EU Working Time Directive (NHS)
Sarah Wollaston (Totnes, Conservative)
I congratulate my hon. Friend Charlotte Leslie on securing this important debate. Why it matters so much is summed up well by Sir John Temple, in his report, "Time for Training":
"Training is patient safety for the next 30 years",
and that is absolutely right.
My own experience is as one of the junior doctors who worked those catastrophically long hours, having qualified at Guy's in 1986. Before coming to the House, I was involved in teaching and training junior doctors and medical students, including F2—foundation year 2 —doctors, so I have the advantage of seeing the system from its very worst through to the current practice. What we had in 1986 was entirely unacceptable. I was routinely working 100 hours a week, and sometimes up to 120 hours a week. I often worked very long shifts, from Friday morning at 8 am through to 6 pm on a Monday, sometimes without any sleep. It was catastrophic, demoralising, dehumanising and, frankly, dangerous. Training was acquired simply through saturation exposure to techniques. Often the training was ad hoc and the supervision was not ideal. There was an ethical practice that we would find unacceptable today. Often the attitude was: see one, do one, and teach one. Sometimes the see-one stage was omitted.
I remember—I hope that this never happens now because it would be, and it was then, entirely unacceptable—having to insert a chest drain into a patient for the first time. I had a telephone propped on my shoulder and a terrified patient on the bed, but there was no alternative to carrying out the procedure. I am happy to report that the patient survived that experience, but it was not enjoyable for either of us. Both of us were half scared to death as the process went ahead. It was the equivalent of being bayoneted by someone who looks about 12 years old. As I have said, extra time was no guarantee of better training in those days. Happily, the NHS today operates to far higher ethical standards.
However, the firm structure that existed then guaranteed a continuity of care. There was not an issue about contacting the junior doctor because the junior doctor never left the hospital. Professionalism was affected in some ways, especially in the attitudes that were engendered. Sometimes there were very paternalistic attitudes from senior doctors, and certainly attitudes towards consent were not as high as they are today. That was engendered by very long hours and not enough attention given to the quality of training for junior doctors. In addressing this matter, we have to be cautious about referring to the old days as the good old days.
We now have a situation in which there simply are not enough staff to cover shifts. Clinics are routinely cancelled as a result of the inflexibility of compulsory rest periods. For example, if a consultant is called in to carry out an emergency endoscopy, they might then be forced to cancel their clinic for the next day, whereas if we had a little more flexibility about the timing of the rest period—perhaps it could happen within 48 hours—we would not see our patients being unnecessarily inconvenienced.
The availability of experienced staff is poor, as has been highlighted in many reports. Nor are we addressing issues of staff fatigue, to which other Members have referred. I want to read out an e-mail that I received this week from a junior doctor who did not wish to be named, who says, "I regularly do seven 13-hour nights on the trot. The argument is that we are given time off to average out our hours over a six-week period. However, we all end up doing the extra hours anyway, partly by covering for colleagues who are off or who do not exist, or simply by staying on after our shift's end because there is so much more to do. So we foundation years are doing the long hours but we are just not being paid for them."
Professionalism faces two problems: either junior doctors work the extra hours and are not paid for them, and are told not to record them sometimes by management; or we develop a clocking-off mentality, which I started to encounter towards the end of the time that I was training junior doctors. For the first time in my career, I heard junior doctors openly talk about clocking off and something not being their problem because they had handed it over to the next doctor on the next shift. That was unheard of when I was a junior doctor: we left when the job was done. We have to be cautious about some consequences in that regard.
Staff absenteeism, which is almost unheard of—I remember one of my colleagues getting tuberculosis and it being a great source of excitement for him, because it meant that he would have some time off for treatment—is increasing. According to a survey by the Royal College of Physicians, the absenteeism rate has increased from 0.8% to 3.5% since the implementation of the directive in 2009. Therefore, the changes towards exhausting shift patterns have not only not resulted in doctors who are less tired, but have led to increased absenteeism. Whether that is due to sickness or to a change in professional attitudes to taking time off is a fine point, but the implementation of the directive has led to serious consequences.
In my area, we have heard about some rotas starting at unacceptable times. I do not think that any hon. Member here would accept that starting a shift at 2 am is acceptable, but it is going on.
As hon. Members have said, we are hearing in our surgeries and postbags that patients and their relatives are noticing changes in continuity of care. The other serious issue is handovers, particularly where senior doctors or consultants are not present. The fact is that shifts do not tally up between junior and senior doctors. Again, referring to the e-mail that I received, on continuity of team, where senior doctors are in different shift patterns there is no sense of a team structure or possibility of handovers being carried out professionally.
Margot James (Stourbridge, Conservative)
My hon. Friend is making an eye-opening speech. Does she agree that there are implications for health inequalities? For a patient who is well educated and knowledgeable about medical matters and/or has a supportive, informed family around them, the issue of handover is perhaps not as serious as for a patient who is not similarly advantaged.
Sarah Wollaston (Totnes, Conservative)
Yes, I agree. But even articulate families of patients tell me that sometimes they find it impossible to track down the doctor who has been looking after their relative. It is not just relatives, but general practitioners, who are having this difficulty. I am afraid that, as a result of this loss of continuity, the times have gone when GPs could phone and be guaranteed to have some
feedback regarding patient care. Handovers have been identified, time and again, as a significant source of mistakes in the NHS, leading to incorrect diagnoses and treatments, often repeated, unnecessary or even inappropriate investigations and poor communication between patients, relatives and medical colleagues.
The directive results in poor team work, a loss of training opportunities and is, as we have heard—I will not repeat it—expensive, not only in terms of staff time, but in the penalties that are applied to trusts if they breach it. Finally, it does not stop doctors working at other hospitals, so it does not necessarily even address the problem that it was designed to address.
That is enough about the problems. What about the solutions? Nobody here advocates a return to dangerously long hours for junior doctors, because tired doctors are dangerous doctors. We want the safest care for our patients. I should like the Minister to respond to the idea that the definition of "on-call" is overly restrictive. Doctors should be able to sleep on site and be available for occasional emergencies without that counting towards the 48-hour week. The requirement for compulsory rest periods should be far more flexible on timing, and we need special consideration of the problems facing district general hospitals. The directive is one thing for staff in a metropolitan centre, but it is causing a particular crisis in many of our district general hospitals. We should maintain individual opt-outs.
The point about the European working time directive, as has been made so eloquently by Kate Hoey, is that European time is not the same as human normal time. Being realistic, the possibility of a rapid change in the directive is small, so we must look at the alternatives. What progress are we making towards a consultant-delivered service? There is no doubt that the directive does not affect all specialities, and its effect can undoubtedly be mitigated by moving towards a consultant-led service and taking up many of the points raised by Sir John Temple in his report.
There is no doubt that consultant-led care is the safest care for our patients. Much more can be done to make use of existing training opportunities. Not all specialties are affected, but when they are the effect can be mitigated by greater use of, for example, simulation, better design of rotas to enable the shifts and working patterns of seniors and juniors to dovetail so that there are better opportunities to train, using hospitals at night, and separating the emergency model from the routine model so that we have far more emphasis on juniors being able to get the training they need.
Real problems are facing juniors now with getting assessments signed off by senior colleagues, and in the level of their daytime routine supervision. The problem is also that they are not having enough experience signed off, so many doctors have to extend their training, which is a huge source of extra cost for the NHS. Some of that could be addressed with better rota and service design.
We all recognise that the NHS functions as a result of the dedication of its staff, and I pay great tribute to all my former colleagues, and recognise what an excellent job they do on our behalf.
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Sarah Wollaston (Totnes, Conservative)
Does my right hon. Friend think that one of the problems with the EU's priorities is that it is demanding a 6.8% rise in its budget, rather than dealing with more pressing problems?
Local Newspapers
Sarah Wollaston (Totnes, Conservative)
My hon. Friend is being most generous. As everyone knows, she is prolific and effective in her use of new media. It is wonderful to see that she also supports traditional media, too; papers such as South Hams Gazette in my constituency, which does a fantastic job. I agree with her completely that this is not about subsidy. Supporting advertising through our local press is the best way to support democracy.
National Planning Policy Framework
Sarah Wollaston (Totnes, Conservative)
I congratulate the Minister on an excellent consultation, which showed all Departments how it should be done. Localism really matters to our constituents, and nowhere more so than in Totnes. Their only regret is that it has come late, and they would like to be able to set back the clock and have local consultation on a number of projects, such as the Riverside development, that are causing great local concern.
Surrogate Parents (Leave, Pay and Allowance Arrangements):
Sarah Wollaston (Totnes, Conservative)
I welcome the significant improvements that have been made in respect of domestic violence, so I shall concentrate on Lords amendment 168.
The Secretary of State says that because welfare appeals often involve arguments about points of fact rather than points of law, welfare appellants should not qualify for legal aid. However, justice is about facts. Many of the people whom we meet in our surgeries have fallen through the gaps in Atos assessments. They may not have ticked the right boxes, but within five minutes it is abundantly clear that the wrong decision has been made. In my experience, the expert and professional advice marshalled by the citizens advice bureaux makes all the difference to whether our constituents receive justice. Cost-shifting might be reasonable, but only if the £20 million per year went far enough to fill the gap that has been created.
Historically, South Hams CAB in my area has received 60% of its funding through legal aid. It was not a question of local authority cuts; the authority had not funded the CAB in the first place. Although some of
that £20 million has gone to my local CAB and will make a significant difference, the CAB has nevertheless had to cut staff, and has lost 45 hours per week of high-quality professional time. Of course we all pay tribute to the volunteers, but it is mostly the detailed and specific marshalling of facts by specialists that determines whether the right decision is made at a tribunal.
I believe that the employment of more decision-makers would make a big difference, but I also believe that the work done by CABs saves us a great deal of money in the long term. I ask the Secretary of State to think again about how much more we can do to fill the gap so that our CABs can maintain the incredibly high-quality professional service that they provide for all our constituents.
National Planning Policy Framework
Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah live
Residents in Churston are desperately trying to protect one of Torbay's last and most beautiful green spaces. It is home to the rare and lovely cirl bunting. Will sustainable development sustain the lovely cirl bunting?
Greg Clark (Minister of State (Decentralisation), Communities and Local Government; Tunbridge Wells, Conservative)
My right hon. Friend the Secretary of State is a twitcher of some renown and will be better placed than I to advise on whether this is a bird that enjoys protection and therefore whether the sites in which it nests enjoy the rigorous protections available.
Eric Pickles (Secretary of State, Communities and Local Government; Brentwood and Ongar, Conservative)
indicated assent .
Health & Social Care Bill
Sarah Wollaston (Totnes, Conservative) (Click here to watch Sarah live)
I have just been reading a kind of risk register—the risk register for Ibuprofen—and I have been reading it in the British National Formulary, which is kind of recipe book and technical how-to-do manual for doctors and nurses. When I read it, I see that it is scary stuff. If I take this medicine, I might develop a fatal skin reaction, I might bleed to death from a stomach ulcer, I might develop kidney failure, I might collapse with pancreatitis, hepatitis and all sorts of things. Why on earth did I take this medicine—this potentially dangerous Ibuprofen?
Listening to Labour and seeing the extreme shroud waving that has been going on is, frankly, enough to give anyone a headache. I took the Ibuprofen because of what I read in the impact assessment. The impact assessment presents a sensible, balanced portrayal of the realistic risks and benefits, and warns me of many points of which I need to take heed. It is far more likely that I am going to develop indigestion from taking Ibuprofen than that I am going to collapse from a fatal skin reaction.
I am not trying to trivialise the issue; believe me, I understand how vital the NHS is to all our constituents and to patients. My view is that the transition risk register has been elevated to a status far out of proportion to what it merits. I completely understand the points made by Lord Wilson and Lord Armstrong—very experienced civil servants who tell us that they would feel constrained in giving full and frank advice. However, we have seen how any detail can be taken out of all proportion in this House; we are all partly responsible for that. As I said, some of the shroud waving over this Bill has been disgraceful, and I know of patients who have been genuinely frightened by it. I would be prepared to see the risk register published, but I accept the point of my right hon. Friend Mr Dorrell that it has to be done on the basis of a clear understanding.
Andy Burnham (Leigh, Labour)
I am listening carefully to what the hon. Lady is saying. I remember, however, a comment that she made to The Guardian, I believe, at the start of this process, when she said that this Bill was like throwing a hand grenade into the NHS. What has changed?
Sarah Wollaston (Totnes, Conservative)
There we go—a deliberate misrepresentation. After I made those comments, I wrote to senior colleagues and told them that what I had said was completely different. I was deliberately misquoted on that statement and have been consistently misquoted by Labour Members. They should go back and look at the original.
I feel that it would be reasonable to present all the risks, but it would be crucial for Members of all parties to recognise that we are talking about a lasting change. We would also need to see a change in how risks are extrapolated out of all proportion to what they represent and an end to the deliberate frightening of patients into believing that they will have to pay for health care, which has been a consistent feature of how this Bill has been misrepresented by Labour Members.
Grahame Morris (Easington, Labour)
In the context of her medicinal anecdote, does the hon. Lady not accept that members of the public at least have the right to read the little inserts in books of pills before they take them? Should we not have the same right to read the risk register?
Sarah Wollaston (Totnes, Conservative)
The equivalent of that is actually the impact assessment. However, as I have said, I would be prepared to allow the publication of the register, because, in this internet age, the misrepresentation of the Bill, and the extrapolation out of all proportion to the risks, has been a complete disgrace.
John Pugh (Southport, Liberal Democrat)
Does the hon. Lady recall saying that the absence of an intermediary body between small GP commissioning and the National Commissioning Board was a serious flaw in the legislation? Clearly that flaw is still there.
Sarah Wollaston (Totnes, Conservative)
I believe that by the time of the next election, our patients will still be going to see GPs. They will still be being referred to the hospitals of their choice, that referral will still be free at the point of use, and it will still be based on their needs and not on their ability to pay. The only thing that will be missing will be an apology from the Labour party.
Common Fisheries Policy
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah live
Does my hon. Friend agree that extending the limit to 12 miles is crucial? People in Brixham, in the area I represent, have done a great deal to conserve stocks, but they see Dutch vessels coming in to fish inside the 12-mile limit and that causes great resentment.
Sarah Wollaston (Totnes, Conservative)
Does my hon. Friend agree that there is a great discrepancy in the way that the EU and the UK define these vessels, with the EU using the under-12 metre definition and the UK using the under-10 metre definition? Would we not be better using a definition based on the extent to which vessels are high catching? There is sometimes an assumption that all under-10 metre vessels have to be low-catching, sustainable vessels, whereas some of them catch large amounts of fish.
Sarah Wollaston (Totnes, Conservative)
Does my hon. Friend accept that Marine Management Organisation statistics reveal that only 33 English vessels caught more than 80% of the monthly catch limits for quotas for more than six months in each of the past four years?
Health & Social Care Bill
Dr Sarah Wollaston (Totnes) (Con):Click here to watch Sarah live
I have good news: people in their 40s and 50s are at the pinnacle of evolution, according to Dr Bainbridge writing in the New Scientist. I do not think my children would agree with that assessment, but they would agree that they feel rather outnumbered. This is a cause for celebration, however, and we should note it in this House: it is a good thing that we are all living longer—after all, the alternative is very unattractive indeed. A man who reaches the age of 65 can now expect on average to live a further 18 years, and a woman at 65 can expect to live even longer—to 85 and a half. We should welcome that on international women's day. This is good news all round, therefore, but these extra years must be lived well. We should add to people's years of life while also helping them live with independence and dignity.
I have the privilege of serving on the Health Committee, and I have also had the privilege of working for 24 years on the front line in the NHS. I have therefore met many carers, and also many people who, sadly, are suffering from dementia. Many Members have commented on that topic however, so I will not discuss it further now.
I want to focus on the Select Committee's recommendations following our inquiry into social care. I acknowledge that, by 2014, an extra £2 billion a year will be spent on social care, and I welcome that investment. There is still an issue that needs to be addressed, however, and it transcends party politics.
As the King's Fund and the Dilnot commission have made clear, demand is outstripping supply—by 9% over the past four years—and the Local Government Association and the Association of Directors of Adult Social Services have stated that this underfunding is a long-term problem. According to the King's Fund, the funding gap could be as high as £1.2 billion by 2014. Also, about 890,000 older people in social care may have a need that is not being met. As the Select Committee heard, some councils are tightening their eligibility criteria, so that people who perhaps would have been classed as having "substantial" needs are now being classed as having "moderate" needs. Other councils are setting a different benchmark, so they are funding only "substantial" needs, rather than both, as they might have done in the past. Obviously, the problem goes beyond the total spend. Government Members are taking a realistic attitude to our national debt, knowing that there are no blank cheques. However, we need to continue to increase our social care funding slightly, so that we can achieve what we want to achieve for our older people: dignity and independence.
It will not matter how much we spend unless we change how we spend it. One thing the Dilnot commission examined well was how we divide our spending. We know that we spend £145 billion a year on older people in England, about half of which goes on benefits, such as pensions, housing-related benefits and pension credits. Some £50 billion is spent on the NHS but only £8 billion goes towards social care. That balance is not right. If we were designing the system from scratch, we would not set the funding in that way. That structural problem has been recognised for decades, but the White Paper and the changes in the Health and Social Care Bill give us an opportunity to address it. I therefore ask the Minister to rebalance things by examining the Select Committee's key recommendation, which was to deliver integrated health and social care, with a single commissioner or a commissioning body, and to drive this joint working by also looking at pooling budgets.
Some wonderful examples of that approach are available, as we found when the Select Committee visited Blackburn with Darwen PCT and Torbay Care Trust. I am fortunate that the Torbay Care Trust covers much of my constituency, because it achieves real results: low average lengths of stay; rapid access to equipment, thus avoiding hospital admissions; and getting people out of hospital much quicker. The key to all that is recognising that keeping people independent in their own homes, rather than admitting them to expensive hospitals, saves money. As has been said, for every £1 we spend on integration, we save £2.65 for the health service—as is so often the case, the best care turns out to be the cheapest care.
I was disappointed to hear the Minister describe the care trust model as an experiment that never really got "out of the lab". I urge him to get back into the laboratory with care trusts, because this is good practice. They bring a positive culture on joint working, pooled budgets and putting patients first. In Torbay, they have considered an imaginary patient, "Mrs Smith", who has complex care needs and at every stage in the system they have designed everything around her, putting her needs first. That sometimes means sweeping away the silo working that we so often see. In many parts of the country, six different phone calls have to be made when dealing with a patient with complex care needs, and there are endless delays and frustrations, and repeated assessments, but Torbay has a care co-ordinator with a single number. We need to adopt that kind of working.
Paul Burstow: The hon. Lady is making an important set of contributions to this debate. That comment I made during the Health Committee's evidence session was very much born out of frustration—it is frustration that my hon. Friend the Member for Southport (John Pugh) has echoed. How we spread best practice and get it adopted is one of the key challenges in delivering more integrated health and social care, and it is one of the things we are going to address in the White Paper. The Select Committee's contribution to that process has been very helpful.
Dr Wollaston: I thank the Minister for that encouraging response. I am glad to hear him say that rolling out good practice is key to this. I ask him to consider the Select Committee's recommendation that the way that we can best drive that is by having a single outcomes framework. We are currently going to have outcomes frameworks for housing, for social care and for elderly people in health. Bringing those together would drive proper integration. Having a single commissioner for all these services would bring people together. If we do not have that, we risk carrying on as we are. When budgets are stretched, as we all accept they are, there is more of a tendency for organisations to say, "This money is for social care"; where spending the money would perhaps improve only health outcomes, there is less of an incentive to spend it. We should consider pooling the budgets, and having a single commissioner and a single outcomes framework. I am not saying that we should be too rigid in imposing how that is done, but we should set out what we expect. In addition, we should recognise how important housing is in this area. We should not leave it out of the equation when we consider how we help older people to continue to live independently.
Damian Collins (Folkestone and Hythe) (Con): Would my hon. Friend include more informal forms of care, such as referring patients who are socially excluded to local walking or singing groups where they can participate and be with other people? There are some good models of that in my constituency.
Dr Wollaston: I thank my hon. Friend for that intervention and agree with him absolutely. In the past couple of weeks, I have visited an organisation called Brixham Does Care in my constituency as well as another, Saltstone Caring, and I am sure that we all have wonderful examples in our constituencies, sometimes involving social enterprises and sometimes charities.
I feel that one of the most encouraging things about the Health and Social Care Bill is that it will give commissioners the flexibility to draw in partners, because there is sometimes an assumption that only the NHS can deliver good care. The NHS remains at the core of good care and I trust that GPs will have the sense to commission integrated care pathways that do not fragment local services. I do not know a single GP who wants to privatise the health service or social care; GPs want the flexibility to bring all these elements together while having the good sense to protect their much valued local NHS services. I am very encouraged to see that there will now be a focus on integration, but I ask the Minister specifically to consider integrated care with a single commissioner, because the Committee felt that that would be the most encouraging way forward.
In conclusion, let me return to Dr Bainbridge in the New Scientist, who describes middle-aged people as
"the most impressive things yet produced by natural selection."
The Minister fits that bill perfectly and has a fantastic opportunity to achieve what we have been trying to achieve for 50 years: an integrated health and social care model. It can be done and I hope that he will look at the Health Committee's report and make it a reality.
European Council
Sarah Wollaston (Totnes, Conservative)(click here to watch Sarah live)
The Assad regime is committing crimes against humanity in Syria. Are there any further practical measures that Britain and the EU can take against both China and Russia to help to stop them colluding with this mass murder, or should individual consumers be making choices in boycotting goods from China until they do?
David Cameron (Prime Minister; Witney, Conservative)
I think that there is evidence that both China and Russia feel the pressure that their previous veto has brought about. The Arab League is absolutely unified in the view that what is happening in Syria is completely unacceptable, and I think that Arab League countries saying that to China and Russia will have an influence, as well as our saying it. I think that there is a lot of diplomatic pressure to be brought to bear, and I hope that in the coming days we can really make that happen.
Prime Minister's Question Time
Sarah Wollaston (Totnes, Conservative)( Click here to see Sarah live)
Will the Prime Minister join me in paying tribute to the courage of the war photographer Paul Conroy from Totnes, who was injured showing the world the horrors of the Syrian regime? Will he join me in thanking all those who helped to secure Mr Conroy's safe passage to Lebanon?
David Cameron (Prime Minister; Witney, Conservative)
I certainly join my hon. Friend in doing that. The role that the media play by being in incredibly difficult places such as Homs in Syria to bring the truth and the news to the world is very important. That is what Paul Conroy was doing and that is what Marie Colvin was doing when she tragically
lost her life. I certainly pay tribute to Paul Conroy and above all, as my hon. Friend says, to the very brave people who helped to get him out of Syria, many of whom have paid an incredibly high price. I can tell the House that Paul Conroy is now safe; he has been in our embassy in Beirut in Lebanon. He is being properly looked after and I am sure that soon he will want to come home.
Health & Social Care Bill
Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah live
I do not know any GPs who want to see inappropriate use of the private sector. They will be doing the commissioning and the public will be able to see what they are doing. Should we not let them get on with it?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
My hon. Friend is absolutely right. I was very pleased to hear what was said by Dr Sam Barwell—I think her name is Barwell.
Sarah Wollaston (Totnes, Conservative)
Barrell.
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
Barrell. One had only to listen to how Dr Sam Barrell and her colleagues in the Baywide clinical commissioning group in my hon. Friend's constituency are providing clinical leadership in south Devon and Torbay to be absolutely clear that the Bill is right to give them that responsibility and that they will use it extremely well.
Cycling
Sarah Wollaston (Totnes, Conservative) (Click Here to watch Sarah live)
Some 30 years ago, I fell in love on a tandem. I have to share the tragedy with hon. Members that last week I turned 50. On my last day of being 49, my husband turned up on the front half of my tandem like a knight in shining lycra and whisked me off for 28 miles on Dartmoor and a 3,000-foot climb. Frankly, I could not care less about being 50—it was a wonderful evening.
It would be a shame if we did not add the joy of cycling to this debate. Cycling makes us feel glad to be alive, improves our mood and quality of life. That is important, because we need to get more people cycling. There is safety in numbers, but we do not want to frighten people away from cycling—we need to send that crucial message. I cycle to work most days in Westminster. When I first started cycling in London 30 years ago, I felt a bit of an oddity, but now whole pelotons sweep past me. Maybe that is because I am getting slower, but it certainly feels a lot safer when there are more cyclists around.
I welcome the campaign from The Times, but I would like it to be broadened to include rural cycling. I represent a rural constituency. Some 36 people were killed on rural A roads, and 26 on urban roads. It is between five and 10 times more dangerous to cycle per mile on a rural A road than it is in the city. I would particularly like to remember the 11 people from my constituency who were killed or seriously injured cycling between 2005 and 2010. In pressing for change, may I also urge the Minister to consider a change to the language and stop calling them accidents? I suggest that driving and overtaking at 60 mph on a rural lane and hitting a cyclist is not an accident—that is a crash. It minimises, and makes it worse for the victims' families if we call them accidents. Let us abandon the language of denial and neglect.
I am grateful to my many constituents who have written to me today to give me their ideas, one of which was on speed limits. I know that other hon. Members have referred to this, but the Netherlands is rolling out changing to 60 kph on rural networks. That is the equivalent of 40 mph, as Nia Griffith said. Will the Minister consider that change? It is disappointing to hear that perhaps that is not something the Department will press forward with. On behalf of all hon. Members, I press him to reconsider. I would also like to reconsider, as many hon. Members have, the issue of a safe passing distance of at least one metre. That should made very clear, be part of the driving test and in The Highway Code.
Cycle training is improving. This weekend, I will visit a Steiner school with a wonderful organisation called Always Be Cycling. Not only does it give excellent training to both children and adults, but it teaches people how to repair their bikes. Most people own a bike, but not everybody uses it. Part of the reason for that may be that they lack the confidence to repair it. I urge the Minister to continue to give more support to such excellent cycling training schemes. I would like to see safer manhole covers—non-slip manhole covers would be an excellent development—and more training for lorry drivers. Finally, I want the Minister to focus on how we separate vehicles from cyclists in rural areas.
I pay tribute to the parents at the Steiner school in my constituency who got together and formed the sustainable transport action group, and actively considered how many children were cycling to school—a miserable 2.8%. By working closely in co-operation with local landowners, the parents have increased that figure to 9.1% in just two years by introducing a safe off-road route. This demonstrates that we really do see effective change.
In contrast, in another part of my constituency, at Littlehempston, with regard to which the Minister has already been helpful, it is a scandal that at the home of the transition movement—Transition Town Totnes—we have possibly the only bridge in the country that keeps communities apart. The final link in National Cycling Network 2, the route running all the way from Kent to Cornwall, could be joined up if there were a safe route through Totnes to Littlehempston. At the moment, if I were a parent in Littlehempston I would not want my children to cycle to school. The road between Totnes and Paignton is hideously dangerous. I have cycled it myself many times.
If only the bridge were open and there was co-operation with landowners and, crucially, the co-operation of a sustainable steam railway—the South Devon Railway—which had the bridge built. The real scandal is that £87,000 of public money went towards the £173,000 cost of building that bridge.
We have all heard the bogus arguments about cycling, including the dangers of vandalism and all that stuff—the resistance that is sometimes seen from communities and landowners who do not understand the real benefits that cycling can bring their communities.
Ben Bradshaw (Exeter, Labour)
I should like to highlight another example, which is the failure so far to complete the cycle route from Exeter to Dawlish, a wonderful route along the Exe estuary, because of the failure of the landowner—the Earl of Devon—to agree to a new bridge over the railway. That bridge would be publicly funded, but he just does not like the look of it.
Sarah Wollaston (Totnes, Conservative)
I thank the right hon. Gentleman for that.
Let us sweep away some of these bogus arguments and have real involvement and drive. I should like Devon County Council, for example, not to be put off from issuing compulsory purchase orders where there are short gaps, so that the local community can really benefit. In this Olympic year, I should like to think that a child living in Littlehempston might be able to start their future Olympic cycling career by cycling from Littlehempston to Totnes.
Health Surgery
Written Answers
Dr Wollaston: To ask the Secretary of State for Health pursuant to his answer of 1 February 2012, Official Report, column 683W, on surgery, what the (a) mean and (b) median waiting time was for open excision of the prostate procedures for patients aged (i) 15 to 39, (ii) 40 to 49, (iii) 50 to 54, (iv) 55 to 59, (v) 60 to 64, (vi) 65 to 69, (vii) 70 to 74 and (viii) over 75 years in each of the last three years for which figures are available. [95480]
Mr Simon Burns: The information is shown in the following table:
Mean and median time waited (days) (1) for finished admission episodes (FAEs) (2) with a main operative procedure (3) of open excision of the prostate for the years 2008-09 to 2010-11
Activity in English NHS hospitals and English NHS commissioned activity in the independent sector
2008-09 2009-10 2010-11
| Age Group |
Mean Time waited |
Median time waited |
Mean time waited |
Median Time waited |
Mean time waited |
Mediun time waited |
| 15-39 | 51 | 34 | 31 | 25 | 24 | 16 |
| 40-49 | 34 | 27 | 35 | 27 | 35 | 31 |
| 50-54 | 39 | 30 | 43 | 33 | 37 | 31 |
| 55-59 | 39 | 30 | 41 | 31 | 38 | 31 |
| 60-64 | 37 | 29 | 38 | 31 | 38 | 31 |
| 65-69 | 38 | 31 | 41 | 31 | 40 | 32 |
| 70-74 | 38 | 30 | 42 | 31 | 41 | 31 |
| 75 + | 47 | 35 | 47 | 33 |
(1 ) Time waited (days) Time waited (days) statistics from Hospital Episode Statistics (HES) are not the same as published Referral to Treatment (RTT) time waited statistics. HES provides counts and time waited for all patients between decision to admit and admission to hospital within a given period. Published RTT waiting statistics measure the time waited between referral and start of treatment. The mean time waited is calculated by summing the time waited for all appropriate FAEs and dividing by the number of FAEs, where the record contains a valid time waited. The median is the middle value when all records with a valid time waited are placed in ascending order of time waited. (2 ) Finished admission episodes A finished admission episode (FAE) is the first period of inpatient care under one consultant within one health care provider. FAEs are counted against the year in which the admission episode finishes. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year. (3 ) Main procedure The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, (eg time waited), but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures. Note: OPCS 4.5 codes used: M34.1—Cystoprostatectomy M61—Open excision of Prostate Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre
Health Breasts Plastic Surgery
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health whether his policy on the replacement of PIP implants will be time limited; and if he will make a statement.
Simon Burns (Minister of State (Health), Health; Chelmsford, Conservative)
There can be no time limit to the duty of care which a health care organisation owes to its patients. If a woman has received PIP implants as part of national health service treatment, the NHS will remove and replace the implants at any time if that is what the woman and her doctor decide. We expect private providers to do the same.
Iran
Sarah Wollaston (Totnes, Conservative)
Is it not in Israel's gift to de-escalate the situation and move away from a nuclear arms race by declaring its own nuclear capability?
Malcolm Rifkind (Kensington, Conservative)
That might be an option, but the political reality is that Israel has had nuclear weapons for 30 years and that has not led to Arab countries threatening seriously to develop their own nuclear capability. The reason the Saudis and others have reacted in such a hostile way to Iran is that they know that Iran is intent on geopolitical dominance in the Gulf region by being the only country of the Muslim world, other than Pakistan, to have nuclear weapons capability or the reality of it. I believe that we cannot rule out a military response because the potential for such a response must be part of the equation.
Alcohol Strategy
Westminster Hall Debate. Click here to watch Sarah live
Sarah Wollaston (Totnes, Conservative)
How far should the state step in to regulate the free market and alcohol? If a jumbo jet fully laden with passengers crashed over Britain every fortnight, drastic action would be taken, and that is what we are talking about—22,000 people die every year in Britain as a result of alcohol. The Office for National Statistics cites the figure of 8,790, but that excludes all the accidental deaths, the homicides, the impulsive suicides and the many victims of road traffic accidents. Alcohol is linked to more than 60 medical conditions, including many cancers.
Some will argue that this is all about personal responsibility and that we should resist the interference of the nanny state, but how can the 705,000 children who live with an alcohol-dependent parent exercise personal responsibility? We have a blind spot when it comes to the destructive effect of alcohol. Yesterday, I spoke to Stephen Otter, the chief constable of Devon and Cornwall police, who told me that the statistics for 2004-05 showed that about a third of violent crime in Devon and Cornwall was related to alcohol. Since then, the statistics have followed a steadily upward path and alcohol is now related to about half of such crime. The trend is increasing, so how do the victims of violent crime feel when we say that we should leave this to the market?
What about taxpayers? The cost of the epidemic is out of control. It is at least £20 billion, but if we look at the finer details of the impact on productivity, we will see that the evidence given to the Health Committee when it looked at this issue showed that the cost could be as high as £55 billion. At a time when the NHS has to make efficiency savings of £20 billion over the next four years, is it right that we are flushing down the drain at least £20 billion a year on alcohol?
The Secretary of State talks frequently about outcomes, so I would like to give some that I think he should look at. Forty per cent. to 70% of all accident and emergency admissions are related to alcohol. The impact on health inequalities is undeniable. The difference between the poorest and the wealthiest neighbourhoods in terms of average life expectancy is about seven years, and early deaths from alcohol-related liver disease are a significant contributor to that. Almost one in four deaths in young people is directly caused by alcohol. That means that every week 12 young people are losing their lives, which is a far higher figure than the number who die as a result of knife crime.
Positive outcomes could be achieved from a reduction in teenage pregnancies, as well as in educational failure and its impact and sexually transmitted diseases. The state has a duty to protect young people and take action. On personal responsibility, harmful drinking does not just affect the individual; it has a knock-on effect on all those around them when they leave a destructive trail in their wake.
If it were possible to solve this problem just through education and gentleman's agreements with the drinks industry and supermarkets, I would say that we should go that way, but that approach has clearly failed. The fact is that when alcohol is too cheap, people die. That was as true in the 18th century with its gin craze as it is
today. This, however, is a general debate on what should be in the alcohol strategy, so I do not want to dwell too long on pricing. Suffice to say that without action on pricing, I am afraid that nothing else will be as effective as it could be. Alcohol is no ordinary commodity and we should not treat it just through market forces.
Philip Davies (Shipley, Conservative)
My hon. Friend appears to be making a coherent argument for banning alcohol altogether. I am concerned that she is like the anti-smoking lobby, which tries to come up with different things to restrict smoking in order to hide its real agenda, which is to abolish smoking altogether. If she thinks that alcohol is such a bad thing and that it does so much damage, why not have the courage of her convictions, follow her argument through and say that alcohol should be banned altogether?
Sarah Wollaston (Totnes, Conservative)
There is a simple reply to that question—it would not work. We have seen that clearly from the efforts at prohibition in the States. I myself enjoy a drink, as I am sure do most Members present. Everyone might like a drink, but nobody likes a drunk, and that is what this is about. It is not about stopping people drinking, but about asking at what point the state should step in to address the real harm. There is a balance to be achieved. I am not suggesting for one moment that my proposals will stop people drinking, and I would not want them to do so. I just want to do something about 22,000 people dying every year in this country.
I propose that we act on price and address availability, marketing, education and labelling, and that we take action on offending behaviour. We should also change the drink-drive limit. Crucially, if we are to put all those measures in place, we also need to help people who already have a problem, which means better screening and treatment in the health service for hazardous, harmful and dependent drinkers. It is also time to send a clear message that we have had enough of drunken antisocial behaviour and violent crime.
On availability—I will try to be brief, because I know that lots of Members want to speak—I welcome the consultation on dealing with the problem of late-night drinking. It is absolutely right that communities should have a greater say in the licensing hours, and I welcome the return from 3 am back to midnight and the idea that those who supply late-night alcohol should contribute to the clean-up cost. Will the Under-Secretary of State for Health, my hon. Friend Anne Milton go further and address whether supermarkets should face greater penalties? The problem for late-night premises and clubs is that their customers are already drunk when they arrive, having pre-loaded on very cheap alcohol. It is crucial that supermarkets should contribute to the clean-up cost.
On marketing, we currently spend £800 million a year on alcohol marketing, which dwarfs the budget given to the Drinkaware Trust, which is industry controlled. There is clear evidence that marketing encourages not only drinking earlier, but children to drink more when they do. Although it is encouraging that fewer children overall are drinking, we should still remember that, after the Isle of Man and Denmark, we are the country with the highest levels of binge drinking and drunkenness in our schoolchildren. The problem is that the current
controls are complex and easily circumvented. There is an off-the-peg solution that is compatible with European Union law, namely to introduce similar measures to those in France under the Loi Évin. Rather than having a set of complicated measures saying what we cannot do, we would set out clearly where alcohol can be marketed and everything else would not be allowed. If we want to protect children, why do we allow alcohol advertising before screenings of 15-cetificate films? It is also confusing that, while we say that alcohol cannot be associated with youth culture or sporting success, we allow alcohol-related sponsorship of the FA cup and events such as T in the park. We need to protect children.
Diane Abbott (Hackney North and Stoke Newington, Labour)
Does the hon. Lady agree that it is no coincidence that, between 1992 and 1996, when the advertising budget for alcohol products marketed at young people rose from £150 million to £250 million, the number of schoolchildren drinking alcohol doubled?
Sarah Wollaston (Totnes, Conservative)
That is a valuable point and clear evidence that marketing encourages children to drink, to start drinking younger and to drink more when they do. We should protect young people—that is an absolute duty of the state.
On education, the most important point is clear labelling. The drinks industry has made some progress, but if it does not meet its targets the issue should be mandated so that people can be clear about how many units they are drinking and receive advice on the sensible limits.
Susan Elan Jones (Clwyd South, Labour)
The hon. Lady is making a powerful case and she can rest assured that most Members present do not think that she is anything like Eliot Ness. On her point about labelling, many of us were rather disappointed that more was not done on the subject of food labelling. Is there is a case for us to do what is done in New York state in terms of food labelling, where an outlet that has more than two branches labels the calorie intake? That gives people a choice and also provides information.
Sarah Wollaston (Totnes, Conservative)
That is an excellent point, and I thank the hon. Lady for making it. Certainly, many young women drinkers would be deterred if they realised what the calorie content is for some of the popular alcohol mixer drinks. That might help to stem the rise in vodka mixer drinking among young women.
John Pugh (Southport, Liberal Democrat)
Is the hon. Lady aware that there is a problem with EU legislation in terms of putting the calorific amount on the bottle?
Sarah Wollaston (Totnes, Conservative)
I thank the hon. Gentleman for making that point. EU legislation is getting in the way of an awful lot of the measures I would like to be introduced.
Returning to why education should not be in the hands of the drinks industry, I would like to draw hon. Members' attention to a problem that arose when the Drinkaware Trust introduced its safe drinking recommendations. It presented those recommendations not as a safe upper limit but a recommended daily amount, as if it was marketing them as a vitamin intake. There is a clear conflict of interest in having the drinks industry controlling education. Although I welcome much of the Drinkaware Trust's work, I do not see the need for the drinks industry to be on the board and would like the Minister to comment on that if possible. Following the report of the Select Committee on Science and Technology, the clear message should be that people should take at least two alcohol-free days a week to protect themselves.
Turning to the health service, relatively few hospitals have a dedicated alcohol service. It is a shame that only 5.7% of dependent or harmful drinkers are able to access treatment compared with 67% of dependent or harmful drug users. There is a clear case for changing that. One third of people who are admitted to hospital with acute liver disease die immediately, and the mortality rate for that has remained unchanged for 15 years. They die without being able to be aware that they even had a problem in the first place.
I would like to make the case for having much better services for screening and early intervention because such an approach works. Some 12% of people who are given brief advice and are informed that they are developing harmful or hazardous drinking traits will significantly cut down or stop drinking. Such a scheme is highly cost-effective, and I would like it to be rolled out, particularly in casualty departments. All hospitals should have a seven-day acute nurse specialist to give brief advice and intervention. That approach should be rolled out further to GP surgeries through the quality and outcomes framework and should also be available in community pharmacies, so that we can let people have clear information and advice. As I say, principally, because such a scheme is evidence based and works.
Regarding people who already have a problem, it is time for all hospitals to have a dedicated alcohol specialist team and an assertive outreach team, particularly to help those revolving-door patients who come in and out of hospital repeatedly. They often have complex mental health needs and issues surrounding homelessness. Again, such an approach has a very strong evidence base and is cost-effective.
The law and order challenge for our police force is vast. May I pay tribute to the people who are at the sharp end of all this? Police officers, street pastors, casualty workers and ambulance staff bear the brunt of the problem. The police are making progress. I pay tribute to Devon and Cornwall police for its work. In my area, people who are picked up by the police can choose between a fixed penalty notice of £80 or attending a course run by Druglink. For those people who attend those courses, there is only a 2% offending rate. That is an example of something very positive that we should be moving forward with.
We should also carefully consider what has been happening in South Dakota in the USA, where they have introduced mandatory breath testing for those convicted of an alcohol-related offence. That has significantly reduced the prison population and has had an effect on domestic violence rates. It would be sensible to at least pilot that in this country to establish whether such a model could work here.
There is a strong case for reducing the drink-drive limit from 80 mg per 100 ml of blood to 50 mg, if for no other reason than for the sake of the 380 people who
are killed every year on our roads and the more than 11,900 who are injured. Of course, we also need to give the police greater powers to breath test people.
What about the industry's role? There is a role for industry in reducing product strength and I welcome those who have already taken action along that line. Crucially, business models should be changed, so that they are based on quality not quantity. The opinion is that that is what has had the greatest effect on the continent, where there have been significant falls in drinking levels because of the move away from drinking vast quantities of plonk towards drinking smaller quantities of quality product. That is something we could do here. I would like to see further work on the use of responsible locations in supermarket aisles and, as I have said, further progress on labelling.
I repeat that it is not the place or the responsibility of the drinks industry to define public health policy. There is a clear conflict of interest. It is time for us to follow an evidence-based approach built on medical advice and for there to be far less involvement with the drinks industry in dictating policy.
