“A reduction in consumption of livestock products could play a significant role in any deep and long-term abatement strategy”
to cut greenhouse gas emissions
“from the UK’s food chain.”
Another relevant paper was called “Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture” and was published in The Lancet in December 2009. It was a collaboration between the National Centre for Epidemiology and Population Health at the Australian National University, Canberra, the London School of Hygiene and Tropical Medicine, the Food Climate Research Network and the London International Development Centre. I am sure that hon. Members do not need me to tell them that work published in The Lancet is peer-reviewed. I would say that that is a considerably more rigorous process than the all-party group inquiry that we have heard about. The paper concluded:
“Agricultural food production and agriculturally-related change in land use substantially contribute to greenhouse-gas emissions worldwide. Four-fifths of agricultural emissions arise from the livestock sector. Although livestock products are a source of some essential nutrients, they provide large amounts of saturated fat, which is a known risk factor for cardiovascular disease. We considered potential strategies for the agricultural sector to meet the target recommended by the UK Committee on Climate Change to reduce UK emissions from the concentrations recorded in 1990 by 80% by 2050, which would require a 50% reduction by 2030. With use of the UK as a case study, we identified that a combination of agricultural technological improvements and a 30% reduction in livestock production would be needed to meet this target”.
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The final report I want to mention is “Setting the Table”, commissioned by the Department for Environment, Food and Rural Affairs and published by the Sustainable Development Commission in December 2009. It found that eliminating waste, cutting fatty and sugary foods and reducing meat and dairy consumption would make the biggest contribution towards improving health and reducing the environmental impacts of the food system. The SDC’s research found evidence that consuming only fish from sustainable stocks, eating more seasonal food, cutting out bottled water, shopping on foot, and some other things not directly related to the meat industry would contribute towards a more sustainable diet. However, it concluded that the most significant health and environmental benefits were from reducing meat and dairy, cutting food and drink of low nutritional value and reducing food waste.
I appreciate the intention of hon. Members who are present today to defend the UK beef and sheep industry; but I do not think it is helpful, in doing that, to ignore much of the other evidence. We cannot look at the issues in isolation. We should begin by acknowledging that there is a problem, and address that. I am slightly concerned that EBLEX, the organisation for the British beef and sheep industry, supports the all-party group, and is thanked in the report. I also note that Weber Shandwick provides the secretariat for the group, and has been thanked for its help in compiling the report. I do not know quite what clients it has that have led to its interest in the issue, but I think vested interests are clearly at work. I was going to say they are trying to pull the wool over our eyes—I have managed to make an entire speech without sheep or cow-related puns until now; I am not sure that the Minister or my hon. Friend the Member for Ogmore (Huw Irranca-Davies) will manage that. He already has a twinkle in his eye. I think that there is, to an extent, an attempt to pull the wool over our eyes, and I urge Ministers to consider the issue in the round, rather than looking only at the narrow points made in the report.
3.29 pm
Huw Irranca-Davies (Ogmore) (Lab): It is a delight to serve in a debate under your stewardship, Mrs Brooke, and to respond briefly, before the Minister takes the stage. I thank the hon. Member for Tiverton and Honiton (Neil Parish) and other members of the all-party group on beef and lamb for their work on the report. I note for the record my membership of the group, although I can take no credit or praise for this report. I was absent from the proceedings during witness statements and so on. My absence in no way diminishes the report; in fact, it probably strengthens it.
I will mention the contributions before I make some detailed points. The chair of the all-party group, the hon. Member for Tiverton and Honiton, went in some detail through the report, which I will discuss in a moment. I should make it clear that I used the example of Welsh White cattle for a particular reason. He made the point ably in his contribution that we should consider not only issues such as carbon reduction, emissions and sequestration, but the wider benefits of particular livestock in certain landscapes and environments.
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The reason why I gave the curious example of the fairly rare Welsh White—a small beef animal—is that its footprint is slightly lighter than other cattle but slightly heavier than sheep. It does a perfect job of breaking up the upland peat bogs of the Plynlimon hills, but not breaking up the ground too much. Combined with excellent work done by local farmers and the Wildlife Trusts to re-block some of the drains dug during the second world war to dry out the land so crops could be planted, which never quite worked successfully, the breed is now yielding great dividends. The right creature in the right habitat helps biodiversity as well.
The hon. Gentleman made the point well in his contribution that there is a wider range of issues, some of which are interlinked. Often, we talk about carbon on this side and biodiversity on the other side. We need to pull the strands together intelligently.
The hon. Member for Strangford (Jim Shannon) made a varied contribution. He always speaks well, and not only about the interests of Northern Ireland and his constituents. He rightly raised food security and food production, as did other Members. We are focusing increasingly on meeting the need for good nutrition and affordable food on the tables of a growing population both within this country and in terms of exports. Export markets are growing for Northern Ireland, Scottish, Welsh and English produce.
The hon. Member for Banff and Buchan (Dr Whiteford) added an extra dimension to the debate when she said that we need to consider both sides of carbon. Again, that came out in the all-party parliamentary group’s report: this is not simply about carbon emissions, but about sequestration within different types of landscape. The point was well made, and I will return to it.
The hon. Member for North Herefordshire (Bill Wiggin) made a good contribution, although I should pick him up on one point. He referred to Wales, “which is next to my constituency.” It is a little larger than simply being next to his constituency; it is next to a few others as well. I understand that Wales is often used as a unit of international measurement, but I would not want to think that it is only the size of North Herefordshire. It is a little larger.
Bill Wiggin: It is definitely still next door to my constituency, though.
Huw Irranca-Davies: It is, but it is next door to a lot of others as well. We may be slightly smaller than other countries, but we are a proud nation, as the hon. Gentleman knows.
My hon. Friend the Member for Bristol East (Kerry McCarthy) rightly challenged the farming sector with its responsibilities in terms of climate change and carbon emissions, saying that it could do more. She was eminently reasonable on the contribution that farming could play as part of the wider UK and global drive to tackle global emissions. She also widened the debate to the issue of biofuels versus food, which other hon. Members also raised, and to diet and other reports that challenge or contradict what we are debating. Those reports were useful for this debate and probably deserve separate debates, which I am sure she will seek; it is right to have challenge.
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This is more than simply an applied academic argument about how we measure and compare the carbon footprint of livestock. It is about effective measures to improve the performance of different types of farms in different farming sectors, and we can seek that improvement only if we measure the right thing in the right way and make like-for-like comparisons both within the UK and its devolved Administrations and internationally. As hon. Members have said, it is also a matter of food security and providing for the demands of a growing global population, and as I am sure other members of the all-party group are aware, it is a matter of reputational importance to the livestock sector. It recognises the work that the sector can do and its role in reducing carbon emissions, while putting good, wholesome British food on consumers’ plates in all parts of the UK and increasingly in other countries, which demand outstanding produce from England, Northern Ireland, Scotland and Wales.
The all-party group’s report raises questions about the accuracy and appropriateness of measurement, the lack of consensus on standard methodologies of measurement and the lack of comparability between measurement approaches domestically and internationally, as well as about how carbon sequestration can and should be taken into account with a standard approach. The all-party group has done a great service to the House by raising those issues, so that the Minister can respond to them domestically and internationally. I will turn briefly to some of the specific issues.
I am grateful for the information provided to all hon. Members by the National Farmers Union and others. One interesting dilemma within the discussions on carbon emissions and sequestration is illustrated in upland hill farming, which is part of my family background. The NFU makes the good point that such farmers could be particularly disadvantaged by how we currently measure, assess and compare carbon impacts. Some of the hill farms are on poor land without any real alternative uses. Such farming is also extensive in nature; it takes far longer to raise lambs to carcase weight. The finishing period is far longer, and generally, the vegetation and forage are of a much lower standard. That has a significant impact. When we look at the farming sector as a whole and say, “You’re not doing well enough,” the question comes back, “What alternatives do you have for that environment?” It is an interesting question. I am glad that I am speaking up for sheep, rather than cattle, after my earlier intervention. As we mentioned, it is also a question of the benefits for landscape management and biodiversity of having the right livestock in the right place.
