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House of Commons

Wednesday 28 January 2015

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Oral Answers to Questions

Northern Ireland

The Secretary of State was asked—


1. Tom Greatrex (Rutherglen and Hamilton West) (Lab/Co-op): What recent discussions she has had on the security situation in Northern Ireland; and if she will make a statement. [907198]

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): Keeping people safe and combating the terrorist threat continue to be the Government’s highest priorities. While the threat level remains at severe, excellent co-operation between the Police Service of Northern Ireland and its partners has put violent dissident republicans under strain in recent months. There have been a number of significant arrests, charges and convictions, which are helping to suppress the threat.

Tom Greatrex: I thank the Secretary of State for her reply. When did she last discuss with the Home Secretary the issue of the National Crime Agency and its taking up functions in Northern Ireland? What assessment has she made of the effects of the delay on fighting organised crime in Northern Ireland?

Mrs Villiers: I last discussed that with the Home Secretary on Tuesday morning. There are some very good discussions under way between the Justice Minister, members of the Social Democratic and Labour party and the Home Secretary on these matters. There is some optimism that real progress is being made, and I urge all involved—I urge Labour to work with its sister party, the SDLP—to work on this, because the NCA provides excellent services. At the moment, Northern Ireland is not getting the full benefit of the protection that it can offer.

Mr Andrew Robathan (South Leicestershire) (Con): The Secretary of State may have seen some rather surprising reports in the newspapers today. Given that she is talking about serious crime and is talking to parties in Northern Ireland about that, has she talked to Sinn Fein, because apparently the Labour party has been talking to Sinn Fein about a possible link-up after the general election? Did she see that?

Mrs Villiers: I was briefed on those stories in The Sun this morning. I certainly discuss many matters with Sinn Fein and the other Northern Ireland parties. It is crucial that all parties—Sinn Fein, the SDLP and all the

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parties in the Executive—get behind the introduction of the full powers of the National Crime Agency in Northern Ireland, because that is a means by which we can ensure that we do more to keep people in Northern Ireland safe, and it helps to relieve pressure on PSNI resources.

Mr Nigel Dodds (Belfast North) (DUP): One of the biggest threats to security in the months ahead in Northern Ireland is the continuing impasse over parades in north Belfast. Will the Secretary of State tell us what she plans to do, as this is not a devolved matter? The ball is firmly in her court after her decision at Christmas not to proceed with the north Belfast parading panel. She will know that on this side of the House we are determined not to allow this matter to be forgotten or swept under the carpet. It needs to be addressed, and the festering sore of the denial of human rights to people in north Belfast must be sorted out.

Mrs Villiers: I fully agree with the right hon. Gentleman that we cannot go on as we are—things cannot be left as they are. It is vital that we get a process in place that will help to resolve the dispute, deal with the impasse, and bring the two sides together. I am actively engaged on that, and I hope to meet him and representatives of the loyal orders soon to discuss this. I would urge a wide range of people to get involved. I accept full responsibility for seeking to drive it forward, but contributions by Church leaders have been helpful on this matter in the past. Other parts of Northern Ireland have demonstrated that input from the business community can be helpful in resolving these disputes. We need to develop an inclusive process that brings a range of interest groups together to try to find a way to resolve this dispute.

Mr Dodds: On the issue that was the subject of exchanges a moment ago—I am grateful that the Secretary of State sees the Labour party putting pressure on the SDLP—Sinn Fein is the real impediment, with a veto in the Northern Ireland Assembly in relation to the NCA. What does the Secretary of State intend to do about that? Is there not a more active role for her to play in resolving this issue, and what confidence can we have in Sinn Fein being prepared to support the NCA when one of its leading members, Gerry Kelly, having promised support and help for a victim’s family, ran around giving letters of comfort to the alleged perpetrator against the innocent family?

Mrs Villiers: I have been very actively involved in these matters for many months, and I raise the issue with Sinn Fein virtually every time I have a conversation with them. It essential that we see movement on this. The reality is that it will be more difficult to seize the assets of criminals without full implementation of the NCA. It will be more difficult to crack down on drug dealing, racketeering and serious organised crime without full powers for the NCA. I will continue to urge Sinn Fein and the SDLP to accept the extension of the NCA’s remit. The reassurances in place ensure that any activity by the NCA will be entirely consistent with the devolved policing and justice settlement.

Lady Hermon (North Down) (Ind): What additional measures have been put in place by the UK Border Force to enhance the security of this country to ensure that young British people who go out to Syria or Iraq

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and become radicalised jihadists there could not easily slip back into the Republic of Ireland, cross the border with Northern Ireland back into the UK and commit the most appalling acts of terrorism? What is being done to improve that situation?

Mrs Villiers: My right hon. Friend the Home Secretary has a range of measures in place on those matters, including the Counter-Terrorism and Security Bill which is under discussion in Parliament, which in certain circumstances would enable UK nationals not to be admitted back into the country. The hon. Lady is right to raise the threat from international terrorism, which we must remember is a threat in Northern Ireland as it is elsewhere in the United Kingdom. I had the opportunity to discuss these matters with senior members of the PSNI last week. They stand ready not only to play their part in Northern Ireland, but to provide assistance and advice to police services in the rest of the country.


2. Rosie Cooper (West Lancashire) (Lab): What recent steps she has taken to ensure that the Police Service of Northern Ireland has adequate resources to guarantee security for the people of Northern Ireland. [907199]

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): The Stormont House agreement included an undertaking by the Northern Ireland Executive to protect the PSNI’s budget from significant reductions. I very much welcome the additional £20 million for the police in the Executive’s final budget for 2015-16. This is in addition to security funding of £231 million provided by this Government to help the PSNI tackle the terrorist threat.

Rosie Cooper: The letter bomb sent to the PSNI headquarters earlier this month is a shocking reminder of the great sacrifices made by officers across Northern Ireland. How closely is the Secretary of State monitoring the resource needs of the PSNI?

Mrs Villiers: This is of course something I take a very close interest in. That is one of the reasons why the Government have provided the extra security funding and why we included provision in the Stormont House agreement to link our funding package with a commitment by the Executive on police resources. Clearly, the threats to police officers continue to be real and significant, and I welcome the success that the PSNI and An Garda Siochana have had in significant arrests and disruptions, which I believe have contributed substantially to suppressing the terrorist threat.

13. [907212] Mrs Mary Glindon (North Tyneside) (Lab): How can the PSNI possibly meet its resource requirements to keep the peace when it has to make budgetary savings of over £51 million by the end of this financial year?

Mrs Villiers: As I said, the resource position for the police has been improved with the changes in the draft final budget. The position of the police would be further improved if the NCA were to operate to its full capacity in Northern Ireland, because at present the PSNI is

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doing work that would otherwise be done by the NCA. The establishment of the Historical Investigations Unit in the coming months will further relieve the PSNI of responsibilities in relation to policing the past, freeing up time and resources for policing the present.

David Simpson (Upper Bann) (DUP): Does the Secretary of State agree that as well as securing resources for security for the PSNI, we need to focus on rural crime, attacks on our elderly and the drugs issue, all of which are increasing in Northern Ireland?

Mrs Villiers: These matters are crucially important. The crime figures in Northern Ireland continue to make it clear that Northern Ireland is one of the safest places in Europe and has some of the lowest levels of crime, but I know that the PSNI takes very seriously the regular crime that is the bane of people’s lives and is working hard to combat it, in addition to its duties in relation to national security.

Naomi Long (Belfast East) (Alliance): The hon. Member for West Lancashire (Rosie Cooper) referred to the attack on PSNI headquarters in my constituency. In addition to being under threat when in uniform and on duty, officers are often under threat in their own homes. The PSNI needs resources to be able to provide adequate security measures at officers’ homes if it is to retain officers who have been trained. What can the Secretary of State do to allow additional funding for the PSNI to ensure that that happens?

Mrs Villiers: As I said, one way to do that would be to take burdens off the PSNI’s shoulders by implementing the NCA. Continued focus on trying to resolve parading disputes is also important, given their potential impact on police resources. It is crucial that we get the new institutions on the past up and running as soon as possible to provide that relief to PSNI funding, and, as we discussed in the House yesterday, we need to consider whether any of the £150 million for dealing with the past can be deployed prior to the establishment of the HIU to help on these matters for the PSNI.

Mr Ivan Lewis (Bury South) (Lab): The Conservative party seems to want to introduce new protocols to the House, believing everything in The Sun and demanding that the Labour party take responsibility for problems that are clearly the responsibility of the Government.

Yesterday, the Secretary of State was unable to tell us how long it would take the PSNI to review the case of all those covered by the on-the-runs scheme. When will she be able to answer that question? In lieu of the creation of a new architecture to deal with the past, what will the PSNI be doing in the meantime to deal with some of the unresolved murders?

Mrs Villiers: How to deal with such cases, the priority given to them and the length of time it will take are matters for the PSNI, but it has said publicly that it will take some years to progress through the cases under Operation Redfield. As I told the House yesterday, it is important for us to consider whether any of the £150 million that is to be devoted to matters relating to legacy cases can be used to assist the PSNI in its work prior to the establishment of new institutions to look at past cases.

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Voluntary Sector

3. David Mowat (Warrington South) (Con): What assessment her Department has made of the role of the voluntary sector in dealing with the legacy of the past. [907200]

The Parliamentary Under-Secretary of State for Northern Ireland (Dr Andrew Murrison): Voluntary sector organisations provide invaluable support for those whose lives have been changed for ever as a result of Northern Ireland’s troubled past. I have visited some of them and I pay tribute to their work, which I know from my dealings with victims and their families is deeply appreciated by many in Northern Ireland and beyond.

David Mowat: The recent Stormont House agreement acknowledged that victims of the troubles from outside Northern Ireland should also be formally recognised, and the oral history archive that is to be set up is a mechanism for doing that. Will my hon. Friend support a role for the Warrington-based Foundation for Peace in co-ordinating input to the archive for such victims?

Dr Murrison: Yes, and I pay tribute once again to my hon. Friend’s contribution to this and his support for the Warrington peace centre and its important work. It is explicit in the Stormont House agreement that the oral history archive will be established for the whole of the United Kingdom, and it will be keen to hear the accounts of the troubles of people in Warrington and throughout the United Kingdom. I look forward to that forming a part of the oral history archive in due course.

Mr Peter Hain (Neath) (Lab): Do the Government agree that the provision of a special pension for those severely injured during the troubles who were unable to build up an occupational pension of their own, long argued for by the WAVE trauma centre’s injured campaign group and included in the Stormont House agreement, should be supported by all parties, and that questions around who should be eligible for that pension can be resolved to ensure that those who were severely injured through no fault of their own are not denied the opportunity to have some financial independence as they grow older?

Dr Murrison: As the right hon. Gentleman will know, because he will have read the Stormont agreement, this item was left largely unresolved, although open. I am afraid to say that the problem revolves around the definition of victims, notwithstanding the 2006 order. That is work in hand and it is something that we will have to return to.

Mr Laurence Robertson (Tewkesbury) (Con): May I join the Minister in paying tribute to all the many charities and voluntary organisations in Northern Ireland, which, as he rightly says, have done so much invaluable work over the years? What recent review has he done of the potential for the Civic Forum for Northern Ireland to contribute to bringing people together in Northern Ireland?

Dr Murrison: My hon. Friend is right to refer to the Civic Forum. It is clear that we need to hear those voices in Northern Ireland, which is a part of the United Kingdom where politicians are not necessarily

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all held in high regard, Members of this House excepted. It is important that we look for alternative voices, and I am sure that in the months and years ahead, with the assistance of the Stormont House agreement, that civic voice will be heard more and more.

Sammy Wilson (East Antrim) (DUP): Does the Minister agree that we will never deal with the hurt and the poison of the past in Northern Ireland while the past actions of police and Army officers and personnel are subject to extensive investigations, police investigations and court action, while terrorists are given letters that enable them to escape the consequences of their crimes?

