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Westminster Hall

Tuesday 8 September 2015

[Mr Philip Hollobone in the Chair]

Hospital Services (South Manchester)

9.30 am

Mike Kane (Wythenshawe and Sale East) (Lab): I beg to move,

That this House has considered hospital services in south Manchester.

It is a pleasure, as ever, to serve under your chairmanship, Mr Hollobone.

I secured this debate to highlight to Parliament some serious and genuine concerns about the Healthier Together process, which is under way in Greater Manchester. Healthier Together Greater Manchester has been a three-year consultation that, according to its own website,

“was created to help make an NHS for the 21st Century, helping to save more lives.”

The Healthier Together proposals relating to hospitals seek to drive up quality and safety by forming a single service with networks of linked hospitals working in partnership. That means that care will be provided by a team of medical staff who will work together across a number of hospital sites within the single service.

The Healthier Together committees in common, made up of GPs from each clinical commissioning group in Greater Manchester, were responsible for making decisions about the proposals based on a wide range of evidence gathered during the past three years. That included evidence from a public consultation and data on travel and access, quality and safety, transition, affordability and value for money.

Before the public consultation, commissioners decided that there should be at least three single services in Greater Manchester, based in Salford Royal hospital, the central Manchester university hospitals and the Royal Oldham hospital, which will each specialise in emergency abdominal general surgery. That decision was made because of the clinical services already provided by those hospitals and to ensure that all areas in Greater Manchester had equitable access to specialist services. Each hospital will work in a single service model with other, neighbouring hospitals in Greater Manchester.

On Wednesday 17 June, commissioners took the decision to implement four rather than five single services to deliver hospital services in Greater Manchester. Commissioners believed that the evidence showed that four single services would offer exactly the same quality and benefits as five, and that it would be quicker and easier to recruit the additional doctors needed to run four single services. The commissioners also pointed out that, in the long term, four single services would cost less to run. At a meeting on 15 July, commissioners unanimously decided that Stepping Hill hospital in Stockport would be the fourth hospital in Greater Manchester to provide emergency abdominal surgery, as part of one of the four single services.

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Andrew Bingham (High Peak) (Con): I congratulate the hon. Gentleman on securing the debate. I apologise, but I cannot stay; I have a Select Committee to go to. I am concerned, as he is, about the initial consultation, which we debated in this Chamber in the previous Parliament. For the record, however, I should say that I am delighted that Stepping Hill was chosen; in High Peak, we are outside Greater Manchester and I was concerned that we had been forgotten. Choosing Stepping Hill means an awful lot to my constituents.

Mike Kane: The Healthier Together commissioners left us in a binary situation, so it became a competition between two hospitals. That should never have been the case.

The aim of Healthier Together—to give patients throughout the region the same standard of excellent service wherever they live—is the right one. The challenge is huge: Manchester has the highest premature death rate of any local authority in the country. There can be no doubt that healthcare services in Greater Manchester need to change.

Angela Rayner (Ashton-under-Lyne) (Lab): Will my hon. Friend join me in congratulating a hospital in my constituency on its news? Today, Tameside general hospital has come out of special measures. Although we are concerned about Healthier Together and some of its proposals, that is fantastic news for the overall package for my constituents.

Mike Kane: May I say a couple of things? On a personal level, I am delighted that my hon. Friend won her seat of Ashton-under-Lyne. She worked at the coalface of integrated care services in east Manchester and she brings all that experience to the House. I, too, was involved in public life in Tameside, for six years, so I am delighted that the hospital has been taken out of special measures today. I pay tribute to everyone who has helped that to happen, from those in the Ministry to local leaders and the consultants at Wythenshawe hospital who over the past few years have advised on bringing Tameside general hospital out of special measures.

Almost £2 billion has been taken out of the budget for adult social care, with more cuts to come. We need to do things differently to meet the challenges of the time. Better integration of local authority services and the NHS will be a key part of that change and will be realised under the new powers being devolved to Greater Manchester. My hon. Friend the Member for Stretford and Urmston (Kate Green), the hon. Member for Altrincham and Sale West (Mr Brady) and I have serious concerns about the outcome of Healthier Together and believe that the decision-making process is flawed.

Reorganising our tertiary services before resolving the huge challenges that we face to integrate our health and social care in the region feels like putting the cart before the horse. The benefits to be gained from our devolved powers in this area are yet to be realised, so we are redesigning our tertiary services in the dark. My constituency is home to the University Hospital of South Manchester Trust, which delivers services costing £450 million, employs 6,500 people and has 530 volunteers who give up their free time to help patients and visitors. The UHSM hospital has several fields of specialist expertise, including cardiology and cardiothoracic surgery,

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heart and lung transplantation, respiratory conditions, burns and plastics, and cancer and breast care services. Indeed, the trust is home to Europe’s first purpose-built breast cancer prevention centre. Its hospital not only serves the people of south Manchester and Trafford, but helps patients from across the north-west and beyond.

Healthier Together has decided that UHSM will partner the Central Manchester University Hospitals NHS Foundation Trust, or CMFT, in a single service for Trafford and Manchester. UHSM and CMFT have agreed to work together to improve collaboration between the trusts. There is clearly a great opportunity for two of Greater Manchester’s leading university teaching hospitals to work together to improve services, to increase integration at all levels, including with social care, and to improve research and education.

The Wythenshawe hospital, however, provides an extensive portfolio of secondary and tertiary services that rely on support from general surgery to maintain their quality and safety. In fact, UHSM provides all 18 of the services identified by Healthier Together as needing support from general surgery, including secondary services such as maternity, gynaecology, gastroenterology, urology and acute medicine, as well as tertiary services such as heart and lung transplant, burns care, cystic fibrosis and extracorporeal membrane oxygenation, which are provided only by UHSM for patients from across Greater Manchester and the north-west.

UHSM regularly accepts elective and emergency surgical patients from Greater Manchester and beyond who require the specialist support of its tertiary services —for example, patients requiring emergency or complex elective general surgery with complex cardiac disease. There is genuine concern that those secondary and tertiary services, which are outside the scope of Healthier Together, could be destabilised or downgraded through the implementation of the proposals.

UHSM also provides all the services, as identified by Healthier Together, on which emergency, high-risk general surgery is absolutely dependent, such as interventional gastrointestinal radiology and interventional vascular radiology. The latter is only provided at three hospitals in Greater Manchester that also provide vascular surgery, one of which is UHSM’s Wythenshawe hospital. Wythenshawe hospital must continue to deliver high-risk, emergency general surgery procedures for in-patients and for surgical emergencies in its secondary and tertiary services. UHSM will need to retain its existing level of general surgery support at Wythenshawe hospital in order to undertake surgical assessment, perform emergency surgery and manage the elective workload from a highly complex group of patients.

We were pleased that, in order to support UHSM’s tertiary services, Healthier Together recognised at a public meeting on 15 July that Wythenshawe hospital would need a higher level of general surgery service than that described in the Healthier Together service model for a local hospital. Much greater clarity, however, is required on how secondary care services, such as maternity, gynaecology, gastroenterology, urology and acute medicine, will continue to be supported, as the service model for general surgery could have significant implications for many services outside the scope of Healthier Together.

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UHSM believes that the key features of a service that would maintain the quality and safety of its secondary and tertiary services are that Wythenshawe hospital should meet the Healthier Together quality and safety standards; should remain a receiving site for emergency general patients, including those with co-morbidities in its tertiary specialties and those who self-present; should have 24/7 senior general surgical assessment and opinion rapidly available to A&E; should remain able to admit and manage general surgery patients of all types; and should continue to deliver all emergency general surgery procedures, both major and minor, for in-house emergencies—for example, in-patients in urology—as well as for emergency general surgery patients with co-morbidities in its tertiary specialties. I am thinking, for example, of a patient with a bowel obstruction who is also being treated by the hospital for cystic fibrosis. As a minimum, the existing level of general surgery capacity must be retained in order to deliver and maintain that level of service in support of UHSM’s secondary and tertiary services.

Wythenshawe currently has a high-capability team of 10 consultant general surgeons with experience in all specialities of managing high-risk surgical emergencies in-patients, supported by a team of trainee surgeons. Although Healthier Together analysed implications for the consultant workforce, it is not clear what analysis there has been of the implications for other staff, including the effects on medical training posts and the support those posts provide to consultants.

Healthier Together has recognised that the service model required at UHSM must be more than that described by the programme for a local general hospital, and UHSM’s surgeons have been invited to discuss potential service models with the Healthier Together team. However, serious questions have been raised with both me and Members whose constituencies border mine about patient safety and quality in what can only be described as a fudged model for UHSM, which would be neither a specialist hospital nor a local one.

Throughout the Healthier Together process, we have been told that the dominant driving force of the proposed changes is to save more lives, yet in the end the final part of the decision to allocate the fourth specialist site was taken based on one factor only: travel and access. It is clear that for the Greater Manchester-wide—indeed, north-west-wide—specialist services provided at UHSM to continue safely, a robust and high-quality general surgery service must be maintained at Wythenshawe hospital. That is essential to ensure the quality and safety of the secondary and tertiary services that our constituents and patients from across Greater Manchester, and beyond, rely on.

Graham Stringer (Blackley and Broughton) (Lab): I congratulate my hon. Friend on securing this debate. He is making an excellent and detailed technical case on behalf of Wythenshawe hospital. Does he agree that the downgrading of the status of Wythenshawe—that is what this is—will make it much more difficult to recruit the necessary specialist staff and is another example of how flawed the whole process has been?

Mike Kane: My hon. Friend knows more than anyone in this place about the principle of subsidiarity. He was fighting for devolved services for Manchester in the

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’80s. We are beginning to catch up with his vision for devolved services across Greater Manchester that he argued for when he was ably leading Manchester through the depression of the ’80s and its economic regeneration in the ’90s. I agree that this fudged proposal could lead to a death by 1,000 cuts. It will undermine confidence, and we are passionate about avoiding that.

I hope the Minister will work with us to ensure that patient safety across Greater Manchester is the primary factor in the decision-making process. Very few Members of Parliament are fortunate enough to represent the hospital that they were born in. There is nothing I would not do for patients—not just in my constituency, but throughout Greater Manchester. We were told that Healthier Together was a clinician-led consultation; unfortunately, our clinicians are now telling us that they have serious concerns. Local MPs must listen and act. We have reached an unfortunate situation in which those clinicians have applied for judicial review, and we are at the stage of the letter before action in that process.

I urge all sides to negotiate to see whether an equitable solution can be found. If it cannot, the proposals are so flawed that any judicial review would probably be successful. That would not please me in any way whatever; I am the last person who wants to see a long and protracted legal process. I believe that, fundamentally, we should move towards a devolved set-up in Greater Manchester and that that process will be put back by this situation. However, I cannot stand by and be told that patient safety may be at risk without raising the issue in Parliament.

9.45 am

Mr Graham Brady (Altrincham and Sale West) (Con): I congratulate the hon. Member for Wythenshawe and Sale East (Mike Kane) on securing this debate. It is a pleasure to be working alongside him, the hon. Member for Stretford and Urmston (Kate Green) and other concerned Members from Greater Manchester, who are deeply worried and troubled by the proposals being put forward in Healthier Together as a whole and for Wythenshawe hospital, the university hospital of south Manchester, in particular.

It gives none of us any pleasure to be here and to have to raise this debate, any more than it gives the consultants at Wythenshawe hospital any pleasure or satisfaction to have been pushed to the point where they felt that the only way to make their voices heard and ensure that their fears about patient safety in the longer term did not come to pass was to pursue the initial stages of judicial review. I could not agree more with the hon. Member for Wythenshawe and Sale East that that is not the way that any of us would wish to have this question resolved.

As the hon. Gentleman said, throughout the Healthier Together process, colleagues on both sides of the House have warned that the process was deeply flawed. The consultation undertaken over a three-year period is the worst instance of public consultation that I have encountered in my 18 years in this place. It moved immediately from discussion of warm platitudes about improved collaboration, and the better results that that can achieve, to a table of possible outcomes that was so complicated that no member of the public could hope to understand the implications. The whole episode raises

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some profoundly serious questions, both about the delivery of the best possible health services in Greater Manchester and about accountability in the delivery of public services and the ways we can ensure that the public view is properly heard and respected.

As the hon. Gentleman—my colleague—said, in Greater Manchester we are poised to embark on some very exciting changes, which, if got right, will make dramatic improvements in our delivery of health and social care and could provide not just a great improvement for our constituents but a model for many other parts of the country to follow. If instead we see this sort of flawed decision-making process proceed, the danger is that people will see devolving power and decision making to a more local level not as something that will empower them and give them a stronger voice but as something that will result in less accountability and is less likely to deliver for local communities. We need to ensure that the Government understand and the Department recognises that there would be a significant cost if this episode were allowed to damage wider public trust. All of us want more devolved decision making in Greater Manchester, but we want it done right, not in the deeply flawed way presaged by this process.

