The financial consequences for my constituents are significant. Single people living in band A properties stand to lose more than £3 a week. Where there are two or more people in a household, they are set to lose more than £4 a week. Of course, they will lose more if the property is in band B. Many of these people are carers or single parents with young children. Nottingham city council’s equality impact assessment found that single parents—primarily women—were disproportionately

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affected. However, disabled people, war widows, veterans and young people facing persistently high levels of unemployment are also left with very limited options. Many will now be forced to go without essentials or go into debt. No wonder there is such a dramatic rise in the use of food banks in my city, and across the country, given that people simply do not have enough money to survive, let alone live a decent life.

I am proud that communities in Nottingham are trying through food banks to support their fellow citizens when they are hit by the Government’s deeply unfair policies, and that the Labour city council is working hard to protect the most vulnerable by investing extra funding in advice services to support its citizens. I visited one of those vital services, the Meadows advice group, last Friday to thank staff and volunteers for the work that they do to ensure that people at least get the help to which they are entitled. They reported a significant increase in requests for help in the past 12 months and said that the total debt that had been dealt with in the past year was up by more than £78,000. They repeatedly expressed concern about the combined impact of the Government’s welfare reform policies.

The individual effects are serious, but the consequences for Nottingham city council’s budget are considerable too—especially now that all the transitional funding has been withdrawn. Complying with the Government’s criteria and delivering a scheme that is as good as possible will mean a £1 million shortfall in this financial year. That is happening at a time when the council is straining to maintain its full range of services, because of the front-loaded cuts imposed on it. Under the present Government things will only get worse, as they seek to make further reductions to funding for the households and areas in the greatest need. There are even greater risks to council finances if those who are asked to pay simply cannot; it is estimated that for every 1% reduction in collection rates, an extra £22,000 is added to the cost of the scheme.

When the Prime Minister said that we were all in this together, it was a cruel joke at the expense of some of my most vulnerable constituents. Meanwhile, millionaires laugh all the way to the bank, where they find that they are much better off, thanks to the Government’s decision to cut the top rate of tax. The Deputy Prime Minister likes to boast that people have benefited from a rise in the personal allowance, but we all know that that does not help the very poorest, who continue to pay the price of the fact that the Government are indifferent to inequality.

3.12 pm

Kate Green (Stretford and Urmston) (Lab): It is a pleasure to serve under your chairmanship, Mr Crausby, and take part in the debate. I am grateful to my right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford) for bringing the matter to the attention of the House. I have only a few points to add to what my colleagues have said, all of which I support.

I am concerned that the effect of the policy, combined with many other policies on social welfare support, is perverse and extremely harmful to those who experience its effects. I endorse the calls that have been made for the Government to take the earliest opportunity to

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review it. My colleagues have mentioned the risk that households will encounter work disincentives. In the next few weeks, a universal credit area will begin for some Trafford residents. The work disincentives that the council tax policy may create could, for those claimants, wipe out all the promised advantages of universal credit.

It is ridiculous to bring in one policy with the intention of incentivising employment, and another that may do the exact opposite. Equally, it is perverse to bring in a policy partly on the grounds of efficiency and cost-effectiveness before any clarity has been reached about how local authorities will organise their staffing complements, particularly as in many local authorities, including mine, housing benefit and council tax benefit—the predecessor of council tax support—were administered by a single team.

We are now going through what could be quite a long transition, until every Trafford claimant is on universal credit. Ministers tell us that that could take until 2017, but frankly, I think it could take longer when I see how it is coming along. That creates huge uncertainty for the local authority in planning the staff complement to manage council tax support, which it will continue to administer, and to prepare for the fact that it may not be managing the housing benefit element of what will become universal credit in relation to a diminishing number of residents over time.

It is incredibly difficult for the authority to plan its staffing resource in such uncertainty, and many good staff are beginning to vote with their feet and leave. Not only have local authorities been presented with all the difficulties of managing the budget described by my right hon. and hon. Friends; they also have a difficult administrative and human resources challenge to manage, because of the policy being brought in against the backdrop of other changes.

I agree with my colleagues that the system is right to protect pensioners, because of their limited options for improving their incomes. However, the policy is one more example of the current out-of-proportion tipping of the whole welfare system away from working-age people. It is becoming a residual system for older people only. Our welfare state was meant to be a welfare state for life—from cradle to grave—to protect us all in bad times if and when we needed it, and paid into by citizens to prepare for those bad times.

It is disgraceful for the Government repeatedly to pervert the philosophy that underpinned the welfare state, which they claim to be proud of, as we are. That is not to say that we do not want to offer pensioners the best possible protection. However, it is quite wrong that families with children, disabled people and their carers, and working people on low wages no longer enjoy the protection of the welfare state. Those, too, are precisely the people it was intended to protect.

My colleagues have pointed out an unevenness around the country in the kind of support that people receive from their local authority, and I am concerned about that too. We have a postcode lottery. No one is against the sensible localising of decisions, but postcode lotteries that leave families in some parts of the country at greater risk of poverty cannot be the kind of welfare support that we want.

In some local authorities, some income-related benefits or cash benefits are treated as income when eligibility for council tax support is calculated. Child benefit,

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child maintenance payments and disability living allowance are being taken into account in calculating someone’s means. However, they are not intended as income replacement benefits; they have the specific purpose of helping families with the cost of raising children and helping disabled people meet the additional cost of living with an impairment. It cannot be right that local authorities must take those benefits into consideration when they assess someone’s ability to meet council tax obligations, or their eligibility for council tax support. That is yet another demonstration of the total lack of regard to—or, perhaps, understanding of—how the welfare state has been constructed, and what the different social security benefits are for.

I endorse the calls made this afternoon for a proper, wholesale, urgent review of the policy, in the context of the coalition Government’s welfare changes. That cannot be just a one-off review, because universal credit and other changes are being rolled out over such a protracted period. I hope that the Minister will tell us a little more about what will happen after the first review and how he expects to keep the policy under careful consideration.

I share all the anxieties expressed this afternoon. The policy is not working for some of the poorest families in our constituencies. Ministers owe such families a duty of care and protection and it is not acceptable for them to wash their hands and pass the problem down to local authorities that have little choice in how they can administer the system.

3.18 pm

Mrs Mary Glindon (North Tyneside) (Lab): It is an honour to serve under your chairmanship, Mr Crausby. I, too, congratulate my right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford) on securing this important debate.

I will speak briefly, but before I say anything about the issue in hand I want to mention the employment figures, in case the Minister refers to them. Yes, employment is up in the north-east but, against that, unemployment is still at 10.3% and the number of people who are unemployed has risen. There may be more jobs for some people, but others are losing theirs.

Julie Hilling (Bolton West) (Lab): Does my hon. Friend recognise that those employment figures include people on Government schemes and zero-hours contracts, and people who have been kicked off benefits or sanctioned? It is hard to know what the accurate figures are.

Mrs Glindon: Yes. I thank my hon. Friend for that intervention. That is precisely the point about how iniquitous the benefits situation now is for people.

Let me place in context the situation in my constituency. The Association of North East Councils has found that the north-east has suffered the biggest cuts and experienced much higher reductions in spending power than the national average. The spending power per household in North Tyneside is, at £2,048, the worst in Tyne and Wear. On top of that, North Tyneside council has had to make efficiency savings of £20 million for this year’s budget, which equates to 11% of the net revenue budget. At the same time, the council will see a £12 million reduction in the revenue support grant. That is a reduction

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of just under 20% for the year. We can see how hard-pressed councils are—a point that my right hon. and hon. Friends have already made.

The history of how the housing support amount has been calculated in North Tyneside is quite curious, because when it first came into effect under this Government, we had a Tory mayor in North Tyneside, and the Tory Administration wanted to impose a charge of 12.5% on people who had not formerly paid any council tax. My former colleagues on the council managed to get that down to 7%. It is still quite a sizeable amount of money for people who do not have the disposable income to pay it.

As I have shown, the council is in dire straits, but it has to do everything that it can to protect the vulnerable. That point has been made over and over again. When the Government impose these kinds of policies, they are not thinking about the most vulnerable in our communities. Some of them are from the working communities. In my constituency, 24% of people earn less than the living wage and 10% earn less than the minimum wage. Let us imagine the effect that any increase in the payments they have to make out of their salary has on them, and not just economically. There is also the mental strain of measures such as the bedroom tax.

Then there is the cost of living. If people are on a restricted budget, even 5p or 10p extra on an item when they go to do their shopping will affect them. We are talking not just about economics, but about people’s peace of mind. They are worrying about how to make ends meet. That takes an extra toll on their health. In the end, it is all a false economy on the part of the Government, because it just means that people will be going to the doctor for antidepressants and so on, perhaps taking days off work and falling into deeper and deeper poverty.

The Joseph Rowntree Foundation says:

“The replacement of CTB with CTS marks a historic move to 326 different local schemes in England. It will be a curious system when a jobseeker with a state-provided income of £71.70 per week pays some council tax in some parts of the country, but is considered too poor to pay in others.”

That just shows how ridiculous the situation is. It is not an equal tax on people. In our country, we strive for equality. We talk of ourselves as a country that has principles, a country people can enjoy living in and feel proud of. How can we be proud of taxation of this sort when it is so iniquitous?

I would like to make a plea to the Minister. Labour has asked for the review to be brought forward. The Lords did the sensible thing and agreed to an amendment on the matter, so will the Minister please bring forward the review as soon as possible, so that he can see the devastating effect that this change in council tax benefit has had on people across the country?