Dr Murrison: The hon. Gentleman makes his points in his usual robust fashion. It is clearly important that justice is done in Northern Ireland as it is throughout the United Kingdom, and that when there are failings they are properly investigated.

Historical Records

4. Mark Durkan (Foyle) (SDLP): What steps she is taking to safeguard records relevant to the work of the Historical Investigations Unit, the Independent Commission for Information Retrieval, inquests, and other inquiries into the past. [907202]

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): The Northern Ireland Office takes responsibility for safeguarding its records very seriously and will continue to follow existing protocols.

Mark Durkan: The Secretary of State gave the commitments on behalf of the British Government in the Stormont House agreement to ensure that whenever the new mechanisms come into place all records will be given to them. What steps is she taking to make sure that all current records will still be available? She knows that there have been many cases where files or their contents have disappeared, to the dissatisfaction of those dealing with them. What steps is she taking to safeguard against that?

Mrs Villiers: The Northern Ireland Office undertook a review of record keeping in the wake of the problems that occurred in relation to the cases involving the RPM—royal prerogative of mercy. We are satisfied that all necessary measures are in place to ensure that records will be available for transfer as appropriate, but we will also take steps to make sure that sensitive material is protected from onward disclosure by the institutions concerned.

Dr William McCrea (South Antrim) (DUP): In 1976, 10 innocent Protestant workmen were brutally slaughtered by the side of the road at Kingsmills. The Historical Enquiries Team report now reveals the chilling fact that a large number of the terrorists responsible included neighbours based in the village of Whitecross just over 1 mile from the scene of the atrocity and close to where many of the innocent victims lived. Does the Secretary

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of State not accept that it is sickening to think that these men were part of that murdering team, when the victims needed neighbours to be faithful most of all?

Mrs Villiers: The Kingsmills tragedy was an appalling terrorist atrocity. I have met the families, and they have my deepest, deepest condolences. Every effort should continue to be made to bring to justice those responsible for this horrific episode in the troubles.

Stephen Pound (Ealing North) (Lab): Further to the question by my hon. Friend the Member for Foyle (Mark Durkan), I am sure that the whole House welcomes the new architecture proposed as a result of the Stormont House agreement. Will the Secretary of State give us some indication of the time scale and, crucially, say whether it will require legislation in this House? Frankly, the victims’ families have waited too long—they need answers and they need them now.

Mrs Villiers: I am meeting the leaders of the Northern Ireland parties on Friday to agree an implementation plan on the Stormont House agreement. It is highly likely that we will need at least some legislation both in Westminster and in the Assembly. We will talk to the Northern Ireland Executive about the balance between the two to ensure that we get these institutions up and running as soon as possible, because current systems are not giving the right outcomes for victims, and that needs to change.

Stormont House Agreement

5. Mr William Bain (Glasgow North East) (Lab): What progress she has made on implementation of the Stormont House agreement; and if she will make a statement. [907203]

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): The Government are committed to timely implementation of the Stormont House agreement and we are making progress—for example, on corporation tax devolution. We hope to agree an implementation plan for the agreement at our first formal review meeting with the parties on 30 January.

Mr Bain: I welcome the Stormont House agreement as further strengthening devolution across the United Kingdom and offering the Northern Ireland Executive nearly £2 billion in new finance and loans. What process will the Secretary of State propose to deal with the unresolved issues of parades, flags and cultural identity?

Mrs Villiers: The SHA sets out a clear pathway for reaching a resolution of those issues with the commission on flags, which was first proposed by Dr Richard Haass. It is right that we have a broader engagement with the public on the matters relating to identity. The SHA commits the Executive to producing options for a new system of parading that could be devolved, we hope, in future.

Mr Gregory Campbell (East Londonderry) (DUP): Does the Secretary of State agree that the Stormont House agreement, with the boost to the economy that should come as a result of the corporation tax decision, the reduction in the size of Government, and the provisions

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on no rewriting of the past and no expansion of cross-border bodies, means that we now have a once-in-a-generation opportunity to make significant progress in Northern Ireland?

Mrs Villiers: I wholeheartedly agree with the hon. Gentleman’s description of the Stormont House agreement. It was balanced and fair, it comes with a significant financial boost for Northern Ireland, and it guards against the dangers of those who would attempt to rewrite history. Corporation tax devolution could be genuinely transformative for Northern Ireland as a place sharing a land border with a low-tax jurisdiction.

Ms Margaret Ritchie (South Down) (SDLP): Further to the question on corporation tax, will the Secretary of State have immediate discussions with the Northern Ireland Executive to force home the point that that lever should be used to bring about balanced regional development in terms of inward investment locations for projects? [Interruption.]

Mr Speaker: Order. Let us make sure we hear the Secretary of State’s answer on the Stormont House agreement.

Mrs Villiers: Both the UK Government and the Northern Ireland Executive are united in our efforts to rebalance the Northern Ireland economy, and we both share the determination to ensure that economic prosperity and the boost that will come with corporation tax devolution are shared throughout all towns, cities and rural areas in Northern Ireland.

Mr Ivan Lewis (Bury South) (Lab): The Stormont House agreement states that corporation tax devolution will not take place until 2017, subject to various conditions, so will the Secretary of State tell the House what tangible benefits the economic pact has so far delivered to Northern Ireland’s economy? When did she last meet the Business Secretary and the Foreign Secretary to talk about how the UK Government can support Invest Northern Ireland?

Mrs Villiers: I regularly discuss such matters with my colleagues in Cabinet. We have rolled out a range of measures under the economic pact—devolution of corporation tax is one, and the investment conference following up on the G8 is another. We are seeing real progress on projects such as the Lisanelly shared campus, as well as increased take-up of the Government’s financial schemes to promote lending to business, so the economic pact is already delivering for Northern Ireland in a range of ways.

Youth Unemployment

6. Pamela Nash (Airdrie and Shotts) (Lab): What steps the Government are taking to tackle youth unemployment in Northern Ireland. [907204]

8. Julie Hilling (Bolton West) (Lab): What steps the Government are taking to tackle youth unemployment in Northern Ireland. [907206]

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9. Alex Cunningham (Stockton North) (Lab): What steps the Government are taking to tackle youth unemployment in Northern Ireland. [907208]

The Parliamentary Under-Secretary of State for Northern Ireland (Dr Andrew Murrison): The questions are timely because last week’s figures show that youth unemployment in Northern Ireland has fallen by 3.3 percentage points over the year, and is 175,000 lower than in May 2010. The Government’s long-term economic plan is promoting a sustainable economic recovery from the mess we inherited, and it is directly assisting young people into real jobs that have a future.

Pamela Nash: I welcome those youth unemployment figures. However, Northern Ireland’s youth unemployment figures remain significantly higher, at 19.2%, than in the rest of the UK. That has a big impact not only on those young people, but on the security of Northern Ireland. Why have the Government allowed this situation to persist, and what will they do to stop it?

Dr Murrison: The matter to which the hon. Lady refers is of course primarily the responsibility of the Northern Ireland Executive. I must observe, however, that unemployment among young people in Northern Ireland rose by 35% between May 1997 and May 2010; it has gone down by 3.3 percentage points in this year alone.

Julie Hilling: Last week’s labour market statistics show a worrying growth in female unemployment. What are the Government doing to address that imbalance?

Dr Murrison: Female unemployment is of course a concern right across the United Kingdom, as is unemployment in general. I would observe the number of apprenticeships being created by this Government. It is important that we get young people, male and female, into jobs for the long term, and not indulge in short-term gimmicks.

Alex Cunningham: The chief economist of Ulster Bank has said that under-25s are failing to participate in Northern Ireland’s labour market recovery. Does the Minister agree that we need to address young people’s prospects, and will he welcome the Heenan-Anderson commission, which will examine skills and education?

Dr Murrison: I certainly welcome any comments from any commission that are worth reading. I would add that the commission recently set up by the Labour party to look into problems in Northern Ireland, chaired by Deirdre Heenan, has started somewhat poorly. She said by tweet, within minutes of being appointed, that the

“key issue for Labour is a lack of distinct policies”.

Inward Investment

7. Bob Blackman (Harrow East) (Con): What steps the Government are taking to strengthen the economy of and increase inward investment to Northern Ireland. [907205]

The Secretary of State for Northern Ireland (Mrs Theresa Villiers): The Government’s long-term economic plan is working for Northern Ireland, as shown by the good

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news on employment statistics last week. We have introduced a Bill to devolve corporation tax-setting powers, which will act as a significant marketing tool to attract foreign investment to Northern Ireland.

Bob Blackman: I thank my right hon. Friend for that answer. Does she agree that reducing corporation tax rates would enable greater employment prospects and a brighter future for the people of Northern Ireland?

Mrs Villiers: I agree with my hon. Friend. That change has great potential to transform the Northern Ireland economy, which is already starting to recover. Since the election, employment is up by 31,000, private sector employment is up by 51,000 and unemployment is down 6,000, and the claimant count in Northern Ireland has gone down for 24 consecutive months.

Dr Alasdair McDonnell (Belfast South) (SDLP): The Secretary of State will be aware that strengthening the economy and increasing investment require multiple factors, not just the reduction of corporation tax. Does she appreciate how critical regional connectivity is, particularly the air links between Belfast and London and Dublin and London that go into Heathrow? Will the Heathrow slots be protected if International Airlines Group takes over Aer Lingus?

Mrs Villiers: It is not for me to speak for IAG, but it is vital that Heathrow maintains its links with Belfast and Dublin. I agree that a corporation tax reduction on its own is not enough for economic recovery; it is crucial that economic reform and investment in infrastructure accompany that change.

Mr Speaker: Last but not least, on the Union flag, I call Kate Hoey.

Union Flag (Driving Licences)

10. Kate Hoey (Vauxhall) (Lab): What recent representations she has received on use of the Union flag on driving licences in Northern Ireland. [907209]

The Parliamentary Under-Secretary of State for Northern Ireland (Dr Andrew Murrison): I understand the strong interest in whether proposals for the Union flag to appear on driving licences in Great Britain should apply in Northern Ireland. However, driver licensing is a devolved matter for Northern Ireland and it is for Executive Ministers to decide whether to adopt the changes that have been announced for the rest of the country.

Kate Hoey: The Minister will know that there is doubt over whether this is a devolved matter. Surely, if we believe in the Union, people in Northern Ireland should have the same right as everyone else in the United Kingdom to have the flag of their country flying on their driving licence. Does he agree?

Dr Murrison: I share the hon. Lady’s sentiments about the importance of the Union flag. However, I emphasise that putting it on driving licences is a devolved matter and therefore a matter for the Executive.

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Prime Minister

The Prime Minister was asked—

Iraq Inquiry

Q1. [907258] Mr Frank Field (Birkenhead) (Lab): When he next plans to meet the chairman of the Iraq inquiry; and if he will make a statement.

The Prime Minister (Mr David Cameron): I have no current plans to do so.

Mr Field: Given that the current Cabinet Secretary said in 2009 that, in his judgment, the inquiry would take a year and that there will have been two general elections before we see the report, might I ask the Prime Minister to write to the chairman to get a date for when the report will be handed to the Prime Minister and then published?

The Prime Minister: I have written to the inquiry chair and expressed my frustration. However, I say to the right hon. Gentleman that it is not for this Government to interfere in how the inquiry, which was set up with terms of reference by the last Government, is conducting itself. That would not be right. I first voted for an inquiry back in 2006. Labour Members, including the Leader of the Opposition, voted against it in 2006, 2007 and 2008. Even as late as 2009, they were still voting against an inquiry that would have been here, discussed, debated and finished by now.


Q2. [907259] Lilian Greenwood (Nottingham South) (Lab): If he will list his official engagements for Wednesday 28 January.

