Category Archives: Speeches

Westminster Hall Debate – Nurses and Midwives: Fees

westminster hallGrahame M. Morris (Easington) (Lab): It is a pleasure to serve under your chairmanship, Mr Havard; regrettably, it may well be for the last time in this Parliament.

I congratulate my hon. Friend the Member for Blaydon (Mr Anderson) on securing this debate and the Backbench Business Committee on allocating the time. It is on an important issue, and the reason I wish to participate in it is because I serve on the Health Committee and we have looked at this issue on a number of occasions as part of our annual accountability hearings. Indeed, we produced a report, which my hon. Friend referred to; it was the fifth report of Session 2013-14, and the reference is HC 699. It is an excellent piece of work. The Committee went into some detail, covering many issues mentioned by my hon. Friend the Member for Blaydon and making recommendations about how best to proceed.

I do not want to repeat the arguments, but it might be useful to put into context the report and the concerns that have been raised. Constituents of mine who are nurses and midwives have written to me individually, quite apart from the petition. I think many hon. Members throughout the country have had similar representations.

There is an issue about fairness in respect of this considerable increase in fees, and about how the increases have come about. There is also an issue about whether those who are required, by the nature of their employment, to be registered should be placed into financial hardship, as has happened in some cases, particularly with women returners who are working limited, part-time hours. We all agree with registration, to maintain public confidence and trust in the nursing profession. However, there is an issue about whether some allowance should be made for them, in terms of a reduction in their fees.

As my hon. Friend indicated, the nursing and midwifery professions are among the oldest established and longest regulated professions in the United Kingdom, with regulation taking many forms over the last century. The current regulator, the Nursing and Midwifery Council, which has given evidence to the Health Committee, has been in operation since 2002. As we have heard, it is the statutory regulator for more than 670,000 nurses and midwives. The £67 million figure relating to its income is an old one, because it now receives more than £70 million.

In 2011, the Health Committee began holding annual accountability hearings in relation to the Nursing and Midwifery Council. Prior to that, our concentration was essentially on the regulation of the medical profession, with the General Medical Council. We have since widened the scope of the annual accountability hearings. In its report on the first annual accountability hearing with the Nursing and Midwifery Council, the Committee expressed concerns

“about the affordability of the registration fee”.

This has not just popped up: we have identified it as a trend since 2011. In that report, the Committee urged the Nursing and Midwifery Council

“to avoid further fee rises and to consider fee reductions for new entrants to the register”.

However, there have been fee rises since then. When I was first elected, the fees were £76 and they increased to £100 in February 2013. The further rise to £120 a year—that would probably account for the increase in revenue—would mean a 52% fee increase, at a time when nurses and midwives are experiencing severe and unsustainable pay restraint. These problems are further compounded by the decision of the Government and the Secretary of State for Health to veto the 1% NHS pay rise, denying a pay increase to 70% of nursing staff and ignoring the view of the independent pay review body. I want to place on record that the incredible work and effort of our nurses and midwives do is of great value, and I want to say how much that is appreciated throughout the country.

Ms Ritchie: My hon. Friend is making a compelling case for the career position of nurses and midwives. Does he agree that the Nursing and Midwifery Council, as well as the Government, should be encouraging people into the profession, rather than providing disincentives, discouraging them from joining it and from training for such vital roles that will benefit all within the wider community?

Grahame M. Morris: I agree wholeheartedly. All across the country—certainly in my area—efforts are made, and have been made consistently, to recruit good quality staff. Often recruitment is done overseas, with adverts being placed in newspapers in countries that train good quality nurses and midwives, but have a surplus. It often strikes me as bizarre that although we have a reservoir of women returners, we not making it as easy as possible for them to return. Doing that would be in the interests of the service and of the country. It would be a false economy to continue doing what we are doing.

Sir Alan Meale: I am here today because my sister is a midwife and has been a nurse all her adult life. This is not just about times of restraint and restrictions on pay; there has also been a thorough re-grading of the whole nursing and midwifery system throughout the UK, which has already re-graded many nurses to lower grades than previously. They are experiencing a double whammy, and this is the third time they have been hit with a fee rise. We should not approve it.

Grahame M. Morris: I am grateful for my hon. Friend’s intervention. That is another excellent point, well made. Pressures are being placed on the NMC, including increases in its costs, that are placing a greater strain and burden on nurses and midwives. The Government have to recognise that. I know that my hon. Friend the Member for Blaydon has reservations about whether the Government supporting the NMC with one-off grants would impact on its impartiality. I do not think that should necessarily follow. We should recognise the considerable pressures being placed on it financially, not least those arising out of public concerns and the recommendations of the Francis report. We want the public to be confident that the profession is properly regulated and that the fitness to practise procedures are operating properly and effectively. However, I agree with my hon. Friend. There was a ministerial statement last Thursday regarding untoward practices highlighted in a report, including bullying of staff and so on, in a hospital in east London—I think it was the Barts Health Trust. If fitness to practise referrals are being used by employers in that way, it is reprehensible and is adding to the strains and pressures on the NMC.

The latest fee increases are being imposed on nurses and midwives who were extensively consulted about them. My hon. Friend mentioned the overwhelming numbers: 96%—many of us would be over the moon to have that as a vote of confidence in the general election—voted against those recommendations. However, it seems that the consultation served little purpose, other than to antagonise nurses and midwives, because the Nursing and Midwifery Council has, apparently, taken little or no regard of the views of NHS staff and has pressed ahead with the fee increase.

The Nursing and Midwifery Council has also failed to provide any assurances that the latest increase will not be followed up by further increases in coming years. As my hon. Friend the Member for Mansfield (Sir Alan Meale) mentioned earlier, if we are to encourage people to come back into the profession, they have to know that the regulator has a reasonable, cost-effective process in place. The Nursing and Midwifery Council stated in evidence to the Health Committee last year that it had introduced an

“annual formal review of the fee level”,

so it is not necessarily an ongoing commitment. However, we have to ask: why has there been such a huge increase, of more than 50%, in a relatively short period?

Clearly the Nursing and Midwifery Council must meet its statutory obligations. We would expect that as Members of Parliament—and the public would certainly that—for maintaining professional standards. Certainly more needs to be done to remove the constraints it faces through the fitness to practise process—a number of hon. Members have highlighted that—which is too costly. Seventy-seven per cent of the Nursing and Midwifery Council’s income of more than £70 million is being spent investigating less than 1% of the nurses and midwives on the register. That is an incredible sum of money, and I find it difficult to comprehend how that can be an efficient use of resources.

The Nursing and Midwifery Council is making progress—I recognise that, and certainly the Committee recognised it, although it said it thought the progress was “fragile”. The NMC recognises past failures—not least in IT systems—and is seeking to overcome some of them, but it is clear that further improvement is required. An assessment by the Professional Standards Authority for Health and Social Care—the organisation that oversees all the professional regulators—has found that the Nursing and Midwifery Council is failing to meet seven of the 24 standards of good regulation. By any measure, I would suggest that there is still a long way to go in bringing it up to standard. Of those seven failures, two relate to fitness to practise.

While it is important that improvements continue to be made, it is wrong to expect nurses and midwives to bear the burden of the costs by themselves, particularly when we have seen the value of their pay fall in real terms over the life of this Parliament. The Government cannot sit idly by and allow continual increases in fees without taking action or giving some guidance. We hear Ministers time and again praising the hard work and dedication of nurses, and I hope the Minister will do that at the conclusion of the debate. Nurses do an amazing job in the most difficult circumstances, but when it comes to pay, pensions or professional fees, the kind words of Ministers seem to be rarely followed up by practical action that would help NHS staff.

In conclusion, I hope the Minister will say what steps he is taking to support the Nursing and Midwifery Council to ensure that it can continue to drive through the improvements we all want to see without having to increase the fees and the cost of employment for nurses and midwives. I also hope that he will address the points made by my hon. and right hon. Friends on the need to speedily bring forward the law commissioners’ sensible and well thought out proposals on the NMC. I would be interested if he could explain why they have not been brought forward before now.

Budget Speech

Commons ChamberA lacklustre and underwhelming budget that makes no real or practical difference to the lives and living standards of people in the North East and East Durham.

Trumpeted as the kick start of the Tories General Election campaign it did nothing to address the failings of the last five years.

The Chancellor has demanded more of the same, with deeper and more extreme cuts in public spending that will damage every service we value, the NHS, education and policing.

This was confirmed by the Chancellor’s own OBR which warned his budget will mean “a much sharper squeeze on real spending in 2016/17 and 2017/18 than anything seen over the past five years”.

