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The Kirkgate Centre has great ambitions to broaden its cultural programme so that local communities can benefit even more from the wide range of high-quality performances and events it puts on. It would be much more likely to be able to deliver those ambitions if arts funding were not so disproportionately divided across the country. If there were less of a regional imbalance, areas such as mine would no longer miss out. We need to ensure that access to music and theatre is not just for people who live in big cities; I do not have a big city in my constituency. Everyone needs access to the arts, wherever they live.

Over the past few years, successive Governments, as well as the Arts Council, have acknowledged the serious imbalance in arts funding, but nothing has been done to alleviate it, the argument being that significant new funds would need to be found. As the hon. Member for Newark said, the latest figures on the funds distributed by the Arts Council show an enormous benefit to London per head of population compared with what goes to the regions. That is even further distorted because most of the regional funding goes to cities such as Manchester, not to rural communities like mine.

I am delighted that the new chief executive of the Arts Council, Darren Henley, understands the situation and has said that it should not be allowed to continue. He has pledged a significant shift in how the Arts Council invests its lottery revenue further out into the regions. Nevertheless, I fear that the areas further from the centre, such as west Cumbria, will continue to miss out, because if regional funding is provided, it gets sucked into the bigger cities within a region and does not make it out to more rural areas. We need to ensure that that does not happen.

Cumbria is often overlooked—it is a bit out on a limb, particularly west Cumbria. When he looks at the distribution of funding to the regions, I urge the Minister to work with the Arts Council to consider how we can make sure that all areas of the country are taken into account.

2.56 pm

Sitting suspended for a Division in the House.

3.10 pm

On resuming—

Sue Hayman: As I was saying, west Cumbria needs continued access to funding, and I hope we can work to deliver that. I like to think really big for my constituency, so there is something I would like the Minister to consider. Right now, major collections in London are left undisplayed: for example, Turner’s watercolours are just stacked away, and if someone wants to see them they actually have to request permission. Why do we not consider moving some of those undisplayed works, which could be national collections, out of London and into the regions to improve cultural awareness, create jobs, increase tourism and, most of all, ensure cultural accessibility?

John Nicolson: Is the hon. Lady aware that a significant percentage of the Government’s secret, undisplayed art collection has gone missing? It is one of the great scandals of the Government—not of the Conservative party in particular, but of the state in general—that we do not know the location of many of those works of art. It is an extraordinary thing.

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Sue Hayman: I was aware that people do not know exactly where all the pieces of art that are catalogued are. I hope that my idea would help to prevent such things from happening in the future. It may even enable the Government to discover some of the lost artefacts.

Leeds, Newcastle and Manchester have all benefited from art being moved out of the capital into the regions, so why not move some to west Cumbria? The west coast of Cumbria will soon benefit from major infrastructure developments, as I am sure the Minister is aware, and with that will come investment in my constituency. Why not use some of that investment to bring about projects such as I describe, which would create a lasting cultural legacy for the area? Will the Minister consider discussing my idea with the museums and galleries to see whether we can consider such a proposal for west Cumbria and perhaps for other areas around the country?

Mr Vaizey: Yes.

Andrew Rosindell (in the Chair): I call Lady Victoria Borwick.

3.13 pm

Victoria Borwick (Kensington) (Con): Victoria Borwick will do. It is a delight to welcome you to the Chair for this debate, Mr Rosindell.

I am speaking today as the MP for Kensington, where we have a great number of fantastic museums. I appreciate the sentiments expressed by some of my colleagues earlier, but it is only fair that I should remind people that we have the fantastic Science museum—many Members will have beaten a path to the door to twirl the knobs, press the buttons and enjoy the secrets of the Science museum, particularly given that we want to encourage more teaching of science, engineering and mathematics. We have, of course, Dippy the dinosaur in the Natural History museum, along with a fantastic range of wonderful educational exhibits, which bring natural wonders to the world. Indeed, I believe David Attenborough said the other day when talking to Barack Obama that he had never met a child who was not fascinated by natural history when things were brought to life in that way.

We also have the glories of the Victoria and Albert Museum and the other Kensington museums, along with Kensington palace. In fact, more than 12 million visitors came to the museums in Kensington and Chelsea as a whole last year, so I very much echo the sentiments expressed about how important this industry is to London, not only for teaching our young people about the great and wonderful history and resources that we have, but for being a worldwide centre of attraction whose goal is to bring more people to London. The UK’s cultural sector will continue to flourish only if we treat it as that.

The relationship between London and the rest of the UK on the arts is one of positive interdependence. In a way, we could say that we are selling Britain as a whole when we showcase our international and national museums. People went on the great European tours in the past and brought back fantastic collections of wonderful things. It is fantastic that we should be able to show them not only to our children, but to those who visit from around the world.

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That is important, as investment in a single place reaps benefits across the country. As a global city, we rely on our creative relationship with the regions to maintain our mutually beneficial relationship. As hon. Members know, our museums do tour—that is an important point— but we also need to ensure the right level of interdependency, so that people who come to London should also have the opportunity to travel further afield. However, it could be argued—depending on how the maths are done—that if funding is calculated by visit, arts funding for London is lower than for other regions.

Therefore, I want to continue to maintain London’s importance as a centre of culture, and not only in our museums and our arts. Speaking, if I may, as the president of the British Antique Dealers Association, I also want to draw attention to all of London’s arts, antiques and creative industries. It is a global hub: we import and export, mostly through London, but there are more than 7,000 art and antique dealers throughout the country, offering employment to thousands. As part of our overall sector, it is important that we should all work together, but obviously it up to me as the MP for Kensington to encourage everybody to continue to visit the wonderful museums that we have on our doorstep.

3.17 pm

John Nicolson (East Dunbartonshire) (SNP): It is a pleasure to speak as the Scottish National party spokesperson on culture, media and sport. I thank the hon. Member for Newark (Robert Jenrick) for kicking the debate off—I am not sure that is exactly the right expression, but—

Mr Vaizey: “For so eloquently introducing the debate”.

John Nicolson: Thank you. You are too kind, sir.

I thank the hon. Member for Newark for initiating this fascinating debate. We have seen a flowering of arts in Scotland since the restoration of the Scottish Parliament, and we find ourselves in a much healthier position than much of England. The truth is—as several in the debate have said—that there is a sharp contrast between the position in London and the position in much of England, which is poorly served by the Department and by Arts Council England. As the Minister will know, the arts in London are funded to the tune of £69 per head, but for the rest of England the figure is £4.58 per head—a truly shocking disparity. That might be great for metropolitan Members on the Tory Front Bench, but it is not so great for the rest of England.

Creative Scotland and Arts Council England fund the arts with grants from their respective Governments, so let me give hon. Members some financial facts. Creative Scotland spends £91.2 million; the Arts Council spends £615 million. Scotland comprises only 8% of the population, so we punch well above our weight, spending nearly 15% of the total UK tally. Next year’s Scottish Government draft budget on culture is up £150 million on this year, whereas in England the Arts Council’s budget has fallen by one third since 2010. In this financial year, Scottish local authorities put £631 million—5.3% of revenue expenditure—into culture. In England, local authorities spend only 2.3%. In fact, the English local authorities are being crushed because of their ever-decreasing budgets. Westminster City Council and Somerset County Council have axed their arts budgets completely.

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Arts of course, as everyone knows, are a window into a nation’s soul. It was Alasdair Gray who wrote:

“People who care nothing for their country’s stories and songs…are like people without a past—without a memory—they are half people”.

On that basis, I am delighted to say that Scots are whole people, because the Scottish household survey shows that 91% of Scots took part in cultural activities in the past year and that Scottish public opinion is overwhelmingly behind public funding of the arts. A Creative Scotland survey found that 92% of the population support the proposition that it is

“right that there should be public funding of arts and cultural activities”.

With public support, the Scottish Government have enhanced spending to provide stability for the Royal Scottish National Orchestra, the Scottish Chamber Orchestra, Scottish Ballet, Scottish Opera and the National Theatre of Scotland, and to guarantee free access to our national collections. But alas, DCMS cuts have resulted in 11% real-terms reductions to English National Opera and 15% reductions for Opera North.

In Scotland, with more than 200 cultural festivals a year, a national youth arts strategy for investing in the future and the glorious Edinburgh festival, we feel that we are in a strong position and are going from strength to strength. The arts are at the core of national life for many. However, arts and arts funding are of course not just about a national feel-good factor; there are practical benefits too. Creative Scotland found that the arts and creative industries in Scotland generate 130,000 jobs. That is in a country of only 5 million people, with a £12.5 billion turnover. That is huge.

I do not want to labour the point, but I will conclude by saying that we in Scotland are very much at odds with the Conservative Government’s sadly rather philistine approach to the arts at every level. For philosophical and cultural reasons, and for practical reasons in terms of generating jobs and money, we intend to carry on investing in the arts. They are too crucial not to.

3.22 pm

Susan Elan Jones (Clwyd South) (Lab): It is a great pleasure to serve under your chairmanship, Mr Rosindell. I thank the hon. Member for Newark (Robert Jenrick) for securing what has been an excellent debate. He made the point that although it is not a question of London versus the rest, there are important issues about how the arts are funded outside London and the metropolitan areas. He spoke with passion about the need for a provincial revival in the arts, and mentioned the great new Labour innovation of free access to museums. He even mentioned Jennie Lee, which of course was music to many people’s ears. It was a very good speech.

I congratulate my very musical hon. Friend the Member for Workington (Sue Hayman). There are not too many Members who walk through the Division Lobbies with copies of “Zadok the Priest” and suchlike. She spoke interestingly about the dedication of volunteers and about the Carnegie theatre in her constituency. A number of us will have examples of Carnegie-type philanthropy in our constituencies, and that is an interesting model for the encouragement of more philanthropy outside metropolitan areas. My hon. Friend’s speech was excellent, with many great ideas for west Cumbria.

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The hon. Member for Kensington (Victoria Borwick) made a strong speech in support of the museums in her constituency and understandably put the case for London. We should of course have arts for all, not just the few. We are all proud of our outstanding London institutions, but the debate has highlighted the need for proper funding for the regions, too—the simple principle that everyone in the United Kingdom should be able to experience and participate in excellent cultural and artistic activities. We can all think of examples, and I would not want to forget the Rhos male voice choir’s tremendous victory on Saturday in the Llangollen international musical eisteddfod in my constituency, coming as it did on the back of three national eisteddfod victories. Incidentally, those victories were all secured while I was their Member of Parliament, although I suspect that that had nothing to do with it.

Sometimes we may feel that not only have the Government ignored and neglected the arts community; they have done nothing for the arts in regions that have suffered from Arts Council budget cuts and from the sustained squeeze on local authority funding. The Select Committee on Culture, Media and Sport, which the Culture Secretary chaired, recognised:

“London has long received a disproportionate share of arts funding”.

Arts Council budgets and direct spending from the Department for Culture, Media and Sport go disproportionately to London, so arts outside the capital, in the regions and nations of the UK, need more support. The challenge is to rebalance without damaging the cultural super-cluster of London. Our vibrant arts institutions in London must thrive, but more needs to be done to improve provision across the country.

