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House of Commons

Tuesday 24 February 2015

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

Oral Answers to Questions

Health

The Secretary of State was asked—

NHS Staff

1. Julie Hilling (Bolton West) (Lab): How many NHS staff have been made redundant and subsequently re-employed by the NHS since May 2010. [907642]

9. Graeme Morrice (Livingston) (Lab): How many NHS staff have been made redundant and subsequently re-employed by the NHS since May 2010. [907650]

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): Over the four and a half years between May 2010 and October 2014, 5,210 people—equivalent to, annually, less than 0.1% of the NHS work force—have been made redundant and then returned to work elsewhere in the NHS.

Julie Hilling: But at a time when A and E is in crisis and there are not enough nurses, how on earth can the Minister possibly justify firing and rehiring thousands of NHS staff? What greater sign could there be of a Government with their priorities totally wrong?

Dr Poulter: I am not sure I recognise that picture of the NHS. We know that there are between 6,000 and 8,000 extra nurses, midwives and health visitors working in our NHS than there were under the previous Government. Also, in respect of A and E, the average length of stay in hospital has steadily come down from about eight days in 2000 to about five days now. So our NHS is getting better and improving under the current Government.

Graeme Morrice: Last year the Prime Minister promised to recover redundancy payments from people who have been rehired. Can the Minister tell us how many payments have been recovered and at what cost?

Dr Poulter: The hon. Gentleman will be aware that it was the previous Labour Government who in 2006 set these eye-watering redundancy payments for the NHS, and we have committed to making sure we reform and change that. Therefore, as part of our negotiations and pay offer to NHS staff we want to introduce a redundancy

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cap of £80,000. Since many Opposition Members are supported by trade unions, I hope they will encourage union members to back that pay and redundancy cap.

Andrew Stephenson (Pendle) (Con): Can the Minister confirm that according to the latest figures there are more nurses working in the NHS now than there were in 2010, including an additional 391 at East Lancashire Hospitals NHS Trust and an additional 59 at Airedale NHS Foundation Trust, the two trusts that serve my constituency?

Dr Poulter: I am delighted to confirm that, and we have made a conscious decision to reduce NHS waste and bureaucracy. NHS administration spending is down from 4.27% under the previous Government to only 2.77% now, which has resulted in £5 billion of efficiency savings and meant we can invest in about 6,000 more nurses, midwives and health visitors.

Maria Miller (Basingstoke) (Con): The extra NHS staff my hon. Friend talks about are welcome, but my constituents want to know that standards of care are the best as well. What progress is he making to ensure that hospital patients get the best possible care?

Dr Poulter: The most important thing we have done is support our front-line staff with additional investment in the NHS, which Labour called irresponsible, and there is about £13 billion more going into the NHS during this Parliament. We have also increased transparency to make sure that where there are isolated pockets of poor care, the Care Quality Commission can intervene and make recommendations to improve the quality of care for patients in those hospitals.

20. [907663] Nic Dakin (Scunthorpe) (Lab): Given the significant challenges facing the NHS and the fact that this top-down reorganisation has led to this hiring and firing and therefore a distraction of energy and attention at crucial times, do not the Government now regret their top-down reorganisation?

Dr Poulter: A reorganisation of NHS services that results in administration spending being reduced from 4.27% under the previous Government to 2.77% under this Government, meaning that there is £5 billion more money for front-line patient care, is a good thing. That is something the Opposition should support, because it means that patients are getting a better service.

Andrew Bridgen (North West Leicestershire) (Con): Can the Minister remind the House of the number of extra specialist A and E doctors working in the NHS in England now compared with 2010?

Dr Poulter: My hon. Friend is right to raise this important point. As part of our commitment to investing more money in the front line, we have been able to ensure that there are between 800 and 1,000 more doctors now working in A and E than there were under the Labour Government.

Several hon. Members rose—

Mr Speaker: Order. May I gently remind the House that the question is not about staff per se in the NHS?

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The question is about people made redundant and subsequently re-employed. Attention to detail tends to profit a Member.

Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op): Those of us on the Public Accounts Committee have heard about the industrial scale of this revolving door of people going out of one job and into another with a fat redundancy payment. Does this not show that the Government have lost their grip on what is truly important in the NHS, which is paying front-line clinicians to serve patients?

Dr Poulter: That is extraordinary. The Public Accounts Committee will be aware that these redundancy terms were introduced by the previous Labour Government in 2006. We are committed to changing them and I hope that the hon. Lady’s party will support us in exerting pressure on the unions to support the pay deals on the table that will introduce an £80,000 redundancy cap.

Mr Speaker: Ms Johnson, do you have a similar question?

21. [907664] Diana Johnson (Kingston upon Hull North) (Lab): Yes, Mr Speaker; I am grateful. I want to ask about the number of nurses who have been made redundant. Lots of hospitals in my area are now recruiting from Spain, and I wonder whether an assessment has been made of the cost to the NHS of using nurses from abroad after making other nurses redundant.

Dr Poulter: Our NHS has always benefited from overseas staff bringing their skills and coming to work here, and we can all welcome that as long as they have a good standard of spoken English, which is something that we are putting right through the legislation that we are introducing. As I outlined earlier, there are now around 7,500 more nurses, midwives and health visitors working in the NHS than there were under the previous Government.

GP Retirement

2. Douglas Carswell (Clacton) (UKIP): What contingency plans his Department has formulated to cope with the expected increase in the number of GPs retiring before 2020. [907643]

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): In addition to the extra 1,000 GPs working in our NHS since 2010, our mandate to Health Education England will ensure that 50% of trainee doctors enter GP training programmes by 2016. This will enable the delivery of 5,000 additional newly qualified GPs by 2020.

Douglas Carswell: I am told that many young doctors are choosing not to go into general practice. That, coupled with the number of retiring GPs, is leading to real shortages in places such as Clacton. What more can be done to make general practice more attractive to young doctors, in order to offset the number of GPs who are retiring?

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Dr Poulter: There have always been parts of our health service where it has been difficult to attract GPs to work; that is a long-standing problem. A new £10 million investment fund has been put in place, and a new 10-point plan is being delivered by NHS England to look at how we can better incentivise younger doctors to work in areas in which it has traditionally been difficult to recruit. I am sure that that will bring benefits to the hon. Gentleman’s constituency and elsewhere in the NHS.

Sir Tony Baldry (Banbury) (Con): Does my hon. Friend agree that this is not just a matter of the total number of GPs? Quite a lot of GPs now want to work part time, and quite a lot now want to be salaried rather than being partners. Is he confident that the model that was set up in 1948, which effectively means that each GP practice is its own separate, private business, is still suitable in the 21st century?

Dr Poulter: My right hon. Friend asks an important question. We can of course support the existing model, and the innovation that comes with GPs being small businesses, and that is exactly what we are doing with the £1 billion investment fund for GP infrastructure and technology. We are supporting those GPs as small businesses to develop better patient services.

Valerie Vaz (Walsall South) (Lab): On what is his last outing, will the Minister tell us how many GPs, in addition to those who have retired, have left the profession and how many have gone to work abroad?

Dr Poulter: It has always been the case—it was certainly the case among many of my medical contemporaries—that many people from our NHS go and work overseas for some time. They often come back to the NHS, bringing broader experience and skills. As I outlined earlier, there are now 1,000 more GPs working and training in our NHS than there were five years ago.

Mr Philip Hollobone (Kettering) (Con): Following the retirement of a senior partner whom it has been impossible to replace, Dr Hadrian Moss of the Dryland GP surgery in Kettering has followed the advice of the British Medical Association and informally closed his expanded list of 2,500 patients on the ground of patient safety. He has now been taken to task by NHS England for a potential breach of contract. What is the Minister’s opinion on reconciling the views of the BMA on patient safety guidelines and those of NHS England on a potential breach of contract?

Dr Poulter: I am sure that my hon. Friend will understand that it is difficult for me to comment on an individual case, but I am very happy to look into the matter and get back to him about it.

Ms Margaret Ritchie (South Down) (SDLP): Given that the needs of patients must come first and that young people are not choosing to pursue GP training as much as they used to, what discussions will the Secretary of State hold directly with the British Medical Association, the Royal Colleges, the training councils and his colleagues in the devolved Administrations throughout the UK to address this issue, to prevent further congestion in accident and emergency departments?

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Dr Poulter: There is a lot of work going on in this area. First, we are encouraging and supporting GPs who have had career breaks, perhaps because they have started a family, to get back into the profession more easily than they have been able to do in the past. Secondly, we also have the commitment that 50% of medical students and doctors leaving foundation training will become GPs in future. That will make sure that we have 5,000 more GPs by 2020.

Andrew Gwynne (Denton and Reddish) (Lab): But the Government’s reorganisation took billions of pounds away from the NHS front line. Figures released last week show that fewer than a quarter of medical students now enter general practice, because they can see the pressure that Ministers have put on it, while GP morale has collapsed. Should the Minister not now admit that the reorganisation was a mistake and instead match Labour’s pledge to invest an extra £2.5 billion a year to recruit 8,000 more GPs and guarantee appointments within 48 hours?

Dr Poulter: I know that the Labour party is full of professional politicians, but medical students do not just leave medical school and straight away become GPs; they become foundation doctors. As I have outlined, 50% of the people leaving their foundation training will become GPs in future, which will increase the number of GPs by 5,000. Under this Government the number of GPs in education, training and working in the NHS has increased by 1,000, which is a move in the right direction.

Countess of Chester Hospital (Scans)

3. Stephen Mosley (City of Chester) (Con): How many CT scans were performed at the Countess of Chester hospital in (a) 2010 and (b) 2014. [907644]

The Parliamentary Under-Secretary of State for Health (George Freeman): I am delighted to report to the House that the number of CT scans performed at the Countess of Chester Hospital NHS Foundation Trust increased by 67% between 2010 and 2014. In December 2014, only 0.6% of patients waited more than six weeks from referral to test at the trust—that is rather better than the figure we inherited in 2010 of 4.9%, and I hope that the Opposition will welcome it.

Stephen Mosley: I welcome those fantastic figures at the Countess of Chester hospital. Will the Minister confirm that early and accurate diagnosis is crucial for dealing with many conditions, and that we are seeing the results of that in improved survival rates for conditions such as cancer?

George Freeman: My hon. Friend is absolutely right to say that diagnostics play a key role in our drive to improve cancer survival, which is why we have committed £750 million to deliver our cancer strategy, including £450 million to achieve better diagnosis of cancer, and better awareness and access to diagnostic tests. Projections show that that is working; we are on track to see 12,000 more cancer patients a year surviving for at least five years in 2015, which is more than double the target of 5,000 we set ourselves in January 2011. I hope that the Labour party will agree that these are real benefits for cancer patients in the NHS today.

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Mr Jamie Reed (Copeland) (Lab): Cancer scanning services in Cheshire and Staffordshire have recently been subjected to a competitive tendering process, and the contract was awarded to Alliance Medical, despite its bid being £7 million more expensive than the NHS bid. Can the Secretary of State explain why the more expensive private sector bid was chosen over the better value NHS bid to provide these services? Will he commit to investigating the bidding process to ensure that the tender was conducted fairly? [Interruption.] He is chuntering from a sedentary position, but will he today confirm, because this is a matter of profound public interest, that no contact of any sort took place between his Department and the board of Alliance Medical with regard to this decision, including at any point with the current board member, the right hon. and learned Member for Kensington (Sir Malcolm Rifkind)?

Mr Speaker: Order. That was a considerable essay to which a pithy but comprehensive response is expected. The House seeks it.