We cannot afford five more years of Osborne-economics, with all of it’s false promises.

We know what a promise means from this government from tuition fees to VAT, the promise to protect the poorest then introducing the bedroom tax, from a promise to make work pay to the pledge to balance the budget within a single parliament.

The Chancellor cannot erase the last five years.

The Government promised to “make work pay” with the Prime Minister telling people “the best route out of poverty is work”.

These words are meaningless to the two thirds of children in poverty who live in working households.

There are over five million low paid workers in the UK, earning less than the living wage, a figure up from 3.4m in 2009.

The number of people in work claiming housing benefit is up 59% since 2010, costing an extra £5 billion, and wages have fallen on average by £1600 a year under this Government.

And yesterday the Chancellor had the audacity to claim that there was no cost of living crisis, and living standards have risen.

They might have risen for his friends in the city who continue to enjoy the top rate tax cut he delivered them.

While making millionaires richer, real people in communities like East Durham have seen their services cut, an increase of insecure employment through zero hour contracts, and 24 tax rises, making their families £1,127 a year worse off.

Not only has the government hit people directly through spending cuts and tax rises, they are failing to deliver the investment needed to grow our economy in the North East.

The much vaunted “Northern Powerhouse” is empty rhetoric for people in my community as the Chancellor has failed to grasp that the North does not end at Leeds and Manchester.

Where was the promised “Northern Powerhouse” in 2010 when their first act in Government was to abolish our successful Regional Development Agency – One North East, or when they took away our voice in government by removing the post of Minister for the North East.

Where is our investment, for every £1 spent in the North East, the Chancellor spends £24.33 in London.

How does the Chancellor plan to create a Northern Powerhouse when he inflicts disproportionate cuts on Northern Councils. My local authority – Durham County Council have had cuts of a quarter of a billion pound.

In response, the Council delivered an ambitious County Plan aimed at delivering jobs and growth only for it to be rejected by his government and the planning inspectorate.

Under what scenario does the Chancellor believe these decisions will rebalance the economy and promote growth in the North East.

What does the Northern Powerhouse mean to the North East when major infrastructure projects the Government announce as of national importance, such as HS2, do not include our region, again stopping at Leeds.

Network Rail suggest the benefits to my constituents would be a cut in journey times from Durham to London of eleven minutes by 2033, at the potential cost of direct services to the capital and slower journey times to major Scottish cities.

I cannot think of a policy which costs so much, with estimates ranging from £50 to £80 billion, and delivers so little to my community.

The priority in my constituency is to improve our connectivity to major lines and increase rail services as we continue to work towards a new rail stop at Horden, Seaview.

I would like the Government to show the same sense of urgency for my constituency and get behind these plans, which are a tiny fraction of the cost of HS2, but would see our communities connected to neighbouring cities, and the UK rail network, helping us to create new economic activity and opportunities for our communities.

The Northern Powerhouse is empty rhetoric while the Government continue to prioritise short term cuts over the long term interests of people in East Durham.

The Government have broken their promise to young people – they trebled tuition fees, abolished EMA, pledged to open more free schools leaving a £4billion black hole while schools like Seaham School of Technology continue to wait for their school to be rebuilt.

As education minister the Government Chief Whip attacked East Durham Schools, however, while they continue to deliver improved GCSE results his free school pet projects which have wasted taxpayers money are failing and his successor has been forced to close Durham Free School, a school which I was once told represented value for money.

I hope the Chief Whip might take the time to explain what he means by value for money to the children of Seaham School of Technology during the election campaign as they continue to wait for their new school building.

However, this is an equal opportunities government when it comes to education.

No matter if you are young and just entering the school system, or if you are leaving to go to college or university, you may be in work or out of work and need to retrain – no matter what your age when it comes to education this government will kick away the ladder of opportunity.

I have recently joined East Durham College’s campaign against funding cuts for adult further education.

The Government has announced a 24 per cent cut to adult further education from 2015/16 affecting all colleges. In addition to previous cuts which will mean that over the lifetime of this parliament funding for adult students in further education has been reduced by 35 per cent.

This means there are one million fewer adults’ receiving skills and training compared to 2010, removing opportunities for adults to receive the qualifications they require to access local employment opportunities.

It is short sighted cuts like these that will cause long term and lasting damage to our communities. With fewer people remaining in the same job throughout their working life people must have the opportunity to retrain and obtain the skills they need to compete in a changing labour market.

I am therefore disappointed at the lack of emphasis in yesterday’s budget to support life long learning, and I have no confidence that after the next election a Tory Government can support and promote educational opportunities in my constituency for people of any age.

Finally, yesterday’s budget promised yet another assault on Social Security after the election while failing to tell us what the Government will cut next.

People are rightly worried as the government’s record to date has been to hit the poorest and most vulnerable in society with no policy more cruel than the bedroom tax.

The Bedroom Tax has affected 1,300 families in East Durham. It has cost low income families £850,000 in East Durham, money that would otherwise have been spent in the local economy, supporting jobs and services. The Government left people with no option but to pay, as they knew there were not sufficient smaller properties for people to move.

However, the impact of the bedroom tax has been felt by the wider community particularly in Horden and Blackhall in my constituency which lost out on millions of pounds in regeneration funding after Accent Housing ended their planned investment because their properties were no longer financially viable due to the lack of demand caused by the bedroom tax.

The Government’s economic record, social security cuts and policies of austerity are scarred across the communities of Horden and Blackhall in the boarded up properties that Accent can no longer let and will no longer invest in, which are an eye sore and a drain on the community.

When people say that we are all the same, and voting does not make a difference it is these properties I will point to, the damage it has done to our communities and the pain and suffering people have experienced as a result of the bedroom tax.

It is an unfair policy which has hit over 400,000 disabled people and 60,000 households with carers, something the Government have always known.


The Budget delivered nothing for East Durham except more of the same policies of austerity and more damaging cuts for our community.

The simple question everyone should ask in fifty day is can you afford five more years of Cameron and Osborne.

County Durham Plan

Westminster Hall Debate
County Durham Plan
Tuesday 3rd March

I congratulate my hon. Friend Phil Wilson on securing the debate, which is timely given the importance of the county plan. I am delighted to stand together with my fellow County Durham MPs. Strangely, or perhaps not so strangely, virtually everybody—the business community, local authorities and community groups—seems to agree that the inspector’s decision is completely out of step and out of kilter. It seems rather bizarre to suggest that the County Durham plan, which we all feel is bold and ambitious in its expectations for the development of the region, is somehow overly ambitious. When my hon. Friend made his opening remarks, I thought about the comments of Michael Gove, who accused east Durham schools of lacking the ambition to produce people who would drive forward the regeneration of that part of the county. Here we have an ambitious plan that is completely achievable and realisable, but the inspector is apparently putting the brakes on it.

I will be interested to hear the Minister’s comments. I cannot anticipate precisely what she will say, but if her position is that the inspectorate is independent and Ministers cannot interfere in that process, there is a precedent for doing so. I represent a coalfield area in the east of County Durham, to the east of my hon. Friend Roberta Blackman-Woods and next door to my hon. Friend the Member for Sedgefield. The coalfield regeneration plan supported the idea of bringing new investment and employment into the coalfields, particularly in east Durham, but the inspector ruled against a retail development, which was the first phase of the Dalton Park development. The then Deputy Prime Minister, John Prescott, overturned the inspector’s decision. Again, he had tremendous support from the local authorities, from the community and from the business community. There is a precedent for overturning a decision of the planning inspector, and I hope that the Minister will think seriously about it.
I fully understand and share the concerns of the business community, which my hon. Friend the Member for Sedgefield has mentioned, after the inspector deemed the plan too ambitious in its aim to build more than 30,000 new homes and create 30,000 new jobs by 2030. As has been mentioned, the Chancellor visited our region just last week, and referred several times to his long-term economic plan and his ambition to create a northern economic powerhouse. That makes for good rhetoric, but it does not offer much in the way of practical support.

Although the Chancellor promised investment for transport links and skills, and said that he would back manufacturing and exports, it is worth noting that spending on transport infrastructure in the north-east is the lowest in the county at £223 a person, compared with £5,426 a person in London. For every £1 that is spent in the north-east, London receives £24.33. I know that London is the capital city, and that it has Crossrail and a huge population, but that disparity is huge. We need some practical support. Yes, we need ambitious plans put forward by the county council, but we need a Government who will correct some of the anomalies that exist. We do not need the inspector to reinforce and worsen the north-south divide. Revising down the plans for more jobs and homes—the estimates are empirically based—will not help to rebalance the economy.

