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I do not think that I heard anything this evening with which I disagreed. I suspect that the issue underlying the noble Lord’s Question is climate change. Climate change is a wicked problem, because past emissions are causing the present symptoms, which were slow to become apparent, and then it took some time to recognise the cause of the problem. Furthermore, we are committed to more climate change and rising sea levels whatever we do. What we do now will take a considerable time before the benefits become apparent. Finally, obvious popular solutions are not necessarily the right ones to adopt. One has only to look at the US ethanol policy to see the dangers. None of this means that we need do nothing, and taking sensible action should not hold back world economic growth unduly.

I take this opportunity to pay tribute to contribution of the noble Lord, Lord Teverson, to the Climate Change Bill. I know that it is much appreciated by my noble friends who are working on the Bill. The noble Lord has explained to us the transport emissions challenge that we face.

There is little doubt that CO2 emissions associated with aviation contribute to the increase in overall CO2 levels. However, it is only a small proportion of overall emissions. Primary power is much more significant. I am a little anxious about everyone claiming that their use of electricity is carbon neutral, because we know that a large proportion of the electricity that we use in the UK is not carbon neutral—far from it. In later years, aviation could generate a high proportion of UK CO2 emissions, as there is little alternative to liquid fuel propulsion, while other uses of power decrease. What is less perfectly understood is the other greenhouse effects of aviation, and further research is needed here to ensure that policy is backed up by sound science.

Unfortunately for the noble Earl, Lord Mar and Kellie, I understand that the climate change model correlates well with the 1,500-year cycle, as well as with the effects of increasing CO2 concentrations. It is obvious that rail enjoys lower emissions than aviation, but are the figures cited by the noble Lord, and those we read, just the marginal CO2 emissions of a journey in terms of fuel, or do they include the energy required to manufacture the aircraft and its materials and the emissions related to the manufacture or recycling of the rails, the manufacture of the sleepers on the railway system and the overhead line support

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structure? The point is that, although rail is a very low-carbon means of transport, as we have heard, it is not a zero-carbon means of transport.

Lord Berkeley: Perhaps I can help the noble Earl. In a Written Answer in the House of Commons about the carbon emissions per passenger mile in kilograms, air shorthaul flights are 0.23 and rail is 0.10.

Earl Attlee: Yes, but that does not tell us which carbon content we are looking at. When we build a railway system, we have sleepers. Sleepers have a carbon content. It is complicated. We also need to look at the energy put into making an aircraft, the electricity used to make the aluminium in the aircraft and whether the energy in the aircraft can be recycled—whether we can recycle the aluminium. So it is a much more complicated picture.

We know and agree that aviation emissions are undesirable, but also that aviation is vital to our economy and world development. The noble Lord’s Question refers to internal air and rail travel. There is a fine balance between the utility and economy of the two modes of transport. There is plenty of evidence that improvement in rail services, both in the UK and Europe, leads to a corresponding increase in rail's share of the market.

In the future we could build really fast new railway lines between city centres that would make aviation superfluous for internal travel. The noble Lord, Lord Berkeley, talked about that opportunity, but he also talked about some of the difficulties of finding a route for such systems. Quite apart from all the planning and financial difficulties, the Minister’s carbon economists would have to study any proposal carefully in order to determine the carbon balance benefits. I suspect that for a given amount of investment there are other, much more effective ways of avoiding emissions.

The noble Lord, Lord Teverson, talked about some of the difficulties in determining policy at the strategic level in government. The reality is that internal air travel is efficient and effective and has great benefits, especially for the periphery of the UK. We need good transport connections to encourage investment in the West Country and in Scotland. Sometimes that will be by air and sometimes by rail; it is not one or the other. Given that the air/rail market is balanced in terms of cost and journey time, reliability of rail services becomes critically important. The noble Lord, Lord Berkeley, reminded us that we need to look at the total journey time from door to door. Although the flight time might be only an hour, we know that going through an airport takes a lot of time—and it is not very pleasant nowadays, either.

The need for reliability becomes particularly important when passengers are not paying the fare themselves. That is normally, of course, for business purposes, when time is extremely valued. It is plainly far more carbon efficient to make our current rail system extremely reliable and attractive than to build an entirely new system. We need to move away from an acceptable level of failure in the system towards

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zero failure. In particular, I do not understand why it is thought to be acceptable to have a signalling failure, even if the system fails at safe. I look forward to hearing the Minister’s response to the noble Lord’s Question.