On the international comparators raised by the all-party group and others, can the Minister give us an update on what progress has been made towards standardising international measures? What is happening on the common carbon footprinting methodology for the lamb meat sector? What is happening on the slightly earlier-stage beef life-cycle assessment white paper by the Global Roundtable for Sustainable Beef? How are those things progressing? They and similar transnational interventions might provide some solutions to what the all-party group seeks.
Some issues raised by the NFU include the uncertainty still associated with agricultural emissions—it existed while we were in government, and it is still ambiguous
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now—the need for good data about the wider aspects of on-farm activity, the choice of unit used to assess on-farm activity and carbon emissions, where the boundary lies and whether farm-specific mitigation measures should be part of the overall measure of a farm’s carbon impact. If a farm takes measures, including on renewable energy and so on, should they be included?
Finally, the NFU has broadly welcomed the recent call by the Agricultural and Horticultural Development Board to develop and deliver a computer-based environmental impact calculator for use by UK farms. It sees that as a way to achieve less ambiguity and more confidence. Will the Minister give us an update on that as well?
I thank the all-party group for its report and for securing the debate this afternoon. The right questions are being asked, and I am sure that the Minister will give us some assurance on them. Much more work needs to be done on measurement and comparability, but while recognising the real issues of food security and affordability, there are also things on which the farming sector—if we can get the measurements right—will want to deliver. Such work will show not only what a good job farmers do, but what more they can do to help us in our drive to tackle carbon emissions and climate change.
3.40 pm
The Minister of State, Department for Environment, Food and Rural Affairs (Mr David Heath): It is a pleasure to serve under your chairmanship, Mrs Brooke, and I think that this is the first time I have done so, so it is a particular pleasure. I, too, congratulate the hon. Member for Tiverton and Honiton (Neil Parish), not only on securing the debate and his contribution to it, but on the work of the all-party group for beef and lamb, which he chairs, and its report.
I am going to introduce a few figures, which are important to the debate. It is a fact that man-made greenhouse gas emissions represent a serious threat of climate change. Inescapably, agriculture directly accounts for about 10% to 12% of global greenhouse gas emissions. More widely, including other emissions associated with agricultural production, such as land use change, energy for fertiliser production and fuel for transport and refrigeration of products, emissions from global food production are far more significant, perhaps totalling 25% of global greenhouse gas emissions. In the UK, the figures are rather different. Agriculture accounts for about 9% of UK greenhouse gas emissions, and overall emissions from the agriculture sector have decreased by 20% since 1990, while we expect them to decrease by 12% from 2010 levels by 2025. I hope that that puts the issue into context.
The hon. Member for Tiverton and Honiton, as well as the hon. Members for Strangford (Jim Shannon) and for Banff and Buchan (Dr Whiteford), stressed the importance in discussion of such matters of recognising balance—there are downsides, but also upsides. The hon. Member for Ogmore (Huw Irranca-Davies) mentioned, for example, the value not only of biodiversity but of having a thriving and positive economy in the country. Getting the balance right is important, therefore, and is exemplified in specific cases. The hon. Member for Ogmore told us about his little, sad-looking White cattle in Plynlimon. I seem to remember that Plynlimon
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is the wettest place in the United Kingdom—it has the highest rainfall—so perhaps that is why the cattle look sad: they are sitting at the source of the great River Severn and feeling sorry for themselves, because it is raining. Nevertheless, he made an important point about needing the right animals in the right places to achieve the right results.
To return to our carbon footprint in this country, UK beef and lamb producers are among the most efficient globally. In 2010, the EU Joint Research Centre published a report showing that British beef is produced with less than half the emissions per kilogram than beef from Brazil. Those results are supported by research undertaken by Ricardo-AEA and Cranfield university, which reported that beef from Brazil is produced with 33% greater emissions than beef from the UK. The point I am making, because many Members have been concerned about what carbon footprinting is all about, is that it can be a useful tool to help businesses identify inefficiencies and emissions hot spots in order to improve not only environmental performance, but business efficiency and competitiveness.
I was slightly concerned by the contributions of some Members, who suggested a serious detriment to agricultural producers in this country, which carbon footprinting is not. Carbon footprints are not used in international policy making; they are tools for the benchmarking and marketing of products. In England and Wales, we do not have Government targets for mitigation in the agricultural sector. International emission comparisons are made using greenhouse gas inventories that are compiled under strict guidance issued by the Inter- governmental Panel on Climate Change. It is important to recognise that carbon footprinting can help the industry to meet not only our societal needs, in dealing with greenhouse gases, but its business needs, in doing the right thing. Carbon footprints are not intended—I can certainly foresee no such intention—to be introduced as targets or as something that individual producers must fulfil.
Nevertheless, the industry wants to do better. The UK beef and sheep industry, therefore, is seeking further emission reductions through the EBLEX product road maps, recognising that measures to reduce agricultural greenhouse gas emissions generally increase business efficiency and competitiveness. My Department welcomes such developments as part of the wider growth strategy for the sector.
The APG made some specific points. Its report draws attention to the problems of standardisation for carbon footprinting of the beef and sheep sector. Under the previous Government, DEFRA worked with the British Standards Institute and the Carbon Trust to develop the PAS 2050 standard for carbon footprinting and to encourage best practice. PAS 2050 aims to simplify carbon footprinting so that it can be carried out by a wider range of practitioners, and provides guidance to ensure greater consistency in approach.
The report is right to point out, however, areas of uncertainty where flexibility is needed, so PAS 2050 is not prescriptive for individual products, although it includes the potential for industry to develop product guidelines known as “supplementary requirements” to ensure that consistent approaches are used and to improve comparability of results. The dairy sector, for example,
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has produced such guidance via DairyCo, in partnership with the Carbon Trust. DairyCo has also worked with the International Dairy Federation to promote international standardisation. EBLEX is, as mentioned by the hon. Member for Ogmore, discussing international standards for carbon footprinting beef production systems with the Sustainable Agriculture Initiative or SAI Platform, a food-industry initiative supporting the development of sustainable agriculture worldwide. Similarly, EBLEX is exploring options to develop international standards for lamb production.
The APG report also calls for improved accounting of soil carbon sequestration in carbon footprinting. PAS 2050 provides for the optional inclusion of soil carbon sequestration in carbon footprinting, but we might have a misunderstanding about the terminology, which I want to address. There is a distinction between carbon storage and carbon sequestration: carbon storage is carbon that is held by permanent pasture or any other land management system; and carbon sequestration is a process by which carbon is captured in that system.
Scientific understanding indicates that UK pastures represent a significant store of carbon, but do not tend to sequester additional carbon from the atmosphere. That is where the distinction needs to be drawn. If we change land management, of course we have a change—perhaps a positive one, perhaps a negative one, but one that could be either sequestration or release of carbon—but, in a steady state, we do not have a movement of carbon on that basis. Where management practices are employed to increase soil carbon sequestration, the benefits are often small, uncertain and difficult to measure. Nevertheless, DEFRA has invested £390,000 in a project to improve carbon accounting under agricultural land management, including work to assess the extent to which agricultural land management can enhance carbon sequestration in the UK, the findings of which will support carbon footprinting studies. We expect the results to be published in the spring of 2014.
Bill Wiggin: My understanding of what the Minister said is that grassland is better storage than a sequestration process. However, the business of farming for cattle and sheep means that the carbon is captured by the grass and then moved along the food chain as the cattle eat the grass and become food and manure. That is the sequestration process, and that is why it is important to measure it.
Mr Heath: There is a constant store in any land management system. Any landscape feature, if it is not changed, will have a constant store, so there is a zero-sum gain. If the land is ploughed up or a different crop is grown, the equation may change and the position will be different. That is the simple point that I am making.