My local authority, Durham county council, has transcended the rhetoric from the Government and the Chancellor. It has put forward ambitious plans for jobs and economic growth in the county, and it is wrong that the Planning Inspectorate should block those plans. We have suffered tremendously. I tried to calculate the number of jobs lost in my constituency over the last few years. They have been lost not just in the public sector, but at some quite large employers, including the Reckitt Benckiser factory in Peterlee, which I hope will reopen, and which used to employ 500 people; the Fin engineering company in Seaham; Cumbrian Foods; and Yearley, the refrigeration and transport company.
A number of substantial employers have gone, but we are seeking to diversify the economic base of Easington, in the east of the county, and indeed of the whole county. My hon. Friend the Member for Sedgefield referred to Hitachi locating in his area and to the positive spin-offs and benefits in the supply chain. I hope some of the engineering factories in my constituency—particularly in Peterlee—will benefit from that additional activity.

The Government have an opportunity to prove they are committed to creating a northern powerhouse, and that that is more than just idle rhetoric. I hope the Minister can give a real commitment to work with north-east MPs, and that we have common cause on this. I am not terribly familiar with her constituency, but we have been through the trauma of industrial closures, and thousands of jobs have been lost in Easington, and we have not had special measures, enterprise zones or a Minister for the area to argue for more investment. It is beholden on the Government to get behind the efforts we are making to generate economic activity and jobs and to improve the county’s collective well-being. Indeed, local businesses are rising to the challenge, raising their ambitions and expectations for the north-east economy.

I cannot accept the planning inspector’s assessment. If he is saying that our county should be less ambitious, that we should aim to create fewer jobs and that the north-east needs less investment in infrastructure that is certainly not the case. The Government cannot allow the Planning Inspectorate to undermine the entire county plan and to stifle the ambition of people in the north-east to bring new investment, businesses, jobs and training opportunities to our region.

The north-east has a number of leading international businesses. The Government often cite Nissan, and Newcastle airport is another tremendous business that generates huge economic activity and benefit for the region. Shortly, we will also have Hitachi. In my constituency, we have world-class companies such as Caterpillar, NSK and GT Group. Between them, they employ more than 2,000 people, and they have huge export orders and huge potential. We need to do everything we can to encourage them and to grow our own companies.

We also need, however, to attract new businesses. Part of the plan is to have a centre of creative excellence in the north-east—a film studio or a Hollywood of the north. However, that requires a commitment from the public and private sectors. An area is set aside, and it requires some housing development if the scheme is to go ahead. Potentially, it could create 2,000 jobs and training places. As my hon. Friend Helen Goodman suggested, we could use all the synergies in our area—not just the tremendous location, with a terrific vista over the County Durham coast, but the skills base at our universities at Teesside, Durham and Sunderland, and the skills at our colleges—to get that enterprise going. We therefore have enormous potential, and I have complete confidence in the people I represent and in the commitment of businesses.

East Durham used to be a centre of not just coal mining, but the textile industry. A large number of factories were located in Peterlee and Seaham. Sadly, much of that business has gone offshore, but we have seen a bit of a revival with an embryonic business called AMA, which I met and helped to encourage. It has now expanded and won a major contract with Tesco, and we hope we can use some of our skills and potential to develop that still further and create more jobs.

We also have innovative training providers, such as Infinite Learning and Development and its Welding Academy. That is important, because we have Caterpillar and GT Group, and we need to give local people skills to address the shortage of highly trained welders in the region. Infinite Learning and Development was one of three finalists nominated at the national Semta apprentice awards, where it was in illustrious company, competing alongside the likes of Toyota UK, Tata Steel and Swansea university for the training partner of the year award. For a small training provider, that is some achievement and some recognition of its commitment.

I should also mention the East Durham Employability Trust, an employment charity in my constituency that helps those not in education, employment or training to secure sustainable employment through its Destination Employment programme. It has had tremendous results, with 94% of those completing the programme moving into employment. That is a terrific outcome.

We have tourist potential. With the right investment, we can create jobs. We can have the most magnificent coastline anywhere in the country, but if people cannot get to it, we cannot really develop its tourist potential, in terms of day visits or longer stays. We have one of the best-kept secrets in the country in the east Durham heritage coast—I know it is referred to as the County Durham heritage coast, but I like to call it the east Durham heritage coast, because that is where it is. We also have the coastal footpath and the newly announced nature reserve on the former Easington colliery site. Those tremendous assets are safeguarding and protecting our natural environment, as well as promoting tourism—it is possible to do both.

Last week, having been involved in the issue for some time, I was pleased to hear the owners of the Dalton Park development announce that work on a £45 million expansion is due to begin in May. That will create 600 retail jobs, with an estimated 400 jobs during the construction phase. That is welcome news. The first phase was in 1999-2000, when the initial planning consent was given. That is a welcome investment in jobs in the local economy. It will provide new amenities for the community, including a cinema, restaurants, a supermarket, a petrol station, a hotel and a family-friendly pub.

We are, however, looking to the Government and the Planning Inspectorate to work with the local community, the local authority and businesses to promote every sector of our economy in east Durham. My hon. Friend the Member for Sedgefield said we were trying to diversify our economic base. We need some practical assistance to do that, whether in manufacturing, light or heavy engineering, retail, the service sector or tourism. I do not want the planning inspector to talk the north-east down. I certainly do not want him talking Easington or east Durham down; and I do not want him to hold us back from transforming our communities. I will not go through the long list of business organisations that condemn the Planning Inspectorate for its decision. However, I share their concern that in rejecting the county plan, in not listening to the concerns of local businesses and elected representatives, and in rejecting the advice of the local authority, the inspectorate has itself shown a lack of ambition for the north-east.

Among the comments that have been made, one that my hon. Friend the Member for Sedgefield did not mention was from Jonathan Walker, of the North East chamber of commerce:
“We work alongside our public sector partners and encourage local authorities to be bold, ambitious and pro-growth in their budgets and local plans. We are shocked by what the inspector had to say and feel his recommendations not only stifle the ambitions of Durham, but, by implication, the North East as a whole.”

I do not want to underestimate the scale of the task. We certainly face challenges in county Durham—and more, perhaps, in Easington than anywhere else in the county. We need support to tackle that. The Government’s reduction of the local authority’s budget by more than a quarter of a billion pounds was certainly not helpful. We need more Government support, particularly with infrastructure, on which we get a poor deal. For example, the proposed railway station in Horden in my constituency is still in the pipeline—in the planning stage. It would be a considerable boost to tourism, employment and the mobility of labour, but instead the Government continue to focus on faster rail services, while in east Durham we need greater connectivity to existing lines. We have had a welcome announcement that Pacer trains are finally to be removed from the network.

County Durham should have our praise for its ambitious plans, and should not be chastised by the Planning Inspectorate. I urge the Minister to give the matter further consideration, look at the views of the business community and local representatives, and help us to get the Planning Inspectorate on board, so that we can move together for a better, more prosperous future for east Durham, county Durham and the north-east.

Epilepsy in the workplace

HoCI, too, congratulate Laura Sandys and Mrs Gillan on securing this important debate. In common with many other Members, I would like personally to thank the hon. Member for South Thanet for the excellent work she has done. She might not thank me for a glowing tribute, given that I am on the left of the party, but I think that she is a thoroughly decent MP who does an excellent job. She will be sadly missed. I am perhaps a less active member of the all-party group on epilepsy, but I am a member of many other all-party groups, particularly those on health and cancer. This is a very timely debate. It is thanks once again to the Backbench Business Committee that we have been afforded this opportunity to raise awareness of this important and often misunderstood condition.

In a previous role—I was not double-jobbing, I might add—I worked in the National Health Service in an analytical chemistry lab where I used to do tests on anti-epileptic drugs using gas chromatography techniques, so I know a little bit about the chemistry but not so much about the clinical manifestations and symptoms.

I pay tribute to the tremendous and powerful speech by Steve Baker, which really brought home the potential risks of this condition if left unregulated. It is one of the most common neurological conditions in the United Kingdom.

As the hon. Member for South Thanet said, 500,000 people in the UK, or one in 100, have the condition. That is a considerable number of people. As I think we are all aware by now, epilepsy is not one condition but a composite. Other Members have mentioned the suspected link with autism.

There are about 40 different types of seizure and perhaps as many as 50 different syndromes with various degrees of severity and complexity. However, with the right treatment, the right medication and the right support, there is no reason why someone suffering from epilepsy cannot lead a full and active life, as the hon. Lady so ably explained.

Many Members have talked about access to medical care and stigma, but I want to stress another aspect—the discrimination that can be faced by those with epilepsy, creating barriers to education, and, more particularly, to employment.