4.37 pm

Lord Bassam of Brighton: I am grateful to the noble Lord, Lord Teverson, for stimulating this debate. It has been useful. I personally regret that we do not have a few more takers in the Moses Room today; they would have greatly benefited from joining in this important debate. Sometimes in the course of our recent discussions on the rail industry, and in looking at aspects of the aviation sector, we have touched on the subject of rail versus air and rail-for-air substitution, and it is interesting to focus in more detail on that aspect of a broader-based debate.

All the speakers have made good contributions. The noble Lord, Lord Teverson, challenged the Government on our lack of vision. I have some comments I want to make about that. I do not share his view; the Government have gone a long way towards having a broader vision of how the transportation system works, and in particular a vision for the successful and sustainable development of our railway. The noble Lord, Lord Berkeley, made a similar point and challenged us not just to think in the short term but to look at where we wanted to be in 20 years’ time. That is right. We need to do that, and it is an important part of our thinking and our vision of the future of the rail network. The noble Lord said we needed to construct policies for the longer term, and I do not think anyone disputes that.

The noble Earl, Lord Mar and Kellie, charmingly confessed to being an anorak. I suppose that if you are prepared to take a six-an-a-half-hour rail journey twice a week, you spend a lot of time thinking and rather falling in love with the rail network. No doubt, as you go through some beautiful countryside, you have lots of time to reflect on how the network could develop. The noble Earl made the case, as he often does, for a high-speed network with continuous improvements.

The noble Earl, Lord Attlee, said that he did not have much to disagree with in the previous speeches. I shall be studying those speeches to see just how much of the noble Earl’s party policy is now carefully aligned with what has been said, because these things are of broader interest.

Earl Attlee: I did not say that I accept what other noble Lords have said as party policy. I would not be here for very long if I did.

Lord Bassam of Brighton: I would not want to shorten the noble Earl’s tenure in his current post. He made a good contribution, and what I did appreciate were his observations on the carbon economist’s view of the world. He brought some reality into the debate in terms of arguing that we need to have a more rounded view of these issues, and I do not dispute that. Indeed, it is probably a view that is more broadly shared than we sometimes think.

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The Government are committed to a sustainable transport system which supports economic growth and pays its environmental costs. The Eddington transport study to which almost all noble Lords referred made it clear that a well functioning transport system is essential to supporting continued economic growth in the United Kingdom and maintaining our quality of life, while the Stern review on the economics of climate change confirmed that urgent action is required to tackle emissions of CO2 and other greenhouse gases, and that there is a clear economic case to do so. Indeed, over the past year or so that review has become an important influence in changing the terms of the debate, and we should all be grateful for that.

We do not see this as being a choice between rich and dirty on the one hand and poor and green on the other. Stern properly exposes that as a false dichotomy. The cost of early action is significant at around 1 per cent of global GDP per annum, and perhaps higher for a developed country such as the UK, so the option of being rich and dirty does not really exist. It was for that reason that last October the Government published their White Paper entitled Towards a Sustainable Transport System, which was our response to Eddington and Stern. It sets out a new framework in which transport can support economic growth and contribute to lower carbon emissions. For example, in aviation the UK’s airports play a pivotal role in supporting both the national economy and regional economies by providing around 200,000 jobs directly and making a national contribution of some £11 billion, while by providing international connectivity they help to support the economies of Scotland, Wales, Northern Ireland and the English regions.

However, we argue that all this must be sustainable. A balance must be struck between tackling environmental challenges so that impacts are effectively mitigated while enabling people to fly and UK business to compete internationally. The demand for air travel is continuously growing and our airports, particularly those around the periphery of London, are operating at almost full capacity. We therefore support the provision of additional capacity in the right circumstances. This means making better use of existing airport capacity as a priority ahead of building targeted additional infrastructure. This is the policy outlined in the 2003 air transport White Paper, which makes it clear that the Government do not support predict-and-provide policies and fully recognise the need for development to be sustainable not only in terms of local environmental effects, but also in terms of aviation’s contribution to climate change.

Our support for two new runways in the south-east, first at Stansted and then at Heathrow—subject to strict local environmental conditions set out in the White Paper being met—is entirely consistent with this view. A new runway at Heathrow would provide much-needed capacity, would support the UK economy and help Heathrow to remain competitive. As noble Lords know, our consultation on adding capacity at the airport closed last week, and the responses are currently being reviewed. We expect to make final policy decisions later this year.

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We are aware that some groups are calling for a halt to airport expansion and for restrictions on air travel—noble Lords this afternoon did not make that call, but there are echoes in things that are said in your Lordships’ House that reflect that view—while others are requesting that greater consideration be given to alternate transport modes such as high-speed rail. That was reflected in comments made this afternoon. The answer is that both aviation and rail have key roles to play as we continue to support the development of a transport system that both supports economic growth and helps the UK to meet its climate change responsibilities. It is not up to the Government to say who can and cannot fly. The fact is that more people than ever want to fly. However, by using tools such as the aviation-emissions cost assessment, we can inform future strategic policy to ensure that aviation pays for its environmental costs.