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

Lilian Greenwood: My constituents keep telling me that their No. 1 concern is what is happening to our national health service. In Nottingham and across the country, essential services are at breaking point. Given that our NHS did not even make the Prime Minister’s top six priorities for the election, should not everybody who cares about our NHS vote Labour on 7 May?

The Prime Minister: What people need to know about our NHS is that it is this Government who decided to invest in the NHS, ignoring Labour’s advice to cut it. In Nottingham, compared with 2010, there are 158 more doctors, 646 more nurses and the NHS is doing well. What a contrast with Wales, where Labour is in charge—[Interruption.] I know that Labour Members do not like to hear it, but they have cut the NHS by 8% in Wales. Because of Labour, the NHS is doing worse in Wales than in England.

Bob Blackman (Harrow East) (Con): Yesterday marked the 70th anniversary of the liberation of Auschwitz-Birkenau. I welcome my right hon. Friend’s acceptance of all the recommendations from the Holocaust

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Commission, which was set up by this Government. Will he in particular make sure that the lasting monument to that terrible tragedy is accessible throughout the United Kingdom and will he safeguard the funding for the Lessons from Auschwitz project, so ably put together by the Holocaust Education Trust?

The Prime Minister: I am sure that my hon. Friend speaks on behalf of the whole House and indeed the whole country in wanting to commemorate properly the 70th anniversary of the liberation of Auschwitz, and to ensure that here in Britain we properly commemorate the horrors of Auschwitz for years to come. The Leader of the Opposition, the Deputy Prime Minister and I were privileged to meet so many survivors yesterday with the extraordinary stories that they have to tell, but they cannot go on telling those stories for ever, so it is vital that we record their testimony; that we make sure that education about the holocaust is maintained; that we establish this national monument, for which three places have been identified; and that this work goes ahead, starting now with all-party support.

Edward Miliband (Doncaster North) (Lab): Let me first associate myself with the remarks of the hon. Member for Harrow East (Bob Blackman) and the Prime Minister. Yesterday was an incredibly moving and emotional day for anyone who was part of the commemoration. I thank the Prime Minister for the work that has been done as part of the Holocaust Commission and I can confirm absolutely that it will be taken forward on a cross-party basis so that we do indeed keep the memory alive.

Before the last election, the Prime Minister said that he would have a “bare-knuckle fight” to save 29 accident and emergency and maternity units, and he published a list. Can he assure the House that in line with his promise all those services have been protected?

The Prime Minister: I am glad that the right hon. Gentleman has mentioned the NHS, because before we go any further he needs to clear something up. He has now been asked nine times whether he made the disgraceful remarks about weaponising the NHS. Everyone in the House and, I suspect, everyone in the country knows that he made those remarks, so he should get up to the Dispatch Box and apologise for that appalling remark, and then we can take this debate forward.

Edward Miliband: The only person who should be apologising is the Prime Minister who has broken all his promises on the national health service. He did not give us an answer: he toured the country, standing outside hospitals and promising that services would remain open. Let me tell him about a few of those services. The A and E at Queen Mary’s hospital in Sidcup is now closed. The maternity unit in Ilford is closed. The A and E unit in Welwyn is closed. Why did he break his promises?

The Prime Minister: It is very simple: one of the most respected political journalists in Britain, Nick Robinson, the political editor of the BBC, said—and I shall quote it however long it takes—

“A phrase the Labour leader uses in private is that he wants to—and I quote—‘weaponise’ the NHS for politics.”

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That is one of the most respected journalists in our country. Will the right hon. Gentleman now get to the Dispatch Box and apologise for that appalling remark?

Edward Miliband: This is a ridiculous smokescreen from a Prime Minister running from his record on the NHS. The answer—because this is Prime Minister’s questions—is that all those units have closed. Let me give him another one. He stood outside the A and E unit at Chase Farm, with the local MP, saying, “Hands off our hospital. No to cuts, no to closure.” Is the A and E at Chase Farm open or closed?

The Prime Minister: I will tell the right hon. Gentleman my record on the NHS—9,000 more doctors, 6,000 more nurses, hospital-acquired infections right down, investment in our health service up. People rightly want to know what his motives are when it comes to the NHS. If his motives are that he cares about this great national institution, that is fine, but he told the political editor of the BBC that he wanted to weaponise the NHS. I ask him again: get up there and withdraw.

Edward Miliband: I will tell the right hon. Gentleman what my motive is: it is to rescue the national health service from this Tory Government. Frankly, this is a man who has got a war on Wales and is using the Welsh NHS to make political propaganda. This is a man who has broken—[Interruption.]

Mr Speaker: Order. For the avoidance of doubt, however long it takes, the questions from the Leader of the Opposition will be heard and so will the answers from the Prime Minister. That is the situation and the sooner people learn that quite simple lesson, the better.

Edward Miliband: We know the Prime Minister is in a hole on the NHS and this is all he can offer the British people. It is time we had some answers from him. He has broken his promises on waiting times in A and E. He could not defend what he said about maternity and emergency services. Can he explain why this morning new guidance has been issued to some hospitals making it harder for them to declare a major incident?

The Prime Minister: Let me answer that very directly. The NHS in the west midlands, without any instruction from the Department of Health and without any instruction from Ministers, issued a statement about major incidents. The head of NHS England was asked about it this morning and she said this:

“I haven’t been under any political pressure. This document was issued…in the west midlands.”

What a contrast between the operational managers of the NHS and the man who wants to weaponise the NHS.

The right hon. Gentleman mentioned Wales. He criticised me a moment ago for mentioning Wales. He seems to have forgotten that yesterday he said this to the BBC: “It is right to look at problems in Wales and to compare”. That is what he said yesterday. Now, let us look at what happened today in Wales. The Welsh ambulance service statistics have come out and they are the worst ever on record: just 42% of emergency calls are answered

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in time, compared with 70% in England. Will he now admit that Labour’s catastrophic cuts and mismanagement in Wales have cost the NHS dear?

Edward Miliband: The last time the right hon. Gentleman was in charge in Wales, people were waiting two years for an operation. That is the comparison—with what was happening. Everyone will have heard that he did not answer the question about what is happening in the NHS in England. This is what the head of operations at one NHS hospital says:

“This is the enhanced criteria that have been introduced by NHS England to…stop trusts from calling a major incident.”

The whistleblower says the hospital’s hands are being tied. The Prime Minister says they are not. Who does he think people will believe?

The Prime Minister: People will believe the head of NHS England, who said this very clearly this morning:

“Local hospitals continue to have responsibility for deciding whether to declare major incidents”.

It is perfectly clear what is happening: the right hon. Gentleman is clasping at straws because he is in a desperate mess on the NHS. He talks about Wales. Here is the record: per head of the population, 10 times more people in Wales on a waiting list for an operation; nearly twice as many ambulances failing to meet those urgent calls; almost twice as many people waiting for more than four hours for A and E. That is what is happening in the NHS in Wales because Labour Ministers cut its budget. But the reason he is in such a mess on the NHS is this: a week ago the shadow Chancellor said that every penny from their new homes tax would go into the NHS. Yesterday, the leader of the Labour party said he had a plan to pay down the deficit with tax changes such as the mansion tax they have announced. There we have it: 99 days to go before the election and they cannot even have a sensible policy on the NHS. What a completely useless Opposition.

Edward Miliband: We have 99 days to kick out a Prime Minister who has broken all his promises on the NHS. Today’s revelation shows once again that, under him, the NHS is in crisis and under strain. It is a crisis of his making and on his watch, which is why nobody will trust him with the NHS ever again.

The Prime Minister: What a contrast—the Government dealing with the unions to stop the action in the NHS, and a Labour party weaponising the NHS. That is what everyone can see. The right hon. Gentleman talks about what has happened this week. We have seen Labour casting around for a coalition with the SNP and a coalition with Sinn Fein—the first time Britain would have people who want to break up Britain and bankrupt Britain. What a useless shower.

Stephen Gilbert (St Austell and Newquay) (LD): Watching that, I am reminded of that famous Stealers Wheel line:

“Clowns to the left of me, Jokers to the right”.

Eight months ago, the Secretary of State for Communities and Local Government assured people in Cornwall that the delay over resolving the EU funding programme

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would be settled. Eight months later, hundreds of millions of pounds of investment and hundreds of jobs are at risk. Will the Prime Minister please sort out this pickle?

The Prime Minister: I have done my best to run a coalition Government, but I occasionally feel stuck in the middle with the Liberal Democrats.

The Government are delivering for the west country: we are sorting out the transport links and the local growth deals; putting money into road and rail connections; and helping with the vital airport and the routes back to London—and we will go on, because we want to close the income gap between the south-west and the rest of our country.

Q3. [907260] Lyn Brown (West Ham) (Lab): Care workers deliver the most basic support needed to provide a life of dignity to so many—bathing, cleaning, dressing, feeding—yet 300,000 fewer older people are enjoying that dignity now than four years ago. Is that because they do not need it, or because the Prime Minister has cut care budgets by £3.5 billion, while cutting taxes for millionaires?

The Prime Minister: The Government have put £3.2 billion of health money into social services, and the better care fund will start on 1 April, putting £5.3 billion into social care—something Labour argued should be delayed. However, there is a question that the hon. Lady has to answer. The shadow Chancellor said—he could not have been clearer—that

“there will be no additional funding for local government”,

which includes social services,

“unless we can find money from somewhere else…but we have not been able to do that in the case of local government.”

This is what Labour does. It goes round the country, promising more money for this, more money for that, and in its few moments of honesty, it reveals that it has not got any more money.

David Tredinnick (Bosworth) (Con): Does my right hon. Friend recall that, not long after the liberation of Auschwitz, the British Army liberated another camp, Bergen-Belsen, freeing 60,000 starving inmates, many of whom were saved by British medical services? Does he also recall that our allies at the time, the Russians and the countries of the former Soviet Union, in their struggle to defeat Nazi Germany, lost 40 million civilians and soldiers? Should we not pay them some tribute too?

The Prime Minister: My hon. Friend is absolutely right. We should pay tribute to all those who helped to defeat the evil of Nazi Germany. It is a good day to pay tribute to the British soldiers who liberated Bergen-Belsen. At the Holocaust memorial event yesterday, a tape of Richard Dimbleby’s incredibly moving testimony of what he and those soldiers found at Belsen was played for everyone to hear, and we should be very proud of the role that British soldiers played in liberating these appalling death camps.

Q4. [907261] Sandra Osborne (Ayr, Carrick and Cumnock) (Lab): Last week, the Institute for Fiscal Studies revealed that poorer families had lost most under the Prime Minister’s tax and benefit policies. What happened to his promise that this Government would be the most family-friendly ever?

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The Prime Minister: The IFS report found that the richest had paid the most to reduce the deficit, so we should be clear about the figures: the richest 20% have paid more to reduce the deficit than the remaining 80%. If the hon. Lady wants to quote the IFS, she might want to remember that it said:

“We’ve had a great big recession. We had the biggest recession we’ve had in 100 years…it will be astonishing if household incomes haven’t fallen and earnings haven’t fallen”.

That is the view of the IFS, and it is right. It also says that the shadow Chancellor’s plans are for an extra £170 billion of borrowing, so if Labour is going to quote the IFS, it should accept its figures for more spending, more borrowing and more debt—all the things that got our country into this mess in the first place.

Richard Harrington (Watford) (Con): The Prime Minister will be aware that Watford GPs were among the first in the country whose practices received money under the Prime Minister’s challenge fund, so that GPs’ surgeries can be open seven days a week from 8 o’clock in the morning till 8 o’clock at night. I would like to commend Dr Mark Semler, who is the mastermind behind this. I hope the Prime Minister agrees that it should be continued and would be absolutely excellent for all GPs’ surgeries in the country.