We want to continue to fund research into improving the sophistication and accuracy of carbon footprinting methods to support the industry and we have engaged actively in the production of internationally agreed standards for carbon footprints. Research under the UK’s agricultural greenhouse gas research and development platform is a £13.5 million initiative which, in response to the hon. Member for East Londonderry (Mr Campbell), who is not in his place at the moment, is shared with the devolved Administrations, so it is also relevant to the hon. Member for Banff and Buchan. Its purpose is
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to improve the understanding of greenhouse gas emissions from UK agriculture, and it will also provide underpinning evidence to improve the quality of carbon footprints.
Given the wide variety of production systems and processes in beef and sheep farming, carbon footprinting inevitably becomes part of the marketing mix, but as with other product information, the industry has a responsibility to be transparent about what it has and has not included in the analyses.
Kerry McCarthy: Will the Minister address the point that was made by the hon. Member for Tiverton and Honiton (Neil Parish) about methane emissions? I believe that 37% of methane emissions are attributable to the livestock sector, but the hon. Gentleman argued that because they come from a natural source they may not be as environmentally damaging as emissions from other sources. My understanding is that emissions are emissions and cause the same harm regardless of where they originate.
Mr Heath: The hon. Lady is of course right. A greenhouse gas is a greenhouse gas and has an effect on climate change. I do not accept entirely the argument about some being natural and others are not. That is transparently the case, but it is not a distinction that should affect our consideration of emissions. Some processes and activities are more avoidable than others, and some have a societal interest. The hon. Lady’s contention is perfectly respectable and she is entirely consistent in what she says about not using pasture land to produce animals as we do at the moment. However, society generally does not agree with that view. Society in this country generally wants to eat meat and wants the most efficient and effective processes, which is why we provide research support to help the industry to make those processes as beneficial and as least harmful as possible, but that does not mean that people do not want to eat meat. In the same way, people want to move around the country despite the fact that doing so has a demonstrable effect on greenhouse gas emissions.
Kerry McCarthy: I thought I made it clear at the beginning that I was concerned primarily about soya and grain production and its impact, rather than grass-fed animals in this country.
Mr Heath: I understand. I am not trying to misrepresent the hon. Lady’s point of view. She opened her comments by saying that she was somewhat masochistic in expressing her view in a debate populated largely by people with agricultural interests.
If we can do anything to mitigate effects on agriculture and any other sphere, we should do so. If we can provide help with research and help the industry to help
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itself in reducing those effects, all the better. We want to put all those factors into the equation with the other undoubted benefits of extensive pasture and the societal changes in parts of the country where other forms of agriculture would be exceedingly difficult, or in areas where there is huge expertise, for example, in beef production. My hon. Friend the Member for North Herefordshire (Bill Wiggin) prayed in aid his Hereford cattle, and I thought there might be tension between those with Herefords and those with Aberdeen Angus cattle, but that did not arise. Let us join together in saying that this country is blessed with not only some of the best breeds of livestock, but some of the best livestock husbandry anywhere. I am proud of that, and it makes my job that much easier.
My final point is about industry development and supplementary requirements, and responds in part to the report of my hon. Friend the Member for Tiverton and Honiton’s all-party group. Getting development of supplementary requirements under PAS 2050 and product rules under the greenhouse gas protocol product standard will help to bring consistency to carbon footprinting in the beef and sheep sector. EBLEX has taken the lead, and is a very effective levy-funded organisation. It is working on a UK-wide basis, which is relevant to some of the arguments about levy funding in the red meat sector, to produce the best possible advice and support for all producers throughout the United Kingdom, and I support it in that.
My hon. Friend and his all-party group have made some important points about the lack of consistency and the interpretation of the information we have to date. We accept that there is a lack of consistency. We want to improve that and to make the information as useful as possible because that will help the industry to move in the right direction in reducing as far as possible the emissions from agriculture and ensuring that we contribute as much as we can to our overall reduction in greenhouse gas. I hope we all support that. It is a principal feature of Government policy.
Neil Parish: I thank the Minister for his response. I want to put on the record the benefits of grass-fed beef and sheep production, and the fact that the amount of carbon stored in the soil balances the methane gas that the animals release. That is the particular point that I wanted the report to emphasise.
Mr Heath: I am glad that I gave way to my hon. Friend to make that final comment without running foul of the procedural rules. This debate has been extremely useful and interesting. The argument will continue to engage us, but we have made a valuable contribution today.
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Legal Aid (Rural Wales)
3.58 pm
Mr Mark Williams (Ceredigion) (LD): It is a particular pleasure, Mrs Brooke, to serve under your chairmanship this afternoon. We have an extra minute or so, for which I am very grateful.
I sought this debate to highlight the increasing number of concerns about the proposals to reform legal aid, following publication of the consultation document, “Transforming Legal Aid” by the Ministry of Justice on 9 April. I hope to obtain some reassurance from the Minister that, at the very least, the impact of the reforms on our constituents will be fully considered before changes are made.
The consultation, which closed on 4 June, outlines a number of reforms to the provision of legal aid across the England and Wales that are causing a great deal of concern. I responded to the consultation, as many other colleagues did, and tomorrow’s Back-Bench debate provides another opportunity to speak on the issue—if hon. Members only have a small bite of the cherry today, there is the opportunity for a bigger bite in that debate.
I wanted to focus on the effect of the reforms particularly in rural areas—in constituencies such as mine and in rural Wales generally—because I believe that that has been lamentably overlooked in the consultation. I worry that, if enacted, the proposals will have a devastating impact on access to justice for my constituents and on solicitors’ practices, and we must be aware that the significance of the reforms is such that, if enacted, there will be no going back.
Before addressing the proposals, I want to raise concerns about the consultation itself. First, as mentioned by the Welsh Assembly Government in their submission to the consultation, there was no mention in the consultation document of the Welsh language in accordance with the Welsh Language Act 1993. The Welsh Language Commissioner, Meri Huws, states in her submission letter:
“There are several references in this consultation to assessing the impact of the proposed changes on various groups as well as assessing the impact in accordance with the MOJ’s duties under the 2010 Equality Act. With regard to the Welsh language, there is no mention of it in the consultation’s documentation.”
What discussions have there been so far between the Ministry of Justice, the Welsh Language Commissioner and the Wales Office? I am glad that a colleague from the Wales Office, the Under-Secretary of State for Wales, the hon. Member for Preseli Pembrokeshire (Stephen Crabb), is present today. It strikes many of us that the specific concerns of Wales have been low down the pecking order.
Mr Elfyn Llwyd (Dwyfor Meirionnydd) (PC):
I congratulate the hon. Gentleman on securing the debate, and I declare an interest, having practised legal aid work as a solicitor and barrister. I support everything that he is saying, but it is worse than he described. As the consultation document was sent out in English only, the Ministry of Justice thereby has broken its Welsh language policy. It is only a mere afterthought, as, I am sure, is getting rid of all these firms. The proposal is for
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four legal aid firms alone to deal with legal aid in the whole of north Wales, and I am sure that it is just as bad in mid-Wales.
Mr Williams: I am grateful to the right hon. Gentleman for that intervention, which illustrates the huge degree of concern. The Government embark on consultations, and we can have a debate about whether they are genuine; I hope very much that this one is, as much needs to be said and changes need to be made. However, I have to raise the treatment of the Welsh language in this case. I see, as an English speaker representing a majority Welsh-speaking constituency—50% of my constituents do so, and in large parts of my constituency, larger percentages speak Welsh as their first language—that what has happened is an insult to those people. All Departments across Whitehall need to be mindful of that when they produce any documentation.
Glyn Davies (Montgomeryshire) (Con): The hon. Gentleman is making a hugely important point to many of us who represent rural parts where the Welsh language is strong. Does he agree that the consultation simply has not been acceptable, and the principal reason is the attitude towards the Welsh language, not only in the consultation, but in the fact that there will be four firms, making it impossible for them to deliver the service and pay proper account to the Welsh language?
Mr Williams: I agree with my hon. Friend completely on that point, and I am grateful for both interventions. They illustrate points that I will make a little later in my speech.