I have already been fortunate to lead a debate on alcohol taxation, so I will not repeat the points I made then. I hope that other hon. Members will give us advice on why the introduction of minimum pricing is compatible with EU legislation. I know that Caroline Lucas will do so. The fact that price influences behaviour is, beyond doubt, completely undeniable. There has recently been further evidence from British Columbia about the impact of minimum pricing, based on 20 years of experience. There has also been evidence from Scotland, where the change in pricing policies, particularly those inhibiting multi-buys, have caused a 14% fall in beer sales. I will conclude and allow other Members to contribute by saying that there is no such thing as a cheap drink, but we are all paying a very heavy price.
Valerie Vaz (Walsall South, Labour)
It is a pleasure to speak in this debate with you in the Chair, Mr Caton, and I congratulate Dr Wollaston on securing it. She is a doughty campaigner on the issue and a valued colleague on the Select Committee on Health. Who would have realised that alcohol would be such a hot topic this week? I am not going to name the beer concerned, but clearly certain beers need a name and a photograph to endear themselves to the punters.
The issue is not about responsible drinking or drinking responsibly; it is about dealing with a problem that is getting out of hand both for society and the health and well-being of members of society. One has only to look at the awful images of young people in the street—I do not know why, but it is more offensive when females are involved—lying down and not knowing where they are or who they are. There is a tension between the people who want to make a living and—dare I say it?—effectively, people who want to live.
If people are offered two for the price of one, they find it difficult to resist the offer. A can of beer can be bought with 38p. A packet of M&M's is 60p and if someone goes to Portcullis House, they can buy a banana for 40p. That is more expensive than a can of beer. The fact is that alcohol is a poison; it has an effect on the physiology of a body. For young people who see adverts of people enjoying themselves by drinking, it is very difficult to resist peer pressure. My niece is a doctor who has worked in A and E. She says that the majority of cases are a result of people who are drunk and who become very abusive. I suggest that any hon. Members who do not believe that that happens should visit their local A and E departments. Let us also consider other public servants, such as the police, who have to clear up the mess on Saturday evenings at a cost of £13 billion. Such problems affect my constituency, too.
The facts are simple. The medical profession believes that almost 250,000 lives can be saved over the next 20 years if strong action is taken. I have checked on the Department of Health's website and it links drugs with alcohol and tobacco. It must therefore believe that alcohol is an issue. If it is an issue, the Department of Health must act; a do-nothing strategy does not work.
Sir Richard Doll made a link between lung cancer and smoking. It is only now that people believe that link. What about the link between alcohol consumption and other diseases? I can go through a list: alcoholic hepatitis, oral cavity cancer, hypertension, acute intoxication with loss of consciousness, psychiatric problems, suicidal ideation, depression, anxiety, loss of libido, fetal alcohol syndrome, impaired performance at work and relationship problems. The list goes on: violent crimes, domestic violence and anti-social behaviour. According to the website patient.co.uk, one in 16 hospital admissions are due to alcohol-related illness, with a cost to the NHS of £2.7 billion. In peak times in A and E, that accounts for 70% of admissions. The hon. Member for Totnes mentioned that England is number three in the top 10 drinking countries. Why can we not be the Eddie the Eagle of drinking countries?
Clearly, something has to be done. The hon. Lady should be supported in her attempts to introduce minimum pricing for alcohol. Other measures have been proposed by Alcohol Concern and a coalition of Churches, which have already written to the Prime Minister. There should be a change in licensing hours and pubs should shut at 10 pm again—people knew when they were supposed to go home. Gone is that clarion call of last orders; I urge the Minister to call last orders on binge drinking and to support the hon. Lady.
John Pugh (Southport, Liberal Democrat)
I congratulate my hon. Friend Dr Wollaston on securing this important debate. I should like to take a slightly different track and speak briefly about alcoholism. I am motivated to do so because a friend of mine died recently of alcoholism. I surveyed his circumstances and wondered what conceivably could have been done to prevent his early death—he died at a younger age than I am now.
I looked back at my friend's history in some depth, trying to find out how it all started. It started, as it does for many people who take to drink, with other psychological problems: a lack of self-esteem, to some extent prompted by his family upbringing. It was accentuated by losing his job as a civil servant—he took early retirement—and then by the loss of his marriage due to the strain
induced by alcoholism. I followed his whole history from that stage on. There were periods of abstinence, where he thought he had licked the problem. There were periods of very aberrant behaviour that sometimes involved the police, but often strange and gratuitous acts of mad generosity. There were periods of treatment when he went in for detox, somewhat ineffectively, and came out and resumed previous behaviour.
There was a period when my friend found that Librium worked in discouraging him from drinking, but he could not be given the amount he needed, so I made an arrangement with his doctor to provide him with the drug. For the first time in my life, I became a drug dealer. He could not receive it himself, simply because it was feared that he would take an overdose. Then there were periods of real sickness when he was losing weight rapidly. He was hospitalised frequently. He had blood transfusions and other forms of hospital treatment for a disease that I fundamentally believed to be, at root, of a mental rather than physical kind. Throughout it all, there were long periods of solitary drinking, punctuated by phone conversations to his friends. Those conversations were not always welcome; any drunken conversation tends to be very repetitive and goes nowhere. Ultimately, this was followed by a phone call saying that he had been found dead alone in his flat.
I reflected on this. I believe that, at root, the cause is psychological, but I had seen my friend struggling when applying for NHS services to get any psychological treatment, because most psychiatrists do not want to mess around with alcoholics. They regard them as a complete waste of time. In some cases, their criteria for treating people exclude alcoholics. I was a member of the Public Bill Committee that considered the Mental Health Act 2007, when it was expressly stated that people could not be sectioned for alcoholism—it was not regarded as the kind of disease that fell under that banner.
My friend phoned me on many occasions and pleaded with me to find some sort of mechanism so that he could be sectioned, because he knew that he could not stop himself drinking. Towards the end of the time when I was trying to help him, I found something that I thought might work. It was a treatment that other alcoholics I had known had benefited from. It was a process of very robust detoxification, followed by rehab, and was clearly producing results. It took place outside the primary care trust area in which he lived and was going to cost £10,000. However, I am sure that the total cost to the NHS of his treatment in all those years was much more than £10,000. I could not, in all honestly, believe that the PCT would respond very positively, given its other priorities, to a case that stated, "This man has had a lifetime's history of alcoholism. Now, will you spend £10,000 in getting him out of this fix?"
I am concerned about what we do for alcoholics under the current regime. Having had to look into it, I found that a lot of them go through procedures that are, in a sense, futile—they do not actually take things a great deal further. They detox people and turn them around again, so they go back to the habits that they had before. Unless there is detox plus rehab, this is not a workable solution. This is a big problem for many families and communities, so it is surprising that so
many organisations out there take so much money out of the NHS to so little effect. The NHS needs to drill down and support only those therapies that genuinely work. In the short term, they may be very expensive, but in the long term, they will repay the investment.
On the voluntary consumption of alcohol, there are a couple of factors that can precipitate people along the route that my friend followed: a cultural permissiveness about excessive drinking and a mishandling of how, culturally, we deal with alcohol. At root, that is our problem. Recent licensing law reforms have been an ineffectual attempt to change the culture into a French or continental system where we can manage our alcohol a little better. Certainly, one of the bedevilling features that impact on how society handles alcohol is its cheap and plentiful supply.
Frankly, I am agnostic—I am not sure whether my hon. Friend is right. Doctors are arguing very forcibly for minimum pricing, and I think that the Government are committed to banning below-cost pricing. Both are helpful, but probably neither are sufficient because in themselves neither will guarantee cultural change. As a former teacher, I am agnostic about what education can do. Asking 14-year-olds to forswear a life of alcoholic indulgence is not an easy task, particularly as most of them have not really engaged much in that direction.
We have to accept that alcohol consumption is always regulated in some form or other, but its long history shows that we do not always get it correct and that no system is flawless. We need to look at good practice and at what works—my hon. Friend Stephen Gilbert has some good examples—and roll them out right across the piece. We do not have many good models to imitate in the control of either alcohol or alcoholism, but evidence-led policy is clearly the way forward.
Jim Shannon (Strangford, DUP)
I congratulate Dr Wollaston on securing the debate. For me and my constituents—as I suspect it is for many in the Chamber—this issue is probably the biggest problem in our area. I deal with related issues concerning community safety every day. I rise to give the perspective from Northern Ireland and to outline the critical and crucial programme that we have to ensure that issues caused by alcohol are addressed.
In Northern Ireland, on 1 March 2010, there were 5,846 individuals in treatment for drug and/or alcohol abuse—a very high number. More than 50% were in treatment for alcohol misuse, some 22% for drug misuse and a fifth of those for both. Approximately 75% were male, 27% female. Although it is predominantly a male problem, clearly a large proportion of females are involved. Valerie Vaz said that it is terrible to see young people drunk. It is always particularly upsetting to see young ladies and girls drunk and we certainly have to consider that. The last figures available show that the number of people receiving treatment increased by 5% in just one year, from 5,583 to 5,846—some 500 extra on that list, which again, unfortunately, is an upward-moving figure which we are concerned about.
There are some 1.5 million victims of alcohol-fuelled violence in the UK as a whole. Community safety is threatened by the misuse of alcohol. We have to deal
with that. The police superintendents have outlined and advised that alcohol is present in half of all crimes. That worries me and I suspect that it worries all hon. Members here. It also shows that a high proportion of victims of violent crime are under the influence of alcohol at the time of the assault. So alcohol runs, almost like blood itself, through all the violence and the problems.
Some 37% of offenders had a current problem with alcohol use; 37% had a problem with binge drinking; 47% had misused alcohol in the past; and in 32% violent behaviour was related to their alcohol use. As other hon. Members have mentioned, drinking starts slowly with small indulgence and increases, with peer pressure involved, then there is binge drinking and then misuse of alcohol, with the violence that comes off the back of that.
I want to focus on young people, who need to learn at an early age to drink responsibly when they are of an age to do so at 18. In Northern Ireland, the average age for young people to have their first drink is 11. When I read that I said, "My goodness me, that's shocking." I am aware, as an elected representative, of people who started with one drink, perhaps when their marital relationship broke down, and drank whenever there was alcohol in the house and whenever there was peer pressure. I fought a case for a liver transplant for a young boy who started drinking at the age that I mentioned and at 17 or 18 he found himself a candidate for a liver transplant. If such facts do not shock people to their core, they should. It certainly shocks me.
John Glen (Salisbury, Conservative)
Throughout society there are different instances of alcohol misuse. In the armed forces, in the under-35 age group, alcohol misuse among men is more than double that in the normal population. Does the hon. Gentleman not think that that underscores the fact that a Government approach must recognise pressures in all different elements of society and the different phases at which interventions need to take place?
Jim Shannon (Strangford, DUP)
I thank the hon. Gentleman for his intervention. I agree wholeheartedly and I think that all other hon. Members do. There are different levels. I was developing a point about young people, but there is a drink culture in the armed forces as well. Perhaps that is to do with the job that they do or the time that they spend together. Government has to address those issues.
Around a quarter of 11 to 16-year-olds in Northern Ireland drink regularly and around one in eight have been drunk more than 10 times. One third of 11 to 16-year-olds who have tried alcohol have bought it from a pub, off-licence or shop. There is an issue there for the police in enforcement and for local councils, where the power lies, to monitor and control what happens. There is also a strong link between starting to drink at a young age and problematic alcohol use in later life. A shocking statistic is that one in four young people claim to have been drunk 20 times in the span of a month. The number of 15 to 16-year-olds who binge-drink in Northern Ireland is one of the highest in Europe.
Alcohol use among young people is of particular concern, as they are more vulnerable than adults to suffering physical, emotional and social harm from their own and other people's drinking. The hon. Member for Totnes mentioned what emerges as a result of that. Drinking leads to a high risk of unsafe sexual behaviour, traffic and other accidents, unintended pregnancies, failure at school and mental health problems, antisocial behaviour, vandalism and violence. This is a serious issue and is not a matter of kids being kids: it goes a lot deeper and the problems caused are a lot longer-lasting and have a great impact on our community as a whole. We have to take on the big issues.
I work in my constituency with many community and residents' associations that are determined to stamp out abuse in their areas. There are many ways of doing that, including through education programmes for children. A group called the forum for action on substance abuse works hard with young people; it takes on the hard issues, gets the community and young people involved and ensures that a safer option is available for kids, other than standing at street corners being pressured into trying drink or drugs.
Community groups in my area are working hard to do what they can to end the vicious circle of alcoholism and drug use. Yet they cannot do it themselves; they need Government help and educational, health and police strategies as well. There needs to be a system in place that lends support and advice and co-ordinates events and information to ensure that people are informed.
A recent survey carried out by a church group in Newtownards in my constituency found that under-age drinking was a major issue that led to people feeling unsafe in their neighbourhood. The abuse of alcohol leads to side effects being felt by other people who are not involved, including not feeling safe. The fact is that problems arise when people are mixed with a large amount of alcohol. When young people, who have not yet had the time to develop their moral standards and ideals, are mixed with alcohol we get a generation fuelled by a desire to live in the moment without the thought of consequences.
Alcohol changes personalities. When young people are learning who they are, adding alcohol to the mix means that they will never have a good understanding of who they are. That is why it is essential that we put in place a way of combating under-age drinking by ensuring that drink is not available for people under 18.
When wearing my other hat as an Assembly Member, prior to coming to this House, we raised the age on buying cigarettes—that has been implemented—as it was recognised that upping the age limit would make it easier for retailers to demand identification. It is time that we enforced the same rigour and control with regard to alcohol. It is time for the Government strategy to take on board the involvement of councils and all the other bodies, which is important. We need to take on the issue of sales venues, including off-licences and pubs. We must increase police activity and police the councils in their monitoring pubs and off-licences.
We also have to say something about parental control that perhaps has not been said yet: it is neglected many times. Parents do not exercise the control that they should, but they need to do so.
I support increasing the price of alcohol. It is important that we do that. I do not see anything wrong with that. We must ensure that drink promotions do not encourage binge drinking.
Eric Joyce (Falkirk, Labour)
The hon. Gentleman has made a great deal of sense up till now, particularly when mentioning education, but does he not think that minimum pricing is simply aimed at the least well-off? It is all very well for those who are not affected by it, but essentially that policy is aimed at the least well-off, who may continue to spend the same amount on alcohol, or more, because it will be more expensive for them, and spend less elsewhere.
Jim Shannon (Strangford, DUP)
I thank the hon. Gentleman for his intervention, but we will have to agree to differ. It is important that we increase the price of alcohol, because doing so takes away the ability to binge-drink from those who are clearly involved in it. Let me just get this important point on the record. We have to address all the issues. There are different ways of doing so and one is to increase the price of alcohol.
Diane Abbott (Hackney North and Stoke Newington, Labour)
Does not the hon. Gentleman agree that all the medical and research evidence shows that price is a key factor for two categories of drinker: young drinkers and problem drinkers?
Jim Shannon (Strangford, DUP)
I thank the hon. Lady for her wise words. That is exactly what we feel is important. We have to take on hard issues and address them early. We need a strategy that reflects an in-built protection for children and adults alike.
I urge that the points of view advanced by the hon. Member for Totnes and other hon. Members be considered and that we adopt a strategy that addresses the issues that plague society today.
Philip Davies (Shipley, Conservative)
It is a pleasure to serve under your chairmanship, Mr Caton.
As a libertarian and a believer in individual freedoms, I had hoped that the country had escaped from the nanny-state health police with the end of the previous Labour Government but, sadly, I was clearly naive in that thought. A great many people in the House seem to want to do nothing else but ban everyone else from doing all the things that they do not happen to like themselves, and I was certainly not brought into politics to do that. I urge the Minister not to be seduced by the reasonableness of my hon. Friend Dr Wollaston, because I assure her that, were she to implement everything that my hon. Friend asked for today, my hon. Friend and the health zealots would still return with another list of things that they want the Minister to do. Such people will never be appeased or satisfied until alcohol has been banned altogether.
I want to focus on two points—the futile proposal on minimum pricing, and advertising and marketing. The very principle of minimum pricing goes against all my Conservative instincts and beliefs—the free market and freedom of choice. The process of setting a minimum price is predicated on the assumption that raising the price of alcohol will make those who misuse alcohol behave differently. However, that is an incredibly simplistic belief. It is worrying that people in the Chamber think that, by increasing the price of a bottle of wine by 30p or 40p, or of a can of beer by 40p, all the problems associated with drinking would at a stroke disappear. People who think that minimum pricing will stop young people going into town centres on Friday and Saturday nights with the intention of getting bladdered, or whatever the current term is, are living in cloud cuckoo land. I will not give way, because plenty of other people want to speak and time is pressing. I will happily debate with him in the Tea Room or at some other point, although I am the only one arguing from this perspective, I suspect.
The Centre for Economics and Business Research conducted research on minimum pricing and concluded that the heaviest drinkers are the least responsive to higher prices. For example, at a minimum unit price of 40p, the CEBR found that harmful drinkers, which the policy is supposed to be targeting, would reduce their weekly consumption by only 1.7 units per week, which at the end of the day is less than one pint of weak beer. A report by Sheffield university found that a minimum price of 45p per unit would trigger a 6% fall in overall alcohol consumption and 60 fewer deaths in the first year alone. Yet the Government figures for 2009-10 show that overall alcohol consumption fell by 7%, while alcohol-related deaths rose by 36. Clearly, there is no link between the two.
Minimum pricing treats all drinkers the same, and penalises—financially and practically—the overwhelming majority of adults, all those people who drink alcohol responsibly and in a socially acceptable way, causing harm neither to themselves nor to others. The people who would be most penalised by minimum pricing are those who are already on tight budgets, such as pensioners, people on fixed incomes or those in low-paid jobs. I simply cannot understand how hon. Members, in a time of economic austerity, are prepared to force some of their poorest constituents to pay more for alcohol, when they know full well that the overwhelming majority of those constituents drink alcohol responsibly and in moderation. If hon. Members want to tackle binge drinking and alcoholism, they should focus their efforts on binge drinkers and alcoholics, not on everyone in the country, which would be unjustifiable.
The Institute for Fiscal Studies produced a report on minimum pricing that found that poorer households, compared with richer households, on average pay less for a unit of off-sale alcohol. For example, households with an income of less than £10,000 a year pay 39.8p per unit, while those on a household income of more than £70,000 pay 49.3p per unit on average. As a result, a minimum price of 40p or 45p per unit would have a larger impact on poorer households and virtually no impact on richer ones.
Sarah Wollaston (Totnes, Conservative)
Does my hon. Friend accept that our poorest constituents are paying the price for harmful drinking and that we should consider the effect of alcohol on health inequalities? Furthermore, the Sheffield study showed that minimum pricing at 50p per unit would only add an extra £12 a year to the cost for moderate drinkers.
Philip Davies (Shipley, Conservative)
I do not accept that for two reasons. First, people should be free to spend their own money as they so wish, without having to obtain the permission of my hon. Friend before they decide how to live their life, in particular if no one else is affected; it is their responsibility. Secondly, the one thing that I have learned about alcoholism is that alcoholics will go to any lengths to get the alcohol they need; if we increase the price of alcohol, all that will happen is that they will give over a bigger proportion of their money to buying alcohol, leaving them less money to spend on other things—it will not change their behaviour at all.
I want to touch on advertising, but not for long. I opposed the ten-minute rule Bill of my hon. Friend the Member for Totnes on advertising. I used to work in marketing, for my sins, and I want to stress its purpose: it is about brand awareness and increased market share. When Cadbury sponsored "Coronation Street", does anyone really believe that at the moment the Cadbury advert appeared at the start of the programme everyone leapt off their seat, switched off the TV set and dashed to the nearest newsagent to buy a bar of Dairy Milk? Of course not. All that Cadbury hoped was that, next time people went into the newsagent, they would buy a bar of Cadbury's Dairy Milk rather than a Kit Kat. That is the whole point of marketing.
If we curb alcohol advertising, more than £80 million of revenue for the broadcasting industry would be jeopardised, leading to a direct loss in programme making in this country. It would also wreak havoc on sporting events, and I expect that the Department of Health would prefer to encourage as much sporting activity as possible. We already have a robust system of advertising regulation in this country, administered by the Advertising Standards Authority and in this case the Portman Group, endorsed by Ofcom. We hear that so many young people are made aware of alcohol by advertising, but lots of young children know about car advertising and yet it does not mean that they go straight out and start driving a car, merely because they are aware of the advertising.
I worry where this will stop. Will my hon. Friend the Member for Totnes return to the House in a few months' time and urge us to ban the advertising of cream cakes, pizzas, chocolate, fish and chips or curry, because they are all bad for us if eaten to excess? This is a slippery slope, and certainly not one that I am prepared to support.
Caroline Lucas (Brighton, Pavilion, Green)
I congratulate Dr Wollaston on securing this important debate, and I pay tribute to her for tenacious campaigning on the subject. I am also pleased to follow Philip Davies, because our views are about as divergent as they possibly could be, so there is an opportunity for some balance.
I want to talk about minimum pricing, because the sale of alcoholic drinks at pocket-money prices is costing not only the economy anything between £20 billion and £25 billion a year, if we look at the total costs, but many thousands of people's lives. This is a fundamental public health issue: people are getting avoidable diseases and dying early. As others have said, those of us who are on the side of supporting minimum pricing do not want to stop people having fun and enjoying a drink; we want a strategy in place to ensure that as far as possible people drink as safely as possible.
The bottom line is that alcohol currently presents us with a massive public health problem in this country. With the British Medical Association, the Royal College of Physicians and the Royal College of Nursing, I believe that we need to act on minimum pricing. John Pugh was right to say that it is not a panacea and, on its own, minimum pricing will certainly not solve the problem, but it is an important tool in our armoury, so we should use it.
As mentioned already, the Government's policy so far is that, instead of supporting minimum pricing, they will bar the selling of alcohol below the rate of duty and VAT. I welcome that as a step forward, with Ministers acknowledging price as a factor in how much people drink, but the policy does not go far enough, as evidenced by the drinks industry calling the approach "pragmatic"—in other words, the industry is not bothered by it. Health campaigners point out that one of the reasons why the industry is so relaxed is because the price floor is probably too low to have a real impact. That was supported by evidence from an investigation by The Guardian newspaper last year, which showed that of 4,000 price promotions, just one would be affected by the Government's policy to bar selling alcohol at below the rate of duty and VAT. I am interested to hear the Minister's response to that research. If the Government fail to act on the evidence, and if they refuse to stand up to the drinks industry, I fear that their alcohol strategy simply will not work. Resources and good intentions will be wasted because a successful strategy must be underpinned by measures to address the easy availability of alcohol.
Local communities are, rightly, worried and want action. For example, in Brighton and Hove, we have been trying to address the £100 million annual bill facing the city from the impact of over-consumption of alcohol. In October last year, the city started what it called "the big alcohol debate", which closed last month. Its purpose was to hear what the residents of Brighton and Hove had to say about alcohol in the city. It is deeply worrying that 40% of the 1,300-plus respondents said that they avoid parts of the city because of the way in which drunken people behave. A clear message came through from Brighton's debate that people are concerned about the too-easy availability of alcohol, and the effects of drunken behaviour in the city.
I am proud of the clear and radical action that city councillors have recently taken on licensing with an expanded cumulative impact area that allows councillors to take into account the impact of other licensed premises in the area when considering new applications. Councillors in the city are doing all they can to work closely with the police, the NHS and many other agencies that must pick up the pieces resulting from the lack of a clear alcohol strategy. The point of the debate is that there is only so much that can be done at local level without a clear lead from the Government on the key issues, which include minimum pricing. Price can and does regulate people's consumption patterns, which seems to me why so much of the drinks industry is so worried about it.
By way of illustration, I shall say a few words about the continued sale of white cider. The issue concerns me greatly, and has been raised in Brighton and Hove as a significant problem connected with the level of street drinking and drunkenness in the city. It makes the case that minimum pricing has an important part to play. White cider is often sold at a cheaper price than bottled water. It is consumed for no other reason than instant intoxication for homeless and dependent street drinkers, as well as young at-risk drinkers. The charities that work with street drinkers report that white cider has a particularly damaging effect on the health and behaviour of the people consuming it. The harm it causes should help to convince the Government that minimum pricing is part of the answer.
I have contacted the supermarkets that continue to sell the product, albeit on their bottom shelves where they know that those who are ill enough and desperate enough to need it will be able to find it. I am encouraged that in response, those supermarkets have agreed to meet me to discuss the issue. However, whatever the outcome of that meeting, white cider will still be bought by many small retailers from cash and carry outlets.
Bigger retailers can and should take a lead, and stop selling this dangerous and damaging substance, but we need action from the Government if we are to eradicate it from our streets and from the lives of vulnerable drinkers. I shall illustrate what a difference a minimum price would make to the cost of white cider. Currently 2-litre bottles of Diamond White cider, consisting of 7.5% alcohol by volume, cost around £3.50 for around 15 units of alcohol. At a minimum price of 50p, the cost would be £7.50, and at 45p it would be £6.75. The point that a minimum price would not unduly penalise people who drink more moderately is underscored by the fact that an average bottle of wine—750 ml at 12%—would cost £4.50 with a 50p minimum price, or £4.05 if it were 45p.
Eric Joyce (Falkirk, Labour)
The hon. Lady has switched from white cider to wine, the implication being that people who drink moderately drink wine. In fact, she is arguing that less well-off people should pay more and middle-class people should pay the same. That identifies that the problem is only with less well-off people.
Caroline Lucas (Brighton, Pavilion, Green)
I reject what the hon. Gentleman says, because I am showing that price will have a big effect on people who consume vast amounts of alcohol, but not for most people who consume it more moderately. I could have given the same figures for cider. Clearly it will not put off moderate drinkers. The big red herring in this debate is that if the price of alcohol is increased, life will suddenly become enormously difficult for moderate drinkers. As the hon. Member for Totnes has said, with a 50p per unit minimum price a harmful drinker would spend an average of £163 a year extra if they continued with the habit, but a moderate drinker would spend an extra £12 a year. I do not want to inflict an extra £12 a year on anyone, but when that is set against the overall cost of alcohol misuse to society, it is far outweighed by an extra £12 for people who continue with their moderate drinking behaviour.
I am aware that Ministers are raising concerns that a minimum price per unit might contravene European competition laws and would be challenged in the courts. My understanding is that the European Commission has indicated that minimum pricing does indeed have the potential to target heavy drinkers. If minimum pricing is to satisfy the law, it must be shown that it is in proportion to the problems caused by alcohol without unduly affecting competition. There is a strong case for saying that action on pricing is proportionate to the problems caused, not least the chronic disease that we have heard about, thousands of deaths, and an estimated cost to the economy of between £20 billion and £25 billion.
In 2009, before the Scottish Government proposed introducing a minimum price policy, a written question on whether minimum alcohol retail prices violated EC law was answered by the European Commission. It clearly set out that treaty rules on the free movement of goods would not be contravened as long as price rules applied to all relevant traders operating within the national territory, and if they affected in the same manner in law and in fact the marketing of domestic and imported products. No one is suggesting that we treat imported and domestic products differently. We could make a strong case, if the political will were there to do so, for saying that such a response is proportionate.
Alcohol-related Crime
Sarah Wollaston (Totnes Conservative)
What estimate has the Minister made of the extent to which cheap alcohol is fuelling the rise in domestic violence?
James Brokenshire (Parliamentary Under Secretary of State, Home Office; Old Bexley and Sidcup, Conservative)
My hon. Friend highlights the very relevant issue of the connection between alcohol and domestic violence and abuse in the home. Studies have drawn attention to that, which is why we are seeking to take the action that we have been taking, through controls on licensing and addressing the issue of pricing. We will be providing further details on the Government's alcohol strategy shortly.
Justice
Sarah Wollaston (Totnes, Conservative)
Devon Rape Crisis was launched last November and has already helped many victims of sexual violence across Devon, but it and Rape Crisis England and Wales are calling for changes to make it easier to identify the number of victims of crimes that are sexually motivated. Will the Secretary of State meet Rape Crisis and me to discuss how we can make such crimes more easily identifiable, and to hear about the excellent work of Rape Crisis?
Crispin Blunt (Parliamentary Under Secretary of State (Prisons and Probation), Justice; Reigate, Conservative)
My hon. Friend has raised an important issue, and I would be very pleased to meet her and colleagues from Rape Crisis to look at the linkages, and at the proper examination and analysis of data in this area. It is important that we continue to improve our knowledge.
Victims and Witnesses Strategy
Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah live
As a result of funding from the Ministry of Justice, women who have been victims of sexual crimes in my constituency can now benefit from help and support from Devon Rape Crisis. As a patron of Devon Rape Crisis, I ask the Secretary of State to ensure that a sufficient amount of the £50 million that is going to be taken from convicted criminals will go towards long-term secure funding for rape crisis centres around the country.
Kenneth Clarke (Lord Chancellor, Secretary of State, Justice; Rushcliffe, Conservative)
The Government will continue to look at rape crisis centres as a national responsibility and consider funding them from the centre. We have been able to open, I think, four new ones since we came to office, but for all existing ones we have for the first time pledged funding for three years, providing them with more sustainable security than under the previous year-by-year changes. I can assure my hon. Friend that we will continue to give very high priority to improving support for such valuable centres as much as we possibly can. I think she agrees and is prepared to say that our record so far is pretty good. My right hon. Friend the Home Secretary certainly helps me to ensure that we keep concentrating resources in this area.
Communities and Local Government: Empty Properties
Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah live
What steps he is taking to make (a) empty houses and (b) vacant properties above shops available for rent.
Grant Shapps (Minister of State (Housing and Local Government), Communities and Local Government; Welwyn Hatfield, Conservative)
Our strategy for empty homes applies to all properties, including flats above shops, but we are also committed to revitalising high streets and shortly will publish the Government's response to the Mary Portas review.
Sarah Wollaston (Totnes, Conservative)
The South Hams is one of the least affordable places to live in the UK, with house prices on average 16.7 times the average income, and more than 1,200 households on bands A to D of the housing waiting list. What does the Minister plan to do to address these affordability issues in the South Hams?
Grant Shapps (Minister of State (Housing and Local Government), Communities and Local Government; Welwyn Hatfield, Conservative)
My hon. Friend is right that for levels of non-affordability in many areas to have reached 16.7 times average earnings is unacceptable. The Under-Secretary, my hon. Friend Andrew Stunell, referred to the social house building programme and the 170,000 being delivered during this Parliament. She will also be pleased to hear about the provisional allocation, within the local authorities comprising her constituency, of more than £3.5 million under the new homes bonus, which will also encourage greater affordability when used to build more homes. We are also considering allowing homes over shops, and many other changes coming from the Portas review.
Food prices and Food Poverty
Sarah Wollaston (Totnes, Conservative)
In the brief time that I have to speak, I shall make three points: first, about the link between food poverty and obesity; secondly, about the impact of loss leaders; and thirdly, about the role of local food production.
Data from the health and social care information centre show that one third of children are now obese, but the link between deprivation and the risk of obesity is stark. We see it in reception class, but it becomes even starker as children move through to year 6, where currently 23.6% of the poorest children, but only 12.8% of the wealthiest, are obese. The reason why is the difficulty not just with buying food, but with the types of food that are the cheapest, with people's choices being driven by supermarkets and with the operation of loss leaders.
I would not call on the adjudicator to issue an outright ban on loss leaders, because previous inquiries have shown that such action does not reduce the cost of food overall, but there needs to be much greater clarity about the cross-subsidies that loss leaders introduce, as subsidising products such as alcohol, chocolate and crisps increases the cost of much healthier foods. We need to address that issue, because one of the Labour Government's greatest failures, as identified by the King's Fund, was in making progress on health inequalities, which we
cannot address without tackling issues such as alcohol and nutrition. That is an important point, because obesity affects children's life chances and costs the rest of us. We know that, unless we address obesity, by 2050 it will cost the country about £10 billion a year, so the adjudicator represents good value for money.
In addition to addressing loss leaders and ensuring that people have access to good-quality food, Ministers should also consider the role of local food production. I pay tribute to Transition Town Totnes and the Campaign to Protect Rural England for clearly setting out how supporting good, local, sustainable food webs and delivering good, fresh, seasonal produce does not necessarily result in higher prices, and for showing that we can use measures to encourage the right choice to be the healthy choice.
Future of Town Centres and High Streets
Sarah Wollaston (Totnes, Conservative)
Does the hon. Gentleman agree that our high streets have a wider role in supporting local supply chains and increasing local resilience? In some areas, there is still a threat not only from out-of-town developments but from large distribution depots, which are merely displacing jobs rather than creating new ones.
Breast Implants
Sarah Wollaston (Totnes, Conservative)
I welcome the clear commitment to putting women's health needs first in this context, but is not the heart of the problem the obvious conflict of interests for private clinics when it comes to the provision of long-term safety statistics? Will my right hon. Friend ensure that any future system allows women to self-report to the registry—albeit with a follow-up from specialists for confirmation purposes—so that we can have a complete picture of the long-term complications caused by devices of this kind?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
My hon. Friend is right. When Sir Bruce and his colleagues are considering the establishment of a wider registry, they will consider not only the possibility of self-registration but the possibility of making clinical professionals responsible for the publication of such data. The responsibility should not rest solely on providers or manufacturers.
Health
Oral Answers to Questions.
Sarah Wollaston (Totnes, Conservative)
I know the Secretary of State cares deeply about outcomes in health. Will he add his support to the campaign for a minimum price for alcohol in England and Wales?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
The Government will shortly publish our alcohol strategy, which will set out how we hope to deliver continuing success in the reduction of alcohol consumption and abuse.
Home Department: Smuggling: Tobacco
Written Questions
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for the Home Department what estimate she has made of the expenditure incurred by her Department on salaries for full-time investigation staff allocated to the tackling tobacco smuggling strategy for staff (a) engaged in detection, (b) engaged in investigations, (c) working on intelligence matters and (d) in total in 2009-10.
Damian Green (Minister of State (Immigration), Home Office; Ashford, Conservative)
The UK Border Agency deployed an estimated 1,504 full-time equivalent staff to the tobacco strategy in 2009-10, assigned to detection and intelligence duties. Further and more detailed information is not available as the Agency's expenditure records are not broken down by specific functions and activities.
Investigation and the provision of legal advice in relation to tobacco smuggling remained the responsibility of HM Revenue and Customs.
Dr Wollaston: To ask the Secretary of State for the Home Department how many staff in the UK Border Agency were assigned to implementing the tackling tobacco smuggling strategy in 2009-10; and how many such staff were engaged in (a) detection, (b) intelligence gathering and analysis, (c) investigations and (d) the provision of legal advice. [83505]
Damian Green: The UK Border Agency deployed an estimated 1,504 full-time equivalent staff to the tobacco strategy in 2009-10, assigned to detection and intelligence duties. Further and more detailed information on expenditure is not available. Investigation and the provision of legal advice in relation to tobacco smuggling remained the responsibility of HM Revenue and Customs.
Health
Sarah Wollaston (Totnes, Conservative) (Click here to see Sarah speaking live)
It is a pleasure to follow Keith Vaz.
I want to speak on behalf of community hospitals, both locally in my own constituency and nationally on behalf of CHANT—Community Hospitals Acting Nationally Together. Before coming to the House, I worked as a GP in rural Dartmoor, covering the smallest hospital in England at Moretonhampstead. I was privileged to see first hand how a personal and compassionate service transformed the care and saved the lives of so many of my former patients.
We know that we need to change the way that health care is delivered. As we all live longer and with multiple complex medical problems, we need to focus on preventing admissions to acute hospitals in the first place. Community hospitals are ideally placed to deliver that care. There are four in my constituency: Totnes, Brixham, South Hams in Kingsbridge, and Dartmouth. I pay tribute to all their staff, and to the volunteers in the leagues of friends.
The leagues of friends are a vital resource in all our constituencies. They raise an incredible amount of money—between £7 million and £8 million has been raised in south Devon alone over the last decade—and are made up entirely of volunteers who co-ordinate fundraising events as well as managing donations and legacies, and then plan how those projects should be managed in the future.
As a direct result of voluntary contributions, patients in South Hams hospital are able to have their chemotherapy locally rather than making the long, arduous journey to Plymouth, and in Brixham, the league of friends has donated £200,000 towards the new hospital ward. There have been numerous projects in Dartmouth and Totnes, all improving dignity, privacy and comfort and raising money for equipment. However, the contributions go way beyond funding. Local residents volunteer their services on the wards for both patients and visitors, and directly improve the quality of care.
I am delighted that the coalition has repeatedly expressed its commitment to community hospitals, and has recognised the vital role that they play in rural areas in particular. However, I should like the Department of Health to respond to a number of concerns and uncertainties so that these much-loved community resources can be put on an even stronger footing. The issues that I wish to raise are the ownership of the community hospital estate and the operation of the current tariff system.
I have heard from some leagues of friends that they are holding back funding of projects as a result of concerns expressed by some of their members about the future ownership of community hospitals. They are afraid that money raised by local communities and invested in local services could end up being lost to those communities should the ownership of the estates pass elsewhere. I know that the ownership of the premises in South Devon will pass to Torbay Care Trust, but concern is still being expressed at a high level in my local NHS about the possibility that the future ownership arrangements will inadvertently decouple community infrastructures from the communities that they serve. Those communities seek reassurance that if for any reason the provider trust that owns a community hospital relinquishes ownership of a building, selling it without reinvesting in an improved and equally local facility, the funds raised by local communities will be returned to them in full.
Harriett Baldwin (West Worcestershire, Conservative)
There are three fine community hospitals in my constituency: Pershore, Tenbury and Malvern. My hon. Friend may wish to invite her constituents to visit the Pershore hospital, which is owned by the district council and operated by the NHS care trust. It is an interesting model.
Sarah Wollaston (Totnes, Conservative)
I thank my hon. Friend for that intervention. There is an understandable fear that many premises in the most stunning locations, which have been bequeathed to their communities by local benefactors, could end up being sold off with communities powerless to intervene. I want to touch on some of the alternative models. Communities are reassured that for the time being there is a clear directive providing that in future only NHS organisations may own the estate, but I agree with my hon. Friend that local models can provide alternatives. NHS ownership may, in some circumstances, create difficulties, and inhibit the development of hospitals' full potential. For example, the Community Hospitals Association is concerned that in some areas management may pass to mental health organisations with little experience of managing community hospitals. There is also a concern that passing management to predominantly secondary-care-focused trusts could cause the hospitals' interests to be sidelined.
In many parts of the country, social enterprises have been formed to provide community services, but currently they cannot own and invest in premises, and nor can GPs acting as commissioners. May I ask the Minister to look into how ownership arrangements could be made more flexible in order to provide local solutions, while at the same time guaranteeing to local people that the value of their assets will be safeguarded for their communities? I hope that all our leagues of friends will then feel confident enough to continue to invest for the future.
Let me briefly raise the issue of the system of tariff payments. As the Minister will know, currently the tariff is not fairly distributed, which means that community hospitals are often not funded for the provision of step-down care. The acute hospital receives all the funding irrespective of how long the patient remains in its care, although community hospitals are ideally placed to provide safe step-down services. I therefore that hope the Minister will give an update on how and when the tariff will be reformed to assist community hospitals to offer the full range of services they wish to provide.
The main focus should be on avoiding the need for acute hospital admissions in the first place. Community hospitals have a key role to play in providing many services, not just in-patient and palliative care. I join the Community Hospitals Association in calling for more investment in research and evaluation of their role and contribution to high-quality care and the wider social care economy.
Finally, I wish all Members and staff of the House a very happy Christmas.
Alcohol Taxation
Sarah Wollaston (Totnes, Conservative) ( Click here to watch the Debate live)
I have watched many of my former patients die as a result of alcohol; there is nothing like witnessing the end of the journey to focus one's attention on the need to prevent people from becoming harmful drinkers in the first place. We are witnessing an unprecedented rise in hospital admissions and deaths from alcohol-related liver disease. Alcohol is directly responsible for more than 6,500 deaths and more than 1 million hospital admissions a year. It is the single largest cause of mortality in young people, accounting for one in four deaths among 15 to 24-year-olds—far more than die as a result of knife crime. There are now 1.6 million dependent drinkers in England alone.
However, the point about alcohol is that it does not just affect the drinkers themselves; it has a devastating effect on their families, especially children, and on entire communities. There are 705,000 children living with a parent who is a dependent drinker. Parental alcohol abuse is a factor in half of child protection cases.
The full costs are hard to quantify, but the bill runs to at least £20 billion a year.
Kevin Barron (Rother Valley, Labour)
The hon. Lady will know that I chaired the Select Committee on Health in the previous Parliament. We conducted an inquiry into alcohol, and it was the first time in many decades that a Select Committee had done that. We took evidence that the cost to the NHS could be as high as £55 billion a year. The situation is similar to that with tobacco: in the end, no one really knows the cost of the use of these products.
Sarah Wollaston (Totnes, Conservative)
I thank the right hon. Gentleman for that intervention. He is absolutely right. The study to which he refers took into account the reduced quality of life years associated with alcohol, which are extremely difficult to quantify.
In three years' time, the Government will be judged not just on the economy, but on other tangible markers, such as violent crime, the prison population, health inequalities—even markers such as teenage pregnancy. It is hard to think of a social marker that is not affected by alcohol.
However, there are other compelling reasons for taking action. At a time of squeezed police budgets and when the NHS needs to find efficiency savings of £20 billion, we should not be pouring that money down the drain because of the problems that this country has with alcohol. About half the offenders in some prisons are jailed for an offence in which alcohol played a significant role. The relationship between crime and alcohol is not linear, but the positive association between violent crime and alcohol is compelling. There is a wealth of evidence to link alcohol price increases and reduced rates of homicide, rape, robbery, assault, motor vehicle theft and domestic violence.
Brandon Lewis (Great Yarmouth, Conservative)
I congratulate my hon. Friend on securing this important debate. In terms of alcohol price increases having the effect that she has just outlined, does she agree that one easy, fast
and effective route that the Government could take to stop under-priced and low-priced alcohol being sold would be to go ahead with duty stamping on beer and wine to ensure that alcohol is sold at the right price and, equally, to save the Government up to £1 billion a year of revenue that is currently lost through the tax being avoided?
