television, radio and so on? Is it not also about ensuring that there should be free entry to games wherever possible? For example, the Northern Ireland women’s football team are playing tomorrow night, and entry is free in order to encourage everyone to go. That is another way of encouraging media coverage and ensuring that games are promoted.

Barbara Keeley: That is right, but that has not happened in women’s football. I have to say, however, that I would be much more comfortable if people were prepared to pay to watch women’s rugby and football, because I think that those games are as good as the men’s.

That leads me to the subject of the success of the England women’s rugby team. They are an extremely successful team internationally. In the 2011-12 season, our team beat the current champions, New Zealand, in a three-match test series, as well as winning their seventh six nations tournament in a row, which was also their sixth grand slam. The England women’s sevens team won the European championships, the European grand prix series and two out of three International Rugby Board challenge series events. Despite all that success, however, only two of the games were broadcast live throughout the whole season. England will host the rugby world cup in 2015, and we must ensure that plans are in place to reach the widest possible audience, in order to inspire women and girls to watch and play rugby.

What needs to be done? As the Secretary of State said in her letter to broadcasters, the Olympics and Paralympics have shone a spotlight on women’s sport, and we need to ensure that that continues after the games. She also highlighted the fact that the substantial television audiences for the summer Olympics illustrated the public appetite for mainstream coverage of women’s sport. Indeed, 16.3 million people watched Jessica Ennis win her heptathlon gold, and 11.3 million watched Rebecca Adlington win her bronze medal in the 800 metres freestyle swimming event. As we got further into the tournament, we also saw capacity audiences watching the England women’s football team, and it was a pity that the team did not make more progress.

I support the Secretary of State’s initiative and her proposal to meet those broadcasters, but there is a need to go much further. The Women’s Sport and Fitness

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Foundation has identified three priority areas. First and foremost, there should be more media coverage of women’s sport. We need that increased media profile because it will be crucial to drive public interest and to fill the grounds for games. It will also be vital to drive the commercial sponsorship of women’s sport. Let us remember that women in sport are unfairly treated in that regard. They have only 1% of the total commercial sponsorship of sport. When we think of our great women cyclists, we must remember that there is no Team Sky for women. Lizzie Armitstead cycles in a team based in the Netherlands, which I understand is losing its sponsor at the end of 2012 She has had fabulous medals success, but will have no sponsorship by the end of the year.

As a second priority, our female athletes need to be showcased as role models. Having positive, active role models is crucial if girls and young women are to be inspired to lead physically active, healthy lifestyles. Surveys conducted since the Olympics have shown that 81% of adults agree that the female athletes at London 2012 were better role models than other female celebrities. It is not about dieting to be slim; it could be about exercising to be slim.

Thirdly, we must concentrate on increased leadership. Only 22% of leadership positions in sport are held by women. That figure needs to increase to ensure that sport is governed and run in ways that appeal to the widest possible market. I would like the Secretary of State to tell me whether she regards those three areas as priorities, and what action her Department plans to take on them in the coming months.

Finally, the all-party parliamentary group on women’s sport and fitness has asked the Culture, Media and Sport Select Committee to consider undertaking an inquiry into the media profile of women’s sport. Through the medium of this debate, I would like to urge the Chair and members of the Select Committee to consider that proposal, because this is absolutely the key time to make a difference to women’s sport.

3.44 pm

Mel Stride (Central Devon) (Con): I rise to address the issue of increasing the flexibility of labour markets, and the effect that it can have on small business growth. In doing so, I pay tribute to the many actions this Government have taken to encourage businesses, particularly small businesses. The Chancellor of the Exchequer’s huge achievement in maintaining our triple A credit rating status is worthy of note, thus keeping interest rates low, which has assisted businesses up and down the country to invest. Also important is the continuing reduction in corporation tax levels, which I think most businesses feel is most welcome.

When it comes to labour market flexibility, and particularly supply-side flexibility, we might usefully view it through the prism of one of the great macro-economic conundrums this country faces: on the one hand, we have reductions in unemployment and increases in employment, yet on the other hand, we have the apparently contradictory information that growth has been negative over the last three quarters. Some of that could be due to the fact that gross domestic product has been underestimated over that time, which would be consistent with the history of these circumstances when recessions are typically estimated at the time to be more

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severe than they are subsequently assessed as being. That certainly happened in 1990-91—three years later, economists decided that the recession had been 40% less deep than it had been estimated at that particular time.