Simon Hart (Carmarthen West and South Pembrokeshire) (Con): I intervene briefly, simply to say that in answer to a question of mine the Under-Secretary of State for Justice, my hon. Friend the Member for Kenilworth and Southam (Jeremy Wright), stated that
“any criminal legal aid contract holder would be required to meet the obligations of the Welsh Language Act.”—[Official Report, 11 June 2013; Vol. 564, c. 280W.]
That sounds all right on paper, but does the hon. Gentleman share my concern that it is something of an afterthought?
Mr Williams: As I shall say later, the delivery in practice will be a different story. There is concern that the consultation period of eight weeks is too short and does not allow people fully to analyse the proposals, particularly when reflecting on the Government’s ambitious timetable not only to get the proposals authorised, but to start tendering the contracts by the autumn. Consultation is particularly critical in this case, given that the proposals can be enacted without further primary legislation, which is why it is opportune that we discuss such matters now.
Jessica Morden (Newport East) (Lab): I congratulate the hon. Gentleman on securing the debate. In April, the Government cut some civil and family legal aid, the consequences of which I am seeing in my office, with many parents fighting custody battles where one parent can get a solicitor and the other parent cannot. Therefore, justice is denied and courts are getting clogged up. In light of those changes, does it not make sense for the Government to slow down and have a look at what is happening already where they have cut legal aid, before rushing into further changes?
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Mr Williams: I concur with much of what the hon. Lady says. This is about process, and what her constituents will find more difficult when they are faced, I think, with nine solicitors’ practices in the whole of Gwent is physically accessing legal aid, if it is available to them.
On the proposals themselves, the model is inappropriate for rural areas. The geography of our country is such that defendants will be allocated a solicitor whom they will find it extremely difficult, physically, to meet sometimes. The proposals do not take into account the vast distances and travel challenges across my area of Ceredigion and the rest of rural Wales. If a defendant from Newtown was allocated a duty solicitor in Llanelli, a meeting would require the defendant or solicitor to make a round trip of more than five hours—not to mention, of course, the challenges with transport links that we face in rural areas.
The reduction in firms that are able to bid for contracts will lead to huge delays in solicitors attending courts, or possibly a police station, and that has serious implications for the defendant. I understand from a local solicitor that, just before Christmas, GEOAmey—one of the private companies—transported a constituent of mine from Manchester to Aberystwyth but was unable to take the constituent off the prison van. It had to take him back, as it had brought only two members of staff, and at least three are needed to escort a prisoner. That vast journey, at huge expense, was a wasted opportunity. A future with a criminal defence system providing that level of service is a worrying one.
Nia Griffith (Llanelli) (Lab): Will the hon. Gentleman give way?
Mr Williams: I give way for the last time—[Interruption.]Sorry, nearly the last time.
Nia Griffith: Does the hon. Gentleman agree that affording that transport is virtually impossible for many clients and that, if they were allocated different people on different occasions, which can happen with repeat offences, they could end up with several different firms representing them at one court hearing? Again, that would be massively wasteful.
Mr Williams: The hon. Lady pre-empts another of my later remarks. The relationship between solicitors and those repeat offenders is critical, and we risk losing that.
It is asserted that there would be four providers across the whole of Dyfed Powys. There would be real access issues, and are the proposed consortia feasible? As we have heard from hon. Members, the proposals plan to have four providers across the whole of Dyfed Powys, four across the whole of north Wales—sorry, I correct myself—and four in Gwent and nine across the whole of south Wales. By contrast, 37 contracts are planned for Greater Manchester, which has a similar population to south Wales. Again, will the Ministry of Justice, and the Whip speaking for the Ministry today, outline how that was calculated? How was rurality factored in? Although my hon. Friends from south Wales and the M4 corridor will have strong feelings about the provision of access there, for those of us who work, live and function in mid-Wales and north Wales, the picture is disastrous. We lose out yet again, and we are put at a real disadvantage compared with other people across the country.
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My next concern is that competitive tendering at 17.5% less will drive solicitors out of business. The competitive tendering proposed for contracts remains a major cause for concern. It will simply drive solicitors out of business. Those remaining will be firms that are willing to cut costs, possibly to unworkable levels. That would lead to tenders being awarded to less able and potentially less experienced firms, which may find themselves unable to deliver on the prices promised to secure the tender. I am clear in my mind where I would like to go if I needed legal advice. However, there is the spectacle of Eddie Stobart or Tesco providing the service. The Co-op has been mentioned recently, and I am a great supporter of the Co-op. It is an admirable place to go to buy food and it has a fine record of burying people—the Co-op funeral service is very good—but we should not be using such examples to justify changes to the legal system.
I am greatly concerned about the capacity of companies such as Capita, GEOAmey, Serco and G4S—and whether they are best placed to represent my constituents. My colleague in another place, Lord Thomas of Gresford alerted us in a Queen’s Speech contribution to Stobart Barristers—an offshoot of Eddie Stobart trucks. Lord Thomas noted that the Stobart Barristers legal director, Trevor Howarth, had confirmed that the firm would bid for the new criminal defence contracts and had said:
“We can deliver the service at a cost that’s palatable for the taxpayer… Our business model was developed with this in mind. We at Stobart are well known for taking out the waste and the waste here is the duplication of solicitors going to the courtroom. At the moment there are 1,600 legal aid firms; in future there will be 400. At Stobart, we wouldn’t use 10 trucks to deliver one product”.
As my noble Friend concluded, the problem with that is that criminal law is not a unit and justice is not a product that can be delivered like a load of bricks. That is the contrast in terms of what we are facing. There is a real fear that many of our high street solicitors will be lost; many will go out of business. The firms with the most cut-throat prices and cut-throat tactics will be the most successful, but I believe that liberty should be in the hands of the best, not the cheapest.
I come now to the loss of specialisms.
Roger Williams (Brecon and Radnorshire) (LD): My hon. Friend is making many very good points, but surely one of them is that the people who supply these legal services will be given a financial incentive to get their clients to plead guilty. Surely, that is a characteristic of a totalitarian state, not the liberal democracy to which we aspire.
Mr Williams: My hon. Friend and I agree. He uses a very emotive word to describe what I think will be the reality on the ground.
Under the proposals, a call centre will allocate a lawyer from any background—an impersonal experience in itself—who might provide a minimal service to meet the requirements of the contract. People will not be able to select a firm by reputation, by personal recommendation or, sadly, by past experience. That discourages good practice and good performance among professionals, as those who gain a contract will get clients regardless of performance. Therefore, clients will be unable to choose a firm according to the nature—sometimes, the specialised
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nature—of their case. I have said this before and it is worth repeating: let us not understate the importance of the relationship between solicitors and clients and the trust that has been built up.
Solicitors in my constituency are concerned that the consultation document encourages solicitors not to provide a good service—not to provide the best service. The aim is to be “above acceptable levels”. That is a worrying prospect.
There will be a lack of choice. Owing to the call centre allocation of solicitors, clients will be left with no choice of representation. They may have a lawyer who does not know them or the area in which they live and who certainly does not know the background to their case. As the hon. Member for Llanelli (Nia Griffith) said, a different company could represent them at different stages. I think that that is bad.
The consultation document suggests that the same fee will be paid—this is the point made by my hon. Friend the Member for Brecon and Radnorshire (Roger Williams)—whether or not the matter is contested. Those firms that are awarded contracts will have a financial incentive to do minimal work to make their business sustainable, to the detriment of the client’s case. That could lead to a perverse incentive for legal advisers to recommend that clients plead guilty, as they would receive the same fee regardless of plea—a conclusion that certainly the solicitors whom I have spoken to are concerned about. They believe that suspicion may be created between client and lawyer.
I want to end where I started, with the effects on language. When we are talking about the consultation, there remain serious issues surrounding the provision of language services. I have anecdotal evidence that the large firm Capita is regularly unable to provide interpreting services to courts in a timely manner. In my constituency, as I said, Welsh is the first language of about half the population. In many parts of Ceredigion, it is overwhelmingly the language of everyday use, so the issue to which I refer is a worry and a barrier preventing many people from accessing the representation to which they are entitled.