Sarah Wollaston (Totnes, Conservative)
That is one of the options. I would like to outline an alternative, but I certainly thank my hon. Friend for that intervention.
Numerous studies around the world have shown public health benefits as a result of price increases and taxation policies, so is it not time for some evidence-based politics? The trouble is that there is no single, simple solution. We know that there are other factors in addition to price: availability, our drinking culture and marketing. Those are all key factors, but today's debate is about taxation, so I will focus entirely on price, not because the others do not matter, but because they are not within the remit of the Treasury.
It is worth pointing out that most health experts feel that changing pricing is the most effective way of achieving results. I draw the attention of my hon. Friend the Minister to the letter in today's edition of The Daily Telegraph signed by 19 organisations. I know that the Treasury is aware of the costs to our economy of dependent drinkers and binge drinking, so I will not ask my hon. Friend to respond in detail on those points. As disposable incomes have fallen, so too has the overall consumption of alcohol, but that comes on the back of decades of steady increases. Alcohol remains about 44% more affordable than it was in 1980.
In 2010, a total of 48.4 billion units of alcohol were sold in the UK. Of those, 31.8 billion units—about two thirds; the great and increasing majority—were sold by the off-trade. The widening gap between the price of on-licence and off-licence alcohol is becoming far more significant and is fuelling the rise in home drinking. Harms are not going down as we might expect as a result of the small fall in overall consumption, because of the low-price deals that are still very widely available in supermarkets, garages and convenience stores pretty much around the clock.
Guy Opperman (Hexham, Conservative)
I congratulate my hon. Friend on obtaining the debate. The north-east has one of the worst rates of liver disease: we have seen an increase of 400% since 2002. I accept entirely the point that she makes about robust regulation in terms of minimum pricing, but does she accept that the local supermarkets in our individual constituencies can make a specific difference on the pricing and availability of alcohol and the way in which it is presented to our constituents?
Link to thisHansard source (Citation: HC Deb, 14 December 2011, c335WH)
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Sarah Wollaston (Totnes, Conservative)
I absolutely agree. Most of the alcohol-related carnage is caused by young binge drinkers and by heavy or dependent drinkers, so the issue is not only about the availability of alcohol in outlets throughout the country. The harm is not going down, because those groups are the ones that are most attracted by the low-price deals.
Andrew Griffiths (Burton, Conservative)
I congratulate my hon. Friend on securing this important debate. I declare an interest as chairman of the all-party beer group. I agree with her about the need for the Government to take action. Does she agree with me on this point? Twenty years ago, the price in a supermarket and the price in a pub were much the same at about 75p a pint. Today, a pint costs £3.10, £3.20 or £3.30 in a pub, whereas in a supermarket it remains at about 70p or 80p. That has encouraged people to drink more and more at home and discouraged them from drinking in a safe, supervised environment such as the community pub that is at the heart of many of our towns and villages.
Sarah Wollaston (Totnes, Conservative)
I thank my hon. Friend: he makes an excellent point about the decline in rural pubs and why any action that the Minister takes has to take into account the impact on rural pubs and, of course, town pubs.
Jason McCartney (Colne Valley, Conservative)
I congratulate my hon. Friend on securing the debate. I have to declare an interest. I worked behind the bar in one of my local pubs on a recent Friday evening, celebrating British beer week. I am also a member of the all-party beer group. I echo the comments made by my hon. Friend Andrew Griffiths. In a pub, we have a safe environment; we have a landlord who is licensed. That encourages responsible drinking. The pub I worked in—the Wills O'Nats in Meltham—was a family environment. Young people were there, drinking soft drinks until early in the evening. Does my hon. Friend agree that any taxation put in place by the Government should not just be about revenue streams, but should encourage responsible drinking in the community pub environment?
Sarah Wollaston (Totnes, Conservative)
I absolutely agree. The point is that in the UK harmful drinkers buy 15 times more alcohol than moderate drinkers, yet they pay 40% less per unit. Those are the groups that are most influenced by pricing. That is why I agree with my hon. Friends that the problem does not come from pubs.
I did have a prop for the debate. Last weekend, my researcher was able to access 2 litres of own-brand cider from Asda for £1.48, which worked out at just 18p a unit. With a four-pack of bitter for 68p, the price was just 17p a unit. I particularly objected to the labelling. It said, "Asda Smart Price". I put it to hon. Members that there is nothing smart about charging 68p for four units of alcohol. That would send a woman well over the safe limit for a single day for just 68p.
Mike Wood (Batley and Spen, Labour)
I, too, congratulate the hon. Lady on securing the debate. It is significant that Asda is the supermarket she cited, because it is seen as the one supermarket that has so far taken a lead in trying to get to the bottom of two-for-one offers and the like. If Asda is still behaving as badly as that, what can we expect from the others?
Sarah Wollaston (Totnes, Conservative)
Asda has acquired a veneer of respectability by signing up to the new responsibility deal, but I would ask whether it is killing its customers with such pricing. Asda has liked to boast of its responsible approach in removing low-price offers from its foyers, but I put it to Asda that those who conduct proxy sales
on behalf of teenage binge drinkers have no trouble in locating the cider at the back of the store. It is the ultra-low pricing that is causing the carnage.
I recognise that the Government are trying to introduce a floor price for alcohol that will include duty and VAT. The trouble is that the policy will not go far enough to solve the problem, as it will still allow white cider to be sold at below 10p a unit. It will establish the principle of minimum pricing without the prospect of delivering any meaningful results. Will the Minister set out what responses she has received from public health experts on that point? All the public health advice that I have seen is entirely pessimistic. The Daily Telegraph pointed out today that the policy will catch only one in 4,000 of the drinks currently being sold and will do nothing to save lives.
Andrew Griffiths (Burton, Conservative)
Does my hon. Friend agree that it was this Government who introduced, for the first time, a ban on below-cost selling? That was an important line in the sand—the first time that a Government have said that selling booze too cheaply is a bad thing. The question now is, how cheap?
Does my hon. Friend share my concern that the current tax system seems to encourage people to drink ever stronger and stronger drinks? The tax system encourages the strength of wine to increase dramatically, and the drink of choice of young people is now vodka.
Sarah Wollaston (Totnes, Conservative)
I thank my hon. Friend for making that point. We need to show what minimum pricing means in practice if we set a reasonable price. If we set a minimum price of around 45p a unit, as the Scottish Government are planning to do, in a Bill introduced at the end of October, it would mean that a bottle of whisky containing 28 units could not be sold below £12.60, a bottle of wine containing 10 units could not cost less than £4.50, and a pint of beer with two units could not cost less than 90p. Such prices would not suck all the fun from a night out; in fact, they would not raise the price of alcohol in the on-trade at all.
Kevin Barron (Rother Valley, Labour)
Will the hon. Lady give way?
Sarah Wollaston (Totnes, Conservative)
May I make a little progress? The case against a minimum price of between 45p and 50p a unit may hang on the loss of income to the Treasury. Alcohol duty raised £9.5 billion in 2010-11, which is equivalent to 1.7% of total Government revenue. There is a certain illogicality in the bands set by the European Union, so to a certain extent, as my hon. Friend Andrew Griffiths said, there is great encouragement towards higher strength products.
The amount received by the Treasury is the same whether a product is sold in a pub or a supermarket. VAT is levied on top, but there are no specific data on where and on what products it is levied. Will the Minister set out estimates of the loss of income that would arise from the introduction of a minimum unit price of between 45p and 50p? Will she also set that against the benefits in estimated savings to the Home Office, the Department of Health and the Ministry of Justice that would result from a reduction in alcohol-related harms?
The Department of Health leads on alcohol policy. It has stated repeatedly that it does not wish to disadvantage moderate drinkers on a low income. However, it has failed to point out that harmful drinking disproportionately affects the poorest and most vulnerable in our society, and is a significant contributor to health inequality. A report on the Department's behalf from September 2011, titled "Narrowing the health inequalities gap", makes it quite clear that if it were not for alcohol-related deaths, and if we had had an effective policy, the objective to narrow the overall life expectancy gaps for the spearhead local authority areas—the most deprived areas in our country— "would...certainly have been achieved for males; and would be well on the way to being achieved for females."
The evidence is not just that low-income groups suffer the most health harms, but that they suffer the most harms as a result of violence in their communities.
If we look at the evidence from some shopping basket data published in a university of Sheffield study, we can see that for
"a 50p minimum price, a harmful drinker will spend on average an extra £163 per year whilst the equivalent spending increase for a moderate drinker is £12."
In other words, the published data state that such a policy will not penalise low-income moderate drinkers.
The deprived spearhead communities have the most to gain from an effective alcohol policy. A minimum or floor price can be set that is not regressive and is affordable for anyone who is not drinking at hazardous levels. As one of my correspondents pointed out:
"If you can't afford 50p per unit it is a good sign that you are drinking too much."
The charge is often made that without an increase in duty the profits will go to the drinks industry and retailers, not the Treasury. I can understand that, but if we can introduce windfall taxes on energy companies, why not have windfall taxes on supermarkets that profit from windfall gains? With more than 31 billion units sold in the off-trade, why not even consider a health levy on unopened bottles, perhaps of between 5p and 10p a unit, targeting just the off-trade? That would be more than enough to allow for decent treatment programmes. Evidence shows that for every pound we invest in such programmes, we save £5 in wider benefits to the economy because of reduced harms.
Guy Opperman (Hexham, Conservative)
Does my hon. Friend think that it would be a good idea to introduce an alcohol Act similar to that which exists in Scotland?
Sarah Wollaston (Totnes, Conservative)
I could not agree more.
Finally—I know that other Members would like to come in—there are those who argue that a minimum price is illegal under EU law. If so, why are the Scottish Government so confident that it is not? I draw the Minister's attention to a reply given by Mr Dalli on behalf of the European Commission to a question put by an MEP on that point. The bones of the reply are that
"the Commission fully shares with the Honourable Member the conviction that there are strong public health reasons for the EU to tackle alcohol-related harm including minimum pricing measures."
Will the Minister set out today whether there have been discussions with the Scottish Executive on the matter? Will she also comment on what steps the Treasury will take to tackle supermarkets' plans to undermine Scotland's decisive action to tackle the carnage caused by alcohol? Tesco recently e-mailed Scottish customers
to reassure them that they will still be able to access cut-price deals after the Act is in force, as the products will be delivered from across the border. Will the Minister join me in condemning that e-mail from Tesco?
Yesterday, the Select Committee on Health returned from a visit to Carlisle, and it is clear that the city is expecting an increase in cross-border sales. It would prefer to see us use an evidence-based policy to protect the north-west, which has suffered from the devastating impact of alcohol. There have been many calls for effective minimum pricing and numerous models show the amount of lives and money saved, so I do not want to go over them in detail, other than to point out again that a 50p minimum price could save nearly 10,000 lives a year.
We have shown that Britain is prepared to stand our ground in the EU when it comes to the City of London. Now is the time to put the lives of our young people ahead of the theoretical risk of a legal challenge. A precedent exists in the loi Evin, which the French introduced to protect children from the effects of alcohol marketing in France. It has been challenged repeatedly by the industry in the EU's courts, but it was upheld on the grounds of the health benefits. I fully agree with that.
Kevin Barron (Rother Valley, Labour)
I agree with the hon. Lady regarding unit pricing, as did the Select Committee. One issue that caught my ear in her presentation is that of spirits. For 10 years, I have sat in Budget speeches in the House of Commons Chamber, when everyone cheered when the duty on spirits never went up. Then a £6 bottle of vodka became the choice for binge drinking. That is one of the lessons that the Treasury should learn.
Sarah Wollaston (Totnes, Conservative)
I could not agree more. Pricing plays, and has played, a role in the massive increase in the drinking of vodka, particularly by young women.
There are other ways of levelling the playing field, if the Treasury wants more income after minimum pricing. I know that the Minister is aware of the paper written by Dr Nick Sheron in which he argued that we could vary VAT between the on and off-trades to achieve minimum pricing, without damaging our pubs. I accept that the Treasury is convinced that that would be illegal under EU law. That is just another example of the completely illogical rules by which alcohol duty is set from across the channel, and is a prime example of the intrusive and frustrating way so much of our legislation is controlled by the EU.
I finish by asking the Minister not to commit to a floor price that will be meaningless. Will she assure the House that she will meet her Scottish counterparts to discuss why they are convinced that it is legal to introduce a realistic minimum price for alcohol? Can she assure me that the Government will look at the consistent and evidence-based advice from health experts on minimum pricing, and at least ensure that supermarkets south of the border do not undermine what is happening in Scotland? Can she also assure me that the Treasury recognises that alcohol is not an ordinary commodity, but a psychoactive, teratogenic carcinogen, which also happens to be addictive?
I finish with a story from one of my constituents, who spoke to me after trying to stop a drunken lout urinating on a semi-conscious vulnerable woman in the street. Is that the picture of Britain that we want to send to the rest of the world in our Olympic year? It really is the picture that other people are starting to have of Britain, and it is completely preventable. We just need bold action from the Government. Otherwise, we are abandoning another generation of young people. There is no such thing as a free lunch and equally no such thing as a cheap drink. We are all cross-subsidising cheap deals in supermarkets by paying extra for our groceries and other products. There is no such thing as a cheap drink: we are all paying a heavy price.
Chloe Smith (Assistant Whip, House of Commons; Norwich North, Conservative)
I congratulate my hon. Friend Dr Wollaston on securing the debate. I recognise that, as a general practitioner, she can draw on direct experience on dealing with the adverse effects of alcohol on health. I also acknowledge her reference to the contribution in The Daily Telegraph today from other professionals in the field.
I can assure all hon. Members who have spoken—it is a pleasure to hear so many—that not only GPs have such concerns about the effect of alcohol on the welfare and well-being of society; that concern is shared by the Government. It is clear that alcohol abuse causes serious harm to health and leads to considerable costs to the NHS and that many towns and cities are affected by alcohol-related violence and crime, as my hon. Friend has said. Like her, of course I abhor behaviour such as that in the example on which she finished her speech.
For all those reasons, the coalition Government are committed to tackling problem drinking across a range of fronts. I shall set out a few points on which action has already been taken. I shall try to do so quickly, to get on to minimum unit pricing, as my hon. Friend has requested. I will begin by trying to tackle a couple of points made by other hon. Members. Irresponsible drinkers, rather than responsible drinkers in pubs and other places of safety, are the problem.
I shall try to tackle a couple of the specific questions. If I do not do get there in time, I hope that my hon. Friend will forgive me if I write to her on a couple of points. With regard to measures that the Government have already taken, I hope that they will demonstrate and reassure her that the Government are committed to an evidence-based approach. I specifically reassure her of that today. It is, of course, a subject on which data speak clearly. It is a complex subject that requires much analysis of evidence.
I shall start that process with what the Government have done. My hon. Friend will know that the Treasury published the review of alcohol taxation in November 2010, which among other things identified a problem with so-called super-strength lagers, about which others have spoken today. The Government confirmed in the 2011 Budget that action would be taken to discourage consumption of those drinks, introducing two new additional duties, which should help. There are also targeted approaches on other types of drink—for example, a minimum juice content for products that qualify as cider. I note my hon. Friend's point about ciders.
Andrew Griffiths (Burton, Conservative)
The Minister has clearly got up to speed quickly on her brief. With regard to cider, does she agree that it seems completely incongruous that the 4% duty paid on a pint of beer is twice that paid on cider—2%—at exactly the same strength?
Chloe Smith (Assistant Whip, House of Commons; Norwich North, Conservative)
I am aware of that specific point, and I am sure that my hon. Friend and his colleagues will be even more aware of that tonight at the all-party parliamentary beer group's Christmas party, if I have that correct. If he will forgive me, I will focus on minimum unit pricing in this debate, to deal with points raised by my hon. Friend the Member for Totnes. I shall briefly note that she raised the wider impacts of alcohol. Of course, it is not just the duty system that is important. I direct her to the Police Reform and Social Responsibility Act 2011, which I hope will help with the late-night economy. To make an important point, I direct her to a forthcoming paper from the Department of Health, which, with the Home Office, is responsible for this area, that will consider the wider social and health impacts of alcohol. I have no doubt that she will look at that in some detail.
Guy Opperman (Hexham, Conservative)
A simple question: when assessing taxation in the alcohol strategy document, working with the Department of Health, will there be a difference in the views on taxing supermarket sales compared with the pubs that we all cherish and that are so affected by this?
Chloe Smith (Assistant Whip, House of Commons; Norwich North, Conservative)
If my hon. Friend will allow me to come to that, I shall attempt now briefly to answer a number of the questions asked. First, as my hon. Friend the Member for Totnes explained, the Scottish Government have recently introduced a Bill that seeks to bring in a 45p per unit minimum price. She asked why this Government believe that that would be incompatible with EU law, when the Scottish Government do not. If I may quote the specific point: we believe that it could be incompatible with article 34 of the treaty of the functioning of the European Union. I should be delighted to go into more detail on that if she required. That is the position.
I should like to deal with the important point made by my hon. Friend Guy Opperman. No one wishes to hit pubs unnecessarily. I take the examples about the behaviour of supermarkets that have been given. Like hon. Members, I am wary of
those. If an indirect tax were introduced, it would be difficult to distinguish between points of sale. I am happy to come back to hon. Members in more detail on why that is difficult, but it is not as straightforward as saying that we want to hit supermarkets and not pubs; it is about how to set up an indirect tax.
On that note, as hon. Members will have heard in other debates, it is difficult to find ways to vary VAT on similar products. Again, I am happy to come back with more detail on that if required. On price distortion and perhaps distasteful practices at the border, the UK Government will look into that closely. My hon. Friend the Member for Totnes asked whether we will discuss matters with the Scottish Government. We will be watching the situation extremely closely in the service of seeing what works and what we can assess among these complex policy and legal issues.
I will go briefly to a couple of other questions that my hon. Friend asked me: have we received representations from public health representatives on the duty plus VAT measure? I regard that measure as a starting point, as a first step. She rightly notes that it introduces a principle and a starting point. Treasury officials are very closely involved in discussing such matters with the Department of Health and, as I have already mentioned, the Home Office, which is also responsible in part for alcohol. I hope that reassures her.
We have mentioned supermarkets. I shall briefly turn to whether a windfall profit tax could be introduced as a method of trying to tackle some of the harms. First, this is about evidence. It is questionable whether windfall profits are likely to arise, and therefore whether there would be something to tax, as a viable approach. That question rests on carefully analysing the evidence, policy and legal issues and what is possible.
Finally, I hope that I have set out that the Government have taken some action and made some starting points. The Government are keen to hear evidence on the matter and will observe carefully what is going on in Scotland and elsewhere.
Question put and agreed to.
Prime Minister: Bovine TB
Oral Answers to Questions
Sarah Wollaston (Totnes, Conservative)
The year after Labour came to power, fewer than 600 cattle were slaughtered in Devon. This year, we are well on course for more than 6,000 to be slaughtered. Bovine TB is spreading remorselessly across the UK and many areas of the country will no longer be disease free unless we take action, so I welcome the Secretary of State's statement today. However, does she not share the concerns of farmers in my constituency who feel that they could be targeted by violent activists? Will she assure them that those who carry out this very difficult task will have their anonymity protected?
Caroline Spelman (Secretary of State, Environment, Food and Rural Affairs; Meriden, Conservative)
The whole House respects my hon. Friend's medical expertise, and she is right to point out that the disease has spread—it has spread from the south-west to the midlands. That fact demonstrates that doing nothing is not an option. As for her important point about personal information, I can assure her that, in the interests of personal security, personal information will be kept confidential.
Transport: Shipping: Rescue Services
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Transport whether her Department has conducted a cost-benefit analysis of the withdrawal of emergency towing vehicle funding comparing the south-west of England and the north-west of Scotland.
Michael Penning (Parliamentary Under Secretary of State (Roads and Motoring), Transport; Hemel Hempstead, Conservative)
The decision to withdraw the emergency towing vessels (ETVs) was part of the comprehensive spending review package announced in October 2010, and reflected the Government's judgment about the balance of risk of pollution around the UK coast in the event of a maritime accident. This decision was based on the then current running costs of the ETV contract, and the determination that the costs of any future pollution incident will be borne by the polluter on a cost recovery basis. There was no specific cost benefit analysis comparing the south-west of England and north-west of Scotland.
Ministerial Statements
Sarah Wollaston (Totnes, Conservative)
My right hon. Friend referred earlier to the discourtesy of leaking to the press, but does he agree that these leaks involve a discourtesy in that they might be given to some hon. Members before others, placing some Members at a disadvantage?
Greg Knight (East Yorkshire, Conservative)
I do indeed, and I believe that that happened last week. For example, the BBC television news in Humberside had the Chancellor's announcement on the plan to reduce the tolls on the Humber bridge pretty much word for word and ran it 24 hours before the House was told. It seemed rather strange to me that a couple of hon. Members who happened to have seats near the Humber bridge were available on the bridge itself to do media interviews when the leak occurred.
If the Government do not believe what they say about Parliament being told first and want to leak or announce policies or decisions to the press first, they should come out in the open and say so and they should change their ministerial code.
I now turn to the motion before us. Although I think we are all grateful to my hon. Friend Mr Hollobone for bringing this matter before us today, I must say that I would have preferred it had he consulted the Procedure Committee before he settled on the wording of the motion. I understand that Mr Barron, to whom I have spoken about this matter and who chairs the Standards and Privileges Committee, was also not consulted on the terms of the motion before it was tabled or the timing. That is unfortunate. I do not want to tell the right hon. Gentleman, who does his own job perfectly well without any intervention from me, what he might or might not want to do, but he might have wanted to take the matter to his Committee and to have shown it the scope of the draft motion before it was brought to the House.
It is a pity that neither of the two Committees that the House has asked to consider these matters was consulted by the signatories to the motion. That is important because we have not yet debated the Procedure Committee's report in the House, but the motion addresses only some of the issues raised by the Committee in its report on ministerial statements and ignores others. It is
a cherry-picking motion and its scope has been determined without any reference to those who have responsibility for looking into this matter, having been asked to do so by the House.
The motion ignores the Procedure Committee's recommendations on urgent questions and written statements. For example, we believe there are some occasions on which written statements should be open to oral scrutiny. The motion is therefore unsatisfactory and its timing, coming as it does without that consultation having taken place, is unfortunate. I do believe that action on this issue is necessary, as Governments of both political persuasions have been prepared regularly to flout the ministerial code when it suits them by leaking news to the press. However, I also believe that the way this matter has been brought forward today is unfortunate. Rather like the leaks themselves, it is no way to do business.
.................
Sarah Wollaston (Totnes, Conservative)
Clearly, in that instance, Members of this House hear the statement at the same time as members of the press. If leaks are going to take place, which my hon. Friend is justifying, should they also be to Members at the same time?
Environment Food and Rural Affairs: Fishing Catches
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs what her policy is on the proposals in the 2012 draft common fisheries policy to ban discards of certain species which are believed to have a good chance of survival if discarded promptly.
Richard Benyon (Parliamentary Under Secretary of State (Natural Environment and Fisheries), Environment, Food and Rural Affairs; Newbury, Conservative)
The UK Government strongly support the European Commission's ambition in seeking to end the wasteful practice of discarding of dead and dying fish, which has rightly attracted so much public interest. Through a reformed common fisheries policy (CFP) we need a flexible regulatory framework that drives the necessary changes in fishing activity and behaviour to end these discards.
There are some species which have a good chance of surviving if discarded, and it is important that the provisions of the CFP reflect this.
Communities and Local Government: Life Sciences
Sarah Wollaston (Totnes, Conservative)
I warmly welcome the Secretary of State's statement, as this strategy will reduce the delay between discovery and dispensing and, undoubtedly, bring great benefits to patients and to our pharmaceutical industry, but in return will he ask the industry to go further and publish negative trial data, as well as positive trial data, as a gesture to improve the quality of research data?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
I am grateful to my hon. Friend for that point. The industry has done quite a lot in recent years in publishing more data, including data that do not necessarily support the positive case that it is looking for, because all of us, and especially those working in the field, learn a great deal and, sometimes, as much from clinical trials that produce a negative result as we do from those that produce a positive result. So, I will certainly take her point away, explore it with my colleagues and write to her if we can take further steps in that direction.
Environment Food and Rural Affairs: Food
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs
(1) what assessment she has made of the implications for food security in 2050 of each extreme of the population range projection made by the Office for National Statistics for that year;
(2) what assessment she has made of food security in 2050 at the upper and lower limits of the population range currently projected by the Office for National Statistics.
James Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs; South East Cambridgeshire, Conservative)
The Office for National Statistics produce population projections for the UK based on a set of demographic assumptions. Their principal projection for the UK in 2050 is 78.4 million. Population projections become increasingly uncertain the further they are carried forward and the long-term figures should be treated with great caution.
Our food security depends on access to the world market; and our domestic food industry needs to be able to compete on the world stage. In a world where climate instability can disrupt patterns of production, food security cannot be delivered from a narrow, self-interested, national protectionist stance, or by recommending self-sufficiency.
Earlier this year the Government's Chief Scientist, Sir John Beddington, published a Foresight report into the Future of Food and Farming which looked at the challenges today and in the future. It explored how we can feed a global population of 9 billion by 2050 healthily and sustainably and identified hunger and environmental degradation as the key problems we face. The Foresight world population figures are derived from United Nations projections.
As an immediate response to the report, DEFRA have signed up to a Foresight Action Plan which will include:
championing an integrated approach to food security;
pressing for integration of agricultural GHGs into UNFCCC process;
taking forward Nagoya work on international biodiversity;
promoting the importance of sustainable intensification;
pressing for trade liberalisation and CAP/CFP reform;
showcasing what can be achieved on food waste reduction within the UK and share best practice; and increasing the productivity and competitiveness of UK food and farming and ensure that agriculture and the food sector can contribute fully to the green economy.
Communities and Local Government: Housing
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Communities and Local Government what estimate he has made of the planning implications of total housing need at the upper and lower limits of the Office for National Statistics-projected population by 2050.
Andrew Stunell (Parliamentary Under Secretary of State, Communities and Local Government; Hazel Grove, Liberal Democrat)
I refer the hon. Member to the answer I gave her on 21 November 2011, Hansard, column 59-60W.
Treasury: Excise Duties: Alcohol Drinks
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Chancellor of the Exchequer what assessment he has made of the extent of alcohol duty evasion.
Chloe Smith (Assistant Whip, House of Commons; Norwich North, Conservative)
Diversion of alcohol without payment of excise duty is the prevalent form of alcohol fraud. Estimates of tax losses are produced by HMRC annually for spirits and beer, the latest of which have been published in "Measuring Tax Gaps 2011".
This publication is available in the House of Commons Library and online at:
www.hmrc.gov.uk/stats/mtg-2011.pdf
Park Homes
Westminster Hall Debate (Click here to watch the full debate)
Sarah Wollaston (Totnes, Conservative) (Click here to watch Sarah speak)
Was my hon. Friend struck at the meeting of the all-party group by the relatively small number of names cropping up all over the country? The thickest file in my constituency filing cabinet is that for Beechdown Park, with its unresolved problems of water leaks and water meters. An owner has not only failed to deal with the leaks but collected money by holding people to ransom—holding
up the sale of their properties unless they hand over money. We discovered that he has not passed any of the money to South West Water and has run up colossal bills. My constituents' appliances have not been working, thanks to Mr Small, which I am sure is a familiar name.
Caroline Nokes (Romsey and Southampton North, Conservative)
As I said, I attended the mass rally last November and listened to many of the stories from around the country, and my hon. Friend is absolutely right that the same small number of names occur time and again at various locations—always, sadly, involving the same story and modus operandi.
Time is pressing and the issue is not new, although I am new to it. Media reports can be found going back 20 or 30 years, commenting on the difficulties of park home residents when selling their properties or gaining reasonable access to services without being charged over the odds for them. The single biggest issue, however, is the blocking of sales by site owners. If park owners refuse to approve a sale, the home owner is left in an almost impossible position. There are reports of owners of properties worth £100,000 having to sell to the park owner for as little as £5,000 as all other sales have been blocked. The home owner currently has recourse to a residential property tribunal but that not only costs the owner about £150 but has limited powers of enforcement and places no binding conditions on the park owner. The situation is being addressed by the Government, and I am eager to hear what assurance the Minister can give that it is subject to a rigorous timetable.
Alcoholic Drinks: Misuse
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what assessment he has made of any link between levels of alcohol duty fraud and the excessive consumption of alcohol.
Chloe Smith (Assistant Whip, House of Commons; Norwich North, Conservative)
I have been asked to reply.
No assessment has been made of any link between levels of alcohol duty fraud and excessive alcohol consumption.
HM Revenue and Customs have recently renewed their strategy to tackle alcohol duty fraud. The Department of Health aims to publish the Government's strategy for reducing harm from alcohol in the coming months.
Alcoholic Drinks: Sales
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for the Home Department whether her Department has assessed the likely effects of any ban on the sale of below-cost alcohol on levels of (a) excessive and (b) underage alcohol consumption.
James Brokenshire (Parliamentary Under Secretary of State, Home Office; Old Bexley and Sidcup, Conservative)
The impact assessment for banning the sale of alcohol below the cost of duty plus VAT will be published by the Home Office in the new year. This will assess the impact of excessive alcohol consumption on harmful and hazardous drinking groups who are most likely to be affected by the ban. The Home Office carefully considered the potential impact on underage and excessive alcohol consumption when considering options for the ban.
Solar Power (Feed-in Tariff)
Sarah Wollaston (Totnes, Conservative)
The Secretary of State makes a compelling case for the need for change, but will he consider a concession for those businesses that have already paid a deposit? Pennywell farm in my constituency aims to be the first carbon-neutral tourist attraction in the country and has already received a gold business award for energy conservation. It has already paid a 10% deposit, but the costs of meeting the 12 December deadline will increase its costs by 11% and it faces great difficulty as a result.
Christopher Huhne (Secretary of State, Energy and Climate Change; Eastleigh, Liberal Democrat)
I hear what my hon. Friend says, and she is not contesting the fact that there will still be a positive return. That comes back to the point I was making. People might not make as much money as they thought they would, because the scheme had not been brought into line with the fall in the cost of panels, but they will still make a positive return. My Department's key objective is to ensure that we make the transition to a low-carbon economy, not to provide excessive subsidies where they are not warranted by the action that is to be taken. If she would like to write to me with the details of her example, we will take it into account as part of the consultation. I repeat that it is a genuine consultation.
The revised tariffs will allow the feed-in tariffs to work in the way they were intended to, supporting the industry and jobs in the long term, rather than burning brightly for a few short months before fading away. The right hon. Member for Don Valley might urge on us the attractions of becoming a sort of policy Catherine-wheel in which we are all fizz, but we do not particularly want to be followed by all phutt, which is exactly what we would have if the Labour party was to have its suggestion.
I am sure that Members will join me in supporting long-term ambition across the whole green economy, rather than windfalls for the few.
The Government are committed to supporting sustainable low-carbon energy, but we cannot continue to write blank cheques. By bringing solar PV returns in line with other investment opportunities, we are guaranteeing the success of the feed-in tariff scheme as a whole, which will mean more renewable energy delivered to more households in a sustainable way.
Energy and Climate Change: Carbon Emissions
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change if he will estimate the additional carbon emissions which would be generated by an additional 10 million people projected to reside in the UK by 2033; and if he will estimate the additional renewable energy capacity which would be needed to abate the emissions arising from such a rise in population and maintain emissions at their current level.
Gregory Barker (Minister of State (Climate Change), Energy and Climate Change; Bexhill and Battle, Conservative)
The latest official Government projections by DECC for greenhouse gas emissions including carbon dioxide were published in October 2011:
http://www.decc.gov.uk/en/content/cms/about/ec_social_res/analytic_projs/en_emis_projs/en_emis_projs.aspx
These provide projections for the period up to 2030. Projections beyond 2030 are not available. The projections assume that the UK population increases by 6.8 million between 2010 and 2030. This is the ONS principal 2008 based population projection, low migration variant. The 2008 based population projections were used because these were the latest available at the time of publication. The low migration variant assumption is used because this is the population assumption used by the Office for Budget Responsibility for GDP growth projections which also feed into the emissions projections. Projections under a scenario in which the UK population increased by 10 million are not available.
Over the period 2010 to 2030 emissions are projected to fall by 168 MtCO2e from 586 MtCO2e to 418 MtCO2e. Carbon dioxide emissions are projected to fall by 146 MtCO2 from 496 MtCO2 to 350 MtCO2 over the same period. The projected fall is attributable to a range of factors including policy impacts on energy efficiency and increased use of renewable energy. Under the central scenario assumptions in the emissions projections, renewable energy demand is projected to increase by 23 Mega tonnes of oil equivalent (Mtoe) from 8.2 Mtoe to 30.9 Mtoe between 2010 and 2030. Renewables electricity generation capacity is projected to increase by 33 GW from 9 GW to 42 GW over the same period. As explained in the report, the generation and capacity mix is dependent on a number of assumptions. Other assumptions would lead to projected electricity demand being met by different capacity and generation mixes.
The projections show that, under central assumptions, existing policies, including those that support increased use of renewable energy, are sufficient to ensure emissions continue to fall up until 2030 despite the projected increase in population of 6.8 million.
Health: NHS: Publications
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what steps he is taking to ensure that information for patients is provided in accessible formats for (a) non-English speakers, (b) partially-sighted people and (c) those with learning disabilities; and if he will make a statement.
Simon Burns (Minister of State (Health), Health; Chelmsford, Conservative)
The Department recognises the benefits of good quality accessible information for patients. The national health service, third parties performing public functions on its behalf and the Department are already subject to the public sector equality duty in section 149 of the Equality Act 2010 which requires public authorities to pay due regard to eliminating discrimination and advancing equality of opportunity. In practice this means that the Department and NHS organisations provide information to patients in alternative formats and languages where appropriate.
As part of the Department's wider ambition to give people more information and control over their care, our consultation document "Liberating the NHS: An Information Revolution", published in October 2010, sought views on how to improve the accessibility of information to patients, including those requiring information in languages other than English and those using learning disabilities services. A copy has already been placed in the Library. The Department's Information Strategy will respond to that consultation and is planned to be published in the winter.
Health: General Practitioners
Written Answers
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what steps he has taken to ensure that his Department's guidance on removing patients from GP lists is followed by GPs.
Simon Burns (Minister of State (Health), Health; Chelmsford, Conservative)
The procedures which general practitioner (GP) contractors must follow when considering removal of a patient from their list are set out in regulations and are included in their national health service contract with their primary care trust. It is the responsibility of the primary care trust to take any resulting action should a contractor not follow these procedures.
Under the terms of its contract, a GP practice may remove any patient from its list of NHS patients if it believes that it has reasonable grounds for doing so, for example, if a patient has moved out of the practice area or has been violent.
No one should be left without access to a GP practice. If anyone who has been removed from a practice list has difficulty in finding another practice, the primary care trust may assign them to another GP contractor's list.
Health: General Practitioners
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health who will be responsible for assigning patients who have been removed from their GP list to other GP lists after the abolition of primary care trusts as part of his proposed NHS reforms.
Simon Burns (Minister of State (Health), Health; Chelmsford, Conservative)
Subject to the passage of the Health and Social Care Bill, this responsibility will lie with the NHS Commissioning Board.
Health: Doctors; List of Patients
Wtitten Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what guidance he has issued to GPs on removing patients from their lists.
Simon Burns (Chelmsford, Conservative)
The procedures which a general practitioner (GP) practice must follow when removing a patient from its list are set out in the regulations covering the contractual arrangements between the GP practice and its primary care trust (PCT).
Under the terms of its contract, a GP practice may remove any patient from its list of national health service patients if it believes that it has reasonable grounds for doing so. Patients should be given a warning before action is taken for removal and specific reasons as to why the removal has occurred.
If anyone who has been removed from a practice list has difficulty in finding another practice, the PCT has a legal responsibility to find them a practice with which to register.
Communities and Local Government: Housing
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Communities and Local Government what plans he has to balance an increase in supply of new housing with measures to stabilise demand.
Grant Shapps (Minister of State (Housing and Local Government), Communities and Local Government; Welwyn Hatfield, Conservative)
The Government are clear that we need to get the housing market, particularly house building, moving again. To improve the affordability of housing and to stabilise the housing market in the long-term, the balance between supply and demand is critical. This is important for our plans for economic growth, but more importantly, it is crucial to the hopes and plans of young people, families and older households across the country. The Government's Housing Strategy for England—Laying the Foundations—was published on Monday 21 November. This ambitious strategy describes the actions we are taking to unblock the market and to support an increase in the supply and quality of new private and social housing.
Communities & Local Government: Housing
Written Answer
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Communities and Local Government what assessment he has made of the planning implications of the housing need represented by the (a) upper and (b) lower limits of the population projections by the Office for National Statistics for 2050.
Andrew Stunell (Parliamentary Under Secretary of State, Communities and Local Government; Hazel Grove, Liberal Democrat)
The Department does not estimate housing need. However, the Department publishes household projections, which are a trend-based view of the number of households that would form given a projected population and previous demographic trends. Local authorities should use the projections as a part of the evidence base for assessing future housing demand.
Household projections are based on the Sub-national Population Projections published by the Office for National Statistics, the most recent of which are 2008-based. The 2008-based Household Projections show that, by 2033, there will be a projected 27.5 million households in England, an additional 5.8 million households compared to 2008. This decreases to 26.3 million projected households in 2033 using the low population variant projection (an additional 4.6 million households compared to 2008), and increases to 28.7 million projected households in 2033 using the high population variant projection (an additional 7 million households compared to 2008).
Lord's Debate
Baroness Thornton (Labour)
My Lords, I rise to intervene on this Motion today with a very heavy heart-and empty-handed, because the Government have refused to release the risk register on the implementation of the Health and Social Care Bill, as instructed in the judgment of the Information Commissioner last Friday. I am grateful to the Minister for his letters to me and other noble Lords explaining the Government's position on this matter. Thorough explanations are helpful but they do not make this a right or just position for the Government to take. The Government inform us that they need 28 days to consider this issue. I would just make the point that the Department of Health has had a whole year to think about this issue.
Noble Lords may recall that I drew this important matter to the attention of the House on Monday and specifically asked the Minister to assist the House in its deliberations by making the risk register available. I am most grateful that the noble Baroness, Lady Williams, supported my appeal. Since Monday, it has become clear that the well respected Conservative MP, Dr Sarah Wollaston, made the same plea to her own Secretary of State in a letter to the Evening Standard.
Fuel Prices
Sarah Wollaston (Totnes, Conservative)
I fully support that, because in south Devon those on the lowest incomes will be hardest hit. They will be spending yet more of their disposable income on fuel or they will be waiting at the side of a road for a bus service that can no longer afford to operate.
Sarah Wollaston (Totnes, Conservative)
When Labour came to power in 1997, fuel duty stood at 36.8p per litre. When it left office in 2010, the price was more than 57p per litre—"a pain in the gas" as they say in the United States. I therefore welcome the early and decisive action taken by the Treasury in taking 1p off fuel duty, scrapping the duty escalator and delaying the 3p per litre rise. Many Members have today made a compelling case for why we now need the Treasury to go further, however.
I represent a large rural constituency in south Devon, and having a car in order to get to work or exercise choice in education is not a luxury; it is an absolute essential. My constituents spend a far greater proportion of their disposable income on fuel than those who live in cities.
A further 3p rise in January would not just hit householders, however; it would hit essential local businesses, too. Some 65% of all the UK's groceries are delivered on retread tyres produced by a company in my constituency: Bandvulc tyres. It also exports to cities across Europe. It is a significant employer and wealth generator, but a 3p a litre rise in fuel duty would cost it an additional £24,000 a year, because it uses more than 500,000 litres of fuel a year. It is a family-run manufacturing business producing a sustainable product and creating local jobs. It wants to stay in Devon but knows that it would make economic sense to relocate part of its business to eastern Europe as a result of the fuel duty rise. There are similar examples among other businesses in my constituency.
Another very important sector in my constituency is tourism. I am talking about businesses such as Sharpham wines and cheeses, which attracts 7,500 tourists a year and employs up to 40 people. More importantly, it is in the top six wine producers in the UK and it is another wealth creator that exports across Europe. That business spoke of the ripple effects of a further rise in fuel duty, as did many others. A business that I visited last week, Palladium Building Supplies, told me of the knock-on effect to the entire building industry across south Devon that there would be if we go ahead with this rise.
Mel Stride (Central Devon, Conservative)
My hon. Friend is making a powerful point about the effect on businesses. Does she accept that not only are these high fuel prices damaging businesses, but that, in turn, that is leading to less revenue to the Exchequer, because businesses are becoming less profitable?
Sarah Wollaston (Totnes, Conservative)
My hon. Friend makes an excellent point. This is about whether a 3p a litre increase will generate any income. Many of my constituents feel that it will lead to a drop in income, because they will simply not be able to fill up their cars.
Jo Swinson (East Dunbartonshire, Liberal Democrat)
I agree with the hon. Lady's case, which has been made by others, that the Government need to take account of the impact of the high price of fuel and the hurt it is causing to families, individuals and businesses. She mentions an important short-term measure, but does she agree that in the medium and long-term it is also important that the Government take action to reduce our dependency on oil, the price of which is only likely to rise, and look towards investment in things such as electric cars and charging infrastructure across the country, so that we will be set for the rest of the 21st century?
Sarah Wollaston (Totnes, Conservative)
My hon. Friend makes a good point. Indeed, one organic business in my constituency said that it would find a rise more acceptable if it could be seen directly as a green tax. Unfortunately, that is not the case. In my constituency, people will be badly hit by a double whammy, in that the bus service operators grant is set to be reduced by 20% next year. Just when they cannot afford to use their cars, people are being hit by a real threat to rural bus services, which are already at a critical level in south Devon. I hope that the Minister will set out what proportion of the rise will be set aside for green taxation purposes.