The Prime Minister: My hon. Friend is absolutely right. The challenge fund we have set up has already allowed 4 million people access to a GP surgery seven days a week, from 8 in the morning to 8 in the evening. I am delighted that people are benefiting from this in Watford; I want to see it spread right across the country. It would be an important part of the answer to relieving pressure on our A and E units as well.

Q5. [907262] Mr Dennis Skinner (Bolsover) (Lab): If the Prime Minister will not apologise for the A and E closures, maybe he will have a go at the following subjects. Why is it that we have a record number of people queuing up at food banks? Will he apologise to them? Will he apologise to those who are on payday loans, struggling to pay them back? Will he apologise to those on zero-hours contracts, another record number? The truth is that this Prime Minister has got a longer record than his mate Andy Coulson.

The Prime Minister: The hon. Gentleman mentions zero-hours contracts. The Government he supported did nothing about them; we have legislated. He mentions payday lending—an industry that boomed under Labour; regulated properly under this Government. He talks about queues. What about the queue of people who have been getting jobs under this Government—over 1,000 a day?

I have to say, I thought the hon. Gentleman might have taken a different tack today, because if you read the newspapers, you can get quite nostalgic. You’ve got Blairites fighting Brownites; you’ve got Peter Mandelson taking out a great big loan. I thought the hon. Gentleman might get all nostalgic on us; it is just like the old days.

Q6. [907263] Mr Tim Yeo (South Suffolk) (Con): Britain’s economic success is making it possible for the northern powerhouse to transform the fortunes of an important part of our country. Does my right hon.

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Friend agree that investment in science, such as in the new institute for advanced materials—the Henry Royce institute—supports our top universities and will promote innovation, which will bring back high quality manufacturing jobs to the north of England?

The Prime Minister: My hon. Friend is absolutely right to raise this. One of the most important decisions we took while making difficult spending decisions was to maintain the investment into science. We have also improved our universities by making sure they are properly funded. This combination of science and universities is going to be an absolute key to Britain’s future economic success. I am delighted that we have got the £235 million investment into the new Sir Henry Royce Institute for Materials Research and Innovation in Manchester. This is a key part of the northern powerhouse project, which is going to properly rebalance our economy and make sure we see growth and prosperity in every region.

Q7. [907264] Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op): Absolute poverty up by 300,000, the rise of the working poor and very seriously sick people impoverished while they wait for their benefit—is the Prime Minister proud of this record?

The Prime Minister: I am afraid that the hon. Lady’s statistics are simply wrong. I know Labour does not like to hear this, but the fact is that there are 600,000 fewer people in relative poverty than there were at the election and 300,000 fewer children in relative poverty. Inequality is lower than it was at the election and we can now see 1.75 million more of our fellow countrymen and women in work. Behind all those statistics are people who are able to go out, earn a wage, have a pay packet and support their families. I would have thought the Labour party of all parties would want to support that.

Q8. [907265] Simon Hart (Carmarthen West and South Pembrokeshire) (Con): My constituent, Kelly Thomas, has been waiting nearly 15 months for urgent bowel surgery, which, if she lived in England, she could have had in six weeks. NHS Wales refused her treatment on the basis that it is technically available in Wales, although ironically there are no surgeons available to do it. Someone somewhere needs to make a common-sense and humane decision. I hope the Prime Minister can help that happen.

The Prime Minister: I will look at this case. It sounds as if it is a very sad case but, I am afraid, not an isolated case. As the Welsh National Audit Office found, overall, Welsh patients face shorter waits for treatment in England than they do in Wales. That is a fact. What we need is a change of direction in Wales from the Labour Administration: instead of cutting the NHS, they should be investing in the NHS; instead of leaving the bureaucracy in place, they should be taking it out of the NHS. In short, they should be taking a different track, so that we give people a better NHS.

Mrs Madeleine Moon (Bridgend) (Lab): Yesterday, Mr Speaker graciously allowed the all-party parliamentary group on motor neurone disease to use his state apartments for the launch of its report, which demonstrates that people with motor neurone disease are having grave problems accessing the funding available for communication support in England. Some 30% of people with motor

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neurone disease will die within a year, and 95% will lose their voice. Will the Prime Minister meet the Motor Neurone Disease Association to sort out why these delays are happening in NHS England? Will he agree to fund communication support so that the association can provide it quickly and effectively while the NHS gets its act in order, so that no one dies without being able to communicate their last thoughts to their loved ones?

The Prime Minister: First, let me commend the hon. Lady and others across the House for the work they do on motor neurone disease. Anyone who has known someone who has suffered from that disease—as I have—realises that it is a most appalling, debilitating condition, which is very difficult for families to cope with. I will certainly look at the report the hon. Lady has produced and make sure that the proper meetings are held with the Department of Health, so we do everything we can to support these people and allow them, as she says, to communicate with their families up until the last moment.

Q9. [907266] Dr Julian Huppert (Cambridge) (LD): It is now clear that the decision by the last Government to put Hinchingbrooke hospital out to tender, with the last three bids under that Government all being led by the private sector, was deeply flawed and has been a massive failure. Does the Prime Minister accept that this experiment in privatisation has failed and that the future of Hinchingbrooke hospital should be fully within a public NHS?

The Prime Minister: It is important that we make decisions based on what will be best for patients. My view is that there is a role for the independent sector within the NHS, but it has only gone from something like 5% of the total to 6% of the total. [Interruption.] It is no good Opposition Members shouting about privatisation: it was their decision to allow this hospital to be run by the private sector. Frankly, on a day when they are in complete confusion about their health policy, we have the shadow Health Secretary saying he opposes all of this but cannot say what percentage should be in the private sector; we have his deputy saying that they want to see more of the NHS in the private sector; we have the Leader of the Opposition refusing to confirm that his shadow Secretary of State has his full confidence—yet this is meant to be Labour’s great big election-winning idea. What a complete shambles!

Q10. [907267] Clive Efford (Eltham) (Lab): The Prime Minister, his Chancellor and the entire Conservative party like to talk about their “economic plan”. An independent report published yesterday by a group of academics—[Interruption.] I can wait. The report shows that welfare cuts contributed merely to cutting tax for higher earners and contributed nothing to reducing the deficit. It also shows that families with children under the age of five have been the hardest hit. What future is there for the country with an economic plan that steals from the poor and gives it to the rich?

The Prime Minister: It is the “long-term economic plan”, by the way.

Let me tell the hon. Gentleman how things are going in his own constituency. Never mind the academics; let us see what is happening for working people in

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his constituency. The number of people claiming unemployment benefit is down by 31%, the youth claimant count is down by 34%, and the long-term youth claimant count is down by 57% in the last year alone. If we look across London, we can see 470,000 more people in work, and more than half a million private sector jobs have been created.

What I want to know is this: when did the Labour party become the welfare party? When did that happen? It is Members on this side of the House who are standing up for hard-working people, and who are on the side of work and on the side of enterprise, reforming work and, yes, reforming welfare to make that happen.

Q15. [907272] Eric Ollerenshaw (Lancaster and Fleetwood) (Con): As part of the Prime Minister’s long-term economic plan to rebalance the British economy, will he continue to support Britain’s coastal communities, such as Fleetwood in Lancashire, to make up for 13 years of neglect by the last Labour Government?

The Prime Minister: My hon. Friend is absolutely right about the importance of investing in our coastal communities, and that is what we have done through our coastal communities fund. So far more than 200 projects have benefited, creating or safeguarding more than 16,000 jobs. I know that Fleetwood received a boost from the fund last year, when Wyre council was given a grant to develop new tourist attractions, but I want to see more happen to help my hon. Friend’s constituents and to help our coastal communities, of which Fleetwood is such an important part.

Q11. [907268] Thomas Docherty (Dunfermline and West Fife) (Lab): The Prime Minister will be aware of the remarkable work that is being done on the Clyde and at Rosyth dockyard to build the country’s new aircraft carriers, but, just as our country needs a new generation of aircraft carriers, Scotland needs a new generation of young skilled workers. Will the Prime Minister guarantee that he will use the procurement power of the Ministry of Defence to deliver real apprenticeship opportunities to young Scots?

The Prime Minister: Of course we will do that. Those who visit the aircraft carriers being built on the Clyde will see that an enormous amount is being invested in apprenticeship numbers, and that that investment is of huge benefit. Moreover, the carriers have not just benefited Scottish apprenticeships, because they have been built, in part, all over the United Kingdom. Let me also make this point: we can only afford to make these decisions because we have a long-term economic plan and a strong economy.

Q12. [907269] Richard Drax (South Dorset) (Con): I know that I do not need to remind the House that 453 members of our armed forces lost their lives in Afghanistan, and that many more were wounded, some seriously. Although we have brought home most of our troops, the 400 men and women of 2nd Battalion The Rifles are still serving in Kabul with great distinction in support of Government forces. Does my right hon. Friend agree that it is time that we recognised the efforts of all who served in that war with a commemorative event?

The Prime Minister: I very much agree with my hon. Friend.

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All British combat troops had left Afghanistan by the end of last year, fulfilling the commitment that I made nearly five years ago. On Monday my right hon. Friend the Defence Secretary welcomed to Parliament the final homecoming parade of our combat troops who had been deployed in Afghanistan, and I am pleased to announce today that on 13 March we will hold a special service of commemoration in St Paul’s cathedral and a military parade to mark the end of combat operations in Afghanistan.

I believe that this is a fitting moment at which to pay tribute to the extraordinary contribution made by our armed forces in Afghanistan over 13 years. During that time, 453 lost their lives, and many more were injured. Their mission has helped to prevent Afghanistan from being used as a base from which to launch attacks on us here at home, and they have enabled Afghanistan to begin the task of looking after its own security in the years ahead. The whole House—indeed, the whole country—is right to be incredibly proud of our armed forces, and of all those who served in Afghanistan.

Jeremy Corbyn (Islington North) (Lab): Has the Prime Minister had a chance to place a call to Alexis Tsipras, the new Prime Minister of Greece, in order to congratulate him on winning the election, and also to learn from him why the people of Greece have finally said no to the imposition of the most appalling austerity, the destruction of their public services, high levels of unemployment, and deepening poverty? Will the Prime Minister use his good offices in the European Union to ensure that they are given the debt write-off they are so desperately seeking, so that Greece can be restored to the prosperity it deserves to enjoy?

The Prime Minister: I have had the privilege of speaking to the new Greek Prime Minister; indeed, I asked him what his long-term economic plan was. What I think is absolutely key to recognise is that over the last four years we have seen the British deficit come down, and we have seen jobs created and the economy bigger than it was before the crash, whereas in Greece they have had repeated economic failures, and we can hardly blame them for wanting to take a different approach. I hope good sense will prevail on all sides, and, as I said to the Greek Prime Minister, there are other areas where we can work together, not least because Britain has led the world on tax transparency and making sure companies pay the taxes that they should—something that needs to happen in Greece as well as in the rest of the European Union.

Q13. [907270] Roger Williams (Brecon and Radnorshire) (LD): General practitioner recruitment is a problem nationally but particularly for rural practices. Many GP practices on both sides of the England-Wales border serve patients from both nations. What can the Government in Westminster do, through working constructively with the Welsh Government, to promote training and recruitment of GPs so these practices remain viable and sustainable?

The Prime Minister: One of the things we can do is share ideas with the Welsh Assembly Government. One thing we are pioneering here is making sure newly qualified doctors are offered special payments if they become GPs, and this is part of a £10 million plan we have to recruit even more. In England we have 1,000 more GPs working than we did back in 2010, and I hope the

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NHS in Wales will, while it is underfunded by the Labour Government in Wales, look at creative ideas like this.

Julie Hilling (Bolton West) (Lab): StepChange has reported today that the average debt of Bolton residents is £11,000. Does this not show that my constituents are suffering because of the Prime Minister’s failure to deal with the cost of living crisis?