I want to ask the Minister and particularly those behind the scenes in the Ministry of Justice about their awareness of Wales and of the Welsh language. As the Welsh Government pointed out in their submission to the consultation, the Ministry of Justice’s own Welsh language scheme—a point that the right hon. Member for Dwyfor Meirionnydd (Mr Llwyd) mentioned—declares the Ministry’s commitment to the principle of treating the English and Welsh languages on the basis of equality. The current system of more local provision means that someone is more likely to satisfy Welsh language needs. These proposals mean that it is much more likely that a provider will be based outside the relevant area and even outside Wales, allowing no provision for Welsh language services at all.
The proposals are socially divisive, as only the wealthy will be able to afford to choose their own lawyer. Only those who can afford to will be able to determine how they are represented. Everyone else, if they are eligible for legal aid, will be allocated a lawyer via a call centre.
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Some of the public narrative on the issue has characterised it as one of fat cat lawyers acting in their own interests, although if we talk to solicitors on the ground, the story is somewhat different. In reality, it is far more worrying. It is about universal access to justice, the credibility of our court and justice system and the responsibility of Parliament to ensure the continued efficacy of our justice system.
Overall, what has been billed as a simple money-saving measure will have far deeper ramifications for society. The proposals take the fundamental principle of access to justice away from anyone who cannot afford it, but it is a right, not a commodity to be bought and sold.
The Minister knows that this is a consultation, and the deliberations will go on about the various submissions. I sincerely hope that it is a real consultation and that the Government will look at the submissions, particularly those from us in Wales and the concerns that we have raised; and I hope that the Minister and the Ministry of Justice will therefore reflect favourably on the needs of rural Wales.
4.16 pm
The Lord Commissioner of Her Majesty’s Treasury (Mr David Evennett): I warmly congratulate my hon. Friend the Member for Ceredigion (Mr Williams) on securing the debate. I have been asked to respond on behalf of the Ministry of Justice by my right hon. Friend the Lord Chancellor and I will of course ensure that he is aware of the representations and comments made this afternoon by my hon. Friend and by other hon. Members present. I am delighted that the Under-Secretary of State for Wales, my hon. Friend the Member for Preseli Pembrokeshire (Stephen Crabb), is able to be with us at this important debate. I am well aware that the Wales Office has received many representations from Welsh MPs on these matters. I would like to point out that my right hon. Friend the Secretary of State for Wales has discussed these issues with the Lord Chancellor and we are sensitive to the interests and needs of the Principality.
Albert Owen (Ynys Môn) (Lab): I apologise for not being present at the very beginning of the debate. Is the Minister saying that he is looking favourably at a Welsh dimension to the whole consultation process? In addition to that, we are talking about rural areas that are on the periphery—areas that have lost court services and lost other forms of access to justice.
Mr Evennett: I am grateful for that intervention. Of course, we are aware of and sensitive to the issues that are being raised. We will obviously take into account everything from the debate and the consultation.
The Government must always be mindful of the impact of their policies on those affected by them. Debates such as this are most welcome, as they help to strengthen and improve Government policy by ensuring that hon. Members’ expertise and local knowledge are fully considered. Before I respond to the substantive parts of the debate, I would like to make three general points about the changes that have been consulted on in respect of legal aid.
First, the Government will continue to uphold everyone’s right to a fair trial. We do, however, have a duty to look at how the system is working, taking into account the
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taxpayer, legal aid applicants and the legal profession as a whole. Secondly, access to justice and access to taxpayer-funded legal aid should not be confused. We have a duty to ensure that all public expenditure is justified. Thirdly, the Legal Aid Agency would ensure, as part of the tendering process, that all providers were capable of delivering the full range of criminal legal aid services under contract across their procurement areas. Quality-assured duty solicitors and lawyers would still be available if these changes were implemented, just as they are now.
I would like to outline the rationale behind the legal aid proposals and their potential impact in Wales. In its programme for government, the coalition set out its intention to undertake a full review of the legal aid scheme. Following consultation, the Government’s final proposals culminated in the Legal Aid, Sentencing and Punishment of Offenders Act 2012. As well as reducing the scope of the civil legal aid scheme, the Act made sweeping reforms to the central administration of the legal aid system. Through the introduction of the Legal Aid Agency, we have strengthened accountability and introduced a more rigorous approach to financial management. We estimate that those and other reforms will save about £320 million per year by 2014-15, but our legal aid scheme remains one of the most expensive in the world. Legal aid spending in Wales has increased, as it has dramatically in England.
Mr Llwyd: First, spending is in the median area of the league; it is not being compared with like common-law jurisdictions. Secondly, the Act to which the Minister refers has a specific section that says, “Of course, people will always have an entitlement to choose their own lawyer.” That is now being swept away.
Mr Evennett: The right hon. Gentleman does not highlight the fact that the cost to the taxpayer of criminal legal aid is still around £1 billion a year, which is a phenomenal amount of money.
Mr Evennett: And yet we are talking about a phenomenal amount of taxpayers’ money.
The Government’s latest reforms, published in the “Transforming Legal Aid” consultation in April this year, tackle the cost of criminal legal aid, as well as finding further savings from the civil legal aid scheme. In particular, the proposal to introduce price-competitive tendering into the market for criminal litigation services has attracted a number of comments, such as those made by my hon. Friend the Member for Ceredigion and others this afternoon. If our proposals are implemented, the number of contracts tendered by the Legal Aid Agency will reduce from about 1,600 to about 400.
For the record, I would like to dispel a few myths, which have been highlighted this afternoon, about the model on which we consulted. The 400 figure relates to the number of contracts the Legal Aid Agency would tender, not the number of firms in the market or the volume of work available. The proposals on which we consulted do not prescribe how many lawyers would be available or how those who have the contracts can divide the work allocated to them. The proposed model would result in a consolidation of the market, but that
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does not mean that smaller firms of solicitors will go out of business. Some may choose to join together to bid for contracts. Others may decide to act as agents.
Mr Evennett: I would like to make a little progress, because otherwise I will not answer my hon. Friend’s points.
Importantly, specialist services—vital for niche areas of law and for clients with particular needs—will be able to continue. We received approximately 16,000 responses to the consultation, many of which address the competition model in detail. We are carefully considering all responses before final decisions are taken. This afternoon’s debate will go forward as part of that consultation and will be fed back to the Lord Chancellor and Ministers in the Department. It will be examined in the pot with the other considerations.
Mr Williams: Will my hon. Friend give way?
Mr Evennett: I will not be able to answer the questions and points raised if I take lots of interventions, but I will take one in a minute.
Among the particular needs to be met in the provision of legal aid is of course the provision of services in Welsh for those who want them. The Government have no intention of changing the requirements placed on legal aid providers operating in Wales to offer a bilingual service—I can nail that concern for my hon. Friend. That that issue, alongside many other practical considerations, is not expressly addressed in the consultation document reflects the fact that it will be, as at present, given effect through the Legal Aid Agency contracts with providers. The document does not propose any change in current practice, but that issue has been raised by some respondents to the consultation and we will provide simple reassurance when we publish the Government response. As well as raising the provision of services in Welsh, a number of legal aid providers have set out their concerns about the operation of the proposed competition model in rural areas, including rural Wales. Some of those concerns have been echoed here this afternoon, and I propose to raise them, highlighting the points made, with the Lord Chancellor to inform his decision making when the consultation concludes.
The consultation sets out a model of competition to cover the whole of England and Wales and seeks to address the needs of both urban and rural areas. In the cases of two regions—the areas covered by West Mercia-Warwickshire and Avon and Somerset-Gloucestershire—it makes an exception to the rule that procurement areas will be based on current criminal justice areas, by combining each pair into a single area. That proposal, however, is based on the volume and type of work, rather than the areas’ rural geography. The consultation in fact sought views on whether the geographical arrangement of contracts it set out was the right one and sought alternatives. We are of course open to good suggestions and urge the profession to work with us to come up with the best solution. The appropriateness of the model to rural Wales was raised during the engagement events held by
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the Ministry of Justice during the consultation period. We will consider carefully the views raised, before finalising our proposals.