Not only was the consultation flawed—it appeared to be designed to obfuscate and confuse members of the public, rather than to be a genuine exercise in seeking public opinion—but the decision-making process at its conclusion was pursued in a way that is clearly unreasonable. I concur with the hon. Member for Wythenshawe and Sale East that, given the unreasonable nature of the process from beginning to end, there is every likelihood that, should judicial review be pursued to its conclusion, it will be successful. That is an important reason why we need people throughout the process—whether power now lies with the Department of Health or with the commissioning bodies—to get a grip on this problem and to try to bring it to a more satisfactory conclusion.

I do not want to go into enormous detail about the decision-making process—the hon. Gentleman has given a good survey of the technical questions that Healthier Together raises for UHSM—but we have seen clear support among the members of the public who responded to the consultation for Wythenshawe to be the fourth specialist hospital. Of course, the weight of responses cannot always be the factor that leads to a decision, but it is incumbent on those involved in any decision-making process to take public views seriously. If those views are to be discounted, that should be only on the most serious grounds and on the basis of clearly reasoned arguments.

I have two principal concerns about the grounds on which the weight of opinion was disregarded. First, there is the deeply spurious decision not to take account of the current standard of care delivered at Wythenshawe hospital. Any lay person and—I venture to suggest, having had many conversations with senior clinicians—any senior clinician would regard it as patently absurd to discount the hospital’s current clinical standards on the grounds that all the other hospitals are expected to reach the same standard at some point in the future so the standard is of no consequence. It is Orwellian to run policy and decision making in that way. I hope that the Minister will accept that that should give serious pause and serious cause for concern.

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The second significant point, which the hon. Gentleman also raised, relates to the decision finally being grounded on the travel time for a relatively small population in High Peak—I am not saying this because my hon. Friend the Member for High Peak (Andrew Bingham) has had to leave the Chamber to go to a Committee. The failure properly to take account of the A6 relief road, which is now being built, and which will deliver flows of patients from High Peak to Wythenshawe in a much shorter time, is again, frankly preposterous.

Kate Green (Stretford and Urmston) (Lab): I am sorry to make this point in the absence of the hon. Member for High Peak (Andrew Bingham), because I am sure that he would want to say something about it. However, is it not also the case that, in looking at the travel time, the failure to consider other options for High Peak patients, outside the Greater Manchester conurbation, also calls the decision into question?

Mr Brady: Yes, absolutely; that is an important point. Without venturing too far into the realms of legal opinion and the judicial review that we could face, what makes the decision so demonstrably unreasonable is the failure to take account of a known factor that will materially change the travel times on which that decision is purported to have been based.

Furthermore, it is questionable policy to proceed with such profound changes to services at the same time as another review was going on. It may be sensible to proceed with some of the shared service propositions for UHSM and Central Manchester—that may be the way forward and may lead to better outcomes for patients in both trusts, and it should certainly be explored—but seeking to arrive at agreement on that while the Healthier Together process was still to conclude was deeply questionable and is a source of serious concern for us all.

I will not rehearse the long list of outstanding tertiary services offered by Wythenshawe not only to Greater Manchester, north Cheshire and north Wales but far beyond. We are debating hospital services in south Manchester, but as the hon. Gentleman reminded us, we are also talking about a hospital that provides the most complex tertiary services for a much wider area. Clearly, therefore, the issue is more significant, and it is more important to get it right, than would be the case were the hospital providing important tertiary services merely for a local population.

The consultants who have spoken to me—I am sure that they have also spoken to my friends on the Opposition Benches—have been very clear. There is no question that they are trying to defend their own patch or their own empire; some are constituents whom I have known for many years, and many of them are at a point in their careers when they really do not need to be concerned about those things. Some are very eminent in their fields, and when they tell me that their concerns are purely about patient safety—they say that they are entirely open to sensible proposals for reorganisation, shared service agreements and so on, but that they are worried that the work being done at UHSM could be threatened and could, in the hon. Gentleman’s words, suffer death by a thousand cuts—I am inclined to take those concerns seriously.

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To boil the consultants’ concerns down to the simplest level, their analysis is that the high level of complex tertiary services at Wythenshawe can continue into the long term only if it benefits from an equally high level of general surgical support to ensure that different, co-dependent services and procedures can always be provided in the safest way. The hon. Gentleman said very clearly and correctly that, in the consultants’ view, the provision of general surgery would remain at an appropriate level only if Wythenshawe remained a receiving centre for complex general surgery. If the same level of support is not present—we have all seen how this works—it will be only a matter of time before we find ourselves here again, with a new review suggesting that it really is not safe to perform heart and lung transplants at Wythenshawe, because it lacks the necessary general surgical support when complications arise.

The consultants make a powerful and plausible case. First, there is the procedural case that Healthier Together has been flawed and that the process and decision were unreasonable. I also find it compelling when they say that having a certain level of general surgical support is the only way to protect the complex services that are provided at the moment.

Graham Stringer: I agree with the case that the hon. Gentleman makes about the importance of general surgery to the highly specialised tertiary services at Wythenshawe. Just over 30 years ago 55 people died on the runway at Manchester airport. I hope that such a thing will not happen again, but with the downgrading of Wythenshawe hospital is it not likely that, if people were to need services following an accident at the airport, those services would be of a lower quality? That is not acceptable.

Mr Brady: I am grateful to the hon. Gentleman, who makes a critical point. Most other airports probably envy the level of support that Manchester has almost on site—given the trauma centre and the combination of capabilities that Wythenshawe enjoys, so close to Britain’s third busiest airport, which is a major international airport. That is where someone planning with a clean sheet of paper would want a major trauma centre. Added to that, Wythenshawe even has its own helipad to receive emergency cases and get them into the operating theatres as quickly as possible. It is a lifesaving centre for many reasons.

I want to conclude with some thoughts about the way forward. As has been said, correctly, if judicial review proceeds there must be a good chance of success. Unlike most branches of the law, judicial review rather relies on reasonableness, which is viewed through the prism of a reasonable lay person’s views. It is pretty clear that the Healthier Together process fails on those grounds. However, if we get a successful judicial review the price will be at the very least a protracted delay in the reorganisation of services, which should bring benefits to patients across Greater Manchester and beyond. Potentially the price may be much worse, if it is to inhibit the move to the new world of integration of health and social care, for which we all have such high hopes.

The least that we need now is a sensible pause for reflection. We need the parties to draw back from the brink and get back to the table—not to the kind of negotiation in which the decision is restated and people

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are told they are being silly not to accept it, but to a genuine consultation and discussion with senior clinicians, who have previously felt excluded from the process and unable to make the input that they should have been able to make in the interest of patients. I do not think that any of us cares whether the pause is effected by Ministers at the Department of Health, commissioning groups or the interim Mayor of Greater Manchester.

We need people to be brought around the table, with the genuine good will that I think still exists on all sides. We need a genuine willingness to reopen the question, and an understanding that unless Wythenshawe either becomes an additional specialist centre in the terms of Healthier Together or, at the very least, is guaranteed a status as a receiving centre for acute general surgery, we will not arrive at a state of affairs that is good for Wythenshawe, for Greater Manchester or for the thousands of patients from north Wales and the north-west of England who depend on the complex tertiary services currently offered there.

10.4 am

Kate Green (Stretford and Urmston) (Lab): I am grateful to my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) for securing the debate. As you have heard, Mr Hollobone, the three Trafford MPs have been working closely together, and with clinical staff at the hospital at Wythenshawe, on our concerns about patient safety, which I want to highlight. Many of my constituents use Wythenshawe hospital as their local hospital, especially following the downgrading of services at Trafford general hospital two or three years ago as a result of the new health deal for Trafford. Indeed, when NHS managers were making the case for that, their argument was that Trafford residents would receive better, more expert care at Wythenshawe. To be told now that services in that hospital may also be downgraded will at least cause a further collapse in public confidence in the processes by which decisions about health service configuration are taken.

My constituents also rely on UHSM’s specialist services, about which we have heard much this morning. They are full of praise for the care that they receive. My hon. Friend the Member for Wythenshawe and Sale East spoke in detail about some of those specialties and I have had the great privilege of visiting some of the specialist teams at Wythenshawe and meeting staff. All are adamant that their success—and they are very successful and in many cases world-class teams—is due to their strong team-based approach and their reliance on the support of a full range of hospital services. Removing or downgrading any so-called ancillary services will have a direct effect on the specialties. It is for that reason that consultants at Wythenshawe have told us that they do not have confidence in the Healthier Together model and that in their view the specialties at Wythenshawe cannot continue to be operated safely under it.

The interdependencies across the disciplines are wide-ranging, but, as we have heard this morning from both my hon. Friend the Member for Wythenshawe and Sale East and the hon. Member for Altrincham and Sale West (Mr Brady), the clinicians we have spoken to are clear that remaining a receiving centre for acute emergency surgery is at the heart of their ability to maintain the holistic care that is needed to ensure patient safety and specialties at UHSM. That is also borne out, for example,

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by some of the NHS’s national standards. The standard for thoracic organ transplants states the need for general surgical in-house support seven days a week. As we have heard, Wythenshawe is a—if not the—leading centre for transplant surgery in the north part of the country.

I recognise that the numbers of such highly complex specialist cases are small and that the vast majority of procedures and services currently provided at Wythenshawe could continue under the Healthier Together model. I am also happy to acknowledge the work that has been done by NHS managers in the Healthier Together team and acute trust and the commissioners, to look at ways in which the design can protect the expertise and specialism that we value. First, trying to manipulate the process to make a fundamentally unsafe model work is not the right way to proceed. Colleagues are right to say as they have this morning that we need to draw back and ensure that the model itself is correct, rather than trying to ameliorate some of its more dangerous elements. Secondly, it is not just a question of numbers and whether another half a consultant will resolve the problem. It is also about the ability to continue to attract, recruit, retain and develop the full range of professional skills; and about building and sustaining the strong multi-disciplinary teams that the consultants tell us are necessary. It is also, as we heard from my hon. Friend the Member for Wythenshawe and Sale East, about the ability to offer the rotations and varied experience that enable UHSM to function as a full teaching hospital.

Of course we all accept that the ambition of Healthier Together to raise standards across Greater Manchester is the right one. It is unacceptable that outcomes are so poor in Greater Manchester and so patchy across different hospitals and acute trusts, but the answer to that cannot be to put at risk one of the best performing hospitals in the conurbation—indeed, in the country—and its highly successful outcomes in the hope that other hospitals will, in time, rise to meet those outcomes. It is absolutely right that we want to see outcomes improved at all our hospitals in Greater Manchester, and very much so in the case of Stockport. I understand, however, that there is not even yet a guarantee that the resources will be available to enable the improvements at those other hospitals to bring them up to the standards currently achieved at Wythenshawe and, at the same time, we risk a deterioration in the outcomes that we enjoy at UHSM.

I am also concerned that the risk to safety could be exacerbated by the proposed governance arrangements. As things stand, UHSM and Central Manchester Foundation Trust—the two trusts that will be working together to deliver some of the services that are currently available at Wythenshawe—will each retain their own governing bodies. As we have heard this morning, some shared services have been agreed by the two trusts, for which I understand there will be a shared services board and a shared clinical standards board. For the rest, however, the model proposed for CMFT and UHSM will, effectively, create the largest single combined acute trust in the country, while retaining two separate governing bodies, creating potential for confusion, inconsistency and a blurring of accountability.

In my view, there are really serious and genuine questions about patient safety inherent in the Healthier Together model, and we all have an obligation to address those. As we have heard, the consultants are seeking to

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expose the risks, possibly via a judicial review, but given the nature of their concerns and the delays that a judicial review process would cause to getting the right health configuration for Greater Manchester, I believe we need to make sure that the process we follow now to reach the right decision is a health-led—clinically led—review of the issues.

When the Secretary of State kindly met my hon. Friend the Member for Wythenshawe and Sale East, the hon. Member for Altrincham and Sale West and me prior to the summer recess, we understood him clearly to say—and we appreciated this—that he would be prepared to intervene if safety were an issue. As we have heard this morning, the various concerns that have been expressed include safety concerns, and I hope that the Minister will say today how the Department intends to satisfy itself that those are being properly addressed.