George Freeman: I admire the hon. Gentleman’s chutzpah but it ill behoves him to talk to us about privatisation; it was his party that led to the increases and it is this Government who have stopped it, and he needs to acknowledge that. On the facts, in December the NHS in England performed more than 130,000 more diagnostic tests compared with December 2013. I note that he did not talk about Wales, where 24% of patients have waited more than eight weeks for their diagnostic test—the comparative figure is 2% of patients in England.

Mr Speaker: Order. The question was about Chester, so there was no particular reason to talk about Wales.

Cancer Survival

5. Paul Uppal (Wolverhampton South West) (Con): What assessment he has made of the implications for his policies of the most recent rates of cancer survival. [907646]

6. Mark Menzies (Fylde) (Con): What assessment he has made of the implications for his policies of the most recent rates of cancer survival. [907647]

13. Mr Robin Walker (Worcester) (Con): What assessment he has made of the implications for his policies of the most recent rates of cancer survival. [907656]

The Secretary of State for Health (Mr Jeremy Hunt): This Government inherited the worst cancer survival rates in western Europe and, as we have just heard, we have invested a record £450 million in improving early diagnosis, which means that record numbers of people are being tested and record numbers of people are being treated.

Paul Uppal: I thank the Secretary of State for his response. Last year, I met cancer patients and carers with the aim of looking at how we can improve cancer survival rates so that they are among the best in western Europe. The main observation was that early diagnosis is key. Does my right hon. Friend agree that it is

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absolutely crucial that we support GPs to find and identify the early signs and symptoms of cancer so that we can improve survival rates?

Mr Hunt: That is absolutely right. What is said by everyone who has been wrestling with this problem about why our survival rates are not as good as we want them to be is that early diagnosis and access to the latest drugs are the two critical things. My hon. Friend will be pleased that 9,000 people in his region have accessed the cancer drugs fund and that, in his constituency, 300 more people every year are now being treated for cancer than was the case four years ago.

Mark Menzies: The excellent progress made in cancer survival rates is great news across the UK and in my constituency in Fylde. A lot of that is down to the increase in availability of diagnostic tests. Statistics from Blackpool’s NHS trust show that just under 33,000 more diagnostic tests were carried out in 2014 compared with 2010. With that in mind, will my right hon. Friend commit to increasing the availability of diagnostic tests?

Mr Hunt: We absolutely can. In fact, we are carrying out about half a million more diagnostic tests for cancer every year than we were four years ago. The result is that, over the course of this Parliament, 700,000 more people are being admitted for cancer treatment in our hospitals than was the case in the previous Parliament, saving 12,000 lives every year.

Mr Walker: I welcome the Secretary of State’s answers. Improvements in radiotherapy have been a key factor in improving cancer survival rates and quality of life for patients. This month, Worcestershire is celebrating the delivery of a state-of-the-art radiotherapy centre at Worcestershire Royal hospital. I visited that £25 million oncology centre last week. With some of the most advanced equipment in the country and eight new consultants recently recruited, does my right hon. Friend agree that the centre will be a key asset in taking forward the fight against cancer?

Mr Hunt: Absolutely. It was a fantastic development for Worcestershire Royal hospital. My hon. Friend campaigned very hard for it, and it is fantastic for his constituents. Cancer treatment is expensive, which is why we can only fund developments in cancer if we have a strong economy. That is what this Government are committed to doing for our NHS.

Grahame M. Morris (Easington) (Lab): May I draw the Secretary of State’s attention to an excellent debate we had in the Chamber on 5 February under the auspices of the all-party group on cancer? May I also draw his attention to the uncertainty surrounding the funding of the national cancer peer review group programme? That programme has recently been reviewed and the Minister had indicated that the funding would continue. Will he take the opportunity to give a commitment to funding that peer review group, because there seems to be some doubt among the 17 national cancer charities that support its work.

Mr Hunt: Let me reassure the hon. Gentleman that we are absolutely committed to furthering and improving peer review as a way of winning the battle against cancer. The NHS is committed to that programme, and it is just looking at how it can be improved. [Interruption.]

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Mr Speaker: The hon. Member for Barrow and Furness (John Woodcock) seems to be enjoying a very close relationship with his mobile phone. I hope that it profits both of them

Derek Twigg (Halton) (Lab): On the early detection of cancer, will the Secretary of State consider putting more resources into socially deprived areas such as Halton where the incidence of cancer is higher?

Mr Hunt: We are putting more resources into Halton. In fact, we are putting more resources into the NHS across the country. We are carrying out 21,000 more diagnostic tests, including cancer tests, every year compared with four years ago, and I hope that that is something the hon. Gentleman will welcome.

Mr John Baron (Basildon and Billericay) (Con): The all-party group on cancer and the wider cancer community have commended the Government on introducing the one-year survival rates for cancer into the delivery dashboard from April of this year as a means of driving forward earlier diagnosis. But what can the Secretary of State tell us about the work that is being undertaken to ensure that the levers of accountability are in place to push under-performing clinical commissioning groups into raising their standards on behalf of patients?

Mr Hunt: I congratulate my hon. Friend on his understanding of the importance of transparency. He will welcome the fact that we are now saving 1,000 more lives a month as a result of focusing on the five-year survival rates. But that transparency must apply to CCGs as well, and discussions are ongoing with NHS England as to the best way to do that for lots of things, including cancer.

Liz Kendall (Leicester West) (Lab): Last week, we learned that the 62-day target for cancer treatment has been missed for a full 12 months:

“This isn’t just about missed targets–consecutive breaches mean thousands of patients are being failed. These targets exist to ensure swift diagnosis of cancer and access to treatment, which is vital if we’re serious about having the best survival rates in the world.”

Those are not my words; they are an exact quote from Cancer Research UK. Which bit of it does the Secretary of State disagree with?

Mr Hunt: I do not disagree with it, but I will tell the hon. Lady why we are missing that one target. Incidentally, we are hitting the seven other targets. We are treating and diagnosing so many more people, with 560,000 more diagnoses every year. That means that in this Parliament we are treating 700,000 more people than were treated in Labour’s last Parliament, saving 1,000 more lives a month. If the hon. Lady looks at some of the other things that Cancer Research UK says, she will see that it welcomes that strongly.

Free Social Care

7. Dr Sarah Wollaston (Totnes) (Con): What assessment he has made of the implications for his policies of Her Majesty’s Treasury’s costing of free social care at the end of life. [907648]

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The Minister of State, Department of Health (Norman Lamb): HM Treasury’s costing demonstrates the limitations of data available nationally in estimating the potential costs of providing free personal care at the end of life. That is why the Department of Health is undertaking further work with stakeholders to develop an evidence base to inform the next spending review.

Dr Wollaston: I thank the Minister for that reply. He will know that most people want to be able to remain at home at the end of their lives, surrounded by the people they love, and I pay tribute to all the carers, volunteers and health professionals, including Rowcroft’s hospice at home, who help to make that possible. Sadly, he will also know that often the situation can break down because of the sheer exhaustion of caring for a loved one at the end of their life. Will he commit that the Government will consider the quality of care as well as the costs when considering introducing free end-of-life social care?

Norman Lamb: I thank my hon. Friend for that question and join her in paying tribute to the work of so many people: volunteers, loved ones and the professionals working in the community. The whole emphasis should be on ensuring that we respect people’s choice about where they want to be and that they get the best possible care. Later this week, the independent review of choice at the end of life will be published and I hope that it will inform discussions. I am completely with her in trying to ensure that we can achieve this.

Lisa Nandy (Wigan) (Lab): One of my constituents recently went through a lengthy, distressing and difficult process to get NHS continuing care for his wife. If we remove the distinction between NHS and social care, many people across this country, including my constituent, will be spared this distress and difficulty at one of the hardest times in their lives. We know that funding should be put where it is needed and we know that that will be more cost-effective in the long run and will be better for patients, so why will the Minister not act?

Norman Lamb: Actually, we are all agreed on this. We all want free care at the end of life, but whoever is in power after the election in May will have to ensure that we understand fully the costs. There is a lot of evidence, and the evidence is growing. We are having very good discussions with groups involved in care at the end of life and we all want to achieve a solution. Of course, the truth is that very many people are receiving free care at the end of life, but they are in hospital, where they often do not want to be. I am completely with the hon. Lady in trying to achieve this.

Paul Burstow (Sutton and Cheam) (LD): Eight out of 10 people say that they would prefer to die at home when their time comes. Since the Government published their White Paper and said that they saw merit in social care being free at the end of life, a succession of reports from Macmillan, Nuffield and others have shown that there are savings to be made and benefits in terms of more dignified deaths and compassion for families. Is it not time to act on the evidence and make social care free at the end of life?

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Norman Lamb: We very much hope that the case will stack up. As I said earlier, we are in active discussions with these groups and I held a round table with them a few months ago to discuss how we can achieve this. Everyone is agreed on the objective, but we need to understand the full costs involved before any Government can make a commitment to it.

Mr Frank Field (Birkenhead) (Lab): Is there not something deceitful about the Government’s promising major changes for the next Parliament when we do not know how they will be paid for? If we want improvements to the NHS and end-of-life care in the next Parliament, Members on both sides of the House need to put before the electorate how we will pay for those important long-term changes.

Norman Lamb: I am tempted to say that that is a bit rich coming from an Opposition Member. I am sure that he would agree that whatever commitments are made, we need to understand their cost. That work is under way and I hope that as soon as we achieve a full understanding we can proceed.

Genomics Programme

8. James Morris (Halesowen and Rowley Regis) (Con): What assessment he has made of the potential of the genomics programme to improve cancer treatment. [907649]

The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman): The Government’s £300 million genomics England programme, led and announced by the Prime Minister as part of our life science strategy, has the potential to improve dramatically cancer diagnosis and treatment. By sequencing the entire genetic code of 100,000 NHS patients and volunteers and combining the data with their clinical records, and launching a genomic medicine service—a world first for the NHS—we will be able to understand the genetic triggers of disease, unlock new diagnostics and identify better treatments from existing drugs.

James Morris: The number of people being treated for cancer successfully and getting appropriate diagnostic treatment in Dudley and Sandwell has increased substantially in the past five years, but does the Minister agree that harnessing genomic medicine is key to the future, and that we need to drive innovation in this field over the next 10, 20 and 30 years?

George Freeman: My hon. Friend makes an excellent point. He is absolutely right: cancer is a genetic disease, and the more we know about genetics, the more we discover about different patients’ predisposition to different diseases and drugs. That is absolutely key, and nowhere more clearly so than in breast cancer, where the HER2-Herceptin breakthrough and the BRCA2 gene are allowing us better to screen, predict and target treatment of breast cancer, freeing women from the choice of mastectomy, which has been far too dominant, and enabling us to treat breast cancer as a preventable disease.

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Mental Health

10. Sir Bob Russell (Colchester) (LD): What guidance he has given to clinical commissioning groups and mental health trusts on jointly funding not-for-profit voluntary and charitable organisations providing support for people with mental health issues. [907652]

The Minister of State, Department of Health (Norman Lamb): The Government are clear that voluntary organisations and charities make an important contribution to the delivery of local health and social care services, including services that support people’s mental health needs. However, it is the responsibility of local commissioners to commission appropriate services based on their local population’s needs.

Sir Bob Russell: The Minister will be aware that although the NHS is one organisation, trusts seem to operate as silos. Will he convene a meeting of all the trusts in the Colchester area to discuss the future of the Haven project?

Norman Lamb: I visited the Haven last week with my hon. Friend, and I was enormously impressed by everything I heard, including the extraordinary testimonies of people with personality disorders who had benefited so much from the Haven’s service. In my view, it would be incredibly sad and very worrying if that service were to be lost. I am happy to invite the clinical commissioning group and the mental health trust to a meeting in the Department to discuss how it can be saved.