The Prime Minister: The hon. Lady’s constituents are benefiting from the fact that the economy is growing, our deficit is coming down and we are creating jobs, but we are dealing with the debt crisis which her Government put in place in our country. That is what is happening, but every day, the British economy and the British country is getting stronger; every day, the Labour party is getting weaker.

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Q14. [907271] Andrew Jones (Harrogate and Knaresborough) (Con): New figures show that, as a result of the focus on earlier diagnosis, increased access to treatments and the latest medicines, 12,000 more patients every year are now predicted to survive their cancer than just five years ago. Does the Prime Minister agree that while this is very encouraging, there is a long way to go and we have to maintain our focus on fighting cancer?

The Prime Minister: My hon. Friend is absolutely right. What we see in our country is a 50% increase in cancer referrals, which means we are identifying cancers earlier and treating them better, and we also have the Cancer Drugs Fund, which has helped 60,000 patients. We need to go on with these improvements, but we will only be able to do that if we have a strong economy backing our strong NHS.

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NHS Major Incidents

12.38 pm

Andy Burnham (Leigh) (Lab) (Urgent Question): To ask the Secretary of State for Health if he will make a statement on what guidance has been issued by NHS England on declaring a major incident.

The Secretary of State for Health (Mr Jeremy Hunt): As you know, Mr Speaker, I am always happy to come to the House to discuss the NHS, but today we have been brought here to discuss a local operational issue that, regrettably, the Opposition have tried to spin as part of their policy to “weaponise the NHS.”

As I said to the House earlier this month, a major incident is part of the established escalation process for the NHS, and has been since 2005. It enables trusts to deal with significant demands, putting in place a command and control structure to allow them to bring in additional staff and increase capacity. It is a temporary measure taken to ensure that the most urgent and serious cases get the safe, high-quality care they need.

The decision to declare a major incident is taken locally, and there is no national definition. We must trust the managers and clinicians in our local NHS to make these decisions and support them in doing so by ensuring that there is sufficient financial support available to help them to deal with additional pressures. The document that has been questioned this morning by the Opposition Health spokesman was issued by the local NHS in the west midlands. That was done to help its clinical commissioning groups to work with local NHS organisations to deal with the unprecedented pressures they have been facing this winter. The chief operating officer of NHS England, Dame Barbara Hakin, has said this morning that this was a local decision and neither the responsibility of Ministers nor the result of pressure by Ministers.

Let me finish by praising the NHS for coping well with the unprecedented pressures. Performance against the A and E standard improved to 92.4% last week, which is testament to hard-working staff, and this Government will support them, not try to turn their efforts into a political football.

Andy Burnham: In the first week of January, at least 14 trusts across England declared major incidents, including three in the west midlands. Official figures show that pressure continued into the second and third weeks of January, with only seven A and Es out of 140 meeting the Government’s target. There were ambulance diverts, and even an A and E closure, but no further major incidents were declared. On 7 January, when the Health Secretary was called to the House to answer an urgent question, he said:

“The decision to declare a major incident is taken locally—there is no national definition”—[Official Report, 7 January 2015; Vol. 590, c. 273.]

He has just repeated that now, and called this a “local operational issue”, but that does not appear to be entirely accurate. Let me quote from the guidance that was sent in the middle of January. It is headed “NHS England” and it states:

“Major incidents should be agreed with…the Director on call for NHS England”.

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Will the Secretary of State now withdraw his earlier statement to the House and confirm that this decision is not purely local, in that it has to be approved by NHS England?

Let me turn to the impact that this has had on trusts. There are 17 enhanced criteria set out, including requirements that may cause serious time delays for trusts in an emergency. For instance, there is a requirement on the on-call CCG manager to visit the trust and undertake a review. Let me tell the Secretary of State how those new rules were perceived by senior managers. I shall quote from an e-mail sent by the head of operations at one trust, who said that the requirement had been

“introduced by NHS England to effectively stop trusts from calling a major incident…Our hands will be tied in most cases if they wish to call a major incident for capacity reasons”.

Is the Secretary of State confident that the new enhanced criteria are not unduly burdensome and will not cause unnecessary delays for a trust in an emergency situation? Is he satisfied that this guidance is consistent with good practice at national level and safe to be left in place?

The Secretary of State has used the word “local” many times today, and spoken of the only consideration being relieving pressure on hospitals facing severe demand. However, his claim that this matter is purely local is called into serious question right now by this 86-page document headed “NHS England”—[Interruption.] He says it is from the local team, but this is a regional function of the national body, NHS England. The local claim will not wash, I am afraid.

I will tell the Secretary of State what the guidance tells trusts to take into account. He says that it concerns only operational matters, but section 7.2.3 is headed “Politics”, and subsection (a) asks:

“Is there increasing involvement of senior command and control tiers, political involvement or excessive media coverage?”

Subsection (c) asks:

“Is there a risk of reputational damage?”

Does not this muddy the waters hugely? Will it not distract doctors whose sole focus should be on the emergency situation, and not on media and political considerations that should form no part of their judgment? If the Secretary of State agrees with me on that, will he today instruct NHS England to withdraw this guidance and issue more appropriate instructions to the NHS in the region? The NHS remains under serious pressure, and it needs the clearest of instructions based on what is best for patients. Will he act today, so as to leave the NHS in no doubt that that must be its paramount and only concern at all times?

Mr Hunt: In the right hon. Gentleman’s desperate desire to weaponise the NHS, I am afraid that Labour has sunk to new depths today. He said in the media this morning that the Government had put news management over patient safety. That is ironic coming from him, given that so many officials testified to Francis about the pressure they were put under not to come out with bad news when he was Health Secretary. Even the head of the Care Quality Commission was roasted because she wanted to publish details of the problems that were happening in the NHS under Labour and he did not want that to happen when he was Health Secretary. That news management stopped the moment he walked out the door, and those days are over.

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As confirmed by NHS England this morning, this was an operational decision; it was nothing to do with Ministers. This was the local NHS doing its best to get good guidelines out in a tough winter. [Interruption.] It is a local decision. The right hon. Gentleman is the man who talks—he did not deliver this in office—a lot about integration. It is absolutely right that a local hospital should talk to the rest of the local NHS to check about the impact of any decision it makes on major incidents, to make sure that patients are treated safely—is he now saying to this House that local hospitals should not talk to the rest of the NHS? That is what these guidelines say. This was a period when we had 16 major incidents, but that number has gone right down because performance on accident and emergency is significantly—[Interruption.] This is the underlying point, because the reason we have fewer major incidents is that A and E performance has got better. This is the week when we discovered that public satisfaction with the NHS jumped five points last year. This is the week when NHS unions have put patients first by suspending their strike, and Labour focuses not on patients, but on politics. On patients, he did not want to talk about the Welsh ambulance service publishing its worst ever figures, although the Labour leader says that we should be looking at what is going on in Wales.

Let us be clear: where Labour runs the NHS we have double the number of people waiting at A and E; double the number of people waiting too long for ambulances; and 10 times the number of people waiting for their operations. We have seen Labour today in Wales and Labour before covering up around Mid Staffs, ignoring patients and weaponising the NHS for political advantage—has the right hon. Gentleman not proved today that Labour is still not fit to run the NHS?

Dr Sarah Wollaston (Totnes) (Con): Our hard-working NHS staff and, more importantly, patients need to have absolute confidence that the Secretary of State will never lean on operational decision making in these circumstances and will always allow that decision making to take place at the appropriate local level, backed, if necessary, by national guidance.

Mr Hunt: My hon. Friend is absolutely right to say that. It is why many people in the NHS will be so astonished to hear the shadow Secretary of State, who presided over a culture where precisely that kind of leaning from on high happened, making it difficult for people to make those local operational decisions in the interests of patients, now trying to make a political point. This was a local decision and it was confirmed today that Ministers had no involvement in it, and Labour should stop trying to score political points.

Barbara Keeley (Worsley and Eccles South) (Lab): This Government caused confusion about decision making and accountability because of their reckless and expensive restructuring of the NHS. Now, to achieve what the Secretary of State wants to achieve, he has to resort to the sorts of measures we are discussing. We have had two major incidents declared in local hospitals in Salford in one week recently, and I have great concerns that this sort of guidance means that it is harder for clinicians to take the steps necessary to resolve the A and E crisis. They should not have to think about the issues listed in this document: politics and whether there is a risk of

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reputational damage. I do not want Salford Royal hospital and the Royal Bolton hospital thinking, “We can’t do this because of reputational damage.” This should be done entirely on the basis of clinicians’ reasoning.

Mr Hunt: That advice was issued in the west midlands, and not in Salford. The hon. Lady talked about the reorganisation. Well, that reorganisation means that we have been able to afford 82 more hospital doctors and 589 more nurses in her area, which is helping her constituents. Salford is one of the best examples of integrated care in the country, which is why any hospital declaring a major incident should think about the impact on the rest of the NHS locally. That is what the guidance says.

Mr Peter Bone (Wellingborough) (Con): The shadow Secretary of State is a very honourable gentleman, but he might live to regret this political football stuff. In north Northamptonshire, my hon. Friend the Member for Kettering (Mr Hollobone), the hon. Member for Corby (Andy Sawford) and I are working together on local decisions about our A and E. Surely that, and not political football, is the way forward.

Mr Hunt: My hon. Friend is absolutely right. I have spoken to the chief executive of Northamptonshire county council and I have heard about the excellent integration of services that is now starting to happen between the local authority and the local hospital. That is the way forward. The guidance simply says that trusts must pay attention to the impact on the local health economy before they make a local decision. It is time that Labour stopped playing politics with something that they know is a disgrace.

Grahame M. Morris (Easington) (Lab): Is the Secretary of State satisfied that the new guidance with its 17 criteria, to which my right hon. Friend referred, will not have the effect of making it less likely that NHS hospital trusts in the west midlands or in my region declare an emergency plan?

Mr Hunt: Declaring a major incident is the decision of the local hospital trusts, and that is right. But it is important that, before they make that decision, they should take proper account of the impact on the rest of the local health economy. That is what every responsible hospital wants to happen, and that applies to the hon. Gentleman’s area as well as everywhere else.

Mr Bernard Jenkin (Harwich and North Essex) (Con): Following the declaration of a major incident at the accident and emergency unit of Colchester hospital, we now await the Care Quality Commission report into that incident, which will be published very shortly. We want the report to tell the truth, but it is harder to tell the truth in a political atmosphere where there are people who want to gloat over these challenges to get votes.

Mr Hunt: My hon. Friend is absolutely right. I have spoken to the chief executive of the hospital, and I must say that she and her staff are doing a good job in turning around a very difficult situation. What they want is support. We have issued sensible guidance that tells hospitals that if they declare a major incident, they

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must take account of the impact on the rest of their local health economy. A responsible Opposition would support such guidance, and not to try to turn it into a political football.

Valerie Vaz (Walsall South) (Lab): The Manor hospital had to declare a major incident due to inordinate pressure from the closure of Stafford A and E. That is not a local issue, but a national one. When will the Secretary of State provide the hospital with the extra money to absorb the closure of Stafford A and E?

Mr Hunt: I can reassure the hon. Lady that we have provided a huge amount of extra money to deal with the problems in the wake of what happened at the former Mid Staffs Trust. We are continuing to give every support we can to Walsall and Stoke and other trusts. We have more doctors and more nurses and major changes are happening. The problem in Mid Staffs went on for four long years, and we do not want to wait that time before sorting out the problems.

Paul Burstow (Sutton and Cheam) (LD): Clearly, patient safety must be paramount. We must ensure that any guidance supports the ambition that exists on both sides of this House for a more integrated system that takes into account the capacity across the whole service. Does the Secretary of State agree that what we also need is clarity and certainty over how the NHS and social care will be funded over the life of the next Parliament so that we realise the ambition and potential of the Care Act 2014 and we deliver Simon Stevens’s NHS plan?