Concerns have been expressed about the Government’s decision to publish the transforming legal aid consultation in English before the Welsh translation was ready. I shall address that issue directly, because it is unfair to suggest that the Ministry of Justice has not taken its commitments under its Welsh language scheme seriously. The Department has committed to treating English and Welsh equally, as far as is reasonably practicable, and that is what we did. Translating a document of that length and complexity takes time, and it was published as soon as it was available. In translating the entirety of the document, we have gone further than the previous 2010 legal aid consultation. In deciding not to delay publication of the English version until the Welsh version was ready, we were conscious that the majority of the target audience in Wales comprises legal aid providers required to provide services in English, as well as Welsh. Moreover, when the previous legal aid consultation was published in 2010, only the executive summary was translated; the Department did not receive requests for a full translation in Welsh and we did not receive any responses in Welsh. We have so far identified about 10 responses to the current consultation in Welsh. That we have had responses in Welsh reflects, I hope, that legal professionals working in Wales have shown their own expertise in responding to our proposals.
Officials are in the process of studying all the consultation responses received and will consider carefully all views on how Wales’s particular rural geography should be accounted for before final decisions are taken.
Mr Mark Williams:
I have two questions. The first relates to remarks the Minister made some time ago. The consultation ends on 8 June and we have a short time to get the system up and running. How optimistic is he that that can happen and in particular that the consortia he mentioned, of small solicitors, practices coming together, can be realised? Finally, he mentioned
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a consultation event in Cardiff, where I know some of my local solicitors were keen to ask Ministry of Justice officials about the extent of their detailed knowledge of rural, north and mid-Wales and the challenges of rural transport. How much detail has gone into the assessment of rural Wales, or for that matter rural England?
Mr Evennett: I will have to write to my hon. Friend, because I do not have that information to hand. All I will say is that we have engaged with many professionals and received lots of consultation responses in the Department. We are very aware of the difficulties and the particular issues he raises.
Time is ever so short, but I want to mention the Government’s compliance with the Equality Act 2010. We are mindful of the importance of considering the impact of our policies on different groups. In accordance with our obligations under the 2010 Act, we have considered the impact of the proposals, in order to give due regard to the need to eliminate unlawful conduct, advance equality of opportunity and foster good relations. Our initial assessment was published with the consultation paper, and we will update it in light of responses, before final decisions are taken on the equality issues.
I am aware that a half-hour debate is not long enough, but there is of course a debate tomorrow on the Floor of the House, where issues can be developed further. I thank my hon. Friend the Member for Ceredigion for securing this important debate and I thank right hon. and hon. Members for the contributions that they have made. I am confident that, after long discussions and a long thought-out process, which will include the consultation information, the Ministry of Justice will publish final proposals that command the confidence of those who provide and use legal aid-funded services in Wales. Final decisions have not yet been taken, and today’s debate will certainly be read and noted by the Lord Chancellor and his ministerial team. I have listened to the views raised. I again commend my hon. Friend for securing the debate. I will certainly pass on to my right hon. Friend the comprehensive views that have come up this afternoon. The Under-Secretary of State for Wales and I will discuss the issues raised. I am grateful for the opportunity to put forward the Government view.
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Kettering General Hospital A and E
4.30 pm
Andy Sawford (Corby) (Lab/Co-op): It is a pleasure to serve under your chairmanship, Mrs Brooke. I am grateful for the opportunity to debate the future of Kettering General hospital’s accident and emergency services.
Kettering General hospital has served the people of my constituency for 115 years. It is where my children were born, and where my granddads received care at the end of their lives—where I said goodbye to them—and today it is a place that is relied on by my family and my constituents. I declare an interest in that it is where my mum, like many thousands of local people, works. Kettering General hospital is a huge part of the community, because of the care it provides and because it is one of the major local employers. Many of my constituents are employed there, as nurses, doctors and auxiliary staff, and I take this opportunity to thank them, in whatever capacity they work. Working in our health services is demanding and, for most health workers, not particularly well paid. The hours are long and the demands are great, but the overwhelming majority of my constituents receive good care, and for that we are all grateful.
However, we have to face some hard truths. The quality of care at the hospital is not good for everyone. It is not realistic to think that 100% of my constituents will get perfect care every time, but it is something for which we should surely strive. All the evidence shows that too many people do not get the care they need. Kettering General hospital employs more than 3,000 staff, and has more than 600 in-patient and day-case beds and 17 operating theatres. The hospital has a consultant-led level 2 trauma unit in its 24-hours-a-day, seven-days-a-week accident and emergency department, and there are currently two locums and five consultants who are on site until 11 o’clock in the evening and on call until 8 o’clock in the morning. Some cases, such as severe burns and head injuries, are transferred, often by air ambulance, to Coventry, which has a level 3 trauma facility, but Kettering General hospital is where most trauma patients go. It serves the accident and emergency needs of a wide population across north Northamptonshire.
The hospital’s location, right next to one of the busiest arteries in the midlands—the A14—makes it the most accessible accident and emergency for many people, not only in north Northamptonshire but across the whole county and in neighbouring counties, particularly Leicestershire. The core of the hospital’s patients, however, is from my constituency and that of my two neighbours, the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone).
Today, I want to speak about the challenges that our accident and emergency services face, and to seek Government support in meeting them. The context is highly political, and the Minister and I will strongly disagree on some health policies, but I would much prefer us to have as constructive a debate as possible today. Much of what I have to say will be supported by the hon. Members for Kettering and for Wellingborough who are unable to be here, but with whom I am working closely and regularly in support of the hospital. We
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have formed a campaign group, consisting not only of the three of us, but of the local media, the local authorities and many other interested local organisations.
As three Members of Parliament, we meet regularly with the chair and the chief executive of the hospital, and I am pleased to say that, as of last night, we have a meeting arranged with the Minister’s colleague, the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter). We are also in dialogue with the local clinical commissioning groups. A and E services are our top priority.
The Minister will be aware of the Healthier Together proposals for the south midlands area. Last autumn, there was a hurried timetable and inadequate consultation on the proposals. The public gradually became aware of them, the thrust of which was for five hospitals to go into three for some of the services, particularly full accident and emergency, obstetrics and maternity, and in-patient paediatrics. The detailed model underpinning the proposals stated that the best option, according to their criteria, was that Kettering lose its full accident and emergency.
I am pleased to say that, in response to a strong cross-party community campaign, Healthier Together and all those involved, including the clinical commissioning groups and the hospitals, recognised that communities in my constituency and across the north of Northamptonshire would not support the proposals. Our nearest accident and emergency would be at Northampton general, and anyone who knows the county and understands its geography will recognise that that is not acceptable. We do not need the independent experts—as they were called—employed by the Healthier Together team to tell us that it is almost impossible to get from Corby to Northampton along the A43 during peak times without coming to a standstill. There is no rail link between the towns in the north of the county and Northampton, and the bus service is intermittent.
The Department says that it expects proposals for local health service changes to meet four key criteria: support from GPs; strengthened public and patient engagement; sound clinical evidence; and that the proposals support patient choice. I do not believe, nor do the hon. Members for Kettering and for Wellingborough, that those four criteria were met in the Healthier Together work. And it is not just in my area. Councillor Hannah O’Neill, the deputy leader of the Labour group on Milton Keynes council, told me that Healthier Together caused uncertainty across Milton Keynes, that neither communities nor the council was properly consulted, and that they were left with no information about the future of the programme for their hospital. A critical issue for the whole south midlands Healthier Together area is that we do not know where the proposals will take us next.
The final Healthier Together report, published in March, states:
“Current A&E staffing levels do not meet national guidance, which recommends a minimum of ten consultants for a medium-sized A&E department.”