Kevin Barron (Rother Valley) (Lab): I recently met the five UK Youth Parliament Members from Rotherham, who talked about the lack of facilities for mental health help in education, both further education and state education. May I say to the Minister that it is all right saying that it is up to local commissioning groups, but where is the leadership, when our young people are being left in extremely difficult situations and are seen by some professionals but, sadly, not health professionals?

Norman Lamb: The local Members of the Youth Parliament the right hon. Gentleman met make an incredibly important point. I refer him to the children and young people’s mental health and well-being taskforce, which will report very soon. I think that the role of schools will be crucial in its conclusions, and I encourage him to look at the report when it emerges.

Luciana Berger (Liverpool, Wavertree) (Lab/Co-op): The latest figures show a huge rise in the number of young people with a mental illness turning up at A and E. Young people not getting the help they need early on and becoming so ill that they need hospital care shows that the system is failing. Does the Minister accept that this Government’s decision to cut children’s mental health services at the same time as wasting £3 billion on a reorganisation has been a key factor in that failure?

Norman Lamb: This Government have absolutely not made any decision to cut children’s mental health services, and the hon. Lady knows it is misleading to suggest otherwise. These decisions are taken by local commissioners in local authorities and CCGs. Indeed, we have legislated for parity of esteem for mental health. I urge her to look

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at the outcome of the work of the children and young people’s mental health and well-being taskforce, which I think gives us a real opportunity to improve the way in which services operate.

Nurse Numbers

11. Steve McCabe (Birmingham, Selly Oak) (Lab): How many nurses per million population were working in the NHS in each of the last five years. [907653]

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): The full-time equivalent number of nurses, midwives and health visitors working in the hospital and community health services in England per million population from September 2010 to September 2014 inclusive has remained broadly constant at 5,872, 5,768, 5,703, 5,712 and 5,781 respectively.

Steve McCabe: In response to 11 parliamentary questions that I submitted in the past year, the Minister has admitted that he does not know how many part-time, agency and locum GPs are in the health service, the number of agency and part-time nurses, the number of part-time doctors in our hospitals, or how many working nurses and midwives are also drawing their pensions. Given that he has so little detail on staffing, where did today’s figures come from, and what faith can anyone have in them?

Dr Poulter: They are in the monthly staff statistics survey. As the hon. Gentleman would like some detailed information, I am sure he will be pleased to hear that in his constituency there are now 386 more nurses than there were in 2010 under the previous Government, and nationally there are 7,500 more nurses, midwives and health visitors working in the NHS.

Andrew George (St Ives) (LD): Does my hon. Friend agree with me and with the nursing profession that if nurse staffing levels on acute hospital wards fall below one registered nurse to seven acutely ill patients, excluding the registered nurse in charge, it will significantly increase the risk to patient care and result in avoidable excess deaths?

Dr Poulter: My hon. Friend and I have discussed this many times and I do not agree with him, as he knows. What is important is that patients are assessed on their clinical needs. A rehabilitation ward will need a different number of nurses—indeed, it may need physiotherapists and occupational therapists—from intensive care nursing, which often requires one-to-one care, so setting arbitrary staffing ratios is not in the best interests of patients.

Mr Barry Sheerman (Huddersfield) (Lab/Co-op): Does the Minister accept that the issue is not just broad numbers, but the shortage of specialised nurses in many departments, certainly in Calderdale and Huddersfield, where we are finding it difficult to recruit the right qualified nurses for very specialist tasks, as well as the doctors to go with them?

Dr Poulter: In many parts of the country we are seeing more specialist nurses working, particularly in areas such as diabetes, and supporting patients with complex care needs. As we need better to support

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people with those complex care needs at home in their own communities, the Government will continue to invest in specialist nurses not just to provide care in hospital, but to work in the community at the same time.

Ian Austin (Dudley North) (Lab): Russells Hall hospital is being forced to lose one in 10 staff, which could include midwives, to deal with Government efficiency savings of £12 million every year. This morning the hospital’s chief executive has written to me and says that these

“excessive efficiency requirements place care at risk”.

She goes on to say that

“the financial challenge has reached unviable levels”

and that NHS providers

“can no longer guarantee sustainable and safe care”.

What will it take for Ministers to listen not just to us, but to NHS staff, and ensure that hospitals such as Russells Hall have the resources they need to provide care for local people?

Dr Poulter: I am sure the hon. Gentleman will be pleased that, as part of our winter pressures funding, Dudley received £3.5 million to support the hospital during a difficult winter period. There are now 69 more doctors and 324 more nurses, of whom 29 are extra midwives, working in the area than in 2010.

Personality Disorder Support (North Essex)

12. Mr Bernard Jenkin (Harwich and North Essex) (Con): What discussions he has had with (a) the Haven project in Colchester and (b) NHS bodies in north Essex on the need for continuing funding for support for people with moderate to severe personality disorder. [907654]

The Minister of State, Department of Health (Norman Lamb): My right hon. and noble Friend the Under-Secretary of State with responsibility for quality responded in February 2014 to correspondence from the client chair of the Haven project about its funding. As I said a few minutes ago, decisions on NHS funding are a matter for local commissioners, but I will invite North East Essex clinical commissioning group to meet to discuss the issue in more detail.

Mr Jenkin: I am grateful to my right hon. Friend for taking such a close interest in the matter, and for the visit paid by the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). Although I understand the huge cost pressures on the CCG, may I invite my right hon. Friend to study the Enable East report, which made a different recommendation on how the unit should be treated? It would be sad to close the leading example among 11 Department of Health pilots, when all the other 10 are being kept open as the lessons learned are so valuable.

Norman Lamb: I am very much aware of the work that my right hon. Friend and my hon. Friend the Member for Colchester (Sir Bob Russell) have done on this. It is interesting that all the other 10 pilots have continued. They are part of NHS trusts. This is the only

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one run by a voluntary sector organisation. It is an incredibly valuable service. I was struck by the extent to which people said how much they had reduced their hospital in-patient admissions as a result of the incredibly impressive preventive work that this service provides, and I want to look into it further.

Ehlers-Danlos Syndrome

14. Andrew Griffiths (Burton) (Con): What support the Government are giving to people with Ehlers-Danlos syndrome. [907657]

The Parliamentary Under-Secretary of State for Health (Jane Ellison): The Government acknowledge the challenge posed in supporting patients with Ehlers-Danlos syndrome, which encompasses a complex range of conditions with a wide variety of symptoms. Diagnosis and investigation of suspected EDS takes place in dedicated regional genetics clinics, with specialist clinics, as my hon. Friend will know, at Sheffield Children’s NHS Foundation Trust and London North West Healthcare NHS Trust.

Andrew Griffiths: People in Burton have raised £130,000 to pay for a life-saving operation that is not available in the UK for Nina Parsons, my constituent, who suffers from EDS. I have another constituent, Sarah Pugh, who is having to pay for vital physiotherapy and an MRI scan. Will my hon. Friend look at what more can be done to help people suffering the misery of EDS, and will she agree to meet some sufferers to discuss the matter further?

Jane Ellison: I am certainly very happy to talk to my hon. Friend about his particular constituents. I am aware of the work that he has done in his local area. He will be interested to know that in 2013 the Government published “The UK Strategy for Rare Diseases” precisely to address such issues and the complexities around them, and aspects of that strategy speak directly to the challenges that he has just outlined. May I also take this opportunity to mention that there is an event tomorrow in Parliament organised by Rare Disease UK to mark rare disease day, at which the Under-Secretary of State for Women and Equalities, my hon. Friend the Member for East Dunbartonshire (Jo Swinson), will be speaking?

Palliative Care

15. Philip Davies (Shipley) (Con): What estimate he has made of the number of admissions to A & E in the last three years for patients with palliative care needs in (a) areas with a 24-hour palliative care helpline or palliative co-ordination centre and (b) areas that do not offer such services; and if he will make a statement. [907658]

The Minister of State, Department of Health (Norman Lamb): We know from local examples that areas that offer 24/7 community palliative care services have been able to reduce the number of A and E attendances and inappropriate hospital admissions, including emergency admissions, for people with palliative care needs. I would encourage all areas to offer these services in line with the NICE quality standard.

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Philip Davies: A poll conducted by Sue Ryder shows that 82% of people expect advice to be available 24/7, yet only 8% of CCG areas have a dedicated around-the-clock palliative care helpline and co-ordination centre. As I am sure we all agree, carers do wonderful work and need as much support as possible. Will my right hon. Friend’s Department work with Sue Ryder and others to ensure that there is a dedicated 24/7 palliative care service, which would certainly help to take the strain away from A and E, which is already under great pressure?

Norman Lamb: I pay tribute to the professionals in my hon. Friend’s area, which is one of the leading areas for providing strong support in the community, which prevents unnecessary hospital admissions. I am very happy to work with Sue Ryder and others to try to get the message across that if this can be provided throughout the country we will improve the experience of people at the end of life, but critically also save costs further down the line by stopping inappropriate hospital admissions.

Mental Health

16. Mary Macleod (Brentford and Isleworth) (Con): What his priorities are for improving mental health care. [907659]

Mr Speaker: Minister Lamb.

The Minister of State, Department of Health (Norman Lamb): Mr Speaker, you sounded a note of tedium in calling my name again.

Mr Speaker: I feel no sense of tedium but almost a state of ecstasy upon calling the right hon. Gentleman. If I gave any other impression, I most heartily apologise to him. I hope that he is now assured of his status in the affections of the Chair, if, possibly, also of the House? There might have to be a Division on that proposition. I do not know.

Norman Lamb: I am so grateful to be reassured, Mr Speaker.

Mental health is a priority for this Government. We have legislated for parity of esteem between mental and physical health, invested £400 million in talking therapies, significantly reduced the numbers of people who are placed in police cells during mental health crises and are introducing the first waiting times standards for mental health services from April this year.

Mary Macleod: I recently met a constituent at one of my advice surgeries who had been refused NHS mental health care because she was told that she was entitled to only one batch of free support. Considering how complicated and varied mental health issues can be, is there anything we can do for people who need more support after a relapse of mental ill health?

Norman Lamb: If that was the advice the hon. Lady’s constituent received, it is complete and utter nonsense. The idea that someone can have only one episode of care under the NHS is so ridiculous that it hardly merits a proper response. I urge her to encourage her constituent,

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with her support, to go back to those local services and ensure that she gets further support if she needs it, as she is entitled to it.

Community Hospitals

17. Neil Parish (Tiverton and Honiton) (Con): What assessment his Department has made of the future role of community hospitals. [907660]

The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman): Community hospitals can play a hugely important role in the 21st-century NHS. The NHS “Five Year Forward View” explicitly recognised the role of smaller hospitals, including community hospitals, as part of the new care models towards which we need to evolve. Specific local commissioning decisions are rightly taken by local clinical commissioning groups, reflecting local need.

Neil Parish: We have excellent hospitals in Tiverton, Honiton, Axminster and Seaton, and there could be a much greater link between them and the Royal Devon and Exeter NHS Foundation Trust. For example, patients could be moved to the community hospital in Axminster after acute operations, thereby creating space at the RD and E and keeping Axminster hospital open with beds, which the population is keen to see.

George Freeman: I pay tribute to my hon. Friend for his tireless work on this matter. I know that he recently met the Secretary of State to discuss it and that he has been very active locally and here in Parliament. He is right that local community hospitals can play a key role in supporting patient convalescence, providing particularly good care in the community close to home, which is convenient for elderly patients, and relieving pressure on acute hospital beds. You do not have to take it from me, Mr Speaker; take it from Simon Stevens, the chief executive of NHS England. He recently said:

“A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS…The NHS needs to abandon a fixation with ‘mass centralisation’”.

I hugely welcome that.