Mr Hunt: I totally agree with the right hon. Gentleman. I am sure, too, that he will agree with me that the best way to give the NHS certainty over funding in the future and the increase in funding that it needs to implement the five-year forward view is a strong economy, and it is only this Government who are able to deliver that.

Ms Gisela Stuart (Birmingham, Edgbaston) (Lab): According to some statistics, I have more medics per square mile in my constituency than any other MP. I also have the University Hospitals Birmingham NHS Foundation Trust on my patch and a lot of people who work across the west midlands and in Birmingham. The Secretary of State’s operational guidance, as he has interpreted it, is not perceived in the way that he thinks it is. A and E consultants tell me that they are not just overworked and overstretched, but unsafe. If he thinks the guidance is purely operational without any political interference, will he follow the call of the shadow Secretary of State and say that he will issue a new set of guidance that makes that clear, because it is not how it is seen on the ground?

Mr Hunt: I have great respect for the hon. Lady, so I hope she will understand this: when people are worried about political influence over operational guidance, I do not then issue some political guidance. The only thing that I, as Health Secretary, say in respect of instructions going out is that patient safety must always be the priority, and that is what I have said time after

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time. But then the actual decision about whether to declare a major incident must be taken by people locally. Julie Moore, the chief executive of UHB, is fantastic and absolutely able to make those decisions, and those decisions should not be second-guessed by politicians.

Sarah Newton (Truro and Falmouth) (Con): Does my right hon. Friend agree that it is really important to let NHS England’s local teams—in our case the Devon and Cornwall area team—make decisions with local leaders of hospitals? So many people in the north of Cornwall live closer to Derriford in Devon than they do to Treliske in my constituency. It is only right that NHS England staff closest to the clinicians make those decisions.

Mr Hunt: That is absolutely right, but Members on the two sides of the House hold different views. We believe in devolving power locally and we want local decision-making. We accept that that might mean that sometimes services are slightly different in one part of the country compared with another, but the benefit is that we do get that local knowledge. In the past few weeks, I have spoken to South Western ambulance service, which had particular pressures over Christmas, to ask whether there is anything we can do from the centre. What I want to ensure is that the decisions that keep my hon. Friend’s constituents safe are made locally, because they are likely to be better than any that I could make in Whitehall.

Steve McCabe (Birmingham, Selly Oak) (Lab): The Secretary of State is very reassuring when he says that, under him, the NHS is free from political news management. If that is the case, why does he not free it from the constraints of election purdah, and allow these officials to get on with their jobs without having to second-guess the consequences of some of the decisions?

Mr Hunt: We are not in election purdah. The point is that during election purdah we will continue to publish the weekly A and E performances and other figures from the Office for National Statistics, and that has always been the system. But there is a difference between what is happening in the run-up to this election and what happened in the run-up to the previous election. This time, the CQC is free to speak up, without fear or favour, about the quality of care in every single hospital in this country, and it will continue to do so.

Mr Marcus Jones (Nuneaton) (Con): The Leader of the Opposition and the shadow Secretary of State visited the George Eliot hospital on Monday. The Leader of the Opposition praised the hospital for its progress under this Government. If we consider that, and then look at the way the Opposition come to this House and make political point scoring their No. 1 aim, we can see not only that they are hypocritical but that they want to put politics before patients.

Mr Hunt: I commend my hon. Friend for the support he gives to his local hospital. I visited it and did part of a shift in the A and E department. This was a hospital that, under the previous Government, had one of the highest mortality rates in the country. We introduced a new special measures regime and independent inspections. Labour tried to vote them down, but the result is that that hospital has come out of special measures, forged a

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strong new partnership with UHB and gone from strength to strength. Things are getting better because we are being honest about poor care, and did not sweep it under the carpet.

Mr David Winnick (Walsall North) (Lab): The Manor hospital in Walsall was one of the very first in the west midlands to have to declare a major incident—a level 4 incident. I visited the hospital and saw the number of people on trolleys waiting for more than four hours. I want to pay tribute to the dedicated staff at the hospital—medical and non-medical—for all that was done. But the Secretary of State should not minimise the situation that has occurred. He should recognise that it is a matter not of playing politics but of genuine concern for our constituents.

Mr Hunt: I entirely agree with the hon. Gentleman. He should be reassured that because of those real pressures, which I would never seek to minimise, we put in an extra £4.5 million of funding to his local area, paying for more doctors, more nurses, more community staff and more beds. As he says, we should congratulate the staff in that hospital on their work, and also recognise that, despite those pressures, they have made real progress in improving the quality of compassionate care for the patients in that hospital. They have been very well led by the chief executive, whom I have also met.

Robert Halfon (Harlow) (Con): Last week, the hon. Member for Leicester West (Liz Kendall) came to Harlow and attempted to weaponise the local NHS and scare local residents. A day later an interview was published in which she said that she supported privatisation in the NHS. Does my right hon. Friend agree that the best way to help the Princess Alexandra hospital in Harlow deal with major incidents is to do what the Government are doing, with £5 million extra last year for our A and E, and £4 million extra to help the NHS this year?

Mr Hunt: Indeed, across the country we have put in £700 million, which has paid for 6,400 additional beds in the system. All that is possible because we have a strong economy and we can put extra funding into the NHS. What those people in my hon. Friend’s hospital want most of all is support from Members in all parts of the House, and not to see their efforts turned into a political football.

Mr Barry Sheerman (Huddersfield) (Lab/Co-op): Does the Secretary of State agree that Calderdale and Huddersfield trust was, until 2010, one of the most successful trusts in the country? I have a letter embargoed, ironically until 1 pm today, telling me of serious financial problems—not a major incident—caused by the reforms that his Government have introduced in the NHS. I remind him that it is my job as a member of the Opposition to weaponise—to use as a weapon—the disgraceful policies that his Government have introduced that are destabilising and destroying the national health service in my town and constituency, and up and down the country. I am a member of the Opposition, I will use this as a political weapon, and I will do so until the election, which we will win.

Mr Hunt: I am afraid that the trouble is that there are just too many people on the Labour side who think exactly like that. I suggest that the hon. Gentleman go

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and talk to people working in Calderdale and Huddersfield NHS Foundation Trust and ask them whether they want him to use the NHS as a political weapon in that way. They have improved their performance over the past few years and are seeing more people within four hours—every year, 4,000 more people within four hours than when Labour was in office—and MRSA cases are down. There are 79 fewer clostridium difficile cases; 525 more people are treated for cancer every year; and there are 6,200 more operations every year. Those are real improvements making a real difference to his constituents. He should celebrate them, not try to run them down.

Henry Smith (Crawley) (Con): East Surrey hospital, which is the A and E department that covers my constituency, not least because Labour closed Crawley hospital’s A and E in 2005, has not had a major incident. Can my right hon. Friend confirm that major incidents have decreased because of the extra investment that he has put into the NHS, in stark contrast to Labour-controlled Wales, which has cut the budget?

Mr Hunt: I have been to East Surrey hospital, which is a good example. It, too, has had its share of problems with care, but it has addressed them head on. Standards in the hospital are getting better, and it is encouraging to see that refreshing openness and honesty. We have put more investment into the NHS. Welsh patients are angry, because they can see that openness and transparency about results, combined with strong financial support, not cuts from central Government, lead to better service. Rather than try to create a political weapon in England, Labour should act where they can do something about it—in Wales.

Rosie Cooper (West Lancashire) (Lab): I was recently told by staff in Aintree hospital on Merseyside that, in the interests of patients and patient safety, executives should have declared a major incident. Although the execs teetered on the brink, they feared the political consequences of making that decision rather than doing the right thing. What genuine help and advice can the Secretary of State give execs who face that situation on the front line and help them to do the right thing for patients?

Mr Hunt: If executives did not declare a major incident because they were worried about the political consequences, they were wrong, but I would have to be persuaded that they would do that, because every NHS executive I speak to wants to put patients first, with patient safety paramount. On the practical things that we are doing, there are 60 more doctors, and 41 more nurses since 2010, and £4.5 million to help them through this winter. We are doing a lot of practical things to help the NHS in the hon. Lady’s area through the winter.

Andrew Stephenson (Pendle) (Con): Many major incidents have their roots in things that happened some time ago. Blackburn’s A and E department has been struggling to cope with demand since Burnley’s A and E department was downgraded under Labour in 2007—a decision that the right hon. Member for Leigh (Andy Burnham) defended several times in the House, including on 19 November 2009, when he said:

“‘This is saving lives; I will stand by it’”.—[Official Report, 19 November 2009; Vol. 501, c. 236.]

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On behalf of the residents of Pendle, I urge the Secretary of State to take no lessons from Labour on the management of our NHS.

Mr Hunt: That is it, and that is why it is not working for the Opposition politically when they try to put the NHS centre stage. They can see people who downgraded or closed 12 A and E departments across the country during their time in office now coming to Prime Minister’s questions and trying to criticise this Government when similar things have happened. The answer on all these occasions is to put patients first, do the right thing for patients, be honest about the problems and sort them out, and that is what the Government are doing.

Mike Gapes (Ilford South) (Lab/Co-op): The hard-working and dedicated staff at Barking, Havering and Redbridge trust, at King George hospital in my constituency and Queen’s hospital in Romford, know, because their trust is in special measures, that there has been a lot of reputational damage. On 5 January, elective operations were cancelled—in my personal case, at two hours’ notice; I was not the only constituent who had to go through that—because of A and E pressures in the trust. Can the Secretary of State explain whether hospitals in special measures have a special requirement so that they do not need to declare that they are in the position of hospitals that have made the decision to say that there is a major incident, or is it just coincidental that although operations were cancelled on a large scale on 5 January no major incident was declared at Barking, Havering and Redbridge?

Mr Hunt: I can confirm that there is no difference in any guidelines issued for hospitals in special measures and for hospitals not in special measures. This is a good example of a trust with deep, pronounced problems over many years. There was a terrible tragedy in 2007, I think, when someone gave birth sitting on a toilet seat. This Government have said that we are going to tackle those problems and put the trust into special measures. It has more doctors and nurses: 230 more hospital nurses in the past four years in that trust. We are making a real difference—we have a new management team—and I think that things are beginning to get better in that trust in a way that has not been the case for many years. I hope that the hon. Gentleman would welcome that.

Stephen Mosley (City of Chester) (Con): The shadow Secretary of State called on the Secretary of State to intervene to stop political interference in the NHS. May I ask my right hon. Friend to ignore such siren voices and rely instead on local doctors and local health professionals to make the best choices for our local NHS?

Mr Hunt: My hon. Friend eloquently points out the great irony in what we have heard from the Opposition Front Bench. We do not want an NHS in which every single operational decision is made from behind the Secretary of State’s desk. We want to trust people on the ground. Why do we want to do that?

Andy Burnham: Politics.

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Mr Hunt: Exactly. We do not want politics to get in the way of what is right for patients, which is what happened when the right hon. Gentleman was Health Secretary. It will not happen while I am Health Secretary.

Mark Reckless (Rochester and Strood) (UKIP): Do we have sufficient measures, short of declaring a major incident, to help to relieve hospitals such as Medway, where there has been an ongoing problem of excessive waiting times at A and E?

Mr Hunt: Yes, we have other measures in place. At every stage, trusts should do what is right for patients. Sometimes they declare an internal major incident, sometimes it is an external major incident, but what is important is that they take account of the impact on the rest of the local health economy. At Medway hospital, which the hon. Gentleman mentioned, things are getting better. It has been through a difficult period. We have been honest about the problems, we have given it a lot of external support, and I hope that the news will continue to get better.

Richard Drax (South Dorset) (Con): As we know, one cap does not fit all. That applies to the NHS as much as to anything else. In Dorset the clinical commissioning group is reviewing health services and looking for local solutions to local problems. Does my right hon. Friend agree that that is the long-term solution for the NHS, rather than politicians sticking their noses in where, frankly, they should not be?