What are the sources, then, of arts funding? The biggest subsidisers of art are the artists themselves, who often work for little or nothing, for love of the art. Apart from that, the sources are national and local government, sales and philanthropy. The figure for giving to the arts by individual philanthropists that goes to London-based organisations is variously quoted as around 82% to 90%. When the Government started cutting arts budgets, they set up the Catalyst Arts programme to strengthen the sector’s fundraising experience. The rather forlorn hope was that increased private giving would compensate for the cuts. I think we all know that it has not. Unfortunately for the regions, funding from that programme has gone disproportionately to London.

I want to talk now about national funding. In October 2013, a group of regional arts professionals produced a report called “Rebalancing Our Cultural Capital”, which detailed the distribution of DCMS, Arts Council England and lottery money between London and the rest of the country. It said that Londoners got £70 per head each year in funding from DCMS and through Arts Council England, and the rest of the country got only £4.60 per head. That is a ratio of 14:1. Arts Council England announced its funding distribution for the period 2015 to 2018, and the balance for funded organisations—national portfolio organisations—will be 53% outside London and 47% in London. That is only a 2% shift since the period 2012 to 2015.

Lottery funding for the arts is spent 70% outside London and 30% in London. In his first speech, Darren Henley, the chief executive of Arts Council England, announced that he aimed to increase the 70% figure to

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75% by the end of 2018. That is all welcome, but it feels like small beer. Nevertheless, the Arts Council has woken up to the problem and is slowly changing. It should be congratulated on doing so in the face of what could be considered neglect and a little forgetfulness, to say the least—if not ignorance—on the part of the current Government.

As to the lottery, there should be more transparency about where its tickets are bought. I know that some people feel that tickets bought in poor areas are subsidising arts in rich areas. In reality, that suspicion will be dispelled only by the disinfectant of sunlight. We need more transparency, without treading on commercial sensitivity and harming business. It is perfectly possible to do that, and it is the right thing to do.

Direct funding from the DCMS often goes disproportionately to institutions in London. The National Gallery, the British Museum, the Tate and so on are hugely important to our country, and they are one of the things that make London the great cultural super-cluster that it is today. The city attracts millions of tourists, and those places are fantastic and preserve the cultural inheritance of our wider country. Thanks to Labour’s introduction of free entry to museums in 2001, that inheritance is open to everyone. Visitor numbers at some museums have rocketed up by more than 250%. We are justifiably proud of that as a nation. Nevertheless, the money goes disproportionately to London. That can even lead to the absurd situation of Conservative councils in the capital spending nothing—literally nothing —on the arts, while enjoying museums and galleries paid for by the nation.

All that means that in many areas of the country the only public funding for the arts comes from local authorities. The junior Minister present is often very polite in what he says, but even he sometimes blames the neglect of regional arts on local councils. Why does he not talk to his colleagues in the Department for Communities and Local Government, let alone the councils themselves? Why has he not offered help to local councils making these difficult decisions? Why have Government cuts to local government fallen so disproportionately on the most deprived in our country? I know he will have a lot to say about that in his summing up.

I am sure that the Minister will talk about a few million pounds for pet projects here or there. In fact, we have grown used to the cultural baubles that get thrown into the autumn statements and Budgets. The problem is that the Chancellor sometimes likes to give with one hand while taking far more with the other. He likes to give money for cherry-picked projects while cutting local authority and Arts Council funding. Sometimes he likes to choose who gets the arts funding and who does not, sidelining the Arts Council and local people. That is clearly a problem.

We know that the junior Minister does his best—he gets to a fair number of gallery openings and other events —but sometimes one wonders whether he is ignored by the rest of his Government, with the Education Secretary notoriously warning that for children to study arts subjects could

“hold them back for the rest of their lives”.

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She is giving a speech at the Creative Industries Federation event tomorrow morning, and I suspect that she has a bit to apologise for. Indeed, we wondered whether she was scared in some way of her Government’s record. There is currently no formal requirement for arts and culture education in schools, which is deeply concerning. A number of schemes introduced by the Labour Government to improve access have been cut, which has led to the number of primary school children taking part in music, for example, dropping from 55% in 2010 to 36% in 2013.

If we go back in history, we remember the story—it is one of my favourites—of the young George Frideric Handel going into his attic to learn to play the clavichord, because his father did not want him to become a musician. The young Handel managed to learn and do rather well—it came, I suppose, from being a musical prodigy—but most of us are not musical prodigies. Children need to experience and participate in culture and creativity to foster the next generation of creatives, audiences and citizens. However, the Conservatives’ narrowing of the curriculum has led to state school pupils taking fewer art and design subjects. We need Government action, because the alternative is to presume that everyone is a Handel-style prodigy.

This ripples up the rest of the chain, harming the whole of the workforce and the economy. There were only 1,000 apprenticeship starts in the creative industries in 2013-14—the lowest of all sectors, despite it being one of the fastest growing in our economy. For this Government do not govern in the interests of the whole nation; they are not really “one nation”. What many of us fear is a society where some people have access to culture and others do not—that is deeply damaging—and where some areas have world-class museums while contributing little or nothing and others have nothing but the Chancellor’s whim. That is not only unfair; it is holding us back. It is holding back the fastest growing part of our economy, limiting the well-paid, rewarding jobs of the future and diminishing our voice on the world stage. I urge this Minister and the Government of which he is a part to live up to the rhetoric and do more to provide regional support for the arts.

3.34 pm

The Minister for Culture and the Digital Economy (Mr Edward Vaizey): It is a great pleasure to appear under your chairmanship, Mr Rosindell. Obviously you do not have a chance to participate in the debate, otherwise we could have heard your words of wisdom on the cultural assets of Romford—I gather that the Brookside theatre there is successful. I would also have wanted to hear more from you about the Offset music festival, which I am sure you attend regularly. It has included bands such as the London art punks Wire and Gang of Four, which many of us will remember from our childhoods. It is a pleasure to know that they are still playing.

I thank my hon. Friend the Member for Newark (Robert Jenrick) for initiating this important debate. What unites us across party barriers is that there are those of us who are passionate about the arts. I am delighted that my hon. Friend is a member of my own party, but I am also delighted to spend time and associate with members of all parties who care about the arts, because we should band together. It should not be left

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to one, small junior Minister to fight the case for the arts; we should all, from all parties, work together to fight for the arts, regardless of the colour of the party. Indeed, we do not debate the arts often enough in this place. I remember only one official Opposition debate on the arts in the previous Parliament—as a new Opposition emerges, perhaps we will see more official Opposition debates in the main Chamber in the years to come—and only one or two in this hallowed Chamber.

We had some valuable contributions from the new Member—a Lady Member indeed, because that is her title—my hon. Friend the Member for Kensington (Victoria Borwick). She represents some of our finest national museums, so it is right and proper for her to be in the Chamber. She made an excellent speech. The hon. Member for Workington (Sue Hayman) sings in her local choir and her daughter helps out at the local arts centre. She, too, has displayed her passion for the arts. I will come on to her proposal in the body of my speech.

As usual, there were excellent speeches from the official spokespersons, the hon. Members for East Dunbartonshire (John Nicolson) and for Clwyd South (Susan Elan Jones). I hate to sound as though I am appearing in “Groundhog Day”, but we had a debate yesterday when I accused the hon. Lady of a mild case of chutzpah, and I will make the same accusation again during the course of my remarks.

I was excited to discover that this was one of the first digital debates. I do not know whether it is the very first or whether there have been others. It passed me by that this was a digital debate, and no one told me about a vigorous debate on Twitter yesterday, in which I would have happily participated. However, I obviously reviewed yesterday’s tweets and very illuminating they were. One of the great advantages of a Twitter debate is that people live tweet it as we speak, so should I fail to take note of some of the pertinent points made, I can follow them up on Twitter—in particular the points of @MarDixon, who has been live tweeting the debate from the Public Gallery. So far I have only featured in a discussion about whether I should be given a hug or be on her Christmas card list. No doubt I will feature prominently now that I am on my feet and able to make the points that I wish to make.

Over the past five years, arts funding has been an important issue. I am pleased that we in this Government have done our best to protect funding for the arts, because we are passionate about and strong supporters of the arts. We have had to reduce the grant in aid available to the Arts Council, because we had to make tough decisions as a result of the state of the economy left by the previous Labour Government and our need to tackle the deficit, but I hasten to say that we have tried to make the savings where we can and in an intelligent and thoughtful way. For example, we have reduced the central costs of the Arts Council and we had to stop some programmes, such as Creative Partnerships, which were initiated by the previous Labour Government and foisted on the Arts Council. My focus has always been to ensure that we have secured as far as possible the grant in aid available to arts organisations from the Arts Council. On the whole, we have succeeded in doing so.

What is never mentioned, but should be, is that our first decision as a new Government was to rebalance lottery funding to restore the cuts that the previous Labour Government had imposed on heritage and the

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arts, taking them from a 16% funding share to a 20% one —a significant uplift—and so making something like £150 million a year available to the arts and a similar sum to heritage. National lottery funding goes to arts institutions in Scotland as well, which will be relevant to the hon. Member for East Dunbartonshire, as it has helped to lay the foundations of the success he talked about. We have also tried to protect the national funding of museums and secured much lower funding reductions than some other Government Departments, thanks to the advocacy of successive passionate Secretaries of State. I posit that the casual, lazy, characterisation of swingeing art cuts is seen to be very far from the truth when the figures are analysed.

The trouble we face when debating the arts is summed up by that famous phrase, “Lies, damned lies and statistics”. It is possible to put the statistics in such a way that it looks like all the funding goes to London, but that is far from the truth. Take, for example, our national museums, which take up roughly 50% of the overall spending envelope for the arts. We look at the postcode of the Victoria and Albert museum and of the Natural History museum, and think that all that funding is going to a very small part of London, ably represented by my hon. Friend the Member for Kensington. But the Tate, for example, is also in St Ives and in Liverpool; the Royal Armouries, a national museum, is in Leeds. We have the national museums in Liverpool; the Museum of Science and Industry is in Manchester, the National Media museum is in Bradford and the National Railway museum is in York. The V&A is opening a new space in Dundee, in one of the most exciting current architectural projects, as well as one of the most exciting new spaces opening for the arts. Many of our national museums have physical spaces outside London; many also have strong partnerships with museums outside London. Only recently, for example, the V&A was instrumental in helping us to save the important Wedgwood collection just outside Stoke.

My hon. Friend the Member for Newark introduced the debate very ably. I campaigned for him in Newark and am glad he was elected and then re-elected. He has extensive experience in this field, having worked at Christie’s. In the short time he has been in this place—I hope this does not sound patronising—he has made a massive impact in terms of the international work of our arts institutions in protecting antiquities abroad, particularly in war-torn regions such as Iraq, where he has been instrumental in moving Government policy on towards greater funding for cultural protection. His tone and remarks today have shown he will be an important voice in arts policy before his inevitable promotion to Minister—although for selfish reasons, I hope he is not made Culture Minister.

Our national museums clearly play a role throughout the whole UK. There is the debate about regional funding and whether too much Arts Council money goes to organisations based in London and not enough to those based outside it. Again, I do not wish in any way to belittle that debate, but rather I want to rebalance it. Approximately half the arts organisations based in London—that is, those with a London postcode—that get Arts Council grants work, tour and exhibit outside London. The most recent example that comes to my mind, because I met them in Ipswich, is the Talawa theatre company, a black theatre company that does

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fantastic work. Its headquarters is in London, but it tours. We need to get away from the idea that because an organisation has a London postcode, all its work will be in London.

