Clive Efford
MP for Eltham and Chislehurst · Labour · United Kingdom
“Thank you for allowing me to take part in this statement, Madam Deputy Speaker, given that I was not here at the beginning—I was carrying out my duties elsewhere in the House. I welcome the Secretary of State’s statement. What is she likely to do in my part of south-east London for technical and vocational places?”
“I rise to speak to amendment 97 in my name, which would remove clause 10 from the Bill. Clause 10 gives powers to the Secretary of State to vary the proportion of public and private provision of health services if they consider that to do so is in the interests of the health service.”
“Labour’s 2024 plan to make work pay set out a welcome desire to bring more essential services back into public control—something that is welcomed by health workers across the country, because so far the “biggest wave of insourcing in a generation”, as was promised, has felt more like a trickle when it comes to the NHS.”
“The explanatory notes for the Bill say that this new flexibility is necessary “where there may otherwise be a breakdown in provision of a health service.” Can we imagine a situation where the Secretary of State has concerns about a health service and that an approach to assist a local provider would be rebuffed?”
“There are ample powers to enable the Secretary of State to intervene and resolve breakdowns in the provision of a health service. On clause 10, we must balance what it adds in those situations against its potential misuse by an ideologically driven Government that are determined to privatise our NHS.”
“It was a pleasure to join my right hon. Friend at Greenwich council’s development of 435 council properties in my constituency for the launch of the social and affordable housing programme. Some 70,000 homes are planned, and that is welcome and overdue.”
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“She may have received assurances that the contract process had been reviewed, but what has not been reviewed is the impact on vital services that had nothing to do with the contract. They may be undermined by the fact that the NHS is so heavily cross-subsidised for providing vital services. Because members of one of the rival bids were members of the clinical commissioning group, they were required to leave the meeting. That is custom and practice and happens in many fields, but it made the meeting inquorate. In order to allocate a £73 million contract, people who remained in the room were allowed to be double-counted in order to make the meeting quorate. I happen to have a friend who is a lawyer and an expert in health law, and I asked him whether what happened was within the rules.”
“The purpose of an impact assessment is to ensure that no minority or vulnerable group is disadvantaged as a consequence of a decision to let a contract, and it is legally binding. How did Greenwich CCG satisfy itself that no one would be disadvantaged? Responses to the FOI requests to the CCG and NHS England have confirmed that neither party had answers to those questions at that time. As a result of local campaigning, which was led by the local authority, local Members of Parliament and the local community, we now have a review and an impact assessment being carried out subsequent to the contract being let. The Minister was told by NHS England that it had reviewed the process by which the contract was let, but that is not satisfactory.”
“I beg to move, That this House has considered musculoskeletal services in Greenwich. What a great pleasure it is to serve under your chairmanship for the first time, Mr Hanson. In 2016, Greenwich clinical commissioning group decided at an inquorate meeting to allocate a £73 million contract for musculoskeletal services to Circle Holdings plc. There were two rival bids at that time: one from Circle and one from a consortium of local providers led by Lewisham and Greenwich NHS Trust and involving local GPs and Oxleas NHS Foundation Trust. A freedom of information request has exposed the fact that neither NHS England nor Greenwich CCG undertook an impact assessment prior to making requests for tenders or when allocating the contract to Circle.”
“Lewisham and Greenwich NHS Trust made about 50 requests for information about the scope of the contract it was being asked to bid for during that process, and it received very few responses from Greenwich CCG. It is very difficult to say that there was adequate information or consultation about the impact of the service, because very little information came from the CCG.”
“I ask that the Leader of the House offer up a feast for Members on both sides of the House: the Transport Secretary at the Dispatch Box to answer for the chaos that our constituents have been suffering on the railways. It would give him an opportunity to explain why he refused, on political grounds, to give suburban services to the Mayor of London, which is something now supported by businesses in London, and to listen to what Members think about his decision.”