A report published by Young Epilepsy found that three quarters of people with epilepsy have experienced discrimination due to their condition. This situation was reaffirmed by work commissioned by the disabilities charity, Quarriers, which found that more than two thirds of people with epilepsy admit that they worry what members of the public would say or do if they had a seizure, with over a third expressing concern that having a seizure in public has led to anxiety about whether to leave the house – let alone taking up employment.

In relation to employment, more than seven in 10—72%—stated that their condition had an impact on their career progression and choice, with more than two fifths avoiding even telling people about their epilepsy.

There are protections in place for those looking for work and for those who are in work, but I am concerned that these duties and obligations are not being met by employers.

Equality laws make it illegal for employers to treat people with epilepsy unfairly, and protection must be provided against bullying and harassment due to their condition. Employers also have a duty to make reasonable adjustments to help people with epilepsy to get into work, or stay there, and to prevent them from being at a substantial disadvantage.

However, we have found that people with epilepsy have been shown to be twice as likely to be at risk of unemployment as those without the condition.

The case of Karen Guyott, which was mentioned by my hon. Friend Kate Hoey, has been drawn to my attention before.

To comply with the instructions from yesterday, I am, as it says in my entry on page 205 of the Register of Members’ Financial Interests, a member of the RMT parliamentary group, although it is unremunerated and the RMT is not affiliated to my party. It is important that we speak in this House on behalf of working people, and charities, and raise legitimate concerns. That example of someone losing her job is an important test case because, as my hon. Friend said, London Underground did not provide the training or support required.

I only have a little time left, so I want to put this to the Minister, who I know is a decent and reasonable man: at the conclusion of the debate, I hope that he will make it clear that it is unacceptable to discriminate against someone due to their having epilepsy. I hope that he will support people, such as Karen, who are fighting blatant discrimination.

Will he agree to raise her case with the Mayor, because Transport for London comes under the Mayor’s auspices?

TfL is a significant public sector employer, and we want it to be an example of best practice. Will the Minister meet a delegation of interested MPs to discuss discrimination and epilepsy at work?

Pubs and Planning Legislation Debate

House of Commons
Thursday 12 February
Pubs and Planning Legislation

Fair Deal for your LocalGrahame M. Morris: It is an honour to follow the hon. Members who have spoken. I thank and pay tribute to fellow officers of the all-party save the pub group—the hon. Member for Bristol North West (Charlotte Leslie), who opened the debate so succinctly and precisely, and the hon. Member for Leeds North West (Greg Mulholland), who has been such a dogged and long-standing campaigner for Save the Pub. I add my thanks to the Backbench Business Committee, which does such a sterling job in identifying subjects for debate that are dear to the hearts of Members and constituents.

We often say that there should be more cross-party consensus, particularly on policies relating to the NHS and social care, but a long journey starts with a single step, and perhaps on this topic, which has attracted support across all parties, we may be able to reach consensus. I am sorry that the Minister has slipped out for a moment, as hon. Members have made some excellent suggestions for a way forward.

My contention is that a way forward was offered by an amendment to the Infrastructure Bill that was tabled by me and the hon. Members for Leeds North West and for Bristol North West, which attracted the support of 38 Members of Parliament. The proposal was hardly revolutionary: to promote diversity, it offered some choice. It did not offer any permanent protection; it was simply an attempt to introduce community consultation to try to prevent viable pubs being closed and steamrollered into an alternative use, usually as a supermarket.

I echo the disappointment of the hon. Member for Bristol North West at the response of the Government, who have sought to block every effort to support tenants and safeguard our pubs. At all stages the Government seek to water down and amend legislation to favour powerful self-interests in the pub industry—those of the large pub companies—rather than working in the best interests of communities, customers and tenants. It is a shame that this debate is necessary at all. New clause 16 to the Infrastructure Bill would have made quite a simple change to the planning laws, empowering communities to protect their local pubs from being demolished or converted into supermarkets without consultation.

Earlier hon. Members were trying to differentiate pubs that are clearly no longer viable as pubs and those that have support and are clearly viable, and that perhaps offer a range of services, such as restaurants. As today’s motion notes, the existing planning laws in relation to permitted development are causing valued and viable community pubs to be targeted by supermarkets. Hon. Members have given examples in Canvey Island, Bristol and North East Derbyshire, where that is precisely what has happened. In east Durham, in Easington, which has 18 villages and two large towns, there have been so many pub closures that there may be one pub left in a village. In some villages—Hawthorn, Dalton-le-Dale, Hesledon—there may be one or perhaps even two pubs, but there is considerable pressure, particularly on the tenants of pubs that are owned by the large pubcos. As we have heard, research from the Campaign for Real Ale suggests that a considerable number of pubs—I have a figure of 29, but the hon. Member for Bristol North West said that it is 31, and I am sure she is correct—are closing every week, and quite a number of those are being converted into supermarkets.

I greatly appreciated the widespread support that was shown for new clause 16, which offered such protections for community pubs. It was defeated only following a late intervention from the Government when the Minister made a token concession to remove pubs listed as an asset of community value from permitted development rights. While new clause 16 would have protected all pubs, the Government’s amendments potentially protect only 600 of the 48,000 pubs in the UK. This comes from a Government—on both sides of the coalition—who believe in and promote localism. Requiring ACV status to protect one’s local simply adds unnecessary bureaucracy and costs when a much simpler alternative is to empower local people. I am at a loss to understand why the Government believe that nightclubs, launderettes and casinos should have more protection than community pubs.

By opposing planning protections for pubs, the Government have failed to protect pubs and community interests. Not only that, but we continue to see efforts to water down an important decision of this House to empower pub tenants against pub-owning companies. That is an important factor in the many conversions. Last year, the House expressed its clear will to offer tenants a market-only rent option as part of a statutory code of practice between themselves and a large pub-owning company. I recognise that we have a planning Minister here and the purview of ministerial responsibility is perhaps not entirely his, but it is germane to the debate that we consider the implications. Importantly, such a safeguard would help to protect the tied publican who may be struggling financially. Some 46% of tied tenants earn less than £15,000 a year despite their hard work and, in most cases, long hours. Nearly nine out of 10—the exact figure is 88%—identified the beer tie as one of their most significant financial problems.

The market rent-only option agreed by the House helps to level the playing field and redress the balance of power between the tenant and the pub-owning company. That may relieve the pressure that is leading to so many pub closures—31 per week, as I said. It is important to note that the market rent-only option would not end the beer tie—as some critics have claimed, saying that it would be a retrograde step—but would ensure that pub-owning companies had to show real value to their tenants in order to retain the tie.

Despite the House’s support and the benefits to tenants, Tory peers—including some with clear vested interests, if I may say so—have been trying to exempt pub companies from the market rent-only option if they significantly invest in a tenant’s pub. “Significant investment” is an incredibly wide concept. While I am not surprised that a peer with a pecuniary interest would try to undermine the statutory code, I am more concerned about the Government’s efforts to reword and water down the protections of the market rent-only option without consulting MPs, or Fair Deal For Your Local campaigners, prior to inserting replacement clauses into the statutory pubs code legislation.

Subsequently there has been some consultation with the various interest groups, all of which the members of the all-party save the pub group have met, including Fair Deal For Your Local, the Campaign for Real Ale and trade unions representing pub landlords, such as my own union, Unite, and the GMB. Importantly, however, despite promising to do so, the Government did not consult in advance and the discussions seem to have taken place after decisions have been made.

Simon Clarke from the Fair Deal For Your Local campaign is an outstanding advocate in defence of our pubs. He has warned that one revised clause means that existing tenants will not have the option of a parallel rent assessment, resulting in a tied tenant being unable to determine whether they would be worse off than if they were free of tie. That was an absolutely key principle of the Bill and Ministers gave us an assurance from the Dispatch Box that that would be the case.

A Government Minister said in the other place that Ministers

“are always discussing these issues and changes with tenants”.—[Official Report, House of Lords, 2 December 2014; Vol. 757, c. 1243.]

However, despite such assurances, Mr Simon Clarke describes the Government’s amendments as

“an attempt to bulldoze through amendments without the dialogue and consultation promised.”

The Government should explain their position.

I have a number of questions to put to the Minister. Why are the Government failing to support local communities to protect their pubs? What are their objections to allowing local people a say in the planning process when a change of use is proposed for a pub? Will the Minister guarantee that he and the Government will work with MPs and campaigners to ensure that the explicit will of the House of Commons in supporting a market rent-only option in a statutory code is not undermined or watered down in the other place, because that would simply compound the problem?