Simply holding this debate could give the impression of a barren wasteland outside London. Nothing could be further from the truth. If we visit any major city or town in England, we will see a vibrant arts scene. I was recently in Sheffield, where I visited the Crucible and Museums Sheffield, two fantastic organisations working very closely together. In Yorkshire, there is the Yorkshire sculpture park; in Bristol and Birmingham, there are vibrant arts organisations. In the last debate we had on the arts in this Chamber, a lot of colleagues lined up to express their criticisms of Government policy, yet inevitably all their speeches extolled the virtues of the cultural organisations in their constituencies. The arts scene outside London is extraordinarily vibrant, and long may it remain so.

None the less, the Arts Council, quite rightly, is focusing on rebalancing its funding. Darren Henley is the chief executive of the Arts Council—as @MarDixon has tweeted during the debate, his ears must be burning. He made his first speech in the role in Hull—an important fact, as Hull is the city of culture in 2017. We have maintained the successful cities of culture programme begun during the last Labour Government by one of the four people now contending for the Labour leadership. Although I do not think that any of the four will be any good, it would be nice if the Labour party was led by a former Culture Secretary. The scheme worked incredibly well in Derry/Londonderry and will work well in Hull. It galvanised a lot of other places into looking at whether they could get city of culture status; simply by applying, those places renewed their focus on their cultural assets. Mr Henley has announced the ambition for excellence scheme, a new £35 million funding programme to support talent, excellence, leadership and ambition across the arts. The vast majority of that money will be spent outside London. The previous chief executive, Alan Davey, announced the creative people and places scheme, another £30-odd million scheme, the majority of which has been spent outside London. Mr Henley has made it clear that 75% of all lottery funding from now on should go outside London.

That is a massive shift from the situation under the last Labour Government, when less than half of national lottery funding went to organisations outside London. Perhaps that is why I use the word “chutzpah” when referring to the speech by the hon. Member for Clwyd South. I do not think we need to take lessons from a party that spent the majority of funding in London and, indeed, was quick in the run-up to the general election to tweet—tweeting is a theme of our debate—its support for future arts cuts. Having seen Newcastle City Council plan to cut all its arts funding and reverse the decision only after a great hue and cry, I do not think we need to take any lessons from the Labour party.

It is possible for the debate on the arts to look simply at grant in aid and funding, and not look at some of the innovations we have introduced. For example, we have introduced catalyst funding to encourage philanthropy and donations both within and outside London, and have put in place match funding programmes. We will

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publish an evaluation of the scheme shortly, which I think will show some significant success. We have introduced tax credits for theatre, which have already had a major impact. The tax credits for orchestras will come into play next year. The tax credits for theatre are for touring theatre, so will ensure that all parts of the country benefit from the productions they support.

Technology will play an important part in spreading culture. One has to choose one’s words carefully—I do not want somehow to give the impression that crumbs are being given from the table—but my constituents go to see screenings from, say, the Royal Opera House in the cinema, and they think that is the most fantastic thing. It is a different experience from being in the opera house but is equally enjoyable in its own way. That is a very good way of ensuring that culture from some of the leading arts organisations in the country can get out there. That applies to anything, from the grandest opera production to the simplest theatre production, and it is a great way of ensuring that the production can escape its physical boundaries and reach as many people as possible.

I am also interested in how we use technology in our education system and in the pilots getting under way between TES Global, which is the digital arm of TheTimes Educational Supplement, and museums, so that some of their collections can be used by teachers as a teaching resource. That is a real partnership between teachers, who know how to teach and engage their pupils, and museums, which know about curation and the objects in their care.

I should say a word about education, because, of course, we have done a lot to support culture education. The hon. Member for Clwyd South was kind to note that the Secretary of State for Education will be speaking to the Creative Industries Federation, where she will reinforce her support for arts education. As hon. Members know, the Education Secretary gave a very important speech about science education, making the point that although arts education was in itself fantastic, we should not neglect science and technology education. For some reason, some people have—I would hate to say “deliberately”—misinterpreted that as an attack on arts education. They seem to think that we live in a binary world where, if we praise the sciences, we are somehow denigrating the arts. Nothing could be further from the truth, but my right hon. Friend will reinforce her support for arts education tomorrow.

It may be that words will be enough, but by your deeds shall ye be judged. Of course, one of the great successes that we had in the last Parliament, working with the Department for Education, was to ring-fence music education funding and ensure that it was transparent, clear and secure for local authorities to incorporate the In Harmony programme, which was started by the last Labour Government but has now been put on a secure footing so that it can continue. It is interesting that the Liverpool In Harmony programme just had its sixth anniversary, and the enthusiasm that can be seen on Twitter and the massive impact that the scheme is having in Liverpool is really fantastic.

Not only that, but in the last Parliament, the Department for Education increased the amount of funding going to music education. It has also supported other programmes such as the museums and schools programme and the heritage schools programme, which are new initiatives

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to get heritage and museums centre stage in our schools. The Department for Education is an absolutely fantastic partner in all the work that I do as a junior Minister, standing up for the arts with its support. Those are important points.

We are planning to publish a White Paper at the end of this year or the beginning of the next, looking at the arts and heritage, and it is important to recognise what we have done in heritage. We have given £90 million to English Heritage to help it restore all its buildings and to create a new charity that will be set free from the constraints of Government bureaucracy. The need to give freedoms was a point made strongly by my hon. Friend the Member for Newark in his opening remarks, and we have given our national museums more freedoms to borrow and be flexible in how they go about their work. More freedom will be transformative for English Heritage.

The White Paper will look at an idea that I am fascinated by, which is place making. One of the problems in arts funding is that we tend to look at it in silos: how much is this theatre getting? How much is this dance company getting? Even in a small town or city, a lot of arts organisations do not talk to each other and do not see how the whole can be greater than the sum of the parts. We need to put culture at the centre of place making. That is what makes the place someone lives in, grows up in and works in a wonderful place to be, whether they are working, retired or visiting. I think that will be very important, and it will give us a platform to formalise our relationship with other Government Departments. The Department for Education is fantastic, and we need to work more closely with the Department for Communities and Local Government, with the Department for International Development, and with the Department of Health in particular, because we know the incredible impact that the arts can have on health.

One other idea that I am interested in, which I hope the hon. Member for Workington will help me with—this has become a mild obsession of mine—is museum storage. I am obsessed by museum storage—I am also obsessed by radio spectrum, but that is another matter—and the reason is that I echo her sentiments, up to a point. By the way, I am planning to go on beyond 4 o’clock because of the Division; is that all right, Mr Rosindell?

Andrew Rosindell (in the Chair): Yes.

Mr Vaizey: The reason that a lot of objects are in storage is for preservation. Sometimes a Turner watercolour will be kept in storage because it is not sensible to have a Turner watercolour on display permanently, given that it is a fragile and important cultural object. However, lots of objects are in storage, and I want to transform museum storage—I will need the hon. Lady’s help, because I am only a junior Minister—and I want to have big centres outside London. For example, there is Wroughton in Swindon or Boston Spa in Yorkshire, where the Science Museum and the British Library respectively have huge storage facilities. There are also areas such as Cumbria, with fantastic local MPs who are keen to campaign to see more cultural assets in their area, and Thurrock, where the Royal Opera House has its stage and set design facilities. Would it not be brilliant if we could set up storage centres outside London? That is tick-box one. However, can we not go further and make them centres of excellence? For example, they could

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be centres for digital curation, so Boston Spa could become a centre of digital excellence for the preservation and digitisation of print material.

Thirdly, and most crucially—and where I let out a mini cheer when the hon. Lady was speaking—we could make them accessible to the public. That obviously comes with a cost and we would not necessarily make them accessible 24 hours a day or even seven days a week. There is something really exciting and enjoyable about visiting a museum storage site—I know that I am now beginning to sound slightly odd—because it is so informal and people feel like they are on their own voyage of discovery. I go on a lot of regional tours and I remember that, when I went to Liverpool, my private secretary said to me that it was the best trip that she had had, because we went round the stores of the National Museums Liverpool. It was exciting to be able to look in nooks and crannies. I want to bring out that informality and accessibility and build national storage sites all around the UK. I have decided to go public on that in this debate because I have been moved by the hon. Lady, and because I think it is about time that we started debating the issue in public. I have asked people to come to me to talk about the White Paper and about their ideas.

I am sorry that I have not been pugilistic and battered the Opposition on these issues, and defended the Government’s record vigorously. I think the Government’s record speaks for itself. We have never seen a more vibrant arts scene in the UK or more vibrant creative industries. The hon. Member for East Dunbartonshire talked about the incredibly generous funding in Scotland and it is, of course, possible to elide the figures. We remember the terrible, tortuous birth of Creative Scotland, with resignations left, right and centre, but it remains one pot, so if he is going to compare Creative Scotland to the Arts Council, he also has to include Creative England and the British Film Institute.

However, I do not want to divide us. I hope that the hon. Gentleman and I will go together to see the Celtic exhibition that the British Museum and the National Gallery of Scotland are jointly putting on. Perhaps one lunchtime, when the Titians are in London, we can wander up and look at these two wonderful paintings, jointly owned by the peoples of Scotland and England, and reflect on this great Union, brought together by a shared culture and a passion for this great United Kingdom—a passion I know that you share, Mr Rosindell, in your daily life, celebrating this wonderful country of nations. I did not go on beyond 4 o’clock after all.

3.58 pm

Robert Jenrick: Thank you for your chairmanship, Mr Rosindell, and all Members for being here today. I am very grateful for their many contributions and to the Minister, who was entertaining and eloquent as always. It was very interesting to hear about his obsession with storage. From my days at Christie’s, I remember that the best place to take the most valuable clients was the stores, because that always excited them more than the carefully manicured halls. I look forward to seeing that develop in the weeks and months to come.

This has been an important debate. It was important to have it at the start of the Parliament and to say to the many people throughout the country who are passionate

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enthusiasts of the arts and work in arts organisations that Parliament is interested in what they do and care about, and that we will pursue this issue for the rest of the Parliament. I thank everyone who participated in the debate and particularly the 250 people who participated in our digital debate and the allegedly 1.2 million people who followed it on their Twitter accounts.

Question put and agreed to.


That this House has considered regional support for the arts.

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Bank Closures (Northern Lincolnshire)

[Philip Davies in the Chair]

4 pm

Martin Vickers (Cleethorpes) (Con): I beg to move,

That this House has considered bank closures in Northern Lincolnshire.

It is, as always, a pleasure to serve under your chairmanship, Mr Davies. I sought this debate because our high street banks are reducing the service that they give to my constituency and the neighbouring constituency of Gainsborough. My hon. Friend the Member for Gainsborough (Sir Edward Leigh) has asked for his name to be associated with my comments. Unfortunately, a diary clash prevented his being here.