It also raises concerns about the long-term viability of retaining five acute surgical rotas:
“Concentrating A&E and general surgeons onto fewer sites could improve sustainability, but there would still be a need to recruit further A&E consultants to provide consultant presence.”
The report proposes an alternative model of four fully supported accident and emergency sites, with the fifth being a “warm” site, managing and transferring some
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patients under protocols. In the north of Northamptonshire, the worst case scenario is that we would have to assume, based on the previous detailed proposals, that Kettering would be in line to be that “warm” accident and emergency. That is simply not on, not just because of the geography, but because of the demand from the area that Kettering serves.
We recognise, however, that there is a challenge to improve accident and emergency at Kettering. The hospital had to save £11 million last year, and has to save a further £12 million next year, but the answer lies not in taking away our proper accident and emergency and maternity services but in improving the health system. We need a more integrated health and social care system. I will study the detail of today’s spending review announcements, and if they reflect the integration policies that my right hon. Friend the Member for Leigh (Andy Burnham) and my hon. Friend the Member for Leicester West (Liz Kendall) have been championing, they will have my support.
We need local authorities to act more quickly to get elderly patients out of hospital once they have been treated, so that they can have the care they need in the community and so that hospital beds are freed up. That happened just last year with my nan, after she had a stroke. A critical issue is how primary and acute care will work together in the future. It is also about prevention, about which I heard the Minister speak last week at an event organised by Cambridge Manufacturing, a great Corby-based company that exports across the world and helps people become fitter. If the Minister is wondering, the event was at the National Obesity Forum, and Cambridge Manufacturing was the partner organisation. The issue is also about the hospital itself becoming as efficient and effective as possible.
I am sorry to tell the Minister that instead of moving towards an improved service, there are very serious issues at Kettering A and E. This is a very worrying time. The hospital simply cannot cope with demand; we have rising demand, and an ageing and growing population. There are issues relating to the local doctor services and the out-of-hour services, and twice this year the general hospital had to close the doors of the A and E to patients other than those arriving by ambulance, announcing it to the media and asking local Members of Parliament to tell patients not to turn up. We have been told that the principal factor in that was the 111 changes.
Corby is the fastest-growing town in the UK and has the highest birth rate, but there is population growth right across north Northamptonshire. The number of people attending the A and E department at Kettering General has doubled over the past 20 years, from 40,000 in 1992 to 80,000 in 2012. That 100% increase is far greater than the rate of population growth, and growth continued last year. We have continued growth in Northamptonshire’s elderly population, so an increase in acuity, for example, is to be expected, with more people with more complex problems who really do need A and E care. The trust’s emergency department was not designed to see that many patients. In the hospital’s own words, it is now “not fit for purpose”: it is too small and does not have enough rooms to provide appropriate care.
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There are significant issues around the inappropriate use of accident and emergency. A recent patient education project in Northamptonshire showed that 70% of patients did not try to contact out-of-hours GP services before going to A and E. The trust is currently investigating and pricing ways in which it could expand its emergency care department’s footprint to make it more suitable for patients and to make it more efficient to help reduce waiting times.
On accident and emergency waiting times, there has been a dramatic increase in the number of people waiting for more than four hours. In April 2012, 262 people waited more than four hours, but in April 2013 that figure stood at 1,530 people. A year on, we can see how significant the rise in the number of people waiting for more than four hours is. Breaches of the target are largely because of patients waiting in A and E for hospital beds to become available. Kettering General hospital’s bed base runs very hot: 95% to 100% of beds are full. It is therefore often bed availability in the whole hospital, rather than issues in A and E, that leads to breaches of the transit time.
The hospital has launched a transformation programme, which local MPs support, by creating new direct access services for GPs, putting in a new discharge team to improve discharges and expanding the A and E department—for example, with an observation bay for patients needing short-term observation and tests. The hospital is investigating the creation of more of its own step-down facilities in the community.
There are other positive developments. The Corby urgent care centre has improved facilities, particularly for my constituents in Corby. It is not the hospital that Corby people really wanted, but it brings many services closer to my constituency. It is open from 8 am to 8 pm, and it reduces the need for patients to travel to A and E. It is only now coming fully into use, so it will be some time before it takes significant pressure off A and E at Kettering.
I went to the opening of the new foundation wing at Kettering, which is a fantastic new facility. It will improve some of the problems in the hospital, and it increases the number of beds. The hospital is to be congratulated on developing the proposals for that wing. It has been 10 years in the making, and there was a delay in its opening, but it is a significant improvement.
In a few weeks, with the hon. Members for Kettering and for Wellingborough, I will meet the local clinical commissioning groups to discuss GP out-of-hours services. A key issue relates to people using a GP where appropriate, rather than presenting at accident and emergency.
I hope that the Minister will comment on the seriousness of the Care Quality Commission report published in March. It stated that action is needed on cleanliness and infection control, on supporting workers and, in particular, on assessing and monitoring the quality of service provision. In fact, so severe were its findings that it has taken enforcement action against the hospital.
The report makes mixed reading. Most patients seen by the CQC generally commend the hospital. As I said at the outset, most people’s experience is good, but where it is not good, it can be very disappointing. For example, because of that huge rise in demand in accident and emergency, the CQC found open storage of needles and syringes, containers overflowing with syringes, and
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noisy and rusty bins in areas of the department, and it observed that the public toilets were dirty and that floors appeared dirty and stained.
As the CQC has stated, that situation was not because the hospital staff were not working incredibly hard—it observed that the staff were working with clear protocols and trying to do the right thing—but the facility is now frankly too small for what is really needed to serve the north of Northamptonshire. It is cramped, which really affects the quality of care.
The CQC specifically mentioned long waiting times. I have heard cases of people waiting up to 10 hours, which is clearly unacceptable. Not only are there the waits in accident and emergency, but, having been seen in A and E, there are the waits to be transferred to wards in the hospital. There are also knock-on effects. The CQC highlighted issues in orthopaedic and surgical wards, where other medical admissions from A and E have become a way of life, because the beds are needed, but those wards do not have the staff, the expertise or the capacity to meet the needs of the patients transferred.
I want to hear from the Minister an understanding of the pressures facing us in Kettering General hospital’s accident and emergency, and support for initiatives that the local chair, chief executive, trust and staff are taking and which we are trying to support. We want to support this incredibly important hospital. We also want a commitment to capital improvements in accident and emergency. Whether that comes from what I understand is a dedicated fund in the Department of Health for capital improvements for A and E that is underspent or from the general NHS underspend, I hope that we will hear about it today. I also hope that she will comment on the issues about how the health system works locally.
4.45 pm
The Parliamentary Under-Secretary of State for Health (Anna Soubry): As ever, it is a pleasure to serve under your chairmanship, Mrs Brooke. I congratulate the hon. Member for Corby (Andy Sawford) on securing the debate. He quite properly brings forward his constituents’ concerns about their hospital. I am delighted that he is working with two other Members of Parliament whose constituencies are served by the hospital.
I am especially grateful to the hon. Gentleman, if I may say so, for having contacted my office and spoken to my officials before the debate. If only all hon. Members took such a positive step, because it assists hugely. He is quite right to make the point that this is not the stuff of party politics. I fear that I may not be able to answer some questions that he quite properly asked. If that is the case, I or my officials will write to him to ensure that all the matters he raised and all the questions he asked are given proper and full answers.
I am very pleased that the hon. Gentleman will meet the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), on 16 July, with my hon. Friends the Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone). I am sure that there is no connection, but having said that, a frog has entered my throat. I am going to stop for a minute.
Annette Brooke (in the Chair): That would be wise.
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The hon. Member for Corby has raised important issues about accident and emergency services, although I will not be dealing with the national situation. As we know, there have been some issues and problems in emergency departments throughout the country, many of which have been well rehearsed in this place.