Obesity
Westminster Hall Debate
Sarah Wollaston (Totnes, Conservative)
Does my hon. Friend share my concern, however, that organisations such as Asda, which have signed up to the new responsibility deal, are in some ways undermining it by offering hugely discounted alcohol products?
Daniel Poulter (Central Suffolk and North Ipswich, Conservative)
There are areas of obvious concern, where supermarkets can go further. As I said earlier, when we were talking about the agricultural sector, even though several supermarkets are backing honest food labelling, and showing responsibility in food labelling and calorie counting to tackle obesity, it is right to highlight the areas in which they need to show greater corporate responsibility. Cut-price alcohol is one of those, and we will continue to monitor it carefully in our work on the Select Committee on Health, and as physicians. My hon. Friend makes a good point.
In preparing for the debate, although I do not normally take an active interest in children's TV, I found out about an Icelandic TV show called "LazyTown"—the Minister may want to expand on the subject a little later. The show is watched by children all over the world, and we have it in Great Britain as well. There is a healthy sports superhero character, called Sportacus, who motivates children to eat healthily and be active. In Iceland several "LazyTown" initiatives have been run in partnership with the Government and the private sector. For example, children between 4 and 7 years old were sent an energy contract, which they and their parents signed, in which they were rewarded for eating healthily, going to bed early and being active. In one supermarket chain, all the fruit and vegetables were branded "sports candy", which is the "LazyTown" name for fruit and vegetables. That led to a 22% increase in sales at that supermarket, and improved health and reduced obesity levels in Iceland.
The fact that Iceland's child obesity levels have started to fall as a result of initiatives of that kind is good evidence in support of such corporate responsibility. Those initiatives are designed to support supermarkets coming together with Government, to make effective use of the nudge theory of improving behaviour, and they can work—and have worked. For that reason, we must support what the Government are doing, because there is evidence that it can work. It is a good thing and the evidence from Iceland is that we need to do what works, with children and communities.
I understand, and I am sure that the Minister will confirm, that the Department of Health has set up a partnership with "LazyTown" and is interested in expanding that initiative in the United Kingdom. We need more such approaches. The reason supermarkets sign up to such deals and initiatives is that it is good not just for the children, who become healthier and less obese, but for the supermarket and its brand image. Supermarkets see that working with corporate responsibility—we see it in our constituencies with Tesco schools vouchers—can enhance their image and custom, and do real good, for example, by reducing obesity levels.
I have greater faith in the nudge theory than my hon. Friend the Member for Totnes, and we need to allow similar initiatives to take root in the future. What has been done in the past has not worked very well; obesity levels have been going up. We have good evidence, from examples of corporate responsibility, that things can be tackled, so let us give nudge theory a chance. Let us also look to those health and wellbeing boards to provide community-based interventions that will work. If we do not do something, things will get worse, and the boards are a good way to address the problem.
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Sarah Wollaston (Totnes, Conservative)
I thank Mr Campbell for securing this important debate. I do not want to repeat his message about the economic cost of the problem, but I would say, having been a general practitioner for 18 years, that once someone becomes obese, it is extraordinarily difficult to regain their normal weight in the long term.
I would like the Minister to consider the following points. We need to focus on better identification of those who are most at risk, particularly children, and to target action on those high-risk children. A nudge will just not go far enough, and it is time for more of a bit of a shove. We need particularly to look at the role of liquid calories in obesity among children. I ask the National Institute for Health and Clinical Excellence to update its guidance and review the evidence.
Nearly two thirds of adults are overweight or obese, but they do not start out that way. Around one in five four to five-year-olds are overweight or obese, but by the time they reach 11, that figure will have risen to one in three.
Simon Burns (Minister of State (Health), Health; Chelmsford, Conservative)
On the point about NICE, may I give my hon. Friend a reassurance that might be helpful at this stage in her contribution? As she may know, NICE has recently consulted on whether now is the right time to review its original guidance. As a result of that consultation, it will be making a decision later this month.
Sarah Wollaston (Totnes, Conservative)
I thank the Minister for that helpful response and look forward to hearing the outcome of that.
Children at primary school and in the early years before they have reached school are among the really high-risk groups. Some 85% of obese children go on to become obese adults, whereas only 12% of normal weight children become obese adults, so it makes sense to focus on that group of children, but that can happen only if we have better early identification. We should introduce annual measurements of weight and height, so that we can see when children are starting to slip towards obesity. We should target our resources much better on that group.
Diane Abbott (Hackney North and Stoke Newington, Labour)
Years ago, parents with chubby children would be told, "It's puppy fat and they will grow out of it." There is still that idea around among otherwise bright and responsible parents. We need to press the point that chubby children grow into chubby adults.
Sarah Wollaston (Totnes, Conservative)
I absolutely agree with the hon. Lady. We need to be much clearer with parents that their children are at risk and that being overweight is not something that they will grow out of.
We should be much more creative about how we target help to high-risk children. Why not allow all those children to have free healthy school lunches? As poverty and deprivation have such strong links with obesity, considering that high-risk group is particularly appropriate if we are to address the Marmot agenda. Unfortunately, families on tight budgets are much more likely to be pushed towards unhealthy and cheaper choices. If we want to nudge them in the right direction, we must recognise the role that price plays in the choices that they make. We should look at the role of loss leaders. We urgently need a change in what supermarkets offer so that loss leaders are redirected towards healthy rather than unhealthy products.
Why not incentivise exercise in those high-risk families with vouchers for success and free access to good-quality sports facilities? We should incentivise a whole-family approach to cooking skills because cooking is a fun activity. An effective way forward would be to make such a service free and readily available to whole families.
On liquid calories, a survey conducted by the British Dental Association and Ipsos-MORI showed that 47% of children's fluid intake is in the form of sugary and carbonated drinks. That means that one in five children is consuming 500 calories or more a day just in the form of sugary drinks and 73%—nearly three-quarters of children—are consuming more than 200 calories a day. It is a staggering number of calories that children are consuming.
If we look at adults, we will see that there is a particular issue with alcohol. The chief medical officer has already highlighted that around 10% of an adult's calorie intake can be through alcohol. What we should understand from that is the role that discounting plays. I have mentioned that before. It really does not matter how disciplined the rational part of our brain tries to be—the irrational and impulsive side will continue to be irrational and impulsive. It is not helpful to see heavily discounted products in super-sized multi-buy packs piled high at the check-outs in supermarkets. If we want to move "nudge" towards "shove", we should regulate how supermarkets market their products. I do not suggest that the whole answer to obesity lies in regulating supermarkets. I realise that there is a complex interplay between over-supply, pricing, culture, marketing, poor consumer choices and human nature. There is also the interplay between genetic predisposition and a lack of exercise. However, it is unlikely that our current strategy will go far enough in this regard. If we are going to do something about the £5 billion a year that this problem is costing us—the figure is predicted to rise to £10 billion a year by 2050—I suggest and hope that the Minister takes a strong line and abandons the idea of giving the problem a little nudge, in favour of giving it an almighty shove.
Cost of Motor Insurance
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
Further to the unfortunate shock that happened in the Stewart household, may I tell the House about the unfortunate shock in my household when I received a notice saying that I did not need to take any further action to continue my insurance with Tesco, but the small print indicated that the premium had gone up from £900 to £5,700 as I am the parent of a 17-year-old boy? It is a further sharp practice that the small print is not there, and it would have been very easy to miss the fact that I could have spent nearly two months' salary on insuring my 17-year-old boy. I think everybody in the House would agree that it would be entirely unreasonable and very difficult for anyone living in a very rural area, as I do, for my son not to be able to drive.
Iain Stewart (Milton Keynes South, Conservative)
My hon. Friend makes a powerful point. The shock in my household cannot even begin to compare with that in Totnes. She raises an extremely important point. Many of us will pay our motor insurance premiums by a monthly direct debit, and among all the paperwork that we receive it is very easy to say, "Yes, we'll continue with that policy," and then suddenly the premiums that we are paying shoot up. I echo her call for much more transparency and explanation on the renewal documents about what the new cost will be.
Home Department
Oral Answers to Questions
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
The more a balloon is inflated, the more it hurts when it eventually explodes. Would it not be better for us to help the Greeks default and devalue now rather than later?
David Cameron (Prime Minister; Witney, Conservative)
We have argued very consistently that part of any solution has to be a very decisive writing down of Greek debt, because it obviously cannot afford the level of debt that it currently has. That is the plan that it is being offered. Some would argue that even that is not enough, and that is my hon. Friend's position, but our view has always been that unless the debts are written down significantly, there will not be a proper solution.
Alcohol (Under-18s))
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
Should we not address not only the issue of parents sending children away to places such as Newquay with alcohol but the supply of alcohol that is routinely provided in children's own homes? Indeed, should we consider making it an offence for parents knowingly to supply other people's children with alcohol at parties on their own premises, which we would otherwise call proxy buying?
Stephen Gilbert (St Austell and Newquay, Liberal Democrat)
My hon. Friend has opened a can of worms by raising the responsibilities that parents have to not only their own children but other people's children in their homes. Parents often underestimate their influence over their children, whether it involves setting an example or supplying alcohol for parties. She has made an excellent point, and I hope that the Minister will respond to it when he winds up the debate.
We know from research by the Joseph Rowntree Foundation, which published a paper on this issue in June, that if a young person finds alcohol easy to obtain their chances of drinking excessively increase fourfold. Equally, if a young person sees their parents drunk, it doubles the chance that they themselves will get drunk. In that report, parents emerge as one of the crucial influences on teenage drinking. Shockingly, that research, which was based on a survey of 5,700 children, found that one in five children claim to have been drunk for the first time by the age of 14 and that half of all 16-year-olds report having been drunk.
Last weekend, further research from the schools health education unit showed that children as young as 12 say that they drink the equivalent of 19 glasses of wine per week. In that survey, 83,000 school pupils were questioned, and 4% of 12 and 13-year-olds said that they consume 28 or more units of alcohol a week, which is more than the maximum amount suggested in the adult weekly guidelines for alcohol. Clearly, it might not be possible or appropriate to use legislation to solve this widespread
cultural problem, but we must ensure that legislation passed by this House does not create an opportunity for the problem to get worse. I welcome the steps that the Government are taking to crack down on people who sell alcohol to children, including the doubling to £20,000 of the fine for under-age alcohol sales and the extension of the period of closure that can be given as an alternative to prosecution when premises are found to have been involved in supplying alcohol to children.
I want the Minister to touch on a number of issues that continue to cause me and the police concern. The first is section 149 of the Licensing Act 2003, which prohibits the proxy purchase of alcohol by adults for children. The section has been successfully used in Newquay in a campaign supported by Crimestoppers, with a number of individuals being prosecuted when there was evidence that alcohol has been bought by an adult and supplied to a child. There is a clear problem, however, with parent dealers, who when questioned by the police often say that they did not buy the alcohol for their children—they just happened to have it and handed to them. Any well-prepared brief could drive a coach and horses through the attempted prosecution of a parent under that legislation.
Another legal avenue at our disposal are child neglect provisions, but they would apply only to under-16s, leaving a hole where the slightly older, but still vulnerable, 17 and 18-year-olds are. Will the Minister, therefore, undertake to review section 149, and look at tightening up rules on parental supply, perhaps stipulating that parents must be on hand to supervise the drinking of any alcohol that they supply to their children?
A second legislative hole is in the Confiscation of Alcohol (Young Persons) Act 1997, which provides the police with the power to confiscate but to make an arrest only if the request to hand over the alcohol is not complied with. Because of the significant pressure on local police forces, it is often not possible for them to make an arrest even if such action is desirable, and their power in that regard must be strengthened.
I firmly believe that we must look again at alcohol pricing, and I have raised the issue in the House. Even with the changes recently announced by the Government, supermarkets' ability to sell alcohol at prices that are so much cheaper than in pubs and clubs causes genuine concern to many people.
Business of the House
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
May we have a debate on the role and responsibilities of Parliamentary Private Secretaries? Is it appropriate in a modern democracy that Members of Parliament who are neither Ministers nor in the Cabinet should be forced to resign if they vote against the Government? Does not that restrict their ability to represent their constituents and disproportionately reduce the power of the House?
George Young (Leader of the House of Commons, House of Commons; North West Hampshire, Conservative)
I am grateful to my hon. Friend and I am sorry that two Parliamentary Private Secretaries left the Government earlier this week. She will know that when somebody is invited to become a Parliamentary Private Secretary, there is an assumed commitment that they will support the Government in the Division Lobby. If anybody feels unhappy about that, they should not become a Parliamentary Private Secretary. If, having become a PPS, someone feels they cannot support the Government in the Division Lobby, they have to stand down. I think that is set out in the ministerial code and it is a convention that is widely understood on both sides of the House.
Business, Innovation and Skills: Eurozone Crisis
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
How confident is my right hon. Friend that countries such as China will want to contribute to the special purpose vehicle, and what will happen if they do not?
George Osborne (Chancellor of the Exchequer, HM Treasury; Tatton, Conservative)
The short answer is that we will find out whether China wants to contribute. The President of France is speaking to the President of China today, and he will no doubt give us all an update following that conversation.
Work and Pensions: Pensions: Fire Services
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Work and Pensions whether his Department has conducted an impact assessment of the potential effect on firefighters of the provisions of the Pensions Bill [Lords].
Steve Webb (Minister of State (Pensions), Work and Pensions; Thornbury and Yate, Liberal Democrat)
The impact assessment published when the Pensions Bill was introduced into Parliament on 13 January 2011 did not cover specific occupations. It did consider the impact of the proposed increase in state pension age for people previously employed in manual occupations.
http://www.dwp.gov.uk/docs/pensions-bill-2011-ia-annexa.pdf
Health: Alcoholic Drinks
Written Question
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
To ask the Secretary of State for Health how many meetings officials in his Department's alcohol policy team have had with representatives of the (a) drinks industry and (b) drinks marketing industry since the team was established.
Anne Milton (Parliamentary Under Secretary of State (Public Health), Health; Guildford, Conservative)
Officials in the alcohol policy team, which was established in October 2007, meet with drinks industry representatives on a regular basis in the course of their normal activities.
Since May 2010, there have been approximately 104 such meetings with representatives of the drinks industry and one such meeting with marketing industry. This includes meetings with groups of people including non-industry representatives, such as the Responsibility Deal Alcohol Network.
Ovarian Cancer
Westminster Hall Debate.
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
I congratulate my hon. Friend Stuart Andrew on initiating this important debate. Does Fiona Mactaggart agree that although it is wonderful that she had such rapid access to treatment, such access to diagnosis is not uniformly available throughout the country? My experience is that it is difficult for general practitioners to gain rapid access to ultrasound scans, which was a crucial factor in the hon. Lady's diagnosis. Equally, access to CA 125 measurements, although included in the NICE draft guidelines, which is welcome, is not uniformly available to GPs throughout the country.
Prime Minister: Engagements
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
I know that the Prime Minister is serious about tackling violent crime, antisocial behaviour and the fact that there are more than 1 million hospital admissions in England a year for alcohol-related conditions. Will he meet me to discuss the evidence that we need to go further on minimum pricing, availability and particularly the marketing of alcohol to young people?
David Cameron (Prime Minister; Witney, Conservative)
I am very happy to meet my hon. Friend, who has made a lot of speeches and written a lot of articles about the issue, about which she feels passionately. She is right in many ways that there is a problem with binge drinking in our country. Much of it is related to very low-cost alcohol, particularly in supermarkets. I want to see an end to that deep discounting, rather than perhaps the way forward that she suggests, but I am happy to meet her and discuss this vital issue.
House of Commons Disqualification (Amendment) Bill
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
Does my hon. Friend agree that that leads to a form of creeping patronage? Mechanisms such as negative briefings are also used, and I was subject to a hostile Culture, Media and Sport briefing that was sent around. That goes to the heart of a culture in the House that undermines the integrity of individual hon. Members.
Peter Bone (Wellingborough, Conservative)
My hon. Friend has been elected to the House to be a Member of Parliament and to use her own judgment. She hits on a good point, and if I get time, I shall deal with the problem of the black art of misinformation that the Whips operate so successfully.
For a new Member of Parliament, the Whips' threat that their career will be over if they do not vote in a certain way is enormously powerful. However, history suggests that completely the reverse is the case. Many people who have voted against the Whips on the most controversial matters are now Ministers—some are actually in the Cabinet.
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Peter Bone (Wellingborough, Conservative)
My hon. Friend is not quite correct. The Question on the motion was put, but because nobody expressed dissent, it was carried by the collection of voices. Many of us who returned especially to vote on that were delighted that there was no opposition.
My argument about that day is that the Whips should not have attempted to influence support for the actions of my hon. Friend the Member for The Wrekin, as the debate was Back-Bench business. The Whips should simply have butted out. The Bill would make it impossible for such pressure to be applied in the future because
Members of Parliament could not be Whips. Instances of such behaviour abound and we all know several Members whose careers have been significantly affected by the actions of the Whips Office. It is, sadly, a simple fact of parliamentary life that even the size of the room a Member gets depends on how much they have pleased the Whips. My hon. Friend the Member for Kettering is still in a shoebox.
As for disinformation, let me give the House an example, particularly in response to my hon. Friend Dr Wollaston. I know that Whips deliberately misinformed hon. Members about the facts relating to the new Backbench Business Committee by sending out an e-mail out that claimed the Committee always held its business on a Thursday and decided the topic under discussion only a few days before. That was sent out by the Whips as authoritative fact, although it was completely and utterly untrue. It was intended to rubbish the new Committee because that Committee put business before the House that the Whips did not want to see debated.
It is astonishing to think that in an age where employees have more rights than ever before and workplace bullying has, thankfully, become increasingly unacceptable, Members are still treated in such a manner. If I were to treat my staff in this way for even an instant I would, quite rightly, be taken to an employment tribunal, yet it is through these often underhand methods that Whips ensure that the Executive line is strictly obeyed, and that the public are therefore denied the independent-minded Members of Parliament and, indeed, the Parliament that they deserve.
The situation is worse in coalition Governments, as Whips often force Members to vote in totally the opposite way to what their party manifesto stated on issues that they stood on at the last election. Although Liberal Members signed a pledge before the last election not to increase tuition fees, they were forced by their Whips to do completely the opposite when they were in government. Equally, Conservative Members who stood on a platform opposing the alternative vote were forced by the Whips to vote for a Bill on a referendum for the alternative vote system.
Let me give a personal example of Whips' tactics. In the last parliamentary term, on 30 March 2011, a Whip sent out an e-mail, which I will read out:
"I regret to have to inform colleagues that we are all required tonight after 7pm on a strict 3-line whip with respect to a Motion by the Leader of the House to which an amendment has been tabled by Mr Peter Bone and others so it is now votable. Unless you have previously been slipped by me, your presence is required."
The e-mail was sent out to every Conservative Member of Parliament. Not only did it cause great embarrassment, but it was factually incorrect and misleading—another example of misinformation. The e-mail received an understandably negative response from my colleagues, including a Minister who had to return from an important meeting because of the Whip's action. After I contacted many of my colleagues and explained the true situation, they were appalled that the Whips had ever sent out such an e-mail. What was so outrageous was that the Whip was trying to influence Members of Parliament about a matter relating to House of Commons business which was of no concern to the Executive and entirely the responsibility of Parliament. Of course, though, that is insignificant compared with some of the other episodes in which the Whips have involved themselves.
That is not to say that all Whips behave in such a manner, and nor is it to say—this is a response to an earlier intervention—that the Whips do not perform useful functions, but it is the Whips Office that performs those useful functions. We do not need Members of Parliament to be Whips. We can get civil servants, who are currently employed in the Whips Office anyway, to carry out the administrative necessities. There is nothing that the Whips do that could not be done by civil servants, if there was a business of the House committee. The only thing left for them to do would be the strong-arming tactics of trying to tell people how to vote.
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Sarah Wollaston (Totnes, Conservative)
I thank my hon. Friend. In these challenging financial times, has he estimated how much this would cost the taxpayer, and does he think that it would deliver value for money?
Peter Bone (Wellingborough, Conservative)
My hon. Friend hits on a good point that I am going to deal with a little later. Clearly, though, the system does not provide value for money at the moment.
European Union Act 2011 (Amendment) Bill: New Clause 1 - Complaints about exercise of public health functions by local authorities
Sarah Wollaston (Totnes Conservative) Click here to see Sarah Live
Rushanara Ali spoke of health inequalities in her constituency. Perhaps she should look at the King's Fund's annual review of NHS performance between 1997 and 2010, which
"identified the lack of progress in reducing health inequalities as the most significant health policy failure of the last decade."
Opposition Members should bear that in mind when they talk of a two-tier health service, because they fail to focus on outcomes and they fail to focus on inequalities.
I welcome the duty of the Secretary of State, the NHS commissioning board and clinical commissioning groups to have regard to reducing health inequalities. Let us see something done about that scandal. I also welcome the work of the NHS Future Forum in setting out the central dilemma surrounding the role of the Secretary of State. The NHS should be freed from day-to-day political interference, but it must also be clear that the Secretary of State retains ultimate responsibility.
Debbie Abrahams (Oldham East and Saddleworth, Labour)
Will the hon. Lady give way?
Sarah Wollaston (Totnes, Conservative)
I will not, because so many Members are waiting to speak.
There has been real scaremongering about, in particular, the difference between the duty to provide and the duty to secure provision, but I believe that the wording simply reflects the reality. The key issue is the line between the ability to step in if things go wrong, and the very real need for politicians to step back and let clinicians and patients take control.
I shall cut my speech short because I have been asked to be brief, but let me end by saying that, for three clear reasons, I would not be supporting the Bill if I thought that it would lead to the privatisation of the NHS. [Hon. Members: "Have you read it?"] I assure Members that I have read it in great detail.
Let me give those three clear reasons. First, clinicians will be in charge of commissioning. Secondly, the public will be able to see what clinicians are doing. Thirdly,
neither clinicians nor the public will allow privatisation to happen. They do not want it to happen, and neither do Members of this House.
PCTs and foundation trusts did not meet in public, but they will do so in future, and it is the public and patients who will ensure that the NHS is safe in the hands of the Conservatives and the Liberal Democrats.
European Union Act 2011 (Amendment) Bill: Clause 10 - Duties of consortia as to commissioning certain health services
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
My hon. Friend has twice quoted the Royal College of Psychiatrists and asserted that there is a much higher rate of mental illness after termination of pregnancy, but the RCP has made it clear—any Member can look online at the draft of its very comprehensive evidence review—that we have to compare like with like. In other words, we have to make a comparison with rates of mental illness after unwanted pregnancy. Looking at the rates after unwanted pregnancy, we see that there is no difference between the rate of mental illness after termination of pregnancy and live birth. Indeed, the biggest predictor of mental ill health after a termination of pregnancy is whether somebody was suffering with problems beforehand.
Nadine Dories (Mid Bedfordshire, Conservative)
The hon. Lady makes the assumption that I want women to continue with unwanted pregnancies. That is not the case. I have made the point that abortion is here to stay for any woman who wants an abortion. The amendment simply proposes that any woman who feels that she wants or needs counselling can be offered it—that is all. I find it very difficult to understand why the hon. Lady would feel that anybody in a crisis pregnancy should not be offered counselling. Why should they not?
Public Disorder
Sarah Wollaston (Totnes, Conservative)
As a former police surgeon, I have personally witnessed the great professionalism of our police forces in the face of extreme provocation. This week they have faced extreme violence as well. At all times they have been identifiable and therefore accountable. Is it time for us to make it an offence for anybody involved in rioting and demonstrating to cover their faces, so that they too can be both identifiable and accountable?
David Cameron (Prime Minister; Witney, Conservative)
The hon. Lady makes an important point. In my statement I said that we would extend the power that the police have—at present they can do it only in limited circumstances with limited people—so that they have a more blanket power of insisting that people remove face masks.
Bovine TB
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
Can the Secretary of State confirm that badgers infected with TB and with TB lesions in their kidneys excrete large amounts of TB on to grass? We all get many letters from constituents asking us to ensure that cows have access to grass and are not reared on large factory-scale farms, so surely controlling bovine TB is an important way of ensuring that grass is safer for cows to eat.
Caroline Spelman (Secretary of State, Environment, Food and Rural Affairs; Meriden, Conservative)
Of course, my hon. Friend has a professional background that helps her to understand epidemiology. However, the important point is that it is beyond doubt that there is transmission between badgers and cattle. The fact that they share pastures and fields means that they can pass the disease between them in the way she has described. Even the Badger Trust would acknowledge that the disease is passing from badgers to cattle, as well as from cattle to cattle. Controlling the badger population in a particular area in the way I have described should indeed help.
Coastguard Modernisation
Sarah Wollaston (Totnes, Conservative) Click here to see Sarah Live
Twenty-five staff are employed at the Brixham maritime co-ordination rescue centre. I pay tribute to their dedication. Can the Secretary of State reassure those staff that they will be treated fairly when applying for jobs either at Falmouth or at the maritime operations centre? That is a real concern and will be essential to retaining local knowledge. I am concerned at the suggestion that those staff will not have an opportunity to contribute to the further consultation, because neither I nor anyone else in south Devon can understand how safety can be preserved with the closure of that maritime operations centre.
Philip Hammond (Secretary of State, Transport; Runnymede and Weybridge, Conservative)
I am grateful to my hon. Friend for the measured way in which she makes her point. First, her constituents, like anybody else, will of course be able to respond to the consultation, but the consultation itself is limited to the issues that represent changes from the previous consultation. The coastguards employed at Brixham are civil servants. They will be entitled to be considered for deployment elsewhere in the civil service. Wherever possible—and where they are willing—we will look specifically to secure their knowledge and experience by redeploying them to other stations that will remain open. This process will take place over a number of years; it is not going to happen overnight. If at the end of that process there are people remaining who cannot be accommodated elsewhere in the service, they will be offered voluntary redundancy terms. We hope that it will not be necessary to make compulsory redundancies, and any that are made will be made only as a last resort.
Reform of Social Care
Sarah Wollaston (Totnes Conservative) Click here to see Sarah Live
I understand the need for the timetable to allow for adequate consultation, but Andrew Dilnot's excellent report draws attention to several areas including a lack of transparency, a lack of information available to families making decisions about care homes and, in particular, a lack of portability, which results in many patients being trapped and unable to move closer to loved ones. Does the Secretary of State feel that he could expedite any of the report's recommendations to allow such proposals to receive more detailed consideration?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
I entirely understand my hon. Friend's point. In the course of the engagement during the latter part of this year, some of those issues will certainly come to the fore. My colleagues and I felt that it was better for us not to cherry-pick Andrew Dilnot's report now, but rather for us to give people an opportunity to comment on the recommendations in full. That will, however, take place over the space of weeks rather than many months.
Environment Food and Rural Affairs: Land
Written Question
Sarah Wollaston (Totnes Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs whether her Department has assessed the effectiveness of her Department's best and most versatile land policy.
Jim Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs; South East Cambridgeshire, Conservative)
We have not recently assessed the effectiveness, of the best and most versatile land policy, but my Department has commissioned a project on the policy's application by planning authorities. This will assess the spatial location and extent of best and most versatile agricultural that has been built on and/or developed for non-agricultural purposes, in the last decade; and will evaluate the information and processes used by planners to assess BMV land issues. The report is due to be published by late summer.
Adoption (Leave, Pay and Allowance Arrangements): Legal Aid, Sentencing and Punishment of Offenders Bill
Sarah Wollaston, (Totnes, Conservative) Click here to see Sarah live
Does my hon. Friend agree that many citizens advice bureaux—such as my own, South Hams—receive 55% to 65% of their funding from legal aid and are concerned about the time frame with the proposals being introduced in October?
Helen Grant (Maidstone and The Weald, Conservative)
My hon. Friend makes a good point, and change must be paced. Not for profit does not mean "No funds, please." Those organisations still need cash just to stand still, let alone to deal with the massive glut of cases that will fall into their laps, but I am reassured and encouraged by what my right hon. and learned Friend the Secretary of State for Justice said about directing an additional sum of some £20 million towards them. That is very positive indeed.
The plans rely on judges, magistrates and tribunal chairmen having the time to assist numerous litigants in person, but I can honestly tell hon. Members that that time does not exist, because judges already have back-to-back lists. Delays in court will become even worse. The plans rely on less dependency on legal proceedings, but as I have said before in the House, mediation is no panacea. It frequently fails, especially in family cases, where there is often an imbalance of power between the parties. Where will all the mediators come from? Who will pay for them?
Rural Bus Services in South Devon
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I thank you, Mr Walker, for chairing this debate on the important issue of rural bus services in south Devon, and I thank the Minister for his continuing interest in sustainable transport. I want to cover the three areas of the scale of rural transport poverty, the current reductions to services in Devon and, perhaps more importantly, the threats on the horizon: there is a perfect storm brewing for rural transport in my constituency. Finally, I have some proposals, put forward by my constituents as well as by people with transport expertise. I hope to persuade the Minister that doing nothing will be to abandon the transport poor at the roadside. I hope that he will accept an invitation to Townstal in my constituency to meet those who have been hardest hit by cuts to services.
Citizens Advice has found that many low-income families spend as much as 25% of their income on owning and maintaining a car; not through choice but through necessity. In addition, south Devon is one of the most expensive areas of the country, with high housing costs and low earnings, and employment that is often unreliable and seasonal. It has one of the highest insolvency rates in the country, and a high percentage of retired people, who are more likely to be dependent on public transport. It is not only the work that is seasonal; we also have a seasonal population. In summer our population expands dramatically, putting a further strain on services.
It is notable that the more rural an area is, the greater the number of cars and vans per household. Our services have become so infrequent and inconvenient that anyone who can use a car will do so, and those who have no access to a car cannot afford the full fare that is needed for the services to be run on a stand-alone commercial basis. South Hams, for example, has more than 12,000 more cars than households, which only underlines the relative transport poverty of the have-nots. Those have-nots are 14% of rural households in Devon—55,000 people who have no access to a car. Without transport, those people cannot gain access to hospitals, employment, education or even employment agencies or citizens advice bureaux.
The reason for that is clear. Under the comprehensive spending review, the Government grant to Devon county was cut by £54 million in 2011-12. Like all councils, Devon has statutory obligations, so it held a good public consultation exercise. However, unfortunately, people who never need to use public transport do not see it as a priority, so it emerged as a relatively low priority.
Anne-Marie Morris (Newton Abbot, Conservative)
Similar cuts have been suffered in my constituency, in Dawlish, on the 178 Newton Abbot to Okehampton service, and on the 361 Bridford to Newton Abbot service. Does my hon. Friend agree that one of the problems is that Devon's settlement from central Government was in a sense not appropriate, because rurality was not taken into account? Therefore there was a particular challenge in funding the bus service.
Sarah Wollaston (Totnes, Conservative)
My hon. Friend makes an excellent point. Devon county council reduced its public transport support budget by £1.35 million out of a total spend of
£7.75 million. My hon. Friend makes a good point in noting that that did not recognise the particular challenges of rurality.
As I have said, the real problem is the perfect storm that is brewing, with ever-increasing costs and further reductions in revenue. From April 2012 there will be a 20% reduction in the bus service operators grant which will increase operator costs by 1.5% to 2%. When we consider that our fares are already among the highest in the country, if that were passed on to passengers it could result in a further abandonment of bus transport.
The reduction in operator reimbursement for pensioners' bus passes is also creating a particular problem in Devon, because in Devon 56% of all bus journeys after 9.30 in the morning are made by concessionary travel scheme passengers, which amounts to 30% of operator income. Local experts tell me that a reduction of the reimbursement to operators of 15% translates into a 4% to 5% loss of income; but for more rural operators such as those that are found in Devon it could be as much as 30%, which would be devastating. To those figures must be added the cost of administering the scheme. Devon must spend £12 million on that, which ironically is twice as much as it must spend on supporting bus services to ensure that people can travel in the first place. Devon county council estimates that it has been underfunded by approximately £5 million in the current year on that scheme alone. Many of my constituents wonder whether the ability of some people to travel free is more important than the ability to travel at all for many people of all ages.
On top of those reducing subsidies comes the blow of passenger transport inflation, which the Minister knows outstrips the retail prices index, as a result of increased insurance premiums, increasing staff costs as a result of legislation on part-time workers, increased training requirements and bus adaptations. That is before factoring in the runaway costs of fuel. Seventy bus routes have been affected in Devon. Hon. Members will be relieved to hear that I am not going to name them all, but I should like to mention service 111, which illustrates several points.
The 111 was a lifeline in my constituency, running from Dartmouth via Totnes station, stopping off at the Torbay shopping area and taking passengers directly to the door of the local hospital. It ran via several villages and was a reliable service. Crucially, it also allowed parents to exercise choice in the matter of their children's school. The loss of the 111 has been devastating. Last week I met Freda Morgan, who, despite being in her eighties, made the trip from Dartmouth to visit her 91-year-old sister in hospital. Previously she would have been able to travel door to door. This time, on the way out she needed two changes of bus and a very long walk up a steep hill—trust me, people in Devon are used to hills, but this was a very long one from the main road. On the way home she needed to take a completely different operator's buses and a different set of routes, including a ferry crossing. The round trip lasted a total of 10 hours. She managed to get only an hour with her sister, and she arrived home completely exhausted.
Mrs Morgan is not alone. I have had similar emails and letters from many other constituents: patients and visitors, parents who now cannot get their children to school—of course we cannot think it is an option to change a child's school half way through their education—and a flood of people who feel trapped in their homes.
Adrian Sanders (Torbay, Liberal Democrat)
One of the answers is to get more people using the buses, so that they become more viable. Surely one of the best ways to make buses more viable is to get them to run on time. Reducing congestion between the hon. Lady's constituency and mine—I am thinking of the Kingskerswell bypass—would have an enormous impact on bus use throughout Torbay and south Devon, because buses would be more likely to run to timetable.
Sarah Wollaston (Totnes, Conservative)
That is an excellent point. Reliability is a key issue—both reliability in timetabling, and the reliability that means a child who starts at a particular school will continue to be able to get there in the long term.
Another of my constituents, Richard Parnell, made the excellent point with reference to seasonal employment that he has been unable to get to many places because of the changes. Even when he was recently called to do jury service he found it very difficult to attend.
I mentioned bus 111 because it was, in a way, a victim of its own success, showing that the issue is not only cuts to rural subsidies; there is also the perverse impact of the way it has been possible to apply competition to the routes in question, since deregulation under the Transport Act 1985. Some 76 per cent. of bus journeys in Devon are on commercial services and, crucially, Devon county council is unable to consult on changes to commercial services. There have recently been 200 to 300 service changes each year, with only 56 days notice. That leaves little time for those affected to make alternative plans.
Service 111 was operated by Stagecoach under a tender paid for by Devon county council, which allowed Devon to specify the timetable, fares and bus specification. When the tender was due to expire, another operator declared the section between Dartmouth and Paignton to be commercial. To cut a long story short, the unviable parts of the route were cut out, and Devon was left to pick up the sections covering a number of villages, which are now cut off, with an inadequate service, the 149. Stagecoach registered its own commercial service 111, but because Devon withdrew the funding to students whose parents exercised choice to send them to an out-of-area school, it was left unviable, and the service folded. Now all the communities have been left with a woefully inadequate service, as a result of the combination of grant cuts and the inappropriate application of competition.
Many communities in my constituency have been badly affected. They include Kingsbridge, with the loss of the X64, and Dittisham, Blackawton and Marldon. The county maintains that no community has been cut off—I acknowledge that it has tried hard to prevent that—but if a service no longer allows people access to employment, medical appointments or school, they might as well be cut off.
We have some wonderful community bus services in Devon. I am sure that my hon. Friends will join me in paying tribute to them and their volunteers; I think of services such as the Coleridge community bus and "Bob the Bus" in Totnes. Devon has also led the way in demand-led bus services such as the fare car scheme, but it would be a mistake to think that they reduce costs, as some are even more expensive.
Gary Streeter (South West Devon, Conservative)
I congratulate my hon. Friend on securing this important debate and on making such a powerful speech. Given that we cannot anticipate much more Government subsidy over the next two or three years, and given that bus companies understandably do not want to operate unprofitably, does she believe that some improvement could be made if the bus companies, the county council and—as important—parish councils and communities were much more involved in consultation about which routes were necessary and which timetables would suit best? Does my hon. Friend believe that there is enough engagement with local people?
Sarah Wollaston (Totnes, Conservative)
My hon. Friend makes an excellent point. As I said earlier, there is no opportunity for such engagement because of changes in legislation after deregulation. I would like it to be restored and I would like to see an obligation to consult more widely. I would also like to see more sensible ticketing arrangements, so that constituents who have to take different routes there and back are able to use a smart card.
I am surprised by the number of pass holders in Devon who say that they would rather pay a small amount per journey, or even pay an annual administration fee, than suffer reduced services. They understand the financial realities to which my hon. Friend Mr Streeter refers. Experts in local transport tell me that an annual fee of around £30 would cover the administration costs—the £12 million that I spoke of earlier—which is twice as much as Devon is spending on subsidising the extra costs. Such a fee would still represent outstanding value for money. I hope that my hon. Friend the Minister will consider it.
Another excellent question is why foreign vehicles can use our motorways for free when we pay so much to use theirs. Why cannot we have a system like that in Switzerland, where vehicles have to pay for and display a motorway pass even if they use the motorway for only one weekend? Could we not do likewise? The equivalent for British nationals would be the tax disc; we could ask all foreign trucks and cars to pay a smaller amount for the pleasure of using our lovely motorways. Others have suggested increasing vehicle excise duty for high-emission vehicles to subsidise public transport. However, we know that such measures would not directly benefit local rural services unless the increased income were directly allocated to councils and ring-fenced for sustainable transport.
My own suggestion would be to consider giving councils greater powers to require out-of-town supermarket users to pay to park. The money could be reimbursed in store if necessary, but the levy could be used to subsidise local rural services if it was appropriate for the area. It would be a form of localism to allow local people to decide on the matter. It would also help redress the imbalance that blights our rural high streets, which are often subject to high parking charges.
I hope that the Minister will think again about the cuts to bus service operator grants. However, I make a special plea on behalf of community buses: could they use red diesel? I hope, too, that the Minister will reconsider the unforeseen consequences of deregulation, referred to earlier, particularly the impact that it has had; on top of the cuts, it has devastated rural services. I also hope he will meet me to discuss some of the red tape and
additional costs faced by community buses, which provide an invaluable service. I have already referred to smart cards. Again, that would make a huge difference. I stress that none of us feels that doing nothing should be an option.
Finally, as a small plea to another cyclist, may I ask the Minister to consider amending the legislation to allow buses to have bike racks? It happens in European countries but not here; that is another example of UK legislation exceeding that of the EU. I understand that regulations prevent buses from carrying front bike racks—that is what local operators tell me—but if we allowed rural buses to carry bike racks, the services could become more commercially viable in the summer. We all know that there is not an endless pot of money, and that would make a big difference to areas such as mine, which are trying to introduce green transport.
Norman Baker (Parliamentary Under Secretary of State (Regional and Local Transport), Transport; Lewes, Liberal Democrat)
I thank my hon. Friend Dr Wollaston for arranging this debate and for packing a great deal into 16 minutes. I thank our quartet of Devon MPs for saying roughly the same thing about their bus services.
I know well from my constituency that buses are a lifeline for many people in rural areas, providing access to jobs, schools, health care and social activities and the rest. Good bus services contribute to the Government's key transport priorities of cutting carbon and creating growth, not least by allowing access to employment opportunities. Other benefits of removing car traffic from our towns would include reduced noise pollution and improved air quality.
Because of the value that the Government attach to bus services, we are committed under the comprehensive spending review to continuing our financial subsidy of bus operators. It is worth pointing out that the many newspaper stories suggesting that the bus service operators grant would be cut altogether proved to be erroneous. We value the support that we give to bus companies and bus operators.
The bus service operators grant—the BSOG—remains untouched for this financial year. However, as my hon. Friend the Member for Totnes said, it will be cut by 20% from next April, thereby giving bus companies about 18 months notice of the change. Department for Transport calculations suggest that will bring about a change in fares of about 1%. Bus operators are on record as saying that the scale of changes and the notice that they have been given make them hopeful of being able to incorporate the change to the BSOG without affecting fares.
Sarah Wollaston (Totnes, Conservative)
Given the rurality of services in Devon, local experts in the county council estimate that for us the change would be between 1.5% and 2%.
Norman Baker (Parliamentary Under Secretary of State (Regional and Local Transport), Transport; Lewes, Liberal Democrat)
I hear what my hon. Friend says. The Confederation of Passenger Transport UK said that it was hopeful of incorporating the change without affecting fares or services; I hope that reassures her on that point. I shall deal in a moment with local tendered services, which I suspect are more of a problem for my hon. Friend's constituents.
The Government are committed to reducing the budget deficit that we inherited, and every sector has to play its part in that. However, Transport Secretary and I are determined that buses should continue to receive their fair share of funding. We want to encourage more people to use buses, and to make bus travel more attractive in whatever way we can, given the financial envelope within which we have to work.
The Government spend more than £1.2 billion a year on concessionary travel and bus subsidy in England, outside London, of which £15 million or thereabouts is spent in Devon. We remain particularly committed to the concessionary travel entitlement in England for the 11.5 million eligible older and disabled people. I hear my hon. Friend's suggestion of introducing a small charge to help finances. I can only say that the Prime Minister has made plain the importance that he attaches to the present arrangements—that the concessionary travel arrangements continue to be free for those entitled to them. That obviously remains the Government's policy.
My Department recently issued new guidance to local transport authorities to help them ensure that bus operators are reimbursed for carrying eligible passengers on a "no better off, no worse off" basis. My hon. Friend referred to the concessionary travel reimbursement arrangements, but the essential legislative requirement that bus companies should be no better off or no worse off has not changed. All that has happened is that the Department has issued new guidance to enable local authorities better to deliver the requirement. They are not obliged to follow that guidance, although they may do so if they wish; but they are obliged to comply with the legislation, which has not changed.
Adrian Sanders (Torbay, Liberal Democrat)
I raised this matter under the previous Government and suggested, through parliamentary questions, that the cost of a national scheme would be less than lots of local schemes. Will the Minister consider that as a way in which we can reduce the costs overall? It seems crazy that different local authorities pay different rates for the same service.