One route might be—although this, too, would increase the risk of delay—to consider a referral to the independent reconfiguration panel. That would ensure a clinically led approach to the review of the decision, and we are familiar with that route in Trafford, given that it was followed as part of discussions on the new health deal for Trafford. Has the Department looked at that model, or will it? If that is not an appropriate route, will the Minister indicate other ways in which he can encourage a collaborative, clinically led pause and proper analysis of the situation within Greater Manchester, as the hon. Member for Altrincham and Sale West suggested?

None of the three MPs in Trafford wants to delay the changes that we desperately need in Greater Manchester to improve patient outcomes, but if the Minister is not able to give us assurances on behalf of the Department, I am quite sure that the legal action that the consultants are reluctantly considering will proceed. They will feel that they have no alternative, in the interests of their patients, but to ensure that this decision is properly challenged and exposed. I have to say, too, that given the concerns about patient safety that they, as clinicians, are highlighting to us as politicians, I will feel obliged, in the interests of my constituents, to support them.

None of us wants to go down that route this morning. We hope that the Minister will be able to give us practical but reassuring commitments about a better way to resolve these very serious concerns, which, as we have heard, not only affect our constituents directly, but will be far-reaching, both immediately, in terms of the wider care that is provided at UHSM to patients well beyond the Greater Manchester conurbation, and in the long term to the credibility of the approach that is being taken in Greater Manchester and our ability to operate devolved healthcare effectively, as we all want.

10.15 am

Jeff Smith (Manchester, Withington) (Lab): Thank you, Mr Hollobone, for the opportunity to take part in today’s debate. It is a pleasure to serve under your chairmanship for the first time. I echo other hon. Members’ congratulations to my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) on securing the debate.

I will be brief because I do not want to repeat other hon. Members’ comments about Healthier Together, but I agree with a number of concerns raised about the

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process. The consultation was less than ideal and I think we all agree that the model needs review to ensure that we deliver the highest quality services for patients. I also agree that there was a strong case for awarding Wythenshawe the fourth specialist status. The high quality of the services at that hospital has already been outlined and the transport connectivity, especially given the new developments of the Metrolink line and the relief road, makes it the best option.

Like other Members here, I was disappointed by the decision not to award the fourth specialist status to Wythenshawe. What is key now is for the assurances that we have been given in relation to the existing specialisms to be robust, and for those services to be protected. I visited Wythenshawe hospital over the summer and saw for myself some of the absolutely excellent, world-leading specialist heart and vascular care provided there. What I took away from that visit more than anything was how much some of that excellent specialist provision relied on high-quality general surgery support. I agree that it is vital that we do not lose those connections and that expertise.

Having expressed disappointment about the process and the outcome of the consultation and decision making, we should not be blind to the opportunities that we now have in healthcare in Greater Manchester, particularly south Manchester. Co-operation, not competition, needs to be the future for our NHS. That is what lies behind the principles of Healthier Together, which we agree with, and the plans for devolution of health funding and organisation to Greater Manchester.

Angela Rayner: I congratulate the hon. Member for Altrincham and Sale West (Mr Brady) and my hon. Friends the Members for Wythenshawe and Sale East (Mike Kane) and for Stretford and Urmston (Kate Green) on making a compelling case, which I hope the Minister listens to.

Does my hon. Friend the Member for Manchester, Withington (Jeff Smith) agree that when we are looking at devolution and the reconfiguration of health across Greater Manchester, the evidence shows overwhelmingly that public opinion will be undermined if we rush ahead with a proposal that is clearly not good for the people of Greater Manchester? People have genuine concerns that we will not achieve the fantastic things that we could by looking at reconfiguration of health. We must consider pausing the situation and listen to the general population of Greater Manchester, giving them a voice in this process which they feel they have not had so far.

Jeff Smith: My hon. Friend makes an excellent point. Clearly, Wythenshawe was the public choice for a specialist hospital.

On working together, which I was just talking about, there is clearly a growing and improved relationship between Wythenshawe and the Manchester Royal Infirmary. Some people see that as a concern, but I think that it is very much to be welcomed and we need to see it as an opportunity.

In south Manchester, we have the opportunity to be an exemplar of partnership working. We have two fine hospitals in Wythenshawe and the MRI, which are on either side of my constituency. My constituency also houses the excellent—and, I believe, underused—facilities

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at Withington community hospital, which was established under the last Labour Government. I look forward to an expanded role for Withington community hospital in health provision in south Manchester, supporting the two major hospitals and providing joined-up services for all our communities.

We have an opportunity to use Withington community hospital to integrate community services, primary care, secondary care and mental health support, with health services and social care services working together for the benefit of all the community in Manchester Withington and the whole of south Manchester. I urge everyone involved to make the most of that opportunity to expand and improve services at Withington community hospital.

I agree with many comments that hon. Members have made about the Healthier Together process, but I welcome the opportunity to use all those hospital resources together—to use Withington as a thriving community hospital to improve health outcomes for people in south Manchester.

Mr Philip Hollobone (in the Chair): Before I call the Front Benchers, I should say that we are going to have the pleasure of hearing Mike Kane sum up the debate for three minutes at the end. I would be grateful if the Front Benchers would be kind enough to leave him enough time to do that and if he would be kind enough to leave me 30 seconds at the very end to put the motion to the Chamber.

10.20 am

Mr Jamie Reed (Copeland) (Lab): It is a pleasure to serve under your chairmanship, Mr Hollobone. It is a pleasure, too, to be the shadow Minister in the Labour health team not running for the leadership of his party. That is a genuine pleasure, let me assure you.

I congratulate my hon. Friend the Member for Wythenshawe and Sale East (Mike Kane) on securing this timely and important debate, which is of huge importance to his constituents and those of many colleagues from across the House who are in the Chamber today. However, I will be brief, Mr Hollobone.

Hon. Members on both sides of the House will appreciate that changes to local NHS services can often be difficult and cause our constituents major concern. It is entirely appropriate, therefore, that when changes are being proposed, hon. Members speak up for their constituents and express any concerns that their constituents may have. I have been doing that with regard to services in my own local hospital for the past 10 years. The Minister is aware of that, and we are working together to try to resolve the issues.

We all know that the NHS will have to make major changes over the coming years. One of the big challenges facing health and care systems around the world is how to do more for less; that is as true in the UK as it is anywhere else. The ageing society and the need to move services out of the hospital and into the community mean that difficult decisions will have to be taken in the course of this Parliament. If done properly—if done rightly—those decisions could and should lead to a better standard of care for our constituents and a more sustainable future for local health services right across the country. Where that is the case, hon. Members have

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a responsibility to support the changes, but where the clinical case has not been made, hon. Members are right to be questioning and to seek reassurance that any changes are focused on the quality and safety of services.

It is vital when any changes to hospital services are being proposed that a number of basic principles should apply, and I shall outline some of those. First, the public should be involved at the very outset of any proposal for change. The proposals should not be designed behind closed doors, and the clinical case must be presented to the public at the earliest opportunity; I struggle to count how many well intentioned reconfigurations have fallen foul of that test.

Secondly, there must be a proper, meaningful consultation. Too often, proposals for change are presented as a fait accompli and the consultations that follow are little more than box-ticking exercises. My party has previously proposed that the formal responsibility for consultation should be given to an independent body, such as the health and wellbeing board, instead of being a responsibility of clinical commissioning groups. That could go some way towards improving the consultation process and would certainly restore faith in the independence of the consultation process. Thirdly, and perhaps most importantly, the process should be as open and transparent as possible. The public should be entitled to the full range of information and data required for them to have an informed view on any proposals put forward.

Today’s debate has focused on the Healthier Together review and, as we have heard from several colleagues, the review appears to have fallen short on a number of factors. My hon. Friend the Member for Wythenshawe and Sale East spoke in particular about the decision not to choose Wythenshawe hospital as the fourth site to provide emergency abdominal surgery, as part of the single service model proposed by Healthier Together. He made a compelling case as to why Wythenshawe hospital should be recognised as one of the “fixed site” specialist hospitals. I do not want to take up too much time, as I am conscious that hon. Members have raised specific concerns to which the Minister will want to respond in as much detail as he can, but I would like to press him on a couple of points to which my hon. Friend referred.

First, it appears that the decision to allocate the fourth specialist site was made largely on the grounds of travel and access. The strapline for the review includes the phrase “helping to save more lives”, but it seems clear, not just in Manchester but across the NHS, that access to services and the quality and safety of those services are too often presented as a binary trade-off. We must improve on that way of configuring services, so will the Minister tell us what more can be done to resolve what appears to be an invidious choice facing people right across Manchester?

Secondly, I understand that during the public consultation 33% of respondents gave Wythenshawe as their choice for the final specialist site, while Stepping Hill was backed by 26%. The Minister will appreciate that that has led some to question the point of the consultation and, understandably, has led to concerns that the views of the public are not adequately being taken into account. Wythenshawe hospital’s medical staff committee said that the decision was “irrational” and, as we have heard, there were reports last week of a plan to apply for

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judicial review. That is in no one’s interests. No one wants their hospital or services caught up in legal disputes.

I hope that the Minister appreciates that there is genuine frustration among hon. Members across the political spectrum—he has seen that for himself here today—about the Healthier Together process and that there are important questions that require answers. More broadly, I hope he will ensure that the NHS reflects on what lessons can be learned from this process to ensure that the public can have confidence that future proposals for change are focused on improving the quality and safety of local NHS services, and also that access to safe and high-quality—indeed, world-class—services remains equitable for all service users and taxpayers.

My final point is about Manchester airport and the nearest adjacent hospital. As a country, we need to address the needs of those communities that host nationally significant, strategic pieces of infrastructure. That might be Manchester airport or Sellafield nuclear reprocessing plant in my constituency. The communities that house such infrastructure require special regard to be paid to them when it comes to the configuration and supply of services at their local hospital. We should do that as a nation. It is done in other countries. I hope that the Minister will reflect on such an approach. I look forward to working with him on precisely that approach and to hearing his response to the points that I have made.

10.26 am

The Parliamentary Under-Secretary of State for Health (Ben Gummer): First, I thank and congratulate the hon. Member for Wythenshawe and Sale East (Mike Kane) on bringing this debate to the House. It is a particular pleasure to be answering him. His predecessor became something of a friend, and I know that he had a similar admiration for him and certainly a far closer friendship with him, so I feel honoured now to be answering, as one of my first clutch of Westminster Hall debates, a debate brought here by him.

As is so often the case with Westminster Hall debates, it is frustrating that the debate will not be more widely seen and understood by members of the public, because they would see Members of Parliament fighting hard for their constituents and constituencies, and speaking with great eloquence and detailed knowledge and understanding of complicated things. Those things are not necessarily within their professional expertise, but they have done the research and acquired the knowledge to be able to speak about them. And, most important, Members are speaking on a cross-party basis. If more people were to see that, they would see the value that they were getting from their representatives. I value very much the passion and the detail that the hon. Member for Wythenshawe and Sale East has brought to the debate, as I do that of other hon. Members who have spoken and the measured response that the shadow Minister, the hon. Member for Copeland (Mr Reed), has given.

I should say at the outset that I am rather more restrained from giving an expansive answer to the hon. Member for Wythenshawe and Sale East than I would normally be, because a letter before action has been issued and, although the Department of Health is not a

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party to any legal action, I would not like to prejudice something that did come about. I hope that the hon. Gentleman will not mind if I comment on those areas on which I can comment and then on the general principles that were raised. The hon. Member for Stretford and Urmston (Kate Green) specifically raised the general policy of reconfiguration. I can give her more detail about that and give, I hope, a narrative explanation of how I and the Department understand the process as it has gone on so far.

In the round, it is welcome that the hon. Gentleman and other hon. Members understand the importance of devolution. I agree completely with him that the turn of events in Manchester is of serious significance; it is of a generation-changing nature. It was good to hear my hon. Friend the Member for Altrincham and Sale West (Mr Brady) saying exactly the same thing. It is important that decisions that are taken at any stage by devolved administrations, whether they be clinical commissioning groups, local councils or health and wellbeing boards—or indeed the overview and scrutiny committees in the way they look at these decisions—inspire confidence in devolved decision making, rather than acting against it. Of course, reconfiguration and change normally cause some disruption and disquiet in areas not chosen as sites for new or increased activities. He spoke powerfully of the need for devolved powers, but I hope that he accepts that it is in the nature of such decisions that people will sometimes be disappointed.