“We will take no lectures from this Government about funding for social care. They walked away from the cross-party negotiations on the funding of social care before the 2010 election, purely for political gain, and they then cut £4.6 billion from social care during the last Parliament. The crisis we have now was created by the people sitting on the Government Benches. A 1% increase in the precept will bring in £670,000 in my local authority, but we already have a £14 million deficit in our expenditure. This is not going to touch the sides, as the leader of my local authority has said. It is just not good enough. We have a gaping hole, and the Secretary of State has come to the House with a sticking plaster. It is just not good enough. We need cross-party agreement on how to deal with this crisis.”
“We need the Secretary of State back here in the House to account for the chaos on our rail services.”
“In January, the Secretary of State for Transport promised the then Mayor of London that Southeastern’s rail services would transfer to Transport for London when the franchise came up for renewal. On Tuesday, he told the House that he had looked at Transport for London’s business case and that it was not going to provide improvements for passengers in terms of capacity and extra trains, both of which points were incorrect. We now know that his true reason is that he wrote to the former Mayor of London in April stating that he had changed his mind because he would rather keep suburban rail services out of the clutches of a Labour Mayor. That is politically partisan and brings no benefit for my constituents, who suffered delays on that rail service yet again this morning.”
“I rise to support my hon. Friend. Like him, I voted against the war at the time. Nothing has happened since then to make me think that I was wrong to do so, but I did not for one minute think that Tony Blair lied to this House, or attempted to mislead me. I just came to a different judgment. The problem is that in the minds of those who believe that we were misled, there is no report that will ever convince them otherwise, but it is time to learn the lessons for future generations and to move on.”
“We have to pay tribute to Andy Woodward for starting this process. He took an extremely brave step. I concur with the Secretary of State that we need to encourage others to come forward and speak in confidence in the first instance to the helplines that are available. Simon Bailey has said that he expects other institutions to be brought into this, which might result in other sports’ governing bodies having in effect to investigate themselves. There must be some sort of independent oversight, so will the right hon. Lady tell us what discussions she has had with colleagues in other Departments? What are the Government going to do to ensure that this House and the public can be reassured that there is independent oversight of the investigations into these sports’ governing bodies?”
“Last week, the Chancellor adopted Labour policy on fiscal investment to stimulate the economy. This week, the Secretary of State is adopting Labour policy on worker representation on boards— [ Interruption . ]”
“No, you’re coming over here I’m afraid. We need consistency from the Government. I have been advocating for years that football supporters should be represented on the boards of professional football clubs, but the Government have consistently said that that is not appropriate, so what has changed the Secretary of State’s mind?”
“My constituency is not served directly by the London underground or the docklands light railway, much as we would like it to be, which means that we are heavily reliant on rail services. I receive a stream of complaints almost daily about delays on Southeastern railway. This cannot be allowed to continue, because people are heavily reliant on that service. One thing I would say for Southeastern is that it needs extra capacity—it needs extra carriages. The carriages that become available when the Thameslink programme is complete must be made available for Southeastern so that we can deal with the capacity problem, but we must also deal with Southeastern’s performance.”
“My point is that in many of the questions I have asked about this process, I have been told that it is a matter for the local NHS, and this dereliction of duty on the part of the Department of Health has even led to NHS England not scrutinising the process properly. How can we get the record corrected? I will be shocked if you, Mr Speaker, have not heard that the Department of Health wants to make a statement to correct this error. I would like to know how it is going to improve its performance in scrutinising what is going on when such multimillion pound contracts are let.”
“I do not know how to take that, Mr Speaker. I have asked the Department of Health several questions on the process by which the Greenwich clinical commissioning group allocated a £74 million contract to Circle Holdings for our local orthopaedic services. In one of my answers from the Department of Health, I was told that there had been local discussions about the impact this would have on other national health services. Investigations I have undertaken into that answer have exposed the fact that this information, which was supplied to the Minister of State, Department of Health by NHS England, is incorrect. He therefore misinformed me in his answer—I accept that he did so inadvertently—as a consequence of the information he was given by NHS England.”