3.24 pm

Julie Hilling (Bolton West) (Lab): It is a pleasure to serve under your chairmanship, Mr Crausby. I join in the congratulations to my right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford) on securing this most important debate.

Localising council tax support and giving local authorities more control sounds good, doesn’t it? Well, it might have been if the Government had given local authorities

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the same amount of money as they were paying, but instead they reduced funding by 10%. Then they said that pensioners must be protected. I would not be against that, but it means that councils have to impose an average cut of 16% for working-age people. As ever, the Government are devolving responsibility but hiding the fact that they are implementing the cuts themselves. And it is not the ne’er-do-wells of society who are affected; it is disabled people, those in low-paid work, single mums, carers, veterans and those who are desperately seeking work but are among the 2.5 million people who are unfortunate enough to be unemployed.

Council tax has become another part of the cost of living crisis facing my constituents in Bolton West. In Wigan, 13,000 people have been referred to the bailiffs, and that figure does not include the 1,000 businesses that have been served letters by the bailiffs for not paying their business rates. Those are people who cannot afford to pay their council tax, and of course they are usually hit by multiple debt. They may well have been hit by the bedroom tax and seen their housing benefit reduced because they have someone over the age of 18 in the house. They will have been hit by a rise in their food bills and fuel bills, and if they are in work their wages will have been running behind inflation for the last four years at least. They may well have got into debt with payday lenders when they borrowed money to try to keep themselves afloat. They frequently have a whole range of complex issues. Of course, a bailiff’s letter means that the debt has immediately gone up by £75. If the bailiff has to call, the debt rises by another £235. If, heaven forbid, the bailiffs come and seize goods, they will face an additional £110 fee.

It is no wonder that many residents of Wigan and Bolton West have got to the point at which they can see no way out of the situation. Of course, many of those residents were not paying council tax before. They will not be able to set up direct debts and will not have believed it when they got their council tax bill. The council therefore now has a much higher bill for collection. Collection rates have gone down across Wigan to 96%. It is still doing pretty well at collecting the money, but that means that there is less money for the essential public services on which my constituents depend.

This policy has been yet another for which the Government have attempted to devolve blame. Along with other policies, such as the bedroom tax, it causes misery to those who can least afford to pay, and at the same time the Government give tax cuts to millionaires. My constituents deserve better than that. The Minister should review the scheme and take one of the areas of pain away from people who are really struggling to survive in this day and age.

3.27 pm

Andrew Percy (Brigg and Goole) (Con): I apologise to you, Mr Crausby, and to Members in the Chamber, for missing the start of the debate. I did not intend to speak, but I have been driven to it by what I have had to listen to. I have heard some good speeches from Opposition Members, but some absolute drivel as well, about council tax and council spending. In particular, the hon. Member for Nottingham South (Lilian Greenwood), whom I look forward to meeting when she comes to my constituency next Saturday—we will be on the same train going

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through Brigg—seemed to forget completely the financial situation that the country found itself in, which has led to local government having to face some significant savings.

I served for 10 years as a councillor in Hull. At that time, although there was increased funding coming in, we repeatedly had to cut services. It is funny that at the time we did not have an array of Labour MPs or, indeed, Labour councillors in the area running up and down and saying how awful it was that all those extra burdens were being placed on people. Similarly, not a single Labour Member of Parliament was running around saying how awful it was for poor old hard-pressed council tax payers that their council tax had doubled in my area. We did not have a single Labour Member of Parliament worrying about hard-working families who were struggling when our police precept went up by 500% in just a few years. We did not have anyone from the Labour party saying how awful it was for hard-pressed council tax payers, many of whom were on the breadline, when the fire authority precept was added to our council tax bills and increased. We had none of that at all.

I try to work in as cross-party a manner as possible in this place, and I am not a fan of everything that has been done. I voted against the bedroom tax, so I am not a fan of all the changes, but this attempt to present the financial challenge that local government faces as a wicked Tory attempt to attack poor people is truly shameless.

Mrs Emma Lewell-Buck (South Shields) (Lab): Will the hon. Gentleman give way?

Andrew Percy: No.

We did not have a single Labour MP talking about food banks before 2010, despite the fact that there had been a tenfold increase. It is the cheapest, filthiest form of politics.

I am amused to hear Labour representatives talking about hard-pressed council tax payers, because in my local authority they are trying to put the council tax up. They want to increase the council tax of the hard-pressed families they claim to be so concerned about, and they want to reduce those people’s access to social care. We have prevented them from doing that. If a council is run properly, as my local authority is, it is possible to retain all children’s centres, provide ongoing council tax support and build new libraries in communities that have never had them. Those things are possible if the tough decision is taken to reduce senior management posts. When we took control of our council from Labour in 2011, there were, I think, six people who earned more than £100,000. There are now two. Our leader took a 15% pay cut, following increases when Labour ran the council. We have even been able to reduce the cuts to youth services.

The point I am making is that local government is undoubtedly in a difficult situation, but it sticks in my craw when Opposition Members do not take any responsibility for the financial mess that they created, or for the pressure that they put on family budgets through council tax when they were in government. If they wanted a grown-up and sensible debate, Opposition Members would say, “Regardless of who is in power after the next election, there will still be ongoing cuts to

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local government.” They cannot simply oppose every single decision and say, “It would be different if we were in power.”

Several hon. Members rose—

Andrew Percy: We have listened to a lot of Opposition Members speaking, and that is all to the good, but nobody has spoken from the Government side. I would not have done so, as I turned up late, if it had not been for some of the nonsense that Opposition Members were coming out with.

Alex Cunningham: You do not care.

Andrew Percy: I think the hon. Gentleman’s comment sums up the debate. Opposition Members are not interested in having a sensible debate on the matter. All they are interested in is a dirty, filthy little political campaign that is all about trying to label anybody who disagrees with them as somehow not caring. It is ridiculous, and the public are seeing through it. [Interruption.]

Mr David Crausby (in the Chair): Order.

Andrew Percy: Opposition Members should be apologising for the financial mess, apologising for doubling people’s council tax and apologising for what they did to local government during the 10 years in which I worked in the sector, which was to burden us with a great deal. The right hon. Member for Greenwich and Woolwich (Mr Raynsford) was the Minister when my then Labour-run local authority was put into special measures. As a result of the measures that his—

Mr David Crausby (in the Chair): Order. Mr Percy, I know that you were not here for the opening remarks, but you should still confine your remarks to the localisation of council tax support.

Andrew Percy: Absolutely. The point I am making, Mr Crausby, is that after my local authority went into special measures, we had to increase to six the number of people who were being paid more than £100,000, which placed a burden of hundreds of thousands of pounds on our finances. Councils have inherited an over-inflated senior management, which makes it very difficult for them to deal with challenges such as the localisation of council tax support. It is okay to talk about the financial burden and challenge that local authorities face, but the Opposition must take some responsibility for the great cost that they imposed, especially that of senior management.

3.33 pm

Andy Sawford (Corby) (Lab/Co-op): It is a pleasure to serve under your chairmanship, Mr Crausby. May I start by congratulating my right hon. Friend the Member for Greenwich and Woolwich (Mr Raynsford) on securing the debate and on opening with a comprehensive analysis and critique of the Government’s localisation of council tax benefit? I want to address many of the issues that he raised. Just over a year after the localisation of council tax support, it is timely to debate the impact that the policy has had on millions of households across the country.

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We have heard important contributions from my hon. Friends the Members for Stockton North (Alex Cunningham), for Nottingham South (Lilian Greenwood), for Stretford and Urmston (Kate Green), for North Tyneside (Mrs Glindon) and for Bolton West (Julie Hilling). Other colleagues have made powerful interventions. It is good to see so many Opposition Members here to express their concerns, raise issues and ask genuine questions of the Minister about the impact of the policy. In contrast, the hon. Member for Brigg and Goole (Andrew Percy) opened his speech by talking about drivel, and continued on that theme without referring to the topic of the debate at all. Perhaps if he had attended at the start and listened to my right hon. Friend the Member for Greenwich and Woolwich, he would have talked about that important subject, which we know has a huge impact on some of the poorest in our communities.

The “poll tax mark 2”, as the policy has been called by Lord Jenkin, the creator of the original poll tax, is causing misery across the country and driving hundreds of thousands of people into courts and into debt. That is why I fully support the call made by my right hon. Friend the Member for Greenwich and Woolwich for an immediate independent review of the impact of the socio-economic consequences of the localisation of council tax support, and I hope that the Minister will agree to that. The Public Accounts Committee has called for an independent review. The cross-party, Conservative-led Local Government Association has said that councils have been left

“facing an unpalatable choice of either charging council tax to the working age poor, who in many cases had not paid council tax before, or finding savings or extra income from elsewhere”.

That is in the context, as my hon. Friends the Members for Nottingham South and for Stretford and Urmston have said, of other policies such as the bedroom tax that are particularly affecting the disabled and some of the poorest in our communities. It is also in the context, as my hon. Friend the Member for North Tyneside has said, of local authorities having had their budgets slashed by 40% over this Parliament, with councils in areas of the highest need facing disproportionate cuts. Authorities with the highest levels of deprivation are being hit hardest, while the Prime Minister’s local authority, along with those of five Cabinet members, is receiving an increase in its spending power this year. That is directly relevant to councils’ ability to absorb the cuts to council tax benefit, because areas with the highest levels of deprivation that are facing the biggest cuts also contain a larger proportion of residents who require council tax support. Analysis from the special interest group of municipal authorities in the LGA shows that

“Council Tax Support was a much higher percentage of budgets for authorities such as Liverpool and Knowsley at 32% and Manchester and Hull at 29% than the more prosperous ones such as Windsor & Maidenhead and Rutland where the proportion was much lower, around 7.5%.”