I understand entirely why Wythenshawe, with the extraordinary range of specialisms, both secondary and tertiary, which the hon. Member for Wythenshawe and Sale East pointed to, and with a history famous not only in the north-west but across the country, should feel aggrieved that it was not one of the four centres chosen to be part of Healthier Together. It would be unusual if the world-respected clinicians and management at the hospital did not fight their corner, and it is appropriate that he should represent their concerns. I agree with everyone who has said that it would be extremely sad for the matter to go to judicial review. We certainly do not want that to come to pass, either in this consultation or elsewhere.

Before I talk in general about consultations, I want to bring the hon. Gentleman up to date on events in the past couple of days. I understand that there have been some constructive conversations between commissioners and clinicians at the hospital, and that discussions will continue about the relationship between tertiary specialties and the general surgery that, it is proposed, will be moved to one of the four sites. A conversation has begun and is continuing, so there is a glimmer of hope that the parties involved will not go to the courts on this matter, which is so important for patient safety and healthcare in Manchester.

I want to speak about the nature of consultations, and to respond to the shadow Minister’s entirely correct points about how a consultation should be conducted. As a constituency Member of Parliament, I, too, have been through a number of health consultations. Some are good, and some are bad, but I hope that we are generally getting better at them. I remember several, under the previous Administration—this is not a party political point, but I think that the process is generally iterative within government—which were particularly poorly conducted. To their credit, the previous Administration reversed some of the decisions.

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Some consultations are well run, however, and have the support of large numbers of people in the community. I can only report on the information that I have received, but I am impressed by the support from local councils, from clinicians, from the clinical senate, from doctors and from management across Manchester for the Healthier Together programme, and for the size and scope of the consultation. As the shadow Minister and Opposition Members know, a consultation is not a plebiscite, so we cannot take the raw number of responses in favour of any particular solution as a “correct” response. It is important that all consultation responses are taken into account, and I have been assiduous in trying to make sure that the Healthier Together team—the commissioners—have listened to all consultation responses. I have urged them to engage as profoundly as possible with Wythenshawe to show that the responses have been listened to with care.

At the core of the proposal is a noble ambition: to save in excess of 1,000 lives over a five-year period. If Manchester were to match the best mortality rates achieved elsewhere in the country, 300 lives a year would be saved, which is nearly a life a day. The decisions being taken are difficult, but they will produce a considerable dividend not only for hundreds of potential victims of currently substandard care but for their families, extended families and friends. The prize is considerable, and it is worth striving after.

I agree with the shadow Minister that consultations need to demonstrate wide public engagement. I am impressed by the number of people involved in this consultation, which received some 29,000 written responses. There has been 18 months of consultation, and 23,500 people were involved in this specific part of the consultation. There are conflicting answers to the question of how to reduce mortality in Manchester; that has been clear even from hon. Members’ contributions. To mangle St Augustine, we are almost saying, “Let us have service reconfiguration and service improvement, but not yet.”

I do not fully agree with the suggestion made by my hon. Friend the Member for Altrincham and Sale West that consultations and service changes should happen sequentially. It would be impossible to run anything as complex as the health service, or, indeed, anything in government, if one were to take that approach. We must in this instance, as elsewhere, rely on the clinical judgment of commissioners. That lies at the very heart of the changes that the Government have made—both in our coalition iteration and in this new Conservative Government—towards relying entirely on the clinical basis for service reconfiguration. I must, therefore, bow to the judgment of clinicians in this and other instances, and I know that most Members here will want to do the same.

Although the shadow Minister has said that the proposal comes within the global need to try to do more with less—I do not want to rehearse the arguments about healthcare spending—I think that everyone has agreed that, in this instance, finance does not play a part. The chairman of the Manchester local councils made that explicit in his response to the consultation. This is actually about doing more better. There will always be a trade-off between travel times and sites, and clinical excellence. We would all like to have, right next to our house, a hospital with the full suite of tertiary

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expertise, but as we all know, a high throughput of patients would be required to maintain the necessary skills within clinical teams. Clearly, that would not be possible, so there has to be a balance between the number of sites and the distance that people must travel to them. That is the balance that the consultation and the proposal have sought to strike. In the majority of Manchester, it is believed that they have struck that balance correctly.

Kate Green: The Minister spoke a moment ago about the decision being taken by clinical commissioning groups—by clinicians. The problem is that a different group of clinicians, namely the consultants at Wythenshawe hospital, are offering a different opinion about patient safety from that of the commissioners. As politicians, I believe that we must take account of the fact that safety is being flagged up by clinicians. How does the Department reconcile the difference of opinion about patient safety between commissioners and consultants?

Ben Gummer: The hon. Lady is right to say that there are concerns from some clinicians at Wythenshawe hospital, and we should listen to those. There is an established process by which those concerns should be brought to bear. If she does not mind me running through the detail of how reconfiguration policy works, I am sure that she will find answers to some of the questions in her speech.

Our first principle is that the service changes should be led by clinicians, which is the point of the process. In this instance, the service changes are being led by 12 clinical commissioning groups coming together to discuss the future of 10 hospitals. The service changes will affect just under 1% of in-patients, and just under 20% of patients receiving general surgery, at Wythenshawe hospital. Within the context of Wythenshawe hospital as a whole, we are talking about a very small number of patients. I appreciate the hon. Lady’s concerns about the interrelationship with other specialties, but let us keep it in mind that this is a small number of patients.

Once the commissioners have come to their decision, there are two ways of resolving complaints from one party or another. The first is by a recommendation from the joint overview and scrutiny committee to the Secretary of State for Health—such a recommendation has not been made in this case—or by a referral to the Independent Reconfiguration Panel, which the hon. Lady mentioned in her speech. The Independent Reconfiguration Panel has made a number of recommendations in the past. That is no predictor of future performance, but at no point in the past, under any Administration, has a Secretary of State gone against the Independent Reconfiguration Panel’s recommendations. The point of both those exercises is to retain clinical ownership of decisions, albeit by different clinicians from those who made the original decision. If we go back to the bad old days, when decisions were made for political purposes following a clinical recommendation, we would not listen to clinicians in the round and, therefore, would make decisions on the wrong basis, possibly putting lives in jeopardy.

The hon. Lady has raised clinicians’ concerns about the effect on tertiary services, which are impressive at Wythenshawe hospital. All I can say is that NHS England has undertaken a thorough clinically-led review of all

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tertiary services at the hospital and has concluded that the changes to general surgery for stomach and bowel accidents will not adversely impact on the tertiary specialties available at Wythenshawe hospital. That is the advice that the Department has received from clinicians at NHS England. I have described the other options open to parties in Manchester, and I reaffirm that, even if it might suit some Members present to take that decision-making process out of clinical hands at whatever level and to vest it in the Department, it is not a direction that anyone on either side of the House ultimately wishes to take. We must therefore trust the opinion of clinicians in the bodies that have made those decisions so far.

Mr Graham Brady: My hon. Friend, for obvious and very good reasons, is valiantly treading a tightrope between discussing the specific case and addressing the general points, but I must counter the suggestion that any of us is here to try to overturn clinically-led decisions. On the contrary, our concern is that very senior clinicians feel that they have had no voice in this process. As the hon. Member for Stretford and Urmston (Kate Green) said, they are now raising very serious concerns about patient safety. As I said earlier, the consultants I have dealt with at Wythenshawe hospital are serious professionals who do not say that lightly. I also suggest that the three local Members here today do not have a record of hysteria on such things, and we are united in our concerns. We are perfectly capable, and we have shown that we are capable, of making reasonable judgments about reconfiguration when that reconfiguration is reasonable.

Ben Gummer: I am acutely aware of the huge spread of sensibleness on both sides of the Chamber, and I would not want any of my remarks to be construed as suggesting otherwise. On the contrary, I restate that it is not only reasonable but right that local Members respond to the views expressed by very experienced clinicians in their local hospital.

In my short discussions so far with local commissioners —I am sure there will be more discussions—I have impressed on them the need to engage fully with all clinicians. I understand that they began the process afresh before I made that request and that they will continue that engagement. We will only get good reconfigurations across the country if we have the general buy-in of clinicians and the public. We are now doing that better than we were five, 10 or 15 years ago, when every reconfiguration of every kind was fought tooth and nail by everyone. There is now a general move to an understanding that we need to make some changes to some areas. Indeed, the shadow Secretary of State for Health, the right hon. Member for Leigh (Andy Burnham), has made clear his desire to see some services centralised:

“If local hospitals are to grow into integrated providers of Whole-Person Care, then it will make sense to continue to separate general care from specialist care, and continue to centralise the latter. So hospitals will need to change and we shouldn’t fear that.”

I could not agree with him more on that general principle, but it does not change the fact that commissioners need to engage with every single party.

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My hon. Friend the Member for Altrincham and Sale West, and every other Member, can be sure that I will pass back to commissioners their specific concerns about that engagement. In the discussions, which I am sure will continue between all of us, I hope that he and other Members will notice continued engagement between commissioners and clinicians at the hospital, and I hope that there will be a happier outcome than the one that might come about through judicial action.

The hon. Member for Blackley and Broughton (Graham Stringer) and the shadow Minister both spoke about Manchester airport and made interesting and valid points about the need for a stated relationship between important national infrastructure and centres of major trauma care. I will respond to the shadow Minister in writing on that specific question, if he does not mind sharing that response with his colleagues. This is an important matter, and I want to ensure that I can answer it in detail and in full.

If I interpreted his remarks correctly, the shadow Minister also said that consultations had been taken out of the hands of clinical commissioning groups specifically to be conducted by a third party, such as health and wellbeing boards. Again, I have not previously heard that idea, but I am happy to respond to that specific point once I have been able to give it greater thought, with no implication for the current consultation.

I will now close in order to give the hon. Member for Wythenshawe and Sale East time to reply to my comments. We all agree that reconfiguration needs to happen. In this instance, there has clearly been support from those Members who have been the beneficiaries of the reconfiguration in their constituencies, but the most important beneficiaries will be the people of Manchester, who I expect will see world-leading trauma care connected to emergency stomach and bowel surgery as a result of these changes. We must be proud that clinicians are leading the review, we must be proud that clinicians have been prepared to make bold and difficult decisions and we must be proud that Members present have come forward to represent the concerns of some that clinicians have not made those decisions in the right way. Members have made those points with lucidity, care and passion.

I hope that in the next few weeks we will resolve this matter in a rather happier way than it might otherwise have been resolved, and I pledge to continue my discussions with Members on both sides of the House to ensure that that is the case.

Mr Philip Hollobone (in the Chair): I will call Mike Kane to give a winding-up speech of two or three minutes. Members who are here for the next debate should get ready, because we will go straight on to that debate rather than waiting till 11 o’clock.

10.49 am

Mike Kane: Thank you for your excellent chairing of these proceedings, Mr Hollobone. I am grateful to the Minister for his reflective comments on the process and for bringing us up to date on the latest developments. I stress to him that the hon. Member for Altrincham and Sale West (Mr Brady), my hon. Friend the Member for Stretford and Urmston (Kate Green) and I are not behind the curve, as he can probably tell from the excellent contributions made by them.

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I also thank the Minister for what he said about Paul Goggins, who worked with local elected members long before I did on the reconfiguration of Trafford services. In some ways, the assurances that he had about those reconfigurations and about working with NHS England are not being met through the process. It was also Paul Goggins, along with colleagues, who campaigned for the improvements in accident and emergency at Wythenshawe hospital. A £12 million scheme will begin there in November to create a new A and E village, a world-class facility. The Minister is right that this is a once-in-a-generation opportunity to integrate health and social care. It is also a once-in-a-generation opportunity to show that large conurbations such as Manchester, which is moving towards 3 million people, can take control of their powers to deliver their own health and social care.

I thank the Members who have turned up. What my hon. Friend the Member for Manchester, Withington (Jeff Smith) did not say about himself is that he was at the forefront of the campaign to build the new hospital in Withington all those years ago, when we reconfigured the services. We can make more of that hospital; we are already discussing 24/7 GP access there. If we can realise that vision to ease the pressures on A and E departments across the conurbation, it will be a major achievement, thanks in no small part to his campaigning activity long before he came to this place.

I am delighted that my hon. Friend the Member for Ashton-under-Lyne (Angela Rayner) is in her place. The hospital in her constituency has undoubtedly had a torrid time over the past six or seven years, but today NHS England lifted it out of special measures, which is cause for everyone to celebrate. My hon. Friend the Member for Blackley and Broughton (Graham Stringer) has been a constant defender of his local hospital, North Manchester General, and has been a visionary leader, in the sense that we are now getting to the point of being able to devolve powers on skills, housing, transport, business, investment and, eventually, healthcare to Greater Manchester. He has been at the forefront of that.