Underlying themes and problems are often common to all our accident and emergency departments. Undoubtedly, many of the problems at Kettering’s accident and emergency are exactly the same as those that have caused so much difficulty in other A and E departments in this country. I am pleased that huge progress has been made and that overall performance is improving across the country as might be expected, especially given my Department’s efforts.
The hon. Gentleman has pointed out how health services are under pressure in his constituency and having a knock-on effect at Kettering, and those pressures are being experienced across the whole system. He quite properly identified that the reasons for that are complex. Dealing with those pressures means looking at the underlying causes, which the Department has been doing by working with NHS England.
The hon. Gentleman pointed out that Kettering General Hospital NHS Foundation Trust is experiencing many of the issues that I have highlighted. I am aware that, as he told us, the trust has not met the A and E standard. It has struggled with that difficulty for some time. He will know that Monitor, as the regulator of foundation trusts, has unfortunately found that the trust is in breach of its licence in relation to its A and E performance, as well as wider financial and governance issues. That will cause concern not only to the people who use the hospital, but to its outstanding staff.
Monitor has required the trust to implement an urgent care action plan to ensure that it can return to compliance against the A and E standard. The deadline for that is 1 July, so it will not be long before the trust has to implement it. Monitor is working with local commissioners and NHS England to support the trust to meet that requirement.
I appreciate that the hon. Gentleman feels that further investment is needed to expand facilities at the trust to improve its position. It is right that, as I understand it, he has had meetings with the chair of the trust and other Members of Parliament, and that letters have been written, to request assistance in securing extra capital funding. Some £5 million to £10 million has been requested, so that the trust can redevelop and expand its A and E department.
Of course it is for NHS foundation trusts to develop and take forward their own capital investment proposals, and trusts such as Kettering can apply to the Department for a capital investment loan. We understand that the trust has allocated some of its capital budget this year to make improvements within A and E, and it has worked with commissioners to redesign what we call pathways to improve flow. Hot clinics and ambulatory pathways have been developed, which divert patients away from A and E and avoid GP admissions, which, as we know, often stack up in the Department.
On the matter of whether Kettering has ever closed its doors, I am told that its accident and emergency department has never done so, and it is important to put that on the record. I am told that there was a period
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in February when the hospital trust effectively advised members of the public—I think that this sounds like a sensible piece of advice—to ensure that they only went to A and E if they had had an accident or an emergency. In other words, to use the jargon, they were told to use the department appropriately, because the trust had become aware of a sudden and acute rise in people using A and E. Actually, that is a good message for all of us to take back to our constituents. The department is not called “accident and emergency” for no good reason; it is for accidents and emergencies.
When we had a debate on A and E in the main Chamber, Members from both sides told stories about people presenting at A and E when they could have gone to the pharmacy or just taken a paracetamol. The point I am making is that, often for understandable reasons, people attend A and E when they cannot get the appointment they want at the GP surgery. There is this wider issue that perhaps we do not do what we used to do in the past, which was to self-administer, take advice from our brilliant pharmacies or ring the GP surgery for advice before simply turning up at A and E.
As I have said, meetings have taken place, and, as I understand it, the trust has been working with local commissioners in the way that I have described. The hon. Gentleman mentioned the new Corby urgent care centre. I think I saw it before I was in this position—I was there for other reasons which I am sure the hon. Gentleman will understand—when it was in the process of being constructed. I am delighted that it is now open. It is called an urgent care centre. To be frank, we do not always use the best language when it comes to naming places where patients can go. In fact, the review, which is being conducted in the Department of Health, is looking at the sort of language that should be used, so that people understand where they have to go when they have a particular problem. I am delighted that the centre has opened in Corby and is providing additional urgent care services to the hon. Gentleman’s constituents, which should help to ease the unnecessary attendances at the A and E department of Kettering General.
I also want to mention the East Midlands Ambulance Service NHS Trust, because it is of concern to all of us who represent seats in the east midlands. I know that the hon. Gentleman has rightly talked about how problems with EMAS have affected services in his constituency.
Andy Sawford: I wanted to cover more issues in my opening remarks. The Minister is absolutely right to say that EMAS is a huge concern for all MPs across the region. I am sure that she is aware that the proposal is for the hub that would serve my constituents now to be at Kettering and for the level of service to be reduced at Corby, which is a concern for us.
Anna Soubry: Indeed, and it is right that the hon. Gentleman should raise that concern. I think I am right in saying that Earl Howe, who is the Minister with responsibility for the ambulance service, has agreed to meet the hon. Gentleman. If he has not agreed that, then he just has. In any event, Earl Howe will be more than happy to meet the hon. Gentleman to talk about the various issues.
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The hon. Gentleman will also be aware that the NHS Trust Development Authority has intervened at the East Midlands Ambulance Service NHS Trust and is working with local commissioners to ensure that it has robust turnaround plans in place to improve its performance. The fact that the ambulance service has not been meeting the high standards that we all expect of it has been a long-standing problem in the east midlands. It is now implementing proposals to improve the way it delivers services across the east midlands through its “being the best” programme. That includes the replacement of some ambulance stations, including the one in Corby. It is creating 108 community ambulance posts, 19 ambulance stations and nine purpose-built hubs or superstations to enable ambulances to be dispatched from strategic points across the region to meet demand. I know that the “being the best” proposals have been referred to the Secretary of State by Lincolnshire county council. I do not know whether Northamptonshire will now take the same course, but it may not need to as Lincolnshire has already made the referral. As a result, the Independent Reconfiguration Panel is due to advise in the next few days, so it would not be right for me to make any further comments on that matter.
I will conclude now unless of course the hon. Gentleman wants to intervene again, which I am more than happy about because we still have four minutes.
Andy Sawford: I thank the Minister for giving way again and I am delighted to take up the opportunity to use up a little more of the time we have available. It is of course very welcome news that those proposals have been referred to the Independent Reconfiguration Panel. However, I must say to her that, irrespective of how those proposals proceed, I have no confidence in the trust board of the East Midlands Ambulance Service NHS Trust or in its leadership and management.
I will be interested to hear the Minister’s comments about what role, if any, the Department of Health can play in intervening when there are concerns about the management of an ambulance trust. I know that hon. Members from across the eastern region ambulance service, which also serves some of my constituency, have—frankly—successfully changed the leadership of that service. I feel that we may need to make some progress in that regard ourselves.
Anna Soubry: The diplomatic answer to that is to say that, yes indeed, east of England MPs have quite rightly taken their concerns to the highest level and there has been some serious intervention. There has been a report; we had a 90-minute debate here in Westminster Hall only yesterday on it. I have to say that apparently most members of the board of that ambulance service still remain in place, but the board has a new chair. There has been a full report into the service and there is hope that many of the report’s recommendations will now be put forward.
I must say that the Care Quality Commission, notwithstanding some of the comments that were made last week, can play a hugely important role in looking at the performance of ambulance trusts. I speak now as a constituency MP when I say that I myself have been in contact with the CQC and I urge the hon. Gentleman perhaps to take the same course, because the CQC can
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really play an important role in ensuring that ambulance services and indeed many other providers of health care are absolutely up to standard and providing the services that they should be providing. That may be of some assistance, but I must say that I think things have improved.
Andy Sawford: The Minister says that there are issues at Kettering General hospital’s A and E department that are in common with those in other hospitals. Finally, I draw her attention to the exceptional case for investment in Kettering General hospital, because of the growth in population locally. Corby has the highest birth rate in the country; it is the fastest growing town in the country; and the Northamptonshire area is one of the fastest growing areas in the country, so this is an exceptional case.
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Anna Soubry: That is a good point well made, and no doubt this will all be discussed at the meeting to be held on 16 July and the hon. Gentleman will make that point again with all the right force that he should.
I was going to say “in all seriousness”, as if I was being flippant, which I was not being. However, I hope that Kettering General hospital continues to work with Monitor, NHS England and its local commissioners to put in place robust plans for improving its position. That should also include working with all the elected Members in the area, so that we can be sure that the hospital delivers absolutely the best services to the people it seeks to serve and should be serving.