Mr Hunt: I absolutely agree with that. What I will not do is go round the media and say that the problems that the NHS is facing in Dorset, as it faces everywhere, are due to the fact that the area is very rural, which is the excuse that we heard over the weekend from the shadow Health Secretary for the poor performance of the NHS in Wales. We want local solutions and the highest possible standards—what we can do is give guidance and funding from the centre and make sure that patients are always put first.

Jack Dromey (Birmingham, Erdington) (Lab): In his attempt to gag hospitals over the growing accident and emergency crisis, the Secretary of State has sanctioned guidance that “we must avoid reputational damage”. Whose reputation? His reputation? Does the right hon. Gentleman not accept that his reputation on the national health service is damaged beyond repair?

Mr Hunt: I will take no lessons in stamping out news stories on poor care because I am worried about the impact on reputation. That is what happened when the shadow Health Secretary was behind my desk, and it was totally unacceptable. That is why we had a clutch of hospitals where poor care was swept under the carpet year in, year out because a Labour Government did not want bad news to come out in the run-up to an election. It was a disgrace and this Government are putting it right.

Diana Johnson (Kingston upon Hull North) (Lab): Two weeks ago I asked the Secretary of State about a comment that had been made to me by a senior clinician

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in Hull that the trust in Hull at Hull royal infirmary had been on internal major incidents on and off since December. The Secretary of State told me that that was not really an issue and that it was down to the trust, but the documents that have been produced today show that the real reason is that it is politically much more expedient to have an internal incident than to declare one externally and get all the bad publicity and reputational risk mentioned in the document to which my right hon. Friend the shadow Secretary of State referred to. That is the case, is it not?

Mr Hunt: Let me make two points to the hon. Lady. When I talk to the House about the number of major incidents, we make no distinction between internal and external incidents. We talk about them all as major incidents. There is no benefit, if one looks at it in that way, to Ministers from it being either an internal or an external incident. What matters is the right thing for patients. Rather than trying to politicise the issue and turning it into a political football, the Opposition should listen to Dame Barbara Hakin, chief operating officer of the NHS, who said clearly today that the decision was nothing to do with Ministers, they did not know about it and it was not taken at the request of Ministers. Labour should concentrate on supporting the NHS where it could do with its help—in Wales today.

Chris Williamson (Derby North) (Lab): The Secretary of State singularly failed to answer the question from my hon. Friend the Member for Easington (Grahame M. Morris) when he asked whether it would be more or less likely that a major incident would be declared as a result of the new guidance. Clearly, if it is less likely,

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that is bound to have an impact on patient safety. Can the Secretary of State confirm whether this issue was raised in his meeting with NHS England on Monday?

Mr Hunt: It was not raised by NHS England on Monday because I did not know about this local guidance, as I had absolutely nothing to do with it.

Clive Efford (Eltham) (Lab): Can the Secretary of State explain why in the incident response plan from NHS England there is an entire paragraph headed “Politics” under the principles for considering an escalation response? In the House on 7 January he said:

“The decision to declare a major incident is taken locally—there is no national definition”—[Official Report, 7 January 2015; Vol. 590, c. 273.]

However, the guidance issued in the middle of January says that major incidents

“should be agreed...with the Director on call for NHS England”.

If it is not political, the Secretary of State owes the House an explanation of NHS England’s involvement and the meaning of that paragraph.

Mr Hunt: The hon. Gentleman has quoted selectively; he has not quoted the whole guidance. If he looks at the whole guidance, he will see that it clearly states that a responsible trust, before it declares a major incident, which is its decision, must make sure that there is not going to be a negative impact on the rest of the economy, because patients must always come first. He is also not saying what Dame Barbara Hakin said this morning —that none of this guidance was anything to do with Ministers.

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Points of Order

Mr Marcus Jones (Nuneaton) (Con): On a point of order, Mr Speaker. On Monday the Leader of the Opposition and the shadow Secretary of State for Health, the right hon. Member for Leigh (Andy Burnham), visited my constituency. I thank the shadow Secretary of State for Health for having the courtesy to inform my office about his visit, in line with parliamentary protocol. However, this is far from the position that the Leader of the Opposition seems to take, as it is his second visit to Nuneaton in this Parliament. On both occasions he has failed to notify the sitting Member of Parliament of his visit. Given the social media response to the Leader of the Opposition’s visit, I would welcome him to my constituency as many times as he can get there between now and 7 May, but—

Mr Speaker: Order. I am extremely grateful to the hon. Gentleman for his point of order. The nub of the matter is not to make some sort of political point. The nub of the matter is that he is complaining that the protocol has not been observed. If the protocol has not been observed, it should be. If it has been, well and good. That is the end of it.

Clive Efford (Eltham) (Lab): Further to that point of order, Mr Speaker. Members have visited my constituency and have not told me they were coming, but I have never been petty enough to bring the matter to the Floor of the House.

Mr Speaker: I am grateful to the hon. Gentleman. It is perfectly in order for the hon. Member for Nuneaton (Mr Jones) to raise a point of order, but it is much better if Members can resolve these matters among themselves, rather than taking up the valuable time of the House.

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Private Rented Sector (Decent Homes Standard)

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

1.16 pm

Laura Sandys (South Thanet) (Con): I beg to move,

That leave be given to bring in a Bill to require private landlords to ensure that any property they let meets the requirements of the Decent Homes Standard; and for connected purposes.

This Bill aims to expect all landlords to comply with the decent homes standard, which we already demand of council-owned and housing association properties. I find it strange that we demand high standards for those properties owned by local authorities and housing associations, yet we do not have the same standards for the homes that families rent from private landlords. Why the difference? We cannot continue distinguishing between tenure, ownership or lobby when setting the standards that we expect of the homes in which our families, our pensioners, our friends and family live.

Why would we discriminate against some tenants merely on the basis of who owns that property, not who lives in that property? The requirements of the decent homes standard are not particularly onerous nor unreasonable. They are standards of decency. Properties must meet the current statutory minimum safety standard for housing. That is not exactly revolutionary. Properties must be in a reasonable state of repair. Is that an unreasonable expectation, particularly when the properties are occupied by families on low income, who lack the ability or finance to do their own repairs?

Properties must have reasonably modern facilities and services. In some of the properties that I go into in my constituency, I am shocked to see that there are no cookers, only microwaves. That captures those families into having to buy expensive food, with a lack of choice and lack of resilience. We should not allow families to have to live with such facilities in private rented properties, when in many cases we, as the community and society, pay those landlords to house those tenants.

Properties must provide a reasonable degree of thermal comfort—that is, efficient heating and effective insulation. Why should those who rent privately have any different level of comfort or, more importantly, have to pay double what council tenants pay for the same level of heat? It is a perverse situation that we set up elaborate Government schemes to get better energy efficiency when improvements to the standard of the housing itself would help those in greater fuel poverty. It is not the people who leak energy; it is homes that are badly insulated.

I represent one of the poorest wards in the United Kingdom and I am passionate about housing as it is at the heart of many of the problems faced by my community. In one ward, 84% of accommodation is privately rented, which creates fundamental challenges. There are some good landlords and some bad landlords. Some make 14% return on their investment year on year off the back of housing benefit, and do not reinvest that into the properties. I am sure that many hon. Members have experienced properties where deprivation can be smelled before they get to the door. There is the smell of damp and the common parts show that the properties are not

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of a standard that we would consider fit to live in. There is a lack of proper ventilation and of care and attention, and they are unsafe for children or the elderly.

Do we not think that everyone deserves a place of security that can be called home, even temporarily? Draughts can be felt driving through flats that are impossible to heat due to rotten windows. There is mould in the kitchens and wallpaper coming off the walls. These are unfit properties and they create a much greater turnover of tenants, undermining community cohesion, disrupting children’s education, breaking links with support services that are so important to many families, and eroding any sense of permanency that would allow families to put down roots.

Furthermore, some of my elderly constituents find some landlords intimidating and will not make a case for repairs or better insulation. I am sure that many hon. Members have made representations on behalf of such people to landlords, if they can be found. Even councils are confused about the standards needed, with some landlords happy to test enforcement standards in court, and often playing what I call legal chicken with the council. Why are we putting up with all this displacement activity to try to establish decent homes for decent people when a clear standard would create a much more transparent and fair set of expectations on all sides?

The housing crisis is a staple part of today’s political lexicon, but it is crucial to remember and to highlight that the housing crisis that we face is, for many, a qualitative one as well as a quantitative one. It is now time to start setting the standard for the tenant rather than on the basis of ownership. Let us look at the quality as well as the quantity of our nation’s housing, because all families, wherever they live, under whatever tenure, deserve decent homes.

Question put and agreed to.


That Laura Sandys, Dr Julian Huppert, Mr Mark Prisk, Mr Stewart Jackson, Mr Andrew Love, Mark Pawsey, Bob Blackman, Mr Jim Cunningham, Mrs Cheryl Gillan, Caroline Lucas and Stephen Gilbert present the Bill.

Laura Sandys accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 6 March, and to be printed (Bill 164).

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Opposition Day

[15th Allotted Day]

NHS (Government Spending)

1.24 pm

Chris Leslie (Nottingham East) (Lab/Co-op): I beg to move,

That this House notes comments from leading doctors and nurses that the NHS is in crisis under this Government, which has wasted £3 billion on a reckless reorganisation; believes an extra £2.5 billion a year should be invested in the health service, including to fund an additional 20,000 nurses and 8,000 GPs, by raising additional revenue from closing tax loopholes, a levy on tobacco companies and a tax on properties worth over £2 million; further notes that the Office for Budget Responsibility has said that the Government’s spending plans in the Autumn Statement would return public spending to a share of national income last seen in the late 1930s, before there was an NHS, and a level which is incompatible with the Government’s claims to be able to protect the NHS; recognises that only four OECD countries have total government expenditure at 35 per cent or less of GDP and that all of these countries have significantly higher charging as a share of overall national health spending than in the UK; and calls on the Government to reconsider the plans set out in the Autumn Statement for even deeper spending cuts, which the head of the Institute for Fiscal Studies has said could involve a fundamental reimagining of the role of the state.

We have discussed already today some of the issues facing the NHS, but when will the Government realise that our health service faces such unprecedented pressures that it is in intensive care and in need of urgent attention if we are to avoid reaching the point of no return?

I want at the outset to set the context for this debate, because it is important that we look at this Administration’s record so far. We know that the numbers of people waiting for more than four hours in the accident and emergency departments of our hospitals throughout the country have grown and grown, but in 2014 almost 1.25 million people waited for longer than four hours. It is true that the number of people going to A and E has been increasing: in the last four years of the last Government, it was rising by about 60,000 a year, but in the last four years it has gone up by 600,000 a year. This is a rapid escalation in the level of strain on our NHS infrastructure, which has a series of causes that fall at the Government’s door.

Mr Jim Cunningham (Coventry South) (Lab): It gets worse. At University hospital in Coventry, we are now back to the bed-blocking of previous Tory Governments as a result of cuts to local government funding for social workers, which means that people cannot be discharged. That is back to the future, as it were.

Chris Leslie: The accident and emergency situation is a barometer of a series of failures across the health and social care infrastructure. I shall certainly deal with some of those questions, as will my hon. Friends.

Mr Simon Burns (Chelmsford) (Con): Will the hon. Gentleman give way?

Chris Leslie: I will give way to the right hon. Gentleman in a moment. My hon. Friend talked about Coventry; last Friday in my constituency in Nottingham I attended

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a summit with health chief executives, the local authority and others. At the A and E department at Queen’s medical centre more than one in four patients waited for more than four hours in the first few weeks in January—a totally unacceptable situation. This is not something that affects only my constituency; it affects those of all my hon. Friends, and probably even that of the right hon. Gentleman, to whom I will be happy to give way.