“In my constituency, a nurse-led practitioner service has been closed because of a lack of resources. Similarly, stroke rehab has been cut because of a lack of resources. Our A&Es are not meeting waiting times, and are now under threat because their orthopaedic services have been privatised and handed out to Circle, which may not contract back to their local healthcare trust, thereby undermining the capacity to maintain those A&Es. Does the Secretary of State accept responsibility for any of that?”
“We all have examples of constituents with similar stories, but the Government are showing a complete lack of urgency. People are left destitute by these decisions, for no good reason. We want to hear the Government say that they are going to put in extra resources to expedite investigations so that these people are paid and compensated, if necessary at the expense of Concentrix.”
“The Department’s answers to questions that I tabled asking what protections there were from noise pollution at City airport for constituents such as mine were woefully inadequate. It is clear that once expansion has taken place there will be scant regard for protections for the public, whether from industry or the Government. It is hardly surprising that people roll their eyes when the Secretary of State comes here and tells us that there will be all these environmental protections. In order to convince people that he is in earnest, would he be prepared to make those requirements legally binding, with penalties in place, before any permission is granted for this expansion, so that people can be confident that there will indeed be environmental protections?”
“Will the Minister agree to invite all Members whose constituencies are served by Southeastern trains to the meeting with the hon. Member for Bromley and Chislehurst (Robert Neill)? Our constituents are suffering daily disruption to their lives, as a result of the poor performance of Network Rail and Southeastern, and we would welcome a meeting with him to bring that to his attention.”
“Greenwich clinical commissioning group has granted a £73 million contract to Circle Group plc to provide musculoskeletal services. Circle employs no clinicians who can deliver those services and so will rely on contracting existing service providers to provide NHS services. That is complete madness and it is leading to chaos in our local NHS. It is a totally unnecessary tier of bureaucracy in Circle, which will suck out its profits at the expense of patients. May we have a debate on the performance of private companies in the NHS so that we can expose the poor performance of Circle and others?”
“May I take this opportunity to welcome the two new Front-Bench teams? I do not know whether my hon. Friends on the Opposition Front Bench are as surprised to see them there as I am. None the less, will the Secretary of State join me in congratulating UK Sport on its successful Olympics? Team GB won more gold medals in more sports than any other country and came second in the table, but there is still an issue with team sports. There is more work to be done in sports such as basketball, possibly handball and others. Will she therefore join me in congratulating UK Sport but also urge it to do more work on team sports?”
“It has been a trait of this Tory Government that they steal the language of the left to cover up the mean and regressive policies they introduce, using terms like “social mobility” when they mean quite the opposite. All the empirical evidence shows that investment in early-years does more to move children forward than any form of selection at 11 could ever justify, so does the Secretary of State regret closing 800 Sure Start centres? Should we not be investing there, rather than having this pointless debate about bringing back selection?”
“May we have a debate on the performance of Southeastern trains? The Government have put £20 million into trying to sort out the mess of Southern trains, but my constituents are suffering equally due to the poor performance of a company that is behaving like it has one foot out of the door because it can see the prospect of Transport for London taking over the franchise. We cannot continue in this way. The Government are responsible for the contract, so let us have a debate about it in Government time.”
“Further to her answer to the hon. Member for Selby and Ainsty (Nigel Adams), the Prime Minister will have seen the reports that we have seen that there is a lack of people in the UK with the necessary experience to negotiate trade deals. Is that a matter of concern to her? Are we being forced to employ people from overseas to do that job because they have those necessary skills?”
“Let me appeal to the Government again. We have lengthened the platforms, and we have told people that they will have longer trains. We have no underground, we rely heavily on those train services, and we must have that additional rolling stock to improve the quality of the service. I have only a few moments left, but I want to raise one more issue. I have written to the Minister about a planning application for the site at the Gaelic Athletic Association. The planning inspector has recommended approval, but I urge the Minister not to set such a precedent. There is a viable plan for that sports ground, and we should not be building on it.”