It is time for the Government to do more than pay lip service to supporting communities, consumers and tenants, and to safeguard pubs and begin to offer some practical support. As my Health Committee colleague the hon. Member for Bristol North West (Charlotte Leslie) has said, before we call time on this Parliament—that is a really good expression—we should ensure that we can, in unanimity, provide some modest protection to pubs that are in the interests of all our communities.

Housing in Horden Debate

Westminster Hall
Wednesday 11 February
Housing (Horden, County Durham)

westminster hall2Grahame M. Morris It is a pleasure to serve under your chairmanship, Mr Owen, for what I believe is the first time. I am grateful to have this opportunity to raise an important issue on behalf of the residents and community of Horden in my constituency of Easington.

By way of background—this is for the Minister’s benefit, because I am unsure whether he is familiar with the communities of east Durham—Horden, like many of the communities I represent, is a close-knit former mining community, located on the east Durham heritage coast. The village, which has a long and proud industrial heritage, was established to serve the needs of the colliery. The sinking of the pit brought new workers and the village began to take shape with the construction of terraced housing—that style of housing will be familiar to you, Mr Owen, because similar terraced housing exists in all the former mining areas, including in Wales and Yorkshire.

The demand for housing remained high until the closure of Horden colliery in 1987. I recall that Horden was one of the biggest collieries in Europe when it was at peak production and we had a number of associated industries, including a petrol-from-coal plant, which was a considerable employer, which I think was developed during the war.

The loss of the coal mine has led to issues found in many former mining communities such as unemployment, health inequalities and an ageing and declining population, which has led to lower demand for family-type housing in particular. While today’s debate is on the situation caused by the Accent housing association, I hope that the Minister will acknowledge the wider issues concerning the lack of investment and support given to Horden in particular—other mining communities have received such support—to attract new industries, jobs and investment since the end of its mining operations.

I hope that the Minister is aware of precisely what has happened with Accent. It is quite a large housing association that manages more than 20,000 properties nationally, but I want to raise specific concerns regarding the 361 properties that it manages in Horden and Blackhall, the neighbouring village. Of its 220 homes in Horden, 130 are currently empty. In Blackhall it owns 141 properties and 30 of those have become vacant. The problem is that, as properties become empty, Accent no longer seeks to let them as homes. Instead, vacant properties are being boarded up, which are an eyesore and a drain on the community.

It is clear, from walking around the area, that properties have gradually fallen into a state of disrepair and now require substantial work. Accent did have an investment plan in place to improve those properties to the decent homes standard through replacing bathrooms, kitchens, windows, doors and heating systems as well as making other repairs, but millions of pounds of regeneration funding were withdrawn following the Government’s implementation of the bedroom tax. In Accent’s view, those properties are no longer financially viable because many of them had been let to single people who, under the terms of the bedroom tax, would be under-occupying them and so be subject to an additional charge.

Although the bedroom tax was the tipping point, to be fair to the Minister—I hope that he is paying attention—the cause of the problem is long-term mismanagement by a social landlord that has failed to invest in the homes over many years. Accent acknowledges that as long ago as 2008, it was letting two-bedroom former colliery houses to single people in the knowledge that that was not a long-term option. Its failure to maintain its properties adequately is evident: estimates suggest that to bring the homes up to a fit standard would require a £7 million investment, based on £20,000 a property. The bedroom tax significantly reduced demand for the properties and although I will criticise Accent for many things, it cannot be blamed for the bedroom tax. However, it is responsible for a chronic lack of investment.

I have had considerable communications with local residents and representatives of Horden residents association, who are highly critical of Accent. They said that it has had a “non-dynamic” approach to the care and maintenance of the properties that goes back as far as 2006. It seems to have total disregard for the community in terms of vetting potential tenants. The residents’ groups, who have worked closely with the local authority and the police, have been out litter picking, clearing up fly-tipping and identifying problems to report to the local authority. However, the residents say that their efforts to clean and improve the area have been undermined

“as a result of poor quality tenants being given access to poor quality properties, which were suffering from a lack of investment by Accent”.

As we know, when areas fall into disrepair, they become a target for crime and we get a vicious circle of decline. Accent has an obligation not just to its existing tenants, but to the neighbours of its tenants, because its properties are not necessarily continuous on streets; they may be in small clusters and groups. Residents in neighbouring properties are also experiencing problems such as antisocial behaviour, fly-tipping and rat infestations owing to issues in the Accent-owned derelict properties. The crime figures from the previous three months indicate that in this relatively small village there have been 409 reported incidents, including 88 incidents of antisocial behaviour and 14 incidents of criminal damage. Arson is not uncommon at the derelict properties.

The feeling is that Accent has abandoned the community and I would like the Minister to ensure that it will not be allowed simply to walk away from its responsibilities. I understand that it is currently seeking permission from the Homes and Communities Agency to dispose of its properties on the private market, which means that it will put them up piecemeal for auction. However, a wholesale sell-off where the homes disperse into many ownerships would be the worst possible option for the community. The genuine fear is that that will lead to an influx of absentee landlords with no interest in the community buying and letting substandard properties to maximise their return and get a quick profit from housing benefit. That would be bad for the residents, future tenants and the wider community.

I would also like to mention the role of the Homes and Communities Agency, which in relation to Horden has been hugely disappointing and incredibly ineffective. It seems to have no long-term plan for the regeneration of housing in Horden. As an aside, I perhaps should have declared a non-pecuniary interest at the start. I am the secretary of the all-party group on housing in the north. We have had many presentations from housing associations and organisations with an interest in housing. The big issue that we face in the north and in particular in my constituency—in Easington, Horden, Blackhall and some of the other villages—is not so much a lack of housing, although there is a need for new housing, but the fact that the existing housing stock in many cases is very old. It needs modernising. We need some selective demolitions and the existing stock needs to be refashioned in a way that accommodates the needs of local populations. The Homes and Communities Agency should be taking a lead in developing that strategy.

The views that I have received on the effectiveness of the HCA are that its priority and primary concern seems to be the viability of the social landlords of the housing association, rather than the legitimate concerns of the local community on the condition of their neighbourhoods and localities.

The Homes and Communities Agency and the Government have no strategic plan for housing in the north. Particularly in former industrial areas and especially in former coal mining areas, housing is often tied accommodation—houses were built to accommodate the workers—and part of the legacy of the coal mining industry. There is a failure to recognise that the problems with housing needs in the north are not the same as those faced, acute though they are, in London and the south-east. Housing in the north needs a different set of solutions and strategies. We certainly need more housing, but we also need to reshape our communities, replacing high-density colliery housing with more modern housing to meet the needs and aspirations of local communities.

You might be aware, Mr Owen, that these densely packed terrace houses have no gardens or parking facilities. They tend to have a path running along the front of the terrace and yards at the back. We need some selective demolition and some strategic oversight to open up these areas, as has happened with Easington colliery, where some excellent schemes have been carried out by the Durham Aged Mineworkers Homes Association, East Durham Homes and others. There is a model to follow there.

Will the Minister rule out the wholesale disposal of the properties on the private market? Everyone in the locality feels that that would be a retrograde step that would hurt the community in the short, medium and long term. Instead, I would like the Minister to intervene and to seek alternative options.

A homesteading scheme has been suggested, and I saw some coverage in the national news of schemes in Staffordshire, Liverpool and Middlesbrough. Homesteading involves a property being purchased by a first-time buyer at a significant discount. They then renovate the property as a home and are prohibited from selling the property for a specified period. I understand that the aim of that is to deter speculators, who would pick up the properties very cheaply, improve them and sell them on. If that happened, that would put us back in the same situation we are in now, where large amounts of property are in the hands of absentee landlords.

We need stable communities. Homesteading would help that, and the proceeds from any sales of such properties could be used to support the homesteading initiative or be reinvested in the remaining housing stock, to bring it up to a decent standard where it could then be re-let. It is an interesting idea that is worth considering, but significant investment is required to repair the properties in Horden and, to a lesser extent, in Blackhall. If it is a viable solution, I would welcome the Minister’s thoughts on it.

I highlight the community initiative of the Horden residents association. It has been extremely active in looking to establish a community-led co-operative similar to those in Liverpool and closer to home in Middlesbrough. It will be holding a meeting on Friday to explore the option further. Can the Minister provide an assurance that the Homes and Communities Agency will offer practical assistance to the residents association if it tries to pursue that option? Ideally, we would like a long-term investment strategy for former industrial communities, both for regeneration and redevelopment.