It might be helpful if I give a brief outline of Barton-upon-Humber, which is the northernmost part of my constituency. That market town is being affected by two bank closures. Both HSBC and NatWest have announced that they are closing their local branch; the NatWest one will close on 20 August and the HSBC one in early September. Barton-upon-Humber is a long-established trading town, situated on the southern bank of the River Humber. It has held some significance from as long ago as Saxon times. It has developed into what I think it is fair to say is a typical market town. The banks have announced the closures at a time when the population is increasing and there is a real boost to the local economy, wrought in part by the reductions made by the coalition Government in the Humber bridge tolls, which have made journeys between the northern bank and the Barton area much more accessible.

When we talk of a high street, we have a vision of a cluster of small shops—butchers, bakers, newsagents and so on—but they are always supplemented by the local solicitor’s office, perhaps an insurance broker and, of course, our high street banks. They come together and provide the essential ingredients of a thriving local economy, not just in our provincial towns but—perhaps even more so—in our market towns.

Barton-upon-Humber is one such place. Three years ago, it suffered a major setback when the Kimberly-Clark factory closed. That resulted in more than 500 job losses but, thankfully, Wren Kitchens took over the factory and it is now a thriving commercial enterprise, employing almost as many people as when Kimberly-Clark had it and with the prospect of yet more jobs in the pipeline. As I mentioned, the reduction in the Humber bridge tolls has been a real boost to the local economy, but the offshore renewables sector, based around the ports of Immingham and Killingholme, has made Barton very much an expanding town. More residents equal more potential customers, whatever the business—or so people would think. That will not be so at our high street banks, NatWest and HSBC, which, as I said, have recently announced the closure of their branches.

Of course, we all recognise that banking has changed, particularly for the personal customer, and in that respect most of us are to varying degrees guilty. We want the bank or the bookshop there when it suits us, but for the rest of the time we are tempted by online banking, Amazon or whatever. However, that is no help to our local butcher, newsagent or other trader who wants to offload his takings for the day.

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Let me focus on NatWest, as it was the first of the two banks to announce the closure of its branch. Like most high street banks, it occupies a major building in the marketplace in Barton. It has been there since 1913. The announcement came as a major disappointment to the community: private customers and, as I have mentioned, small businesses. Older residents in particular feel it as a blow. Once again, personal contact is being taken away from a commercial transaction. Local people, of course, are concerned that this might be the start of a trend. I am pleased to say that I met officials from Barclays earlier this week and they have given me an assurance that they are not planning any closures—for the moment; that is the big concern of local people.

I mentioned the neighbouring constituency of Gainsborough, where two towns, Caistor and Market Rasen, are affected. For Caistor, it is a particular blow because the NatWest is the last bank in town.

There are more ways than ever to bank. NatWest has provided me with a host of statistics. It says that branch transactions have fallen by 36% in the past five years and mobile transactions have increased by 300%. It states:

“Only 9% of our transactions were undertaken in our branches in 2014, compared to 25% in 2010”.

It goes on to state:

“We know the value of the High Street branch, we have the second largest branch network in the UK, and it will remain the cornerstone of our service to customers.”

How will it remain the cornerstone if it is closed?

Branches are important because, as I mentioned, they provide an opportunity for customers to interact with staff on what may be big life decisions, such as taking out a mortgage or starting a business. Both NatWest and HSBC are very keen to tell me that they are making alternative arrangements with the Post Office. That, of course, is in line with the protocol agreed between the British Bankers Association and the Government earlier this year, but local post offices do not constitute a vast network. As anyone who has queued up in the post office with loads of money from their takings will know—I used to work in Market Rasen and can tell my hon. Friend the Minister that even to go and buy a stamp was a half-hour job—the reality is that post offices are not an ideal alternative.

The British Bankers Association has provided me with a host of information about how banks go about assessing closures. As the Barclays representatives told me yesterday and, indeed, as the HSBC representative told me, this is customer-led—customer-led meaning, of course, that people are moving online or to mobile transactions. I hope that the Minister will be able to give some reassurance that the agreed protocol will be firmed up a little. As I am sure she will appreciate, people are rather cynical about consultation processes. They tend to think that the bank decides on closure and consults on how to go about the closure, not on whether the closure should take place. I hope that the review of the protocol, which is scheduled for a year after it comes into force, will result in its having a few more teeth than has been the case up to now.

The British Bankers Association protocol does go into a fair amount of detail, whereas the Government’s website is a bit thin on the ground when it comes to what should actually be provided. The previous Minister,

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who is now my hon. Friend the Minister of State at the Department of Energy and Climate Change, said at the time of the protocol’s introduction:

“I’ve received a lot of correspondence from consumers and businesses who are worried about bank closures and the trend in banking services moving online, and I think it is essential that banks continue to take into account the impact of their decisions on their customers.

I therefore welcome the agreement announced today that banks will work more closely with their customers and local communities to minimise the impact of bank closures.”

In other words, it is an acceptance that bank closures will take place. My constituents look to me, and I look to the Government, to be on their side and the side of customers—not on the side of the banks, which are well positioned to take account of themselves.

If we look further at the details from the British Bankers Association, they go on to outline community engagement. Although it happened eventually, NatWest was seemingly somewhat reluctant to meet Barton Town Council. It has now done so, and has also met North Lincolnshire Council. The meeting was to discuss the impact of the closure on the community and customers, and to look at alternative provision. It was not—I repeat not—to discuss whether alternative arrangements could be made, such as mobile banking or reduced opening hours. I look to the Minister to give some reassurance that when the review takes place, she will seek to strengthen the protocol on behalf of my constituents.

Hon. Members across the political spectrum continually speak about the high street and how important it is to maintain a vibrant local economy and support our local shops. If we are to expand our market towns, however, shops need the services of our local banks. Banks, I am afraid, take a rather high-handed attitude. It is easy for us all to slip into the much-favoured habit of criticising bankers, and I accept that we are talking about high street bankers rather than those who have even less public appeal. The reality, however, is that customers, such as the local newsagent, who are looking for services from their bank will easily notice the large profits and the rather generous—to put it kindly—payments to senior directors. If just a little of that were to trickle down into the local branch network, perhaps we could sustain our market towns and small shops to a much greater extent than we have done in the past.

I go back to the Government’s website, which is, as I say, a bit basic when it comes to outlining the protocol. The website states:

“Today’s ground-breaking agreement will make sure customers still have banking services close at hand if a branch closes. Communities will be given fair notice of any closure and clarity about the alternative places and ways to bank. This includes the Post Office, which is an ideal shared service for customers who prefer to use counter services. The agreement will also make sure there is the right support to help customers use internet or mobile banking.”

I have to say that my constituents in Barton have not seen many examples of support for customers when it comes to greater involvement of online banking.

I conclude by appealing once again to the Government to be on the side not only of my constituents in Barton and those in the neighbouring constituency, in Caistor and Market Rasen, but of customers throughout the country who deserve and need a proper high street commercial banking network if high streets and the business community are to survive.

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4.14 pm

The Economic Secretary to the Treasury (Harriett Baldwin): What a pleasure it is to serve under your chairmanship this afternoon, Mr Davies! I congratulate my hon. Friend the Member for Cleethorpes (Martin Vickers) on securing the debate. He has spoken eloquently on behalf of his constituents and communities. He is without a doubt the most diligent and effective Member for Cleethorpes I have ever known.

As my hon. Friend set out, bank branches play an important role in their communities—communities such as Barton-upon-Humber, Caistor and Market Rasen. They are valued by individual consumers and small businesses, and the services that they provide make a real difference to people’s lives. One of my key priorities as Economic Secretary is financial services that deliver for customers. I strongly believe that banks should be there to help and enable customers to achieve their aspirations at every stage of their lives, whether that is saving for their first home, taking out a mortgage, buying a car or saving and investing for the future.

As my hon. Friend mentioned, how we bank is going through a period of unprecedented change. New online and mobile technology means that customers are reducing their use of high street branches. As he mentioned, some banks had pledged not to close a branch if it was the last one in town, but since those pledges were made the volume of transactions in high street branches—including in the last branches in town in places such as Caistor—has continued to decline. Those changes mean that the banking industry, which has to modernise and improve its services to maintain profitability, often has to make tough decisions. They are commercial decisions for the individual institutions, but it is right for the Government to seek to ensure access to banking services for everyone, wherever they live.

We made strong progress on that agenda during the last Parliament. In March this year, the Government welcomed an industry-wide agreement known as the access to banking protocol. I am pleased to say that all the major high street banks agreed to that protocol, which came into effect in May this year. The protocol means that when a bank decides to close a branch, it must think carefully about the consequences of doing so; it must engage with its customers; it must consider the needs of its customers; and it must identify ways for its customers to continue banking after the branch has closed. The results of that engagement with the community and an impact assessment will be made public before the branch is closed. We have also made it easier for my hon. Friend’s constituents in north Lincolnshire to switch their bank accounts, with seven-day switching to one of the banks that remain open.

I appreciate my hon. Friend’s concern about the impact that branch closures will have on shops in local high streets. I assure everyone that the Government are committed to safeguarding high streets and town centres. For example, through the high streets innovation fund we have provided funding to the 100 towns that have the highest rates of empty property. Small business rate relief is also a valuable bonus for high street shops. In March 2015, the vacant share of retail outlets fell to 13%, which is the lowest vacancy rate since 2010.

As well as taking seriously the impact of branch closures on local communities, we must consider how customers will continue to access banking services. A range of

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alternative measures is in place, and I would like to talk in more detail about some of those measures. As my hon. Friend mentioned, at more than 11,500 of its branches in the UK, the Post Office allows customers to access their bank accounts, check their balances, withdraw money and deposit cash and cheques. Sixteen banks offer services to their personal customers and small businesses through the Post Office, including those that he mentioned. That is a huge network, which offers most customers a real opportunity to continue banking locally.

I know that more can be done, however. The range of services offered by the Post Office may be more limited than those offered in a traditional bank branch, and my hon. Friend has mentioned how popular they are. Service provision may vary by bank and by the capacity of each post office. That is why the Government are supporting measures to improve the banking services that the Post Office offers and to make those services more consistent for customers.

Late last year, the British Bankers Association and the Post Office began negotiations to agree a standard set of services, such as withdrawals, deposits and balance checking. The agreed services will be made available to bank customers at post office counters across the country. The negotiations are ongoing, but I make it clear that the Government consider completion of that work to be a priority. The protocol includes a measure for an independent review after one year, which I hope will indicate whether it has been effective—I will take a close interest in that matter.

We also expect to see concrete progress on publicising the services that are already available. As I have made clear, banks should be there to help their customers achieve their aspirations at every stage of life. We should also recognise that the modernisation of banking services is leading to new opportunities for customers, and we should all be excited about that. Since April 2014, for example, customers have been able to transfer money instantly to another bank account using only their mobile phone number; from 31 July 2016, customers will be able to use their smartphone to photograph cheques for payment into their bank account, helping to make life easier for customers in remote areas. Banks are taking action to ensure that customers are able to use such new and exciting technologies with confidence.

Those innovations also apply to the UK’s ATM network, which can play a more important role in addressing some of the concerns voiced by consumers when their local branch closes. Steady progress is being made in extending the ATM network across the UK, and the number of free-to-use ATMs is at an all-time high. In fact, 97% of withdrawals are now made free of charge. Isolated, disadvantaged and rural communities often have the worst access to free-to-use ATMs, however, so the Government are working closely with the Link network’s financial inclusion programme to subsidise free-to-use cashpoints in more than 1,400 remote and deprived areas across the UK. Importantly, members of the public in my hon. Friend’s constituency can nominate their area for inclusion in that programme.