“According to a recent survey conducted by Passenger Focus, passenger satisfaction is going down sharply. In autumn 2012, 83% of passengers were satisfied with the service, and punctuality stood at 91.4%; in spring this year, the satisfaction rate was down to 70%, and punctuality stood at 87%. That is just not good enough. According to a Passenger Focus survey of Southeastern passengers, only 53% were satisfied with its services. It was one of the worst performers. One problem that confronts my constituents is overcrowding. Our platforms have been lengthened to accommodate 12-car trains, but we have yet to see those trains. We know that rolling stock will become available when the Thameslink upgrade has been completed, and that existing rolling stock will be available to Southeastern if the Government give their approval.”
“I hope that a health Minister will hear my appeal and intervene, bang some heads together, and ensure that we do not lose that vital service on the estate. Another issue that I want to raise is the quality of service that is being provided by Southeastern. It is utterly appalling. We have had some truly hot weather this week, for the first time this summer, and what has it resulted in? A minor change in the weather for a short time has resulted in major disruption to the service. It seems that no matter what sort of weather we have—whether it is heavy rain, severe cold, a bit of snow, or some hot weather—Southeastern cannot run the trains. We in south-east London do not have direct access to the London underground, and we rely heavily on those rail services to travel to and from central London.”
“That is completely unacceptable, and I will be there with my constituents lobbying very hard for all the health managers—general practices, the CCG and the local authority—to come together and maintain the service on the estate for my local residents. It provides vaccinations and treats people who need dressings renewed, so that they need not undertake arduous journeys to other places. It has been said that many of those services will be replaced by home visits, but at a cost of £26.63 per visit to the centre, it cannot be cost-effective to travel all the way to the far end of the borough to treat people in their own homes when those people are asking for the service to be maintained because they use it for many purposes.”
“Everyone recognises that it is really good value for money, and everyone recognises that this is a deprived community which needs direct access to health services, but because of the bureaucracy, people are being penalised. Although all those people are Greenwich residents, some of them were forced to join Lewisham practices because the estate was on the border, and now they are being penalised. Having lost their own general practice years ago, they are now being told, “We are not prepared to fund this service”, because a fifth of the people who use it are Lewisham patients although they are Greenwich residents.”
“As part of the single regeneration budget 5 funding, in 2007 facilities for the introduction of a nurse practitioner-led service were funded, but now, because public health has been separated off from the previous primary care trust, the service falls between two stools. Local GP practices refer people to this service, and they appreciate the quality of it. No one disputes the fact that it provides good value for money, but because of this split in the funding between public health and primary services funded by the CCG, no one is prepared to continue funding it. Last year, this service treated 5,332 patients, and 4,489 in the previous year. The annual cost is about £142,000, which is minuscule in the scheme of things. The average cost per visit is about £26.63. This is really good value for money.”
“I am grateful for the opportunity to raise a number of important issues on behalf of my constituents. Next Wednesday, I shall join residents of the Horn Park estate in my constituency to lobby the clinical commissioning group to urge it not to take the decision to cease funding of The Source, which is a nurse practitioner-led health centre on the estate. We do not want to lose any form of health service provided locally. The estate has no pharmacy and no GP practice. In fact, the nearest GP practices are almost two miles away. One of the reasons given for taking this service away is that many of the patients treated by The Source, which is funded by Greenwich CCG, are patients of Lewisham doctors. I campaigned against the closure of the GP practice on this estate 25 years ago, when it first lost its practice.”
“Does the Minister accept that our high streets are in decline? We are losing small retail shops at the rate of 16 a day. We are seeing a decline in retail goods being bought on our high streets. He announced a plethora of things this morning, which he has repeated now, and he has said that that will, hopefully, turn things around. How will we measure the success of what he has announced in turning this decline around?”
“I was here in 2003, and I was one of those who rebelled against the leader of my party and voted against action in the Iraq war. I think that the hon. Gentleman is being disingenuous, because it was one of the biggest rebellions that there had been against a Government from that Government’s side. I remember how difficult it was to make that judgment against the leader. When someone is being led by a party leader whose judgment they respect, it is a tough call to say, “I am going to disagree, and vote against action of that kind.” I had a difference of opinion, and I have had no cause to change my mind about the decision that I made, but can the hon. Gentleman not accept, as I do, that the people who made those decisions did so believing that they were doing the right thing?”