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I thank the shadow Minister for his erudite contribution and for linking the issue to Manchester airport. We cannot consider health on its own. The decision on “The Northern Way”, or the northern powerhouse, can be pivotal in getting world-class inward investment in healthcare in Manchester. It will link to the airport next to the hospital, which had 23 million passengers this year, increasing to 40 million over the next couple of years. We have plans in our area to expand the Metrolink at some stage to connect Wythenshawe directly. Currently it connects to Manchester airport, but we want to send the loop around to connect with the High Speed 2 station and back to Wythenshawe hospital.

We in the north-west have had problems in the past, as hon. Members will know. I pay tribute to the hon. Member for Macclesfield (David Rutley), who has been considering life sciences across the region, including AstraZeneca and regenerating Alderley Park, and linking the issue to our vision of a life sciences institute medi-park on the Roundthorn industrial estate next to our hospital. That could be further linked to the Corridor project involving graphene and the life sciences, associated with Central Manchester hospital. We need more links with that in the future. That site also ties into Airport City, which is in development both south and north of the airport. We are expecting massive change in south Manchester and Trafford over the next 10 to 15 years. It will be generational change that will drive the northern powerhouse, with the addition of HS2 and possibly, given the discussions that the Department for Transport is having, of HS3.

We have a wider vision for the site, and we do not want it to be set back by process issues. Let us all—people watching today and everybody in this Chamber—commit to the vision of making south Manchester and Greater Manchester a world-class place for economic investment and healthcare.

Mr Philip Hollobone (in the Chair): Would all those who are not staying for the next debate please be courteous enough to leave quickly and quietly?

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Business Rates (Rural Areas)

10.55 am

Jake Berry (Rossendale and Darwen) (Con): I beg to move,

That this House has considered business rates in rural areas.

It is a pleasure to serve under your chairmanship, Mr Hollobone—not only for the first time this Session, but for the first time ever. It is also a pleasure to see my hon. Friend the Member for Nuneaton (Mr Jones) on the Front Bench as Minister and to have him respond to the debate.

I am pleased to have secured this important debate, in which I want to raise with the Minister the effect of recent changes to the policy and practice of the Valuation Office Agency, or VOA, and their effect on the rural economy. Our rating system is just over 30 years old. During his excellent Budget speech in March, my right hon. Friend the Chancellor of the Exchequer announced a review of business rates to see what more can be done to ensure that we have a fair system that supports businesses across our communities.

That is set against a background since 2010 of significant steps taken by the Government to support small businesses during the economic crisis. We have supported them by doubling the small business rate relief, ensuring that such relief is automatic, capping increases on business rates and introducing a new business rate discount for high street stores with a rateable value of less than £50,000. However, with the business rate review in mind, I want to draw the Minister’s attention to what I believe are anomalies in the behaviour and practice of the VOA that unfairly penalise people who choose to live and work in the countryside and contribute to our rural way of life.

My constituent Mr Alan Walker of Higher Fairbanks farm was understandably surprised to be contacted earlier this year by the Lancashire office of the VOA. The VOA told him that it wished to visit him to assess his domestic stabling for business rates, despite the fact that the stabling at his home is used solely to keep his family’s horses, which they regard as pets, and that planning permission for the stables specifically precludes commercial use. In what appears to be a classic case of mission creep, the VOA is visiting farms across Rossendale and Darwen assessing what, if any, part of the farm accommodation can be charged business rates.

When Mr Walker challenged the assumption that business rates should be charged on his stabling, he was told that it is a grey area of the law. That statement seems to be backed up by the VOA’s guidance, issued in February 2015, which states that every stable should be considered on a case-by-case basis. Mr Walker has, of course, appealed the VOA’s decision, but if his appeal is unsuccessful he could be charged £3,000 a year in business rates on his stables. Combined with his council tax, that will mean paying more than £5,000 a year in property tax on his home, although it has never been used for any commercial purpose whatever.

In Rossendale and Darwen and across our country, our equine community make a significant contribution to the rural economy. The changes will damage businesses such as our local farriers, vets, horse dentists—apparently such things exist—and farmers who provide feed, as well as businesses that supply tack.

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As far as I am aware, this new way of taxing people’s homes has never been discussed in Parliament. It is bizarre that we seem to be applying business rates to areas of people’s houses where they keep their pets. What will the VOA come up with next—the kennel, or the rabbit hutch? I have spent long periods of my life in the doghouse—just ask my wife; I worry about the charge that might be levelled against me.

Sadly, the case I have mentioned is not the only example of unfair taxation being applied to the countryside economy. I was contacted recently by Live Nation, which is concerned about how business rates are assessed against agricultural land that hosts music festivals. They have also been subject to unannounced and undebated changes, putting at risk not only the music festivals, which are enjoyed up and down the countryside, but our Government’s commitment to support rural economies and rural businesses, many of which are struggling to remain viable.

We have only to look at the recent protest over milk prices to know what a tough time many of our farmers are having. Festivals and such events are a huge success story for the UK economy, and in terms of festivals, our music industry is now unrivalled around the world. An analysis in 2014 by the Oxford Economics Institute identified that 9.5 million music lovers attended festivals, gigs or other such events, generating £3.1 billion for our economy. At a time when farmers are struggling to compete and stay financially viable, events such as festivals are an essential part of diversifying their agricultural activity and generating supplemental income. That success story is endangered again by creeping changes by the VOA.

Currently, land on which festivals and events take place is exempt from business rates due to its status as agricultural land. However, the VOA has decided to revisit and reassess festival sites for business rates, resulting in sites being classed as rateable. As with the stables, such revisiting is particularly serious because the new classification is retrospective; landowners have ended up receiving large backdated bills for the past five years. Many sites receive no warning from the VOA that they should expect a retrospective application of rates or a large backdated bill. The large and unexpected bills are damaging to small and medium-sized festivals in particular.

David Simpson (Upper Bann) (DUP): My apologies, Mr Hollobone, for being late. I congratulate the hon. Gentleman on obtaining the debate. He touched on diversification. It seems that farmers are being penalised. It is Government policy to encourage them to diversify into different areas to subsidise their income, yet when they do that, they are penalised. Surely something should be done to give them a period during which they would not be liable.

Jake Berry: I thank the hon. Gentleman. There is an opportunity to take advantage of the small business rates exemption, and some farmers in my constituency and beyond who have holiday accommodation have used the exemption where they can have it for free. I hope that the Minister will take all the issues on board, including the hon. Gentleman’s eloquent point, in the reassessment of the way that business rates are charged, with a particular focus on agricultural communities.

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Festivals have had to pay large backdated business rates bills to avoid enforcement proceedings by billing authorities. As with Mr Walker and his farm, that has led many festivals to appeal the bills, imposing additional costs and burdens on the VOA. The VOA has provided little justification or explanation as to how it is taking into account the individual circumstances of different festivals, and, as with the stables, there is a serious lack of clarity in the existing ratings manual, making it effectively for a festival organiser to know whether rates will be levied. I gently say to the Minister that although music festivals are not for everyone—they are not for me—they have notable supporters. He will recall that in 2013 the Prime Minister was photographed at the Cornbury music festival—without his shoes on I believe. I hope that when the Minister considers the issues, he will think of those notable music festival fans who may control our future careers.

The final point I wish to make about business rates in today’s debate is the rateable charge levied against cash machines. Over recent years, our rural areas across the country have lost literally hundreds of banks. Every Member here today will be aware of the bank closure programme in their constituencies. It has meant that, for many people, the hole in the wall or the through-wall ATM at the village shop or post office is their last access to cash. The importance of such facilities reflects the fact that about 80% of transactions are still in cash.

In the past five years, the number of ATMs liable to business rates has risen from about 3,000 in 2010 to over 12,000 this year. Each through-wall ATM that is liable to business rates has an average charge of £3,600. Major supermarkets or petrol retailers, such as Shell or BP, may be able to absorb such costs, but a small village store or post office will not. A small village store or post office may be exempt from business rates, due to this Government’s action, through small business rates relief, but creating a second rateable unit at the shop means that it is hit with a bill in excess of £3,000.

John Howell (Henley) (Con): My hon. Friend describes a situation in which a bank has been closed down in a constituency, which often happens in rural constituencies such as mine. Has he found that the current position inhibits people from taking up ATMs in the transfer of that banking business to another business?

Jake Berry: I thank my hon. Friend for his contribution; I will come on to the effect of that, but the short answer is yes. Cash machine operators have warned that the attachment of business rates to through-wall ATMs makes them uneconomic, particularly in rural areas where there is low footfall and their use is not as common. They have estimated that 1,000 existing ATMs, let alone ones that we would hope to bring into our communities following a bank closure, are at risk.

An additional danger for our village shop, post office or former bank is that many of the small businesses in the village will do the majority of their transactions in cash. If people’s access to cash is suddenly a car or bus journey away, some of our most vulnerable rural residents, who will not have access to transport, will be forced to leave their village or small town to access cash and, having made the journey, will also do their shopping outside the village. As with festivals and stables, taxation of ATMs is described by the VOA as an area where

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some inconsistencies exist. Those inconsistencies are leading to the removal of cash machines or large, historical and significant claims for rates. It is currently estimated that 1,000 or so cash machines are at risk of removal due to the charge.

I believe that the charges were brought about by action we took in 2012. Correctly, in an attempt to encourage local authorities to seek business growth in their areas, the Government empowered local authorities to retain 50% of business rates, with the idea that they would go out and find new businesses, in the towns, villages and countryside, and encourage them to open in their areas. Local authorities now collect £26 billion a year in business rates—to put that into context, I should say that it is a bigger money spinner for local authorities than the fuel duty.

As we hoped, we have seen significant behavioural change by both local authorities and the VOA since 2012, but not in the way we hoped. Instead of localism and the encouragement of new businesses, local councils seem to have been inspired to carve out stables in people’s homes for a pet tax, festivals for a party tax and ATMs for a cash tax. I hope that the Government will urgently address such anomalies in their business rate review.

I make a final appeal to the Minister. During that review, can we look at putting a mechanism in place so that, when the VOA changes policy on the collection of business rates, that is announced and we have the opportunity to discuss the impact of that change here in the House? I say that because these unknown changes, which MPs find out about through their postbags, are seriously impacting on and damaging rural businesses. I hope and believe that, as part of our review, we will ensure that that does not continue.

Mr Philip Hollobone (in the Chair): If the Minister would allow me 30 seconds at the end of the debate to put the motion to the Chamber, that would be appreciated.

11.10 am

The Parliamentary Under-Secretary of State for Communities and Local Government (Mr Marcus Jones): Thank you, Mr Hollobone, for calling me to speak. It is a pleasure to serve under your chairmanship.

I congratulate my hon. Friend the Member for Rossendale and Darwen (Jake Berry) on securing this debate on the important issue of business rates, and in particular on how business rate rules apply in rural areas. I assure him that during this debate I will not take off my shoes, and I hope that I will not end up in the doghouse as a result of my comments.

My hon. Friend referred to several rural businesses. The rural economy is significant, contributing around £120 billion to the English economy in 2013. Our commitment to supporting businesses, including rural firms, was reflected in the Budget, when the Chancellor repeated what we have always said; the best way to create jobs and raise living standards over the long term is to support businesses, to increase productivity by making them more competitive, and to prioritise investment in skills and infrastructure. Therefore, the Budget set out a plan to back business and support productivity by introducing another cut in the corporation tax rate, increasing the level of the annual investment allowance,

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raising the employment allowance, introducing high-quality apprenticeships and committing sustained investment to the strategic road network.

As for specific support for rural areas, between October 2012 and March 2015 the five pilot rural growth networks helped more than 3,200 businesses, gave advice to more than 1,000 individuals interested in starting a business, created 530 new businesses, and created and safeguarded more than 1,200 jobs. As part of the new £3.5 billion rural development programme, the Department for Environment, Food and Rural Affairs is also investing nearly £500 million to benefit rural businesses, people and communities.

Before I talk about the future of business rates and our review of them, I will set out the action that we have taken on those rates since the 2010 election. We have doubled small business rate relief for more than five years. We have also given local authorities powers to grant their own discounts entirely as they see fit, because they know their local areas best and can use those powers to support any rural business they choose, and where they provide relief we automatically fund 50% of the costs. We have also introduced the business rates retention scheme, which provides an incentive to authorities to encourage local growth. In addition, we have introduced more than 20 enterprise zones, and we have plans for more.

I turn now to the reviews that we are currently undertaking. Through our review of business rates administration, we have listened to businesses to find out the changes to business rates that they want to see. Therefore, we will ensure that from 2017 the business rates system properly reflects the structure of a modern economy, and provides clearer billing and better information-sharing. The Enterprise Bill will also introduce a faster and more efficient appeal system. In addition, in the 2014 autumn statement the Chancellor announced a wider review of business rates, and I assure my hon. Friend that in that review we will certainly take full account of the position of rural businesses and the other matters raised in this debate. We expect that review to report by the end of 2015.