This debate has focused on branch closures, but it is also important to recognise that many banks are choosing to prioritise their branch network and are opening new high street bank branches, with TSB and Metro bank

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being good examples. Metro bank is planning to open 150 branches by 2020, and its branches are open seven days a week.

Martin Vickers: I thank the Minister for the information she has provided. My constituents, and people across the country, would appreciate more opportunities for face-to-face contact. Can she give an assurance that the Government will do all they can to influence the banks to make provision for people who want personal contact? It is one thing for people who are applying for a car loan of a few thousand pounds not to have face-to-face contact, but people who are committing to a mortgage for 25 or 30 years need detailed, experienced advice. It is much easier to provide such advice on a one-to-one basis.

Harriett Baldwin: I agree. My hon. Friend will be glad to know that 58% of people agree with both of us that face-to-face contact and having a local branch are important when choosing where to bank and engaging in major transactions. Some banking organisations take the view that they will gain market share by opening new branches. I have mentioned Metro bank, and TSB currently has 630 branches serving 4.5 million customers, which makes it the eighth-largest branch network with 6% of all UK branches. The Government are keen to encourage such healthy competition between different brands, some of which offer a face-to-face banking model.

The Government’s ambition is for 15 new banks to enter the market over the life of this Parliament. If we achieve that, it will give customers far more choice of whom to bank with and encourage banks to compete more effectively with one another. Competition will also continue to drive innovation in the delivery of banking services, such as contactless payment and payment by mobile phone. Atom bank, which recently received

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its banking licence, is a good example of innovation. It plans to be an online-only organisation and has ambitions to offer a range of innovative services to customers, which could include face-to-face contact through technology, as well as between individuals in the same location.

One often suggested solution is the sharing of bank branches, which would allow banks to lower overheads and maintain local provision when they may otherwise have to close their branches. Of course, each bank must specialise and differentiate itself from its competitors, but that should not prevent the industry from thinking creatively about how premises and services could be shared. The British Bankers Association is currently considering that issue in consultation with its members. In particular, it is exploring where local circumstances may mean that sharing a branch is the best solution.

I understand the concern of communities in northern Lincolnshire about local bank branch closures—my hon. Friend mentioned Barton-upon-Humber, Caistor and Market Rasen—and many communities across the UK, including the one I represent, are experiencing a similar situation. Changes in the banking industry reflect changes to customers’ needs and habits. Banks and building societies need to balance customer interests, market competition and other commercial factors when considering their strategy. It is right that the Government do not intervene in such commercial decisions, but we are clear that banks and building societies should support access to banking services for everyone.

Once again, I congratulate my hon. Friend on raising these important issues today.

Question put and agreed to.

4.26 pm

Sitting suspended.

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Barking, Havering and Redbridge University Hospitals NHS Trust

4.30 pm

Mike Gapes (Ilford South) (Lab/Co-op): I beg to move,

That this House has considered the future of Barking, Havering and Redbridge University Hospitals NHS Trust.

I begin by declaring an interest: I was a patient at Queen’s hospital in January. My operation was cancelled at two hours’ notice, but despite that hiccup I was given excellent treatment a couple of weeks later. I want to place on the record the fact that despite being in a very busy department, the staff were working very well and had excellent morale, as far as I could see during my groggy recovery from my operation.

The Barking, Havering and Redbridge University Hospitals NHS Trust was established in the 1990s. It brings together two acute general hospitals—King George hospital in Ilford in my constituency and Queen’s hospital in Romford, which was a new-build private finance initiative hospital to replace the old church hospital.

Since 2006, there have been many pressures for reorganisation of services in north-east London. There was a misnamed project called “Fit for the Future”, which was scrapped because it was clinically unsound. Since then, there have been proposals that would have meant downgrading services at some hospitals, particularly King George hospital. To cut a long story short, an independent reconfiguration panel looked at the proposals, and eventually, in 2011, the then Secretary of State for Health, Andrew Lansley, gave the go-ahead to close the maternity and accident and emergency services at King George hospital in around two years. The maternity services were reconfigured in early 2013, but A&E is still at King George hospital.

The trust is very big. There are 750,000 people in its catchment and it covers three London boroughs—Barking and Dagenham, Redbridge, and Havering. Havering has an elderly population overall, but Barking and Dagenham and Redbridge have some very young people. There is a churning population, with lots of migrants, from both elsewhere in the UK and many other parts of the world. GP services and primary care services have been poor and inadequate for many years. There have always been pressures on the hospitals and trusts in north-east London. Those pressures have led to accumulated deficits and concerns about the quality of service.

In October 2013, the Care Quality Commission carried out an inspection of the services at the Barking, Havering and Redbridge trust. It concluded that the trust should be put into special measures. The press release put out on December 18 said:

“The NHS Trust Development Authority…today confirmed that Barking, Havering and Redbridge…will be placed into special measures. The move follows the CQC Chief Inspector of Hospital’s report…which concludes that while there have been signs of sustained improvements in some areas, the leadership of the Trust needs support to tackle the scale of the problems it faces. While aware of many of the issues raised by CQC around patient safety and patient care, attempts to address these issues have had insufficient impact.”

As a result, the trust was put into special measures and all the management were got rid of. It took a while to fill the various posts, but an interim chief executive was

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brought in and other posts were changed. I have been impressed with the chief executive, Matthew Hopkins. He and the team around him are doing their best to improve services in the area. However, fundamental, difficult problems remain.

The CQC’s 2013 report, which led to the involvement of the NHS Trust Development Authority, highlighted a number of areas of concern, and follow-up work was carried out. One underlying issue was the financial crisis, which remains at the trust. A new finance director, Jeff Buggle, was appointed in July last year, although he did not take up his job until December. The press release at the time he was appointed said that the trust had a £38 million deficit, with expenditure of somewhere around £400 million or more in 2013-14. I understand that the target for the deficit this year was £29 million, but that has not been met; the deficit remains at about the level it was a year ago. That is not surprising; the Health Service Journal from June 26 this year has an interesting statement from Richard Douglas, the former director general for finance at the Department of Health. He said that trusts placed in special measures

“tend to exit the regime with a financial position that had deteriorated”.

The reason is that there is so much pressure to improve services that the expenditure must continue.

It is a bit like the situation in Greece: we have an underlying deficit, a temporary troika, or body, comes in to sort out the problems and the trust is put into special measures. Fortunately, we do not have a far-left, far-right coalition running the hospitals. Nevertheless, we face fundamental difficulties.

The special measures, which were called for, have led to a number of changes. I wish to draw attention to the further inspection that the CQC carried out in March, the results of which were published only at the beginning of July. To the disappointment of the new leadership of the trust, the CQC says that BHRT must remain, for the next few months at least, in special measures. The CQC’s latest report says that although improvements have been made in a number of services, many are still rated as requiring improvement. Professor Sir Mike Richards concluded that significant improvement was still required, and therefore there will be a further inspection before the end of the year to see whether other changes have been introduced since that assessment was made in March.

Clearly I do not have time, even in an hour-long debate, to go through the voluminous reports—the general one and the one on each of the hospitals in the trust—but I will refer to some of the main points. I hope the Under-Secretary of State for Health can reassure me on some issues in his response.

First, I want to make it clear that anything I say here is not a criticism of the staff in my local hospitals. They face enormous pressures; we have a trust that faces huge demand and there are huge pressures on it. I will just give some figures. There are just over 1,000 beds in the two hospitals, of which 80 are maternity beds, 32 are critical care beds, and 972 are general and acute beds. There are 73,000 in-patient admissions, 592,000 out-patient attendances and 245,000 emergency department attendances each year. That figure of 245,000 is divided into 97,000 attendances at King George hospital in Ilford, which Andrew Lansley said in 2011 should be closed within about two years, with the rest—nearly 150,000 attendances —at Queen’s hospital in Romford.

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Average bed occupancy in the hospitals is consistently around 93%, 94% or 95%. There is almost no flexibility, and my own experience in January of having an operation cancelled at short notice is sadly repeated from time to time. We had a mild winter and yet operations were being cancelled in January. The same pressures will come each year in this area in outer north-east London, which has a young population and rapid population growth.

I will refer to some of the issues affecting the hospitals. I begin by quoting Mike Richards again:

“Despite considerable attention the trust is failing to meet waiting time targets in the emergency department. Outpatients and diagnostics can’t cope with demand and the children’s services do not meet local need.

I am particularly concerned at the large backlog of investigations into serious incidents, which suggests that safety has not been given the priority it requires and lessons are not being learnt as they should.

However, the new executive team has made significant improvement ensuring the overall culture of the trust was more open and transparent making it a much more positive place to work.”

The point I am making is that this trust needs support, and it needs that support to continue for a period of time.

The CQC report asked whether services at the trust were safe, effective and caring. The rating for all three was “Requires improvement”. It asked, “Are services at this trust responsive?” The rating was “Inadequate”, which is the red one on the traffic lights. It asked whether services were well led; the rating was “Requires improvement”. That is the overall rating for the trust—“Requires improvement”—and there are particular concerns about urgent and emergency services.

The CQC report covers a range of different services at the two hospitals, but the essence of the report is that there are major difficulties, and I will refer to just a few of them. First, the report says:

“The service planning for children’s services was not responsive to local needs.”

Secondly, it says:

“The trust faces significant capacity pressures which it has tried to address”.

Thirdly, it says:

“Across all core services there was limited evidence of learning from complaints and concerns being applied to service improvement. We identified areas where complaints response was slow leading to backlogs, lack of action planning and absence of thematic analysis.”

Fourthly—and this is very significant—it says, under the heading “Governance, risk management and quality measurement”:

“Amidst many improvements within the trust since our last inspection, governance, risk management and quality measurement is an area of significant concern as little improvement has been made…Previous cost reduction plans had significantly reduced the infrastructure to support governance and safety.”

This is a trust with a deficit of about £37 million or £38 million, and it has to eliminate that deficit. When it comes out of special measures—as it no doubt will, perhaps in a few months or maybe in a year, depending on what the next inspection says—it will still face these financial pressures. One of the reasons why it has had difficulties is that it has already had to subject itself to those pressures.

The CQC report continues:

“There is a heavy reliance on individuals and the use of short term interim staff.”

Recruitment and retention of staff have been major difficulties, and they have added to the cost pressures.

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We face a difficult situation. We have a management—a leadership—who are trying to turn the trust round, and they are doing much better than their predecessors. They face enormous pressures, and those difficulties are perpetuated and even made worse by the cuts in social care at local authorities, the fact that we have inadequate GP services and the fact that many people just present themselves at accident and emergency rather than going to a GP. That is because they have been trying to get an appointment with their GP for two weeks, and, in the case of the Loxford polyclinic in my constituency, they have been phoning for hours but cannot get through because there is a problem with the switchboard. The same problems arise in a more intense way while the trust is dealing with this financial crisis.

What is the way forward? I will speak for just a few more minutes, to allow my colleagues the chance to contribute to the debate. The CQC report carries out a “Friends and Family test”, and I find the results for the trust extremely concerning. In the test, there is an assessment of the different departments. The report says:

“NHS Friends and Family test (July 2014)—average score for urgent and emergency care was 20%, which was worse”—

in fact, considerably worse—

“than the national average of 53%.”