Declining unemployment is probably due to increases in part-time employment, but also to the extremely positive action taken by Ministers and the Secretary of State at the Department for Work and Pensions, which has encouraged people off welfare and into work. There is one other reason why the employment figures might appear to trump the growth figures—our extremely flexible labour markets, which are due, in turn, to the supply-side flexibility introduced in the 1980s. Ironically, there are probably many thousands of people up and down this country who owe their current livelihood to the courage Margaret Thatcher had in the 1980s to improve the supply side of our economy.

Why, then, as I would argue, do we need to go further in reducing supply-side rigidities if our labour markets are so flexible as they stand? The reason is that we are competing in an internationally competitive global marketplace in which our future competitors are not going to be simply the likes of France and Germany, as we will increasingly be bumping shoulders with the likes of China and India, which have extremely flexible labour markets indeed.

If we are to improve labour market flexibility, it will have at least two effects on business. One is that it will make it easier for them to transact business; the second is that it will send a very positive message to businesses that the Government are very serious about supporting entrepreneurship and business. That will be particularly important, given that this country currently suffers from a lack of business confidence. UK plc is sitting on some £750 billion-worth of cash, which is not being released to invest in jobs and growth simply because it lacks the confidence to do so.

I think we should take some further action, and I strongly believe in the comments made by the CBI and the Federation of Small Businesses to the effect that we should look at the area of employment-protected leave of absence or maternity and paternity leave, and particularly at how it affects small businesses and micro-businesses.

Let me clarify, first, that I strongly believe in and adhere to the principle of employment rights. It is quite right and proper in a civilised society that companies and Governments should be helpful to women at their time of child birth and beyond. It is also an important tool of policy for ensuring that we increase and improve the engagement of women within the work force. That is my starting point, but I believe that our balance has become out of balance: it is now too much in favour of rights and there is too little emphasis on the onerous provisions that apply to businesses.

Last year, I asked the Library to prepare a comparative grid to show the levels of various maternity rights across various countries in the world. It is certainly the case that we are not the most generous, but we are among the most generous. In Australia, for example, the entitlement is to 18 weeks; in Greece, it is to 17 weeks; in India, it is 12 weeks—but in the United Kingdom, it is 52 weeks. Let us consider the problem that that may cause an employer in the United Kingdom, particularly a small employer whose business consists of, say, between six and 12 people. A key member of staff, such as a senior manager or director, is able to be absent from the

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workplace for more than a year—over 52 weeks. The employer must then make a contribution to maternity pay, and, in some circumstances, continue to provide a company car and a mobile telephone and pay for any membership of clubs or organisations that may have been granted as a work-related benefit.

Moreover, the absent employee will have been accruing holiday leave, and it is entirely possible that, at the end of the 52 weeks, the business will have to pay in full for the employee to be absent for a further month, or even two months. Any options agreements or share incentive schemes will continue as normal, although the employee may not be present to make any contribution to the success of the business. The employer will also continue to pay in full any pension contributions that have previously applied.

Huge uncertainty is caused by the fact that employees do not have to inform their employers whether they will be returning to the workplace until the period of absence is well under way. It is quite conceivable that, in a company with six to 12 employees, a senior individual who has been absent from the workplace will not inform the employer until the 11th hour—after an absence of at least a year—that he or she will not be coming back.

Fiona Bruce (Congleton) (Con): We should also bear it in mind that replacing expertise does not involve like-for-like funding. Acquiring a locum can be very expensive for a small business, and as a result the owner of the business often ends up doing two jobs throughout the period of the employee’s absence.

Mel Stride: That is an extremely important point. One of the problems with excessively onerous employment rights of this nature is that they build up a fair amount of resentment among existing members of the work force who are often expected to work longer hours or, indeed, to change the pattern of their work in order to accommodate the person who is absent.

In no way do I wish to attack the notion of rights of this kind. I think that they are very important, for the reasons that I have given, but I hope that the Government will look closely at the balance in how they operate, particularly in the case of micro-businesses employing 10 people or fewer.

3.53 pm

Kate Green (Stretford and Urmston) (Lab): I am grateful to the Backbench Business Committee for facilitating today’s debate.

Six years ago, in August 2006, Luke Molnar, the 17-year-old son of my constituents Gill and Steve Molnar, died on the island of Tokoriki. Luke was a paying volunteer on a diving expedition arranged by a UK-based company, Coral Cay Conservation Ltd. On the day of his death, he went to assist a friend who had received an electric shock when he touched a washing line. When Luke touched the line, he received a massive electric shock which killed him.