I turn now to the specific issue of cash machines and business rates. Business rates are paid on non-domestic properties and are the means by which those businesses contribute towards the cost of local services. Cash machines are a non-domestic use of property and therefore are included in business rates. It is for the Valuation Office Agency to decide, based on the facts, whether an automated teller machine should be separately assessed for business rates. That is decided independently of Ministers, based on the facts of each case, and we do not intervene. However, where cash machines are assessed for rates, it is fair that the cash machine operators, which include banks and other financial organisations, pay rates alongside other sectors, such as retail and offices. The rules also ensure that the rates assessments of cash machines reflect the value of specific sites. Busy sites have a much higher rateable value than quiet sites, and this approach is based on actual market rents that are agreed and paid by the cash machine operators.

Furthermore, we have given local authorities the power to grant local discounts. We have urged them to support access to cash machines that are free to use

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through their local discount powers. Those powers can also be used, for example, to support cash machines on high streets or in rural locations, so they take into account the comments made by my hon. Friend. Where councils use those powers, we will automatically meet 50% of the cost. As I said earlier, we are currently conducting a review of business rates and we will certainly take into account the comments on business rates of my hon. Friend and those of other hon. Members who have contacted me on this issue.

John Howell: I wonder whether the Minister will allow me to give a plug for that review. I am conducting a review of businesses in my own constituency, and I know that they see business rates as just another tax. It would be extremely good for them to see something in return for paying their business rates—something that they have control over.

Mr Jones: I thank my hon. Friend for that intervention and it is always good to get the views of businesses, both in Henley and across the country. I will certainly take into account what he has said and I will feed those comments into the ongoing review.

I turn now to the issue of stables and local taxation. Property is subject to either council tax or non-domestic rates, which are commonly known as business rates. The boundary between the two can certainly be complex, but broadly speaking stables are only likely to be included within the council tax band if they are sited within the domestic curtilage of a property and used for purposes on a domestic scale appropriate to that property. It is for the VOA to apply the legislation and case law to the facts of a particular case.

All ratepayers have the right of appeal to an independent tribunal. Of course, a stable property that is separately rated may be eligible for business rate relief, which I think is the case in the situation that my hon. Friend the Member for Rossendale and Darwen referred to. Where a stable is taken into account in a council tax assessment, that may well result in a council tax band increase. So it is not necessarily the case that someone will pay more when a stable or stable block is separately assessed.

Caroline Nokes (Romsey and Southampton North) (Con): I thank my hon. Friend the Minister for giving way on that point and I appreciate his comments about stabling with regard to non-domestic rates or council tax. Does he agree that the British Horse Society has made an excellent submission to the Treasury’s business rate review, which brilliantly highlights, first, just how complicated and grey an area stabling can be and, secondly, the many anomalies that exist for those who run equestrian premises as part of either an agricultural holding or a domestic property?

Mr Jones: I thank my hon. Friend for making that point. It is extremely important that organisations such as the one she mentioned bring forward their views and concerns during the review process. I will certainly take them into account, as I am sure my colleagues in the Treasury will, and I will also take into account the views put forward by my hon. Friend the Member for Rossendale and Darwen, who secured today’s debate.

I turn now to the matter of festivals. The VOA has a duty to maintain fair and accurate rating lists, and it is of course right that music festivals and other such

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events pay business rates, just like any other occupier of non-domestic property. However, I assure my hon. Friend that if there are no permanent physical adaptations to the land to facilitate festival use, and the duration of the festival is only a matter of a few days, it is unlikely to attract a rating assessment in its own right. Any assessment would be proportionate to the scale of the festival. Of course, if a ratepayer is unhappy with their assessment, they have a right of appeal to an independent tribunal.

The VOA is working with the Events Industry Forum to draw up guidance to help organisers better understand when rateability will arise. We will certainly take into account comments made by my hon. Friend and other hon. Members during the review process.

Jake Berry: Does my hon. Friend acknowledge that backdating the rate bill for five years for such events, and sometimes for stabling, is putting their viability at risk? Those involved in setting up events in 2010 or 2011, for example, had no possible way of knowing that they would be hit with a large historic bill that could make the future of those events unviable. Will my hon. Friend undertake to ensure that there is a conversation with organisers, in respect of historic bills charged to music festivals, to find out whether there is a fair or reasonable way of charging them that would enable them to stay in business? If they do not stay in business, we will be shooting the goose that lays the golden egg.

Mr Jones: I thank my hon. Friend for making that important point. He made certain points about the collection of taxation, but that is difficult to change retrospectively. Having said that, I am more than willing to make further inquiries and to respond to him in writing soon.

Picking up the other point made by my hon. Friend in relation to the VOA making unexpected changes, I reiterate that the VOA is there to interpret the law made in this House, and it does so; and it also works on the basis of case law. We can certainly consider that matter during the current review, which I have mentioned once or twice during this debate. However, it is important to say that we must have a mechanism for interpretation of laws made in this House, rather than have this House interpreting laws that we Members make. We need to bear that in mind.

In conclusion, we have taken significant action to support the rural economy, including through the business rates system. We will certainly take into account matters mentioned by my hon. Friend and other hon. Friends and colleagues during this debate. Once again, I thank my hon. Friend for securing this debate and giving me the opportunity to set out the Government’s position on these important issues.

Question put and agreed to.

11.24 am

Sitting suspended.

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FM Radio Applications

[Mrs Anne Main in the Chair]

4 pm

Amanda Milling (Cannock Chase) (Con): I beg to move,

That this house has considered FM radio applications.

It is a pleasure to serve under your chairmanship, Mrs Main. I thank the Minister and fellow Members for their time this afternoon. I am grateful for this opportunity to raise the ongoing challenges faced by Cannock Radio and other community radio stations in a similar position when it comes to applying for an FM licence.

Before that, however, I want to touch on the importance of community and community spirit. When I worked in market research, I conducted a project looking at the concept of localism and community throughout the UK. People would comment that community spirit was not what it used to be. Well, I certainly do not think that is true among the towns and villages of Cannock Chase. I have spoken before about the strong sense of community spirit there—largely, in my view, down to the strong mining heritage in the area. Although we no longer have the mines, we have many community groups, volunteers and local charities that we can thank for helping us to create, support and maintain that all-important community spirit.

One essential way to create and maintain community spirit is to ensure that the public are engaged, and local media, whether the press, social media or local and community radio, play an important role in that. There has been a real vacuum for local and community radio in and around Cannock Chase. Although we are served by BBC WM 95.6FM, that station covers a huge and diverse area, including Birmingham, the black country and the surrounding west midland counties. Before Cannock Radio was launched last November, there was no truly local radio.

Cannock Radio is an independent station with a credible and sustainable business model and plan. It has been incredibly successful since its launch not even a year ago. The community has really embraced the station. Only the other week, I walked into Cannock market and could hear Cannock Radio playing in the background. The station also broadcasts regularly from local events. Last week, I saw its staff broadcasting from a local charity football match that was held to raise money for Help for Heroes.

Cannock Radio epitomises the real value that community radio can offer for social gain, providing updates on local news and school closures, and local non-league football coverage—and that is just a flavour. The station already has close links with the police. It can broadcast police reports and incidents immediately, thereby playing its part in protecting the local community and residents. For example, two men were posing as charity workers. One would keep the person talking on the doorstep while the other would break in through the back door. Announcements were made on the station so that residents were not only made aware of the potential risk, but could play their part in helping to track down the criminals.

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Cannock Radio also has a credible and sustainable plan for the future. It is not reliant on public sector grants, but is self-funding through local businesses advertising on the station. It also has exciting plans to help to create local jobs and offer a training scheme for budding young people interested in a future in radio. I would be delighted if the Minister joined me on a visit to Cannock Radio’s new studio in Bridgtown, into which it moved only a couple of weeks ago, to see for himself what a fantastic community radio station it is and to hear first hand the station’s plans.

Cannock Radio’s future and ability to fulfil its potential is reliant on an FM licence, in terms of both fulfilling the station’s community role and growing advertising revenues, which will help it to create more local jobs and develop training opportunities. The FM licence is also important for the many residents of Cannock Chase who cannot access the station because it is currently online only.

Cannock Radio has been looking to apply for an FM licence since its launch last year, but the Cannock area more generally has been fighting for such a licence since 2009. At that time, Chase FM was seeking a licence, but, due to unforeseen and unfortunate circumstances, its owner was unable to apply for one when Ofcom invited applications from the midlands last year. It was only when it was clear that Chase FM was no longer operating that Cannock Radio was created and launched. Having missed the midlands round of applications, and with no future rounds for the area announced, Cannock Radio faces a great deal of uncertainty as to whether and when a licence application will come to fruition.

To some extent, I can understand the broad principles and rationale for a region-by-region approach, but currently no further regional rounds have even been announced, and there is no clear indication of when or whether regions will be revisited, and in what order. That proves that the existing system is not creating certainty or fairness for applicants.

Iain Stewart (Milton Keynes South) (Con): I might be able to offer my hon. Friend some hope. In the previous Parliament, MK FM, the community radio station in my constituency, faced challenges similar to those faced by Cannock Radio. However, working with the Minister and Ofcom, we were able to revisit the timetable, and MK FM made a successful bid for a licence. Yesterday, the station started to broadcast from its new studio on its new, permanent licence, so there is light at the end of the tunnel.

Amanda Milling: I thank my hon. Friend for his intervention and the hope that Cannock Radio might also be successful in getting a licence in future. I am sure that its staff will be very pleased to hear about the success of his local community radio station.

Nevertheless, the future of applicants in regions where time frames have not been published hangs in the balance. From past form, we know that it can take as long as four years before they get an opportunity to apply. Such an undefined waiting period is enough to force even the best local radio stations to close. Will the Minister liaise with officials at Ofcom to try to provide

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more certainty and transparency in future rounds of FM licensing, both in those regions that are yet to be considered and in those to be revisited?

I have reviewed section 104 of the Broadcasting Act 1990, which deals with applications for community radio licences, and I believe that there is scope for Ofcom to consider invitations outside the region-by-region process. Subsections 1 and 2 say that where an authority proposes to grant a licence for a local service, it shall publish a notice in such manner as it considers appropriate, specifying the region or area where the service is to be provided, providing clear time frames and stating the fee. According to my interpretation, Ofcom is not bound by a region-by-region process and has a lot of jurisdiction over the invitations to apply that it issues. Section 104 also suggests that the decision to specify areas or localities in the UK from which applications are invited lies solely with Ofcom. In short, there is nothing in the legislation that prevents Ofcom from varying its region-by-region specification, if it so wished.

I suggest a couple of solutions. Ofcom could invite applications from stations in special circumstances, such as Cannock Radio, alongside its existing region-by-region assessments. For Cannock Radio, I ask that an invitation to apply on a one-off basis, even on a five-year trial, be considered. The community wants and needs it. Cannock Radio has a business plan that totally satisfies all Ofcom’s prerequisites, and there is no local competition. The Community Media Association, the industry body, has advised that it has no knowledge of any other applications of merit in the Cannock Chase area, so such an invitation would not result in a flood of similar requests adding to Ofcom’s workload, which I appreciate could be a concern given its finite resources. A frequency—104—is also available.

My hon. Friend the Member for Milton Keynes South (Iain Stewart) raised the matter of community radio in the previous Parliament, and one of his suggestions was an on-demand system that would address some of the resource issues of greater and more flexible licensing. It would see stations paying a premium fee for their application to be considered outside the prescribed region-by-region rounds, which I am sure many would be prepared to pay. The fee would cover the additional costs of any extra staff and resources required. What does the Minister think of that approach?

In conclusion, community radio stations such as Cannock Radio have a distinct and invaluable role in our communities. Regional radio stations deal with cities, towns and villages, but community radio stations deal with roads and houses. I hope the Minister will consider my points about the FM licensing process and how it could be improved to give greater certainty to community radio stations such as Cannock Radio, for which an FM licence is key. I look forward to hearing his views.

4.12 pm

The Minister for Culture and the Digital Economy (Mr Edward Vaizey): It is a pleasure to serve under your chairship, Mrs Main. I thank my hon. Friend the Member for Cannock Chase (Amanda Milling) for securing this important debate about the future of Cannock Radio. I am an unashamed fan of community radio and it was a pleasure to hear how, within the space of a year, Cannock Radio has established itself as an important online

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presence and is making a contribution to the community. That is all too typical of the contributions that community radio stations make: providing not only important ultra-local information and training opportunities for people in the community, but an opportunity for community organisations to promote their work.