I understand that we are in a time of austerity, but if there is a political will, we can overcome any barriers on finance. With all due respect, I point out that huge spending commitments have been made recently—on High Speed 2, for example. My good and hon. Friend the Member for Gateshead (Ian Mearns), who is serving on the Committee considering that legislation, tells me that the estimates on the cost of HS2 vary between £40 billion and £50 billion. Already, £1 billion has been committed to acquisition, and the scheme has not yet got full parliamentary approval. The lifetime cost of replacing the Trident missile system is estimated to be in excess of £100 billion.

Those are just two items of Government spending. One is not coming to the north-east and the other’s success is based on the assumption that it will never be used. I am not asking for tens of millions of pounds or billions of pounds, but a similar level of commitment from the Government to former industrial communities. At the moment, we lack a national plan and the political will and resources to tackle this important issue.

I will conclude, because I would like to hear what the Minister has to say. Before that, I will ask him some questions and raise three specific issues. First, in the short term, will he use his influence with the HCA to ensure that Accent is not allowed to walk away from its responsibilities by disposing of its properties in a piecemeal fashion on the open market? That would be another betrayal of a community that feels it has already been betrayed by Accent.

In the medium term, will the Minister investigate the role and effectiveness of the Homes and Communities Agency? As a Government agency, it has clearly failed in Horden, and I am sure there are other examples. We need to work in the interests of the community, rather than in the interests of social housing providers; as we have seen with this case, they are not necessarily one and the same. In the long term, we need a national housing plan that recognises the unique needs of former industrial communities. We need not only more housing, but full-scale regeneration to ensure that our communities can succeed and thrive for future generations.

Speech: Improving Cancer Outcomes

House of Commons,
Thursday 5th February,
Improving Cancer Outcomes,

Grahame M. Morris (Easington) (Lab): I place on record my thanks to the Backbench Business Committee for allocating time for this timely debate on cancer services. I also thank the hon. Member for Basildon and Billericay (Mr Baron) and the various co-sponsors who made the case for this debate. I also pay tribute to the various all-party groups covering the issues. Many Members are dedicated to particular groups and play an important role in compiling research, getting information to Ministers and raising specific issues in Adjournment debates. We should pay tribute to all of those people for all the work they do, irrespective of which party they represent.

I wish to raise two specific issues; one that, I hope, is not terribly controversial but another—an issue I have raised previously—that I suspect might be. The hon. Member for Castle Point (Rebecca Harris) touched on it as well. I echo the comments of the hon. Member for Basildon and Billericay that we have made excellent progress within the NHS on tackling cancer and bringing forward new treatments and on promoting early diagnosis. But there is still an awful lot we need to do. I get angry when I see reports indicating how badly we are doing in this country at treating cancer patients when looking at international comparators. I know it is difficult because like has to be compared with like and there are issues about centres of excellence. I understand all that, but I think the NHS should be the best in the world. We argue about resources, but the funding should be there to deliver an excellent service.

The most recent Concord report on the use of advanced therapeutic radiotherapy puts the UK behind in Europe for certain cancers, but also behind Malaysia, Indonesia and Puerto Rico. It says there are a range of reasons why we are falling behind, and one of them is the lack of access to advanced radiotherapy.

Today, cancer treatment in England is an area of health care where the most money is spent on the least efficient method of treatment. I do not want this to become an argument between the cancer drugs fund and alternative cancer treatments, because they are, in essence, complementary. My concern is that we have taken our collective eye off the ball and have not made sufficient investment in what could, as the hon. Member for Castle Point mentioned, save many thousands or tens of thousands of lives, particularly outside the regions where there is limited access.

According to the Department of Health commissioning guidelines, radiotherapy cures 16% of all cancers on its own. When combined with surgery, that figure becomes over 40%. I know that my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), on the Opposition Front Bench, has heard all these figures from the Society of Radiographers before, but they are important statistics. In comparison, cancer drugs, which are incredibly expensive—there is a huge outcry if the National Institute for Health and Care Excellence does not approve a cancer drug or if resources are not put into the cancer drugs fund—are statistically very different. If we look at the statistics in a cold and objective way, we find that cancer drugs by themselves cure only 2% of all cancers. The drugs are effective only in combination with other therapies such as surgery and radiotherapy.

Modern technology has made radiotherapy more effective and much safer for cancer patients. Yet the cancer drugs budget consumes a far larger proportion of the NHS budget in comparison with the radiotherapy budget, which I believe is in the order of £400 million. The disparity is huge because of the requirement to invest in the infrastructure, staff, training, evaluation of techniques and so forth. I personally do not understand how we can make a moral or economic case for not putting greater emphasis on advanced radiotherapy.

There is, in my view, no better example of unbalanced spending than in this country’s appalling record in delivering SABR—stereotactic ablative body radiotherapy—to cancer patients. This is one of the most precise ways of delivering radiotherapy. It is so accurate that it allows tumours to be targeted in a way that was almost impossible 10 years ago, and it can do so without causing harm to healthy tissues.

I went to see one of these machines in operation. I managed to get one of my constituents referred to a unit in St Bartholomew’s hospital. I saw that the machine focuses a beam—in fact, 200 beams—of intense radiation precisely on to the tumour. This is an incredible development in medical technology. It has the added benefit because of its accuracy, of reducing the number of radiation doses a cancer patient needs from 30 to five. I recall undergoing two courses of radiotherapy like that myself some years ago. That was the standard procedure then; now it is potentially condensed through this advanced form of treatment to five doses. That will be invaluable for older patients. Members have talked about inequalities and how patients over 75 are often unable to access surgery. Perhaps the medical opinion is that they might not stand up to surgery or that conventional radiotherapy might not be an option for them.

SABR is now used to treat 18 different cancers in the United States. Closer to home, in Europe, it is used routinely in countries such as Italy, Belgium and Switzerland. Its use in France is so well developed that in one centre in Lille the SABR machine is treating 500 patients a year, whereas an identical machine in our country treats fewer than 100. It is all to do with the number of staff who are trained to deal with extended operations. I met a member of the Lille team at a conference in London, and he explained to me how they were able to achieve such a tremendous throughput.

A recent international survey of more than 1,000 clinicians in 43 countries revealed that 83% of them were using SABR. Only 34% of our radiotherapy centres in the United Kingdom—and it should be borne in mind that we have 28 cancer networks—have the capability to deliver SABR, and nearly all of them use it only for treating lung cancer.

Five years ago the National Radiotherapy Implementation Group, which consists of some of the best cancer doctors in our country, produced a plan which received extensive support, and which I have raised—not with this Minister, but with her predecessors—during Health questions and Adjournment debates. The plan would allow a wider range of cancer patients in England to be treated with SABR. More importantly, the group recommended that patients should be treated closer to their homes, in centres of excellence. My region, in the north-east, has two cancer centres. Why should your constituents, Madam Deputy Speaker, have to travel from Bristol to London in order to have access to advanced radiotherapy?

Sadly, that report was ignored—before the present Minister took office, I should add. However, the hon. Member for Wells (Tessa Munt), to whom I pay tribute, has been tenacious in raising the issue since I entered the House in 2010, and, following a campaign by the former England rugby captain Lawrence Dallaglio, which lasted for about two years, NHS England was finally persuaded to start putting it right. The “Dallaglio agreement” will allow our country to start treating cancer patients with SABR and to increase the number of cancers that are treated. It will facilitate the development of centres of excellence in the English regions. I certainly hope that we shall have some in the north-east. Those of us who represent constituencies outside London should pay attention to the agreement. We need to ensure that those centres of excellence are created, because they will be able to treat hundreds of cancer patients each year closer to their homes and families, and will have the right technology and staff who are trained to use it.

However, the Dallaglio agreement is just the beginning. We have a long way to go before we can catch up with our European neighbours. In particular, we need to adapt more skilfully to new technologies as they become available. Quicker adaptation does not mean cutting corners with patient safety; other countries appear to be able to use new technology safely, and to be adapting to it much faster we are. New technology does not have all the answers, but it cannot be a coincidence that countries that adapt speedily to technological advances seem to have much higher cancer survival rates than we do.

This week, Cancer Research UK said that half of us living today will get cancer. The NHS needs to work out how to deal with that. Cancer is one of the biggest health challenges we face in the 21st century and we need to know that in tackling it we are utilising our valuable resources most effectively. The Government should conduct a full and independent review into the matter, particularly if they are going to spend many billions of pounds on cancer drugs as the best way forward, at the expense of adopting rapid advances in technology, especially robotic technology that is making radiotherapy safer, more efficient and better for patients.