Confidentiality Agreements

18. Mr Andrew Robathan (South Leicestershire) (Con): With reference to the recent Francis report, if he will investigate (a) the case of Meirion Thomas at the Royal Marsden hospital and (b) cases where staff have been disciplined or required to sign confidentiality agreements. [907661]

The Parliamentary Under-Secretary of State for Health (Jane Ellison): The Government welcome any individual who has the courage to shine a light on malpractice, wrongdoing or patient safety issues in the NHS, and the House will be well aware that that is something the Secretary of State has very much championed. Professor Thomas has a right to express his views on the health service and on wider issues, and I understand that the trust has confirmed that. The Department is not responsible for investigating cases involving individual members of

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staff, but I want to be clear that confidentiality agreements cannot be used to prevent individuals from making a protected disclosure in the public interest.

Mr Robathan: I am glad to hear that, and I note that the Secretary of State has had dealings with Professor Thomas. However, I think it is very important that this is looked at closely in the light of the Francis report. If it is the case, as is said in media reports, that Professor Thomas has been forced to sign a confidentiality agreement—a so-called gagging order—I think that is disgraceful and shows a very dire state in the NHS in the Royal Marsden. Perhaps the Minister would like to comment on that.

Jane Ellison: I can only reiterate this Government’s complete commitment to openness when it comes to patient safety and say again that confidentiality agreements cannot be used to prevent individuals from making a protected disclosure in the public interest.

NHS (West London)

22. Mr Andy Slaughter (Hammersmith) (Lab): What plans he has for the NHS in west London. [907666]

The Parliamentary Under-Secretary of State for Health (Jane Ellison): Clinicians in west London are leading a process that is very much aimed at improving services for people in west London. As the hon. Gentleman is well aware, the local NHS is pressing ahead with the implementation of service improvements as part of the clinically led reconfiguration programme, “Shaping a healthier future”.

Mr Slaughter: The Minister does not sound very convinced by that herself. I wonder whether she saw the comments from the College of Emergency Medicine yesterday, which said that attempts to dissuade people from going to A and E have been a dismal failure and that what we should do is locate primary care services alongside A and E. That is the model we have at Charing Cross hospital and in the rest of west London, and it is succeeding. What is failing is the closure of emergency departments, which is creating an intolerable strain. Will the Government look again at the issue? Will you stop closing A and Es in west London?

Jane Ellison: I am afraid that the hon. Gentleman has a dismal track record of campaigning on this issue. We have all seen the leaflets being put out in west London. I can only say to his constituents that in the run-up to the election they would glean more from reading their tea leaves than from reading his leaflets if they want to know the truth about the NHS in west London.

Topical Questions

T1. [907718] Sir Nick Harvey (North Devon) (LD): If he will make a statement on his departmental responsibilities.

The Secretary of State for Health (Mr Jeremy Hunt): At the end of this Parliament, and before returning, I trust, to the same side of this Chamber in late May, I am pleased to update the House on NHS work force numbers. On the back of a strong economy, our NHS

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now has more doctors, nurses and midwives than ever before in its history, including 7,500 more nurses and 9,500 more doctors. The result is 9 million more operations during this Parliament than the previous Parliament, fewer people waiting a long time for their operations, and a start in putting right the scandal of short-staffed wards that we inherited and were highlighted by the Francis report. Indeed, last year the Commonwealth Fund said that under this Government the NHS has become the safest, most patient-centred and overall best health care system in any major country.

Mr Speaker: Let me point out that topical questions and answers should be brief. It is a rank discourtesy—[Interruption.] Order. It is a rank discourtesy to the House to expatiate at length and thereby to deny other Members the chance to put their questions. It will not happen. Simple, short, factual answers are what is required.

Sir Nick Harvey: In the past couple of days, a number of Devon and Cornwall hospitals have declared black alert status, meaning, essentially, that they are full and cannot cope with any more demand. Do Ministers therefore understand the public concern that the clinical commissioning group is considering closing beds in community hospitals, including Ilfracombe and South Molton in my constituency? Can anything more be done to help rural health economies that are trying to restructure but already struggling to cope with existing demand?

Mr Hunt: We do understand those concerns. It is absolutely essential that CCGs make sure that they have the right bed capacity to deal with the pressures of winters.

Andy Burnham (Leigh) (Lab): Let me take the Secretary of State back to a subject he likes to avoid—NHS privatisation. He tries to deny that it is happening on his watch, but we heard earlier about the ideological privatisation of cancer scanning in Cheshire and Staffordshire, despite its being more expensive than the NHS bid—and now it could get much worse. On the Friday before the recess, the Government sneaked out the public contracts regulations, which require NHS contracts worth over €750,000 to be opened up to full EU competition. Will the Secretary of State confirm that that is indeed the case in these regulations, and can he explain what mandate he has from the public to open up the NHS to private bidders across Europe?

Mr Hunt: Since the last time the right hon. Gentleman and I met, the King’s Fund has published its assessment of the NHS reforms over the past few years, and its words were:

“Claims of mass NHS privatisation were and are exaggerated”.

He knows perfectly well that outsourcing grew at double the rate under the previous Labour Government than it has grown under this Government.

Andy Burnham: The King’s Fund report said that as a result of the Secretary of State’s reforms there is

“greater marketisation of the NHS”.

People will notice that he failed to answer my question. That is because he wants to sneak these plans through under the radar. I serve notice on him today that we will

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fight him all the way, right to the very last day of this Parliament. If passed, these regulations will mean that almost every NHS contract will be forced to be advertised across Europe, shattering the promise he made to protect the NHS from EU competition law. Is it not now abundantly clear that he has forfeited the public’s trust on the NHS, and that five more years of this Government will lead to huge acceleration in NHS privatisation?

Mr Hunt: I repeat:

“Claims of mass NHS privatisation were and are exaggerated”.

If the right hon. Gentleman does not like the reforms, let us look at a country that did not have them—Wales. The number of people waiting too long for A and E is nearly double that in England, the number of people waiting too long for urgent ambulances is nearly double that in England, and the number of people waiting for operations is 10 times that in England. That is our record—it is a record of success.

T3. [907720] Glyn Davies (Montgomeryshire) (Con): Not enough GPs want to practise in rural Wales. I am told that one of the reasons is that GPs registered in England have to go through a bureaucratic process to be able to work in Wales. Will my hon. Friend the Minister work with the Welsh Government to ensure that we have a common registration process so that GPs can move between England and Wales without having lengthy, time-wasting new bureaucracy?

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): I am very happy to look into that issue and to do what we can to support our NHS work force to move as freely as possible between England, Scotland, Wales and Northern Ireland. GP numbers in England have increased because we have protected the NHS budget, unlike in Wales, where it has been cut by the Labour Administration.

T2. [907719] Karl Turner (Kingston upon Hull East) (Lab): A recent Ashcroft poll shows that only 15% of the public think that this Government have the best approach to running the NHS. Will the Secretary of State stand up at the Dispatch Box and apologise for his top-down reorganisation of the NHS and his Tory privatising Health and Social Care Act, and accept that the public will never trust the Tories with the NHS?

Mr Jeremy Hunt: I will tell the hon. Gentleman what the public think about the NHS: last year, under this Government, dissatisfaction was at its lowest ever level and satisfaction jumped the highest among Labour voters. And where did satisfaction go down? In Wales.

T5. [907723] Annette Brooke (Mid Dorset and North Poole) (LD): I have previously made Ministers aware that there are no beds for females in Dorset who need intensive psychiatric care. Our local newspaper, the Daily Echo, reports that such places will not be provided in Dorset for another three years. Meanwhile, patients are being sent as far away as Bradford. Do Ministers regard that as satisfactory? Are there enough resources coming to Dorset, or is it a local organisational issue?

The Minister of State, Department of Health (Norman Lamb): No, I do not regard that as satisfactory and I am happy to talk to the local commissioners. We have

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ensured that there will be real-terms increases in mental health funding for 2015-16, and that should be regarded locally as a matter of urgency.

T6. [907724] Mr David Crausby (Bolton North East) (Lab): Bolton’s accident and emergency department has been in crisis recently, partly because the clinical commissioning group closed the town’s walk-in centre. Will the Secretary of State support my petition calling for its reinstatement, or will he say, more predictably, “It’s not me, guv; I’m just the Secretary of State for Health”?

Mr Jeremy Hunt: I am accountable for what happens in the NHS, so let me tell the hon. Gentleman what is actually happening in Bolton: compared with four years ago, 2,756 more people are being seen at A and E within four hours. That is a record of investment and success.

Duncan Hames (Chippenham) (LD): What alternatives do clinical commissioning groups have to a full-scale commercial procurement when their existing contracts for community health services approach the time when they have run their course?

Norman Lamb: That is a matter for local commissioners. There is no requirement on them to tender competitively if their judgment is that it is right for the local community that services remain with the existing provider. We have been very clear that that is a matter for local commissioners.

T7. [907725] Graeme Morrice (Livingston) (Lab): My constituent Wilma Ord was prescribed Primodos in the 1970s, an oral hormone pregnancy testing pill that she blames for her daughter’s birth defects. As the Secretary of State is aware, it was announced back in October that an inquiry would be established to look into the whole issue. What progress has been made in setting up the inquiry and what assurances can he give my constituent, and the many other women and families affected throughout the country, that the inquiry will be fully comprehensive, transparent and independent?

The Parliamentary Under-Secretary of State for Health (George Freeman): I am delighted to report that I have met colleagues from across the House and patient representatives of that campaign on a number of occasions. We have appointed the chair and made sure that the terms of reference for the inquiry are clear and comprehensive. It is not, I stress, a judicial inquiry; it is a medical inquiry looking at the evidence.[Official Report, 19 March 2015, Vol. 594, c. 1MC.]

Tim Loughton (East Worthing and Shoreham) (Con): A constituent of mine has pointed out that, despite it being a long-term condition, drugs for cystic fibrosis are not subject to an exemption from prescription charges, apparently because, when it was first diagnosed, it was considered to be only a children’s disease. Will Ministers look into this anomaly?

The Parliamentary Under-Secretary of State for Health (Jane Ellison): This issue came up in a debate on cystic fibrosis last year and I am very happy to look at it again. I looked at it subsequent to that debate, in response to an inquiry from, I think, the hon. Member

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for Colchester (Sir Bob Russell), but I am happy to look at it again and get back to my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

T8. [907726] Paul Blomfield (Sheffield Central) (Lab): When I asked the Minister last June what guarantees he would give to GP practices at risk because of the withdrawal of the minimum practice income guarantee, I was told that NHS England would ensure threatened practices

“get to the right place.”—[Official Report, 10 June 2014; Vol. 582, c. 400.]

Over the past seven months, those discussions have not alleviated the threat to two highly regarded practices in my constituency that face closure. Will the Minister agree to meet me and representatives of the practices to discuss what is really happening, and to consider what can be done to save them?

Dr Poulter: I am very happy to meet the hon. Gentleman, but he will be aware that the move away from the historical funding formula towards a per head or capitation formula is a move in the right direction. If there are certain local concerns, I am very happy to meet him to discuss them.

Robert Jenrick (Newark) (Con): May I commend the Government on raising the priority for dementia in their announcement last week? Will the Secretary of State and the Department of Health put all their resources behind towns such as Newark, which are trying to establish themselves as dementia-friendly towns and are working with shopkeepers, banks and the business community to make it easier for older people with dementia to lead fulfilling lives?

Mr Jeremy Hunt: I commend my hon. Friend on his work in that area. People with dementia want to lead as normal a life as possible, and being able to go out to the shops is one very important thing they want to continue to do. We now have 1 million dementia friends in this country. That is a great step forward, and with his help we will do even more.