The report continued:

“The average Friends and Family score for inpatients was 73, which is the same as the national average…The Friends and Family score for maternity…was 70, which was better than the England average of 62.”

So it is not all bad news.

However, the urgent and emergency care is a significant problem, yet the Government decided in 2011, based on the independent reconfiguration panel and the CQC report, that the A&E department at King George hospital should be closed and all A&E services should be relocated to Queen’s hospital. Queen’s cannot cope as it is. Consistently, the Queen’s A&E has had worse assessments than the King George A&E. Yet the sword of Damocles is still hanging over the A&E at King George, and there is this mass of 245,000 patients who go to the A&E departments at the two hospitals, which they cannot cope with.

Let us suppose that the assessment in December, or whenever it is, leads to the trust coming out of special measures next year. What will that mean? What will the consequence of that be? I will quote the summary of the CQC report on urgent and emergency services. The “Friends and Family test”, which I have just quoted, said those services were

“showing no signs of improvement over the 12 months prior to the inspection. The hospital had not achieved the national four-hour waiting target of 95% of patients seen within this timeframe for more than a year, and usually averaged around 90% of patients seen within this time. Patients often had waits of four hours or more in the department and were waiting for long periods of time to be moved to an appropriate bed once it has been decided they should be admitted.”

This is the key sentence:

“There was no clarity about the future of the department and when, or if, it might close in the future.”

This has been hanging over my local hospital since 2006. We have fought vigorous community campaigns and the issue is still hanging over it. There is no clarity. If, because of improved management, the situation improves

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later in the year and the trust comes out of special measures, will that mean—I suspect it will—that there will then be moves to close the A&E at King George because the trust is no longer in special measures? There is not the capacity at Queen’s to deal with that. It will take years, considerable cost, and millions of pounds of investment on the Queen’s hospital site before Queen’s hospital is ready to cope with this situation.

Rather than wasting millions of pounds and causing more difficulties for several years, would it not be better if the sword of Damocles was taken away, thereby ending the uncertainty and lack of clarity mentioned in the CQC report? Then we could deal with the problems of recruiting sufficient specialist doctors and having adequate cover at all times, and maybe work out a plan for a relationship between the two acute and emergency departments whereby there would not be a closure, but perhaps a rethink about how services were run.

Clearly, Queen’s cannot cope today. However, it is still the Government’s plan to close King George. I have asked Ministers about this for several years and the answer has never changed. There is still uncertainty. What will the future of King George be? It is time to end the uncertainty, to give a sense of clarity and, as the trust improves, to take away the threat to close the A&E department at King George.

4.52 pm

Margaret Hodge (Barking) (Lab): I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) and join him in commending and thanking the many staff who work under huge pressure in both King George hospital and Queen’s for the very good work they do, which I hear a lot about from my constituents.

I have been involved with BHRUT and its predecessors for over 20 years. I have seen six chief executives and 12 different chairs, men and women. Every new generation blames their predecessors for the problems that they inherit. I am perhaps a little more sceptical than my hon. Friend: I do not think that we have suddenly, magically got a new team that will solve many of the intransigent problems facing that trust. It has been co-operative and is trying hard, but we are now over a year into the new regime, and on many of the indicators I cannot see demonstrable improvements. The trust has been bankrupt for years; the deficit has not gone down for years and I cannot think that it will go down much in the coming period, given the pressures and the failures to deal with some of the intransigent problems.

Quality has been pretty poor for years. We finally got the CQC report that put the trust into special measures, but the most recent report shows that the necessary improvements that I wanted for my constituents and that would take the trust out of special measures have not been made. Although I share my hon. Friend’s hope, I am not confident that we will get there by the time the CQC comes back yet again.

Compared with all other trust areas throughout the country, ours is the eighth most deprived area in terms of health need. The NHS ought to be delivering equal access to high-quality care to people wherever they live, but it is not. I sincerely feel that that is the biggest battle for my constituents. Where I live, I get much better access

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to much better quality healthcare than my constituents in Barking and Dagenham who use both Queen’s hospital and King George hospital.

I should like some assurances from the Minister about the north-east London sector. Not only are we bankrupt in our neck of the woods, but Barts City—predictably, I have to say—is also in incredible deficit. One knows how these allocations of moneys go and how views are taken about the health service across the country. There is a real danger that salvaging the new Barts hospital, with its £1 billion PFI and the massive call of that on revenue funding there, will come at the expense of BHRUT and the hospital provision that we need locally. I seek assurances from the Minister that, in considering an undoubtedly difficult financial situation across the whole north-east London sector, he does not disadvantage our residents by putting everything into the much more powerful Barts and the Royal London Hospital NHS Trust.

I want to raise three other issues. First, I have been shocked in recent times by how much is spent on agency staff by BHRUT. For example, in 2013-14, it spent £27 million, and in June this year it spent £2.5 million. When Matthew Hopkins gave evidence at the Public Accounts Committee, when we were looking at the state of a number of vulnerable trusts, he talked about a 50% shortage of consultants in the A&E department and told us that he was spending £1,760 on one 16-hour shift of A&E consultants. After that session, I asked a consultant in A&E during one of my usual visits round the hospital whether he was an agency consultant or a full-time employee. He had been a full-time employee, but deliberately switched to being agency staff because as an agency member of staff he earned more and did less. His doing so put the trust in greater difficulties.

That sort of behaviour is simply an unacceptable waste of what we all understand is a very small amount of money that is not enough for local healthcare. According to the CQC’s most recent inspection, a third of the nurses on night duty on the first night of its inspection were agency nurses. I should like the Minister to talk a little bit about how he is going to tackle the use of agency staff, who provide poorer quality care, because they do not know the systems or the people and do not know their way around the hospital, and cost the hospital a lot of money.

Secondly, although I recognise that there have been improvements, particularly in maternity, where we were first alerted to quality really going wrong in Queen’s, on reading the report I was worried about radiology. There is still a huge bill—millions of pounds—to be paid to people now litigating against the hospital because of what happened to the mothers and children through poor maternity care there, but the original CQC report in 2010 highlighted that the radiology department was poor. There were delays in people having scans done and scans were not passed to the relevant consultant, so people with cancer were simply not being diagnosed in a proper, timely manner that would have allowed them to access the treatment they needed. The recent inspection still finds problems there: it is too short-staffed, with too many locums.

One of the incredible things I read was that on one day of the inspections, five radiologists were on leave. What sort of culture does a hospital have if it allows five radiologists to go on leave on the same day and so

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provides a poor service to patients? There is a large backlog of patients who have waited well over 18 weeks. During the inspection, the CT scanner kept breaking down and patients had to be transferred from Queen’s hospital to King George hospital. That is unacceptable. It is about more than money; it is about a culture in the management that was originally identified in 2010 and now, in 2015, the A&E is still appalling.

I will raise a couple of other issues that I think are relevant and which my hon. Friend alluded to. The first is GP services. If we cannot sort out primary care, demand on acute and hospital services will continue to exceed their ability to respond. Barking and Dagenham has the highest number of GPs aged over 60 in the country: a third of our GPs are over 60. We have been completely open—we will try any experiment on the ground. We have had salaried GPs, private practice GPs and GPs linked to universities in an attempt to provide some training. We will do anything to attract and get more and a better cadre of GPs in our patch, but we have failed. We are still the eighth in London in terms of concentration of single-person practices. I raise this issue all the time with the powers that be in the health service locally. One in five of our GP practices remains single-handed. We know that that does not provide an adequate service to local people, yet there is not any sort of energy or urgency in the actions of the local health service officials to sort that out. They ought to be able to do so and to apply much greater pressures on some of the GP services, so that we get better primary care.

People cannot get appointments. We have done a survey of our residents—it is not a proper survey; I do it when people attend my very regular coffee afternoons. However, those surveys show that 50% of our residents had to wait more than a week to get access to their GP. Some 30% went to A&E because they could not get access to the GP. Nearly half said that they had found it difficult to get an appointment. The typical story is, “I ring up at half-past 6 to see the GP the next morning. I am told to ring the next morning. When I ring the next morning, it is engaged and engaged, and in the end I give up and go to the A&E.” Unless there is a forceful, determined attempt to sort out the failures of our primary care system, we will not make progress in the acute sector.

One of the little things we did was run a campaign on the use of premium phone numbers. From constituents who came to see me, we uncovered in 2013 that 10 GP practices in the constituency had 084 numbers. One constituent had spent £10 trying to get an appointment, because ringing such numbers from a mobile costs 41p or 42p a minute. Another constituent spent £30 trying to get an appointment for her son because she had to hang on until she was dealt with. She got through to the system, but the call was not answered by anyone to secure an appointment. We have run a tough campaign on that, but two and a half to three years on, we still have one GP practice—Castleberry medical centre—that is refusing to put in a landline, and three others that have a landline but have kept their premium phone line, and my bet is that patients cannot get through on the landline and have to use the premium phone line. Access to GPs is important. I thought we had halted the use of premium phone numbers after another PAC inquiry, but it has not happened.

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My final plea is on access to the hospital for the poorest people in my constituency. They live in the most south-western part of my constituency, in Thames ward. Getting to Queen’s hospital from there takes three buses. I did the journey during the election period, and it took me about two hours. If someone has to go for regular chemotherapy or kidney treatment—whatever it is—that four-hour journey every day means that the person does not go and so does not get that treatment and therefore dies younger. I have been pleading with the Mayor and the transport authorities to ease that just by diverting the No. 5 bus so that it goes straight to the hospital. That would save people one change—they would get two buses, not three—but I have completely failed so far. I have been fobbed off. I urge the Minister to join me and write to the relevant authorities to ensure that while at least keeping those hospitals there, trying to get them properly funded, sorting out the financial mess and improving the quality, we also allow people to get there easily, particularly those who need the hospital services the most and are most dependent on public transport.

5.5 pm

Wes Streeting (Ilford North) (Lab): It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this important debate and on opening it in the way he did, setting out the chequered history of the trust and the particular challenges we face right across our borough of Redbridge and the wider north-east London health economy.

I will not repeat the points made by my hon. Friend and my right hon. Friend the Member for Barking (Margaret Hodge). I want to express my concern about the outstanding problem that the CQC has identified with the trust and the impact that is having on patient care in a wide variety of areas. I share the concerns expressed by both my colleagues that the CQC inspectors rated the trust as “requires improvement” on most measures, and the responsiveness of service at the trust was deemed “inadequate”, but it is also important to highlight some of the areas that were identified as having outstanding practice—in particular, the values of the trust and how they have been embedded in the culture of the staff.

Like my colleagues, I congratulate the NHS staff who work in the trust on the hard work they do in difficult circumstances. I commend the fact that the radiotherapy unit was one of the top five in the country. There are good outcomes for stroke, and the genito-urinary medicine clinic had

“excellent service with appropriate protocols”.

Significant improvements have been made, so while it is disappointing that the trust remains in special measures, the improvements described in the report are encouraging and reflect well on the NHS staff and the reinvigoration of the trust leadership. They can take genuine pride in their teamwork. I have no doubt that the trust will emerge from special measures sooner rather than later.