It transpired that a local electrician had wired the washing line to the electricity supply in order to run power to a number of huts that were being used as accommodation for the volunteers. A coroner’s inquest

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held in Manchester in 2011 returned a verdict of unlawful killing and the electrician awaits trial in Fiji, but no proceedings have been taken against Coral Cay or its then directors. The company has since been taken over, and is under new ownership.

At Luke’s inquest, the coroner identified significant shortcomings in Coral Cay’s health and safety procedures, and highlighted the discrepancy between the claims made in documents and on its website with regard to the emphasis that it placed on health and safety and its actual practice. The coroner also noted that Mr and Mrs Molnar had placed great credence in Coral Cay’s claims about its approach to health and safety: that full and careful health and safety checks were carried out; that personnel on site were fully trained; and that there would be a full risk assessment of the site. None of that turned out to be the case.

Following the inquest, the coroner wrote to the Secretary of State for Business, Innovation and Skills under rule 43 of the coroners rules, setting out his view that the regulation of companies offering such trips abroad, particularly for young people, should be carefully and closely monitored to ensure that the claims made in their literature and on websites were lived up to. I was very pleased when the then Minister, the right hon. Member for Kingston and Surbiton (Mr Davey), met Mr and Mrs Molnar with me last September to discuss how that might work. It was broadly agreed at that meeting that the best way forward would be to work with the British Standards Institution to determine whether British Standard 8848—which covers such overseas activities and which is strongly supported by the Molnars as representing a gold standard—could be made more robust, whether approval processes for the standard could be strengthened, and whether a certification scheme could be put in place.

As a result, the Molnars and I have had useful discussions with BSI officers about the processes that exist. The conclusion that we have drawn is that there is currently a deeply confusing plethora of organisations, companies and standards. As a result, parents cannot rely on claims made by overseas adventure companies that their activities have been objectively assessed to comply with rigorous safety standards. Put simply, parents do not know what they can believe.

I have to say that the matter was not much helped by a parliamentary written answer I received on 22 May 2012 from the then Minister for Schools, the hon. Member for Bognor Regis and Littlehampton (Mr Gibb). His response served to paint a picture of real confusion about the appropriate role of the Health and Safety Executive, the learning outside the classroom regime, BS 8848 and a range of organisations that purport to assess whether safety standards are being met. Some of those organisations doubtless do an excellent job, but the overall landscape is a minefield for parents desperate to be assured that their children will be safe.

Let me repeat that the Molnars and I strongly support BS 8848, which covers overseas activities. We also acknowledge the role that the learning outside the classroom regime plays, but I suggest to Ministers that its purpose is, in fact, different: although it purports to cover safety aspects of overseas activities, it is primarily a learning-focused, rather than a safety-focused, standard, and many providers and schools prefer BS 8848 for these

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activities as a result. As for the HSE, I am surprised that in that written answer the then Minister suggested that the work it is doing to develop a code of practice to replace the Adventure Activities Licensing Authority was a potential solution. The HSE has no jurisdiction overseas—and, in any case, I understand that that work is on hold.

I ask Ministers to consider more carefully how to promote the adoption of BS 8848 as the industry standard with which all overseas providers will be expected to comply, and also to consider, along with the BSI and as part of the five-year review of the standard now in progress, whether that standard could, and should, be extended to UK activities as well. I also invite Ministers to support the establishment of an independent register so that parents can be absolutely clear about whether an organisation’s claims to meet health and safety standards are merely self-declared or have been independently evaluated. I would like to see the elimination of duplication between the different accreditation systems, including the learning outside the classroom regime, BS 8848 and whatever eventually replaces the AALA, and clarity about their different purposes and roles. I would also like to see action to simplify and strengthen oversight regimes, so that independent evaluation and accreditation is put in place.

No one, least of all the Molnars, whose son was a keen and excellent diver, wants to stifle or prevent young people from participating in adventure activities overseas. No one wants to create a complicated bureaucratic structure that prices companies out of compliance, and no one can want one single further avoidable death. It is abundantly clear that the current system is confused and deficient, and Ministers have a responsibility to ensure that a regime that is fit for purpose is put in place. I passionately ask the Deputy Leader of the House to do all he can to secure a meaningful response from his colleagues in all relevant Departments on the steps they will take now to ensure that that is what will be achieved.