Authorities that face additional cuts in their budgets have a difficult choice to make about whether to pass that on to claimants. As we know, four in five authorities have not been able to absorb the reduction in council tax benefit funding. The New Policy Institute found that of the 326 localised schemes, 82% reduced the level of support to working age recipients, with almost three quarters of councils introducing a minimum payment. Analysis from the Institute for Fiscal Studies makes it

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clear that Conservative and Liberal Democrat councils are more likely than Labour councils to introduce a minimum payment. That is a testament to Labour councils, given the cuts that they have faced and the higher proportion of council tax benefit recipients among their residents.

The LGA says that the scheme is “regressive”, because those on low incomes are dedicating higher percentages of their earnings to paying their council tax. Several hon. Members have talked about the fact that the amounts of money in question may seem small, but to some of our constituents, as we know, they make a huge difference to their ability each week to meet their household bills and their cost of living. Just like the bedroom tax, the policy is hitting those who are least able to pay.

As my right hon. Friend the Member for Greenwich and Woolwich has said, when the Government introduced the scheme, they had four main objectives in mind: to transfer the system to local control, to make savings, to protect vulnerable people and to support work incentives for claimants created by the Government’s wider welfare reforms. I believe that on all four of those objectives, the Government are failing. When it comes to the first objective, the localism for which I campaigned for many years outside this place, and which councils up and down the country wanted, was not merely about the devolution of the axe as exemplified by the localisation of council tax benefit. As my hon. Friend the Member for Bolton West has said, why not transfer the whole budget to councils and give them the discretion to seek to make savings if to do so is right for their local area? Ministers are happy to meddle in everything from the level of reserves to when the bins are collected, while passing on cuts to councils that put those councils in a near impossible position. As my hon. Friend the Member for Stockton North pointed out, the Government calculate that residents will identify the local authority as having made those choices when it has, in fact, been put in a really difficult position.

Mr Marcus Jones (Nuneaton) (Con): Will the hon. Gentleman give way?

Andy Sawford: I will not give way because the hon. Gentleman was not present at the start of the debate and there is much to discuss relating to the informed contributions that have been made.

The Government’s second objective was to make savings. As the Local Government Information Unit, always a sound source of commentary, points out:

“Local authorities have incurred new costs through the changes to Council Tax Benefit”—

Mr Jones: Will the hon. Gentleman give way?

Andy Sawford: The hon. Gentleman’s hon. Friend the Member for Brigg and Goole did not have the courtesy to give way to my hon. Friends, so I am afraid that the tone has been set.

I was quoting the Local Government Information Unit:

“Local authorities have incurred new costs through the changes to Council Tax Benefit, including the cost of designing and modelling schemes, communicating changes, consulting with local residents, paying IT suppliers, and setting up a system for appeals”.

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As my hon. Friend the Member for Stretford and Urmston said, it is an administrative nightmare. Some local authorities have actually had to employ additional staff to cope with the increased burden of council tax collection, including the cost of issuing 600,000 summonses across England and sending in bailiffs.

As well as new outgoings, the Local Government Association has said there has been a year-on-year drop in overall collection rates. It is, of course, quite rightly expected that council tax collections will increase and costs will decline over time as local authorities find it easier to collect money and the new system beds in, but the scheme’s difficulties in these early years have made it much more of a problem for local authorities and meant that the costs have ultimately been passed on to the most vulnerable residents.

On the Government’s aim to protect vulnerable people, it is a relief to poorer pensioners in my constituency and throughout the country that they will not be hit by the policy. Nevertheless, that protection has placed the burden of any reduction in council tax more on the shoulders of low income working-age people and families, as several of my hon. Friends have illustrated. In its March 2014 report, the Public Accounts Committee said:

“Contrary to the Department’s intentions, many local authority schemes have not protected vulnerable groups other than pensioners and war widows”.

The Government have not yet responded to that report, but when they do, they will claim that they are protecting vulnerable groups by freezing council tax. Of course, that is a con. Many Tory councils, including the Prime Minister’s own local county council, are putting council tax up. In my area, the county council has increased council tax, while the Labour-controlled borough council has frozen it, building on the record of Labour councils such as Hackney that have been freezing council tax for many years.

In many areas, including those where the council tax has been frozen, people on low incomes have seen their bills rise by more than £100 a year because of Tory cuts to council tax support. In fact, if someone lives in an area controlled by a Tory council, not only is their council tax £334 a year higher on average, but the Institute for Fiscal Studies calculates that their council

“is 14 percentage points more likely than Labour councils…to introduce minimum payments for council tax for low income households”.

That is confirmed in the report published last month by the Joseph Rowntree Foundation, which shows that low-income families have been affected by changes to council tax support.

A number of my hon. Friends referred to that important report, and I would be grateful if the Minister told us whether he has read it. If so, what does he make of its findings that 2.34 million low-income families will pay on average £149 more in council tax per year than they would have done under council tax benefit, and that 580,000 families have seen their council tax increase by 55% on average? How can the Government credibly seek to claim that there is a council tax freeze when 580,000 families around the country have seen their council tax increase by more than 50%?

Can the Minister account for the huge rise in the number of people approaching Citizens Advice with concerns about council tax debt? The chief executive of Citizens Advice told us in a briefing on this debate:

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“In the past year Citizens Advice dealt with more than 150,000 problems of council tax debt”.

We know that many people have had the bailiffs at the door; indeed, my hon. Friend the Member for Bolton West highlighted how bailiffs can now charge £75 to charge a letter and £235 to pay a first visit, costing a debtor £310. Of course, such costs only mount. Many such people are already in financial hardship and are prey to loan sharks as they struggle to cope financially. They are also often the victims of other measures, such as the bedroom tax. The Ministry of Justice estimates that bailiff profits will double on the back of the Government’s new hike in bailiff charges. The debt charity StepChange says that profits will be made by compounding

“the hardship of some of the UK’s most vulnerable people”.

As we have heard, the Government’s proposal is not achieving their fourth objective: to make work pay. The Public Accounts Committee found that in 19 local authority areas, individuals are losing more through the combined impact of income tax and national insurance contributions and the withdrawal of council tax and housing benefits than under the previous scheme; some are losing 97p for every extra £1 earned. The Committee called it “a perverse result”.

If the Minister will not listen to the PAC or to organisations such as the Resolution Foundation, which has said that the scheme is not making work pay, perhaps he will listen to the Conservative commentator Fraser Nelson, who said that there is

“Precious little sign of…anger”

that the very poorest in our country face 98% tax rates. The Opposition are angry about that, and I hope that the Minister understands that he should feel angry about it too, because there is huge injustice in our communities.

I sense that you are encouraging me to draw my remarks to a close, Mr Crausby, so I will. There must be an independent review, to which I hope the Minister will agree. We have tabled amendments to that effect in the Lords because that is the right thing to do—it is the right time to assess the impact of the changes on the poorest people in the country. I very much hope that the Minister has listened to the powerful case made by my right hon. Friend the Member for Greenwich and Woolwich and other hon. Friends from across the country about how the policy is affecting the poorest in our society.

3.45 pm

The Parliamentary Under-Secretary of State for Communities and Local Government (Brandon Lewis): It is a pleasure to serve under your chairmanship in such an important debate, Mr Crausby. It is always good to debate a topic such as this with someone as knowledgeable about local government as the right hon. Member for Greenwich and Woolwich (Mr Raynsford). I congratulate him on securing the debate.

Some comments have been made, not least by the hon. Member for Corby (Andy Sawford), about where we are with council tax levels more generally. That is a bit off topic—I know that the hon. Gentleman made a similar comment earlier—but it is worth recapping why the policy was introduced. We must remember that, as my hon. Friend the Member for Brigg and Goole

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(Andrew Percy) said, council tax doubled under the previous Government, hitting families right across the country.

To address the comments just made by the hon. Member for Corby, it is worth being clear that a Conservative-run authority is cheaper on average than a Labour or Liberal Democrat council, for a band D property. Conservative councils charge on average about £89 less than Labour councils and more than £100 less than Lib Dem councils on band D, so they are still the best value for people across the country, as I am sure he well knows in reality. We have also seen Conservative authorities in London and other parts of the country, such as Rugby, actually cutting council tax by managing their finances very well.

Council tax benefits spending doubled under the previous Government, costing taxpayers more than £4 billion a year, equivalent to almost £180 a year per household. Welfare reform was vital to bring such spending under control and tackle the horrendous budget deficit we inherited. Localising support for council tax is part of a wider policy of decentralisation, giving councils increased financial autonomy and a greater stake in the economic success of their local area. As council tax is a local tax, we believe that it makes sense for councils to have power and responsibility for making decisions about the levels of reduction to be granted to low-income, working-age claimants—their residents—and for providing the required support. Local schemes should reflect local needs, and local authorities are best placed to make the decisions, not someone sitting in Whitehall.

The Government have offered local authorities a great deal of help and support as the programme has rolled out. We must remember that £3.7 billion was provided for council tax support in 2013-14 and 2014-15, and we will be providing the same in 2015-16. There was new burden funding of £30 million in 2012-13 and a further £33.5 million in 2013-14. Tomorrow, 15 May, we will be paying out £34.8 million towards new burdens for 2014-15. That funding relates to costs incurred for the consultation and design of schemes, appeals, IT costs and communications. As some Members mentioned, the Government made an additional £100 million transition grant available for 2013-14, which helped councils develop well-designed council tax support schemes and maintain incentives to work. Claims totalling roughly £53.5 million were made by 196 billing authorities, and 69% of all authorities received funding. We also provided local authorities with guidance on work incentives and their responsibilities for vulnerable people.