Mr Burns: I read the motion carefully. It is about the NHS and spending on it, as the hon. Gentleman has illustrated in his remarks so far. Will he explain something that puzzles me? I know that the shadow Secretary of State’s interview with Kirsty Wark on “Newsnight” last night was a car crash, but why is he not opening this debate? He has never been reticent in the past in coming forward to try to weaponise the NHS. Is it because his leader has wrapped him up in cotton wool to keep him away from the public gaze?

Chris Leslie: The right hon. Gentleman raises a number of issues there. He has plenty to puzzle over, and he will always be a puzzled individual. The bigger question is where is the Secretary of State for Health when we are talking about these particular issues? [Hon. Members: “There!”] There he is. He is so anonymous he just did not make any impact on me whatever. I am delighted that he has walked in. He is quite unforgettable, isn’t he?

The NHS has experienced problems not just in accident and emergency departments, as has been said, but across a series of services: missed cancer treatment targets for three successive quarters—15,000 people having to wait longer than the recommended 62 days to start their cancer treatment in the past year. It has not always been like this.

Charlie Elphicke (Dover) (Con) rose

Chris Leslie: The Government inherited a situation in which 98% of patients were seen in accident and emergency departments within four hours. While one in four patients is now waiting a week to see their GP, when Labour left office the vast majority were seen within 48 hours. In January, we know that 14 NHS trusts declared major incident status. [Interruption.] The urgent question today did not really provide the opportunity to clarify the exact words in the NHS England document, so I want to take this opportunity to do so on behalf of my right hon. Friend the shadow Secretary of State.

Charlie Elphicke rose—

Mr Speaker: Order. Members shouting, and then expecting to intervene, do not display great wisdom. The hon. Gentleman can probably do better, and he should certainly try to do so, within the limits of his capacity.

Chris Leslie: I am very grateful, Mr Speaker.

In urgent questions, there is obviously a time limit on our ability to read out quotes from NHS England documents, but there is no such time limit in an Opposition day debate, so let us take the opportunity to spell something out clearly for the record. The Secretary of

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State is here now. I apologise for not noticing him as he came into the Chamber, but he is here now, and that is good, because I can hold this document up and show it to him—it says “NHS England” on the front. He is nodding; he has accepted that point. I turn to page 21, where in paragraph 7.2.3, under the heading—




Government Members want to shout me down. If the Under-Secretary of State, the hon. Member for Battersea (Jane Ellison), is patient I will read out the full quote from the NHS England document. It refers to principles for considering escalation and the responses to be had. Paragraph 7.2.3, under the heading “Politics”, says:

“(a) Is there increasing involvement of senior command and control tiers, political involvement or excessive media coverage?

(b) Is there a requirement to bolster or assure public confidence?

(c) Is there a risk of reputational damage?”

I do not understand why an NHS document contains those exact words. The Secretary of State can probably read them from there, across the Table—he is nodding again. Yet only a few minutes ago he denied that NHS England had such a document. What am I holding up—a mythical piece of paper? We can now at least establish that NHS England has been issuing documents suggesting that reputational damage and politics need to be taken into account when preventing major incidents. We have now at least had the opportunity to read into the record, as Hansard will reflect, the full text of that NHS England document.

This is the set of situations and circumstances that the NHS faces: pressures on A and E departments, pressures on cancer treatment, and pressures on the major incidents as we have seen. Why are things in such a fragile and critical state? The Government took £3 billion out of elderly social care and wasted it on a £3 billion reorganisation of the NHS that nobody voted for and nobody wanted. They are cutting corners and rushing the care that is needed to help the frail elderly to stay out of hospital. What greater example of a false economy could there be?

Mr Marcus Jones (Nuneaton) (Con): Given the hon. Gentleman’s comments about the adult social care budget and the Opposition’s complaints about the money that has been taken from local authorities, will he commit to giving the money that he says has been taken from local authorities back to them in the next Parliament, should we have the misfortune to have a Labour Government?

Chris Leslie: That was a very helpful intervention. I thank the hon. Gentleman, who has only a number of months to go in his current job. We have explained how we can hire a further 5,000 home care workers, a further 3,000 midwives, a further 20,000 nurses and a further 8,000 GPs through the time to care fund—the £2.5 billion a year that is fully costed and fully funded. I will methodically go through the detail of how we pay for that—he need not worry about that.

Stella Creasy (Walthamstow) (Lab/Co-op): Let us take this debate back to the people we care about most—the patients, such as the mum who got in touch with me today who had rung her local GP 28 times to try to get through to get an appointment for her daughter, and whose friend had been told, “Don’t risk it—go to A and E because we simply cannot see our doctors.”

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Does my hon. Friend agree that the fragmentation of the NHS has made it much harder to hold to account our local health care services such as the Royal Free trust?

Chris Leslie: I am glad that my hon. Friend mentions the situation with GP numbers, which is another factor in the NHS infrastructure being under such pressure.

Let us look at what has been happening with GP numbers, which are not keeping up with demand in the rising population. In 2009, there were 62 GPs for every 100,000 people; that has now fallen to 59 and a half GPs per 100,000 people. We have also seen cuts to GP training. It is no wonder that the Government ditched the 48-hour guarantee for people to be able to see a GP.

Charlie Elphicke rose—

Chris Leslie: I will give way to the hon. Gentleman if he can explain why the Government dropped the pledge that patients, including his constituents in Dover, should be able to see their GP within 48 hours.

Charlie Elphicke: Can the hon. Gentleman explain why he, rather than the shadow Health Secretary, is leading this debate? Is it because the shadow Health Secretary is reported to be clinging to his job, without any guarantees from the Leader of the Opposition?

Chris Leslie: There you have it, Madam Deputy Speaker. Government Members are not concerned in any way about the state of the NHS or about GPs, but only about asking questions about procedure and process. I am here today because the shadow Treasury team, like every shadow departmental team on the Labour Front Bench, is committed to supporting our NHS and to making sure that we get the investment that is needed.

Why is the situation so fragile? The Government scrapped NHS Direct and fragmented it into 46 separate, cut-price 111 contracts, which does not ensure that 60% of calls are dealt with by medical staff. That figure is now down to 20%. It is no wonder patients are so quickly being driven back to—[Interruption.]

Madam Deputy Speaker (Dame Dawn Primarolo): Order. Minister, I heard what you said to your Back Benchers and it is out of order. The hon. Member for Wyre Forest (Mark Garnier) will disregard the advice from the Minister. I will not embarrass the Minister by saying exactly what it was, but I will not hear him say it again.

Chris Leslie: That is rather curious, Madam Deputy Speaker. I would be quite interested to know what the Minister was saying. Perhaps the hon. Member for Wyre Forest (Mark Garnier) heard it. What did the Minister say to him?

Mark Garnier (Wyre Forest) (Con): I have to confess that I did not hear it—I do apologise—but it would have been very sound advice.

I am curious. As we have a shadow Treasury Minister here, perhaps this is an opportunity for him to explain to my constituents what he proposes to do to help them. It is important to remember that one of the very first things the Labour Government did when they came

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to power was to close the A and E department at Kidderminster hospital and downscale that hospital. As a result, Labour policies were so massively hated by my constituents that they voted in an Independent, Dr Richard Taylor. That demonstrated just how unpopular Labour’s NHS policies really are.

Chris Leslie: Labour Members are absolutely committed to saving the national health service from the fate that would befall it should the hon. Gentleman’s party have a further five years in office. We will absolutely not apologise for fighting tooth and nail to do what we can about, for instance, the staffing crisis that the NHS also faces.

Dr Sarah Wollaston (Totnes) (Con) rose

Chris Leslie: Before I give way to the hon. Lady, I shall tell her what is happening with staffing in the NHS. The NHS is now spending a further £500 million a year on agency nurses. Six thousand nurses who were trained in the UK have left the country and gone elsewhere, and 4,000 nurses are coming from overseas to try to back-fill some of those places. We are spending a fortune, day after day—far more than we ought to be—on these more expensive agency nursing staff. I know that as Chair of the Health Committee, the hon. Lady has a view on agency nursing within the NHS. Is she really content with the situation?

Dr Wollaston: I will write to the hon. Gentleman on that point, which is very important, but I wanted to respond to his question to my hon. Friend the Member for Dover (Charlie Elphicke) about why we dropped Labour’s policy of 48-hour access. I will tell him why, as a former GP who was there at the time: it was because patients could not get advance appointments. It caused enormous distortion of clinical priorities, and it was absolutely right that it was dropped, as called for by the profession. It was a ridiculous policy and it is absolutely right that it has been dropped.

Chris Leslie: The hon. Lady should know that there were provisions for advance appointments in the system that we had. Given that we have these pressures, with GPs being totally overstretched and having more and more people to deal with, and the shrinking number of GPs per head of population, she should not be surprised that we are in this situation. We have to do more to recruit and train more GPs. That is part of the way in which we would save the NHS from the situation that it is facing.

When all these different factors are combined with the high levels of winter flu and the growing population, we have an NHS in crisis—but there is an alternative. Yes, we have to repeal the competition-driven Tory changes, but we also have to deliver a sustained increase in resources and a fund designed urgently to alleviate the pressures. That is why, as shadow Chief Secretary, I want to take the time to talk about our £2.5 billion fund.

Tim Loughton (East Worthing and Shoreham) (Con): I am grateful to the shadow Chief Secretary, because I have sat quietly and listened to 16 minutes of his speech trashing the NHS. Will he take the opportunity to

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congratulate staff at Worthing hospital who, in very difficult circumstances, have met waiting times targets in above 98% of cases? Will he congratulate the staff who have cut hospital-acquired infections by 50% since 2010? Will he congratulate NHS staff who have reduced the number of people in mixed-sex wards from 11,802 in 2010 to 170? May we hear some good news about the staff who are doing a really good job?

Chris Leslie: We will hear this time and again from the Conservatives. They want to gag us when we dare to criticise their record on the NHS. We are not going to be quiet about it. We are going to fight for the future of the NHS. I would tell the hon. Gentleman that we do not have any criticisms of the staff in the NHS, or even of the managers who are trying their best in very difficult circumstances to keep the NHS on an even keel. He should know about the BUPA contracts in his West Sussex hospital—

Tim Loughton indicated assent.

Chris Leslie: The hon. Gentleman nods. Those contracts have greatly destabilised his local hospital. He voted for that in the then Health and Social Care Bill, which was designed to drive competition all the way through the NHS by stealth, and what a mess it has created in his own patch. I am happy to give way to him if he wants to apologise to patients in West Sussex for the waste and distraction the BUPA contractual arrangement has caused there. Will he apologise?

Tim Loughton: I am delighted to intervene because the shadow Secretary of State, who has now appeared, mentioned that in his car crash interview last night. I do not know if the shadow Chief Secretary has been to Worthing or has looked at the contract, but it made no difference in money terms. As it happens, I opposed the contract, as did my hon. Friend the Member for Worthing West (Sir Peter Bottomley), because there was no impact study. As a result, we will now get a better service—run by the hospital—that is more seamless for patients. Will the shadow Chief Secretary apologise?

Madam Deputy Speaker (Dame Dawn Primarolo): Order. Interventions must be brief. Mr Leslie, get back to your speech.

Chris Leslie: I think we got the gist of the intervention. The hon. Member for East Worthing and Shoreham (Tim Loughton) opposed such competition, but I think he voted for it in the Health and Social Care Bill. He has his own demons to worry about on that.

Grahame M. Morris (Easington) (Lab): I, too, served on the Health and Social Care Bill Committee. Does my hon. Friend agree that one of the great problems we face with work force planning, as Government Members have highlighted, is that private sector providers by and large are not training the doctors and the range of staff we need to deliver an integrated health service?