Alison Seabeck (Plymouth, Moor View) (Lab): When does the Secretary of State expect NHS England to confirm a date for the national tariff for the supply of prosthetic services and equipment? The lengthy and, quite frankly, unacceptable delay on his watch is now causing really serious issues for those who need prosthetics, as well as for those who want to deliver the services.

Mr Hunt: I am happy to look into that issue and get back to the hon. Lady.

Jeremy Lefroy (Stafford) (Con): In addition to the work that Monitor does on tariffs for individual pathways, what work has it done to assess the base funding that acute hospitals need to maintain core services, which are so interdependent?

Mr Hunt: Monitor has done extensive work on this issue, but my hon. Friend is absolutely right to talk about it. If we are to meet the financial challenge that the NHS faces over the next five years, we need to have

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a very sensible discussion about what realistic efficiency gains need to be made, and I am sure that he will engage in those discussions.

Mark Reckless (Rochester and Strood) (UKIP): Medway clinical commissioning group is looking at putting GPs at the front of our accident and emergency department to help relieve pressures on emergency doctors. Do Ministers believe that that is a promising way forward?

Dr Poulter: There is certainly a lot of benefit from having general practice co-located alongside A and E so that people with more minor ailments or concerns can be seen by GPs. That can often take the pressure off A and E services, but more senior expertise is also on hand when required.

Sarah Newton (Truro and Falmouth) (Con): Will my right hon. Friend update the House on what steps he is taking to prevent avoidable deaths from sepsis?

Mr Jeremy Hunt: I am absolutely happy to do that. Overall, we have 1,000 avoidable deaths every month by some estimates, and a number of those are from sepsis. We have launched a big campaign to prevent those deaths. Indeed, we will shortly have the results of the Morecambe Bay inquiry, from which I think we will hear more about the issue. I want to thank my hon. Friend for her campaigning and her work with the all-party group on sepsis to raise awareness of this very important issue.

Bridget Phillipson (Houghton and Sunderland South) (Lab): GPs across the north-east say that they are facing a work force crisis, with falling numbers of family doctors. Does the Secretary of State not recognise the connection between people being unable to get an appointment to see their GP and the rising and major pressure on our A and E department?

Dr Poulter: I am sure that the hon. Lady would like to support the plans we have put in place to ensure that we increase the number of GPs by 2020, and to ensure that 50% of doctors leaving foundation training go into careers in general practice.

Mr Adrian Sanders (Torbay) (LD): In order to combat fraud, the previous Government quite rightly introduced five-year prescription charge exemption certificates. Now that the certificates are coming up for renewal, people are finding that they have to pay for their medicines once their certificate has expired, and they have even been fined. Unlike for a TV licence, there is no renewal reminder. Will the Government look at how to ensure that people are told they need to renew their prescription exemption certificates?

Dr Poulter: As my hon. Friend will be aware, 90% of patients receive free prescriptions either because they are older—over the age of 60—or because of long-standing or other factors. If his constituents are running into difficulties and have problems with renewing their certificate, I am very happy to look into that and to meet him to discuss it further.

Mr David Anderson (Blaydon) (Lab): Despite assurance from the Prime Minister, it is now clear that the drug Translarna will not be available until after NHS England has concluded its internal consultations. The Secretary of State and others have told me repeatedly that they

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have no control over the issue, but can the Minister give the House any idea when the drug will be available for young boys suffering from Duchenne muscular dystrophy in this country, in the same way as it is across Europe? The drug is saving young boys from going into wheelchairs earlier. Does the Minister have any idea when it will be available?

George Freeman: I have had a number of meetings with patient groups, campaigners and charities over recent months, and the hon. Gentleman will appreciate that due process is important. NHS England is looking

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at whether to make an interim ruling on the drug in advance of a decision by the National Institute for Health and Care Excellence, and I have worked with NICE to ensure that its process is accelerated. We should get a decision from NICE this summer, and I hope that NHS England will make a rapid decision based on that judgment.

Several hon. Members rose—

Mr Speaker: Order. I am sorry to disappoint remaining colleagues, but as usual demand has exceeded supply.

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Points of Order

12.35 pm

Glenda Jackson (Hampstead and Kilburn) (Lab): On a point of order, Mr Speaker. This is a genuine request for information, because I am ignorant about this matter. On 13 January, I forwarded correspondence from one of my constituents to the Prime Minister. My constituent was very concerned about what he perceived to be the Prime Minister’s wish with regard to encrypted communications

“to enable the government to snoop”

on the private individual.

As the months passed and I received no response, I followed the matter up, and on 23 February I received a copy of a letter sent directly to my constituent. It is on Conservative party paper and comes from the political correspondence manager at No. 10 Downing street. The correspondent was sorry to read of my constituent’s concerns and stated:

“The Conservative manifesto will therefore make very clear that a Conservative government will introduce the legislation”.

The final sentence of the letter states:

“I do hope you find this reassuring and that you will feel able to support us in the months and years ahead.”

It was my understanding that no humble Back-Bench MP was ever allowed to use their parliamentary offices or salaries for party political campaigning. It is also my understanding that No. 10 Downing street does not become the property of its incumbent’s political party. I would be grateful for your advice, Mr Speaker, about precisely to whom I can address my concerns about what strikes me as totally unacceptable behaviour on the part of the Prime Minister.

Mr Speaker: Although I understand the considerable unhappiness that the hon. Lady might feel and that her constituent has experienced, it is not clear to me that this is a matter for the Chair. I say that in all sincerity—I have had modest advance notice of the matter, and it is not clear to me. The question of the letterhead is not a matter for the Chair; it may well have been judged proper in the circumstances to volunteer a view as to what a party to the coalition would intend for the future, rather than to purport to speak on the behalf of the coalition Government as a whole. In other words, it might be thought by some people to be a prudent judgment to answer on behalf of a party on party note paper, rather than on the part of a Government. That may be a matter of opinion.

I take what the hon. Lady says seriously, not least because she does not regularly raise points of order—certainly not frivolous ones that, believe it or not, some people are inclined to make. I therefore treat her with great seriousness. She will be with us, fortunately, in the House for a little while longer, and I feel sure that there will be an opportunity for her to air her concerns. She will look at the Order Paper and see what opportunities for questioning there are, and she will draw from her study the appropriate conclusion. Perhaps we can leave it there for now.

Mr Barry Sheerman (Huddersfield) (Lab/Co-op): On a point of order, Mr Speaker. I hope you do not consider this frivolous. You gave me a very considered

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reply when I asked for guidance on the unique situation of having a fixed-term Parliament, and ministerial visits around the country. We have just had Health questions, where Ministers referred to visits to Members’ constituencies—to look at things, presumably. What guidance can you give me, Mr Speaker? We are seeing targeted ministerial visits in this long campaign, which are obviously purely political visits to prop up candidates in marginal seat. I do not mind, as I said in my previous point of order, if these are political visits and they are paid for by Conservative central office or whatever. What I object to are political visits by Ministers to marginal seats, such as those in west Yorkshire, being paid for by the taxpayer. Can you guide me as to whom I complain to, Mr Speaker?

Mr Speaker: The short answer to the hon. Gentleman, whom I thank for his point of order, is that if he thinks there has been an abuse of public funds, it is open to him to raise that matter with the National Audit Office. However, the question of Ministers’ visits is not, and very properly not, a matter for the Chair. The only point I would make is that Ministers must visit the Chamber in order to answer questions—that is a matter of course—and Ministers must visit the Chamber, at the instruction of the Speaker, to answer urgent questions, something that happens rather more now than in the past. Beyond that, the day-to-day activities of Ministers—where, when, for how long, or in whose interests they perambulate around the country—is, thankfully, not a matter for me.

Mr Sheerman rose—

Mr Speaker: I do want to come on to the ten-minute rule motion, but—[Interruption.] Unlike some people, who are tolerant of the sound of their own voices but spectacularly uninterested in those of others, I will hear the hon. Gentleman. If there are a few Members who do not like it, they will have to lump it.

Mr Sheerman: Further to that point of order, Mr Speaker. I do not want to make myself unpopular with anyone, but I would like guidance on a matter similar to that which I raised in a point of order two weeks ago: Ministers coming to constituencies and not telling the constituency MP. They are telling Government MPs, but not Opposition MPs. That is breaking a convention that this House has honoured for a very long time.

Mr Speaker: On that point the position is clear: it is a convention and not a rule. The convention should be honoured. What I have said many times in response to protests from Members on both sides of the House, as the hon. Gentleman knows, is that the spirit of the convention should be observed. What that means is that a Member should give decent notice to the person whose constituency he or she is intending to visit, of the fact of that prospective visit. That is pretty clear, but it ought not really to be necessary for it to be constantly aired on the Floor of the House. I think people outside this place attending to our proceedings, who are often very critical of the way in which we conduct ourselves, would expect that grown-ups could treat each other with courtesy and respect in this matter, and indeed, perhaps, in a good many others.

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Mr David Winnick (Walsall North) (Lab): Further to that point of order, Mr Speaker. I support my hon. Friend the Member for Huddersfield (Mr Sheerman), but may I just make the point that the more Ministers visit my constituency, the more my support grows? I am making no complaint.

Mr Speaker: I note what the hon. Gentleman says and I repeat the point I have often made. The hon. Gentleman has served without interruption in the House since 1979, so it is coming up to 36 years in the House without a break. Before that, he served for four years in a different constituency from 1966 to 1970. The hon. Gentleman is now a celebrated denizen of this House and he must be doing something right.

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Nature

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

12.44 pm

Sir John Randall (Uxbridge and South Ruislip) (Con): I beg to move,

That leave be given to bring in a Bill to set biodiversity and other targets for 2040; to establish a Natural Capital Committee; to require local authorities to maintain local ecological network strategies; to identify species threatened with extinction; to make provision for access to high quality natural green space; and to include education about the natural environment in the curriculum for maintained schools.

The idea of our green and pleasant land is more a part of the Great British identity than of any other country I know—more than the rainforests of Borneo or the rolling savannah of the Serengeti. In recognition of the importance of our environment, the House has pioneered laws that have changed the world by protecting nature. Even as the bombs of the second world war were falling, MPs from all parties were debating how recovery would depend on protecting and restoring our natural landscapes. Looking back in Hansard, I found that hon. Members were urging the Government, especially in view of the new national health crusade, to take action on

“the countryside and its amenities, including the reservation of areas of natural interest against disorderly development and spoliation and the improvement of their accessibility to the public.”—[Official Report, 9 December 1936; Vol. 318, c. 2132.]

Even a century ago, people knew that our countryside was vital to people’s health and well-being.

With cross-party support, visionary MPs introduced the National Parks and Access to the Countryside Act 1949 to protect our national parks and areas of outstanding beauty. Since then, the House has legislated to protect thousands of species, in the Wildlife and Countryside Act 1981, and to provide countryside access for everyone, in the Countryside and Rights of Way Act 2000, and it was the first in the world to create binding national targets to tackle climate change. I congratulate the Prime Minister, the Deputy Prime Minister and the Leader of Her Majesty’s Loyal Opposition for reaffirming those vital commitments last week. That announcement was reported and commended around the world.

Today, I am proposing a nature and well-being Bill to take us further. We are the generation of David Attenborough and “Springwatch”. We are also the Danny Boyle generation—probably the only people in the world to understand why the Olympic opening ceremony started off with a flock of sheep and some farmyard geese. We all understand that nature is a part of our lives and a part of our identity, but we are also the generation that could preside over a terrible loss. We know that 60% of our native species are in long-term decline and that more and more of our countryside and wildlife are disappearing. Unless we do something about it, many of the next generation will never see a house sparrow in London, hear the song of the turtle dove or cuckoo, or smile at a hedgehog snuffling along their garden path.