The hon. Member for Corby misunderstands the difference between decentralisation and the abrogation of responsibility. The previous Government amazingly managed to centralise and abrogate responsibility at the same time. This Government decentralise; we move power to local authorities. Even Labour voices in Manchester have noted that this Government have done more in three years to decentralise than any previous Government, let alone the 13 years of Labour centralisation. That does not mean, however, that we take a vow of silence. It is right that we outline to councils best practice and what we and the country expect is right for residents.

Local authorities have a wide range of choices about both how they manage their funding and how they design their schemes. For example, apart from asking

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some claimants to meet some or all costs, they also have new flexibilities on empty homes, on making efficiency savings, on reducing fraud and error and on using reserves. Let us remember that local authorities have built up a record level of £19 billion in reserves, and figures from the National Fraud Authority show that they lose £2.1 billion annually from fraud and error, let alone what better collection rates can bring in.

So all councils have had options about whether they pass on all or any of the changes and about what groups they protect. It is for councils to ensure that the effect on particular groups is proportionate and fair, and to consult on local schemes. In year 1, for example, all 326 councils adopted schemes that continued to apply the same level of premiums as council tax benefit for vulnerable claimants; 52 councils protected the same vulnerable groups as council tax benefit; 89 offered some protection for particular vulnerable groups; and 84 introduced a hardship fund.

Most councils retained the work incentives that applied under council tax benefit: 307 maintained the taper at 20% or reduced it; 324 maintained the four-week period of extended payments, or increased it; and 324 councils maintained the level of earnings disregards, or increased it. Year 2 schemes, which came into force in April this year, continue to take a wide range of approaches that are locally appropriate and locally consulted on.

I recognise there are challenges in working with people who may be paying council tax for the first time, and I am encouraged to see that councils are taking a variety of approaches to help people adjust to the change. They are working out better payment arrangements that suit those people. They are looking at waiving costs as an incentive to encourage payment or a reward for clearing debt; proactively engaging with people who have not previously had to pay council tax; and looking at additional and earlier reminders to help people understand the situation and what they are dealing with.

Final year 1 data on collection rates will not be available for a few weeks yet. However, £20.3 billion of council tax was collected in England over the first nine months of 2013-14. That is £771 million—3.9%—more than in the same period in the previous year, despite the comments made earlier. The policy is now embedded, and councils have experience in designing and operating local schemes. However, the work we are doing on the policy has not ended, and should not end, yet.

In 2014-15, the Department will work with the Department for Work and Pensions to consider the allocation of the local council tax support administration subsidy, and to understand the ongoing costs of administering, reviewing and revising council tax support

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schemes. The Department is working closely with the DWP and local authorities in advance of the roll-out of universal credit to develop data sharing arrangements and to ensure that the savings that can be made through data sharing will be realised.

An independent review of schemes will be carried out within three years, as required by the Local Government Finance Act 2012. As set out in the Act, the review will examine effectiveness, efficiency, fairness and transparency; the impact on the localism agenda; and whether local schemes should be brought within universal credit. The Department is currently working with the council tax partnership forum and local authorities to identify appropriate and proportionate data for the review. The timetable, coverage, process for data collection, and detailed terms of reference will be agreed and published in due course.

Councils have challenges—nobody denies that—but there is much they can do in using their reserves and in cracking down on fraud and error in collection rates. Some authorities have seen increases. The increases that the hon. Member for Corby referred to should be celebrated, because those councils are doing good work. Their increases are a result of their benefiting from the new homes bonus, an incentive that we put in place. Business rates are an opportunity, in a way they never had before, for local authorities to see their money increase as they develop business and get more people into work locally.

Our reforms to localise council tax support are delivering national and local benefits. The programme is delivering a 10% saving on the forecast council tax benefit expenditure from 2013-14. We must be clear about that, and we should remember that it is an important contribution to the Government’s vital programme of deficit reduction. In 2013-14 the saving equates to £414 million, which is not a sum to be sniffed at. Despite the previous Government’s profligacy with money, we believe those sums are important in reducing the deficit.

At a local level, councils now have a stronger incentive to support and develop local firms and to see more jobs in their local areas, as reflected in today’s employment figures. I am delighted that even in my own constituency of Great Yarmouth, which Labour left behind, we have had a 27% fall in unemployment. Councils can cut fraud and promote local enterprise to get people into work, as the Government’s programme is clearly doing.

I thank the right hon. Member for Greenwich and Woolwich for securing this debate, and I hope hon. Members appreciate that we have got the power in our local authorities to really make a difference.

3.55 pm

Sitting suspended.

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Small Business Start-ups (Scotland)

4 pm

Mr Iain McKenzie (Inverclyde) (Lab): It is a pleasure to serve under your chairmanship, Mr Crausby. I thank the Minister for taking time out of his busy schedule to come to this debate. I am delighted to have secured it, because we are all aware of the importance of small businesses to our economy. Small businesses are the lifeblood not only of regional economies, like Scotland’s, but of the overall UK economy.

Scotland has at last seen much-needed growth in the small business sector and that should be welcomed, encouraged and further developed, because small businesses account for over half of private sector employment in Scotland—just over 1 million people. Today we are looking at just short of 350,000 small businesses in Scotland. A great many of our unemployed who find work do so by joining or setting up their own small business. Scotland has seen an increase in small business start-ups over the last year. As I said, almost 350,000 small businesses were operating in Scotland in 2013-14, all with fewer than 50 employees. The Federation of Small Businesses in Scotland represents some 19,000 of those.

However, it is not all good news on start-ups and small and medium-sized enterprises. According to Scotland’s insolvency service, the number of Scottish-registered companies becoming insolvent or entering receivership increased in 2013-14. The total of recorded insolvencies last quarter was higher than the previous quarter, although when compared with the equivalent quarter of the previous year, it was slightly lower. The Scottish Government’s website acknowledges that, stating that the number of Scottish-registered companies becoming insolvent or entering receivership in 2013-14 increased. This could be because the recession has lasted so much longer than anyone expected, with the increased figures for insolvencies reflecting, perhaps, that not all Scots business owners are trying to operate more effectively in relation to the current market conditions. Alternatively it could be, as I will go on to highlight, that the quality of a start-up and support for it should be as important, if not more so, than quantity.

Although I welcome this growth in Scotland’s small business start-ups, in Scotland there are clearly many reasons for increased start-ups. Even the reduction in the number of unemployed people in Scotland has been slower than in the rest of the UK, perhaps reflecting people’s inability to find employment with bigger or established employers. It may not be so much that Scotland is finding its entrepreneurial confidence, as the fact that for many in Scotland the only route out of unemployment has been to start up their own business. Figures released recently by the Global Entrepreneurship Monitor show that Scotland now has more entrepreneurs than at any other point in its illustrious history.

Whichever reason people accept for the increased number of small business start-ups in Scotland—I would not encourage increasing unemployment as a way of increasing business start-ups—SMEs now account for more than half of private sector employment in Scotland. As I said, that underlines the important role of small businesses in our economy and communities. A recent survey of Scottish SMEs found that the vast majority had an annual turnover of less than £100,000.

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Across Scotland there are hot spots and cold spots for start-ups. It is not surprising that Edinburgh and Glasgow are popular locations for start-ups, along with Aberdeen. That is obviously because those are large cities with lots of other businesses, making it easier for people to trade and form associations with giants on their doorstep.

What could be the reason for the cold spots—places where there are fewer start-ups? In many areas, including my constituency of Inverclyde, it could be because of a narrow economic base in the past. In such areas, there is over-reliance on a small number of large employers as a consequence, sometimes concentrated in a particular sector. That makes these communities vulnerable to outside economic pressures, meaning that the effect of an industry-wide decision, such as the electronics industry deciding to cut costs by moving manufacturing east, is more acutely felt.

In Inverclyde, over the years, we have seen a drive to replace heavy industry with electronics manufacturers and then replace them with financial services companies. Those will, in turn, if the pattern follows, be replaced by whatever is deemed to be the next big thing. Each of these is a major global industry subject to external factors that we cannot control, but it is into their basket that we happily place an entire community’s future.

A better way would be to broaden the economic base by having a greater number of businesses operating in a broader range of sectors and crucially, for the long-term health of the economy, encouraging and nurturing more home-grown businesses with a real stake in and ties to the area. We should not just try to attract some foreign inward investment that can skip off elsewhere the first time it does not get its own way.

How could we go about broadening that economic base? What support is there at present for start-ups and SMEs in Scotland? Boosting start-up numbers has been the major priority for Business Gateway and UK Government initiatives such as the New Enterprise Allowance are to be welcomed. There are also good programmes, such as Entrepreneurial Spark, Bridge 2 Business and, of course, the extra services provided by local authorities to supplement the core Business Gateway offer.

In terms of usage, the Federation of Small Businesses in Scotland’s most recent member survey found that 20% of members had used Government-funded business support, such as Business Gateway, in the last year and 11% had used other, local government-funded support. However, many had also used Entrepreneurial Spark.

Entrepreneurial Spark is a new and fast-growing incubator for start-ups, launched in January 2012 and backed by a trio of Scottish entrepreneurs. It is based in three sites: Glasgow, Edinburgh and Ayrshire. It describes itself as a business accelerator for early-stage and growing ventures. It works in a collaborative office environment suitable for building teams. Businesses receive free IT and wi-fi and also have access to business advice and support, with a pool of more than 50 specialised mentors. If there is one thing that I have learned when speaking to new businesses, it is that they value that mentoring. They also receive networking opportunities, workshops, pitch practice and more, offering greater confidence and, hopefully, opportunities to their new business.