I would like to address another important matter: end-of-life care and the need to make improvements for people with cancer. Seventy-three per cent. of cancer patients want to die at home but less than a third are able to do so. The palliative care funding review has pointed to the fact that providing free social care is key to supporting people to die at home. Evidence from Macmillan suggests that savings of £345 million could be made. The right hon. Member for Sutton and Cheam (Paul Burstow) will remember the debates that we had. I think we won the argument, although we lost the vote. I sensed that there was a lot of support for free end-of-life care across all parties. I press the Minister to consider that. The Government previously stated that they saw much merit in such a policy. Does the Minister still see merit in the principle of free social care for people at the end of their lives?

Two further policies are fundamental to improving end-of-life care. The first is the provision of 24/7 community care to ensure that, regardless of what time of day it is, if someone is at the end of their life, they do not have to contact the emergency services to be admitted to A and E. Secondly, there should be better recording of patient preferences at the end of life and better sharing of information between all the services that come into contact with that patient. I support the motion.

Building Sustainable GP Services

House of Commons,
Thursday 5th February,
Building Sustainable GP Services

Commons ChamberGrahame M. Morris (Easington) (Lab): I congratulate my hon. Friend the Member for Halton (Derek Twigg) and the hon. Member for Brighton, Pavilion (Caroline Lucas) on securing the debate, and all those right hon. and hon. Members who supported the bid to the Backbench Business Committee, and the Committee itself, on accommodating the debate.

It has been said before that when someone is the last person to speak in a long debate they find that perhaps everything has been said—but not everything has been said today. I will try not to repeat the arguments that have been rehearsed, but I wish to air two specific points that have not been covered. One is about the importance of GP work force planning, and the other is about the north-south divide and the need to refine our recruitment to address inequalities in areas of particular need.

We must accept, although Government Members are reluctant to do so, that we have a crisis on the front line—primary care and GP services are the first line of our NHS. I do not want to apportion blame—I can see the Minister staring at the heavens thinking, “Here we go again”—because I will let others do that. However, I wish to identify some problems and propose some practical solutions to address this crisis, because we face an unprecedented health challenge and it certainly has a bearing on what is happening elsewhere in the health service, particularly in accident and emergency.

We are all aware now, because it has been repeated many times, that we have an ageing population; people are living longer, and they are living with multiple and much more complex long-term conditions. Numbers have been given on the rapid increase even between 2008 and 2018, when we estimate that the number of people living with multiple long-term conditions will rise from 1.9 million to 2.9 million. Dramatic projections are made about the numbers of people who will have dementia, who will be living with cancer—surviving it and living beyond that—who will have diabetes, and who will have heart disease. Despite the increase in the age of the population and rising demand, GP numbers have not kept pace with population growth and with this increase in demand.

As today’s motion states, local GP services play a “vital role” in our communities, with 1 million patients every day receiving care from their family doctor or a nurse based in a GP practice. Many Members have mentioned being contacted by the Royal College of General Practitioners about its Put Patients First campaign, which highlights some alarming statistics: as many as 90% of doctors are saying that general practice does not have sufficient resources to cope; and spending on GP services as a share of the NHS budget has been falling and, at 8.3%, is at an all-time low. Surveys carried out by the BMA have been showing that six out of 10 GPs were considering taking early retirement because of the stress of an increasing work load, with a third of them actively planning for their retirement.

The problem we face relates not only to early retirement, but to retention and recruitment. A large number of GP trainee vacancies are unfilled and there is a stark north-south divide; almost all trainee posts were filled in the south, but in my region of the north-east—an area with the highest levels of deprivation and health inequality, where there is already an acute shortage of GPs—30% of training places were unfilled. That was confirmed by the deputy chair of the BMA, Richard Vautrey, who said:

“These figures are deeply concerning and represent a serious threat to the delivery of effective GP services to patients.

They show that we are experiencing serious shortfalls in the number of doctors choosing to train to become GPs, which will ultimately mean fewer GPs entering the workforce across large parts of the UK, most worryingly in already under-doctored areas such as the North East”

We need to address the imbalance in posts between the north and the south, because if we do not, as my hon. Friend the Member for Copeland (Mr Reed) indicated from the Front Bench, we will see a division in the standard of care. There is always a risk of this in different parts of the country.

I also recommend the “Securing the Future GP Workforce: Delivering the Mandate on GP Expansion” report by Health Education England. It states:

“There is a variation in availability of GPs of more than 40% between the most under doctored areas”—

which include the area I represent—

“and the areas with most GPs. Our most under doctored areas tend to be those with most deprivation, and therefore with the highest incidence of health inequalities.”

The Centre for Workforce Intelligence analysis shows that GP coverage is especially critical in the north-west and north-east.

I welcome my party’s announcement in this area and the important commitments that have been made to improve the NHS and, in particular, access to GPs. Our £2.5 billion Time to Care fund will help to integrate health and social care services, with more health services delivered in our communities. Inevitably, that will create additional pressures on primary care, and I fully support the aim of setting aside funding to employ 8,000 more GPs. I wish, however, to raise a question with my Front Benchers as well as the Government’s. Increasing the number of GPs alone will not address health inequalities, nor will it improve the health care services of my constituents if those resources are not properly targeted to the areas of greatest need, so I want to see real and practical solutions to the crisis.

First, I would like the Government to take a long-term approach, targeting and offering careers advice to children in secondary schools, sixth forms and colleges in areas where there are GP shortages, raising aspirations and promoting medicine as a viable career choice. If we increased the number of people from the north-east going into medicine, we would increase the pool of medical students willing to work in our communities, particularly if they have an affinity with and personal connection to the health and well-being of the community where they would be in general practice. The problem is that many newly qualified medical students are going back to their home areas in the home counties in the south and south-east.

Secondly, what steps are the Government taking to improve the number of GPs in under-doctored areas? Will they encourage postgraduate training in areas where there is the greatest work force need? One practical suggestion is to pay the student loans of medical students who are willing to work in under-doctored areas. In exchange, medical students would be expected to train and spend a specified number of years in employment in an under-served area. A survey by the BMA showed that up to 80% of medical students reacted positively to that option.

I am delighted to support today’s motion. I am interested to hear the responses from the Front-Bench teams on how we intend not only to increase GP numbers but to target and direct GP services to the areas of the greatest need. Without that distinction GP services will never be sustainable in the areas of highest deprivation, and the very communities that need access to greater GP services, such as east Durham, will not have it.

Firefighters Pension Debate

Firefighter pensions

As a member of the FBU Parliamentary Group I wanted to make a contribution during Monday’s Firefighters Pension debate but was not called by the Speaker.

These are the comments I wanted to make as part of the debate

I am proud to stand here today in defence of our fire and rescue service, and to thank all firefighters for what they do for our communities.

As we know all too well, they are often the difference between life and death in emergency situations.

No one wants industrial action, but I have had no hesitation in joining firefighters in my constituency on picket lines as they fight for a fair pension settlement and to safeguard public and firefighter safety.

There had been signs of optimism, especially when the Fire Minster, (Hon. Mem. For Portsmouth North) wrote to all firefighters in August promising:

“My goal is clear to get the best deal possible for firefighters and resolve this dispute.”

However, since taking up her new role in July, the offer on the table is exactly the same as that of her predecessor, this will result in firefighters paying more, receiving less, and will risk public and firefighters safety.

We are here today Mr Speaker because This Government has continuously refused to deal fairly with our firefighters.

In devolved administrations in Northern Ireland, Scotland and Wales, a fair deal has been negotiated between firefighters and the governments in those parts of the UK.

In Scotland and Wales it has been agreed that pensions will be reduced by 9% with the pension age being 55 years. Contrast that in England, where this government wants firefighter’s pensions reduced by 21.8% ­ nearly a quarter Mr Speaker, and increase the retirement age to 60yo.

Yet even the government’s own evidence on the physical demands of firefighting state this will not work.

Their own report highlights over 60% of firefighters aged 55-60 would be unlikely to meet the fitness standard used by most fire services and would therefore be unlikely to be able to achieve the new normal pension age of 60.

Not only are the government’s proposals ill-thought out and unworkable because of the unachievable levels of fitness firefighters are expected to maintain, but they directly discriminate against female firefighters.

The same report shows that all female firefighters will not meet the fitness standards and therefore be effectively drummed out of their job.

Only Elite Women Athletes will have the remotest chance of meeting these requirements.

Scotland, Wales and Northern Ireland have recognised this, why not the bench opposite?

This is a recipe for a diminished service, and threat to public safety. If firefighters are unable to achieve the required fitness standards what will happen?

They cannot be re-deployed – only 16 non-operational roles were available across the whole of England in 2012.

It will mean firefighters are forced to leave the service without a fair pension, after a career of service to their community.