4.1 pm

Andrew Bingham (High Peak) (Con): We are all aware of the three main emergency services, the fire, ambulance and police services, all of which are available to all of us whenever we need them. However, I want to talk about another emergency service—the mountain rescue service. It is called upon by the fire, ambulance and police services, and it stands by not only to help climbers and walkers who are in trouble, but to assist rural communities when conventional services cannot get to where they have to because of the weather. So when, on a winter’s day in Glossop in my constituency, which is very hilly, the ambulance service cannot get up a certain road, it will call the mountain rescue to help out.

The mountain rescue service, unlike its publicly funded counterparts, relies on a network of 3,500 volunteers operating in 56 teams nationally. Four of those teams are in my constituency—the Buxton, Edale, Glossop and Kinder teams, all of which I have visited. Every time I visit, I leave very impressed by what they do. Each team is a self-contained unit with its own equipment, supplies, vehicles and communications. The teams carry equipment required to remain operational—unsupported—for more than 12 hours, and they are trained in first aid and casualty care.

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The Secretary of State for Communities and Local Government has said in the past that in a

“cold snap, the values of the Big Society are more important than ever…Volunteers in mountain rescue teams worked round the clock to help the stranded…We should celebrate that community spirit.”

They are fine words, but celebrating the community spirit is not enough; we should support these men and women, who risk their own well-being in appalling conditions to save and help others. I am talking about people such as my constituent Paul Hitchen. On three occasions when I have been out with him and his wife socially, he has left us early because he has been called out to go up on Kinder Scout to rescue ramblers, hikers and the like. This has been in weather that may not have appeared too bad in the towns and the villages, but it can be a very different world on the hills of High Peak.

The Government do not fund the mountain rescue service; we do not fund it as a country. We actually take revenue from its funds, which goes into the Treasury’s coffers. It is estimated that if central Government had to provide these services, the cost would be about £6 million a year. I wish to acknowledge the funding for the mountain rescue that was announced last year, which will help the teams, but the vast majority of their money comes from voluntary donations; they do bag packs, coin collections and all sorts of other things to raise their money. Not only is that money necessary to purchase the vehicles, fuel, equipment and clothing they need to do their job, but the service also has to fund about £250,000 of VAT that is payable to the Exchequer each year.

It has been suggested that, while acknowledging the need to tax mountain rescue sympathetically, the Government would not want to pursue a policy that would favour one charity over another. However, distinctions are made elsewhere: the Royal National Lifeboat Institution can reclaim VAT and can access red diesel; St John Ambulance can claim back VAT on fuel and vehicles; and the Royal Society for the Prevention of Cruelty to Animals can do the same in respect of its rescue vehicles. The mountain rescue is not able to access many of the benefits that those other charities enjoy.

Some vehicles enjoy access to fuel that is not subject to duty, known as red diesel. Red diesel has a significantly reduced tax levy compared with the undyed diesel fuel used in the ordinary diesel road vehicles that many of us drive. It can be used in registered vehicles such as tractors, forestry vehicles, excavators, snowploughs, gritters and boats. Working vehicles, including four-wheel drives that are used mainly on the land, can also use red diesel regardless of whether they are being used commercially or for charitable purposes as long as the vehicle is used on a public road only for a distance of no more than 1.5 km while passing between different areas of land occupied by the same person. So, if the mountain rescue teams owned the land on which they operated or restricted their activities to specified national parks, they could get the lower fuel duty. They are volunteers acting for the benefit of the whole community who are willing to go out and help whenever and wherever they are needed and that works against them.

Let me give the example of a cold winter day in High Peak, on Kinder Scout, with a sheep in distress in one field and a rambler in another field. The farmer going

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to help the sheep could go up using red diesel, whereas the mountain rescue team bringing back the hiker would pay the full price for diesel. That team is going to rescue someone in distress, so to me the difference in the price paid seems wrong.

At sea, all rescue vehicles qualify to use red diesel. On land, conventional ambulances qualify yet they cannot get to the difficult terrain where the mountain rescue teams need to go. Yet again, mountain rescue pays for the fuel. Over the past decade, rescue teams in England and Wales have paid about £500,000 in tax on fuel as well as VAT on other items that they have had to purchase to carry out their work.