Ultimately, nature’s loss is our loss too. No Government can meet their social and economic objectives at the expense of nature, and it is impossible to create a sustainable economy while we continue to take more

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from our natural world than we put back. Perhaps the most obvious example is our fisheries. Restoring our fish stocks to the levels of 50 years ago could bring in £1.4 billion a year and revitalise our seaside economy—one has only to ask the fishermen whose lines come up empty because the sea has been trawled to ruin. Or think of the bees. The Environment Secretary has rightly recognised the importance of nature’s pollinators to our farming sector—the biggest manufacturing sector in Britain—and I understand that she even has bees on the roof of DEFRA.

Neither will we ever have a truly fair society with a decent standard of living while environmental inequality remains, because it is the poorest and most vulnerable people who live along the most polluted streets, with no access to green space. It is a travesty that people still die years earlier in some places than in others because the air they breathe is dirtier and they have no safe green places to walk in or exercise. Natural England has estimated that we could save £2.1 billion for the NHS every year if everyone had decent access to nature.

We all want nature because, frankly, it is brilliant, but we also need it for our livelihoods. The first thing to do is to admit there is a problem and then make a commitment to change. I know that targets might not be in vogue in this House—there are people who do not always agree with them—but people outside this place understand what they mean, and I want to tell people that we will be the first generation ever to turn around nature’s decline. I want us to make that promise and to set targets for wildlife sites and species, with regular reporting to Parliament. In the next 25 years, we should ensure that British biodiversity is richer than today, measured by an index of wildlife. We should make sure that our most precious landscapes—places such as the north Norfolk coast, which I was lucky enough to visit last week—are in better condition than today.

We all know, however, that targets are pointless unless they help to change the way we behave, which is why I am also proposing new ways to put nature at the heart of decision making.

The present Government created the Natural Capital Committee, and the last Government conducted the national ecosystem assessment. That amazing work has begun to show how crucial our natural world is for our businesses and communities, but we routinely ignore our need for nature in the way in which we make decisions. I want to do what the Environmental Audit Committee recommended and set the Natural Capital Committee on a legislative footing, giving it new independence and new powers to report on progress. Its duty will be to ensure that when we make new law, the importance of nature is taken into account.

However, it is not enough to create new-fangled accounting mechanisms without changing what is actually happening in our countryside, and also in our towns and cities. One inspiring example is Wallasea island. Crossrail has recycled 4.5 million tonnes of earth from its works to build a new island, which I hope will be home to some amazing birds such as the spoonbill. Thousands of ducks and geese are already enjoying the site. Moreover, the development is expected to save £650,000 in flood defences, create new jobs, and protect the existing jobs that are supported by the fisheries and dockside businesses in the area.

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We shall need a great many new homes over the next few years, so let us ensure that we provide them in a way that works for nature. The best businesses are already thinking about that. Barratt Developments has just teamed up with the Royal Society for the Protection of Birds to build 2,500 homes in Aylesbury. Some 50% of the development will be green space, and RSPB scientists will monitor the site over the next 20 years to ensure that we end up with more wildlife than we started with. That is good for nature, good for the people who live there, and good for business, but it must not be the exception. We need to make sure that we reward the businesses that look after nature, and that we set the right standards to help to give people what they need. That is why I am also proposing new ways in which to plan for nature at local level. Sir John Lawton has shown how important nature networks are in linking big green spaces, and the wildlife trusts have shown how mapping those spaces in local plans can help to speed up planning decisions and improve important services such as natural flood defences.

Today, our children are more cooped up than they have ever been before. The average distance between the areas where they play and their homes is a fraction of what it was a generation ago. We should set basic standards for access to green space so that everyone has a chance to enjoy nature. Of course, that does not mean that every house can have Richmond Park down the road, but it does mean that when planning decisions are made, we should consider how nature can improve people’s health, mental health and education. In built-up areas, that might mean planning for a new road bridge, or planting wild flowers to bring a patch of grass to life.

I am not alone in calling for a Nature Act. More than 20 organisations have joined the campaign for a nature and wellbeing Act, including the RSPB, the wildlife trusts, the Green Alliance and the Ramblers, as well as health and mental health charities. They recognise that even in tough times—perhaps especially in tough times—people need nature, and nature needs us.

Let me end by reminding the House that there are always great challenges for society to face. Today we are recovering from an economic challenge, but we are also planning to meet huge challenges for our NHS, and we are looking for ways in which to build enough homes. Let us follow the example set a century ago by those Members of Parliament who knew, even in wartime, that if we were to meet our biggest challenges, we would have to look after our natural world. Let us be the first generation to make a commitment in law to turn around nature’s decline, for its own sake, for our economy, for our communities and for our children. We should do that not only because nature is special—here in the House we can look at the peregrines that nest on the top of Victoria Tower, and I can see them from my office window—and not only because we need it for our economy and our health care, but because it is a part of who we are.

This will be an issue for the next Parliament, and I shall be watching all Members then. I commend the Bill to the House.

Question put and agreed to.

Ordered,

That Sir John Randall, Nick de Bois, Michael Fabricant, Richard Harrington, Rebecca Harris, Dr Julian Huppert,

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Simon Kirby, John McDonnell, Dr Matthew Offord, Miss Chloe Smith, Henry Smith and Mr Mark Spencer present the Bill.

Sir John Randall accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 6 March and to be printed (Bill 176).

Pension Schemes Bill (Programme) (No. 2)

Motion made, and Question put forthwith (Standing Order No. 83A(7)),

That the following provisions shall apply to the Pension Schemes Bill for the purpose of supplementing the Order of 2 September 2014 (Pension Schemes Bill (Programme)):

Consideration of Lords Amendments

(1) Proceedings on consideration of Lords Amendments shall (so far as not previously concluded) be brought to a conclusion two hours after their commencement at today’s sitting.

Subsequent stages

(2) Any further Message from the Lords may be considered forthwith without any Question being put.

(3) The proceedings on any further Message from the Lords shall (so far as not previously concluded) be brought to a conclusion one hour after their commencement.—(Steve Webb.)

Question agreed to.

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Pension Schemes Bill

Consideration of Lords amendments

Clause 27

Requirement to wind up scheme in specified circumstances

12.55 pm

The Minister for Pensions (Steve Webb): I beg to move, That this House agrees with Lords amendment 1.

Mr Speaker: With this is will be convenient to take Lords amendments 2 to 9, 44, 49, 56 to 65, and 117.

Steve Webb: I believe that the Bill is in a better state as a result of the two groups of Lords amendments that we shall discuss today. Many of them are Government amendments, designed to tidy things up or deal with errors, and some reflect their lordships’ desire for the affirmative procedure to be used in the case of certain statutory instruments. The amendments are largely technical, but I shall of course be happy to deal with them in more detail if the House wishes me to do so.

Lords amendments 1 to 9, 49, and 59 to 65 deal with defined ambition and collectives. The Bill contains key reforms to private pensions; encouraging and enabling “defined ambition” or “shared risk” pension schemes and “collective benefits”. In the following amendments, their lordships sought to refine or build on the legislation since it had left the Commons.

Lords amendments 1, 2, 3 and 6 introduce minor changes to ensure drafting consistency. Clause 27 provides for regulations to require a scheme providing collective benefits to wind up the whole or part of the scheme, while clause 37 provides for regulations to impose a duty on managers of non-trust-based schemes to act in the best interests of the members when making certain decisions. Both clauses refer to different types of obligation that may apply in relation to the scheme, including those that are part of the scheme—that is, provisions of the scheme—and those contained in legislation that applies to the scheme. The amendments provide for descriptive consistency in the clauses in relation to those different types of obligation.

Lords amendments 4 and 5 clarify “publication of documents” provisions. Powers in part 2 of the Bill may require trustees or managers of schemes providing collective benefits to have policies in relation to a number of matters, including the factors used to calculate member benefits, the calculation of transfer values, and steps to deal with a deficit or surplus in relation to the target. Clause 32 allows regulations made under part 2, which require trustees or managers to prepare or obtain any document, to include requirements relating to the publication of those documents and the sending of copies to a specified person. Specified persons could include members and regulators.

The publication of various policies is a key feature of the regime that we are seeking to introduce in order to ensure that it is clear how members’ assets and benefits will be managed or calculated by the scheme. It ensures that there will be transparency in regard to the way in which collective benefit assets are treated in certain

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circumstances, because there is a less direct relationship than there is in a money purchase benefit when it comes to a member’s entitlement in relation to contributions. We also have regulation-making powers to make certain requirements in relation to the policy. An amendment was required to put it beyond doubt that the provisions of clause 32 also apply to the policies specifically. The amendment ensures there is no possibility of a scheme’s “having” a policy that we cannot require to be published or sent to a specified person.

Lords amendment 7 puts the meaning of the amendment made by clause 45 beyond doubt. The change to section 67A of the Pensions Act in the clause makes any modification to an occupational pension scheme that would replace a member’s accrued rights with a right to a collective benefit a “protected modification”. Protected modifications can be made only if the member consents. Lords amendment 7 makes it clear that the provision applies only when the existing accrued right is not a right to a collective benefit.

Lords amendments 8, 9, 59 and 60 address an omission in the current legislation. While the changes made by the Bill were being checked, omissions in the Pensions Act 2014 came to light. The amendments that were needed all relate to overriding legislation. When legislation overrides conflicting provision in the scheme rules, there are circumstances in which that legislation needs to be treated as if it were part of the scheme rules. The amendments ensure that overriding requirements made under regulations provided for by schedules 17 and 18 to the Pensions Act will be treated as part of the scheme rules for the purposes of the Pensions Act 2004, in the case of Lords amendments 64 and 65, and subsisting rights provisions in the 1995 Act, in the case of Lords amendments 8 and 9. The amendments provide for consistency and clarity in the way in which the overriding provisions are dealt with.

1 pm

Amendment 49 changes the parliamentary procedure that applies to certain regulations under part 2 of the Bill. Part 2 defines the concept of collective benefits and makes provision for regulation-making powers in relation to them. Regulations made under clause 8(3)(b) and clauses 9 to 11 and 21 determine important aspects of the arrangements for “collective benefits”. These powers cover matters such as the exclusion of benefits from the definition of collective benefits, the setting of targets in relation to benefits, the factors to be used in the determination of benefits, and the policy for dealing with a deficit and surplus in relation to the target.

The effect of amendment 49 is that the regulation-making powers in clause 8(3)(b) and clauses 9 to 11 and 21 will be subject to the affirmative procedure the first time they are used, and will be subject to the negative procedure for subsequent uses. This amendment relates to recommendations made by the Delegated Powers and Regulatory Reform Committee about the powers on how collective benefits are defined, and how schemes that provide those benefits will operate.

Amendment 61 makes a minor correction, replacing a stray reference to “hybrid schemes” that was missed when the Bill was introduced, while amendments 62 to 65 amend the amendments to section 99 of the Pensions Act 2008. Section 99 lists the definitions used. Currently two separate provisions in paragraph 50 of schedule 2

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relate to the definition of “defined benefits scheme”. One adds a new definition drawn from part 1 of this Bill; the other is intended to remove the existing definition. Lords amendments 62, 64 and 65 replace two provisions with a single provision that substitutes the old definition with the new one. Lords amendment 63 also adds a definition of “collective benefit” to section 99.