On top of all of this firefighters are being asked to do more with less.

Figures published this year by DCLG in my own area, where we have seen multimillion-pound cuts, show brigades across the region have seen some of the biggest increases in fire call outs. My own fire service, County Durham and Darlington Fire and Rescue Service saw the second highest rise in call-out figures. Call outs increased by 35.7%, from 2,496 to 3,388.

Mr Speaker, more than 300 full-time firefighters roles have been lost in the North-East in the last four years. Durham and Darlington FRS has lost 49 firefighters. Even with the hiring of more backroom staff and some ‘on-call’ roles it means my local service is down 4.1% from 2010 figures and this is expected to double.

It is even worse for other North-East brigades – Tyne and Wear FRS has been reduced by 18.4%.

In fact recent plans put forward by my local brigade proposes training firefighters to deal with medical emergencies, including heart attacks, bleeding, breathing difficulties, trauma and strokes. Firefighters also have to deal with increased flooding and other risks, including helping in other parts of the country as we saw in the West Country and the South East of England

Yet to meet cuts imposed centrally, the same plan has local fire stations being staffed part-time and overall staff reductions.

This means the service firefighters are able to provide is not as good as it could be or as good as it was and will only get worse.

It means people are waiting longer after they dial 999 for firefighters to arrive. The ability to do the job safely is being undermined and this puts lives at risk.

Mr Speaker I expect the Tories to reject today’s motion, it is clear that the members opposite (with a few notable exceptions) support a race to the bottom in terms of wages, conditions and pensions across the public sector.

However, the Liberal Democrats declare they are different to the Tories. The number of engineered disagreements with their Coalition partner continue to rise on a daily basis as we approach the election campaign and they seek to find a degree of separation from a toxic legacy.

Well, today is an opportunity to provide more than warm words.

Today they can show the British People that on issues such as we are discussing in this debate, they are willing to stand and be counted, literally, when they walk through the lobby to vote to support this nations firefighters.

The success or failure of this motion will largely depend on the Liberal Democrats. I implore you to show that your disagreement with the Government is genuine and have the principle to stand up on the side of real working people and support our firefighters so they can achieve a fair pension settlement as well as safeguarding the health and safety of all of us and firefighters themselves.

Small Business Bill: New Clause 2

House of Commons
Small Business Bill: New Clause 2
Tuesday 18 November

HoCGrahame M. Morris: I do not know whether I can take on one of the characters from “The Lord of the Rings” and better that finish from the hon. Member for Bedford (Richard Fuller).

I want to speak in support of new clause 2, and I declare an interest as vice-chair of the all-party save the pub group. I pay tribute to my fellow officers, the hon. Member for Northampton South (Mr Binley), the hon. Member for Leeds North West (Greg Mulholland), who has done such a sterling job of researching new clause 2, and the hon. Member for Romsey and Southampton North (Caroline Nokes). Like other Members, I acknowledge the important role played by Fair Deal for Your Local, the Campaign for Real Ale, the Fair Pint campaign, my union Unite, the GMB, various support groups for tenants and the Punch tenants’ network.

New clause 2 is about stopping exploitation by large pubcos of pub landlords up and down the country. The situation has not come out of the blue. We have been discussing the issue for some years now, and it has been known about for a long time. The hon. Member for Burton (Andrew Griffiths) gave an example from his constituency, and the point I sought to make, although there was not time for me to do so during his speech, was that I can think of many cases in my constituency where a tenant of one of the large pubcos has effectively invested their life savings, and often their redundancy money, in taking over a business and turning it around. They have built it up and taken on additional responsibilities, such as opening a restaurant or providing bed-and-breakfast rooms, but when the review of the tenancy has come around, the pubco has doubled the rent, so that it is not viable for those people to continue.

Andrew Griffiths rose—

Grahame M. Morris: I will give way to the hon. Gentleman, even though he would not give way to me.

Andrew Griffiths: I think that I was pretty generous in giving way. The hon. Gentleman has done a lot for beer and pubs, and I acknowledge his support in scrapping Labour’s hated duty escalator. I agree that it would be absolutely unfair of a pubco to do what he has described, but does he not accept that under the statutory code, the tenant could take the case to the adjudicator, who could rule on whether it was fair, and get the decision overturned? The tenant would have protection under the code.

Grahame M. Morris: I think that the best protection is offered by new clause 2, with the market rent only option. Time is short, but I shall try to explain why. We have heard from the respected Chair and former Chairs of the Select Committee on Business, Innovation and Skills. We have had debates, and the all-party save the pub group is certainly aware of the four reports produced by the Committee that concluded that there had been abuse of the tied system, and that recommended time and again the market rent only option.

During her opening remarks, the Minister was harangued by Government Members with prophecies of doom about the consequences for local economies and regional brewers, but in truth the Federation of Small Businesses suggests that there will be a considerable benefit to the economy of offering this option. CAMRA estimates that large pub companies force their tenants to buy beer at prices that are inflated by as much as 50% or 70%; that is on top of rent that is already excessive. Anyone who believes in fairness would support new clause 2, which would correct that.

John Healey (Wentworth and Dearne) (Lab): My hon. Friend makes a powerful case. Does he agree that tied tenants, such as those of the Monkwood tavern in Rawmarsh, The Crusty Pipe in Goldthorpe and The Bull’s Head in Cortonwood, simply want a fair basis on which to run their pubs as a business for them and their families?

Grahame M. Morris: Absolutely. All we are arguing for is fairness—[Interruption.] The hon. Member for Burton asks from a sedentary position why this has not been done before. We have an opportunity to do something now, and I cannot be answerable for things that happened before I was a Member of this House.

As a result of excessive behaviour by the pub companies, an estimated 57% of tied landlords earn less than £10,000 a year. That is a disgrace. Anybody who, like me, frequents pubs regularly will realise what an incredible effort goes into running a public house—the hours put in bottling up after customers have gone home, the huge commitment it takes, and the toll it takes on the owners’ personal life. For them not to have the opportunity to earn a decent living is a disgrace.

Mr Jim Cunningham (Coventry South) (Lab): Does my hon. Friend agree that the tied pub concept is old-fashioned and antiquated in the 21st century? We had the same issues with tied housing in the past. Surely big brewers inflicting on landlords a certain label of ale, for want of a better term, is one of the factors that led to the demise of the working men’s club. Those clubs ended up in a lot of debt.

Grahame M. Morris: The demise of the Club and Institute Union, and the working men’s clubs, is a huge issue, certainly for me. New clause 2 does not propose the end of the tie; rather, it seeks to make it work more effectively and fairly. If a pub landlord agrees to a tied arrangement in relation to the purchase of alcoholic drink from the pubco, they should get a lower rent, especially if they are paying as much as 70% over the top for those beverages. That is the way the tie should work. If the landlord does not want to be tied to a company in respect of beverages, they should pay the market rent, or have that option. I am not suggesting that the tied system should be done away with—just that it should work in a manner that is fair to both the pub company and the tenant. At the moment, it certainly does not.

Members have suggested that the impact is not huge, but there are lots of villages in my constituency of Easington, such as Hawthorn and High Heselden, where only a single pub is left. These communities are really feeling the effects. If landlords are compelled to pay as much as 70% more for their alcoholic beverages, despite what the hon. Member for Burton says, the tenant will be absorbing some of that cost, but when there is only a single pub in the village, it is basically passed on, and the customers pay a lot more than they need to.

It is no coincidence that thousands of pubs have closed in recent years. In some cases, profitable, popular pubs, beloved by local communities, have been sold off by big pubcos to developers and supermarkets. Pubcos have sought to cash in on the real estate or land value, with little or no thought for local people, or the effect of the loss of a community hub. As the hon. Member for Leeds North West pointed out, that is often because these pubcos have saddled themselves with huge debts. There is a suspicion that the rents they charge are deliberately high to get rid of landlords, so that it is easier for them to sell.

Those landlords who opt for the market only rent can purchase drink supplies from elsewhere, leading to better and fairer access to the pub market for smaller local brewers and cider producers. It would also increase the choice for all our constituents. I would like Members to support new clause 2 because it would help to deliver increased licensee profitability, increased investment in pubs, greater consumer choice and fewer pub closures. If avaricious pubcos are stopped from exploiting their tied landlords, hiking up rents and charging up to 70% more for a pint, the price of a pint can only fall. I am sure that I speak for all hon. Members on both sides of the House and their constituents—I certainly speak for myself and my constituents in Easington—when I say that such a move would be warmly welcomed. For that reason, for fairness and for the benefit of the economy as a whole, I commend new clause 2 to the House.