Norman Baker (Parliamentary Under Secretary of State (Regional and Local Transport), Transport; Lewes, Liberal Democrat)
There is a national arrangement in place in Scotland, which was considered. Responsibility was moved from district councils to county councils, which helped to bring some consistency to services and reduce some of the overheads. However, we have to balance that with our need to pursue a localism agenda, which both coalition parties firmly support. To have a national scheme would counter that and go against our direction of travel.
When the Department was considering the new guidance for the concessionary travel scheme, we took representations from the bus operators and local councils. I then personally amended the guidance to ensure that it reflected the particular challenges of operating in a rural area.
I recognise that the recent local authority funding settlement has been challenging and that in some areas, local councils have responded by taking the axe to local bus services. That badly hits rural areas such as Devon where supported services make up a much higher share of the total than in metropolitan areas. The formula of the Department for Communities and Local Government, which allocates money to local councils, incorporates a sparsity factor, which should help areas such as Devon.
The Department is also committed, through the local government resource review, to looking at the entire way in which funding takes place and local moneys are raised from the local taxpayer, and that process is ongoing.
I am naturally concerned when I hear that vulnerable people with few other transport choices have lost their only bus service, or that children have reduced public transport access to the school of their choice. Those are serious and unwelcome developments. As my hon. Friend says, fewer than a quarter of all journeys in Devon are made on supported services. That means that more than three quarters are made on commercial services, which are unaffected by changes to council income or changes in council policy.
When difficult decisions are to be made on local bus services, I am clear that they should be made at a local level and not in Whitehall. The Government set out in the local transport White Paper their commitment to ending top-down decision making and one size fits all solutions. That means that we will see different decisions made in different places across the country depending on the priorities given by elected local members in those areas.
Some councils have taken an almost slash and burn approach to bus services, while others such as East Riding have percentage cuts in single figures. They have been more careful about making decisions that affect bus users. I note that Devon county council has cut its budget for supported bus services by 17% this year. In a consultation that it held called "tough choices", which I welcomed, savings on bus services were one of the top three areas that were identified by 60% of those who responded. I accept the point that my hon. Friend makes that those who do not use buses will be more likely to identify them for cuts than those who use them. Nevertheless, it was an attempt by the county council to validate the decisions that we are taking, and that is entirely helpful. Other areas have consulted and reached different conclusions. Cornwall, for example, has chosen to keep its morning peak-time concessionary travel entitlement on a countywide basis.
It is up to Devon to prioritise its spending as it sees fit, and it is not for central Government to intervene in that matter. How much it spends on buses, roads and libraries is ultimately a matter for Devon county council. Rather than telling councils what to do, my focus instead is on encouraging bus companies and local transport authorities to work together to deliver improvements that make the bus a more attractive option. They need to improve reliability and produce smarter and more integrated ticketing—to which my hon. Friend referred—reasonable fares and understandable timetables. She will be aware that an application has been made to the local sustainable transport fund in respect of smart ticketing. Decisions on the outcome of that particular application will be made shortly.
I am also keen that local authorities make the most efficient use of their resources. It is a good idea that there is a maximum efficient use of the vehicles that a council may have. We still have cases in which there are adult social care vehicles in one box, public transport vehicles in another box and school buses in a third box, and they are all run by different departments of the council. These days, councils, which need to make efficiency
savings, should eliminate those sorts of duplications and that silo mentality. I am not clear what the position is in Devon. I hope that it has identified savings such as that to be made. None the less, those sorts of practices can still be found in local councils up and down the country. Therefore, local councils have a job to do to ensure that they get the best value for money.
My hon. Friend also mentioned community transport. I accept that that is not a panacea for any reduction in bus services, but it can be a useful facility for particular individuals with special needs or for small communities where a bus service would not be practical. We are keen to build up the capacity of community transport organisations, which is why I recently provided local authorities with £10 million of extra funding. Devon county council was given a grant of £425,000 for that purpose. I was pleased to learn that the council has maintained its community transport budget in recognition of the important work that such organisations do at a local level.
I pay tribute to Devon Wheels 2 Work scheme. It is an excellent example of a not-for-profit organisation that provides vital links to education, work and training by loaning motorbikes and scooters at subsidised rates. Other examples can be found across England, and it is exactly the sort of grassroots activity that I would like to see more of and to encourage.
Let me now pick up on some of the points that were made. My hon. Friend made reference to route 111. As she will understand, I am not familiar with that route. However, it is a matter for Devon county council to judge whether or not it is one of the routes that it should support. It is sometimes the case that routes to hospitals are difficult to justify commercially. As people move in and out of hospital, it is difficult to build up a regular clientele for that particular service. It certainly seems that some people have been significantly inconvenienced by the withdrawal of that route, and I hope that she and her colleagues will be able to persuade Devon county council to think again.
As for the integration between the transport authority, Devon county council and the bus operators, I have noted my hon. Friend's point about 56 days' notice for changes. That is something that I am currently looking at. No decisions have been made, but it is something that is on the radar. It is up to Devon to decide whether it takes advantage of the terms of the Local Transport Act 2008, which facilitates quality partnerships or even quality contracts. If Devon wants to get more of a handle on bus services, there are powers in legislation available to use should it wish to do so.
My hon. Friend raised other matters that do not fall under the Department for Transport. She will be interested to know that the Under-Secretary of State for Transport, my hon. Friend Mike Penning is introducing proposals for HGV charging, which will, for the first time, capture foreign lorries in terms of what they have to pay to use our motorway network.
My hon. Friend seemed to want to go wider into road charging and almost edged into the Lib Dem manifesto from the last general election, but that is not presently Government policy. She also came up with some interesting ideas on red diesel and hypothecation, which are matters for the Treasury and not the DFT. However, her comments have been noted and I will ensure that they are passed on to the relevant officials at the Treasury.
My hon. Friend also raised an interesting idea, which has been around for some time, about out-of-town supermarkets. I can see why she has raised that matter, and I will make sure that her comments are passed on to colleagues at the Department for Communities and Local Government, who have the lead responsibility for that matter.
I do not have an answer on buses with bike racks, but I will drop her a line to let her know what the legal position is and how we view the matter. Finally, if my hon. Friend wants to bring up some of her constituents to discuss matters, I will ensure that a slot is made available in my diary for her to do that.
Food
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs what steps she is taking to support the sale and production of local food.
James Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs)
To meet the growing demand for more food with a local and regional provenance, our food and drink producers' access to market must be improved. We are providing funding under the Rural Development Programme for England for a range of measures aimed at supporting the availability of local food, including assistance to individual food producers and retail outlets, food hubs and farmers' markets.
I welcome the fact that retailers have put in place policies aimed at increasing the availability of regional and local food on their shelves. This provides opportunities for UK farmers to capture a greater market share by becoming more competitive.
Research shows consumers are increasingly concerned about the origins of their food, and the Government are committed to clearer origin labelling to provide consumers with the information they need to make informed choices about the food they buy.
We are also committed to ensuring that food procured by Government Departments, and eventually the whole public sector, meets British or equivalent standards of production wherever this can be achieved without increasing overall costs.
International Development: Departmental Manpower
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for International Development how many full-time equivalent staff his Department employs; and what the cost of running his Department was in the last year for which figures are available.
Stephen O'Brien (Parliamentary Under Secretary of State, International Development; Eddisbury, Conservative)
During the year ended 31 March 2010 the Department for International Development (DFID) employed an average of 2,322 full-time equivalent staff across its UK and overseas locations. Total staff costs for the year ended 31 March 2010 were £112 million, within total expenditure for the Department of £7 billion.
Legal Aid
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
On legal aid for medical negligence cases, can the Secretary of State reassure the House that he has made an assessment and we are not going to end up transferring additional costs to the NHS Litigation Authority?
Kenneth Clarke (Lord Chancellor, Secretary of State, Justice; Rushcliffe, Conservative)
Obviously, the NHS Litigation Authority has been involved in our consultation, but at the moment I see no reason why that should be the consequence at all. Indeed, I think—I hope—that the NHS will be spared some of the more speculative litigation that has taken place, whereby people really hope that somebody will pay a kind of settlement to avoid incurring the further costs of resisting the claim. In genuine cases, we have to ensure access to justice, of course, because clinical negligence claims are very important, and we think that the no win, no fee system, as modified, is the best way of doing so.
NHS Future Forum
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
This is clear evidence of a listening Government. Does the Secretary of State agree that what the NHS now needs is consensus
across all political parties, and for everybody to put their money where their mouth is and support the NHS and these changes as we move forward?
Andrew Lansley (Secretary of State, Health; South Cambridgeshire, Conservative)
I am grateful to my hon. Friend, who makes a very good point. The Future Forum made the point that what people across the NHS want now is the certainty of knowing what the policy is and to move forward to make that happen.
Women (Government Policies)
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Does my hon. Friend welcome the fact that over the next three years nearly £250,000 will be put into developing a rape crisis centre in Exeter, serving the women of Devon, who have been disgracefully under-resourced over the past 10 years?
Claire Perry (Devizes Conservative)
My hon. Friend makes an excellent point. Of course, under the previous Government nine out of 10 local authorities did not have a rape crisis centre. At a time of significant fiscal constraint, we are managing to find new money to invest in that incredibly important area and I thank her for her intervention.
Finally, as regards an area on which many of us in this House have campaigned together, the Government are taking active steps to deal with the oncoming tide of sexualisation and the commercialisation of childhood, whether by getting retailers to act in a responsible way or by getting internet service companies to consider a system that allows us not to have pornography piped into our homes and makes getting it a choice. Work is happening under this Government that I applaud.
This is a bit of a depressing debate to be involved in. Many Members share many of the same aspirations and campaign on important issues, but all we have is the bandwagonism and hypocrisy of the Labour party. What I have enjoyed most in this debate has been listening to Ministers who have told how we are focusing scarce money on those who need it now while taking steps so that the profligacy of the previous Labour Government does not leave our children and our grandchildren with debts to pay off.
Winterbourne View Care Home
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Will the Minister address the question of how long these vulnerable people were filmed being abused, because that simply would not have been tolerated if they were children?
Paul Burstow (Minister of State (Care Services), Health)
My hon. Friend makes an important point. I do not know the answer to the question of how long the people were filmed before the whistle was blown again by "Panorama". However, it is an important point that will undoubtedly become clearer as we come on to the details of the inquiry.
HM Coastguard
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Transport what definition of national resilience his Department uses in relation to its proposals for the future operating model for HM Coastguard.
Michael Penning (Parliamentary Under Secretary of State (Roads and Motoring), Transport)
In relation to the proposals for a future operating model for HM Coastguard, national resilience is the interoperability between all Coastguard Centres within a national network. This would enable HM Coastguard to maintain the provision of its mandated operational responsibilities during specific threat periods, intense loading or impairment to one or more centres as a result of staff shortages or infrastructure impairment.
Fisheries
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I congratulate my hon. Friend Zac Goldsmith on his tireless efforts to reduce fish discards.
All hon. Members understand the importance of fishing to our local economies, but I represent Brixham, which lands the highest-value catch in England. That represents more than £17 million for our local and national economy. That is real jobs, not just at sea but on land, and a very valuable export market.
I thank the fisheries Minister for his recent visit. He is now aware of Project 50%, which is being carried out in Brixham, to which many hon. Members have paid tribute. I should like to recognise the work of Darren Edwards, the net designer, and scientists at the Centre for Environment, Fisheries and Aquaculture Science. Shaun Gibbs, who presented the results of Project 50% to Maria Damanaki, and other trawlermen, have fitted cameras to their trawlers to monitor catches, so that we can get away from the existing quota system. They are taking part in the International Council for the Exploration of the Sea area 7e sole catch quota trial.
I also recognise the work of south-west fish producers, who are working with the Government through the Fishing for the Markets project to look at how to achieve better sales for unusual fish, such as pout, whiting, gurnard and dragonet. I hesitate to give anyone cooking advice—my family certainly do not miss my cooking back at home—but all one has to do with gurnard is stick it in the oven with a bit of butter and rosemary. Nothing else is required, and it is absolutely delicious. I commend gurnard to the House!
Fisherman in Brixham and surrounding areas have made extensive efforts to reduce discards—all hon. Members will recognise that—but we can imagine their frustration. They have reduced their fishing effort and taken part in a series of trials to reduce discards, at great personal cost, and improved the sustainability of the mixed fishery in the English channel, only to find that Dutch fly-draggers that have fished more than their quotas and destroyed their fishing grounds in the North sea are coming over and having the same impact in our waters. That is extremely demoralising for our fishermen.
The CFP is undoubtedly outdated and unsustainable, but we must be careful in how we implement measures on discards. I was reassured that the wording of the motion was altered so that we recognise that not all species that are thrown back into the sea die. My hon. Friend Sheryll Murray, who is very experienced, drew attention to the fact that if we landed all the crab that we catch, crab would become extinct, which is an important point. We must also recognise the efforts made in the lobster fisheries, which now notch rather than land buried, egg-bearing lobsters, which has greatly increased fish stocks locally. Therefore, we need to be careful in how we talk about discarding, and look at all the alternative measures that have been outlined, which I hope the Minister will consider.
I know that the Minister works tirelessly on behalf of our fishing industry, but we would also like to see some fairness. I am in the difficult position of representing both the under-10 and the over-10 metre fleets, which clearly have different needs, as we all recognise. However, if we are to have fairness, their efforts must not be undermined by foreign vessels. I am sure that all Members would ask the Minister to press home the point in Europe that this is the only way forward. However, I know that many other Members wish to speak, so with that I will take my seat.
Future of the NHS
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I have no doubt that one of the main reasons why I was elected to the House was because I promised to bring my clinical experience to bear on the health debate and to stand up for our NHS. I would therefore like to set aside party politics for a moment and give my personal take on the direction that I hope the proposed reforms will take and where we should go from here.
At the heart of the Bill lie issues of choice, competition and clinical commissioning. My right hon. Friend Mr Dorrell set out clearly the huge funding challenges that face the NHS. We have always had rationing in the NHS, but we are squeamish about discussing it. In an ideal world with unlimited resources, unrestricted choice would of course be a good thing, but it is not deliverable. Because of the limited budget, we need to focus on getting the very best value while openly and honestly involving communities in how we do that fairly. If that happens locally, one person's local commissioning becomes another person's postcode lottery.
The central problem with unrestricted choice in the form of the "any willing provider" model is that it forces commissioners to act as bill payers and has the potential to undermine good commissioning. What is the point of commissioners designing high-quality, locally responsive clinical pathways that deliver good value for money for the whole community if patients have a free choice of any willing provider and commissioners have no choice but to write the cheques?
Chuka Umunna (Streatham, Labour)
The hon. Lady has long experience of working in the sector. One of my concerns about the "any willing provider" model is how it will potentially disadvantage teaching hospitals. [Interruption.] The Minister of State, Mr Burns, might want to listen to this, because one of the hospitals involved is St Thomas's, which serves the House, and if he fell ill here he would probably go over there. One of my concerns is about how teaching hospitals will be able to compete with other providers given the extra burdens of training and supervising those who are learning to work in the NHS. Does the hon. Lady share that concern?
Sarah Wollaston (Totnes, Conservative)
Of course, one of the greatest burdens on many hospitals is that of the private finance initiative, and I will come to the issue of training later. I am not
opposed to competition in the NHS, but it should not be an end in itself. It can have a role in improving some services—take, for example, the provision of mental health services and talking therapies, on which I am repeatedly told that the voluntary sector delivers better results. If I were facing a long wait for an MRI scan, for example, I would not mind if it was provided by the private sector as long as it was free to me at the point of use as part of the NHS.
The point is that competition should be used only where there is evidence that it can deliver real benefits for patients and value for money for the whole patient community. If competition becomes an end in itself, that can actually increase costs and risk fragmentation. For that reason, I hope that as the Bill moves forward, there will be fundamental changes to the role of Monitor. The NHS cannot operate like a regulated industry, and I believe that concern about the proposed role of Monitor is the impassable barrier to co-operation from the professions, without which we will not achieve the great success that we need from these reforms.
We must return to the original promise of the reforms, which was about clinical commissioning and a focus on outcomes rather than targets. For years, commissioning has failed because decision making in primary care trusts has not been clinically led. The NHS has been dogged by illogical care pathways, top-heavy management and a target-driven mentality, often completely divorced from any evidence base. The idea that clinicians should be put at the heart of decision making is still very sound, and it has become divisive only because of the stipulation that GPs should hold all the cards and be the sole commissioners.
Where clinical commissioning is already successful, that is achieved through a collaborative process with multi-disciplinary input. I hope that as a result of the Government's welcome listening exercise, the call to broaden the membership of commissioning consortia will be heeded, along with the need for a more graduated and phased introduction so that consortia are authorised only when they are ready. The same should apply to foundation trusts. They should take on functions only when it is right for that to happen.
If commissioning consortia are to achieve the best results for their patients, they will need to focus on the integration of health and social care, as my right hon. Friend the Member for Charnwood said. I pay tribute to Torbay, which was at the forefront of moves that were widely applauded nationally and internationally, including by the King's Fund, and that achieved real results for patients, driving down unnecessary admissions and improving outcomes. The integration of health and social care is complicated to achieve, so perhaps Monitor could have a relevant role in it—not arbitrating in disputes about competition law, but driving down costs and facilitating integration. We know that splitting tariffs, for example, could benefit community hospitals. Again, that is complex to achieve, so perhaps Monitor could also help in that regard.
For consortia to succeed, not only do we need to focus on the make-up of their boards, but they must be geographically logical and, I am afraid, cater for geographically defined populations. Giving a free choice to register with any consortium risks encouraging consortia
to cherry-pick their patients. One striking feature of the Bill is its sheer scope. All junior doctors will remember the fiasco of MTAS—the medical training application service. We currently have a successful model of deaneries in this country. I hope that we can retain them as the Bill goes forward, because they have a vital role to play in encouraging quality. Of course they are not perfect, and they need to look at regional variants, but we should keep our deaneries.
Speaking of quality, at present, PCTs play a vital role in maintaining what is called the performers list, on which all GPs have to be registered in order to practise in an area. As we move forward, we need to clarify who will take over that role. That is particularly important because we have a crisis with many doctors coming here, particularly from the European Union, who do not speak adequate English, as we saw in the case of Dr Ubani. We need to ensure that the person responsible for the performers list can get rid of this nonsense, so that all doctors not only have the necessary qualifications, clinical skills and experience, but have good spoken English.
I welcome this listening exercise, which I believe is genuine, and I hope that the Opposition will engage with it constructively. The public's affection for the NHS is well justified. At its best, the NHS is outstanding. Where that is the case, it is not competition that has delivered those good results, but a relentless focus on what is right for patients. We need to do the same in this House.
Alcohol Sales: Children
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
What legislative proposals she plans to make for further restrictions on the sale of alcohol to children.
Theresa May (Home Secretary)
The Government do not tolerate the sale of alcohol to children. The Police Reform and Social Responsibility Bill will double the maximum fine from £10,000 to £20,000, delivering on a coalition agreement commitment, and will extend the minimum period of voluntary closure that can be given for persistent under-age sales. We are also committed to working with the Sentencing Council and the Crown Prosecution Service to prosecute those found guilty of persistent under-age selling and to use the full range of sentences available.
Sarah Wollaston (Totnes, Conservative)
In England alone, about 36 children every day are admitted to hospital as a result of alcohol-related harm. Will the Home Secretary consider making the reduction of alcohol-related harm an objective, and prioritise it in respect of licensing decisions?
Theresa May (Home Secretary)
I am grateful to my hon. Friend for raising this issue, particularly given her experience as a general practitioner. I recognise the picture she paints, and I would add that half of all violent assaults are believed to be alcohol related, so there is a real issue with alcohol that we need to consider. We think there is merit in making health a material consideration under the Licensing Act 2003. The Police Reform and Social Responsibility Bill will make certain health bodies responsible authorities under the Act. We are talking to the Department of Health about what we might do to ensure that the health aspects of alcohol are properly taken into account.
Medical Students
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
The other point that needs to be made is that many of these courses are for six years, not just five. We need to take into account
the cost of living expenses and the fact that many medical students have to take out commercial loans in addition to student loans, which makes the matter especially significant. I declare an interest as the mother of a medical student on a six-year course.
Larch Disease
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
May I back that up by talking about the experience of my constituent, Mr Rob White, who has lost 20 hectares of his Japanese larch under a compulsory felling notice? He is on a planted ancient woodland site and only 50% to 70% of his replanting costs would be covered—even if he planted
wholly broadleaf species—and he is seriously considering the extent to which he will replant. He would, of course, like to use his common sense and replant a range of species; he has talked to me about replanting Sitka spruce and Douglas fir, which are relatively disease-resistant, and he would also like to mix in some broadleaf species. Does my hon. Friend feel that we should trust our constituents to use their common sense in that regard?
Medical Training
Prime Ministers Questions
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
In 2007, the Labour Government implemented the Medical Training Application Service, or MTAS. Junior doctors will remember what a disaster it was. That large-scale, disruptive and untested system had disastrous consequences for junior doctors in training. Is the Prime Minister aware that there are concerns that the current proposals to reorganise medical training and work force planning could have similar unforeseen consequences?
David Cameron (Prime Minister)
I must say to my hon. Friend that she is a lot better at getting them to shut up than I am. I think that she is a future Speaker in the making.
I can absolutely guarantee to my hon. Friend that we will not make the mistake that the last Government made in respect of medical training. They created an utter shambles.
Police
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for the Home Department what plans she has for future numbers of front line police officers in England.
Nick Herbert (Minister of State, Justice)
It is for chief constables and their police authorities to make decisions on the number of police officers within their available resource. The Government believe that forces can make savings while maintaining or improving the service they provide to the public.
Alcohol Marketing
Commons Debate
Sarah Wollaston (Totnes, Conservative) Clich here to watch Parliament Live
I beg to move,
That leave be given to bring in a Bill to introduce measures to reduce the exposure of children to the marketing of alcohol products;
to make provision to establish the permitted content of marketing of alcohol products;
and for connected purposes.
About 13 young people will die this week as a result of alcohol, and about 650 this year. Nearly a quarter of all deaths of young people aged between 15 and 24 are caused by alcohol. That is two every day-far more than are killed by knife crime or cancer-yet this tragic loss from alcohol attracts far less by way of a response. These totally avoidable deaths are just the tip of the iceberg and do not begin to represent the full scale of the harm caused by alcohol to children.
Alcohol blights lives, with criminal records as a result of violent and antisocial behaviour, and it results in educational failure. Regretted and unprotected sex raises the risk of unwanted pregnancies and sexually transmitted infections. Around 7,500 children are admitted every year to English hospitals alone as a result of acute intoxication, and that figure does not include the carnage in our accident and emergency departments.
There are many contributing factors and no simple solutions. Ultra-cheap alcohol and saturation availability still need to be tackled, but we also need a change in our drinking culture. The Bill aims to tackle one of the root causes of that culture, and there is a clear evidence base to support it. Youth culture is heavily influenced by marketing and our children are saturated by alcohol advertising. Despite the clear evidence of harm-only Denmark and the Isle of Man have higher levels of binge drinking and drunkenness in their schoolchildren-the European school survey demonstrated that our children have the most positive expectations of alcohol of any children in Europe and were the least likely to feel that it might cause them harm.
Where do those positive expectations come from? Let us just look at the scale of marketing in the UK. The estimated spend on alcohol marketing is around £800 million, compared with the Drinkaware trust's funding by the industry of just £2.6 million. When £307 is spent encouraging drinking for every pound spent promoting sensible behaviour, the results are predictable. The World Health Organisation hit the nail on the head when it said:
"In such a profoundly pro-drinking environment, health education becomes futile."
The Portman Group, one of the main regulators of the industry, would have us believe that it runs a very tight ship and is effective in protecting children. That simply is not true.
Our confusing and inadequate combination of legislation and industry self-regulation is not working. The report on alcohol by the last Health Committee highlighted the fact that 96% of 13-year-olds from a sample of 920 were aware of alcohol advertising in at least five different media, and between 91% and 95% were able to identify masked brands. Nearly half owned alcohol-branded products, such as clothing. Does that matter?
A systematic review of multiple studies looking at the impact of alcohol advertising and media exposure on adolescents-a study that reviewed many studies-concluded that increasing exposure to alcohol marketing encourages children to start drinking younger and to drink more when they do. The Academy of Medical Sciences report "Calling Time" showed a consistent correlation between consumption levels by 11 to 15-year-olds and the amount spent on marketing. We can be sure that, if alcohol advertising did not work, the industry would not pay for it.
So many of the possible solutions to our binge-drinking epidemic are incompatible with European law, so it is rather refreshing to hear that France has found a way forward. In 1991, in response to saturation inappropriate marketing, the French introduced a measure called the Loi Evin. This law has been repeatedly challenged in the European courts and has been upheld as
"proportionate, effective and consistent with the Treaty of Rome",
which all Members would agree makes a pleasant change.
Alcohol was a serious problem in France. In 1960 the French were consuming over 30 litres of pure alcohol per capita per year. Consumption is well under half that figure now. I accept that French levels of alcohol consumption were falling before the Loi Evin was introduced, but the French have managed to sustain that decline and the long-term trend continues to be downwards. That is partly because their young people are no longer exposed to a continuous barrage of insinuating and pervasive messages about alcohol.
I am not suggesting a retreat to the nanny state or a ban, but we should aim to protect children, especially as there is clear evidence of their exposure to marketing and the consequent harm. We currently have an absurd situation where advertisers are not supposed to link drinking with social or sexual success or portray drinkers as youthful or vigorous, but they can regularly sponsor major sporting and youth events, such as T in the park. The Bill aims to reduce the exposure of children to the harmful effects of alcohol marketing by setting out what advertisers are allowed to say and where they can say it. Rather than the current confused cocktail of legislation and self-regulatory codes, let us switch to something that works.
The Bill would permit the promotion of alcohol in media that adults use. That would include the print media, where at least 90% of readers are adults rather than children, radio after 9 pm and films with an 18 certificate. It would allow advertising at the point of sale in licensed premises and at traditional producer events, so it would not penalise, for example, west country cider makers or small Scottish distilleries. In these media, advertisers would be permitted only to make factual and verifiable statements about their products, such as alcoholic strength, composition and place of origin. Every advert would also carry an advisory message about responsible drinking or health.
Any other marketing or promotion not specifically permitted would therefore be banned, and this would include television, social media and youth-certified films. The Bill would specifically prevent the growing threat from viral phone marketing and ploys such as "advergames" on the internet, where so-called games are a cover for alcohol marketing. I think we would all agree that those are designed specifically to appeal to young people. Ofcom in its own research has demonstrated that for every five 24-year-olds who see an alcohol advert on television, there are four 10-year-olds who see the same advert. The industry will claim that these measures will kill off sport and culture, and that advertising is designed only to persuade people to switch brands. The same claim was made before the tobacco advertising ban. I point out that France has managed a World cup and a European cup without any help from alcohol sponsorship.
Across the channel, the Loi Evin is backed up by heavy penalties which have been imposed by the courts and now act as a significant deterrent. May I ask that we stop putting the fox in charge of the chickens and have a clear statutory code to protect our children? The Government could adopt this measure very quickly. I am pleased to see the Under-Secretary of State for Culture, Olympics, Media and Sport, Mr Vaizey in the Chamber today. I call on him to meet me to discuss further how we could implement the measure in the Government's alcohol strategy.
The coalition has staked a great deal on talking about outcomes. If we are serious about outcomes such as reducing health inequality, reducing violent crime and domestic violence, improving the life chances of our children and reducing teenage pregnancy, we must stop talking to the drinks industry, with its vested interest in increasing drinking, and start listening to those with real expertise in preventing alcohol-related deaths. Not so much big society, perhaps, as big sobriety.
Philip Davies (Shipley, Conservative)
It will come as no surprise to my hon. Friend Dr Wollaston that I object to the Bill in principle and in practice. Despite her best efforts to suggest otherwise, it is clearly an attempted extension of the nanny state, of which we have had far too much already. It is gesture politics to try to appease the health zealots in this country, most of whom cannot be appeased anyway.
I accept my hon. Friend's point that the British Medical Association found that 96% of 13-year-olds are aware of alcohol advertising. However, I dispute the inference that that leads them to go out and drink. After all, many 13-year-olds are probably well aware of car adverts, but that does not mean that they all go out driving as a result of watching them. All the research has shown the exact opposite. When young people were asked what was most likely to influence people under the age of 18 to drink alcoholic drinks regularly, 67% said the influence of friends, 56% said the availability of drink, just 5% said TV advertising, and only 3% said sponsorship.
If we accept this policy, where will it end? All sorts of products are bad for us if taken in excess. Cream cakes are undoubtedly bad for us if we partake of them in excess, as are pizzas, chocolates and curries. Does my hon. Friend propose to come back at a future date to ban the advertising of cream cakes, pizzas and curries, or anything that happens to be bad for us? This is the start of a very slippery slope, and one that I am not prepared to go down.
The Bill would do enormous damage to sports clubs. It is estimated that alcohol companies spent between £150 million and £200 million a year sponsoring sport alone, including many amateur sports teams. Without that sponsorship it would be difficult for those clubs to continue. We have the rather ludicrous suggestion that we should for health reasons attempt to try to stop the advertising of alcohol, the only consequence of which would be to stop lots of people being able to take part in sporting activities, which is presumably something the health lobby wants to encourage. The Minister for Sport and the Olympics reiterated that point when he stated:
"I know both from my own experience of growing up playing sport in Kent and my work as a constituency MP that the sponsorship offered by alcohol companies to community sports clubs brings a considerable number of benefits, both financially and in kind. This allows sports clubs to reach out to more people or improve their offer in a way that would not otherwise be possible."
I object to the Bill in principle, but even the people who accept it in principle must recognise that it is completely unnecessary. It is a solution looking for a problem. Alcohol already cannot be sold to anyone under the age of 18, so if my hon. Friend is concerned about young people drinking alcohol, surely the solution to the problem is to stop anyone selling it to them. That law already exists.
The UK already has a comprehensive framework of regulation that makes the Bill completely unnecessary. The Advertising Standards Authority has an established regulatory system, the Portman Group provides its own code of practice and Ofcom regulates TV programme sponsorship. The current alcohol advertising rules were tightened in October 2005, in response to the alcohol harm reduction strategy, and they were reviewed again in 2008, taking into account the latest evidence commissioned by the Department of Health, and were subject to a full public consultation in 2009. The rules already state that adverts must not target under-18s; be shown around programmes that especially appeal to under-18s; link alcohol with seduction, sex or social success; link alcohol with irresponsible, anti-social, tough or daring behaviour; show alcohol being served irresponsibly; show people drinking and behaving in an adolescent or juvenile way or reflecting the culture of people under 18-years-old; or be shown in publications aimed at under-18s or where more than 25% of the readership is under 18.
Additionally, alcohol adverts already cannot be shown around programmes popular with young people, such as "The Simpsons" and "Ugly Betty", even if the programmes appear after 9 pm. The Portman Group also introduced a code in 1996 that regulates all drinks marketed in the UK through its code of practice on the naming, packaging and promotion of alcoholic drinks. Its code is so rigorous and highly regarded that the better regulation taskforce described it as a good example of how effective self-regulation can be, and the International Harm Reduction Association includes the code within its leading 50 global alcohol harm reduction initiatives.
Furthermore, the aim of the Bill is not evidence-based. The argument is that it will reduce drinking levels among younger people, but that has not been proven by any research evidence. If any such impact did exist, it would be outweighed by other factors, such as the family environment. In fact, a study, "The Impact of Alcohol Marketing on Youth Drinking Behaviour", found that
"no association was found between uptake of drinking and baseline awareness of alcohol marketing or number of brands recalled at baseline...no association was found between uptake of monthly drinking at follow-up and baseline awareness of alcohol marketing".
Professor Hastings actually completed a longitudinal study to try to measure the impact of alcohol marketing on 13-year-olds in the west of Scotland. He found no association between awareness of alcohol marketing at age 13 and either the onset of drinking or the volume of alcohol consumed two years later. Surprisingly, that part of the study received very little publicity.
The lack of evidence is also apparent if we look at international comparisons. Norway has strictly no advertising for alcoholic beverages, yet consumption has been steadily increasing. In Italy, where alcohol advertising is permitted, consumption is decreasing. France is also an interesting case, as it is the example on which my hon. Friend bases her Bill. The equivalent Loi Evin Bill was introduced in France in 1991, but it has not had the intended consequences that she would have hoped for. Statistics from the World Health Organisation show that French alcohol consumption decreased from 18.46 litres per capita in 1981 to 14.88 litres in 1991. Since the Loi Evin was enacted, consumption has levelled off, dropping to only 13.24 litres, highlighting the fact that the legislation has had little, if any, impact.
The Bill smacks of the nanny state and would set a dangerous precedent for future legislation. It would damage an already fragile amateur sporting club base without any evidence-based proof that such a change in the law would reduce youth alcohol consumption. There are less burdensome means by which we can reduce underage drinking, such as enforcing existing laws on the sale of alcohol to under-18s and to do what the Government should be doing, which is highlighting the health implications of drinking alcohol and allowing people to make up their own minds. In a free country, that is what we should believe in. This is a further extension of the nanny state to try to appease health zealots and fanatics who will never be appeased.
Question put (Standing Order No. 23) and agreed to.
Ordered,
That Dr Sarah Wollaston, Mr Kevin Barron, Tracey Crouch, John Pugh, Stephen Gilbert, Paul Flynn, Mr David Amess, Chris Bryant, Kelvin Hopkins, Mike Wood, Anne Marie Morris and John McDonnell present the Bill.
Dr Sarah Wollaston accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 9 September, and to be printed (Bill 176).
English Constituencies
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
On that point, would the right hon. Gentleman accept that English constituencies feel that there is great unfairness? We feel under-represented but over-taxed. For example, we wonder why we are subsidising university education for Scottish pupils, and free prescriptions.
Alcohol Drinks: Misuse
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health
(1) what estimate he has made of the number of deaths (a) directly attributable to alcohol consumption, (b) where alcohol consumption was an attributable factor and (c) where alcohol consumption was named on the death certificate as a contributory cause in each of the last three years;
(2) what estimate he has made of the proportion of deaths from (a) oesophageal cancer, (b) colorectal cancer, (c) breast cancer, (d) pancreatic cancer and (e) liver cancer that were attributed to alcohol consumption in the last year for which figures are available;
(3) what estimate he has made of the number of (a) suicides and (b) accidental deaths that were attributed to alcohol in the last year for which figures are available.
Nick Hurd (Parliamentary Secretary (Civil Society), Cabinet Office)
I have been asked to reply.
The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.
Letter from Stephen Penneck, dated March 2001:
As Director General for the Office for National Statistics, I have been asked to reply to your recent questions.
Table 1 provides the number of deaths where an alcohol-related cause was (i) the underlying cause of death, or (ii) mentioned anywhere on the death certificate, either as the underlying cause or as a contributory factor, in England and Wales, for 2007 to 2009 (the latest year available). The National Statistics definition of alcohol-related deaths only includes those causes regarded as being most directly due to alcohol consumption, as shown in Box 1.
It is not possible to provide figures for the number or proportion of deaths from (a) oesophageal cancer, (b) colorectal cancer, (c) breast cancer, (d) pancreatic cancer or (e) liver cancer which were caused by alcohol, from the information collected at death registration.
Internationally accepted guidance from the World Health Organisation requires only those conditions that contributed directly to the death to be recorded on the death certificate. Medical practitioners and coroners are not supposed to record all of the diseases or conditions present at or before death, and whether a condition contributed is a matter for their clinical judgment. Lifestyle and behavioural factors, such as the deceased's alcohol consumption, are not recorded.
Estimates of alcohol-attributable mortality for specific causes of death in England have been published in a collaborative report by the Centre for Public Health at Liverpool John Moores University and the North West Public Health Observatory, The report, titled 'Alcohol-attributable fractions for England: Alcohol attributable mortality and hospital admissions', is available at the following link:
http://www.nwph.net/nwpho/Publications/AlcoholAttributableFractions.pdf
Table 2 provides the number of deaths where alcohol poisoning was the underlying cause of death, where the intent was (a) intentional (suicide), (b) accidental, or (c) undetermined, in England and Wales, for 2009 (the latest year available). The figures do not include deaths caused by suicide, accidents or other circumstances where the deceased had consumed alcohol before the event, as this information is not routinely recorded in coroner inquest reports or at death registration.
Table 1: Number of deaths where an alcohol-related cause was the underlying cause of death, or was mentioned anywhere on the death certificate, England and Wales , 2007- 09( 1, 2, 3, 4)
Deaths (persons)
Underlying cause Mentioned
2007 7,042 11,988
2008 7,344 12,417
2009 7,099 12,550
(1) Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10). The specific conditions which are included in the National Statistics definition of alcohol-related deaths, and their corresponding ICD-10 codes, are shown in Box 1.(2) Deaths were included where an alcohol-related cause was the underlying cause of death, or was mentioned anywhere on the death certificate, either as the underlying cause or as a contributory factor.
(3) Figures for England and Wales include deaths of non-residents.
(4) Figures are for deaths registered in each calendar year.
Table 2: Number of deaths where alcohol poisoning was the underlying cause of death, by intent, England and Wales, 2009( 1, 2, 3)
Intent Deaths (persons)
Intentional 2
Accidental 179
Undetermined 8
(1) Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10) codes X65 (intentional self-poisoning by and exposure to alcohol), X45 (accidental poisoning by and exposure to alcohol), and Y15 (poisoning by and exposure to alcohol, undetermined).
(2) Figures for England and Wales include deaths of non-residents.
(3) Figures are for deaths registered in each calendar year.
Box 1: National Statistics definition of alcohol-related deaths
International Classification of Diseases, Tenth Revision (ICD-10) codes
Definition
F10 Mental and behavioural disorders due to use of alcohol
G31.2 Degeneration of nervous system due to alcohol
G62.1 Alcoholic polyneuropathy
I42.6 Alcoholic cardiomyopathy
K29.2 Alcoholic gastritis
K70 Alcoholic liver disease
K73 Chronic hepatitis, not elsewhere classified
K74 Fibrosis and cirrhosis of liver
(Excluding K74.3-K74.5-Biliary cirrhosis)
K86.0 Alcohol induced chronic pancreatitis
X45 Accidental poisoning by and exposure to alcohol
X65 Intentional self-poisoning by and exposure to alcohol
Y15 Poisoning by and exposure to alcohol, undetermined intent
Free School Meals: Totnes
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Education
(1) what proportion of pupils in (a) Totnes constituency, (b) South Devon and (c) England qualify for free school meals;
(2) how many children in (a) Totnes constituency, (b) South Devon, (c) the South West and (d) England received (i) free school meals and (ii) education maintenance allowance in the latest period for which figures are available.
Nick Gibb (Minister of State (Schools), Education)
The number and percentage of pupils known to be eligible for and claiming free school meals is shown in the tables. The answer includes full-time pupils aged 0 to 15 and part-time pupils aged 5 to 15.
It is not known how many pupils are eligible for free school meals but do not claim.
The question of how many children in Totnes constituency, south Devon, the south-west and England received EMA is a matter for the Young People's Learning Agency (YPLA) who operate the education maintenance allowance for the Department for Education. Peter Lauener, the YPLA's chief executive, has written to the hon. Member for Totnes with the information requested and a copy of his reply has been placed in the House Libraries.
Maintained nursery, maintained primary( 1) , state-funded secondary( 1,2) and special( 3) schools: school meal arrangements( 4,5) as at January 2010 in Totnes parliamentary constituency, Devon local authority, south-west Government office region and England
Totnes parliamentary constituency Devon local authority
| Number on roll (4,5) |
Number of pupils known to be eligible for and claiming free school meals (4,5) |
Percentage known to be eligible for and claiming free school meals |
Number on roll (4,5) |
Number of pupils known to be eligible for and claiming free school meals (4,5) |
Percentage known to be eligible for and claiming free school meals |
|
| Maintained nursery and maintained primary (1) |
5,320 | 780 | 14.6 | 49,790 | 5,990 | 12.0 |
| State-funded secondary (1,2) |
5,830 | 730 | 12.5 | 37,690 | 3,940 | 10.4 |
| Special (3) |
60 |
20 | 29.5 | 770 | 170 | 21.9 |
South-west Government office region England
| Number on roll (4,5) |
Number of pupils known to be eligible for and claiming free school meals (4,5) |
Percentage known to be eligible for and claiming free school meals |
Number on roll (4,5) |
Number of pupils known to be eligible for and claiming free school meals (4,5) |
Percentage known to be eligible for and claiming free school meals |
|
| Maintained nursery and maintained primary (1) | 357,850 | 47,470 | 13.3 | 3,838,680 | 711,410 | 18.5 |
| State-funded secondary (1,2) | 281,730 | 29,460 | 10.5 | 2,864,350 | 441,140 |
15.4 |
| Special (3) | 6,570 | 1,970 | 29.9 | 78,330 | 27,330 | 34. |
(1) Includes middle schools as deemed.(2) Includes city technology colleges and academies.
(3) Includes maintained and non-maintained special schools. Excludes general hospital schools.
(4) Includes sole and dual (main) registrations.
(5) Includes pupils who have full-time attendance and are aged 15 or under, or pupils who have part-time attendance and are aged between five and 15 (age as at 31 August 2009).
Note:
Figures have been rounded to the nearest 10.
Source:
School Census
Letter from Peter Lauener, dated 24 March 2011:
I am writing in response to your Parliamentary Question PQ47599 that asked:
"How many children in (a) Totnes constituency, (b) South Devon, (c) the South West and (d) England received (i) free school meals and (ii) education maintenance allowance in the latest period for which figures are available."
The Department of Education has responded to you regarding the first part of your question. I have been asked to provide a reply to the latter part of your question regarding how many children in Totnes constituency, South Devon, the South West and England have received Education Maintenance Allowance (EMA) in the latest period for which figures are available.
Information on the number of young people who have received EMA is available for upper tier local authorities but not by constituency or by local authority ward.