Amendments 44 and 56 relate to public service pension schemes. New information suggests the pension schemes for the Secret Intelligence Service and the Security Service were misclassified when the Public Service Pensions Act 2013 was originally drafted. When the Act was drafted it was thought that the agencies schemes were “public body schemes”, which must close and reform by 2018. The agencies have since been working to reform by April 2016, but we now believe the agencies may be “existing schemes” as defined in the Act. This would mean they have to close and put in place a new scheme by 1 April 2015, like the other main schemes, such as for teachers. At this late stage it is not possible to put a new scheme in place by 2015. Without the amendment, the agencies’ staff could be left without lawful pension provision after 2015. Amendment 44 introduces a new clause after clause 77 that prevents this by ensuring the agencies schemes are not included as “existing schemes” in the Act. It ensures reform of the agencies schemes can proceed to the expected timetable of 2016. Amendment 56 to clause 84 enables the new clause to come into force on Royal Assent.

Amendments 57 and 58 provide general amendments to part 6 of the Bill, to include reference to the Bill in the definition of “pensions legislation” in the Pensions Act 2004, and they come into force from 6 April 2015.

Amendment 117 relates to pension schemes for fee-paid judges. This amendment is required to fulfil the recommendation of the Delegated Powers and Regulatory Reform Committee report proposal that regulations made under the new section 18A of the Judicial Pensions and Retirements Act 1993 should be subject to the affirmative resolution procedure.

These amendments are welcome, and as far as I can see are largely technical, and I commend them to the House.

Gregg McClymont (Cumbernauld, Kilsyth and Kirkintilloch East) (Lab): I thank the Minister for his explanation of amendment 1 and those with which it is grouped. Let me make a number of points. There are two parts of this Bill, and we will come to the second part regarding the way it interacts with the pension budget flexibilities announced in last year’s Budget in a moment. I would like to put on record my thanks to the other place and particularly those on the Opposition Front Bench who have done such a sterling job on what is often a rather technical Bill. I also want to put on record my appreciation for the work done by Baronesses Drake and Hollis who have done so much to make this a better piece of legislation.

Let me pick the Minister up on a couple of things, particularly around clause 8. He referred in his explanation to clause 8 and the delegated powers contained therein. He will be aware that the debates in the other place focused for some time on the implications of clause 8 because, of course, it is a key and critical provision setting the definition of what are collective benefits, on which the rest of the clauses in part 2, and many of the

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associated delegated powers, depend. That is why it is so critical in its construct and its definition of the delegated powers associated with it.

In the other place, Baroness Drake made it clear that in her view the power to set regulations under clause 8(3)(b) should be subject to the affirmative procedure because a definition of what is or is not a collective benefit is critical to the whole scope of part 2, which deals with collective benefits. Clause 8(3)(b) would allow the Government to use regulations to avoid schemes being subject to the expense of meeting the detailed requirements set out in clauses 9 to 35 if they are deemed not to be proper collective benefits, but the clause, in granting the Government power to significantly alter by regulation the constituent benefits that are not included in the definition of collective benefits, has the ability potentially to remove members of schemes from the protection of the requirements in the other clauses in part 2.

The Minister will know that this could have considerable implications for members and the scope of the whole of part 2. The potential of this regulation to remove members from the protections they may already have by being in a designated collective benefit scheme which subsequently a change of regulation deems they are no longer in makes it in our view compelling that this should remain a power that is subject to the affirmative procedure. The Government’s reply to the scrutiny from the Opposition in the other place was to say, “Well, the affirmative procedure will be used in first use, but subsequently not,” but surely this is worth considering. I will be interested to hear the Minister’s response.

In the other place, the Government gave a detailed response to this critique. As anyone who reads the debates will see, it revolved around the fact that the first use will be by affirmative procedure, but the affirmative procedure might be used in the first instance on something quite straightforward, such as that an obvious with-profits policy arrangement is not to be included in collective benefits, but the subsequent use of the regulation under the negative procedure might go-to the heart, to something much more fundamental such as an existing collective benefit scheme. We must be aware of the possibility that regulations could be used to weaken the protections scheme members have.

In response to this specific point, Lord Bourne said in the other place that the negative procedure will still provide a measure of protection, but we know that is not the level of protection that would be provided by the affirmative procedure. This is rather technical, but it does bear upon a very important aspect, which is that moving towards a negative position rather than a positive position through an affirmative vote could be a way in which the protections are weakened—I am sure against the Minister’s inclinations and desires. I would appreciate hearing his observations on that part of the debate in the other place.

More widely, much of the debate in the other place on this part of the Bill focused on clauses relating to the duties of fiduciaries or managers of the schemes. The Minister and I have had that debate a number of times, but given all the regulatory complication of setting up the independent governance committees and giving them fiduciary responsibilities to monitor the behaviour of

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private pension providers while exempting the private providers themselves, this just seems an unnecessary complication. Pensions are complex enough without making them that much more complex. The responsibility should be put directly on the decision makers in the pensions industry by applying a fiduciary obligation not to them themselves, but to trustees to do the job of governance throughout.

The Minister will be aware that Professor John Kay, reporting for the Government—and particularly for the yellow-tinged part of the Government, as the Minister will no doubt be aware—was clear that everyone managing someone else’s money or advising on investment should be subject to fiduciary standards of care. I have argued on a number of occasions—and if it is exhausting for me, it must be exhausting for those listening—for extending a clear fiduciary duty to those who have discretion over the management of other people’s money. The Australians have that principle at the heart of their system, and while that system is not perfect, that aspect of it makes it clear unequivocally that conflicts of interest must be resolved in favour of beneficiaries.

I am not expecting the Minister dramatically to change course at this stage, but I would just point out that the Financial Conduct Authority’s recent investigations into the pensions industry have provided substantial arguments in favour of the proposition that I and others have been advancing. We have now had numerous reports on how the market is not serving pension scheme savers well, whether they have legacy schemes or annuities, owing to a lack of transparency, charges and many other factors.

Steve Webb: As the hon. Gentleman says, we have discussed these issues before. Will he just clarify which of the amendments he is referring to, so that I can respond helpfully to him?

Gregg McClymont: I was referring to clause 8, to which the Minister has also referred, as well as referring to that part of the Bill more widely where it pertains to governance. I am sure that the Minister will be weary of the debates that we have had on these issues, and that he will be keen to set out his current thinking on this aspect of the Bill. He will be aware that this issue is central to his ambitions for collective defined contribution. If it were not, he would not have set out the Bill in this fashion.

I should like to put on record again my thanks to the other place and in particular those on the Opposition Front Bench, including the good Baroness Drake and the good Baroness Hollis. I am grateful, too, for the constructive spirit in which the Government in the other place have approached the Bill. I look forward to hearing the Minister’s observations on the issues relating to delegated powers and, more widely, on the governance of the pension schemes that he rightly wants to make permissible under the Bill.

Steve Webb: I shall respond briefly to the issues that the hon. Gentleman has raised. I am grateful to him for his comments, and I should like to extend my thanks to our noble Friends in another place for bringing the Bill forward on our behalf. I also share his respect for his colleagues, Baroness Drake and Baroness Hollis, for their knowledge and their contribution to the debates.

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As the hon. Gentleman says, the issue of whether the affirmative or negative procedure is used in regard to regulations in clause 8 was debated at length. He pointed out that Baroness Drake wanted the affirmative procedure to be used in all cases, while the Government originally planned always to use the negative procedure. The Government then responded to the views of the Delegated Powers and Regulatory Reform Committee and agreed that, on first use, the affirmative procedure would be used. Obviously we could say that everything should always be decided through the affirmative procedure, but there is a balance to be struck here. The Committee wanted that, but the Government do not consider that to be appropriate because we sometimes need the flexibility to act quickly if schemes are being inappropriately caught by the collective benefits definition.

There is always a trade-off in these circumstances. Sometimes in the world of pensions, things happen that we do not expect. People might be in the wrong place, for example, or their rights might be at risk or inappropriately protected, and the Government need to be able to move quickly rather than having to go through the rather lengthy parliamentary process that the affirmative procedure requires.

We accept, however, that clause 8 is a key provision and I can put on record that it is not our intention for members who are in schemes providing collective benefits, and subject to the provisions, suddenly to lose the important protection that the regulations made under part 2 of the Bill will provide. If the situation were to arise in which those protections were to be taken away, we would want to understand the situation and ensure that it was appropriate and necessary before taking action and laying regulations. As the hon. Gentleman said, even under the negative procedure there is scope for praying against the regulations if a particular concern should arise, and for a debate to take place.

Most of my experience has been from the Opposition Benches, and during the passage of primary legislation, the Opposition always seem desperate for everything to be conducted under the affirmative procedure while the Government want nothing, but many of the affirmative statutory instruments that the hon. Gentleman and I have dealt with, over the past however many years it has been, have been over in 10 minutes. We get very exercised about the need for affirmative scrutiny, but when we get to that scrutiny, it can occasionally border on the desultory. I hope that we are striking the right balance in recognising that these are important matters and providing affirmative protection on the first use and further parliamentary scrutiny on any subsequent use through the normal processes.

1.15 pm

The hon. Gentleman raised certain wider issues, but I am not sure that it is appropriate for me to go into them in great detail now. I recognise that he wants to strengthen the fiduciary duties of those who oversee pension schemes, and I am sure that that debate will continue. I believe that the new independent governance committees will mark a big step forward from where we have been in the past, and that they will provide scrutiny. I have talked to most of the major insurance companies in the past few weeks, and they are setting up their IGCs now. It is clear that they will be organisations with teeth and with serious people heading them, and that they will be

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listened to. We will also continue to keep the situation under review. With that, I commend Lords amendment 1 to the House.

Lords amendment 1 agreed to.

Lords amendments 2 to 9 agreed to.

Clause 47

Pensions guidance

Steve Webb: I beg to move, That this House agrees with Lords amendment 10.

Mr Speaker: With this it will be convenient to consider Lords amendments 11 to 43, 45 to 48, 50 to 55 and 66 to 116.

Steve Webb: This group of amendments relates primarily to the new pensions freedoms announced by the Chancellor in the Budget last year, which will generally come into effect on 6 April this year. I shall begin with the pension guidance and guarantee, now known as Pension Wise, covered by amendment 10 and amendments 66 to72. The Government intend that all those who stand to benefit directly from the new pensions flexibilities provided by the Taxation of Pensions Act 2014 should have access to guidance. The amendments to clause 47 and schedule 3 are technical amendments to ensure that that is the case.

The amendments adjust the definition of pensions guidance in new sections 333A and 137FB of the Financial Services and Markets Act 2000 to extend pensions guidance to survivors of members who have flexible benefits, rather than just the members of pension schemes. This is needed because in some circumstances pension schemes may provide benefits to survivors of members of the scheme other than insurance-based products or cash lump sums—that is, flexible benefits—without their becoming members of the scheme.

Amendments 11 to 18 and amendment 50 provide advice safeguards. Clauses 48 and 51 were amended in the Lords via Government amendment. These contain the provisions creating the advice safeguard, which requires schemes to check that financial advice has been received before an individual exchanges their safeguarded rights for those that can be taken flexibly. Clause 48 makes provision for Great Britain, while clause 51 makes corresponding provision for Northern Ireland. Amendments 11 and 15 improve the drafting of clauses 48 and 51, while amendments 12 and 16 ensure that the requirement to take advice also applies when a member takes an uncrystallised funds pension lump sum from benefits that are safeguarded.

On Report in the other place, a second group of amendments to those clauses were made in response to the recommendations of the Delegated Powers and Regulatory Reform Committee. Amendments 13 and 17 specifically provide for the only exception to the advice requirement that is intended to be in effect by 6 April—namely, an exemption from checking that advice has been received in the case of those with safeguarded wealth of £30,000 and below. Amendment 50 provides that regulations creating this exception are subject to

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the negative procedure, while regulations creating any other type of exception are subject to the affirmative procedure.