However, still and all too often, SMEs and those thinking of starting up feel that the system is stacked against them. Businesses are struggling with rising costs

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and a lack of finance. The UK is the only member of the G20 without a dynamic industrial strategy. In the USA, the head of the United States Small Business Administration reports to the President. Yet in the UK no one reports to the permanent secretary in the Department for Business, Innovation and Skills or is solely responsible for small businesses.

Looking at finance, 26%—a sizeable number of businesses with growth ambition—stated that it was “likely” or “very likely” that they would seek external finance to grow their business. Banks are still not lending money at a rate to support the demand to grow. That is in stark contrast to what is taking place on the continent, in Germany, where more than 1,000 banks provide about two-thirds of lending to small and medium-sized business. SMEs here are held back because they cannot obtain finance on reasonable terms. Recently, the Treasury Committee heard of a dossier of complaints from 1,000 small firms against RBS’s controversial restructuring division.

Even if they get the financial backing, there are still other problems affecting small businesses’ growth or even survival. For example, late payment was considered to be a big problem for Scottish SMEs. Big organisations can manage late payments more easily than SMEs—quite simply, late payments put SMEs out of business. More than 1,600 companies have signed up to the voluntary prompt payment code, although many are making much of their sign-up and then not actually meeting the requirements of the code. The code has been described by the FSB in Scotland as “pretty toothless”, with those who fail to uphold it subject to no rebuke; they are not even named and shamed.

Rising business rates are also putting a heavy burden on small businesses. More than one in 10 small businesses say they spend the same or more on business rates as on rent. Rising energy prices are hitting them hard, too; those can be the second biggest cost that businesses face. Even technology seems to be failing small businesses in Scotland. The ability to communicate speedily via the internet through faster broadband connection is patchy or even non-existent in some areas. Slow, old copper wire connections still exist in abundance, and many areas of Scotland are still unable to connect to a superfast fibre-optic line, which could have a major negative impact on the future growth, competitiveness and even survival of Scotland’s small businesses. What are the Government doing with the Scottish Government to get better broadband connections across Scotland?

Clearly, many things can be improved to give small businesses an opportunity to flourish in Scotland. One of the first things that both Governments could discuss is improving attitudes to entrepreneurship among Scots to help people, especially young people, realise that a career in business is a realistic option and a good thing to do. Reports suggest that encouragement to improve attitudes towards entrepreneurship is happening in some areas, but there needs to be a better focus on the cold spots for start-ups.

In my constituency of Inverclyde, our education team has been engaging with secondary school fifth-year pupils to encourage awareness of entrepreneurship and business careers. In our “The Recruit” programme, which is established along the lines of “The Apprentice”

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television programme—the only difference being that our local businesses say, “You’re hired”—students begin a year-long intense introduction to business.

Once people have taken the plunge and started their business, we need to help them sustain those businesses and assist more in helping them grow. We know that the key stages in any business’s life—or, rather, the major hurdles to growth—are becoming an employer and employing the first member of staff, and moving out of the home office or garage and into the first premises. Targeted help, such as using some of the retail space lying empty in towns as incubator space for businesses, would be a good idea.

Assisting in the promotion of SMEs through events such as small business Saturday encourages people to buy local and small. The idea of small business Saturday started as a US shopping event held on the Saturday after Thanksgiving, one of the biggest shopping periods of the year. The event helped to put $5.5 billion into the pockets of independent shops and local service providers in the US. The small business Saturday idea was replicated in the UK in December 2013, just before Christmas. The initiative had cross-party support from more than 200 MPs, including the Prime Minister, and the day was backed by a third of all UK local authorities. We need more regular events that support and promote small businesses.

My Labour-controlled council in Inverclyde currently offers a marketing grant to SMEs, which is open to companies with registered offices in Inverclyde that have been trading for at least six months. The scheme provides free marketing advice and up to £1,000 of funding to cover 50% of marketing costs. I am glad to say that, to date, 48 companies in my area have benefited from the grant. Advertising helps local businesses across the country to reach new customers, increase sales and grow. It would help if start-ups received support for advertising and marketing. What steps will the Minister take to help start-ups and smaller companies to advertise?

Labour believes that business is the solution to achieving continued economic success. We must back businesses and support our wealth creators as part of the race to the top. To achieve that, Labour has promised a freeze on energy bills until 2017, which we believe will benefit small businesses across Scotland, and continued help by reforming the energy market. Both those promises are important, as energy costs are one of the largest overheads for businesses. Let us also support small businesses by cutting business rates in 2015 and freezing them in 2016, rather than going ahead with the Government’s corporation tax cut for the largest firms. That will help every SME and start-up across Scotland.

What more can be done? We need to improve access to finance for SMEs. Small businesses constantly rank access to finance as the biggest barrier to growth. Labour has committed to creating a British investment bank, along with a network of regional retail banks with a responsibility to boost lending in their areas. We also believe that “make work pay” contracts will share with small businesses the tax benefits to the Government of a living wage. We will address the exploitation of workers through zero-hours contracts, bogus self-employment, agency working loopholes, blacklisting and other practices that help bad employers gain an unfair advantage.

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The Government need to encourage more SMEs to bid for Government contracts and become part of their supply chain. Development of both ease of tendering and relationships with SMEs through procurement would, hopefully, assist more SMEs to bid for and win Government contracts. I believe all those measures will help good SMEs to compete and grow, and they will also aid and encourage further small business start-ups across Scotland.

4.14 pm

The Minister for Skills and Enterprise (Matthew Hancock): It is a pleasure to respond to this debate. The hon. Member for Inverclyde (Mr McKenzie) thanked me for being here, but that is my duty, not least because, as the Minister for Skills and Enterprise, I am responsible for small business. I take particular umbrage at his criticism that nobody in the Government is responsible for small business. Indeed, rather than small business being supported through an independent agency separate from Government, it is at the heart of the Government’s agenda here in the UK, hence the plethora of measures over the past couple of years to make life easier for small business.

I start by reflecting, acknowledging and supporting the figures that the hon. Gentleman mentioned on the growth of small businesses. There are more entrepreneurs in Scotland than ever before, and they are building on Scotland’s historical strength in exporting entrepreneurs the world over. It is good to hear that that, which has been going on for centuries, continues.

As someone from a family with a small business background, I am passionate about strengthening the small business environment across the whole UK. Of course, some of these issues are devolved, but the UK Government have been taking steps to strengthen the position in Scotland. I will set out some of those steps, and I will also respond to some of the points that the hon. Gentleman raised.

The hon. Gentleman called for a British investment bank, and I am delighted to say that in the past 12 months we have opened the British business bank. Of the £782 million of loans to and investments in smaller businesses, £35.4 million was in Scotland—a £20 million increase in support compared with the previous year. The British business bank brings together the management of all Government lending and investment programmes into a single, commercially minded institution that includes some of our most popular schemes.

The hon. Gentleman mentioned the new enterprise allowance, which is important in helping unemployed people to start businesses. The start-up loans and the enterprise finance guarantee schemes have been benefiting start-ups and small businesses across the country, including in Scotland. We launched the start-up loans programme in Scotland in March, and it has already helped nearly 300 entrepreneurs to set up their own businesses, with a total investment of just under £1 million. In the Inverclyde constituency, nine individuals have benefited, with more sure to follow.

Likewise, since May 2010, 850 Scottish businesses have been supported by the bigger enterprise finance guarantee scheme to the tune of £109 million, with just under £1 million of that sum going into the Inverclyde constituency. The enterprise finance guarantee is for slightly bigger businesses, whereas start-up loans are

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targeted at people at the very start of building their business. Some 7,500 people have signed up to the new enterprise allowance in Scotland.

Those are targeted schemes. We have also improved the tax system for small business that applies across the whole UK. That includes the launch of the seed enterprise investment scheme, which incentivises people to invest in smaller and growing businesses. We have also expanded the enterprise investment scheme for slightly bigger businesses. Those schemes are hugely popular, and we announced in the Budget that the seed enterprise investment scheme will be made permanent—we introduced the scheme for a few years as a trial—in part because of its popularity and its impact on ensuring that Britain is the best place to start and grow a business. That is our goal.

The hon. Gentleman talked about the breadth of sectors—an important point—and growing home-grown businesses and businesses that come from the communities that serve as their customer base. The best thing that the Government can do in that is support the ideas that people have, rather than trying to give direction, by supporting all small businesses to start and grow—not only by reducing regulation, taxes and barriers to growth, but by putting in place the infrastructure, skills and support necessary to help them.

Mr McKenzie: Will the Minister not also say something about the mentoring factor, which I have already highlighted? A lot of small businesses need that in the initial stages of set-up and afterwards, to take them past the many pitfalls and hurdles that they will encounter.

Matthew Hancock: The hon. Gentleman is absolutely right. The start-up loans scheme has mentoring built into every loan. The reports we get back show that the mentoring is as important as the money in helping businesses to expand. There are mentoring schemes on a local level—he mentioned his local authority—at the level of the Scottish Government and at a national level.

Ensuring that there is simplicity in the communication of the available schemes is important, and we are bringing those schemes together to try to ensure that the various offers that the Government have to support businesses to grow are clear. Smaller businesses in particular do not have time to navigate through the large bureaucracy inevitably involved in government. It is our job to ensure that the offer is consumer-focused and focused on and responsive to the needs of individual small businesses.

The hon. Gentleman mentioned the industrial strategy, and it is a great credit to this country that we now have an industrial strategy that covers many different sectors and brings together the players across the country, including the Government and various Government agencies, as well as businesses large and small in different industries.