EMA take-up is defined as young people who have received one or more EMA payments in the academic year.
The table below shows take-up as at 28 February 2011.
Number
Devon 8,652
South West 57,693
England 628,751
EMA take-up data showing the number of young people who have received one or more EMA payments during 2004/05, 2005/06, 2006/07, 2007/08, 2008/09 and 2009/10 is available on the YPLA website, at the following address:
Excise Duties: Fuels
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Chancellor of the Exchequer if he will introduce fiscal measures to assist charities and voluntary organisations to meet the cost of fuel.
Justine Greening (Economic Secretary, HM Treasury)
Charitable organisations are free to pay volunteer drivers mileage payments through the approved mileage allowance payments scheme which is intended to cover motoring costs. Budget 2011 increases the payments scheme rates from 6 April 2011 to 45p per mile for the first 10,000 miles and 25p per mile thereafter.
Volunteer driving can involve the carriage of passengers to essential appointments such as at hospitals or local doctors' surgeries. Budget 2011 extends the payments scheme's existing 5p per mile passenger payment to volunteer drivers.
Coastguard Service
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I agree with the hon. Gentleman, but the problem is not always pronunciation. Sometimes there are problems with the sheer number of locations with the same name and spelling. We have 12 Cod rocks in my area, and someone local wrote to me recently about a serious incident when he was stranded off Cod rock.
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I will cut my speech short, as other hon. Members wish to contribute. We are not disputing the need for modernisation. We accept that the technology of Her Majesty's coastguard is outdated, but the staff are not. I dispute whether we can reduce the number of staff from 491 to 248 without a significant loss of local knowledge.
Detailed local knowledge is important, as is recognised in the fact that coastguard officers take rigorous local knowledge tests on their area of responsibility every two years and must receive an 80% pass mark to continue carrying out their highly professional role. I dispute whether two maritime operation centres could carry out such a role. To illustrate, if a child on a lilo is in difficulty off Blackpool sands, is the maritime operation centre likely to send the rescue effort to the west coast or to my constituency, which has a small cove by that name?
As time is short, I ask the Minister to consider the alternative proposals from Brixham coastguard. When he met Brixham coastguard, he invited its members to propose an alternative. They have discussed it with at least 14 other coastguards, who have endorsed their proposals. Time is short, but I hope that he will agree to consider them in detail.
To summarise the proposals, Brixham coastguard recognises the possibility of reducing the number of stations, but it proposes reducing that number to 14 rather than adopting the current proposals. It disputes the rationale for having two central maritime operation centres, but it understands that it might be necessary to review how duty rosters are managed and to use more of an evidence base to consider the details of call-outs, for example. That would be much more rational.
Brixham coastguard feels that it is possible to improve rostering, reduce staff and rationalise the management of the coastguard. For example, it disputes the need for regional management and suggests that we need only one national management centre for the coastguards. Again, that would generate considerable savings.
A review of technology is essential, but Brixham coastguard suggests that we consider electronic charts. It currently buys its own. Electronic charts are used by the RNLI and shipping, but not by Her Majesty's coastguard. The current system is outdated.
Brixham coastguard asks the Government to reconsider the replacement of radio equipment. There is a strong feeling in the coastguard that the system has not been adequately piloted. I have heard, for example, that it has been difficult to page rescue teams. I ask the Minister to reconsider and definitely to pilot any new system before it is rolled out.
The Minister knows what issues have arisen with fire and rescue centres, so I will not reiterate them-many Members have already made the point-but I will mention the fiasco of the NHS's over-reliance on IT. More than £12 billion has been spent on a system that has not been fit for purpose. It is a question not of just throwing money at the problem, but of piloting systems and ensuring that they do the job required of them.
The Brixham proposals ask the Minister to consider an alternative method of linking stations. We all recognise that resilience is an issue within the coastguard, but will he consider extending stations' areas of responsibility, so that they cover the stations to either side and are linked in triplets? That would increase resilience, rather than having centralised maritime operation centres, about which all Members who have spoken have expressed concern. That way, we can retain local knowledge and improve resilience. We feel that that, as well as considering staff rostering, would be a much better way forward.
I reiterate the strength of feeling nationally. Within my constituency, my local paper, the Herald Express, published an article on the issue and had 6,625 signatures and letters. That shows the strength of local feeling. I am sure that every Member will have seen similar responses in their constituencies. It is a national matter that we hope the Minister will take back to the drawing board and start again with a blank sheet of paper. The coastguards who do the job on the ground feel that they were not consulted and that experts or coastguard officials who had been away from operational responsibilities for some years were involved. I ask him to consider proposals from grass-roots coastguards with multi-centre support.
Renewable Energy: South West
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change what assessment his Department has made of the potential for (a) tidal power, (b) wind power and (c) solar power in renewable energy projects in (i) Totnes constituency, (ii) South Devon and (iii) the South West.
Gregory Barker (Minister of State (Climate Change), Energy and Climate Change)
The Department assessed the potential development of marine energy projects in England and Wales as part of the development of the Second Offshore Energy Strategic Environmental Assessment (SEA) scoping report. The SEA Environmental report has just been published and is now open for consultation. The SEA should pave the way for future leasing rounds for marine (wave and tidal) energy in English waters.
The Department has funded renewable and low carbon energy opportunity assessment studies covering some onshore renewable technologies in England, including for the south-west. We believe that the studies will be helpful to local planning authorities and local communities in drawing up local and neighbourhood plans. It will be for local planning authorities and communities to decide how best to use the findings of the studies to inform their development plans and to maximise opportunities for the deployment of renewable and low carbon energy in their areas.
DECC has not made an assessment of offshore wind potential in the south-west. However, in January 2010, the Crown Estate leased the Bristol Channel Round 3 offshore wind Zone 8 to RWE Npower Renewables, the UK subsidiary of RWE Innogy. The target capacity for this zone is 1.5 GW. The total Bristol Channel zone area is 950 km(2).
Following the award of the zone, RWE Npower renewables announced their intention to develop a 1.5 GW wind farm called 'Atlantic Array' within the zone. The site extends over 492 km(2) and is 14 km from the north Devon coast and 18 km from the south Wales coast at its closest point.
The Element Energy report on 'The Growth Potential for Microgeneration in England, Wales and Scotland' provides an overall picture of the current and potential future level of demand for microgeneration, including solar power. It includes regional specific information. Further information is available at: Department of Energy and Climate Change
Crime: Devon
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for the Home Department what assessment she has made of levels of (a) violent crime and (b) domestic violence in South Devon in each of the last three years.
James Brokenshire (Parliamentary Under Secretary of State, Home Office)
The Home Office collects data on violence against the person offences recorded by police forces in England and Wales. Data are collected at police force area level but can be broken down to local authority, Community Safety Partnership (CSP) and Basic Command Unit (BCU) levels. None of these levels have an area exactly corresponding to South Devon, however data are provided for South Hams alongside the total figures for England and Wales for each year from 2007-08 to 2009-10 in Table A.
Data on domestic violence are collected via the British Crime Survey but these can only be broken down to regional level. Data for the South West Region are provided in Table B. Further information can be found in 'Homicides, Firearms Offences and Intimate Violence 2009-10' at the following link: Home Office
Data on police recorded offences of domestic violence are collected but cannot be broken down beyond police force area level. Data for Devon and Cornwall police force area for 2007-08 to 2009-10 are provided in Table C.
Table A: Recorded violence against the person offences in South Hams and England and Wales, 2007-08 to 2009-10
Area 2007-08 2008-09 2009-10
South Hams 634 554 502
England and Wales 961,099 903,447 871,712
Table B: Percentage of adults aged 16 to 59 who were victims of domestic abuse in the last year, 2007-08 to 2009-10 BCS
Statistically significant change:
2007-08 2008-09 2009-10 2007-08 to 2008-09 2008-09 to 2009-10
South West 5.8 4.1 4.7 * -
Note:To enable comparisons over time, these figures do not include stalking as questions on stalking were not included in the 2007-08 BCS.
Table C: Reported domestic violence incidents( 1) , Devon and Cornwall police, 2007-08 to 2009-10
Number of reported domestic violence incidents
2007-08 23,789
2008-09 25,872
2009-10 25,659
(1) All data are provisional and unverified.
Tourism
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Culture, Olympics, Media and Sport what assessment he has made of the effect of his tourism strategy on (a) seaside towns, (b) rural communities and (c) Dartmoor National Park and other areas of outstanding natural beauty.
John Penrose (Parliamentary Under Secretary of State, Culture, Olympics, Media and Sport)
Over the next four years we are aiming to attract 4 million extra visitors to Britain adding £2 billion additional expenditure and create 50,000 jobs through the new £100 million overseas tourism marketing fund.
In measurable terms we should increase the proportion of UK residents who holiday in the UK to match those who holiday abroad each year. For longer stays (four nights or more) this would mean 29% of travellers holidaying in Britain rather than just 20% today (creating 4.5 million extra domestic trips each year, £1.3 billion more spend and 26,000 new jobs). And if we can replicate this scale of improvement for shorter stays as well, we will create a further £750 million of spend and 11,000 new jobs.
I am afraid we have not broken these figures down into the particular categories suggested in this question.
Business: Rural Area
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Business, Innovation and Skills what support his Department provides to (a) reduce the burden of (i) taxation and (ii) administration on and (b) increase the rates of lending to small rural businesses.
David Gauke (Exchequer Secretary, HM Treasury)
I have been asked to reply.
To reduce the burden of taxation on small business, the Government announced in the June 2010 Budget that it will reduce the small profits rate of corporation tax from 21% to 20% from 1 April 2011. This reduction will enable approximately 850,000 companies with profits below £300,000 to retain a greater a share of their profits to reinvest. For small business with employees, the Government announced, from April 2011, a rise in the secondary threshold for national insurance contributions and income tax personal allowance. These measures will reverse the impact of the previous Government's planned £6 billion a year rise in the taxation of labour and will reduce the amount the government takes, from what an employer sets aside to cover wages, before it becomes take home pay.
The Government launched the independent Office of Tax Simplification in July 2010 and tasked them with a review of tax reliefs and a review of small business taxation. The Office of Tax Simplification's final report on tax reliefs was published on 3 March while the interim report on small business taxation was published on 10 March. The Government will respond to these reports at Budget. The Government is committed to simplification and easing the burden of tax administration on business.
On 9 February the Chancellor announced a new lending commitment by the UK's biggest high street banks. As part of these commitments:
The banks intend to lend £190 billion of new credit to businesses in 2011, up from £179 billion in 2010. If demand exceeds this, the banks will lend more. £76 billion of this lending will be to small and medium-sized Enterprises (SMEs). This is a 15% increase on 2010 lending of £66 billion.
The banks have also proposed to increase the size of the £1.5 billion Business Growth Fund (set up by the British Bankers Association Taskforce), announced in October last year, which will invest in small businesses with strong growth potential. The four major UK banks had already pledged £1.5 billion to the Business Growth Fund. They have now committed to increase its capital by a further £1 billion over the next three years, front-loaded over the next two years so that more help can be given to businesses sooner. This will increase the amount of equity investment allocated to SMEs, at the same time helping to attract further bank lending to these businesses.
These measures apply to all small businesses, including rural small businesses.
Apprenticeships: Totnes
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Business, Innovation and Skills how many apprenticeships were created in Totnes constituency in the last 12 months; and what estimate he has made of the number to be created in the next 12 months.
John Hayes (Minister of State (Further Education, Skills and Lifelong Learning), Business, Innovation and Skills)
There were 450 apprenticeship starts in Totnes parliamentary constituency in 2009/10, the latest year for which full year data are available.
The apprenticeships programme is demand led; Government does not set targets for apprenticeships but provides funding and forecasts the overall number of places that may be afforded. We rely on employers and providers to work together to offer sufficient opportunities to meet local demand.
This is underpinned by this Government's commitment that by 2014-15, we will have in place sufficient funding for 75,000 more adult apprenticeship places than the previous Government were providing.
Information on the number of apprenticeship starts is published in a quarterly statistical first release (SFR). The latest SFR was published on 27 January: The Data Service
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Business, Innovation and Skills what proportion of apprenticeships in Totnes constituency were taken up by women in the last 12 months.
John Hayes (Minister of State (Further Education, Skills and Lifelong Learning), Business, Innovation and Skills)
Table 1 shows the number and percentage of apprenticeship starts by gender for Totnes parliamentary constituency for 2009/10, the latest year for which full year data are available.
Female Count Percentage Male Count Percentage Total Percentage
Totnes constituency 210 48 230 52 450 100
Notes:1. All figures are rounded to the nearest 10. Percentages are calculated based on unrounded figures.
2. Geography information is based upon the home postcode of the learner.
Source:
Individualised Learner Record
Information on the number of apprenticeship starts is published in a quarterly statistical first release (SFR). The latest SFR was published on 27 January:
Both the Department for Business Innovation and Skills, and the Department for Education are responsible for the promotion of equality of access to apprenticeships. The National Apprenticeships Service (NAS), as the body responsible for promoting apprenticeships to employers and to potential apprentices, manages its systems to ensure equal access to information about the programme and to apprenticeship vacancies. A priority for NAS is to address stereotyping and under-representation across apprenticeships including gender, race and disability.
Music: International Baccalaureate
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Education what consideration he has given to the merits of including music in the English Baccalaureate.
Nick Gibb (Minister of State (Schools), Education)
We are concerned that the number of pupils, especially those in disadvantaged areas, who receive a broad education in core academic subjects is far too small. We want to encourage more pupils to take these core subjects and to bring about greater fairness of opportunity.
The English Baccalaureate does not include all the subjects worthy of study. We recognise that study in other subjects will be just as valuable to pupils and we will encourage all pupils to study non-English Baccalaureate subjects alongside the English Baccalaureate in order to benefit from a well rounded education. This is why we have kept the number of core subjects small enough to allow wider study. Subjects, such as music, which do not count towards the English Baccalaureate, can and will play a part in a well rounded, rigorous education. Achievement in these subjects, as with all GCSEs, will continue to be recognised in the performance tables as part of the A*-C measure, which will remain the basis for secondary school floor standards.
Cancer
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what recent steps his Department has taken to increase the provision of (a) cancer services and (b) mental health services in South Devon.
Paul Burstow (Minister of State (Care Services), Health)
We expect the national health service in South Devon to comply with the national policies on increasing the availability of cancer and mental health services. The national policies are outlined as follows:
'Improving Outcomes-A Strategy for Cancer', published on 12 January 2011, sets out a range of measures to improve the quality and efficiency of cancer services in England. Backed by more than £750 million over the next four years, the strategy sets out the Department's plans to improve earlier diagnosis, access to screening and treatment and improve patients' experience of care.
The Department published the national 'No Health Without Mental Health' Strategy on 2 February 2011. It has the twin aims of promoting and sustaining good mental health and well-being in the wider population, and improving the quality of existing services for people across the full range of mental health problems. It looks at prevalence of problems and effective approaches at different stages in life, stressing the importance of prevention and early intervention.
Copies of both publications have already been placed in the Library.
Public Sector: Pensions
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Chancellor of the Exchequer what legal advice he and his colleagues have received on proposals to change the basis of index linking of public sector pensions already in payment, including on amendments to such schemes whose members made a specific contribution in return for index linking in a particular way.
Danny Alexander (Chief Secretary, HM Treasury)
Where relevant the Government consider legal advice before announcing and implementing new policies. In line with longstanding practices and to protect legal privilege this advice is not released.
Disability Living Allowance
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Work and Pensions how many people in (a) Totnes, (b) the South West and (c) England receive the higher rate mobility component of disability living allowance.
Maria Miller (Parliamentary Under Secretary of State (Disabled People), Work and Pensions)
The information is as follows:
Disability living allowance recipients with higher rate mobility component in Totnes parliamentary constituency, the South West and England , August 2010
Number
Totnes 2,550
South West 127,130
England 1,432,020
Notes: 1. Caseload figures are rounded to the nearest ten. 2. Totals show the number of people in receipt of an allowance, and excludes cases where the payment has been suspended. 3. Constituencies used are for the Westminster Parliament 2010. Source: Department for Work and Pensions, Information Directorate, 100% WPLS.
Fuel Prices
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change
(1) if he will bring forward proposals to regulate the price of heating oil (a) for rural communities and (b) in general;
(2) if he will consider the merits of introducing a domestic heating oil price stabiliser for rural communities.
Charles Hendry (Minister of State (Renewable Energy), Energy and Climate Change)
The OFT has launched its market study into the off-grid energy market, particularly with regards to heating oil and liquefied petroleum gas (LPG). The study will cover both consumer and competition issues. It will look at the market's structure and the choice of suppliers, whether competition is working well for consumers, and contractual terms and fairness in supply agreements. The OFT expects to publish the study in October 2011; its findings and conclusions will help to determine whether any changes are needed to the off-grid energy market.
Agriculture
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs what measures she is taking to promote sustainable farming; and what assessment she has made on the effect this will have on (a) Totnes constituency, (b) South Devon and (c) England.
James Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs)
The first priority in DEFRA's business plan is to support British farming and encourage sustainable food production. Sustainable farming is essential to protect the natural resources on which future food production depends, and to protect biodiversity and the countryside. We are working closely with industry partners to achieve this: by backing the industry led Campaign for the Farmed Environment and Greenhouse Gas Action Plan. Specific support that DEFRA provides to farmers to help them undertake sustainable farming is funding via the Rural Development Programme for England (RDPE) in the form of agri-environment schemes such as Entry Level Stewardship, Higher Level Stewardship and Uplands Entry Level Stewardship. We also provide advice and guidance on effective nutrient management of land to maximise efficiency whilst minimising environmental impacts.
The Department uses a number of complementary approaches to assess the economic, environmental and social impacts of sustainable farming policies, including on the wider rural economy, but measured principally at a national level. These include specific evaluation projects, such as that of the RDPE, monitoring the uptake of relevant schemes, such as Entry Level Stewardship and the Campaign for the Farmed Environment, and developing comprehensive indicator sets to monitor progress along the economic, environmental and social vectors. Among these a small number of high level impact indicators will be used to track progress with respect to the DEFRA business plan but a much wider range of information is available, in particular, from the Agricultural Change and Environment Observatory indicator set, published at: DEFRA Observatory Programme Indicators
Epilepsy
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health how many people were diagnosed with epilepsy in (a) Totnes constituency, (b) South Devon and (c) England in each of the last 10 years.
Paul Burstow (Minister of State (Care Services), Health)
The information requested has never been collected.
The national Quality and Outcomes Framework (QOF) records the number of people, aged 18 or over, recorded on practice disease registers who are receiving drug treatment for epilepsy. The register is not a count of patients newly diagnosed with the disease within each year but rather a count of patients receiving drug treatment for epilepsy on a specific day within the year. These data are available for the releases of QOF covering financial years 2005-06 through to 2009-10 at: NHS Information Centre
Fuel Poverty
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change what recent assessment he has made of the level of fuel poverty in rural areas in (a) Totnes constituency, (b) South Devon, (c) the South West and (d) England.
Gregory Barker (Minister of State (Climate Change), Energy and Climate Change)
The following table shows the number of households and the number of rural households in fuel poverty in 2008, the latest year for which this information is available.
Thousand
Geographical area Number of households in fuel poverty Number of rural households in fuel poverty
(a) Totnes constituency 7 n/a
(b) South Devon(1) 31 n/a
(c) South West 339 152
(d) England 3,335 847
(1 )South Devon here comprises of the following local authorities: Plymouth, South Hams and Torbay.
The number of rural fuel poor households is not available for geographical areas smaller than Government office region.
Free Schools
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Education how many proposals for free schools he has received from (a) Totnes constituency, (b) the South West and (c) England.
Nick Gibb (Minister of State (Schools), Education)
As at 25 February 2011, we have received one proposal from the Totnes constituency, 29 proposals from the South West region, and a total of 329 for England.
UN Women
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
I should like to take this opportunity to raise the issue of women's rights in Saudi Arabia, and to pay tribute to Wajeha al-Huwaider, a remarkable woman-an author, journalist and human rights campaigner-who has done so much at great personal cost to raise the profile of women's rights in Saudi Arabia.
Women in Saudi have the status of perpetual minors and are denied the most basic human rights. Those abuses stem from the male guardianship system and the strict gender segregation in Saudi. A 2008 Human Rights Watch report spells out what that means in practice. Every Saudi woman must have a male guardian-normally a father or husband-who is tasked with making the most basic decisions on her behalf. An adult woman will sometimes have her son appointed as a guardian.
Fully competent adult women are treated as legal minors, with little or no authority over their lives, bodies or well-being. Every Saudi woman is affected, regardless of her economic or social status. Adult women must obtain permission from their guardian to study, work or travel, and many are denied the right to make even the most basic decisions on behalf of their children. All hon. Members know that whenever women are hidden away, with few rights, the risk of domestic violence is increased, but the male guardianship system makes it almost impossible for those women to gain access to justice even when they are subject to violence.
Officials may-and frequently do-demand a guardian's consent even when no law or guideline requires it. Many women have been asked to produce written consent from a male guardian for medical treatment. The Saudi authorities insist that the rules are being relaxed, but in practice, I am afraid that they are not. In theory, a woman-only over 45, mind you-may travel without permission. In practice, however, many women without written permission from their guardian are turned away at airports.
Wajeha al-Huwaider first came to international attention on international women's day in 2008, when-rather shockingly-she drove her car on her own. Subsequently many Saudi women tried to follow her lead, and one woman was seriously injured after being forced off the road. Following that, women were so ostracised for such actions that they ceased.
This was not always the case. Wajeha al-Huwaider described how in her grandmother's day women had much greater freedoms: they were allowed to work in markets, travel freely and go abroad without permission; there were not the same dress restrictions; and they could divorce and remarry easily without being ostracised. I am afraid, however, that that is no longer the case in Saudi Arabia.
As women in this country and across the world look forward to the Olympics, women in Saudi Arabia are banned from the Olympic team, and have no access to public sport at all. Not only is it impossible for a Saudi woman to participate in a football match, for example, but she is banned from attending one as a spectator. That is truly shocking. From a letter of support from both sides of the House to Wajeha al-Huwaider last year and subsequent correspondence, we know that she is not seeking to westernise Saudi society; she is seeking fundamental human rights. Women must be free to travel, study and access medical care, and to escape from violent and abusive relationships without the consent of a male guardian.
Saudi Arabia has vast wealth and vast opportunities to spread that wealth, but half of its population are among the most deprived people in the world. As we move towards the Olympics, I ask the Minister to use this opportunity to highlight the fundamental right of women to take exercise-a right denied to Saudi women. Will she join me in calling for all countries participating in the Olympics to allow women not just to sit in the spectators' gallery, but to take their rightful place on the starting line?
Water and Sewerage Charges
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I congratulate my hon. Friend Mr Sanders on securing the debate and on raising this really important issue.
I shall start by reading from an e-mail that I have received from a hard-working 52-year-old constituent of mine, Mr Bamber. This is the first time that he has written to his MP:
"I'm having a pay rise of 0.0% this year, but being a good bloke it's for the good of the country. Then my water bill arrives-it's risen by 9.75635%. I'm mad, and I'd like something done about it."
He is not alone; I have received several e-mails. Another disturbing fact was raised in an e-mail from a constituent who pointed out that his elderly mother, who is 80, has a water bill of £1,040, despite existing on a post office pension and being in substantial difficulties.
Although we all appreciate schemes such as WaterSure, many constituents have great difficultly in accessing them. I was particularly disturbed by a visit to my surgery this week by the husband of a constituent who suffers from severe multiple sclerosis. He brought with him evidence that he had sent to South West Water of her very much increased water usage as a result of her condition, and of the fact that she is on the higher rate of disability living allowance. They have, however, been declined access to WaterSure, which I am sure hon. Members agree is a complete disgrace. I hope that South West Water address that matter immediately.
The issue is one of unfairness. As my hon. Friend the Member for Torbay has pointed out, our constituents do not have any choice in the matter, other than to live somewhere else in the country, which is clearly ludicrous. The rises have been described as 8.1%, but for many constituents, they are nearer 10%.
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I agree completely. If Ofwat were doing its job properly, it would see that that is inherently fair. It is completely unreasonable to expect anyone to deal with a rise of more than 5%. Near 10% is totally outrageous, particularly given that our constituents have no choice whatever in the matter.
As other hon. Members have said, we are not, as is often assumed, a wealthy area. Some 22% of people in the south-west are pensioners, which is well above the national average. No one would suggest that pensioners are a wealthy group, but they are none the less being subjected to outrageous rises in their water bills. Will my hon. Friend the Minister take all those points into consideration? It cannot be fair for 3% of the population to shoulder the burden of cleaning up 30% of the coast. Of course, none of us feels that we could have continued using 200 sea outfalls to dispose of sewage, and we all welcome the economic boost from the infrastructure programme instituted by South West Water, but it is clearly unfair that the burden of that necessary programme should fall on our constituents.
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
May I raise the point that the accepted figure is 8.1% because the figure that the Minister quotes assumes that people will be switching to water meters?
Richard Benyon (Parliamentary Under Secretary of State (Natural Environment and Fisheries), Environment, Food and Rural Affairs)
My understanding is that that is the figure over the piece. However, I am happy to look into that and give my hon. Friend an absolutely clear and unequivocal answer, because it is important that we know that figure. In my hon. Friend's earlier remarks, I think she raised the point about why we use the retail prices index rather than the consumer prices index. [Interruption.] Sorry it was not her; it was my hon. Friend the Member for Torbay. Bills have been tied to inflation since privatisation because, when inflation is higher, water companies' costs increase. As is the case with other regulators, Ofwat uses RPI. Although RPI was higher than CPI this year, it was actually lower than CPI when last year's bills were calculated, so average bills that year were lower. We can argue about percentage points, but that is an important factor. Let us take that matter forward in our consultation, which I will come to in a moment.
I am acutely aware that nobody wants to see higher bills, particularly in these tough economic times. However, we should not lose sight of the fact that the money raised will pay for £159 million of investment in the region during the next financial year, which will benefit customers. I know that that sounds trite, and I am not diminishing the effect of the increase, but we must recognise that there are also benefits, including £14 million to improve tap water quality, £10 million to repair crumbling sewers and £28 million to further reduce pollution incidents.
Mileage Payments Allowance
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Chancellor of the Exchequer what plans he has for the future level of the mileage payment allowance.
Justine Greening (Economic Secretary, HM Treasury)
I refer the hon. Member to the answer given in response to Gordon Banks on 13 September 2010, Hansard, column 785W.
Fuel Oil Prices
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change what estimate he has made of the number of properties in (a) Totnes constituency, (b) the South West and (c) England which do not have mains gas access and which use domestic heating oil.
Charles Hendry (Minister of State (Renewable Energy), Energy and Climate Change)
In 2008, the latest year for which this information is available, there were around 773,000 households in England which had no access to mains gas and that used heating oil as their main heating fuel. Of these households, around 191,000 were located in the South West Government Office Region.
Equivalent figures for the Totnes constituency are not available.
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Energy and Climate Change if he will commission an inquiry into the reason for recent trends in the price of domestic heating oil.
Charles Hendry (Minister of State (Renewable Energy), Energy and Climate Change)
I refer the hon. Member to the written ministerial statement I gave on 21 January concerning the Off-Grid Energy market. I am keen that the reasons for the high price of domestic heating oil and supply issues this winter are thoroughly investigated by an independent authority. The Office of Fair Trading market study will provide an independent assessment of the off-grid market and establish what further action may be necessary to ensure it works properly. I look forward to seeing its conclusions in advance of next winter so the lessons from this winter can be learned and any necessary changes made.
X-Ray Expenditure
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for the Home Department what expenditure HM Revenue and Customs incurred in operating X-ray scanners in 2009-10.
Damian Green (Minister of State (Immigration), Home Office)
The United Kingdom Border Force recorded an operating cost for 'Scientific Aids' of £3.4 million in the financial year 2009-10.
Non Domestic Rates: Devon
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Communities and Local Government how many residential properties in the South Hams district council area have been transferred from council tax to business rates in the last 10 years.
Bob Neill (Parliamentary Under Secretary of State, Communities and Local Government)
A precise count of the number of residential properties that transfer from council tax valuation lists to non domestic rating lists in the South Hams district council area is not held, but the Valuation Office Agency (VOA) has used its records to make the estimates shown in the following table, which have been rounded to the nearest 10.
Nearly all these movements between lists are as a result of seasonal holiday lets being treated as commercial property during the summer and residential property during the winter.
Estimated number of properties inserted in non domestic rating lists that were previously residential properties
As at April to March each year Number
2000-01 40
2001-02 50
2002-03 70
2003-04 60
2004-05 190
2005-06 100
2006-07 120
2007-08 120
2008-09 120
2009-10 90
Local Government Finance: South West
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Communities and Local Government how much funding per capita (a) Devon county council, (b) Cornwall county council, (c) Dorset county council and (d) Somerset county council received from his Department in 2009-10.
Bob Neill (Parliamentary Under Secretary of State, Communities and Local Government)
The following table sets out the funding per capita for both the Department for Communities and Local Government funding and local government funding for the named authorities in 2009-10.
£
2009-10 funding per capita
Type of authority Local government funding Department for Communities and Local Government funding
Cornwall All purpose authority 403 103
Devon Shire county 225 74
Dorset Shire county 169 65
Somerset Shire county 200 76
Figures for Shire counties exclude funding for district councils within their county area.
Smuggling: Tobacco
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Chancellor of the Exchequer
(1) how much his Department spent on its Tackling Tobacco Smuggling strategy in 2009-10;
(2) how many staff of his Department were assigned to implementing the Tackling Tobacco Smuggling strategy in 2009-10; and how many such staff were engaged in (a) detection, (b) intelligence-gathering and analysis, (c) investigations and (d) the provision of legal advice;
(3) what estimate he has made of the expenditure incurred by his Department on salaries for full-time investigation staff allocated to its Tackling Tobacco Smuggling strategy for staff (a) engaged in detection, (b) engaged in investigations, (c) working on intelligence matters and (d) in total in 2009-10;
(4) what expenditure his Department incurred on publicity campaigns intended to reduce tobacco smuggling in (a) 2008-09 and (b) 2009-10.
David Gauke (Exchequer Secretary, HM Treasury)
The full-time equivalents of staff employed on tackling tobacco smuggling in detection, intelligence gathering and investigation for 2009-10 are shown as follows.
2009-10
Number
Detection 153
Investigation 360
Intelligence 172
Total 685
These figures represent HMRC's best estimate of the way resources were used in the year specified, bearing in mind that the work of staff employed on anti-fraud and smuggling activity often covers a number of different taxes and commodities.
Expenditure incurred on salaries for full time equivalent staff allocated to tobacco smuggling is shown in the following table.
2009-10
£
Detection 5,362,740
Investigation 20,840,605
Intelligence 7,946,658
Total 34,150,003
HMRC is unable to disaggregate time spent on the provision of legal advice on tobacco from time spent on other advisory work.
HMRC incurred no expenditure on targeted media campaigns to support their anti-tobacco smuggling strategy in 2008-09. HMRC funded £170,000 for targeted media campaigns in 2009-10.
Meat: Ritual Slaughter
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs what progress she has made on bringing forward legislative proposals for the labelling of meat in respect of (a) method of slaughter, (b) method of rearing and (c) name of the abattoir of slaughter.
James Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs)
No legislative proposals have been made in relation to labelling meat in respect of method of slaughter, method of rearing and name of the slaughterhouse where slaughter was carried out. However we are aware of the considerable public interest in this issue.
People should know what they are buying in shops or when they are eating out, and I have had discussions with the supermarkets, the food and catering industries about the role labelling and point of sale information can play in giving consumers a greater choice. This is a difficult, complex and sensitive issue that cannot easily be resolved in view of the many competing interests involved.
We will be looking at this further, but will need to consider the impact of existing EU meat labelling Regulations on our ability to propose national method of slaughter labelling carefully, before any final decisions are taken.
NHS Compensation
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what the largest 25 settled claims were under periodical payment orders in each of the last five years; and what the average annual cost of future care was at the date of settlement in respect of such claims.
Simon Burns (Minister of State (Health), Health)
The information on the average cost of initial annual payment is shown in the following table. The annual payment may cover costs other than care.
Settlement year Average of initial annual payment (£)
2005-06 71,002
2006-07 94,326
2007-08 99,686
2008-09 141,241
2009-10 114,965
Notes:1. The NHS litigation authority have shown the annual periodic payment value as at the point of settlement in each case.
2. Some periodic payment orders have agreed 'steps' in annual payments to recognise changes in the future costs eg at age 18 where 'independence' or university etc. may have a bearing. The table therefore shows the average of the initial annual payment.
The following table shows the largest 25 settled claims under periodical payment orders in each of the last five years. The total value for each estimate is based upon information at the time of settlement.
£
Position 2005-06 2006-07 2007-08 2008-09 2009-10
1 8,300,000 6,500,000 8,000,000 9,750,000 8,000,000
2 5,800,000 5,750,000 7,100,000 9,000,000 7,700,000
3 5,526,000 5,260,000 6,858,150 8,800,000 7,500,000
4 4,800,000 5,250,000 6,750,000 8,558,000 7,500,000
5 4,700,000 4,800,000 6,750,000 8,000,000 7,300,000
6 4,500,000 4,794,855 6,630,000 7,940,000 7,250,000
7 4,500,000 4,750,000 6,250,000 7,750,000 7,250,000
8 4,139,000 4,700,000 6,000,000 7,582,000 7,158,000
9 4,000,000 4,612,510 5,750,000 7,538,438 7,000,000
10 3,988,000 4,509,148 5,750,000 7,500,000 6,800,000
11 3,850,000 4,500,000 5,750,000 7,300,000 6,765,000
12 3,750,000 4,500,000 5,650,000 7,250,000 6,680,000
13 3,710,000 4,360,000 5,600,000 7,200,000 6,642,000
14 3,700,000 4,358,000 5,500,000 7,195,484 6,500,000
15 3,700,000 4,250,000 5,458,372 7,047,000 6,460,000
16 3,636,200 3,800,000 5,400,000 6,600,000 6,400,000
17 3,500,000 3,800,000 5,300,000 6,466,293 6,317,200
18 3,500,000 3,750,000 5,200,000 6,400,000 6,258,770
19 3,500,000 3,740,000 5,200,000 6,200,000 6,000,000
20 3,500,000 3,650,000 5,136,328 6,133,000 6,000,000
21 3,375,000 3,600,000 5,000,000 6,000,000 6,000,000
22 3,250,000 3,600,000 5,000,000 6,000,000 5,903,584
23 3,250,000 3,500,000 4,800,000 6,000,000 5,855,750
24 3,200,000 3,402,251 4,667,159 5,800,000 5,800,226
25 3,100,000 3,400,000 4,500,000 5,800,000 5,800,000
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health how many deaths there have been of claimants receiving payments under a periodical payment order from the NHS Litigation Authority and aged (a) 0 to 17, (b) 18 to 65 and (c) over 65 years at the date of the award in the last five years.
Simon Burns
(Minister of State (Health), Health)
The following table shows the number of patients receiving a periodic payment who have died in the last five years.
Age at settlement Number of periodic payments
0 to 17 30
18 to 65 4
Over 66 4
Total 38
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health how many patients aged (a) 0 to 17, (b) 18 to 65 and (c) over 65 years at the date of award were receiving damages payments under a periodical payment order awarded against the NHS Litigation Authority on 31 March (i) 2005 and (ii) 2010.
Simon Burns (Minister of State (Health), Health)
The following table shows the number of patients receiving a periodic payment as at 31 March 2005 and at 31 March 2010 by age of patient at settlement date.
Number of periodic payments
Age at settlement As at 31 March 2005 As at 31 March 2010
0 to 17 277 539
18 to 65 99 261
Over 66 1 12
Total 377 812
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health how many NHS Litigation Authority claims valued above £500,000 were settled by (a) lump sum and (b) period payments in the last five years; and what the value is of each such claim.
Simon Burns (Minister of State (Health), Health)
Information on how many NHS Litigation Authority claims valued above £500,000 were settled by lump sum and periodical payments in the last five years is shown in the following table.
Year of settlement Claims settled as a periodic payment Claims settled as a lump sum Total claims
2005-06 56 108 164
2006-07 66 84 150
2007-08 82 102 184
2008-09 131 77 208
2009-10 129 124 253
Total 464 495 959
A table to show the value of claims over £500,000 has been placed in the Library.
Ovarian Cancer: Health Services
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what steps he is taking to support effective commissioning for ovarian cancer.
Paul Burstow (Minister of State (Care Services), Health)
The White Paper 'Equity and Excellence: Liberating the NHS' describes the Government's vision to create a more autonomous and accountable national health service. Within this new commissioning architecture, responsibility for most commissioning is devolved to local general practitioner (GP) commissioning consortia, supported and held to account by an independent NHS Commissioning Board.
'Improving Outcomes: A Strategy for Cancer', published on 12 January, discusses how commissioners can be supported to commission cancer services, including ovarian cancer services, in the reformed NHS. A significant amount of cancer care is best commissioned for populations covering one and a half to two million and, where population size requirements mean that a single GP consortium is too small to commission a particular service, then GP consortia will wish to work collaboratively. GP consortia will be able to decide whether they wish to identify a lead consortium for commissioning more specialised cancer services or to do so through commissioning support organisations.
In addition, health and well-being boards in every upper-tier local authority will provide a mechanism for bringing together local NHS, public health and social care commissioners. This could provide a forum for the development of cross-cutting commissioning approaches to improve cancer services.
The Department and the National Cancer Action Team have previously provided commissioners with a range of commissioning guidance and support, such as 'the Cancer Commissioning Toolkit' and the 'Cancer Commissioning Guidance'. Going forward, this guidance will be developed to reflect what works best in supporting pathfinder GP consortia. In 2011, we will also develop a cancer commissioning support pack to enable commissioners to access in one place the key information they will need to discharge their functions effectively.
Parliamentary Reform
Sarah Wollaston Click here to watch Parliament Live
I congratulate the Honorable Member-who is, of course, much better known as Caroline Lucas-on her excellent debate. I do not wish to repeat the many points that she has made, and instead I will refer to a few things such as creeping patronage, new politics and the role of the payroll vote. I agree with Mr Meacher. What is a Back Bencher for? We exist not only to represent our constituents, but to hold the Executive to account. It is disturbing that about 235 hon. Members out of 364 coalition MPs are on the payroll vote, and there are a floating number of Parliamentary Private Secretaries-around 45 because the number varies.
I want to share my experience. I was elected by an unusual process because I came to this job through an open primary. I have no doubt that I was selected because I have no track record in politics. I have 24 years' experience in the health service, and I have experience in education and as a police surgeon treating female victims of domestic and sexual violence. That is why I am an MP, and I promised that I would come to Westminster to stand up for the NHS.
Shortly after I arrived-I am probably not allowed to say this-I was approached and asked whether I would like to become a PPS. I went to the Library and asked for a briefing on the job description, because there are no job descriptions in this place. I was told that I would have to leave the Health Committee, never speak on health matters and always vote with the Government.
How could I justify that to my constituents in Totnes? How could I look them in the eye if I chose my own professional advancement? It is a Faustian pact. I would have welcomed the opportunity to spend more time quietly behind the scenes, perhaps with Ministers, influencing policy, but in reality that does not happen. I had to make a decision, which is wrong. I have no objection to the principle of a PPS, because one can see how a Minister might lose touch with what is happening on the Back Benches. However, I profoundly object to the fact that people have to make a choice and always vote with the Government. I believe-I hope that hon. Members agree with this-that there is something profoundly toxic in that.
Now that I have committed career suicide, I may as well go in for a penny as in for a pound. One of the more bizarre experiences I had when I arrived as a new MP was the call from the Delegated Legislation Committee. I had a call about an exciting Committee that was discussing double taxation in Oman. I know nothing much about single taxation, let alone double taxation-my constituents can rest assured that I shall not be applying for the Treasury Committee or called to the Treasury. I sat through that Committee, and I sent a worried note to the Whip in charge, wondering whether I had been put on the right Committee. I received a note to say that my only duties were to turn up on time, say nothing and vote with the Government.
Hon. Members can be confident that nobody died as a result of my knowing nothing about double taxation in Oman. However, could the same be said for the Health and Social Care Bill? I would have liked to have been on the Health and Social Care Bill Committee, because I genuinely feel that one of the reasons why I was elected to the House was to apply my experience in medicine and medical education to the scrutiny of that Bill. The thing that I have found most enjoyable and most useful in this place, apart from representing my constituents, has been serving on the Select Committee on Health, which provides an opportunity for a real cross-party, close examination of the issues, and I would like to think that that would be the same for Public Bill Committees.
When I suggested to the Whips that one reason why I wanted to be on the Health and Social Care Bill Committee was so that I could table a few amendments, I effectively-[Laughter.] I examined the list for the Bill Committee and saw that my name was missing. Many members of the Committee have a genuine interest in health matters, which I welcome, but I regret to say that several members have no experience in, and have never expressed any interest in, health or social care. The country should be concerned about that. I put it to the Procedure Committee that we not only examine the role of Parliamentary Private Secretaries and remove them from the payroll vote while retaining their only important role, but examine Public Bill Committees. Our legislation would be much stronger if the people examining Bills-
Douglas Carswell (Clacton Conservative )
Does my hon. Friend agree that the solution to the problem is to ensure that all sitting Members of Parliament, particularly those in the Whips Office, are subject to open primaries, if they want to be the party candidate at the next election?
Sarah Wollaston
What a marvellous idea! Obviously, I say that open primaries are a good idea, and they have an important role in establishing a bit more credibility for the House. Yes, the process is expensive, and my selection was criticised, but I see no reason why we cannot combine open primaries, perhaps for several candidates and parties at the same time, and why that cannot be done through secure electronic voting or a series of public meetings. The process does not have to be vastly expensive, and it would certainly improve our accountability. Of course, I have to play the role that I set out on the tin. I stood as a Conservative, and that means that on the vast majority of occasions I will vote along Conservative lines, but with the important proviso that I have to represent a broader constituency. I have to take into much greater account the feelings of those of my constituents from across the board. What has been suggested would be a very valuable way forward. That is a little vote from me for open primaries, but, as I have said, I must declare an interest.