Lord Teverson: I do not particularly disagree with the Minister. I am not at the end of Liberal Democracy that says that Heathrow Airport should disappear. As the noble Earl, Lord Attlee, rightly said, aviation is incredibly important for a number of areas, and the railway will never be a substitute for it in certain ways. However, given the way in which the economy is structured, airport expansion is driven these days by the private sector rightly being able to say, “There is the demand, and we can get the investment”. There is always pressure—through government, planning or whatever—to meet that capacity, because there are straightforward ways in which it can be done.

However, the expansion of the rail infrastructure cannot work that way, because, unlike in the 19th century, it must be driven by Crossrail or whatever, as we have seen. It must be brought together by government because the private sector is not capable of delivering it. There is an equal demand for capacity and an increase in rail, as we have seen, but there is not the same pressure from government to meet it because of public expenditure and planning for the service. I want to understand how government can create a more level playing field, not so much on the cost side but in the ability to enter the market and create additional infrastructure, because it is clear to me as a traveller and as someone who reads the statistics that the rail industry will hit capacity within the time that it takes to plan these new routes. I apologise; I have intervened for too long.

Lord Bassam of Brighton: The noble Lord is a little like a fast-running train sometimes; he gets carried away with his arguments. I was going to come to that part of the argument, and will say simply this. If we turn from aviation to the Government’s wider strategy for the rail network, the White Paper published in July 2007 is, we can fairly argue, the most positive statement about the growth and development of Britain’s railways in the past 50 years. It commits substantial funding—£15 billion—in public support for the rail network between 2009 and 2014 and is a whole-scale vote of confidence in rail travel. Certainly in my lifetime, it surpasses anything that has been

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committed previously. Some £10 billion will be spent specifically on enhancing capacity—the very issue touched on by the noble Lord—in those years, and these investments will enable the railway to accommodate a further seven years of what we anticipate will be record growth.

The recent £8.8 billion west coast main line upgrade has had a significant impact on shifting people from air to rail, with two-thirds of passengers now travelling from London to Manchester by train, not plane—up one-third from 2004. The figures have reversed precisely for air and rail travel. By the time the work is completed, many journey times on the route will have reduced by almost a fifth compared with those in September 2004. Pre-project, the Glasgow to London journey time was 5 hours, 6 minutes. From December 2008, the fastest journey will be possible in 4 hours, 10 minutes, so the noble Earl, Lord Mar and Kellie, will have a little less time to spend on thinking about railway systems. The typical reduction in journey time on today will be around 30 minutes. However, rail clearly cannot provide an alterative to aviation in all cases, particularly not for intercontinental passengers who are using hub airports such as Heathrow to make onward connections.

We argue that Heathrow’s status as a hub airport is crucial to the UK maintaining its strong connections with international centres. Over the past decade, regional airports have helped drive the regeneration of cities such as Manchester, Birmingham and Newcastle by connecting the regions to international destinations and markets that would not otherwise be served directly by local airports. As experience with the London-Manchester route demonstrates, rail can provide a highly attractive alternative to air travel, especially over short distances such as end-to-end journeys of two to three hours. That is where the major benefit is. As distance increases, however, air travel becomes increasingly attractive. The fact is that neither air nor rail alone can provide all the required capacity.

There are currently around 50,000 domestic flights a year within the UK from Heathrow and around a further 50,000 to Amsterdam, Paris, Brussels and Rotterdam. Even if half those flights switched to rail, Heathrow would be operating at around 90 per cent of its capacity and would be full by 2020, when a third runway could be in operation. That bears some thinking about. Even if we were able to achieve that level, we would still have a major problem with Heathrow.

Noble Lords have touched on the fact that there has been much debate about possible new railway lines. The Government have not ruled out new lines in future, nor have we ruled out high-speed rail being an important feature of our policy, but Eddington told us that most of the links the country needs are already in place; the priority is to increase the capacity of those links, not to construct new ones. High-speed lines are expensive and do not address immediate needs. A north-south high-speed rail line would cost tens of billions of pounds and absorb the entire rail budget for years, just to serve one particular corridor of travel activity.