For too long, Britain was an outlier in not having a proactive approach to industrial strategy, with the view that the Government should not have a say. That was in the heady days of new Labour and seemed to be the religion of the Department for Business, Innovation and Skills and its various forerunners. That has changed over the past few years, and there is now strong cross-party support for industrial strategies that actively support the growth of businesses and sectors and that try to

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improve the links between Government and business—they are inevitable in almost any sector—to support growth and jobs.

The hon. Gentleman mentioned prompt payment, a vital part of the effectiveness of the business environment. We have recently consulted on strengthening prompt payment to improve transparency and on putting the prompt payment code on a statutory footing. We have also asked whether we should go further and say that there should be a statutory limit on the length of payment terms. We will publish the results of that consultation shortly.

We put all options on the table and we had a large number of responses. The goal is to improve not only the length of payment terms, but the certainty around them. There are two slightly different issues with prompt payment: one is how long payment terms are and the other is how frequently payments are made on the agreed terms. In both cases, failure by a client can have a negative impact on a small business.

Mr McKenzie: Does the Minister agree that some of the larger, more household high street names have been pushing out their payment terms? Although they have signed up to prompt payments, they have now pushed their terms well beyond that and are taking advantage of being associated with it.

Matthew Hancock: That is exactly what was looked at in the consultation, and we will publish the response to it shortly. The hon. Gentleman also mentioned small business Saturday. We saw the success of small business Saturday in the USA. The President of the United States is a passionate advocate of it, and we listened to him and introduced small business Saturday last year. I can tell the hon. Gentleman that it will take place on the first Saturday in December. I very much hope and fully expect that there will be cross-party support, as there was last year, to strengthen the institution and take it on to a higher level with even broader awareness. The awareness of small business Saturday in its first year was pretty amazing. It was high last year, and I hope that it can be higher still.

Mr McKenzie: Perhaps the Minister would consider holding two or three small business Saturdays a year.

Matthew Hancock: It could be said that too much of a good thing might be a problem. One for the time being is probably the right approach. The date was chosen because it is the busiest shopping day of the year. The run-up to Christmas is an important time, especially for retailers.

There is one important issue that the hon. Gentleman did not directly mention, although I am sure we are on the same page on it. The Union is an extremely important

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element in the support of small business across Scotland, not only in supporting exports—UK Trade & Investment supports exports right across the world—but because ensuring that we can trade within the United Kingdom without international borders is a huge strength to the Scottish economy just as it is a huge strength to the economy of England, Wales and Northern Ireland.

Other parts of the UK buy 70% of Scottish exports, which is more than Scotland exports to the rest of the world and four times as much as Scotland exports to the European Union. Borders matter. They reduce trade and labour migration and disrupt economic and cultural links. I very much hope that the hon. Gentleman is as supportive as I am of the larger UK economy, which provides Scotland with jobs, stability and security. The Union is absolutely vital and we will be passionately arguing for it in September.

Mr McKenzie: I share the Minister’s commitment to keeping the United Kingdom together and to having that larger trading area for businesses, be they small, large or even bigger enterprises. Does he believe that one of the benefits might be the linking up of supply chains from larger organisations in the rest of the UK with smaller businesses in Scotland? That would be put in jeopardy if the Union was not preserved.

Matthew Hancock: There are huge advantages to the Union in supply chains. I put it in a positive light: this great trading union has been very successful over a long period, and we want that success to be built on, rather than put at risk. When we think about small businesses in Scotland and how we can support them, an important element of that is supporting free trade within the United Kingdom.

The economy is growing and unemployment has come down throughout the country in the past year. There was good news today with the Bank of England’s forecasts for the UK, which were increased again. That shows that there is growing confidence in small business in Scotland and across the country. We know that the people of Scotland are passionate and tenacious in their support for and execution of business, whether large or small. We are equally passionate about helping them achieve their ambitions.

Whether businesses are large or small, they are all driving in the direction of trying to increase prosperity and jobs. It is not right to try to split off large and small businesses and propose tax increases for one part. It is far better to support the growth of all businesses and the incomes, jobs and economic security they bring to the people who run them and the people who are employed because of them.

I hope that this debate has been an effective airing of the support that the Government have for businesses in Scotland, as well as in the rest of the United Kingdom. Finally, I have no doubt that although we have done a lot to improve the environment for business in Scotland, there is much more to do.

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Ambulance Resources and Response Times

4.30 pm

Mr Iain Wright (Hartlepool) (Lab): May I begin by saying what a pleasure it is to serve again under your chairmanship, Mr Crausby? I hope that you will pass on my most grateful thanks to Mr Speaker for assisting me in securing this important debate so quickly after I made my request to him.

I also want to thank the front-line ambulance staff and paramedics whose professionalism and expertise, combined with care and compassion, can often mean the difference between life and death. Time and time again, we hear of the dedication beyond the call of duty of front-line staff in the NHS, and it is entirely right that we hold them in high regard and give them the recognition, remuneration and resources to do their job.

This debate was prompted by the tragic circumstances surrounding the death of one of my constituents, Mr William Gouldburn. Mr Gouldburn was 73 and had served his community as a special needs teacher. He had heart problems, and in the previous couple of days he had come out of hospital after surgery to his shoulder. After leaving hospital, he had felt unwell, to the extent that a doctor was called to his home at 9 am. Less than 90 minutes later, Mr Gouldburn collapsed in his bedroom and an ambulance was called by 10.32 am. The call was not considered to be urgent by the contact centre that took it, and a response time of 60 minutes was given. However, even that response time was not met. It was after 12 noon that a St John Ambulance arrived.

My understanding is that Mr Gouldburn’s family, who were naturally frantic about his condition, placed a total of seven calls about his case to the emergency services during this period. At this point he was lying on the floor of his bathroom, and he was to do so for more than 90 minutes. A regular ambulance was eventually dispatched, but Mr Gouldburn was pronounced dead shortly afterwards. I hope that the whole House will join me in sending condolences to Mr Gouldburn’s family.

At the inquest into Mr Gouldburn’s death last month, a manager for the North East Ambulance Service said that the service had been experiencing a high level of calls and that ambulances were delayed in admitting patients to North Durham hospital due to a lack of available beds. The manager was asked by the coroner:

“Is what I’m hearing you don’t have resources to meet demand?”

The ambulance service manager stated:

“Yes, that’s correct. It is a national problem”.

Mr Gouldburn’s case raises some significant questions about ambulance services, which is why I wanted to secure this debate.

Grahame M. Morris (Easington) (Lab): Will my hon. Friend give way?

Mr Wright: I will certainly give way to my parliamentary neighbour.

Grahame M. Morris: I am grateful to my hon. Friend for giving way and I congratulate him on securing this important and timely debate. There are serious concerns about the performance of the ambulance service in the

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north-east region. What is his opinion of the assessment by its chief executive, Simon Featherstone, that the service’s unsatisfactory performance is not as a result of the cuts, given that the trust is having to make £23 million of cuts during the lifetime of this Parliament?

Mr Wright: I must praise my hon. Friend, because he does fantastic work on health issues through his passionate commitment to the NHS and in his work on the Select Committee on Health. He is absolutely right, and I will come on to the finances and resources for ambulance services in a moment.

Mr Gouldburn’s case was tragic, and from what the coroner said, it was avoidable. However, a further tragedy is that his case is not unique or isolated. I have been told about similar cases, as my hon. Friends have been.

Pat Glass (North West Durham) (Lab): I commend my hon. Friend for securing this debate so quickly. I have raised the issue of the NEAS a number of times. I have met the Minister about it; I even recognise some of the civil servants who are here today, having met them before. However, I was talking then about cases in the dales, where we accept that there will be an issue about logistics. Recently, cases have been raised with me every week. The latest one involved an elderly lady who fell outside and broke her hip. When her son rang to find out where the ambulance was, he was told that she was 42nd in the queue. She was lying outside with a broken hip for three hours, and that happened in Consett, where there is an ambulance service in the town. The whole situation is spiralling out of control, and I would welcome my hon. Friend’s views on it.

Mr Wright: My hon. Friend is absolutely right that the situation is spiralling out of control. The case that she has just told the House about is simply unacceptable and downright distressing, but it is not unique.

Mr Andrew Smith (Oxford East) (Lab): My hon. Friend is being very generous in giving way, and I congratulate him on securing this debate. I concur, of course, with what he has said in praise of front-line ambulance staff, and I also express my condolences to the family of his constituent.

The South Central Ambulance Service, which has a good record against targets in urban areas but a less good record in rural areas, has faced rising demand as well. One of the specific factors that it has pointed to is the increasing number of referrals it receives from the 111 service. Is that also a factor in my hon. Friend’s area?

Mr Wright: It could have been a factor in Mr Gouldburn’s case, because originally his family contacted the ambulance service via 999 but subsequently they went to 111. I do not think that there is sufficient join-up between the ambulance services and the contact centres about what is appropriate to 999 and what is appropriate to 111. I hope that the Minister will respond to that point.

Jim Shannon (Strangford) (DUP): The hon. Gentleman is being very kind and gracious in giving way, although I had asked his permission to intervene beforehand.

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Obviously I do not represent the immediate area covered by the ambulance service that the hon. Gentleman is referring to. In Northern Ireland, however, we have a system whereby the ambulance service can respond to someone who has had a heart attack, as was the case with his constituent. It is a rapid response unit, whereby a car goes out in advance of the ambulance and staff take the urgent remedial and medical action that is necessary in the critical first minutes after what has happened, and then the ambulance follows. Does he feel that the Minister could consider using that system in parts of England as well?