Returning to Public Bill Committees, I do not think that the job description for a member of a Committee should be to turn up on time, say nothing and vote with the Government.
Coastguard Service
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I want to talk about Brixham maritime rescue co-ordination centre and its importance. Last year it co-ordinated more than 1,300 search and rescue incidents, assisting more than 1,900 people and saving more than 350 lives; 78% of those incidents were inshore or shoreline. Those are the incidents that need local knowledge, as I think all hon. Members would agree.
Mr Adrian Sanders (Torbay, LD)
Local knowledge is an extremely important point from a west country perspective. I wonder where someone in Solent would direct services if a call came in that someone was in difficulties off Blackpool beach. We have a Blackpool beach, just as Lancashire does.
Sarah Wollaston
I thank the hon. Gentleman. Of course, we have the equivalent of 22 full-time and highly skilled watch-keepers. I know that the Minister pointed out that local knowledge will not be lost because the individuals can be relocated-to Falmouth, in the case of my area. However, unfortunately Falmouth is also drastically cutting staff under the proposals, so I suspect that the highly skilled staff at Brixham will find that very difficult. I suggest that their important local knowledge would be in danger of being lost. The point about local knowledge is that Devon, for example, had 25.2 million visitors last year-bringing in £2 billion to the local economy-and those individuals have no local knowledge. I have been told by a coastguard that very often a distress call will come in from people who do not know where they are. They might know that they are in Devon but they will not know they are on Blackpool beach, for example. They have no local knowledge and are often very distressed. The highly skilled individuals dealing with them on the phone must cope with that, to find out where they are.
The other issue is IT. My experience of IT in the NHS, for example, is that we had a £12.7 billion project, which was very disappointing, over-budget and highly overrated. We have also seen what the fire service experienced, which I shall not talk about much as it is the Minister's area of great expertise. My understanding is that it cost £423 million and the Taunton regional fire centre has not opened. The air traffic control system went £150 million over budget and was much delayed. I would say, to coin a phrase, "Over-budget, overrated, over time and over here."
Andrew George (St Ives, LD)
One of the primary drivers-in fact the primary one, to go by page 16 of the consultation document-is so-called limited resilience. As the document recognises, coastguard stations are paired. There is no suggestion that the resilience has failed. Yet we are not told anywhere in the document how resilience is improved under the proposals.
Sarah Wollaston:
I thank the hon. Gentleman. I agree. Currently, we have paired coastguard stations, which are directly linked by cable as part of an existing BT cable network. In addition, the stations are linked by point-to-point communications on a so-called BT kilostream unique to the coastguard-a kind of private radio network used by VHF radios. However, I find it hard to understand why it is so difficult to piggyback on existing cable networks to network all stations. I am dubious of the argument that it would be immensely expensive. I suggest that it is possible to network all existing stations at less cost than has been stated. It has also been stated that coastguard radio equipment is 12 years old and needs upgrading, and that it cannot be installed in existing coastguard stations, but the vast majority of calls are made by phone.
Brixham has been disadvantaged by the costings. In the year the costings were made, Brixham received a brand-new roof and an upgrade to its generator, which means that the building will now be fully fit for purpose for the next century. Given that its ongoing running costs will be considerably lower, it seems a shame that those renovations have been taken into consideration.
Like the coastguard stations in many colleagues' constituencies, Brixham also performs other functions. For example, the marine surveyors, which are vital to the Brixham trawler, are based there. Brixham also houses cliff rescue equipment, a rescue vehicle and a radio station. I hope the Minister will take that into consideration.
As many Members have said, we do not want one station to be pitted against another. We call on the Minister and the Maritime and Coastguard Agency to review the proposals thoroughly and hold a debate on the Floor of the House.
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I take issue with the Minister because I know that Brixham coastguard takes over from Falmouth in international incidents, when Falmouth is unable to respond.
Mike Penning (Parliamentary Under Secretary of State (Roads and Motoring), Transport)
The case that we heard earlier, which was brilliantly made on behalf of Falmouth, referred to the fact that it is the centre of excellence. That is the place with all the knowledge, all the information, all the expertise and skill. It is not duplicated identically across stations.
Alcohol (Minimum Pricing)
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
There are only a few minutes left, so I shall address just four issues. Is it worth it? Will it work? Is it unfair? How can we do it? We have heard many statistics this morning, on which I will not dwell in the short time I have. Suffice it to say that nearly 15,000 people died of attributable deaths to alcohol in 2005, and they are the tip of the iceberg. Those figures do not take account of the person knocked over by a drunk driver or people whose deaths were perhaps attributable to alcohol in ways that are not recorded in the true statistics. We underestimate the scale of the problem. On the human cost, as an NHS doctor for 24 years and a police surgeon, I cannot begin to tell hon. Members the hideous nature of a slow death from alcoholic psoriasis.
Will the policy work? Yes, there is very clear evidence that it will. Several meta-analyses were studied in the university of Sheffield report that was commissioned by the previous Government. Those show that it is clear that pricing is a very good mechanism not only for controlling overall consumption, but for targeting those who are most at risk: young people and heavy drinkers.
On the question of whether the policy is unfair, let us consider the statistics. Someone from a deprived area is three to five times more likely than someone living in an affluent area to die of an alcohol-specific cause. In addition, they are two to three times more likely to die of an alcohol-related cause and two to five times more likely to be admitted to hospital for an alcohol-related cause. It is completely untrue to say that we penalise low-income families by addressing the problem. That group of people is most at risk. If we consider the statistics on children who are affected and the figures on domestic violence, again, there is a skewing towards lower-income families. We should address that matter and not hide it under the carpet.
Time is very short so, finally, how can we do it? There are various ways. We could, for example, look at varying VAT. I recently wrote to the Treasury to provide a copy of an article written by Nick Sheron that was published in the British Medical Journal. He argues that we can achieve minimum pricing by varying VAT, and that we should perhaps lower VAT on on-licence sales of alcohol. That would mean that we protect the licensed trade. I think everyone would accept that we do not want to penalise pubs. Simply using the blunt instrument of raising duty is the incorrect way forward, but having a variable rate of VAT would be an interesting method, allowing us to protect the on-licence trade. Unfortunately, the Economic Secretary has written back to me to say that she feels that that would be illegal under EU law.
Under EU law, we cannot make supermarkets have different ways of adjusting to adopt such proposals, so the alternative is to introduce minimum pricing across the board. That is worth doing. I know that the Treasury feels that such an approach would perhaps deprive it of income, but we are all paying a very heavy price in costs to the criminal justice system and to the health service. Many hon. Members have cited the £2.7 billion figure in relation to the health service, but it is probably more than that. Certainly, the cost overall to our economy is nearer to £20 billion than some of the lower figures that have been cited today. If we can address that, the Treasury would benefit indirectly, if not directly.
I shall mention a final mechanism. There are 30.4 billion units of alcohol sold in the off-trade. Perhaps we should consider introducing a levy just on the off-trade of 5p to 7p a unit on all off-licence sales. That would still leave 18 billion units of on-licence sales of alcohol unaffected. Perhaps that is another mechanism that could looked at by the Treasury, which could benefit more directly while trying to achieve something closer to 50p a unit. Like many hon. Members, I do not seriously believe that the Government's current proposals, while a step in the right direction, will have any meaningful impact on severe problem drinkers, particularly young binge drinkers.
Public Forest Estate
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Does my hon. Friend share my concern that when phytophthora ramorum, otherwise known as sudden oak death, is starting to devastate large forests and mixed woodland, it is not the right time to do something that might put at risk measures to control it?
NHS Acute Medical and Surgical Services (Working Time Directive)
Dr Sarah Wollaston, Charlotte Leslie, Dr Phillip Lee, Jack Lopresti, Craig Whittaker, John Hemming, Rebecca Harris, Nick de Bois, Damian Hinds, Stephen Phillips and Stephen Barclay present the Bill. Charlotte Leslie accordingly presented the Bill.
I beg to move,
That leave be given to bring in a Bill to require the Secretary of State to conduct an assessment of the impact of the European Union Working Time Directive on NHS acute medical and surgical services;
to require the Secretary of State to make provision to exempt NHS acute medical and surgical services from the European Union Working Time Directive in the light of that assessment if certain conditions are met;
and for connected purposes.
Before I start, I must declare an interest. My father has been a consultant orthopaedic surgeon in Bristol for more than 30 years and has just retired. If growing up in a medical family has taught me anything-I have seen the NHS under a succession of Conservative and Labour Governments-it is that politicians must listen to the professionals who know the most about the NHS, medicine and patients: the doctors. If politics is to serve the place outside these four walls, it has to get real. It has to listen to real people and get lessons from the real professionals working in our hospitals today.
I bring the Bill before the House for one reason: the people who know best about patient care-the doctors-have been raising the alarm to say that the 48-hour European working time directive is endangering patient safety. That is serious, and it is not what the directive was ever intended to do. The directive was designed to ensure that workers were not subjected to overlong working hours and were entitled to reasonable pay and conditions, time off and paid leave. In reality, that well-meaning directive is endangering patient safety in four key ways. I will expand on those four factors in the brief time that I have, because I believe that they speak for themselves. First, continuity of care is being eroded. Secondly, trainee doctors are being denied the training that they need. Thirdly, appropriate clinical expertise is not available to patients when they need it, and fourthly, I add with a certain grim irony that junior and senior doctors are more exhausted by the shift rotas that the directive imposes than they were before.
I shall elaborate. Continuity of care is sometimes an overlooked factor of medical health care, but it is absolutely key. It is what allows professionals to use their professional expertise on a patient. That link between the patient and the person caring for them is vital, but the shift rota system that has been imposed under the European working time directive has meant that there are far more handovers of patients to a new doctor. At those handover points, complications arise because crucial information can be missed out and not passed on. Handovers did occur under the old system, but they were far less frequent.
From the patient's point of view, the shift system has meant that instead of having one or two doctors whom they know and begin to trust, and who have seen them from the beginning to the end of their treatment, patients are subjected to a seemingly never-ending conveyor belt of doctors. From the doctor's point of view, there is a kind of patient pass the parcel. That absolutely must stop. It is no good for the patient's care, no good for their experience of their treatment and it is clinically risky. In fact, a third of all doctors have said that since the European working time directive was implemented, they have seen significant deterioration in patients over the handover period.
The training of our doctors for the future is also suffering. The Royal College of Surgeons has estimated that 400,000 hours of surgical time are lost every single month. It does not take a genius to work out that if the trainees are not getting the hours in, they cannot get the training that they need. Two thirds of trainees have said that they have seen significant deterioration in their training in the short time that the working time directive has been fully implemented. The irony is that the directive was supposed to alleviate the exhaustion of junior doctors, but because all their hours are clumped together in one go, it has actually led to more exhaustion. More exhausted doctors are getting less training, and it does not need me to expand on that for all Members to see that it is madness.
Particularly worrying from a patient's point of view is that clinical expertise is not there when it is needed. If there are fewer people available, there are fewer specialist doctors when they are needed. For example, a doctor has told me that whereas before there would have been an orthopaedic senior house officer, a urology junior doctor and a general surgery SHO on duty at night in case any complications arose, under the working time directive, there might be only the general surgery SHO. If a complication arises with a patient's treatment, they will not have the specialist doctor available to them that they would have had before the directive was imposed.
Attempts to solve the problem are very expensive, and I do not just mean the human cost, which is obviously the key issue. There is also the economic cost. The attempts to patch up the gaps left in the provision of health care professionals and doctors has led to an explosion in the number of NHS hospital locums being employed. The cost of that to the public purse has doubled in the past two years to a staggering £700 million, and the cost of surgical NHS locums has also doubled.
This cannot be allowed to continue. No one is advocating a situation in which junior doctors work too long to be able to perform their job, and the RCS has mentioned a 65-hour working limit. However, under the current arrangements, doctors are more exhausted, there is less training and patient safety is being compromised. That was never the intention behind the directive, and there are ways in which the Government can act. The police and armed forces already have an exemption from the directive. My Bill calls for the reality of the European working time directive to be assessed properly and for appropriate action to be taken to allow doctors to look after their patients in the way that they intended when they went into the profession.
We all have constituents who are patients and those who are junior doctors. No Member would seek to put their constituents' safety at risk, and no Member would seek to stifle junior doctors' desire and ability to perform the job that they went into the profession to do. That is why I seek to bring the Bill before the House.
Bill read the First time; to be read a Second time on Friday 10 June and to be printed (Bill 140 ).
Health and Social Care Bill
Debate
Sarah Wollaston (Totnes, Conservative) Click Here to watch Parliament Live
It is easy to see why politicians continuously want to fix the NHS. The perspective from the green Benches is very different from the perspective one gets as a GP-I say that having worked in the health service for 24 years. My surgeries and postbag, and I am sure those of other Members, are full of stories of delays, frustrations and sometimes really poor practice. The trouble is that not enough people write to their MP to tell them how sensitively or compassionately they have been treated, or how the NHS saved their life. They do feel those things, however, and they do appreciate the NHS. That is why they are understandably wary of any changes, proposed by whatever Government.
Here are the things in the Bill that I welcome. I really welcome clinical leadership. We should be in no doubt about this: there is clear evidence that commissioning works best when there is clinical leadership backed up by excellent management. The Bill will go some way to pushing us towards true clinical leadership in all parts of the NHS.
The provisions will also result in an information revolution. That will involve information about not only whether someone's treatment worked but what the experience was like-a kind of TripAdvisor for the NHS. We all know that, with information, daylight is the best disinfectant. If people know that their performance is going to be compared with that of others, that is likely to drive up performance in the NHS.
The provisions will allow for that early scan that can make all the difference in an early diagnosis of cancer. When GPs can commission very good early diagnostics much more quickly, we will see a difference. The changes will also give GPs much greater flexibility to respond to their own area. In Devon, for example, community hospitals are really important, but they might not be so important in inner cities. The provisions should also give better choice to services such as mental health, and bring in opportunities for the voluntary sector. I recently met a group of carers for patients suffering from mental health difficulties, and they told me that they wanted better access to talking therapies. Rather than the support that has traditionally been supplied to them, they want better access to other kinds of support. I also really welcome putting public health back where it belongs, with local authorities.
Our spending now matches the European average, and I genuinely congratulate the Labour party on that, but I am afraid that that has also been a wasted opportunity. It is unforgivable that so much of that money was squandered, and that we have seen flat-line productivity. For that level of spending, patients should be able to expect the kind of services that people receive in France or Germany. I am sure that we have all heard instances of people coming back from a holiday on the continent with a minor condition, having had a scan and treatment within a week. We should be able to deliver that here. Health care workers should not have to spend three weeks chasing down a patient's results. I am sure that we have all heard instances of that, as well.
The challenge is to improve aspects of the NHS, to look at the detail, to listen to patients and professionals and to ensure that we get this right. In Torbay, they have been getting it right for some time. It has been part of a national pilot of integrated care. Baywide, a not-for-profit company of local GPs, commissions health and social care from a pooled budget.
Sarah Newton (Truro and Falmouth)
My hon. Friend mentions GPs working together on a not-for-profit basis. Does she share my huge disappointment at some of the terribly derogatory comments made by Opposition colleagues about GPs' motivation, comparing them to the worst kind of bankers in the City? Is it not disappointing that they are so disrespectful to GPs?
Sarah Wollaston
I agree with my hon. Friend. We have heard some terrible slurs about GPs profiteering and lining their own pockets. I am absolutely confident that that is not what we are going to see.
Torbay has been highly successful because it has pooled budgets and it can design integrated care. That saves lives and money. No one should be in any doubt that improving the quality of care, and thereby the quality of life, for those with complex, long-term conditions is the key to improving health care and cutting costs.
Andrew George (St Ives)
My hon. Friend talks about the role of GPs in cutting costs. I would be interested to hear whether, from her experience, she believes that the introduction of price competition-in which a maximum tariff would be set, below which there could be competition -will be helpful, or does she believe, as many authorities and other bodies do, that it is likely to put quality at risk?
Sarah Wollaston
I am very confident, because I have discussed that question with the Secretary of State, who has assured me that the reforms are about competition not on price, but on quality. All doctors know that if they get it right the first time, they provide not only better care, but better value care.
GPs and PCTs throughout Devon are rolling up their sleeves and getting on with the job in hand, but to deliver the undoubted benefits of integrated care, they need to be able to work closely with colleagues in hospital, as well as with people in the community, to design those logical pathways. As I just mentioned, the Secretary of State has reassured me on the question of price versus quality competition, but it would help to spell out explicitly in the Bill that that will be protected. Professionals are understandably scared, and I hope the Minister will make the position absolutely clear in his winding-up speech.
Commissioners will not feel liberated if they are liberated from the Secretary of State but shackled to Monitor. Fundamental to the outcome of the reforms will be the powers of Monitor. I should like those powers to be carefully constrained in the Bill, so that it does not take on an unintended role. Focusing on quality and not on cost would help to bring all the professionals back into thinking that this is a positive step forward, because that remains a concern.
Graham Stuart (Beverly and Holderness)
My hon. Friend rightly emphasises quality ahead of cost, but surely both should be considered. In a time of constrained budgets, it is entirely right that commissioners use a service of comparable quality, which can deliver for patients at a lower cost, when they can find one, precisely so that they have additional funds available to look after other patients.
Sarah Wollaston
I am confident that commissioners will consider the impact of those decisions across the health care spectrum, which is very important.
In the limited time I have left, I should like to ask the Secretary of State to consider how we will monitor the quality of primary care. Who will be responsible for performers' lists, audit, and identifying poorly performing doctors? As I understand it, all GP contracts will be held with the NHS commissioning board. What powers will GPs within consortia have to deal with those whom they feel are underperforming if they have no control over their contracts? What will be done about the ongoing, disgraceful situation regarding doctors from the EU with poor English skills, over whom we have few powers to protect patients until there has been a problem?
Professionals are also concerned about the make-up of consortia. Will they have the flexibility to include consultants and other specialists-
Lindsay Hoyle (Deputy Speaker)
Order. Time is up
Alcohol
Commons Debate
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Last year, nearly half all violent crime in Devon was alcohol-related. That represents 4,568 instances of completely avoidable violence. I welcome the introduction of a ban on below-cost sales of alcohol as a first step, but does the Minister share my fear that, because it involves only VAT plus duty, it will not go far enough in tackling this serious problem? What other measures will be introduced to tackle alcohol-related crime?
James Brokenshire (Parliamentary Under Secretary of State, Home Office)
My hon. Friend is right to highlight the link between alcohol and levels of crime. In fact, 50% of violent incidents are associated with alcohol. Our proposal to ban below-cost sales on the basis of duty plus VAT constitutes an initial package. We will introduce further measures to deal with licensing and other issues involving problem pubs and other alcohol outlets, and also with problem practices. That is precisely what the duty plus VAT element is about.
We will continue to monitor this complex area of policy. In particular, we will consider the rate of duty in the context of super-strength lagers, which have been associated with problematic behaviour.
Sustainable Transport
Oral Question
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
May I join Mr Sanders in recommending the expressway along Kingskerswell for a bus and cycle route? I welcome the local sustainable transport fund. Will the Minister meet a delegation from Littlehempston and Totnes, to consider not just how funding is crucial in advancing cycling schemes, but also some of the unnecessary roadblocks that such schemes come up against?
Norman Baker (Parliamentary Under Secretary of State (Regional and Local Transport), Transport
It is often the roadblocks, as my hon. Friend puts it, the pinch points, that cause disruption to the transport system, congestion and unnecessary carbon emissions. It is certainly important to deal with such issues, and the fund that I am announcing today is well designed to do that. Of course, I will be happy to meet her and her colleagues.
Coastguards
Oral Answers to Questions - Prime Minister: Engagements
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Brixham coastguard in my constituency has helped more than 2,000 people in the past year. It is earmarked for closure. Will the Prime Minister meet a delegation from Brixham coastguard to hear about the importance of their local knowledge and skills, and to hear how we can avoid a fiasco similar to that of the regionalisation of fire services?
David Cameron (Prime Minister)
I am grateful for my hon. Friend's question. I looked carefully at the time of the announcement at exactly what was proposed for the coastguard. There are proposals to try to put more people on the front line by sharing back-office services and through the way in which the coastguard is co-ordinated. I know that there are very strong local feelings, and I will arrange for her to meet the Transport Secretary to discuss the matter. What is essential is that we have really good coastguard coverage for all of our country.
Health Maternity Services
Written Question
Sarah Wollaston (Totnes Conservative)
To ask the Secretary of State for Health what steps his Department has taken to increase the (a) availability and (b) standard of provision for psychological and social support for new mothers of pre-term babies since 2009.
Paul Burstow (Minister of State (Care Services), Health)
More and more people across England are getting access to psychological therapies for the most common mental health problems, such as anxiety disorders or depression. About 140 new psychological therapy services are now up and running around the country and by March 2011 60% of primary care trusts will have an Improving Access to Psychological Therapies service. 900,000 extra people with depression and/or anxiety disorders will have been seen in the first three years of the programme. Some 3,600 more therapists will have been employed in the same period, already meeting the programme's March 2011 target.
The Health settlement in the spending review included funding to expand access to talking therapies. The money will complete the roll-out of the nationwide training programme and services which began in 2008 and begin to extend the benefits of talking therapies to the young, the elderly, those with serious mental illness and those who have anxiety disorders or depression alongside long-term physical health conditions like diabetes, heart or lung disease. By March 2011, the roll-out will achieve 60% geographical coverage of England. The spending review settlement will complete this by 2014-15.
With regard to social support, the coalition programme committed the Government to reforming the system of social care in England to provide much more control to individuals and their carers. On 16 November 2010 we published 'A Vision for Adult Social Care: Capable Communities and Active Citizens', which sets the context for the future direction of adult social care in England and a copy has been placed in the Library.
The Vision focuses on the Government commitments to:
break down barriers between health and social care funding to incentivise preventative action;
extend the greater rollout of personal budgets to give people and their carers more control and purchasing power; and
use direct payments to carers and better community-based provision to improve access to respite care.
We want to make services more personalised, more preventative and more focused on delivering the best outcomes for those who use them. The document also states that councils should provide personal budgets, preferably as a direct payment, for everyone eligible, by 2013, and develop the Big Society, with more local preventative activity to support people's independence.
On 4 November 2010, the social care sector published 'Think Local, Act Personal: Next Steps for Transforming Adult Social Care', which sets out the sector's commitment to moving forward with personalisation and community-based support. To support its implementation, a number of best practice documents have been published and are available on the Putting People First website at:
www.puttingpeoplefirst.org.uk
Cheques
Sarah Wollaston (Totnes, Conservative)
Written Question
To ask the Chancellor of the Exchequer
(1) what arrangements he plans to put in place to mitigate the adverse effects on small businesses and individuals arising from the phasing out of cheques;
(2) what recent discussions he has had with the UK Payments Council on alternative methods of payment to replace cheques.
Mark Hoban (Financial Secretary, HM Treasury)I have written to every Member of the House to set out the Government's position on cheques.
Treasury Ministers and officials have discussions with a wide variety of organisations in the public and private sectors as part of the process of policy development and delivery. As was the case with previous administrations, it is not the Government's practice to provide details of all such discussions.
Park Homes
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
This afternoon we have heard from Members tales of fraud, neglect, intimidation and vandalism. For me, this is not a complicated issue. As a doctor, if I committed any of those crimes I would very quickly be declared not a fit and proper doctor and struck off. I call on the Minister to consider seriously the ability to designate people not fit and proper site owners.
It is obvious from attending the all-party parliamentary group that the same names keep cropping up. It is evident that we are talking about probably fewer than 10 owners who commit these crimes across the country. Many of my constituents have relayed shocking tales of crime and fraud, but are genuinely too intimidated to go to the police.
We have heard excellent suggestions-I will not repeat them-from my hon. Friend Mr Buckland and I join in the congratulations for Annette Brooke on initiating this excellent opportunity for debate. I call on the Minister to take action, because we have waited long enough. I hope that he has listened to what all hon. Members have said.
Financial Support (Students)
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
During the conference recess, I took the opportunity to visit the sixth forms in my constituency. Many of the students I met were underwhelmed by EMA. Many felt that it was unfair because it was poorly targeted, and many told me stories of friends who spent the money inappropriately. Overwhelmingly, the students felt that the priority, particularly in my very rural constituency, was getting to college in the first place. Jeremy Corbyn made the point that in London students already benefit from free travel passes. In a rural constituency somewhere such as Devon, that would be extremely difficult for the council to implement.
I would like the students in my constituency, who attend excellent colleges such as KEVICC-King Edward VI community college-South Devon college and Paignton community college, to be able physically to get to them in the first place. The students were asking for free or greatly subsidised travel. I call on the Minister to respond to the point that many hon. Members have made today and make transport part of a much enhanced programme of support arrangements-particularly for disadvantaged students, such as those from low-income families, for whom that really makes a difference in helping them to get to college. They do use the allowance for that.
Courts Service Estate
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
My hon. Friend has confirmed that the work of Totnes magistrates court is to be relocated. I know he is aware that the building provides an useful facility for the coroner and those who assist him in his work, such as Victim Support, and also that the citizens advice bureau has worked extensively on a plan to share the court building. Can he assure us that this important local asset will be put to its best local use by those valuable organisations?
Jonathon Djanogly (Parliamentary Under Secretary of State)
My hon. Friend has raised an important point. I hope that the answer is yes, and if I can be of assistance she should get in touch with me to that end. Courts will be empty, and there may be local authorities or other local agencies that could make use of them. Now that we have a final list of the courts that will close, that process can begin.
Defence: Local Government Finance
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
Towns such as Dartmouth and Kingsbridge in my constituency are resisting the imposition of high and unwanted on-street parking charges by the county council that they see as a back-door form of revenue raising. Would my right hon. Friend encourage them to organise a local referendum?
Eric Pickles (Secretary of State, Communities and Local Government)
It is always a bit of an inconvenience when the public make their position known-democracy is always a bit messy, but it is the best system we have. I cannot see any problem with local authorities facilitating such a referendum. The county council could also think about delegating that function to the local towns, so that they can organise these things. That is what happens in an awful lot of districts. My hon. Friend represents an attractive part of the world that many of us visit in slightly more clement times. However, car parking can be vital to a local economy so if she wants to start the referendum process, she has my full support.
Fisheries
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
I am fortunate to represent Brixham and fishing is the absolute heart of Brixham. The catch there is worth £17 million a year. The jobs involved are not just those at sea; there are many more related jobs on land. That is particularly important in Torbay, where there are 3,500 people claiming jobseeker's allowance.
The English channel fisheries are worth more than £70 million a year at first sale and 60% of that money comes from non-quota species, such as scallop, crab, bass and lemon sole. That is particularly important because, for its size, the English channel is the richest sea area-in pounds per square mile-in European waters.
Of course, those rich fisheries exist because of rich habitats. We all understand that the Minister has to tread a very careful line between protecting habitats and protecting livelihoods. However, when he signs statutory orders protecting sites, he creates offences that carry penalties of £50,000 or more and he needs to take great care to ensure that areas closed to fishing are absolutely necessary and evidence-based, in terms of giving a chance for regeneration of fish stocks that can then contribute to fishing livelihoods.
Commissioner Maria Damanaki has recently praised the work of trawlermen in Brixham who are involved in Project 50%. In that project, skippers such as Shaun Gibbs work closely with net designers, including Darren Edwards in Brixham, to innovate at their own expense, by designing new gear that allows small fish to escape and that significantly reduces the by-catch. In fact, they have managed to reduce discards by more than 50%, which of course saves fuel, preserves stocks and reduces the impact of the benthic species.
I ask the Minister to press the case for such projects to be recognised and to provide an incentive for others to follow suit, by rewarding them with increasing quotas for the key target species, such as Dover sole, anglerfish or monkfish and plaice. It is also very important that he recognises that the Commission's proposal to change the management regime of channel plaice, particularly in areas VIId and VIIe, would have far-reaching implications beyond the simple quota tonnage numbers. Those areas are currently managed in combination, but if they are split that would result in a large increase in discards in area VIIe, which is the western channel, particularly in the beam trawler fisheries in my constituency.
I think that we would all agree that policy drivers must be consistent. There is no point having projects such as Project 50% if we are going to see discards driven up by measures that are poorly thought through and by policies that are, frankly, inconsistent. Has the Centre for Environment, Fisheries and Aquaculture Science been asked to conduct a full regulatory impact assessment of the Commission's proposal, including an assessment of how many perfectly healthy plaice will be thrown back into the sea dead if a mixed fishery catching sole is unable to land perfectly good plaice over quota? I call on the Minister to resist the proposal to split areas VIId and VIIe for that reason.
The Commission proposes a 15% increase in the available catch of sole, but it is accepted that the TAC for area VIIe should not have been reduced by even 5%, because, as I understand it, the status quo would have yielded a full improvement in the spawning stock. As my constituents see it, the only fair outcome is the full, scientifically justified 19% increase in the TAC for 2011, and I hope that the Minister will press for that.
The skate distribution among member states is unfair. We recognise that it is unlikely to be reworked, so I call instead on the Minister to press for an increase in the quota so that skippers can land what they catch rather than discarding skate. We all recognise that current arrangements are not preserving stocks; they are just causing dead fish to be thrown back into the sea.
We believe that sprats are not depleted. One of the many daft Commission rules is "use it or lose it". I think that many Members here share my hope that the Minister will resist further reductions for under-utilisation.
I represent not just the beam trawler fleet but the under-10-metre fleet. I am sure that the Minister recognises that the two fleets sometimes have conflicting interests, but there are issues common to them both. They both agree that the "use it or lose it" proposals are counter-productive, particularly when it comes to the under-10-metre fleet. Skippers pay large sums to acquire vessels, often with a high premium because they come with a shellfish quota that the skippers do not wish to use. I hope that he will look into that issue. Such skippers are also disadvantaged because they must often buy vessels that are under-equipped in terms of engine power to fish safely or efficiently. They would like me to draw to the Minister's attention the unfair discrimination that they face when compared with the recreational and charter fleet. They often fish alongside such vessels, using the same methodology, but they face expensive restrictions in terms of training courses and qualifications, and of course the charter and recreational fleet has no quota. I call on him to consider that issue.
I extend the Minister a warm invitation to come back to Brixham. He kindly visited before the election, but at that time we had not completed our wonderful new fish market, which was funded in part by DEFRA. I know that all my colleagues in Brixham would warmly welcome him. I close by paying tribute, again, to the work of the Royal National Mission to Deep Sea Fishermen, the RNLI and the coast guard.
Church Commissioners: Public Health White Paper
Sarah Wollaston (Totnes Conservative) Click here to watch Parliament Live
Is my right hon. Friend aware that about 30,000 people a year in this country die as a result of alcohol, and that Department of Health modelling has shown that if we were to increase the minimum price per unit to 50p we would save over 2,000 lives a year? Will he look at the proposals published in the British Medical Journal to have variable rates of VAT so we can increase the price without penalising the on-licence trade?
Andrew Lansley (Secretary of State Health)
My hon. Friend will know that the Chancellor of the Exchequer made an announcement today about the level of duty on beers, in particular. We have made it clear, in the coalition agreement and since, that we will act to ban the below-cost selling of alcohol. I think that that will make a significant difference. We will also in due course publish an alcohol strategy, through which we will examine a range of ways in which we can not only enforce the current legislation more effectively, but create an environment in which we progressively reduce the abuse of alcohol. It is very important for us to understand that we must distinguish between our relationship with tobacco, whose use we want to minimise-we want to encourage people never to use tobacco-and our relationship with alcohol, where we are seeking its responsible use, rather than seeking to penalise people who engage in responsible drinking.
Justice: Controlling Migration
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Has the Home Secretary made an estimate of the number of sham marriages, particularly those to EU migrants to the UK? What further measures will she take to deter this and punish those responsible?
Theresa May (Home Secretary)
I do not have an estimate of the number of sham marriages, but I am happy to say to my hon. Friend that the UK Border and Immigration Agency was very active in stopping sham marriages over the summer; we had a very big crackdown on them. Many people were concerned and surprised to see that a Church of England vicar was caught and arrested for helping sham marriages to take place.
Justice: Legal Aid (Clinical Negligence Cases)
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
What assessment he has made of the effects on the NHS of removing clinical negligence from the scope of legal aid.
Jonathan Djanogly (Parliamentary Unders Secretary of State ( HM Courts Service & Legal Aid) Justice
Clinical negligence cases against the NHS are funded approximately 50:50 between legal aid and no win, no fee agreements with lawyers. We will be interested to understand through our consultation the specific impact on the NHS of the removal of clinical negligence cases from the scope of legal aid, which should save some £17 million to legal aid. However, we also estimate that our proposals to reform no win, no fee conditional fee agreements will save around £50 million each year to the NHS in reduced legal costs.
Sarah Wollaston
Could reducing legal aid for clinical negligence lead to an upsurge in no win, no fee deals and an increase in the compensation culture?
Jonathan Djanogly
My hon. Friend is right to point out that changes in one area can have knock-on implications in another area. It is important to point out that that is precisely why we put out the legal aid consultation document on the same day as Sir Rupert Jackson's proposals on no win, no fee agreements. The two can be weighed up together and the consultation will therefore take a holistic approach.
Fire Safety (Protection of Tenants) Bill
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
I start by congratulating my hon. Friend Mr Sanders on this Bill. My Totnes constituency shares half of Torbay-an area in which people know only too well what the consequences of tragic fire deaths mean both for families and for the wider community.
Thirty-one people died in the Paddington rail disaster; we quite rightly held a public inquiry and no expense was spared to make the railway safe. The fact is, however, that in the year running up to March of this year, 328 people died in fires, but they did not all die on the same day or even in the same week; otherwise we certainly would have held a public inquiry into those deaths.
Most people in the outside world would assume that smoke detectors are already compulsory, but they are not. They would also assume that for the most vulnerable households in our country-houses in multiple occupation or homes where vulnerable children are living with adults who are not in a position to care for them properly-protection already exists. After the incident in Torbay, to which my hon. Friend referred, people assumed that corporate manslaughter charges would be brought; in fact, there was no possibility of that because there was no compulsion in the law for smoke detectors to be fitted, even though this was a vulnerable household.
Smoke detectors save lives, and nobody disputes that. Nor does anyone dispute that hard-wired smoke detectors are far preferable to battery-operated smoke detectors. This amounts to a law of diminishing returns. If the Minister will not accept the expense of installing hard-wired systems, there must surely be a case for insisting at least on extended-life batteries that provide 10-year protection. Again, that really would save lives, so I put the same question to the Minister as was put previously: if there is another fire death, or particularly if there are large-scale fire deaths, will he come back to the House to explain why this very simple measure, which would save so many lives and be so simple to introduce, was not introduced?
I agree with my hon. Friend the Member for Torbay: if we have annual gas safety checks and if it is possible to insist at the beginning of an occupancy on an energy-saving certificate and an electrical safety certificate, why is it not possible to insist on a system that, as a bare minimum, will have a 10-year battery life? My preference is for hard-wired systems, but if that is not possible, what is wrong with simply requiring a technician at the beginning of a tenancy to press a test meter, especially if it could save lives? I urge the Minister to consider those issues; I will not detain the House further.
NHS Reorganisation
Sarah Wollaston (Totnes, Conservative) Click here to watch Parliament Live
Does the right hon. Gentleman realise that not all GPs will have to be involved with commissioning? Does he welcome the efforts the Royal College of General Practitioners to introduce real clinical leadership and tuition for those GPs interested in taking up commissioning, helping them to provide this service?
John Healey (Wentworth and Deane Labour)
It is a very good thing that the Royal College of General Practitioners is trying to bring the skills of many GPs up to speed because this is a big job for which GPs are not trained and not equipped, and which many do not want to do.
Equitable Life
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
This is not just a question of fairness. Many of those individuals are older and very vulnerable indeed. The letters that I have received make the point that those people are living on very low incomes at a very vulnerable time of their lives, and they have already suffered from the effects of inflation. I agree with my hon. Friend that we should talk about this as parliamentarians, not on a party political basis.
Bob Blackman (Harrow East, Conservative)
My hon. Friend clearly demonstrates that we are talking about the oldest and most vulnerable people, and that they have been dealt with in a most disgraceful way following this scandal. We have a moral duty to compensate them.
Going back to the points made by my hon. Friend Jonathan Evans, it is clear that when the bonuses that were attached early in the process are taken into account, some policyholders might not receive a penny piece in compensation. We need to recognise that, but there is an 18-month gap between the cut-off dates. A large number of the retired people who had taken out annuities could not adjust them once they had purchased them, and they are now trapped in that position. That is why we have a moral duty to compensate them.
Environment Food and Rural Affairs: Rural Development Agency
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs what transitional arrangements she plans to put in place for applicants for funds from the Rural Development Programme for England following the ending of regional development agencies.
James Paice (Minister of State (Agriculture and Food), Environment, Food and Rural Affairs)
DEFRA will ensure that delivery arrangements for the Rural Development Programme for England continue to be in place following the abolition of the regional development agencies, based on a stronger national lead by DEFRA for the remainder of the programme period to 2013, and will minimise disruption for potential beneficiaries.
Commencement or repeal of amending provisions
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
Does the hon. Gentleman have any threshold at which he thinks we would be completely without any validity at all? Perhaps he would like to suggest a threshold.
Chris Bryant
I was actually trying not to suggest a threshold. The hon. Lady is right in one sense, of course. I hope that this might appease my hon. Friend the Member for Blackley and Broughton as regards some of what he said. There is a complexity about the referendum that we might have next May, because we might have very differential turnout in Wales, Scotland, Northern Ireland and England.
If, for instance, there were to be a very low turnout in England that returned a no vote and a very high turnout in the other places-there is a Scottish parliamentary election, in Northern Ireland there are two other sets of elections and in Wales there is the Assembly election at the same time, and in Wales and Scotland those feel in many senses like general elections-returned significant yes votes, people might start to question the validity of what we were doing. This is all the more important because the referendum is not just an advisory referendum-as referendums have always been in the past-but an implementing referendum. In other words, if there is a yes vote, it comes into law. It happens, and the next general election will be held on the basis of the alternative vote.
I am not convinced by the arguments that are being advanced in favour of thresholds. I personally will be voting yes in the referendum. I do not believe that there should be a referendum, but there is a legitimate argument that others might want to consider about whether the fact that we are combining the polls will produce a differential turnout in different parts of the country that might make a necessity of a threshold.
Comprehensive Spending Review
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes Conservative)
Has the hon. Lady met people trapped on benefits, many of whom, incidentally, are women? The failure to address the perverse incentives operating in our benefits system was utterly spineless and ignored the real misery affecting those who live trapped in our benefits system.
Angela Eagle (Wallasey, Labour)
The hon. Lady's intervention was extremely helpful. Of course I have. We have all done a great deal of work on social security reform, and I hope she will be the first to acknowledge some of the progress we made, particularly in helping lone parents into work. Tax credits and all the support we gave on child care were among the measures that were crucial in ensuring that we managed to increase significantly the number of lone parents in work when we were in office. I hope she will be the first to recognise our success in those areas. She should take a close look at the increasing rates of marginal tax that came about because of some of the changes, particularly for lone parents, and the savings made in tax credits, and she should also have a word with her party's Front-Bench team about their priorities for cuts, given that they are taking away benefits that particularly help women go out to work.
In softening up the country for this age of austerity, Ministers have been anxious to establish some myths, the first of which is that the deficit was a Labour spending choice. We heard a lot of that today from the Chief Secretary to the Treasury. The second myth is that the cuts announced are unavoidable. We need to start with some facts. When the credit crunch struck in 2008, Britain had the second-lowest debt in the G7. We had low interest rates, low inflation and low unemployment. There is nothing reckless about that. Now, however, the Conservative party and the Liberal Democrats are trying to rewrite history.
Transport Investment
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
The Kingskerswell bypass in my constituency has been tantalisingly close to approval for half a century, which must be a record. I am grateful to the Secretary of State for agreeing to meet a delegation from Devon and Torbay councils, because the scheme is vital to regeneration for three constituencies. What further evidence should they bring to that meeting to press their case?
Philip Hammond (Secretary of State, Transport)
As I hope I have made clear, the process for the appraisal of projects is pretty rigorous, and will be based on the cost-benefit analysis and the external non-monetiseable effects of the scheme. If my hon. Friend looks on the Department for Transport's website, she will find chapter and verse on how we do it. Of course I will always be happy to talk to hon. Members about their schemes, but I can assure her that the process for appraising schemes in the pre-qualification pool will be done rapidly and objectively, and the best schemes will move up into the development pool for consideration for funding next year.
Armed Forces. Dental Service
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Defence what the total annual cost to the public purse is of dental care provision for the armed forces under each budgetary heading.
Andrew Robathan (Parliamentary Under Secretary of State (Defence Personnel, Welfare and Veterans), Defence)
In financial year 2009-10, £62.316 million was attributed to public funds for the provision of dental care to the armed forces. This sum is broken down as follows:
Defence dental services, financial year 2009-10
£ million
Manpower
Service pay 46.917
Service allowances 1.339
Civilian pay 9.035
Total manpower 57.291
Non-manpower
IT and communications 0.036
Inventory/stock consumed 3.380
Equipment support 0.040
Training 0.029
Medical-health services 0.730
Admin, PR, welfare & medical support equipment 0.154
Fees for professional services 0.053
Travel and subsistence 0.226
Transportation allowances 0.652
Other costs 0.026
Receipts -0.301
Total non-manpower 5.025
Total 62.316
Excise Duties Biofuels
Written Question
Sarah Wollaston (Totnes Conservative)
To ask the Chancellor of the Exchequer what assessment he has made of the effectiveness of existing levels of taxation on biofuels.
Justine Greening (Economic Secretary, HM Treasury)
Under plans inherited from the previous Government, the 20ppl biofuel duty differential ended on 1 April 2010 for all biofuels (biodiesel and bioethanol) except those produced from used cooking oils, which is currently subject to a two-year temporary extension of the differential. Support for biofuels is provided by the renewable transport fuel obligation, which has a greater environmental focus. The Chancellor keeps all taxes under review.