In answer to a written question, the then Treasury Minister, my right hon. Friend the Member for Putney (Justine Greening), said:

“It would be difficult to make a clear distinction between vehicles used by mountain rescue teams and privately owned vehicles”.—[Official Report, 14 July 2011; Vol. 531, c. 487W.]

I do not believe that to be the case and if I had more time—I am conscious that many other Members wish to speak—I could dismantle that argument. I believe that a mountain rescue vehicle dedicated to mountain rescue—let us face it, they are usually big ambulances with logos and so on all over them—could quite easily be allowed to run on red diesel.

The growing burden of high fuel costs and high inflation and the downward pressure on wages, particularly in rural areas such as High Peak, means that volunteers are less likely to be able to finance the provision of the service and I think we should help them. There has been a spectacular lack of common sense in seeking a way forward. The cost to the Treasury of permitting vehicles that are registered to mountain rescue teams and used for mountain rescue purposes and for no other to use red diesel would be negligible in the grand scheme of things. It would be simple to introduce and to police.

When national or regional emergencies devastate areas of the UK, mountain rescue is the only service that can help. It is adaptable and can go anywhere at any time. I think it is time that we replaced the warm words of support and congratulation with some practical action to help. No more excuses. No more time for reflection. Let us have some action. We could do a lot. We could make the change on red diesel that I am calling for today. We could make a direct payment to rebate the VAT, we could revise the ambulance rules to allow more all-terrain vehicles to qualify or we could just offer a direct grant.

I am aware of the difficult financial circumstances in this country, as we all are, so I ask the Treasury to allow mountain rescue to use red diesel in their own vehicles—I am sorry that no Treasury Minister is in the Chamber, but I hope the message gets back as I am determined to keep pressing the point. It would save each and every team in this country money that would help them to continue to provide the service. Some of us might never have used it, but I suspect that we will all—particularly those of us with rural seats—know somebody who has seen it in action. For example, the mountain rescue website gives details today of a busy weekend for the Buxton mountain rescue team.

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I once set off on Kinder Scout in shorts and a T-shirt—[Interruption.] Someone laughs, but I promise hon. Members that it is not that bad. As I got higher up, the weather got worse. Fortunately, as I am from the area I was well equipped but by the time I reached the top of Kinder Scout I was wearing three layers of waterproof clothing and had my torch, whistle and everything I needed. I still saw somebody coming back the other way wearing flip-flops, would you believe, because people set off from what seems like a different world. The only people who can get to them if they get into trouble are the mountain rescue. There are many examples, such as the people who get stuck in peat bogs because they follow a global positioning system or satellite navigation device on the hills. We are at the mercy of the elements in High Peak and mountain rescue is our lifeline.

I repeat my call and hope that the message gets back to the Treasury, because if it does not I shall keep repeating it. Let us consider allowing such vehicles to use red diesel. When the call comes to mountain rescue for assistance, doing nothing is not an option. Now, in my view, it is our turn. Doing nothing is not an option for us, so we should consider this idea. We should do it, because it will not cost a lot, it is easy and it will make a big difference to mountain rescue teams up and down the country.

4.10 pm

Jim Shannon (Strangford) (DUP): As I was coming to today’s debate, I thought of all the issues that are pertinent to my constituency and, I suspect, to all hon. Members’ constituencies, such as tax credits and housing benefit, both of which I hear about regularly in my constituency office. There are so many concerns that my constituents have spoken to me about and asked me to speak about. I have chosen to speak about the appeals against decisions on employment and support allowance and disability living allowance, which increasingly make up the greater part of my work load. It used to be housing and planning, but benefit issues now make up an equal amount of my work load.

Where do we begin on this issue? The best thing to do is probably to illustrate it with an example. One situation that still concerns me is that those who are recovering from cancer are being turned down for ESA and other support. I met a gentleman—this is truthful—who had 30 bouts of radiotherapy and 15 chemotherapy sessions to help him put his cancer into remission, and it has worked so far—thank the Lord. However, since the treatment, he has been unable to put the weight back on and has no appetite, leaving him a tiny 7 stone in weight. Anyone who knew him before the treatment and saw him today would know exactly what I am talking about. In our part of the country, we would say that he is skin and bones, as he clearly is, after all he has been through. He is lethargic, tired, severely underweight, but that is not taken into account in the standard ESA tests. Therefore, despite the fact that he is recovering from cancer and is in no fit state to work, his application was turned down. It would be dangerous for him to go into a working environment, yet that is what he has been asked to do.