Mr Wright: We should have that system already, but it is simply not working in the north-east and in other parts.

Let me cite another case. A constituent of mine from the Headland part of Hartlepool, which is an urban area, contacted me to say:

“My dad has kidney failure and has only 12% of his kidneys working. Just over three weeks ago, my mam rang me concerned about dad. When I arrived at their house, I could see he was very, very ill. I rang immediately for an ambulance. A nurse rang me back for an assessment of dad. No ambulance. I rang again, another assessment, no ambulance. I rang again, another assessment, (the 4th one), this time stressing that I was angry because he was dying and the family would be driving dad to the hospital if they didn’t come, even though this was impossible. After two hours ten minutes, the ambulance finally arrived. In each phone call that I made, I stressed the fact that dad had kidney failure, which results in potassium build up, which results in a heart attack.”

Thankfully, my constituent’s father went to hospital and, almost against the odds, is slowly improving. As my constituent stated to me:

“He is still weak but my dad has always been a hard worker and a tough, strong man. He is at home but missing going to his allotment! There is no doubt the wonderful nurses and doctors saved dad’s life.”

I want the Minister to respond to and take action on a number of points raised by the examples that I and my hon. Friends have given. First and foremost is that stark admission from a manager within the NEAS that the service does not have the resources to meet demand, and that that is a national problem. As my right hon. Friend the Member for Oxford East (Mr Smith) said, demand is clearly rising. Since the 2010 general election, emergency calls to ambulance services in England have increased by about 12%, and calls in the north-east have gone up by about 13%. An ageing population will only increase demand further. In the next decade, this country will need more ambulance resources, not less.

Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab): My hon. Friend has secured an excellent debate. We know from the NEAS itself that it had an expectation of 415,000 call-outs in the financial year 2012-13, yet it was funded for only 376,000 calls. Also, the use of private ambulances has gone up ninefold, with an initial cost of £96,000 in 2009-10 rising to £754,461 in 2012-13.

Mr Wright: I know that my hon. Friend has spoken in the House about this issue before, and I praise him for that. The use of private ambulances is taking resources away from our having a sustainable public service, which all our constituents want. As a result of that, the

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ambulance services are not able to invest in their work force, and something needs to be done about it. I hope that the Minister will respond directly to my hon. Friend about that issue, because the use of private ambulances is simply unacceptable.

Grahame M. Morris: I am grateful to my hon. Friend for giving way again. As this is a 30-minute debate, I will keep my interventions short, although I have a whole list of constituents who have waited an inordinate length of time; there is not the opportunity in a short debate, such as this one, to give all those examples.

In relation to the specific point about private ambulances, is it possible that the Government’s health reforms have led to fragmentation? I ask that because I have met representatives of front-line ambulance staff who have told me that the one-year contracts from the clinical commissioning group are not helping with the North East Ambulance Service NHS Trust’s forward planning of the services and resources that are needed to meet local demand.

Mr Wright: My hon. Friend makes an important point. How can an ambulance service plan for the next five years if it faces annual commissioning rounds? That does not work and does not provide long-term sustainability.

The North East Ambulance Service, which, like other ambulance services, has received a flat cash offer from the Government over the course of this Parliament, has been required to cut £4.83 million from its budget for 2012-13, which is some 5% in real terms, and another £4.35 million for 2013-14. Unison estimates that real cuts of about 20% to 25% have been made to ambulance services so far over this Parliament. Those cuts, coupled with rising demand, are having a detrimental impact on the quality of ambulance service that people receive.

Dr Thérèse Coffey (Suffolk Coastal) (Con): Will the hon. Gentleman give way?

Mr Wright: If the hon. Lady will allow me to continue for a moment, what I am about to say is relevant to her area. Response times, especially for the most life-threatening emergency cases, are getting worse. In March 2012, 75.5% of emergency calls in England were responded to within eight minutes. In March 2014, in the latest figures available, that had gone down to 74.7%, with seven of the 11 ambulance trusts, including the North East Ambulance Service, seeing a deterioration in performance. The East of England Ambulance Service saw the proportion of emergency calls responded to within eight minutes fall from 76.2% to 62.4%. That is simply unacceptable, and the hon. Lady will want to respond to it.

Dr Coffey: I congratulate the hon. Gentleman on securing the debate. I agree that this is a depressingly familiar situation, but I do praise Anthony Marsh, the new chief executive of the East of England Ambulance Service. I recognise the hon. Gentleman’s points, but what is the North East Ambulance Service’s board doing? MPs in the east of England campaigned and successfully managed to get rid of the entire board.

Mr Wright: As a north-east collective, we work closely to ensure that our constituents get the best possible services.

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Let me move on to average response times. In the north-east, the average response time increased from five minutes and 16 seconds in 2011 to five minutes and 48 seconds last year. The east of England saw a 90-second increase in response times. Only one ambulance trust actually reduced the average emergency response time. Those figures reinforce what the senior management from the North East Ambulance Service confirmed at Mr Gouldburn’s inquest, namely that ambulance services do not have the resources to meet demand, that it is a national problem and that response times are suffering as a result. There has been an admission from a senior manager in the ambulance service that resources are not keeping up with demand. Response times, in particular for more serous cases, are deteriorating and lives are being threatened, if not tragically lost. Will the Minister therefore pledge this afternoon to provide more resources to ambulance services in Hartlepool, the north-east and across England to meet rising demand?

I also want to question the assessment process used to screen calls and prioritise response times. Given Mr Gouldburn’s history of heart problems, his age and the fact that he had recently undergone surgery and had seen the doctor that same day, why on earth was he not prioritised as an emergency case and provided with an eight-minute response time? Why did it take seven calls to escalate the case to an emergency? The Minister must accept that that is simply unacceptable. Is there pressure from the Government to downgrade the priority of emergency calls due to inadequate resources?

This week, I received a letter from the Health Minister Earl Howe stating in response to Mr Gouldburn’s case that

“the 999 call was triaged correctly, although some of the questioning could have been better.”

Why was it not better? Why is the questioning not relevant and efficient in every case? The constituent whose father had kidney problems said to me:

“Phone assessments should be changed. In each assessment they asked me did dad have a rash and could he put his chin on his chest! Words like kidney failure and potassium should be taken note of. Because I’m not a rude person I didn’t react angrily, but wish I had because dad could have died. We realise that there is a shortage of ambulances and this can’t go on. We are a rich country. Shortages of ambulances are something you read about in poor countries. It shouldn’t be happening here.”

Assessment and prioritisation seem to be failing and the right questions are not being asked during initial screening. What will the Minister do to address that?

The third issue is that ambulances were delayed because of a problem in admitting patients to North Durham hospital due to a lack of available beds. That seems to show both a lack of joined-up thinking on hospital admissions and the fact that ambulance and NHS resources are hanging by a thread. Is it really acceptable, as seems to have happened in Mr Gouldburn’s case, that because of a delay at a single hospital in County Durham due to insufficient beds, the whole ambulance service for the north-east, or certainly the south of the region, grinds to a halt? The Minister surely cannot find that acceptable. Are resources being spread so thinly that services are not being provided to my constituents?

Hospital services in my area have gone through dramatic changes in the past few years, as my hon. Friend the Member for Easington (Grahame M. Morris) knows all too well. Hartlepool’s A and E closed in August 2011, much to the town’s concern, on the grounds of clinical

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safety and the specialisation and centralisation of appropriate medical skills. There is a mismatch between the Momentum programme of centralising services and the Government’s failure either to commit to funding a new hospital or to provide resources to reinstate services at the existing Hartlepool hospital. If there are fewer A and Es across the country and ambulances have to travel greater distances to a smaller number of centres, will that not increase the handover and turnaround times of patients between the ambulance service and hospital staff? Ambulance crews—my hon. Friend the Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) has been strong on this—are queuing up outside fewer hospitals, making handover and turnaround times worse. Does that not reduce the amount of time for which ambulance staff can be in a position to respond to emergency calls?

Tom Blenkinsop: Such cases will only increase in my constituency, where it is proposed to close two minor injury units and the walk-in centre in Skelton. That all comes on the back of a recent development at the South Tees Hospitals NHS Foundation Trust, which could have a £50 million deficit. My main problem is that we have been refused meetings with Health Ministers to discuss such matters.

Mr Wright: It is wrong for any Minister to refuse a meeting request from a Member of Parliament, in particular on something as important as ambulance response and handover times.

Will the Minister respond to my point about the trade-off between the specialisation and centralisation of services, which is how the NHS is going, and the impact on the distances travelled by ambulances and their subsequent response and return-to-road times? Those are links in the chain that will ensure a seamless and high-quality NHS service, but they do not seem to be as locked together as they should. What is the Minister doing to address that? Will she commit to monitoring handover times to ensure a better and more responsive service for all patients?

At times of emergency and crisis for themselves or their loved ones, the public expect a responsive and professional ambulance service, but as we have heard from those working at a senior level within the North East Ambulance Service, resources are not matching demand, response times are worsening and lives are being threatened. Will the Minister act to ensure that in Hartlepool, the north-east and across the country we have ambulance provision that meets demands, is professional and is the best in the world?

4.48 pm

The Parliamentary Under-Secretary of State for Health (Jane Ellison): I congratulate the hon. Member for Hartlepool (Mr Wright) on securing the debate. Given the wide range of topics that he and his colleagues raised, I am not sure whether I will be able to cover them all in the time available, so if I do not, I will attempt to respond to any substantive points after the debate. I will also certainly alert my noble Friend Earl Howe to the points made.