My right hon. Friend spoke about the high level of agency spend. One of the problems that the trust has suffered from for a number of years—frankly, some of the trust’s challenges were well known before the inspectors put the trust into special measures—is that when a trust has a poor reputation, it is hard to recruit and retain the

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best staff. While I am disappointed that we are not yet out of the woods, I hope that when people are thinking about their careers, they identify not only that the trust requires improvement, but that it is improving and is a good place for good people to be at this point in its journey.

I want to speak briefly about the wider north-east London health economy. Until May, I was chair of the Redbridge health and wellbeing board, deputy leader of Redbridge Council and the cabinet member for health and wellbeing. It is fair to say that the challenges in the north-east London health economy—the challenge in primary care has already been touched on—are not just restricted to the trust. I was the first chair of the primary care transformation board, which is trying to change how primary care is delivered and bring about genuine service improvements. In the very first meeting, I asked GPs about their experiences, and they described primary care as being in crisis. They know that they are not providing a good enough service to their patients. They work hard to do so, but the pressures are immense. That relates to the quantity and quality of GP provision. My right hon. Friend talked about the wider concerns about the number of GPs who are past or nearing retirement and the workforce pipeline. Combined with the fact that Redbridge has one of the lowest levels of public health spending in London, that gives me cause for great concern. I am concerned not only about the level of public health funding but about the fact that the Government are seeking to give councils new responsibilities —for example, for health visiting—without sufficient funding. The in-year cut that my council will experience will place even greater pressure on services. On that note, I should probably declare that I am still a member of Redbridge Council, albeit an unpaid one.

Finally, I want to talk about A&E. Since January, there have been some improvements in A&E performance at both King George and Queen’s. In January, King George’s performance standard was 92.67% and at Queen’s it was 79.15%. As of June, King George had improved, up to 96.56%, but Queen’s was still lagging behind at 93.31%. I have seen absolutely nothing in either the CQC’s inspection report or the performance data for our local A&E departments to alter my view that the loss of the A&E department at King George hospital would be a disaster for patients.

Since the decision to close the A&E department at King George, much has changed in terms of both the population pressures and the immense strain on the whole health economy in our part of London, which I have already described. In that context, it is really not unreasonable to ask Ministers to intervene, to look at the A&E closure with a fresh pair of eyes, and to ask the clinical commissioning group to reopen the A&E closure decision and reconsider its position. Previously—this always happens at the height of elections, particularly local elections—my local Conservative association put out a statement claiming that there had been some sort of reprieve and the A&E would not be closing, but nothing of the sort has happened. Thousands of residents across Redbridge will never forgive the Conservatives if they do not at least look at this matter with a fresh pair of eyes.

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We all heard what my right hon. Friend the Member for Barking said about the financial issues at the trust. There is absolutely no doubt in my mind that those issues and the difficulties in recruiting staff across two A&E departments are what are really driving the closure of King George’s A&E. It is being driven not by what is in the best interests of patients or what good A&E configuration in our part of London would look like, but by the inability to get the right staff and to rescue the trust from its very difficult and precarious financial position. That is not good enough. I hope that, when he responds, the Minister will at least assure residents that the Government will look at this matter with a fresh pair of eyes and ask the CCG to do the same.

5.12 pm

Jon Cruddas (Dagenham and Rainham) (Lab): I will be brief, given that I want to leave sufficient time for the shadow Minister and the Minister to respond. I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this debate.

From the contributions so far, I think we would all agree on what politicians tend to call the challenging environment that the trust has existed in for many years—including the initial Care Quality Commission report, which contained a lot of criticism, specifically on A&E and maternity. A whole host of other issues were raised, leading to the placing of the trust into special measures in December 2013 and the improvement plan of 12 months ago.

We know that there are huge demographic pressures on the trust, reflected in the number of emergency patients, of which there were 220,000 across Queen’s and King George last year. That illustrates the pressure from footfall. All speakers so far have mentioned the huge budgetary pressures, in terms of both the debt overhang from the private finance initiative and the management’s ability to secure the in-year budget. The deficit was some £38 million last year, and it is estimated to be the same this year.

There have been huge management changes across the trust, and I, too, support Matthew Hopkins’s work. As my right hon. Friend the Member for Barking (Margaret Hodge) mentioned, there has been a squeeze on Barts, on the west side, and also on the Essex trust, on the east side, meaning that there is a danger in the distribution of resources: we could be squeezed between the two trusts on the western and eastern borders of our trust.

The CQC report was a bit of a mixed package. There were positive outcomes for radiotherapy, strokes, nurse-led oral chemotherapy and the humane end-of-life care service, and there was increased cleanliness and good infection control across the trust, which compares well with some of our experiences a few years ago. However, the report also consistently pointed to issues relating to clinical governance and waiting times, especially for A&E.

The in-patient survey results mentioned improvements in single-sex placements, the decline in changes to admission dates and the offering of alternative hospital placements to patients. It also mentioned the need for improvements in waiting times for beds, doctor communication and the number of nurses on duty. I acknowledge, however, that in 2015-16 there will be £5.8 million of extra spending on improved nursing care, which will amount to some 80 additional nurses.

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On the broader issues that have been raised, I echo a number of points mentioned by colleagues about the pressures on primary care, the age profile of the GPs, the number of single-handed practices and the fact that we have waited for a promised new integrated health centre in Dagenham East for 10 years—it has still not been delivered. Similarly, the Rainham practices desperately need new facilities. Getting appointments is becoming more difficult, putting more and more pressure on the acute sector because of people rolling up to A&E.

Overall, there have been improvements—we all support the management—but there is a long way to go. As we, hopefully, move out of special measures, it is especially important that we remove what my hon. Friend the Member for Ilford South called the sword of Damocles that is hanging over King George. I hope for a positive response from the Minister on that specific point.

5.16 pm

Andrew Gwynne (Denton and Reddish) (Lab): It is a pleasure to serve under your chairmanship, Mr Davies.

I pay tribute to my hon. Friend the Member for Ilford South (Mike Gapes) for securing this important debate. His speech highlighted the very real danger of closing his local A&E department while the trust is, sadly, in the protracted throes of special measures.

I also pay tribute to my right hon. Friend the Member for Barking (Margaret Hodge) and my hon. Friends the Members for Ilford North (Wes Streeting) and for Dagenham and Rainham (Jon Cruddas) for their contributions. All have been champions for patients at the Barking, Havering and Redbridge University Hospitals NHS Trust for a number of years. Like my right hon. and hon. Friends, I pay tribute to the staff at the trust who, in very difficult circumstances, are working hard to deliver high standards of care to patients.

As we have heard, the trust is facing particularly profound challenges. It is one of the largest in the country, serving a huge and diverse population. There is a lot of churn and movement of people and, as a result, things are even more difficult for GP and primary care services, which, as we know from elsewhere in the country, have been under intense pressure in recent years. My right hon. Friend the Member for Barking made some particularly pertinent points on that: if someone cannot see their GP, the pressure is moved on to local hospital services. When those services are already in difficulty and struggling to cope, they could well do without the added pressure of extra demand.

I hope the Minister will accept that the trust needs real support, because it has been hit hard by certain decisions. The trust itself must bear some responsibility, but I am afraid that some of the previous Government’s policies came at the wrong time. Last winter, as we heard, the trust suffered its worst quarterly A&E performance since records began. In January, more than one in four patients were waiting longer than the recommended four hours in A&E—some were even waiting longer than 12 hours.

In December 2013, the trust was placed in special measures following a Care Quality Commission report that raised serious concerns about patient safety and care, particularly in A&E. The report said that staff at the A&E at King George

“did not have confidence in the trust leadership to make the necessary improvements in A&E.”

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Although some of the problems at the trust are deep-seated, the CQC report was clear that many of the problems, such as the difficulty in recruiting staff to the emergency department, have either become worse or emerged in recent years. The report also suggested, for example, that staff were concerned about the wide range of locum doctors turning up to shifts. They felt that there was no problem when they were assigned locums with whom they had worked before, but they were clear that the lack of permanent staff posed a risk to patients.

The trust is in a difficult financial situation. As my right hon. Friend the Member for Barking said, and she was echoed by other Members, that is not helped by its having to spend £27 million on agency staff last year because of a shortage of qualified staff. The trust has also been forced to recruit nurses from overseas because not enough home-grown nurses are being trained. It is well worth remembering that, despite what Ministers claim, the NHS now contains fewer nurses per head than in 2010.

The future of A&E services at King George hospital obviously remains in doubt. I remind the Minister that the 2010 Conservative manifesto promised to

“stop the forced closure of A&E and maternity wards”.

Since then, the maternity ward at King George hospital has closed. The plan to close the A&E unit and relocate it to Queen’s hospital has been delayed, but not abandoned. The Minister can, hopefully, update us on those plans and address the valid concerns not only of local MPs, but of the local communities that they represent on the capacity issues that have been mentioned.

Clearly, many of these challenges cannot be tackled in isolation and require working across London and, indeed, considerable support from the Department of Health, but I hope the Minister has listened carefully to the assessment of the problems laid out by my hon. Friend the Member for Ilford South. I also hope that he is prepared to take on board some of my right hon. and hon. Friends’ suggestions. What they have said is eminently reasonable. With the right support from central Government, I know that their constituents can receive the standard of care that they deserve.

5.22 pm

The Parliamentary Under-Secretary of State for Health (Ben Gummer): It is a great pleasure to serve under your chairmanship, Mr Davies. I thank the hon. Member for Ilford South (Mike Gapes) for raising what is an important matter not only for his constituents, but for the whole health economy of east London, and for the measured way he presented his case. He has been a watcher of and campaigner on the matters in his constituency for a long time. This matter has been addressed and debated on several occasions in this Chamber, and I know he has raised it in the main Chamber too. The last time he raised it here was in January 2014, just after the trust had been put into special measures by the Care Quality Commission in December 2013.

The distance that has been travelled since then is quite considerable. I was able to see it for myself recently, as my first ministerial visit was to visit the Queen’s hospital site—albeit to hear about the trust as a whole. It was clear from talking to staff, which I was able to do without management being present, that the distance travelled over the past 18 months has been considerable and transformative not only for patient care, but for

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staff experience of the workplace—the two, as all Members will recognise, are coterminous. The most instructive moment came in the staff discussion, when a nurse explained that, the day before, a petition signed by 3,000 local people, which had not instigated by anyone at the hospital, had been delivered to say how much they valued staff efforts to turn around their hospital and how they felt that it was a different place from the one that had gained a mixed reputation in the many years before the hospital was put into special measures.

I will address each of the issues raised by hon. Members in turn, but I want first to set the context and add slightly to the narrative provided by the hon. Member for Ilford South in his recounting of the trust’s history. The key review in the matters that we are discussing was begun in 2009. The review took in the whole of Health for North East London and was conducted under the right hon. Member for Leigh (Andy Burnham), then the Secretary of State for Health and now the shadow Secretary of State. It began reporting just before the 2010 election and required an answer immediately after. The hon. Member for Ilford South will know the report’s conclusion, which is basically what we are still sitting with. It encompassed not only the health economy of north-east London, but the relationship with what is now the Barts Health NHS Trust, encompassing Whipps Cross university hospital, St Bartholomew’s hospital, Newham university hospital and the Royal London hospital.