Unfortunately, I cannot praise a community radio station in my constituency, because I do not have one. I have a truly excellent local independent station in JACKfm, but it is one of the great tragedies of my life that Didcot, the main town in my constituency, does not have a community radio station, despite my dropping strong hints to everyone I know in Didcot that they should consider one. It would be the perfect place, not least because of the stunning success of Didcot Town football club, but I digress. I get my community radio fix locally by visiting the constituency of my hon. and learned Friend the Member for South Swindon (Robert Buckland), home to SWINDON 105.5, which is another great example of the success of community radio. It is the commitment of all the stations that have taken up licences since 2005 that has firmly established community radio as part of our radio landscape.

As I hinted earlier, community radio stations range from stations serving small rural communities, such as Mearns FM and Bute Island Radio in Scotland, to stations for our forces such as British Forces Broadcasting Service Edinburgh and BFBS Colchester, to stations targeting particular communities such as students or ethnic minorities. Community radio meets an important gap not served by other services such as local commercial radio. As I said earlier, it provides a genuine link to communities and represents their interests. I look forward to visiting Cannock Radio at the earliest opportunity to see it in action. The national picture is that we have some 230 stations with a licence, with more due to come on air from the current licensing round. Demand for licences remains strong.

While we are perhaps concentrating on the difficulties that Cannock Radio has experienced in its relationship with Ofcom, it is important to recognise Ofcom’s role in helping the community radio sector achieve success, ensuring a range and diversity of community stations that few of the access radio pioneers in the early 2000s could have imagined. The Government help the sector not only through licensing, but also financial support through the community radio fund. I am pleased that we have been able to maintain the fund despite the difficult economic climate and the need to find savings in the Department’s budget. We have also kept the rules governing community radio under review, because we do not want stations to be overburdened by regulation and want them to have the opportunity to raise their own finances. We reviewed the rules relating to financial restrictions on advertising and sponsorship, but it is important that we maintain the dividing line between community stations and commercial radio. We also gave community stations the ability to extend their licences for a third five-year term. Those changes were brought in earlier this year and were supported by the community radio sector and by the Community Media Association, the sector’s member body, with which my hon. Friend the Member for Cannock Chase has worked closely.

My hon. Friend will recognise that demand for community radio stations is great and sometimes exceeds supply in terms of licence availability and applications.

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Ofcom needs to manage that demand, because it must ensure that spectrum is available and is used effectively and it must be fair to the various community groups and organisations that want to hold a community radio licence.

The Community Radio Order 2004 established the regulatory framework and the powers under which Ofcom licenses community radio stations. The arrangements were developed with due care by Ofcom following a consultation with a range of stakeholders, including the Community Media Association, leading to an agreed approach under which invitations to apply for licences are carried out on a region by region basis over a three to four-year period, giving prospective applicants the time to develop strong and sustainable applications for their licences. At the same time, it allows Ofcom to provide advice in areas where, because of existing use, the available frequencies might be insufficient. In assessing applications, Ofcom is governed by the various requirements set in legislation, which specify among other things that applicants must demonstrate that they will be run on a not-for-profit basis for social gain, will retain distinctive characteristics and will be distinctive.

I mention those points to emphasise that such applications receive careful consideration, because, as my hon. Friend indicated, such applications can be time-consuming and resource-intensive. As part of the process, Ofcom needs to consider whether awarding licences in one area may restrict development in a nearby area because of the scarcity of suitable FM spectrum or where there may be an over supply of similar services in an area that might mean that a particular community service was unviable. The process of assessing a community radio licence application is therefore not completely straightforward and depends on a number of variables. The large number of applications that each round generates and the various checks and technical work mean that it can take time to award a licence.

I take on board my hon. Friend’s points about the frustrations felt by Cannock Radio and its proposal that community licences should be available in effect on demand. I acknowledge that were that process to be introduced, it could help some stations get on air sooner, but there is a risk that moving to a purely demand-led system for community radio licences could slow down the process overall, because decisions would be made in an unco-ordinated way. The current system of regional rounds, as developed by Ofcom with the Community Media Association, enables Ofcom to manage the licence process in a way that is fair and equitable to all comers and to manage all the moving parts, as it were, in a particular region. The way in which Ofcom manages that process strikes the right balance between the operational challenges of managing the licensing process and Ofcom’s aim to license a community radio station for every community that meets the criteria. It avoids the situation with earlier rounds where Ofcom initially allowed applications from all over the UK, resulting in a large number of applications being submitted, with many applicants having to wait a long time for their applications to be considered.

The third licensing round is due to be completed this year, so it is a good time for Ofcom to look at whether changes can be made to the design of the next round to reflect the fact that 230 licensed community radio stations

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are on air. That is another important point in favour of my hon. Friend’s argument. We have established a critical mass of community radio stations. She raised the issue of Ofcom inviting bids in areas where demand for spectrum was determined by Ofcom to be low. She indicated that Cannock Radio would in effect be the only bidder for such a community radio licence. The suggestion is interesting, and I would like Ofcom to consider looking at it in the design of the next licensing round. I know she has had an exchange of correspondence with Ofcom on that point.

It is important to note that over the period of awarding community radio licences, Ofcom has improved its guidance on the regions where it might be difficult to find a radio frequency. That allows people to determine whether there will be serious hurdles to providing a community radio station. Conversely, where many frequencies are available, it allows for an area not to be unfairly excluded. It is important to note that Ofcom has taken steps to streamline its internal processes to enable it to process applications more quickly.

My hon. Friend also suggested in her excellent speech that community radio stations coming out of cycle should have the option of paying an enhanced fee—a premium licence fee application. Some difficulties surround that suggestion. It is important to remember that community radio licences are not commercial licences. The proposal could be perceived to be unfair on organisations that are not as strongly funded as others. As far as possible, we want to keep a level playing field for all those who are thinking of applying for community radio licences. I take her point about staffing, however, and I know that Ofcom is looking seriously at how it can speed the processes up in future rounds.

I know how disappointed Cannock Radio was when its application for a community radio licence was rejected because it was in effect submitted outside of the deadline date. My hon. Friend gave the context. I of course recognise that Cannock Radio needs to access a radio platform to develop the station further and that FM is its best option, although I note that it has the opportunity to bid for an AM licence later this year. I also acknowledge the uncertainty—she made this point in her speech—on when details of the next licensing round for FM licences will be announced. I understand that Ofcom will be announcing details of round 4 in 2016, and I hope that Ofcom will make those details as clear as possible, as soon as possible.

While I have time, I will quickly mention the role that digital radio can play in the future of community radio, and perhaps in the future of Cannock Radio. We are

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working on a process to give community radio stations and small independent stations a route through to digital audio broadcasting. The Government make no secret of the fact that we believe that digital radio is the future of radio. Digital radio is growing at a significant rate. As DAB coverage improves significantly between now and 2016, it is important that we put in place a system to allow community stations to migrate on to DAB frequencies, particularly where an FM frequency might not be available. Previously, that has been difficult for them to do because with the multiplexes, the network for digital radio has effectively been at county and regional level.

Some 18 months ago, we announced details of funding for a major trial of low-cost, small-scale DAB technology, which should open the way for many community stations to go digital. We are trialling that in 10 areas, the first of which was launched last month. The rest are due to come on air this month, carrying a total of 60 services. We will complete the trial next year. Subject to a successful technical evaluation, we will bring forward plans next year to allow small stations to be licensed on a digital platform.

I hope that Cannock Radio and my hon. Friend do not find my remarks too discouraging. I hope that Cannock Radio will continue to build its online service into an essential local resource and look for an opportunity to obtain a community radio licence in the next round. My hon. Friend made perfectly valid points about timings and processes, and I know that Ofcom will have taken note and will take account of them when it comes to develop the process for the next phase of community radio stations.

As my hon. Friend the Member for Milton Keynes South (Iain Stewart) indicated, I tend to take a practical approach with these issues. I have outlined some of the parameters within which we are operating, some of the frustrations and the wider context of how Ofcom manages community radio licences, but I am more than happy to continue discussions with my hon. Friend the Member for Cannock Chase on how we can give Cannock Radio a route to an FM licence. Fundamentally, I want to do all I can to help any community radio station grow and expand; I recognise the passion and enthusiasm that so many wonderful volunteers all over the country bring to community radio. I also recognise the passion and enthusiasm of my hon. Friend, the new Member for Cannock Chase, and her championing of the cause on behalf of her constituents.

Question put and agreed to.

4.27 pm

Sitting suspended.

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Urban Regeneration (England)

4.30 pm

Alison McGovern (Wirral South) (Lab): I beg to move,

That this House has considered regeneration of towns and cities in England.

It is a pleasure to serve under your chairship, Mrs Main.

I will use the time allotted to consider some of the issues to do with the regeneration of towns and cities in England. The matter is most vexing for my constituents—and, I suspect from the number of colleagues present, for many others. I will reflect on issues specific to New Ferry, a small town that I represent, but I intend to use the example of New Ferry to discuss wider issues in England.

By way of a caveat, and to help the Minister, I should say that we had a good debate in Westminster Hall in February, before the election; we covered a wide range of town centre issues—parking, business rates, shopping locally and that sort of thing. I do not intend to go over the same ground, with the exception of out-of-town shopping centres. I want to talk about proper regeneration and what happens when a place is deprived and the market fails. I am talking not about making a small shopping centre or retail market work, but about what we do and how we respond when a market has failed and about whether the Government care. Specifically, I want to talk about two things: Government policy on planning and access to capital; and the views of my constituents. I want the Minister to hear how their situation makes them feel.

First is Government policy. Having read through the transcript of the February debate and looked at the evidence, I can only conclude that the national planning policy framework has failed. The “town centre first” approach is not working. An Association of Convenience Stores report tells us that 76% of new retail space is out of town. Did anyone in our country intend that the wonderful town centres that we have all known and grown up with should be gradually shut down in favour of out-of-town retail spaces?

By and large, people have to drive to out-of-town places, which is less healthy and causes more pollution; those people who do not drive or do not have access to a car for whatever reason cannot get there. Did anyone in our country intend for that to happen? I argue that the answer is no. I argue that no one in England thought that it was a good idea for us to sacrifice historic town centres for out-of-town retail. Such retail can be a good thing and work well, but planning policy should ensure that it happens alongside and not instead of town centres. How will the Minister reshape Government policy to change our country’s aspiration, which I honestly think is probably a cross-party one? How will he make that aspiration real and not only words on a piece of paper? As we know from the ACS report, so far that aspiration has failed.

The second part of Government policy that I am extraordinarily concerned about is access to capital. We need to think not only about our successful city and town centres. I am proud to be from Merseyside. Those who are familiar with Liverpool and have visited it down the years know that, some years ago, when I was growing up there, it was possible to wander around and

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to see many sites left derelict since the second world war. The beautiful buildings were the exception rather than the rule. Thanks to the efforts of the previous Government, that has changed a great deal. There are still gaps and spaces, but things have changed and the city is doing well now. Its population is growing for the first time in my lifetime—more people are now coming to live in Liverpool than are leaving, which is a great success.

What, however, is happening to the peripheral town centres? What is going on outside, in places where businesses cannot make a good argument to invest? Those places are sinking further and faster. We cannot see the same kind of business investment as in Liverpool in towns such as Birkenhead, Ellesmere Port or New Ferry, which I represent. Merseyside has had some success in the centre, but Knowsley, Southport and other places around the city centre are not seeing the same benefit. That is because of market failure—the degradation has been so great that the regeneration needed is too big for the private sector on its own.

Conor McGinn (St Helens North) (Lab): My hon. Friend and I share not only the region of Merseyside, but similarities between our constituents and constituencies. St Helens has seen huge cuts to local government, plans for investment in transport shelved, a moratorium on a new police station and now the proposed closure of the court house. Given the points that she has made, does she agree that that denigration of the status of our town discourages business and, most importantly, people?

Mrs Anne Main (in the Chair): Order. May I ask for interventions to be kept brief? That was more like a mini-speech.

Alison McGovern: Thank you, Mrs Main. I think that was the first intervention that my hon. Friend the Member for St Helens North (Conor McGinn) has made in Westminster Hall, so I am sure he will take your advice.

My hon. Friend is right, however. Of course I care that businesses should be successful; I want people to be able to make a profit, to enjoy their town centres and to have a good environment to be in. My main point, however, is that regeneration matters because of what the quality of buildings and the built environment do to people’s hearts and souls. Being from a place that other people think is rubbish is no good—I know—so regeneration matters not only because it helps people to make a buck and to get a job, but because of the pride we take and the status of our towns. That is why I am having the debate today.