As the hon. Gentleman said, ambulance services are vital to the health care system and provide rapid assistance to people in urgent need of help. Many lives are saved

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by the hard work of ambulance service personnel. He is right to place his congratulations on the record and I want to place on the record my appreciation of the work done by staff in ambulance trusts. I gently suggest that I do not recognise some of the words and phrases used in the debate to characterise the service provided, but I am sure that they were used to stress a point.

Pat Glass: Will the Minister give way?

Jane Ellison: No, because I have only just begun and the hon. Gentleman took many interventions.

Emergency services are the first port of call for many of us when serious illness or accident strikes. The total number of emergency calls to ambulance services in England in 2013-14 was 8.4 million, which is a 0.9% drop over the previous year. Unfortunately, a small proportion are unnecessary or frivolous, but the overwhelming majority are from people who feel in need of urgent help.

The growing number of people living with chronic conditions and the ageing population to which the hon. Gentleman referred are placing increasing pressure on urgent care services, something that we all acknowledge. It is important for my Department to work with Public Health England, local commissioners and health care providers to educate and engage the public on measures to prevent chronic health problems from developing. There are a number of people who end up in A and E because they have not taken medication properly or who suffer acute problems as a result of a chronic condition. Hon. Members will be aware of some of the longer-term problems in their region, which result from difficult public health challenges. Tackling those is my own particular portfolio, and is one way in which we can make the emergency services more sustainable in the longer term.

I hope hon. Members recognise that. At times, it seemed that they were merely committing themselves to significant additional future spending rather than also turning their minds to the longer-term challenges.

Grahame M. Morris: Will the Minister give way?

Jane Ellison: I am going to continue and try to make a few substantive points. If I have time, I will give way.

All 999 calls are triaged into two basic categories, red and green, depending on the seriousness of the call. Those placed in the red category are calls where the patient is in a life-threatening condition; an example would be someone suffering a cardiac arrest. Such calls require assistance on the scene as quickly as possible and the Government have set targets for all ambulance services in England of a response within eight minutes in 75% of cases. The latest figures, for March 2014, show that in north-east England—the area of the hon. Member for Hartlepool—the median average response time for red category calls was 6.4 minutes. Nationally, those figures show that 76.2% of red 1 calls, which are the most critical, received a response within eight minutes. In the north-east the target was also met, with 75.2% of patients receiving a response within eight minutes. That is not to say that there are not significant problems in some cases, but it is important to place on the record the service’s effective work in meeting that target.

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Less critical 999 calls placed are in the green category. Those calls are not subject to national targets. Some ambulance services set their own targets for response times, and NEAS uses a one hour standard. It is important that such calls receive a timely and appropriate response, but red calls must be prioritised, as a person’s life may be in immediate danger.

There has been recent media coverage of long waits for ambulances, and hon. Members have alluded to constituents’ experience of such waits during this short debate. Every patient should expect to receive first-class care from the ambulance service, but the nature of emergency response work means there will always be incidents where unfortunate timing leads to a situation in which someone who is assessed as being in a non-life-threatening situation calls 999 at the same time as several other people who are in life-threatening situations. I am sure that hon. Members recognise that that would be the case under any Administration.

Grahame M. Morris: Will the Minister give way?

Jane Ellison: Briefly.

Grahame M. Morris: I am grateful to the Minister for giving way, but I cannot let that pass, because the situation is different now. I have had the honour of representing Easington for four years and it is evident from the cases that are coming to me and to colleagues from the region that the situation is worsening. One case was that of a young man who broke his hip playing football and waited for two and a half hours in the rain. He was in the centre of the constituency, in an area that is readily accessible. Another was of an old lady who waited two and a half hours for an ambulance. She died the following day. Something is sadly wrong with the North East Ambulance Service and the situation is deteriorating. We have all had cases that are really quite shocking, and something needs to be done.

Jane Ellison: I am not familiar with the cases that the hon. Gentleman mentioned, but I will draw them to the attention of my ministerial colleagues and of the trust. I spoke to the head of the trust yesterday, and will make sure that the debate is brought to the trust’s attention. However, I gently say to hon. Members that they surely cannot be suggesting that at no previous time, under any previous Government, have there been any cases in which a service did not get this right. It is important to—

Pat Glass: It’s a service in crisis!

Jane Ellison: I do not recognise that description, and I do not think the service would recognise it.

Very rarely, as we have heard, waits may be unacceptably long, but it is important to remember that the vast majority of people receive a timely response when they dial 999. I am aware of the case of William Gouldburn, who was the constituent of the hon. Member for Hartlepool and who sadly died in April last year as the result of an existing heart condition. He waited two hours for an ambulance after his collapse at home. His case is distressing, and his MP is right to champion it and make us aware of it. The trust acknowledges that it failed by not getting an ambulance to Mr Gouldburn within the one-hour target it had set itself. It has been accepted that that was not good enough.

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Difficult as his story is to hear, it is important to note that Mr Gouldburn’s 999 call was categorised as a green call—that is, a non-life-threatening situation—and at the inquest the coroner accepted that the call had been correctly triaged and categorised. That is not to say that there were not things that clearly should have been done differently, but it is right to put on the record what the coroner said. There is no denying that Mr Gouldburn waited an unacceptably long time for an ambulance, but the decision on his call’s priority was made when other calls were at the same time being prioritised as red.

It is a matter for local commissioners to agree with ambulance trusts the appropriate protocols for dealing with green calls, based on available clinical guidelines and local circumstances. I know that in the case of the hon. Member for North West Durham (Pat Glass) those local circumstances have been recognised with the introduction of a specific response vehicle in her constituency. There has been increasing demand on ambulance services—the North East Ambulance Service says that it saw a 5% increase in the volume of emergency incidents in the year up to March 2014—but thanks to the hard work of service staff, fast response times have been delivered in the vast majority of cases.

NEAS advises that over 40% of the calls it receives are categorised as red, so its consistent ability to exceed the national target for response times should be commended. NEAS has also told me that in 2013-14, 74.8% of calls categorised as green 2, or serious but not life-threatening, received a response within 30 minutes.

4.56 pm

Sitting suspended for a Division in the House.

5.11 pm

On resuming—

Mr David Crausby (in the Chair): I will adjourn the sitting at 5.15 pm. I call the Minister.

Jane Ellison: Thank you, Mr Crausby. Welcome back to the hon. Member for Hartlepool—I think some colleagues may not have been able to rejoin us.

As I was saying, NEAS tells me that in 2013-14, 74.8% of calls categorised as green 2, meaning serious but not life-threatening, received a response within 30 minutes, and 71.2% of calls categorised as green 3, meaning non-emergency, received a response within 60 minutes. Although that does not in any way diminish the tragedy of cases such as Mr Gouldburn’s, which are never acceptable, it is important that we recognise the generally excellent service provided by the trust and its staff.

Mr Wright: I appreciate what the Minister is saying, but when it goes bad, it goes catastrophically bad, with life-threatening consequences. Surely she realises that we should make sure that we minimise that as much as possible.

Jane Ellison: I think we can all agree that those are circumstances that we want to minimise.

I want to turn briefly to one or two specific local points, and then to one or two wider points. Most recently, the Government recognised the importance of

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investment in front-line services with £14 million provided to ambulance services last December. Obviously, it is for local commissioners and trusts to decide how that money is used. I recognise that in the hon. Gentleman’s region, local commissioners see that more investment is needed for ambulance services, and we recognise that the trusts are working with local commissioners on that, making sure that they get that commissioning piece right.

More generally, there is also an issue about staffing in the ambulance service. Since 2010, the NHS has recruited 16% more paramedics, but we know that in some areas of the country, there is insufficient academic capacity, for example, to produce paramedics in the numbers required. Again, the Association of Ambulance Chief Executives is working with Health Education England to address that issue in the medium term.

The hon. Gentleman also alluded to ambulance handover delays. We absolutely recognise the role that they can play in making the job of the ambulance service more difficult. I believe there has been an ongoing issue, to which he alluded, for NEAS at County Durham and Darlington NHS Foundation Trust hospitals. Local commissioners have advised that there has been recent improvement, helped by winter initiatives supported by the urgent care working group. That has included support from the fire and police service, but I know there is more to be done.

Indeed, my colleague from the east of England, my hon. Friend the Member for Suffolk Coastal (Dr Coffey), who has not been able to rejoin us, was talking as we went to the vote about work that had been done specifically in her area to look at some particular issues that affect handover delay. As she said in her intervention on the hon. Gentleman, it is well worth local Members exploring some of that detail with their board as well to see whether lessons can be learnt from other parts of the country.

The urgent and emergency care review is being led by Sir Bruce Keogh, the national medical director of NHS England. He was asked to undertake a review of urgent and emergency care, looking at all aspects of the sustainability of the urgent and emergency care system. That does not exclude ambulance services. The review proposes the development of 999 ambulances; they would become more like mobile treatment services, not just urgent transport vehicles. There is a lot of fresh thinking in all sorts of areas of delivering excellence in emergency health care, and it is right that we look at new ways of delivering that health care with regard to ambulances as well, rather than just looking at the old model.

I want briefly to put a point on the record in the 30 seconds left to me. Let us not minimise the importance of people being asked about a rash as a symptom on the phone. It is one of the signs of meningitis and the royal colleges have advised that that should be asked as a question, so it is not an insignificant point.

With regard to private ambulances, that provision was brought in by the right hon. Member for Leigh (Andy Burnham), when he was in office—

Mr David Crausby (in the Chair): Order.

5.15 pm

Sitting adjourned without Question put (Standing Order No. 10(13)).