Amendment 14 provides more detail on the nature of the “appropriate independent advice” that is to be required under the safeguard. It provides that “appropriate independent advice” must be given by an “authorised independent adviser”, who has permission under the Financial Services and Markets Act 2000 to carry out a regulated activity specified in regulations. The Financial Conduct Authority sets out the standards for regulated activities in its rules, and that will allow it to set the standards for advice provided under the advice safeguard. Amendment 18 makes corresponding provision for Northern Ireland.

Let me now deal with amendments 19 to 21, 23 to 25, and 38 to 43, which are amendments to clauses 55 and 56, consequential on the Taxation of Pensions Act 2014. They allow a person to leave any remaining money purchase funds to a nominee or a successor. Schemes will be able to offer both nominees and successors a drawdown fund, so they need to be included in the clauses which deal with such arrangements. Amendments to clauses 60 and 61 do the same thing for legislation covering Northern Ireland, while amendments to clauses 72 to 74 make small changes to the definitions of terms used in part 4 of the Bill.

Let me now deal with amendments 22, 26 and 73 to 116, which are technical amendments to reflect the extension of the statutory right to transfer benefits and to ensure that the transfer process continues to operate smoothly after the requirement to take “appropriate independent advice” comes into force in April. Without these amendments there is a risk that the new transfer rights would not operate as intended after the new flexibilities come into force. Schedule 4 of the Bill amends the existing transfer rights provisions contained in part 4 of the Pension Schemes Act 1993 to give scheme members a statutory right to transfer a particular category of benefits, and gives scheme members with flexible benefits a statutory right to transfer these rights up to and beyond their scheme’s normal retirement age. Amendments 73, 92, 94, 96 and 115 would make consequential amendments to reflect numbering changes made elsewhere in schedule 4.

Amendments 22, 82 and 83 ensure that clause 55 and regulations under clauses 56 and 57 override any pension scheme rules which conflict with the statutory right to transfer overriding provisions for the purposes of the definition of “scheme rules”. These provisions amend the Pension Schemes Act 1993, the Pensions Act 1995 and the Pensions Act 2004, while amendments 26, 105 and 106 make corresponding provision for Northern Ireland. Amendment 75 replicates existing powers in the 1993 Act and will be used to preserve the effect of existing regulations under those powers, while amendment 98 makes identical provisions for Northern Ireland legislation.

Amendments 76 and 78 provide powers to extend the period within which a member who has received a statement of entitlement must take the cash equivalent of their accrued rights, and for the right to take the cash equivalent to lapse. Amendment 80 provides a power to extend the time in which the trustees of a scheme must

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do what the member requires. Amendments 88 and 89 make similar provision to extend time for pension credit members, and for trustees to act on members’ instructions. Amendments 99, 101, 103, 111 and 112 make similar amendments to the corresponding Northern Ireland legislation.

Amendments 79 and 102 make changes to section 98(1) of the 1993 Act and clarify that a member’s right to take a cash equivalent falls away where the trustees’ duty to carry out the member’s wishes is extinguished because they have been unable to confirm that the member has taken appropriate independent advice. Amendments 81, 86, 93 and 95 ensure that the definitions of scheme rules in the 1993 Act and the 2004 Act work for personal pension schemes. Amendments 82, 83 and 105 ensure that the definitions of “scheme rules” in the 1993 and 2004 Acts also apply for personal pensions, while taking account of any provisions that override these rules. Amendments 104, 109 and 116 do the same for Northern Ireland. Amendment 87 inserts a power to disapply the right of a pension credit member to transfer their pension credit rights in relation to prescribed descriptions of persons. Amendment 110 makes a similar amendment to Northern Ireland legislation. The remaining amendments in this group make a number of drafting, technical and consequential amendments to schedule 4 of the Bill.

Amendments 27 to 37 relate to public service scheme transfers. These are technical changes to improve drafting and ensure that the new safeguard applies where it should. The remaining amendments 45 to 48 and 51 to 55 are general amendments to part 6 of the Bill and are what are often known as the “back of the Bill” provisions. Amendments to clauses 80 and 81 would extend provisions to Northern Ireland, while the amendment to clause 84 would ensure that pension flexibilities provisions come into force at Royal Assent. I hope that what I have said has been helpful, and I commend the amendments to the House.

Gregg McClymont: The Minister raced through his text, much to the chagrin of the whole House I am sure, as we were enjoying it so much. Let me pick up on a couple of issues. We are dealing with the part of the Bill that has created some complexities because, to put it politely, it dovetails with the 2014 Act. If we were being less kind, we would say that some tensions are created because we cannot examine this Bill while, side by side, scrutinising that Act. I put that point on the record, although it has been discussed previously.

Lords amendments 13, 14, 17, 18 and 50 refer to the much-discussed guidance that those eligible to access their pension pots from April will be offered. The Minister mentioned Government amendments being tabled in the other place. Of course, the amendments are welcome, both as a necessary second line of defence and because they show that the Government are listening to the Opposition in this place and in the other place, and to the campaign led by interested pensions organisations outside the House. Why is it so important to have that second line of defence? As the Government accept, it is simply because it is one thing to offer guidance online from gov.uk, in person from citizens advice bureaux and by telephone through the Pensions Advisory Service, but what happens when an individual discusses buying a product from a provider is another thing entirely.

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Much of the debate on this Bill and other pensions Bills in this Parliament has revolved around that issue. According to the FCA studies and a variety of sources, decisions often end up being much more in the interest of those selling the product than those buying it. The Government have recognised that when someone comes to consider buying a product, the provider must check that they have received the appropriate guidance, either from the services I mentioned or from other sources. It is welcome that they have accepted the argument of the Opposition and others on putting in place a second line of defence, which the Minister calls the “advice safeguard”.

That brings us to one question that relates to part of the 2014 Act, as well as this Bill: how do we ensure that individuals are equipped to make what at times are complex financial decisions about what to do with their retirement income? Much of the legislation pertaining to this important aspect lies in the 2014 Act and, on one level, is outwith the bounds of what we are discussing today. But it is important to put on the record that significant questions remain about how the guidance guarantee will work from April. That view has been heard repeatedly from those in the pensions world and I am sure that the Minister, if he is not having sleepless nights about it, is paying close attention to it.

The impact of the new flexibilities, which will be introduced from April, on eligibility for means-tested benefits was the subject of much discussion in the other place. This pertains to the guidance amendments and, more widely, to the 2014 Act, which of course goes hand in hand with the Bill. Baroness Hollis asked a series of important questions of the Minister in the other place and the Government about how this new system of pension flexibilities will work in harness with existing eligibility for benefits and, more widely, with Department for Work and Pensions benefit rules. I have to say that it is not that reassuring to hear from the Minister in the other place that all will be revealed before April. As things stand, there is still no clarity over how the new flexibilities will interact with DWP benefit rules, which will concern the whole House.

1.30 pm

Let me give three examples, the first of which is on income. Let us say that, at 56, a person has a modest wage of £20,000. They rent privately and get housing benefit as they have minimal savings. They have a small pension pot of £25,000 and, after April, they take £15,000 of that pension pot to pay off debts or buy a new car. Up to 25% of that pot—some £6,000—is obviously tax free under pension rules, but will count as income against their means-tested benefits under DWP rules. Above that £6,000, they will pay income tax as well as lose benefit on the rest of the £15,000. Surely it is essential that anyone on means-tested benefits at the age of 56 knows what the impact will be of accessing their pension pot in line with the new flexibilities after April. I suspect that most people are simply not aware of that interaction. Something will need to be done rapidly to ensure that that kind of interaction and detriment are understood.

That is a simple example, but what about capital? What happens if, instead of accessing their pension pot to count as income, a person lets it sit there as capital, fully accessible when they need it, but not yet taken—a bit like an untouched ISA, as Baroness Hollis said. Up

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until now, inaccessible pension pots, which cannot be accessed under current rules, have, quite sensibly, been ignored. They do not count against the DWP’s capital savings rules, whereas other accessible incomes and savings such as ISAs do. That is another issue. In the debate in the other place, the Government said that they would clarify that matter shortly. But it is already nearly the end of February, and the rules come into place in April. It is not unfair to suggest that the Government are really running up against time here. Individuals need to understand the potential impact on their eligibility for benefits if they access their pension pots.

Let us say, for example, that someone is earning £25,000 a year, and have £25,000 in ISAs and £25,000 in their pension pot. They have injured their back and need to stop work and want means-tested benefits, but their £25,000 of ISAs savings debar them. What do they do? It is a no-brainer, as Baroness Hollis observed. They cycle their ISAs into a pension pot and shelter them. When they retire next year, at 56, they will get full means-tested benefits and, potentially, the same access to their savings that they had when half of them were ISAs. It is great for that individual, but for the rest of us, as taxpayers, it means bigger benefit bills. In the other place, the Government did not provide a compelling answer to that problem.

Finally, social care is means tested. At normal retirement age, a person’s pension pot—even if they have not touched it—is treated as if it is giving a notional annuity income. That notional income is included when assessing how much a person should pay in social care. Pension pots are not sheltered. Let us take another example. A person of 55, who may have built up a modest pension pot at work, has broken their back and needs social care. Although their pension pot is fully accessible, as if they were 65, their pension is not taken into account for social care means testing. If someone gets injured at 55, they pay little or nothing for their social care. If they live a little longer, as we hope, their pension is taken into account and their social care bill soars. How is that fair? Baroness Hollis suggested that it was age discrimination. How can we expect people to understand such contrary rules?

The Government might have compelling responses to those hypothetical case studies, but so far they have not provided any enlightenment on how the pension flexibilities contained in the Budget will interact with eligibility for DWP benefits.

In the other place, the Government said that they intend to come forward “soon” with explanations of how the Budget reforms will interact with DWP rules. But time is marching on. We are very close to those flexibilities “going live”, and it is incumbent on the Government to let us all know how the reforms interact with DWP benefit rules.

The issues and amendments pertaining to the second part of this Bill are necessarily related to the Pensions Schemes Bill. The Minister will not be able to provide us with all the answers. One problem is that the questions that one feels compelled to direct at the Minister of State for Pensions would be better directed at Treasury Ministers. That is something that has emerged during the course of these two parallel Bills.

I am sure that the Minister would agree that the interaction with DWP benefit rules is crucial. Unless the Government very rapidly explain the situation, significant numbers of people might undergo detriment.

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Let me end on a note of consensus. The second line of defence, which came about as a result of the great work of the Opposition in the other place, has been accepted by the Government and will be welcomed by Members from all parts of the House. I rest my case.

Steve Webb: I hope that I can respond helpfully to the two sets of issues that the hon. Gentleman raised. I thank him for using the attractive word “dovetailing” to describe what is happening between DWP and HM Treasury legislation.

The hon. Gentleman asked about the second line of defence. I think that there might have been some confusion in what he said. I apologise if the speed with which I went through my remarks put him off the scent. I had assumed that nothing I said would affect what he was going to say, which is why I went so quickly. To clarify: the second line of defence, which is the requirement on providers to ask searching questions of people choosing to do things with their pension pot, is not in the Bill at all. The amendments that refer to advice—as in independent financial advice and regulated advice—are the safeguards for people who are transferring from a defined benefit pension into a defined contribution pension with a view to accessing the flexibilities. The Bill requires them to have taken independent financial advice, and the amendments help to specify exactly what that is. I hope the hon. Gentleman is not confused. The amendments relate to the advice safeguard, which is about things such as DB to DC transfers. But he is right that the issue of a so-called second line of defence is an important one. The Government have listened. We anticipate that the Financial Conduct Authority will bring forward its detailed rules on how that should work in practice and we will be working with the trust-based pensions sector to do the same through the pensions regulator. I agree that those who raise such important issues both within and beyond the House deserve credit for doing so. I am grateful to him for the credit that he gave to the Government for listening to those concerns.