Higher Education & Student Finance
Oral Question Click here to watch Parliament Live
Sarah Wollaston (Totnes Conservative)
Will the Secretary of State consider carefully how we can prevent students from being deterred from undertaking longer courses such as medicine and pharmacy-very able students in particular may be put off from those courses-perhaps by introducing a three-year cap on fees?
Vince Cable (Secretary of State, Business, Innovations and Skills)
The answer to that question is similar to the one that I gave on the other STEM subjects. Medicine is a costly course, which is why continuing support is needed through the teaching grant from Government to keep graduate contributions at a moderate and reasonable level, and that is what we shall aim to do.
Strategic Defence and Security Review
Debate. Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
We have heard this afternoon from both a wife and a mother, so I am happy to complete the set as the daughter of an Air Force officer. I grew up for most of my childhood on Air Force bases, so I fully understand the value of our armed forces.
Last month, I visited the cold war nuclear bunker at Bolt Head in my constituency. I hope that it can be saved from dereliction and opened as a museum, because it is a chilling reminder of how close we came to Armageddon. That did not happen largely because both sides understood the rules of the game, but does anybody seriously believe that stateless terrorist groups or rogue regimes understand those rules or even care about the consequences?
Many of my constituents cannot understand why our strategic nuclear weapon is being left out of the strategic defence and security review, because the uncontrolled proliferation of nuclear weapons is one of the greatest threats to our existence. That voice has not been heard this afternoon. I hope that hon. Members will bear with me, because it needs to be heard.
At the heart of the 1968 non-proliferation treaty was a commitment to the goal of disarmament by recognised nuclear weapons states; it was the cornerstone of the pledge to the nuclear have-nots in order to stop them seeking to acquire their own weapons. Dissatisfaction among states without nuclear weapons at the lack of progress in achieving the aims of article VI is widespread. Let me remind the House that at the sixth non-proliferation treaty review conference in 2000 we signed up to
"an unequivocal undertaking by the nuclear-weapon States to accomplish the total elimination of their nuclear arsenals leading to nuclear disarmament to which all States parties are committed".
In renewing Trident, we break that pledge and remove our moral credibility. How can we begin to persuade nations such as Iran to step back from the nuclear cliff edge unless we are at least prepared to step back from the precipice ourselves? I am not advocating a unilateral approach, but if this obsolete, expensive and unthinkable weapon has any value at all, surely it is as the means to bring others to the negotiating table. I am rather tired of being told, "It cannot be done" and that to advocate nuclear disarmament is to be incapable of understanding the complexity of the issue. Nor do I accept the argument that these weapons cannot be un-invented; we cannot un-invent biological weapons, but nobody is suggesting that we take that route to mutually assured destruction.
My concern is that as time distances us from the destruction of Hiroshima and Nagasaki, the horrific consequences of nuclear war become clouded and remote, and that we lose our sense of outrage. In the event of such an outrage-even with a dirty bomb-would we seriously consider nuclear retaliation? Against whom would we retaliate? I am not alone in believing that among the greatest threats facing us is uncontrolled nuclear proliferation and the risk of these weapons then falling into the hands of those who would not hesitate to use them. I have received a great deal of correspondence, as I am sure many hon. Members have, from constituents opposed to the renewal of Trident.
I would ask the Secretary of State to address those real and present dangers, as well as the unknown future threats, by delaying Trident in order to persuade others to join us at the negotiating table. Specifically, I would ask whether any efforts have been made to do that; has any contact been made with those countries that lie outside the non-proliferation treaty-Israel, India and Pakistan? Even more importantly, has Trident been offered up as a means of persuading Iran away from its goal of acquiring a nuclear weapon? Surely that would be preferable to waiting for an Israeli strike against Iranian installations.
I ask Members to consider how secure Pakistan's nuclear arsenal is from falling into the hands of extremists. An area the size of Italy is underwater in Pakistan and it will rightly be the greatest recipient of UK overseas aid. Surely Pakistan cannot afford to waste precious resources on maintaining a nuclear deterrent-come to that, nor can we. I would rather have an effective Army, Navy and-I have an interest here-Air Force than spend at least £20 billion of their resources on a weapon that we can never use and that no longer acts as a deterrent. I call on the Secretary of State to delay his decision on Trident, not because I am an idealist, but because I am a realist. I call on him to protect our conventional armed forces and, specifically, to recognise that in my constituency, Britannia naval college is far more important.
I shall conclude by reminding the House that Alfred Nobel, of peace prize fame, was famously convinced that his invention of dynamite would make war too destructive to contemplate. We would be wrong to make the same mistake with Trident.
Equitable Life
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
Does the right hon. Gentleman feel that the emptiness of the Opposition Benches represents a lack of interest in trapped annuitants, or merely shame? I assure him that the fact that the Benches on this side of the House are so full represents a strength of opinion that we wish to express to our Minister on behalf of members of Equitable Life.
Stephen Timms
I wish the hon. Lady success. I believe that she is one of those who signed the pledge, and I am sure that she will be training her fire on Ministers. As I have said-and as EMAG has made crystal clear-we are currently heading for the breaking of that pledge.
UK Armed Forces in Afghanistan
Debate Click here to watch Parliament Live
Sarah Wollaston (Totnes Conservative)
Does the hon. Gentleman not accept that if we walk out of Afghanistan now, we will leave it to those very people, the Taliban? Does he want a bloodbath for the people we would leave there?
David Winnick
Obviously no one in the House wants a bloodbath. As for whether Afghanistan would be left to the Taliban if we went, we just do not know, but it should be borne in mind that at no stage did the Taliban have unanimous support as such. Before our military intervention, there was already constant military engagement against the Taliban in Afghanistan.
Health
Oral Question. Click here to watch Parliament Live
Sarah Wollaston (Totnes, Conservative)
One year on from the implementation of the European working time directive, there is evidence that patient care is suffering. Handovers have been inadequate in some cases, and junior doctors' training time has been reduced. Will my right hon. Friend reassure me that he will take action to allow some acute specialities to opt out of the European working time directive?
Andrew Lansley (Secretary of State: Health)
Yes. I am very clear that, together with my right hon. Friend the Secretary of State for Business, Innovation and Skills, we need to take the European working time directive back to the European Union. We need to discuss it again. We need to go to the European Union with the intention of maintaining the opt-out and of giving ourselves, not least in the health context, the flexibility that we lack, so that junior doctors, in particular, have the capacity to undertake the training that they need. It is not that we want to go back to the past, when there were excessive hours-100-hour weeks and so on-but we want junior doctors to be confident that they will get the training that they require in the period allocated for training.
Summer Adjournment: Hope Cove
Debate
Sarah Wollaston (Totnes Conservative)
Many Members this afternoon have laid claim to the industrial revolution. Totnes cannot lay claim to that, but it undoubtedly has the finest beaches and countryside in the land, and I hope that many Members will visit us over the summer.
If any of our visitors get into deep water or find themselves drifting off to France, they will doubtless believe that they can rely on the coastguard to protect them. I want to draw to the House's attention a serious incident in that regard. On 28 June, four teenagers went swimming shortly before 8 am, and they got into difficulties in a rip current. A call was made from Bigbury coastguard to Brixham coastguard requesting the attendance of the Hope Cove lifeboat. The reason for that request was that the Hope Cove rescue boat was just 3.1 miles away and could have covered the distance in 14 minutes, including muster time. The coastguard chose not to send it out, however, because the Hope Cove rescue boat has had unilaterally imposed upon it an arbitrary and very small distance in which to operate.
That decision was not taken on the grounds of cost. In fact, it costs far more to send the lifeboat from Salcombe, which is 11 miles away and takes 27 minutes to get there. Nor was the decision based on a sensible worry about the cost of operating the Hope Cove rescue boat, because a generous benefactor sent a cheque for the entire running costs to the coastguard, which was returned. The decision had no basis in common sense. Had it not been for a person passing in a kayak who pulled one of the teenagers unconscious from the water, that teenager would, sadly, have died rather than just spending a day in intensive care.
The local community has requested, through a solicitor, to see a transcript of the recording of the call from the Bigbury coastguard to the Brixham coastguard. After all, we are not talking about a passing member of the public making this recommendation; it was made by the Bigbury coastguard itself. That request has been refused, even though the information was requested under the Freedom of Information Act 2000. I would like to know what is the point of that Act if it is not to call public bodies to account, to cut through and say, "Where is the decision-making process and what was it based on?". I am calling-and I hope the House will support me in doing so-for Her Majesty's coastguard to release that information.
I know that many other Members wish to speak so I will be brief, but the other point here is that the Under-Secretary of State for Transport, my hon. Friend Mike Penning, has kindly offered to visit and see the situation for himself. He has given an assurance that he will not close down the rescue boat without doing that. There is no substitute for seeing conditions in person on the ground. I hope that the Minister will give us a date for his visit. We are expecting at last the barbecue summer that was promised us last year. We are expecting many visitors to the South Hams and we would like them to be safe. In the interest of public safety, we call for the rescue boat at Hope Cove, which is so valued by the entire community, to be safeguarded and not to have the Maritime and Coastguard Agency wash its hands of its responsibility in this regard by seeking to devolve all responsibility for safety at sea to the Royal National Lifeboat Institution.
Transport: Sea Rescue
Written Questions
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Transport what the construction and use requirements are for rescue boats to be classified by the Maritime and Coastguard Agency as approved vessels.
Michael Penning (Parliamentary Under Secretary of State (Roads and Motoring) Transport)
Rescue boats that are operated by commercial entities or where the organisation is not wholly voluntary are subject to the requirements of the Maritime and Coastguard Agency (MCA) Workboat Code (or the Police Boat Code if the boat is operated by a Police Authority.
There are no specific requirements relating to the construction or use of rescue boats used by wholly voluntary organisations which are not declared as facilities for Search and Rescue.
Declared facilities are facilities that have been designated as being available for civil maritime SAR according to a specific standard or set criteria as agreed with the MCA. The authority providing this facility is responsible for:
- declaring the standard of capability and availability for each facility;
- maintaining each facility to the standard and availability declared by the authority;
- informing the appropriate Coastguard Rescue Co-ordination Centre when there is any change in the declared standard or availabilty of each facility;
- informing the appropriate Coastguard Rescue Co-ordination Centre of any reason for not making any facility which has been requested by the Coastguard.
Sarah Wollaston
To ask the Secretary of State for Transport whether the Maritime and Coastguard Agency issues guidance to operators on the construction and use requirements of their rescue boats.
Michael Penning
The Maritime and Coastguard Agency (MCA) has produced a Rescue Boat Code which is in circulation in draft form. The draft code covers design, construction,inventory and operation and is considered to represent best practice when advising potential voluntary rescue boat operators and when assessing independent lifeboats that seek declared status as search and rescue (SAR) assets when they are being operated by wholly voluntary organisations.
Until the code is finalised, the MCA is willing to advise prospective operators on the standards it requires to include a rescue boat in the co-ordination of UK SAR.
Declared facilities are facilities that have been designated as being available for civil maritime SAR according to a specific standard or set criteria as agreed with the MCA. The authority providing this facility is responsible for:
- declaring the standard of capability and availability for each facility;
- maintaining each facility to the standard and availability declared by the authority;
- informing the appropriate Coastguard Rescue Co-ordination Centre when there is any change in the declared standard or availabilty of each facility;
- informing the appropriate Coastguard Rescue Co-ordination Centre of any reason for not making any facility which has been requested by the Coastguard.
Equitable Life
Debate
Sarah Wollaston (Totnes Conservative)
Although I congratulate the Minister on the undoubted speed and transparency of the process, many of my constituents will be seeking reassurance that it is safe to save in the future. Will the cap of 20 to 25% be sufficient in giving them that reassurance? If not, what other measures will be taken?
Mark Hoban (Financial Secretary, HM Treasury)
I welcome my hon. Friends comments. Many people's confidence in saving has been shaken as a consequence of what happened at Equitable Life, but she will recall that last month, my right hon. Friend the Chancellor announced reforms to the regulation of financial services, which will include a new consumer champion - a consumer markets and protection authority. That is one way to help to improve regulation and to give people confidence about saving for their future.
Alcoholic Drinks: Death
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health what evidence his Department holds on the effects on health of alcohol consumption; and what estimate he has made of the number of deaths from cancer in which alcohol was a contributing factor in the last 12 months.
Anne Milton (Parliamentary Under Secretary of State (Public Health) Health)
The Department reviewed the evidence on the known health effects of alcohol for its 1995 report 'Sensible Drinking'. A copy has been placed in the Library. Effects on health were also summarised in 'Dangerousness of Drugs' (National Addiction Centre, 2001 updated 2003) that was commissioned by the Department. The updated 2003 report has been placed in the Library.
The Committee on Carcinogenicity published a statement on the role of alcohol in breast cancer in November 2004.
The Department commissioned the North West Public Health Observatory to provide a fetailed analysts of the impact of alcohol use on mortality and hospital admission in its June 2008 report 'Alcohol-attributable fractions for England: Alcohol-attributable mortality and hospital admissions'. A copy of which has already been placed in the Library.
The Department has also analysed the key international research - particualrly the extensive reviews on the effects of alcohol on health published by Corrao (Corrao et al 1999. Exploring the dose-response relationship between alcohol consumption and the risk of several alcohol-related conditions: a meta analysis. 'Addiction'94, 1551-1573.) and by Rehm (Rehm et al.2004. In WHO (ed). 'Comparative quantification of health risks: Global and regional burden of disease due to selected major risk factors'. Geneva: WHO); and it has drawn on other published research and reports and on the advice of established experts.
The number of deaths in England from cancer in which alcohol was a contributing factor in 2005, the latest year for which data are readily available is 3,163.
Mortality Rates: Alcoholic Drinks
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Minister for the Cabinet Office what the mortality rate was for alcohol-related conditions in (a) England (b) Scotland (c) Wales and (d) Northern Ireland in each of the last 10 years.
Nick Hurd (Parliamentary Secretary (Civil Society) Cabinet Office)
The information requested falls within the responsibilty of the UK Statistics Authority. I have asked the authority to reply.
Letter from Stephen Penneck, dated July 2010:
As Director General for the Office for National Statistics, I have been asked to reply to your recent question asking what the mortality rate was for alcohol-related conditions in (a) England, (b) Scotland, (c) Wales and (d) Northern Ireland in each of the last 10 years.
The table ( on They work For You link) provides the age standardised mortality rate per 100,000 popluation where the underlying cause was alcohol-related, in (a) England, (b) Scotland, (c) Wales and (d) Northern Ireland, from 1999 to 2008 (the latest year available)
The figures for alcohol-related deaths in the United Kingdom by sex and broad age group, are published on the National Statistics website and are available for the years 1991 to 2008.
Kabul Conference
Debate
Sarah Wollaston (Totnes, Conservative)
In the drive to tackle corruption in Afghanistan, will my rt. hon. Friend say a little more about what steps are being taken to disrupt the drugs industry, which does spread its tentacles very directly to our streets?
William Hague (Secretary of State, Foreign and Commonwealth Affairs)
Yes, the British Government continue to give a lot of resources to counter-narcotics work - £26 million in the current financial year. We support programmes for growing alternative crops in Afghanistan. I was interested to note in Herat on Monday that saffron is being grown on a wide scale and brings a much larger income to the farmer than the growing of opium poppies. The UN Office on Drugs and Crime has reported a 22% fall in opium poppy cultivation in Afghanistan in the last year.
Sunbeds: Young People
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health when he plans to bring into force each of the powers to protect young people from sunbed use available under the Sunbeds (Regulation) Act 2010.
Anne Milton (Parliamentary Under Secretary of State (Public Health) Health)
The Sunbeds (Regulation) Act 2010 (the Act) comes into force on 8 April 2011. This purpose of the Act is to prevent people under the age of 18 from using sunbeds on commercial premises, by making it an offence for sunbed operators to allow people under the age of 18 access to sunbeds on their premises.
Regulation making powers (for example the one requiring that the use of sunbeds to be supervised) would begin as soon as possible after the Bill became an Act. Departmental officials are considering options to take forward the powers to regulate and may make recommendations to Ministers in due course. However they are giving priority to implementing the main provisions of the Act (namely those that prohibit sunbed operators from allowing those under the age of 18 from using their sunbeds). However, this parliamentary question is an illustration of the continuing interest there is in this topic within Parliament and beyond.
We are currently considering the regulation making powers contained in the Act.
Transport: Sea Rescue
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Transport how many rescue boats operating in the UK are not operated by the Royal National Lifeboat Institution but have the Maritime and Coastguard Agency as their launching authority.
Michael Penning (Parliamentary Under Secretary of State (Roads & Motoring) Transport)
Independent lifeboats are rescue boats which are declared facilities according to a specific standard or set criteria as agreed with the MCA.
There are 52 independent lifeboats in the UK that are declared for Search and Rescue (SAR) to the Maritime and Coastguard Agency (MCA). The MCA will request their attendance for search and rescue purposes as part of its role in the co-ordination of UK SAR activities. Authority to launch following a request from the MCA rests with the operators of the boat concerned.
Equitable Life
Debate
Sarah Wollaston (Totnes, Conservative)
Another point is that so many Equitable Life members are very hard up. I have received letters from many constituents, and one couple I heard from are now surviving on pension credits and rent rebates after a lifetime's savings were decimated by the Equitable Life scandal.
Alcoholic Drinks: Misuse
Written Questions
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Health whether he has made an estimate of the likely costs to the NHS of treating alcohol-related health conditions in (a) 2015 and (b) 2020.
Anne Milton (Parliamentary Under Secretary of State ( Public Health) Health)
No estimate has been made of the cost to the National Health Service of treating alcohol-related health conditions in 2015 and 2020. we plan to publish a White Paper on public health in the autumn, which will consider how to prevent future increases in ill health from alcohol misuse and associated costs.
Sarah Wollaston
To ask the Secretary of State for Health what the cost to the NHS of treating alcohol-related health conditions in each of the last 10 years.
Anne Milton
The information requested can be provided only at disproportionate cost. However in 2003 the annual cost of alcohol misuse to the NHS in England was quantified at £1.4 - £1.7 billion in 2001 prices Cabinet Office (2003). A more recent estimate of £2.7 billion per year for 2006-07 was published in Cost of Alcohol Harm to the NHS, department of Health 2007. Available at:
Sarah Wollaston
To ask the Secretary of State for Health what recent research he has evaluated on the effects on the level of alcohol consumption of (a) price and (b) availability of alcohol
Anne Milton
The Coalition programme for Government includes a commitment to review alcohol taxation and pricing, to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries. Her Majesty's Treasury and the Home Office will jointly lead the review. It will report in the autumn and will take account of recent research.
The National Institute for Health and Clinical Excellence issued public health guidance, Alcohol-use disorders:preventing the development of hazardous and harmful drinking in June. This report, which is available at:
http://guidance.nice.org.uk/PH24
was based on a series of effectiveness reviews, which summarise and assess the evidence from research, including research on the availability of alcohol. This will be considered by the Department over the coming months.
Youth Unemployment
Oral Question
Sarah Wollaston (Totnes Conservative)
In my constituency at this time of year when there is seasonal work, things are not so bad, but there up to 470 young people under 24 claiming Jobseekers Allownace at other times of the year. Can the Secretary of State clarify what measures will be taken to boost apprenticeships to give young people better life chances.
Iain Duncan Smith (Secretary of State, Work and Pensions)
Yes I can. As my hon. Friens knows, we made provision in the Budget for more than 50,000 new apprenticeships. It is also worth remembering that one thing that the last Government set in train, and would have introduced had they been returned, was a hike in national insurance, which would have damaged any prospect of young people in her constituency being in long term viable jobs. There is a good story to tell, which could not have happened if we had not taken over and found savings within the budget in our first year.
Phytophthora Ramorum
Written Question
Sarah Wollaston (Totnes, Conservative)
To ask the Secretary of State for Environment, Food and Rural Affairs
1. What recent estimate she has made of the rate at which Phytophthora Ramorum is spreading
a) nationally and
b) in the South West.
James Paice (Minister of State (Agriculture & Food) Environment, Food & Rural Affairs)
Since the first detection of Phytophthora Ramorum in Sussex in May 2002, a systematic programme of surveys has been carried out by the Food and Environment Research Agency and the Forestry Commission covering nurseries, garden centres, woodland and other sites in the wider environment, with action being taken to destroy infected plants that posed a risk of further spread, especially Rhododendrons.
While the disease caused by the pathogen has spread, and is now found in much of the south-west of England and Wales, occasionally in other parts of the south of England, and to a much lesser extent in Scotland, the rate of spread and the intensity of infection has been slowed by the action taken.
In August 2009, the pathogen was found for the first time in Japanese Larch, a commercial forestry tree species, at sites in Devon, Cornwall and Somerset, and surveys have found a number of further sites where trees have been infected. These surveys have intensified and are ongoing, supported by aerial surveillance by helicopter. Infected sites totalling around 1,850 hectares have been found in Devon, Cornwall, Somerset and in South Wales. The evidence suggests that all of the woodlands that have been found with dead and dying Larch could have become infected as a result of a weather event causing aerial spread, possibly in 2008. The extent of subsequent spread is still being investigated.
Police Reform & Social Responsibilty Bill
Written Question
Sarah Wollaston (Totnes Conservative)
To ask the Secretary of State for the Home Department which health organisations her Department plans to consult on the proposals on the cost of alcohol to be included in the Police Reform and Social Responsibilty Bill.
James Brokenshire (Parliamentary Under Secretary of State, Home Office)
The Home Office plans to consult with the following health organisations on the proposals on the cost of alcohol planned to be included in the Police Reform and Social Responsibilty Bill: the National Institute of Clinical Excellence, the British Medical association, Alcohol Concern, the Royal College of Physicians, the Royal College of General Practitioners, the Alcohol Health Alliance, the British Liver Trust, and local/regional representatives of primary care trusts and strategic health authorities.
Sarah Wollaston.
To ask the Secretary of State for the Home Department what discussions she had had with the Secretary of state for Health on the scope of the consultation on the proposals on the cost of Alcohol to be included in the Police Reform and Social Responsibilities Bill.
James Brokenshire.
The Secretary of state fro the Home Department and Secretary of State for Health have ongoing discussions on policy development and specifically the alcohol proposals to be included in the Police Reform and Social Reponsibilities Bill. Officials from both Departments continue to work together to develop and take forward these new measures.
Communities & Local Government
Oral Question
Sarah Wollaston (Totnes, Conservative)
My Constituency is home to Transition Town Totnes, which has a great interest in sustainable development. If the planning process for community land trusts is to be streamlined, provided that 90% of residents are in favour of a proposal, will the Department clarify how that 90% figure will be ascertained and how the low-carbon building agenda will be upheld so that we meet our commitments to cut emissions?
Grant Shapps (Minister of State (Housing and Local Government), Communities and Local Government)
I will gladly answer my Hon. Friend, Mr Speaker,
The 90% threshold is subject to a simple referendum of the people in the local community, parish or village. The idea is that the judgment should be made through the ballot box by those who go to vote. The buildings themselves will be judged against the criteria of sustainability codes 1 to 6, and the sustainabilty levels that will be required will be exactly the same as those for all buildings by 2016.
Carers: Young People
Written Question.
Sarah Wollaston (Totnes Conservative)
To ask the Secretary of State for Health what recent estimate he has made of the number of carers under the age of 18 (a) nationally, (b) in Devon and (c)in Totnes Constituency.
Tim Loughton: I have been asked to reply.
There is no national data collected as to the number of young carers identified at local level or constituency level.
The 2001 Census "snap-shot" indicated that 139,000 children and young people across England were offering some care. Of these, some 22,000 (16%) were reported to be caring for substantial periods of time - between 20 and 50 hours or more a week. These figures are likely to represent an under-estimate as caring roles resulting from parental substance misuse are not included.
The 2011 Census will provide more up to date national and local authority level data on the number of young carers.
Sarah Wollaston: To ask the Secretary of State for Health whether he has made an estimate of the number of people under the age of 18 years who provided care for a parent with an alcohol-related condition in (a) 2007-08, (b) 2008-09, and (c) 2009-10.
Tim Loughton: I have been asked to reply.
There is no centrally collected national data as to the number of people under the age of 18 years providing care for a parent with an alcohol-related condition.
The 2001 Census day "snap-shot" indicated that some 139,000 children across England were offering some care to family, neighbours, or friends. Of these, some 22,000 (16%) were reported to be caring for substantial periods of time - between 20 and 50 hours or more per week. These figures are likely to represent an under-estimate as caring roles resulting from parental substance misuse are not included.
The National Alcohol Harm Reduction Strategy, 2004, found that up to 1.3 million children live with parents who misuse alcohol.
NHS White Paper
Oral Question
Sarah Wollaston (Totnes Conservative)
My Rt Hon. Friend recognises how toxic many targets were in the NHS, but they were not all bad. There were some that ensured that standards were maintained, for example the two-week wait for cancer referrals. How will he ensure that standards are maintained when targets are abolished?
Andrew Lansley (Secretary of State, Health)
I am grateful to my hon. Friend, who is absolutely right. That is why, as I said in my statement, not only will we be clear about what we are trying to achieve, for example, where cancer is concerned, one and five year survival rates, at least as good as the European average and hopefully as good as any in Europe, but we will require the NHS to look towards clinically led, evidence based quality standards that enable those working in the NHS to be clear about what constitutes quality. That will enable us to deliver those outcomes
Debate: Defendant Anonymity
Before she became an MP, Sarah was a forensic medical examiner for Devon and Cornwall police, and spent many long nights with women and some men who had been the victims of horrendous sexual and physical violence. Sarah is convinced that the odds are heavily stacked against the victims, and anonymity would especially protect serial offenders.
FULL TEXT
Sarah Wollaston (Totnes, Conservative)
I congratulate Caroline Flint on her speech and on the passion with which she spoke during the Adjournment debate that she initiated. Many right hon. and hon. Members have brought special expertise to the debate, either as barristers or from a background in social work. My background is that I am a doctor. For five years, I was a forensic medical examiner for Devon and Cornwall police and spent many long nights with women and some men who had been the victims of horrendous sexual and physical violence. I have also been a family doctor for many years and have been a practitioner for 24 years in total.
I have lost count of the number of women-they are mostly women-whom I have seen who have not made an allegation of rape. The reasons are many and complex. I can testify that the vast majority of those crimes go unreported, because of misplaced feelings of guilt, real fear of reprisals, a belief that the victims will not be believed and, in many cases, just a sense that they want to put something so horrible in a box on the shelf and never visit it. That is the truth of the matter.
I pay tribute to the many women who have the courage to go forward and make a complaint. I want to point out something that the women saw had in common. Many of them told me that the reason they were going through what is, quite frankly, a very unpleasant examination after a horrendous experience was not for themselves, but because they believed that it would protect other women. I ask the Minister to consider why those women would report a rape if they thought that there was no possibility that other women might benefit.
I completely understand the many arguments made in favour of protecting the innocent who are subject to false allegations, but we need to remember that the odds are heavily stacked in their favour. For every 100 women I saw-I believed the vast majority of them-I can count on the fingers of one hand the number who had their day in court and saw a conviction. We need to be clear that the scales are already tipped in favour of the defendant in a rape case. We need to be very careful that we do not add a further barrier to women coming forward and making allegations.
The second point I should like to make is on the difficulty in this country with serial offenders. Many hon. Members have referred to John Worboys, who drugged his victims in the back of his taxi, but let us be clear that the No. 1 date rape drug remains alcohol. Many rape offenders are serial offenders-they are frequent fliers. When I examined women in the presence of police, it became clear that many of those whom the women named as the person who had attacked them were known to the police and had form. We need to be careful that we do not put further barriers in the way of identifying such people so that others can come forward with their experiences.
Those were the two main points that I wanted to make today. Many hon. Members have said that this is not a gender issue, and I agree. However, we need to be careful that we do not make it a political issue. I have some reservations about the way in which some Members have tried to make it so. I would like the Minister to consider free votes, because that is the best way to take the political heat out of the argument and to focus on the real issue of who we want to protect. I request that he look carefully at my suggestion.
Westminster Hall Debate: Fuel Poverty (Rural Areas)
Sarah Wollaston (Conservative, Totnes)
I congratulate my hon. Friend Dr Coffey on securing the debate. Many hon. Members have suggested solutions to the problem, but I want to emphasise a particular reason why the Minister and the House should be concerned. It is the excess of winter deaths. The fact is that 36,700 more people died in the winter of 2008-09 than expected. Even more worrying is the fact that, of the most vulnerable-those aged 75 and over-29,400 more died.
We do not have figures for excess winter deaths last year, which is unfortunate as it was a very cold winter. The figures are calculated by taking the number of deaths over the winter and comparing them with figures for the previous autumn and the summer, to the end of July. We will have those figures at the end of the month, and I expect that we will be in for a further shock. However, the figures for 2008-09 were themselves shocking, being the highest for a decade.
It is an interesting phenomenon that the further south or west one is in Europe, the higher the excess-between 5% and 30%-but we have a particular problem in this country. A study in the British Medical Journal found that a prime reason was the inadequacy of housing; it considered whether improving housing and heating would protect vulnerable people. Of course there were many other reasons, but I hope that the Minister will consider why that problem is crucial.
Gregory Campbell (East Londonderry, DUP)
What the hon. Lady says about the inadequacy of housing stock is important. Does she agree that in many regions of the UK the problem is not with housing associations or housing authorities, but with the private sector? Landlords are not always assertive in establishing whatever Warm Front schemes are available to provide better heated homes for the private-sector tenants.
Sarah Wollaston (Totnes, Conservative)
I thank the hon. Gentleman for that comment. Unfortunately, the BMJ study did not comment on that aspect, but it is an interesting point.
In the south-west, 11.7% of households, or 259,000 people, live in fuel poverty,. It is a serious problem, and many Members have spoken about why that is the case in rural areas. Hard-to-treat housing stock with solid walls are a particular problem. Tim Farron spoke strongly about rural households being disadvantaged because fuel costs for transport are so high. There is an inadequate bus service, which means that people have to travel quite long distances by car, thus putting them at a double disadvantage. Moreover, they are hit again by the fact that their housing costs are high. In my constituency, we have some of the lowest wages in Britain, so we are disadvantaged on all fronts. I hope that the Minister will address those points.
House of Commons Debate: Finance Bill
Sarah Wollaston (Conservative, Totnes)
I would like to ask the hon. Gentleman whether he realises why all these very sad cases are unavoidable. It is because we have a national debt of £1 trillion. I was looking at what that means. If every pound were a second, that would be 31,546 years and we would all be sitting here for a very long time.
House of Commons Debate: Political and Constitutional Reform
Sarah Wollaston (Totnes, Conservative)
I welcome the opportunity for the electorate to have a chance to vote on AV, but does the Deputy Prime Minister share my concern that it gives a second bite of the cherry to minority parties such as the BNP?
Nicholas Clegg (Deputy Prime Minister, Lord President of the Council; Sheffield, Hallam, Liberal Democrat)
I think that the alternative vote system, were it to be introduced, would not be susceptible to the dangers of some other electoral systems of fostering and allowing extremist parties to get a foot in the door of mainstream politics. If it were susceptible to such dangers, I would be as concerned as she is.
Debate: Budget Resolutions and Economic Situation
Sarah Wollaston (Totnes, Conservative)
I am extremely grateful to my right hon. Friend for giving way. My constituency is home to Transition Town Totnes, of which he may have heard. It leads the way in looking at climate change and peak oil, and I am sure that the people involved will be very interested to know the size and scale of the projects that will be funded by the green banks. What will be the time scale? When might they be able to start looking forward to making applications?
Christopher Huhne (Secretary of State, Energy and Climate Change; Eastleigh, Liberal Democrat)
I thank my hon. Friend for that intervention. [Hon. Members: "Answer!"] Opposition Members know perfectly well that there are certain processes in Government that we have to go through. We have to consult. We have to make sure not only that we produce decisions at the moment that both Opposition and Government Members would like, but that those decisions are right and have gone through all the normal processes.
Westminster Hall Debate: Supporting Carers
Dr Sarah Wollaston (Totnes, Conservative)I am grateful for the opportunity to speak in this important debate. After 24 years as a doctor, I do not need to be told how important carers are, and I pay tribute to the many whom I have met in my experience as a doctor-they really are extraordinary people.
I would like to focus on young carers in particular, and to draw hon. Members' attention to the fact that the average age of a young carer is 12, which is extraordinarily low. The 2001 census showed that there were 175,000 young carers in the UK, 13,000 of whom cared for more than 50 hours a week. Those young carers provide not only help with cooking, cleaning and shopping, but often very intimate and personal care, and emotional support to parents with severe mental illness. Organisations such as Barnardo's need our thanks for their work, particularly in helping young carers to cope and in identifying them before they find themselves in crisis.
My constituency takes in much of Torbay, where there are 350 identified young carers. Those children suffer low attainment at school, which is partly due to their poor attendance as a result of their caring work. They are also particularly prone to living in poverty. I would like to draw the Minister's attention to a particular subset of young carers: the 20% of the children and young people in the Torbay area who are carers as a result of alcohol and drug abuse, and associated mental illness. Those who have been identified are the tip of the iceberg. Some fear coming forward for help because they worry that they might be taken into care. Those children have no access to the carer's allowance. They are particularly prone to living in poverty and to going on to misuse drugs and alcohol themselves, and also at risk of domestic violence.
My interest is in prevention as well as cure. We know that drinking adversely affects up to 1.3 million children in the UK, and that group especially needs our help. Police forces estimate that 40% of all child abuse cases and 62% of incidences of domestic violence are directly related to alcohol. I would like the Minister to look again at the evidence on what works to reduce alcohol-related crime and violence, and therefore the number of children becoming young carers. The evidence shows that that is about pricing and availability, so I hope that there will be support for the Health Committee and NICE, which is clearly on the side of minimum pricing as the way forward.
I pay tribute to the caring organisations in my constituency. A fortnight ago, I was privileged to attend the opening of the Brixham carers centre. Brixham is particularly fortunate as it is also home to Brixham Does Care, which supports 150 carers and has 150 volunteers. Those organisations asked me to raise with the Minister the time that volunteers' Criminal Records Bureau checks take. Only this morning I was told that some checks submitted in April were still pending. We need to look closely at how we reduce the barriers to volunteering, because volunteers are a lifeline for carers. I welcome the review of the vetting and barring procedure that has been announced by the Home Secretary, but I would like the Minister to look at the time that the checks take.
Respite care is another concern of carers in my constituency. Will the Minister consider the issues facing the John Parkes unit, which provides respite care for some of the most severely disabled children in my constituency and is used by many of constituents?
Sarah's Maiden Speech in Parliament
HANSARD RECORD OF MAIDEN SPEECH IN PARLIAMENT
BY DR SARAH WOLLASTON MP on 2/6/2010
Click to watch Parliament Live
6.49 pm
Dr Sarah Wollaston (Totnes) (Con): Thank you, Mr. Deputy Speaker, for letting me catch your eye when so many hon. Members wish to do the same.
I thank the hon. Members for Chippenham (Duncan Hames) and for Luton South (Gavin Shuker) for their passionate speeches about education. I come to the House with little political experience, but as a doctor and teacher selected through an open primary, the first in the country to give every voter in a constituency the chance to select their candidate. I would also like to thank my predecessor, Anthony Steen. He served this House for an extraordinary 36 years. He is not the sort to retire, and I wish him well in his continuing fight against the evils of human trafficking.
I am very fortunate to represent one of the most spectacular and diverse constituencies in this country. The Totnes constituency stretches from the hill farms of Dartmoor to the most stunning of West Country coastlines, which supports a diverse tourist and fishing industry. Many people may not realise this, but more fish are landed at Brixham than at any other port in England-and I hope all Members will join me in recognising the adverse effect of the common fisheries policy on our fishing industry.
Mr. Peter Bone (Wellingborough) (Con): Hear, hear; very well said.
Dr Wollaston: Thank you.
We are also home to "Transition Town Totnes", which is the home of the transition towns movement. As such, it recognises not only the problem of climate change, but problem of the peak oil; it is planning ahead for a time when we no longer have abundant or cheap fossil fuels.
In the South Hams, we also have some of the most spectacular countryside, but I have to inform Members that that countryside is in crisis. We are fast losing our sustainability as more and more dairy farms in particular go out of business because of the problems of bovine tuberculosis. Devon is, in fact, at the very heart of the bovine TB epidemic. As a doctor, I have to tell Members that we cannot treat infected badgers by vaccination. Vaccination can only hope to prevent the disease in unaffected individuals. I have been teaching junior doctors evidence-based medicine for 11 years, and I can say that one of the problems we face is that the randomised badger culling trial has for years wrongly been used to justify a policy of inaction. Unless we do something about bovine TB, more and more of our farmers will go out of business. We need to recognise the effect on them and their families, and the very real distress bovine TB causes them.
The main reason why I came to this House is because I feel passionately about our NHS and the patients it treats. I welcome the proposals in the Gracious Speech to get rid of top-down bureaucracy in the NHS and to hand power back to clinicians on the front line.
In my constituency, we have four community hospitals, and I would like to pay tribute to their staff, and also their volunteers, for the work that they do. I hope that giving patients a louder voice in our NHS will prove to be the best protection for community hospitals, because people, particularly those in rural constituencies, really value them. I hope Members will support me in this endeavour.
There is another issue I wish to highlight, which affects not only my constituents, but those of all Members. After the tragedy of the Paddington rail disaster in which 31 people lost their lives, we rightly held a public inquiry and that led to the setting up of the Rail Safety and Standards Board, and after 3,000 terrible deaths in the USA, we joined a "Global War on Terror", so what should we say should happen after 15,000 to 20,000 deaths every year in this country as a result of alcohol? I pay tribute to the right hon. Member for Rother Valley (Mr. Barron), who has chaired the Select Committee on Health. It has recommended minimum-price alcohol as the best way forward. That may not be popular-in fact, in suggesting that we cull diseased badgers and raise the price of alcohol, it is clear that I am going for the popular vote! However, unless we do something about this, our constituents will continue to suffer. Let us look at the statistics: 1.3 million children in this country are directly affected by alcohol, and alcohol is a factor in half of all homicides. Members also need only consider the number of constituents they see in their surgeries who are victims of domestic violence. Alcohol continues to be the number one date-rape drug in this country, too. I ask all Members to look at the evidence, so we can have evidence-based politics.
The evidence is out there, and it is very clear. If we want to do something about the death toll-15,000 to 20,000 people a year in this country-we have to do something about price and availability. This is not about the nanny state; lives are at stake, and I ask the House to look again at the evidence, not only from the National Institute for Health and Clinical Excellence report issued today, but from its own Select Committee. I commend minimum-price alcohol to the House.
There is no such thing as cheap alcohol; we are all paying a very heavy price.
6.55 pm
Emma Reynolds (Wolverhampton North East) (Lab): I congratulate the hon. Member for Totnes (Dr Wollaston) on making such an excellent maiden speech.
ENDS
First month at Westminster
This is my first month as an MP representing the Totnes Constituency at Westminster.
In fact, many of you have questioned why this is called the Totnes Constituency when it covers parts of Torbay, most of the South Hams and stretches as far north as Dartmeet on the moor...as well as Totnes. I intend to write to the Boundary Commission to ask them to review the name. I would welcome your suggestions for an alternative name. Please email me at sarah.wollaston.mp@parliament.uk or write to me at the House of Commons. I will post the most popular suggestions in the Herald Express and on my website.
The Palace of Westminster is a beautiful but confusing labyrinth of corridors and committee rooms. My first experience was of feeling completely lost and forever needing to ask the way. It is friendly yet intimidating, fascinating but frustrating and surprisingly unprepared for the flood of new Members. New MPs have no offices and no secretarial support, not even a telephone; just a locker and a ‘hot desk' which needs to be left clear for the next wandering MP to use for a few hours.
As a new Member, you receive hundreds of emails and letters every day. These range from simple opinion cards to highly complex cases requiring many hours of research and correspondence. All cases need detailed tracking and without an office this seems like a mountain to climb. Old hands look on sympathetically and tell you that it will feel much better this time next year and that within ten you will have the measure of it.
Like all my colleagues, I want to do a professional job and to ‘hit the ground running'. My first task, however, is to learn to walk and recruit a team to help me to provide an effective service for my constituents. It is hard to convey how many obstacles are thrown in your path. Please bear with me if you have written but not yet received a reply from me. I hope soon to have an office but am told it may take a few weeks.
It is been a fascinating time to enter politics with the excitement of a new Coalition Government and the huge challenges it faces. I was very struck during the Election campaign by how many people told me they wanted to see political parties working together for the benefit of the Nation. For myself, having come to Parliament through an open primary, I feel a responsibility to represent all points of view, so the Coalition makes this commitment much easier. I want to see this new politics working; it is what the Country voted for and now politicians have to deliver. This will mean abandoning narrow Party agendas and working in cooperation.
So what do I hope to deliver? Above all, a voice for South Devon at Westminster, championing essential local issues such as the Kingskerswell bypass and standing up for our hard pressed farmers in their struggle against bovine TB. But being an MP should also be about holding Government to account and helping to scrutinise legislation. As one of only a tiny number of MPs with front line experience in the Health Service, I want to make sure that we finally get on top of one of the greatest problems of our times, namely binge drinking. Visit any town centre or casualty department on a Friday night and you will be only too aware of the problem. The waste of lives and money cannot be understated and so I will continue to champion this issue at national level on your behalf.
Overall, I start this new career full of optimism but well aware of its limitations. I will do my best and ask only for your patience whilst I grow into my role. I will always be willing to listen and learn and will welcome your suggestions.
ENDS
A proper and meaningful Coalition
Commenting on the political alliance which will form the next Government, Sarah said:
"Throughout the Election Campaign in my many doorstep meetings with constituents, it was made clear to me that they wanted to see politicians working together for the benefit of the Country. This has now been achieved through the creation of a proper and meaningful Coalition of the Conservative and Liberal Democratic Parties, who will form our new Government.
"I welcome this political alliance because it is in the best interest of the Totnes Constituency and the Country. We need a strong, united and stable government to tackle the problems ahead."
ENDS