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We also need to think carefully about the assumption that high-speed trains are necessarily the greenest option. Increasing the maximum speed of a train from 125 miles per hour to 220 miles per hour leads to a 90 per cent increase in energy consumption and, in exchange, cuts station-to-station journey times by less than 25 per cent and door-to-door journey times by still less. The Government’s strategy is therefore to improve the quality of inter-urban rail services and to make the best use of existing networks by lengthening existing trains, increasing service frequencies and tackling key congestion pinch points. We recognise that in the longer term, extra route capacity might be needed on some interurban corridors, and the department will look at that in a multimodal context and announce its conclusions in time for the next High Level Output Specification.

I am conscious that we are getting close to 5 pm. I have a few more points to make and then I will wind up. Increasing rail capacity will improve the passenger experience in getting passengers to the airport, and in some cases will offer an alternative to short-haul flights—an objective we always see as desirable. But demand for both aircraft departures and aircraft arrivals exceeds capacity in the south-east. Not addressing that risks damaging the UK’s economic interests, not only in aviation but more widely across our economy, and it would not provide any environmental benefit. The way to tackle aviation emissions is internationally, through an effective Emissions Trading Scheme. Under current plans, all flights arriving from and departing to the EU would be included by 2012.

We need to recognise, however, that to provide a complete end-to-end service to travellers, we need the capacity and capability to build in reliability throughout the whole journey. That is why, rather than planning along modal lines as has happened in the past, we will be focusing in future on those areas—our cities, our interurban links and our international gateways—where transport can best support economic growth and productivity, while also tackling the climate change challenge. We will identify the problems, look at solutions across all modes and prioritise the best value-for-money solutions.

This is a new way of thinking, and we see it as an important part of our transportation vision. We know that it will take time to deliver, but we are committed to delivering on it because we have to, to ensure that we secure a viable economy, effective transport networks and the most environmentally sustainable outcomes. I am grateful to noble Lords for joining this debate, and I am sure that we will have many more on other occasions.

[The Sitting was suspended from 4.55 to 5 pm.]

Arts and Healthcare

5 pm

Lord Howarth of Newport asked Her Majesty’s Government how they intend to develop their policies to link the arts with healthcare.

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The noble Lord said: There is much to celebrate in the contribution of the arts to healthcare across the country. Bibliotherapy groups on Merseyside are enabling literature to alleviate pain and mental distress for people with Alzheimer’s, motor neurone disease and mental health problems. Poems in the Waiting Room is the most widely read poetry publication in the United Kingdom. Live Music Now presents concerts and runs workshops to support people in mental health units, care homes and hospices. The Peninsula Medical School has appointed the distinguished violinist, Paul Robertson, as visiting professor of music and medicine. The Royal Northern College of Music and Arts for Health at Manchester Metropolitan University are promoting collaboration between centres of excellence in musical education and medical education. Paintings in Hospitals, led by Stuart Davie, not only lends from its own collection but runs artists-in-residence programmes and has brokered loan exhibitions to hospitals with the V&A.

Gloucestershire Hospitals NHS trust’s Leading the Way programme; Stockport’s Arts on Prescription and Bradford’s Dance for Life have been exemplary. In London, Guy’s and St Thomas’s, under the cultural leadership of Karen Sarkissian, with its beautiful Evelina Children’s Hospital designed by Hopkins Architects; Homerton Hospital, with its arts programme led by Shaun Caton; Bart’s, where the Gibbs grade 1 listed west wing has been reinvented by Greenhill Jenner Architects and enhanced with art commissioned by Vital Arts; and Chelsea and Westminster, where the brilliant tradition established by Susan Loppert continues, are all enlisting the arts creatively and effectively in support of healthcare. Over 100 arts managers are running hospital arts groups across Britain. I look forward to hearing in the debate about Bromley-by-Bow and the King’s Fund’s Enhancing the Healing Environment programme. The document jointly produced by the Department of Health and Arts Council England in 2007, A Prospectus for Arts and Health, describes a wealth of activity.

What are the benefits of linking the arts with healthcare? It is important to make clear that practitioners are not making exaggerated claims. No one is suggesting that you should send for an artist instead of a doctor, or that a poem can substitute for a drug. What is claimed is that the arts can supplement and enhance the efficacy of conventional medical treatments. Dr Rosalia Staricoff’s research at the Chelsea and Westminster between 1999 and 2002 demonstrated that the integration of the visual and performing arts in healthcare induces significant differences in clinical outcomes, reduces drug consumption, shortens stays in hospital, improves patient management, increases job satisfaction and staff retention, and enhances service. In a later review of the medical literature on the arts and health, Staricoff found significant evidence of reduced anxiety and depression during chemotherapy, improved blood pressure and heart rate in cardiovascular patients, improved clinical and behavioural states in intensive care, diminished stress before surgery and less need for pain-reducing medication after it.

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