My hon. Friend the Member for St Helens North made another good point. The problem with regeneration is the fact that the Government pull away access to capital from every direction. The housing market renewal initiative, which was helping lots of parts of Merseyside, including just up the road from New Ferry, has been cancelled and done away with. Swathes of grassland just by New Ferry are not being built on because the market is providing no capital to build the houses, and the Government will not do it. Regional development agencies—gone. Bromborough, where I am from, was rebuilt by the regional development agency, which identified business opportunities and pushed friendly capital towards

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there, so that our place would grow, and it did—but the RDA is now no longer there. We have the local enterprise partnership, which is a lovely organisation, but it has no resources. As my hon. Friend said, every Department of Government has stopped spending capital that previously went to regenerate our towns.

The net impact is that market failure simply cannot be addressed. Where a town centre has deteriorated to such an extent that no business can make a decent case to the markets to access capital to invest there, nothing can be done. Only the state can fix this—it is not for the private sector alone. It is not down to Government alone, either, but it cannot be done without Government.

I want to say a few words about New Ferry. It is where my office is, and I have spent time trying to get a regeneration scheme off the ground there. It is very close to a cancelled housing site that is now just scrubland, and there are lots of empty shops. There is a genuine need, not just for business investment but for regeneration. The area needs reshaping and a new idea of what it can be; there are so many empty shops that people do not go there any more. No business is prepared to risk expending capital by itself on New Ferry. What the Government have done means that there is no mechanism to make regeneration happen, so I am standing here today to ask the Minister to create a mechanism—to find a way for the state to do regeneration in our towns once more. That is desperately needed and it must be done.

I will briefly share some of my constituents’ views. In advance of this debate, I distributed leaflets and used Twitter and Facebook to tell my constituents about it, and they have written to me in great numbers to tell me what they think. Miriam Clack of Stanley Road in New Ferry said, about the place that we are from:

“it’s a pig hole, and it’s a disgrace, and no one is in the least bothered about it.”

I am bothered about it, and I think the Government should be as well. This is the place where we live. She asks why the closed shops are not pulled down or made into something else, and she is right to. She goes on:

“If I was younger I would leave but I can’t so I’m stuck in this hole.”

Another constituent, Matthew Thomas, has had a great idea. He says:

“I think we already have a sufficient number of shop premises. I would even say we have too many. In my opinion it is worth considering the impact of removing the shops”.

He is right. New Ferry needs to be reshaped, but only the Government can do that. No one business, on its own, is going to lead a private sector solution to deal with it; it needs to be a partnership.

The local community has done great things, but, as Joan Rawcliffe of Ortega Close said,

“in spite of considerable efforts carried out by the New Ferry Regeneration Action Group (e.g. the farmers’ market, the landfill site”—

we have a new park there—

“regeneration of the area as a whole failed to take place. Monies from outside sources…were not received by New Ferry.”

Such money was received in other areas, but is not available now because of the Government’s actions.

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In closing my contribution, I put it to the Minister that the situation is desperate. I see it, day in, day out, week in, week out, when I am in New Ferry staring at boarded-up buildings and the crumbling bricks of those beautiful old buildings I mentioned. I see it; if he does not, he is welcome to come with me to myriad town centres up and down our country to see it. I ask him to think about this: if he, as a Government Minister, could do one thing, it should be to restart the regeneration of our country. That is desperately needed and I ask him to do it.

4.43 pm

Justin Madders (Ellesmere Port and Neston) (Lab): Thank you for allowing me to speak today, Mrs Main. I am grateful to my hon. Friend the Member for Wirral South (Alison McGovern) for securing this debate. She is the Member for the constituency neighbouring mine, so we face a number of similar issues. This is one we definitely share, although, as we will probably hear from other Members, I believe it is also one that a great many town and city centres up and down the country are grappling with at the moment.

As my hon. Friend has mentioned, there have been myriad discussions and debates about the causes of town centre decline, and I do not see any great benefit in rehearsing them. The time has come to find an answer, and I agree with my hon. Friend’s suggestions. There have been attempts in Ellesmere Port, which I represent, to try to regenerate the town centre. We were fortunate, a number of years ago, to have Marks and Spencer invest in the constituency. Despite many efforts on our part as a borough council, we could not persuade it to relocate to the town centre, but it was prepared to invest—in fact, it was its most significant investment in the UK for a number of years—in a large store on the edge of town, in Cheshire Oaks. As many people will know, that is a very popular destination.

Obviously, we were concerned about the impact on the town centre. We were able to agree with Marks and Spencer a generous section 106 contribution for town centre regeneration. Over the past few years, we have been putting that to good use. With that fund a town centre panel was set up, consisting of a number of representatives from the community—from the third sector, local businesses, market traders and the council, including me as I was a local councillor at the time.

The panel is still running today, but the money will run out in the not too distant future. However, it has made some important contributions to keeping the town centre going. A number of events have been put on with the broad aim of getting people into the town centre. We have had concerts and fun runs; there was a big wheel at one point, and a number of Christmas activities. The question we always ask ourselves when we look at how that money should be spent is, “Will this help get people into the town centre?”

Another interesting and innovative use of the money has been on shop front schemes. They have changed the view down the main high street, and people’s perception when they come into the town—they see lots of new shops where before we had empty shops and derelict signs. It is a short-term solution, as those shops still need to be filled. We talked to owners whose units have been empty for a number of years, and put a proposal to them whereby we agreed to use the section 106

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money to refurbish their shop fronts and shop units on the basis that they would then let the units to a third-sector organisation on a peppercorn rent for two years. That has brought new life and new initiatives into the town centre, but it is for a limited period, so at the moment we are grappling with the question of where that will take us in the future. It has kept us going in recent times but will not last forever. Some life has been brought into the high street, but the solution is not permanent.

I know a number of towns and cities have been looking at business improvement districts, but in a town such as Ellesmere Port the local traders do not operate on the sort of profit margins that would justify their acceptance into that sort of scheme. We have to accept that a lot of those operations are run on a national basis and it is difficult for a small stall in a smaller town in the country to justify that additional expense. BIDs have had some success, but they are not right for every town. Some of the short-term initiatives have not really been followed through, which is why I agree that we need a fundamental, sustained long-term financial plan and support for town centres.

To pick up on the point made by my hon. Friend the Member for St Helens North (Conor McGinn), the civic and community importance of town centres has been undervalued in recent years. Current pressures on the public purse and further anticipated court and library closures mean we are seeing further erosion of the civic facilities that invite people into town centres. We need a new approach. Local authorities have local knowledge and so have the tools at their disposal to try to tackle this issue, but they cannot do that without significant financial support. We know that local authority funding is being squeezed at an unprecedented level. Discretionary spend—essentially, that is what this is—is getting ever more squeezed.

I think that we should be looking at residential units as a possible option, and that some sort of new homes bonus for town centre units that are brought back into residential use should be considered. That would give an incentive to local authorities to try to change some of those empty units.

We should look at the way in which out-of-town centres are managed: they have one person who is responsible for all the functions of the shopping centre. We should have a town centre manager in every neighbourhood. We have had a town centre manager as a result of the section 106 money, which has proved invaluable in bringing together all the different strands that make up a town centre. Ultimately, that can pay for itself if the growth that, hopefully, some innovation generates allows the local authority to keep an increased proportion of the rates. I believe that a co-ordinated approach of that ilk is required.

We should also consider whether to look at enterprise zones for town centres. There is a lot to be said for enterprise zones, but when we are giving people incentives to relocate their new offices, factories and premises out of town centres, we are not doing anything to help those centres. It seems a little perverse that we are all here today extremely concerned about the future of town centres, when a system is in place that encourages businesses to locate outside town centres.

Those are just a few of my suggestions, and I echo what my hon. Friend the hon. Member for Wirral South said: if the Minister is up in our neck of the woods, he is more than welcome to come to Ellesmere

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Port and have a look at some of the good things we have done and the challenges that we have to face over the next few years. We have made progress, but, as is the theme of this debate, we can only go so far without a significant financial commitment to regenerate these town centres.

4.51 pm

Chris Evans (Islwyn) (Lab/Co-op): It is a pleasure to serve under your chairmanship, Mrs Main. I think this is the first time you have been in the Chair when I have spoken, so I welcome you to your position. I also welcome the Minister to his position; I think this is the first time I have spoken when he has been winding up for the Government.

I congratulate my hon. Friend the Member for Wirral South (Alison McGovern) on securing this debate about an issue that affects us all, wherever we live, whether in England or Wales. There is nothing worse than the situation she cited in her speech: when someone does not have pride in their community because they believe that the Government or society do not care about them—a feeling underlined by boarded-up shops or derelict places in their communities.

I am also pleased to follow my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders). I was very friendly with his predecessor, who was known as one of the great scientific minds of Parliament. I remember how, in one of our last conversations before he left this House, he waxed lyrical about the fact that his successor knew local government inside out. I am glad that my hon. Friend is bringing that knowledge to bear in the House today.

I will try to keep my contribution short, given what we have heard from my hon. Friends the Members for Ellesmere Port and Neston and for Wirral South. I would like to bring two examples before the House. Community regeneration is something I have been interested in for a long time, in particular through living and having grown up in south Wales, where we are part of the post-industrial age.

In all the time I have been a Member of Parliament, I never thought that I would speak in a debate and praise a Government led by Mrs Margaret Thatcher. However, I find myself doing that in drawing attention to the Cardiff Bay development corporation, which was set up in April 1987 to regenerate the 1,100 hectares of old derelict docklands of Cardiff and Penarth.

If anybody remembers Cardiff Bay—as I know you do, Mrs Main, with your Welsh connections—they will know that Tiger Bay was a no-go area. The most famous person ever to come out of Tiger Bay was Shirley Bassey. It was known, unfortunately, for two things—dockers and prostitutes. It was not a nice place to go. However, when people go there now, it is modern—a place where someone can take their children for a day out. It holds modern office blocks. Essentially, it was part of the British Government’s urban development programme to regenerate particularly deprived and run-down areas of British inner cities, and it showed that when a Government have a political will, great things can happen.

The mission statement for the regeneration project was to put Cardiff on the international map. I am very pleased to say that it has done so, and not just with the

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Ryder cup 2010, held at Celtic Manor just down the road in Newport, or the recent NATO summit. The facilities in Cardiff—including Cardiff castle, where the President of the United States dined during that summit—really put Cardiff on the worldwide scene, and that is because of what is happening in the bay.

The five main aims and objectives identified in the regeneration project were as follows: first, to promote development and provide a superb environment in which people want to live, work and play. Having enjoyed some of the restaurants and the pubs—sometimes too much—I can say that it is certainly a place that I want to visit. My hon. Friends have encouraged the Minister to visit their areas in Merseyside, and I ask him to visit Cardiff Bay, not in an official capacity, but in a personal capacity, with his family. I think he would have a great day out there.

Secondly, the project aimed to reunite the centre of Cardiff with its waterfront, which is, of course, one of the focal features of the city. It has been used as a backdrop for many news programmes and as a filming location in programmes such as “Doctor Who”—unfortunately, a filming request for the new James Bond film, “Spectre”, was turned down.

The third aim was to bring forward a mix of development that would create a wide range of job opportunities and would reflect the hopes and aspirations of the communities of the area. Cardiff Bay is a melting pot; it brings together several cultures, like many dockland towns, such as those in Liverpool. I am glad to say that Cardiff Bay celebrates the integration and diversity that makes our country so great. Fourthly, the regeneration project aimed to achieve the highest standard of design and quality in all types of development and investment. Fifthly, it aimed to establish the area as a recognised centre of excellence and innovation in the field of urban generation.

Some of the significant achievements of the project included the construction of a barrage across the mouth of the bay to create a 200-hectare fresh water lake—I am glad to say that there are many boating trips on there now. There was the construction of new homes, including those at Atlantic Wharf, and the new offices at Crickhowell House, now the home of the National Assembly for Wales. The development also created commercial and leisure facilities, such as those at Mermaid Quay on the waterfront and the Atlantic Wharf leisure village. It is evident that investment in the regeneration of our towns and cities is vital for the most prosperous future. If somebody wants to see the beating heart of that, please visit Cardiff Bay.

My second example, from further afield, is Bedford-Stuyvesant. The change there was brought about by my great hero, Robert Kennedy, when, in 1964, he set in motion a round of legislative action that created the special impact programme, which was an amendment to the Economic Opportunity Act of 1964.