Several hon. Members have discussed the Government’s intentions regarding reconfiguration, but the report was not led by the Government or Whitehall but was under the sensible regime set up by the previous Labour Government of clinically led reconfiguration panels. The principle behind it was a better organisation of A&E and urgent care in east and north-east London—in particular, being able to provide superior trauma care at fewer sites. That model has wide understanding across the House and is based on international evidence and, increasingly, the experience in the NHS. It has affected my constituency as much as it has others around the country.

I understand why hon. Members who are concerned about a hospital that will lose particular services—although King George hospital will retain a 24-hour urgent care service—will feel aggrieved by that change. When engaging with patients and constituents, however, I ask that we remind everyone that this was a clinically led decision that was set up under the previous Labour Government and that the recommendations were continued by the coalition Government as a result. However, none of that questions the fundamental reason why the hon. Member for Ilford South called for this debate, which was to ask, “How can you continue this reconfiguration when one part of the trust is in crisis?” Crisis is the correct word to use for a hospital that was put into special measures. It was not one of the Keogh trusts that were put into special measures due to adverse mortality; it was one of the first to be put in because of systemic and endemic problems at the trust, many of which the hon. Gentleman highlighted.

The change that has occurred over the past 18 months to two years—I am grateful to the hon. Member for Ilford North (Wes Streeting) for highlighting exactly

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what has gone on—has been one of culture. Another remark from a nurse with whom I spoke was that, since special measures, her comments about patient care were being noticed by management for the first time. That was the difference that the CQC inspection made. The change in culture has been recognised by local people and the result is much-improved family and friends figures. I do not recognise the figures provided by the right hon. Member for Barking (Margaret Hodge), but the most recent figures are close to the national average. I will receive those figures in a moment, but I believe the overall A&E figure for family and friends was up at 84%. That is not quite where it should be, but the in-patients figure had also risen to nearly the national average. The most recent family and friends figures showed an improvement in results.

Hon. Members recounted figures suggesting that the A&E performance was poor. It is true that the A&E department has failed to hit its required standard for a long time, but the most recent figures are encouraging. Performance for the first quarter of this year was 93.39%—just under the 95% target—compared with the figure for the first quarter of the previous year of 85.62%. That is like for like. Despite the problems encountered across the NHS over last winter, that hospital showed a sustained improvement in the first quarter of this year.

I second the remarks made by several hon. Members about the quality of the new chief executive and the team he has built around him. I have spoken to him, and although he was not going to make predictions, his confidence about going into winter, as well as the place the hospital was in, was significantly different from where he and his team were this time last year.

Let me clarify the A&E figures before I get upbraided. I believe that the figures are that 96% of in-patients would recommend the service to their family and friends, and 1% would not; in A&E, 84% would recommend and 10% not; in maternity, 98% would recommend; in antenatal, 95%; in postnatal wards, 93%; and in postnatal community, 97%. Those figures are roughly around the averages in national FFTs—family and friends tests—which is a significant and marked improvement, showing that local people are responding to the changes made in the hospital and to what needs to happen.

None the less, despite all the improvements, it is true that the A&E is not in a sustainable position to receive the services from King George hospital, either physically—I saw its buildings for myself—or in terms of the new rotas and rosters, although recruiting is now much better managed than in the past. I understand from local commissioners that there is no intention to move these services from the King George to the Queen’s site until the physical and staff changes have been made to the satisfaction of the commissioners and the provider—the trust itself. I understand also from the commissioners that the time limit they have imposed means that that cannot happen even within the next two years, because they need to see a degree of sustainability before they can have the confidence to make the changes.

Mike Gapes: Does the Minister accept that, given that the A&E will be closed, whether in two, three or four years’ time, there is a level of uncertainty? The CQC report comments on that. Is it not better for the sword of Damocles to be lifted and for us to go ahead on the basis of having two A&Es that work together?

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Ben Gummer: I understand the hon. Gentleman’s points. I accept that uncertainty is created at the King George site and that the effect of that is potentially destabilising, especially when the hospital and the trust have had to endure the whole process of special measures. His solution, however, is a false one in two senses.

First, the decision was clinically led in the first place, so to go against it would be to go against a clinical decision after several reviews. The hon. Gentleman is therefore suggesting that we make a political intervention against a decision made by doctors about the best distribution of trauma centres and urgent and emergency care centres according to population. Decisions have been made on a similar basis throughout the country. I do not believe that he really feels that that would be an acceptable route to take. Secondly, even were we to do that, it would not remove uncertainty, because there would still need to be some sort of reconfiguration in future in order to get the best outcomes for patients. So the uncertainty would remain.

The hon. Gentleman’s point is valid to an extent. If the situation were to occur again—clearly none of us would have wished things to proceed as they have done —we need to make it clear that reconfigurations can happen only when we have the correct sustainability in receiver organisations. That should be something we think about as we go ahead. However, we are where we are now with his trust, and to proceed on the basis that he suggests would not give either the patient outcomes or the certainty that he desires, whether for staff or his constituents.

Margaret Hodge: The Minister referred to a decision that was initiated in about 2009. That is correct, but circumstances change. Our area is the most rapidly expanding in London. I do not know the figures for Redbridge, but those for Barking and Dagenham show, potentially, another 30,000 to 35,000 houses being built over the next 10 to 15 years. That is massive expansion. I put it to the Minister that not only is the number of houses increasing, but the nature of the households is changing. What used to be a house lived in by a couple with perhaps two kids now tends to be lived in by intergenerational families with many more people. What regard has he paid to those changes? Should he not pay regard to them and review his decision in the light of them?

Ben Gummer: It is not ultimately my decision. It is the decision of the Secretary of State, but only on the advice of the Independent Reconfiguration Panel. The IRP takes a view over a long horizon, so it takes population growth into account in the original decisions—

Margaret Hodge: It did not.

Ben Gummer: I will come back to the right hon. Lady with a final comment, but that is what I understand. In the end, such decisions are left to local commissioners, who are the experts in buying the right kind of health provision for their patient groups. If their decision changes, that should be reflected in the IRP’s final decision, but the commissioners remain certain that that is the correct way to go for east and north-east London, and while that remains the case, we as politicians should support that clinical decision.

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I will respond to some of the other points made by hon. Members. The finances of the hospital were brought up several times. It is true that it has had a sustained poor financial performance, but it is unlike other hospitals which have become indebted or are lifting up. The hospital’s position is a sustained one involving a large number—£38 million, which includes a very large figure for agency workers. That figure is now declining as the new management gets a grip on recruitment, and I heard some good stories about the improvement in recruitment when I went there only a couple of weeks ago. There is also £60 million annual provision for PFI payments, which is a problem in many trusts around the country, but there is no point rehearsing those issues, which the right hon. Member for Barking looked at many times in her previous role.

The chief executive is clear about the deficit. He shares my view and that of the Secretary of State that financial performance and quality go hand in hand. No hospital in this country offers outstanding care but has poor financial performance. We cannot get efficient care anywhere if the books are not being looked after at the same time, because the two work together. The chief executive understands that getting the trust into a decent financial position is central to providing the kind of consistently high-quality care that he wants to see across the trust, and not only in the specific areas rightly highlighted by the hon. Members for Dagenham and Rainham (Jon Cruddas) and for Ilford North.

The hon. Member for Ilford South was right to talk about capacity. There was a serious lack of capacity because of the failure to discharge patients and to get people through the system, which caused problems at the front end, in A&E. Remarkable change has been achieved in the past six months through the new measures put in place by the new management, but it is true that there is a great deal more to do. I heard a different story from the one the hon. Gentleman recounted: actually, they thought that the last CQC judgment was completely realistic; the action points highlighted were in large part already being addressed and needed to be done. The new management recognised that special measures was a regime that had to be exited once a sustainable improvement over time had been shown. That was gratifying to hear, because when it is heard from the shop floor, the management and the CQC, that shows that the whole team understands the problems and how they need to be addressed.

Several Members mentioned the problems in primary care, and I am aware of the acute issues in east and north-east London. They are the reason why my right hon. Friend the Secretary of State launched the new deal for GPs a couple of weeks ago. NHS England is now mapping hotspots of GP shortage across the country. It will use that information to target resources to make sure we are putting the new GPs being recruited into the right places and using every possible incentive to make sure that under-doctored areas are brought up to parity. Members will know that this is a historical problem and it will take a great deal of heavy lifting from all of us to change it. It is not simply about sheer numbers of GPs; we must have new models of delivering care and new diversity, so that we can deliver primary care appropriately rather than in a way that is based on a model that does not fit.

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The right hon. Member for Barking raised understandable concerns that the existing system for the Barts trust was set up to finance one PFI deal. She is not alone in those concerns. I am taking a deep interest in the progress of the special measures regime at Barts. The financial performance and accounting procedures at that hospital and trust when it went into special measures were frankly shocking. They have now been changed, and we will be reviewing the situation on a weekly basis. I hope that if she discusses the matter with the CQC and the trust, she will understand better that it is not that the trust is subsidising one PFI but that there are systemic financial problems across the trust. I take her point completely, however. As we address the financial problems in east London we must reassure everyone that mergers have not happened simply to prop up one organisation at the expense of another.

Finally, I welcome the constructive approach and fair questions of the hon. Member for Denton and Reddish (Andrew Gwynne). I hope I have answered the majority of his questions, but I question the idea that Government policy has made the situation worse. The reason we are debating here is that the CQC gave an inadequate rating to the Barking hospital trust and put it into special measures. The ratings and the special measures regime were a creation of the previous Government. They have provided transparency and clarity that we did not have before and allowed us to have an honest discussion about what is wrong and what is right. I can now stand up and say where the problems are and accept responsibility for what needs to change. None of that was possible when we could not say that anything was wrong and had to pretend there were no problems, because there was a culture of denial rather than one of transparency and openness.

We are not at the acme. We have a great deal of distance still to make up, but we are in a much better place than we were back in 2013, when the trust was put in special measures, or in 2010, when the review was

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completed. We now have clarity about what we need to do and the process for doing it. I believe that we will soon have a much better health economy in north-east London than the one that Members have had to endure so far.

5.42 pm

Mike Gapes: I am pleased to have got some injury time, Mr Davies. I emphasise to the Minister and his officials that the problems in north-east London and in my borough of Redbridge in particular are serious. He referred to the Barking and Havering trust and the Barts trust. Every single resident of Redbridge now has to use a hospital that is in special measures, as Whipps Cross hospital is part of the Barts and Royal London agglomeration and King George hospital is part of the Barking and Havering trust. In that borough people cannot go to a hospital that is not in special measures. Some of the constituents of my hon. Friend the Member for Ilford North (Wes Streeting) go to Whipps Cross rather than to the King George.

The reality is that the situation is a fundamental challenge to a population that is growing rapidly. The Mayor of London has just agreed to invest £55 million to build 2,000 new dwellings in the heart of Ilford. A young, dynamic and largely migrant population is moving to Ilford. That means we have to deal with these problems soon—they must not become long-term issues. I am conscious that the people of north-east London—of Redbridge, Barking, Dagenham and Havering—will expect decisions to be taken in their interests. I and my colleagues will continue to fight for them.

Question put and agreed to.


That this House has considered the future of Barking, Havering and Redbridge University Hospitals NHS Trust.

5.44 pm

Sitting adjourned.