“The hon. Gentleman just said that this decision led to the public losing faith in this House, but many of the accusations that were made against the Government are not found in the Chilcot report. Those led to people coming to that conclusion about this House. Does he not accept that that day was difficult for all of us? Even those who voted against were not certain that we were making the right decision. We cannot be so exact about our judgment call on that day. Surely he can accept that those who voted in favour did so believing that they were doing the right thing. At least he could be graceful about that.”
“I wonder whether my hon. Friend’s recollection is the same as mine. My recollection is that, prior to the debate and the statement by the Prime Minister, which was criticised by the hon. Member for Southend West (Sir David Amess), the Conservatives had been calling for action earlier, before that evidence was presented. For them to turn up now and say that it was all because of what Tony Blair said on that day is a little disingenuous.”
“I am sure that the whole House will want to wish the teams of England, Wales, Northern Ireland and the Republic of Ireland all the best in the European championships. Football shows us that we have more in common with our European neighbours than divides us, as I am sure the Secretary of State will agree. That was demonstrated by the singing of the Marseillaise at Wembley in defiant response to the attacks in Paris. In that spirit, will he join me in urging fans to enjoy the tournament peacefully, whether they are travelling to France or watching in the company of their friends at home or in public places, and to assist the police and security services in trying to ensure that we have a safe and secure tournament?”
“Given that it relates to the relationship between the police and the press, it would seem even more imperative that we go ahead with that part of the Leveson report. Will the Home Secretary perhaps have a word with the Prime Minister to ask him to expedite that as quickly as possible?”
“I commend the Home Secretary and my right hon. Friend the Member for Leigh (Andy Burnham) on all the work they have done, along with all hon. Members of this House. It is often the role of a Member of Parliament to give a strong voice to the weak, and this has been an example of that. May I also say a word of gratitude for the kind words of the hon. Member for Worthing West (Sir Peter Bottomley) about some of the work I have done in the past? There are comparisons between what happened to the family and friends of Stephen Lawrence and what happened to the Hillsborough families. They have certainly been strong voices and advocates for themselves, and an example to us all. They were signatories to the letter sent to the Prime Minister earlier this month asking him not to renege on his promise to implement Leveson 2.”
“That sort of propaganda does the industry no service whatsoever, and it is not fooling anyone.”
“It is a pleasure to take part in this debate under your chairmanship, Sir Alan, and I start by congratulating the hon. Member for Strangford (Jim Shannon) on securing it; it is important and has certainly attracted a lot of support on both sides of the House. I get a feeling of déjà vu when I come to these debates, particularly when I read the briefings from the Association of British Bookmakers—I think I could have written the opening sentence of the one I have here before I even received it. It says: “There is no objective evidence from either past British Gambling Prevalence surveys or Government Health surveys that problem gambling levels in the UK are rising.” We ask the question, “Is there a problem with FOBT machines?”, and we get an answer to a completely different question. This has got to stop.”
“When will the former be concluded and when will the triennial review of stakes and prizes start? What steps is he taking to investigate money laundering—several hon. Members highlighted that this morning—and whether there is a money laundering problem? There is concern about late-night betting and the fact that stakes on these machines tend to increase late at night. Should we review the opening hours and the rules that allow live racing from Hong Kong to be played and betting shops to stay open even later so that more people can play these machines? Should we mandate account-based play on these machines? Will the Minister support giving local authorities, once and for all, the powers they are demanding so they can control the proliferation of betting shops in our communities?”
“The time has come to apply the precautionary principle. The betting industry says there is no evidence to prove that the machines are harmful, but there is no evidence to prove that they are not, so we should apply the precautionary principle that if it cannot be proved that they are not harmful, let us remove them until there is proof that they are not. It is time to act. The data are available to the Minister so let us move towards account-based playing of the machines and ensure that we satisfy ourselves that it is safe to have them on our high streets. Otherwise, they should be removed. In conclusion, I want to ask the Minister a few questions. The Government are carrying out a review of the £50 stake, which is why the triennial review has been delayed.”
“If operators fail to make sufficient progress with promoting account-based play, then the case for making it mandatory would need very serious consideration.” Will the Minister therefore consider, in his next discussions with the betting industry, whether that should be made mandatory? If we are not making any progress, we are just not finding out what the problem is. We have the technology. We can do it and we need to make more progress in this area. I say to the betting industry, “Make this move before it is forced on you, or you will lose the machines completely.” I think that the time is coming when action on these machines will be forced on the gambling industry. If there is not a problem, let us have the data and the account-based play, so that we can demonstrate that there is no harm.”
“There were some interesting factors: 37% of the number of people who have loyalty cards or gambling accounts said that at some time, they had a problem with machine gambling—so a very high proportion are presenting with a problem. The Gambling Commission says that the betting industry needs to increase the number of people who have accounts, so that detailed research can be carried out on what is going on with these machines. In the letter, it states: “Consequently, we recommend encouraging operators to promote account-based play with the aim of increasing uptake significantly. If they succeed, playing anonymously might itself become a useful indicator of risk.”
“For the first time ever, the current figures show that the number of people presenting problems to GamCare from gambling online has increased over the number of people who are presenting problems from machine-related abuse. However, that can be explained by the increase in the number of people who are contacting GamCare and does not show a reduction in the problems from FOBTs. It shows an overall increase of people who are presenting with problems, and we have to address that issue going forward. The Gambling Commission wrote to the Secretary of State in March 2015 about the conclusions of research carried out by the Responsible Gambling Trust and NatCen Social Research. It was based on people who gamble from accounts, because they can be tracked and their gambling behaviour can be followed.”
“Many businesses are predicated on the machines being there and if they were to be removed, people would lose their jobs and livelihoods, which is why we must move forward on the basis of evidence. We are told that there is no problem, or that the problem lies elsewhere, or perhaps that the problem is not getting any worse, so we should not do anything about it—or a combination of all those arguments. However, the number of people in treatment, according to GamCare, is up by 39%, and the number of people who present problems as a result of playing FOBT roulette machines represent 26% of those who are in contact with GamCare. The number of calls from people addicted to FOBTs has gone up by 50% over the last five years. I accept that there is a growing problem online.”
“The yield from the machines has been higher than that of over-the-counter betting every year since 2011-12 and now represents 54.2% of the combined gross gambling yield. The number of premises has been in decline since March 2014: there were 299 fewer premises on 30 September 2015 than on 31 March 2014. However, the number of B2 machines has increased year on year since records began in 2008-09 and has now reached 34,500. We have a growing problem in our communities, given the proximity of FOBTs to locations where, I think, they do not belong. Anyone who has been to discuss these machines with me knows I loathe them. I do not think they belong in our high streets, but they are an unintended consequence of the Gambling Act 2005, and they are now there.”
“There is no denying that a high proportion of these machines are in proximity to socially deprived communities, and a disproportionate amount of the money gambled in them comes from people on low incomes. We hear the figures about the numbers of betting shops and all the rest of it, but it is clear that the trend in betting shops is for more money to come from B2 machines than from over-the-counter betting on horse-racing, dog-racing or football, as more of that sort of betting moves online. The growth in the gross gambling yield from machines has more than covered the decline in over-the-counter betting, with a combined gambling yield in 2014-15 of £3.74 billion, which is higher than in any previous year recorded by the Gambling Commission.”
“No, I will not, because of the time. I have argued consistently that if we are going to move ahead with any restrictions on FOBTs, we need to do so on the basis of evidence. People are calling for a £2 stake, but there is no evidence that that will be any safer than the existing stake. However, in terms of the issues confronting us—as many hon. Members have said today—this is about location more than anything else. It is about the proximity of these machines to people who may be vulnerable to developing a gambling habit and to falling foul of their propensity to gamble too much by going into a betting shop and losing more money than they can afford to.”
“Will the Secretary of State confirm that she is rethinking her White Paper in relation to parents, and that she will reconsider whether they should be consulted over the academisation of our schools and their role as school governors?”