Sir Geoffrey Clifton-Brown
MP for North Cotswolds · Conservative · United Kingdom
“If we had to have change, I thank the Secretary of State for listening to the vast majority of people Gloucestershire and coming up with the best proposal that was on the table.”
“I thank the Prime Minister very much for making this appointment. As Chair of the Public Accounts Committee and the appointments panel, I warmly welcome the motion to appoint Michael Jary CBE as the next chair of the National Audit Office.”
“Michael has the skills and the leadership needed to ensure the NAO remains a high-performing, innovative and digitally-enabled organisation, supporting Parliament’s detailed scrutiny of public spending and helping to secure value for money for taxpayers. For these reasons, I am delighted to support this appointment.”
“It would appear that this defence investment plan is unaffordable, but the Public Accounts Committee will be examining that. Deep in the plan is an old accountant’s trick: a vast efficiency savings figure of £10.7 billion. Does the plan rely on that figure?”
“It is clear that the criminal justice system has considerable weaknesses. A central issue is the lack of usable integrated data. The police, courts and prisons operate on separate systems that do not effectively communicate with one another.”
“This has been a constructive debate, and everybody has aired the themes that I raised throughout the debate. The Minister has outlined one or two areas where things are going a little better, namely perhaps a reduction in some of the Crown court backlogs, but that is countervailed by increases in the backlog in magistrates courts.”
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“Wasted spending and shortfalls are stopping our armed forces keeping us safe in the most efficient and effective ways. It is therefore imperative that the MOD releases more information on its finances in a timely manner, so that we can thoroughly scrutinise it and thus assure Parliament that our armed forces can do their job in the most effective way, with world-beating equipment.”
“I cannot tell what is on the Government’s mind, but maybe the Minister will be able to tell us. However, given that the SDR makes it perfectly clear that they want to increase the numbers of our armed forces considerably, we have to consider every aspect of recruiting and retaining more. We must make sure that they do not just leave the Army or the armed forces as soon as they get particular skills. My right hon. Friend has raised a really important issue. In conclusion, there is no greater duty on a Government than defending the nation, yet all Members of this House and the general public need to have confidence that our armed forces are properly equipped to do the job. That does not mean we can complacently give in to every demand, and it is the role of PAC members to carefully scrutinise the defence budget.”
“I deliberately included a little bit about recruitment and retention in my speech. There will, I think, be a tension between the armaments director and the Chief of the Defence Staff over recruitment versus the budget for equipment. It is not possible to suddenly turn on the tap and recruit more people; it takes time. Can the Minister say anything today about when she will start to ramp up that recruitment?”
“I thank the Minister for that positive contribution. Twenty-five years ago, when we sat next to each other in the Public Accounts Committee, passing each other notes and holding the civil service to account, who would have thought that we would be in our respective positions now? I also thank my hon. Friend the Member for South Suffolk (James Cartlidge) for his contribution. In fact, I thank all Members for a very positive debate. We look forward to seeing positive results from all the requests that have been made today, and to working with the Government, while strictly holding them to account for all the promises that they have made. Question deferred (Standing Order No. 54).”
“Secondly, as we said in our report published on 28 February, we found that there was considerable disagreement between HS2 and the Department about the cost of the railway—the highest estimate was the top range of HS2, which was £66 billion in 2019 prices and more than £80 billion in today’s prices—and I think we need an assurance fairly soon about what it is going to cost. Thirdly, I am not at all surprised that the Secretary of State has had to delay the completion date, but this is the second reset in five years, so we really want to see it work. I think that the people of this country will be very keen to know, when her half-yearly report is published and if possible before, when the project is likely to be completed.”
“I welcome the statement, and I do not disagree with a word of the Secretary of State’s analysis of what has gone wrong in the past. The Public Accounts Committee, which I have the honour of chairing, has produced eight comprehensive reports over the 13 years of this project, and there are some common themes throughout those reports. First, the Secretary of State’s Department—I am not in any way blaming her, because this is what went on in the past—did not have the right mix of skills to be able to challenge the assertions of those in HS2 Ltd: project managers, engineers, people who really know how to build a railway.”
“New clause 41 is a sensible and proportionate probing amendment that I hope the Minister might feel able to accept, if it were to be tabled in the other place.”
“In addition, although the Minister has reassured us that all funds received from the full cost recovery of firearms licensing will be ringfenced for improving firearms licensing departments, that is not guaranteed. The British Association for Shooting and Conservation, which acts as my secretariat on the APPG, wrote to all forces when the increase in firearms licensing fees was imposed, seeking assurances that all funds would go to firearms licensing. To date, only a third of constabularies have given that assurance. Including firearms licensing in PEEL inspections is a powerful way to ensure that police forces are publicly accountable, funded properly and run efficiently for the benefit of public safety.”
“I appreciate that the Minister has given assurances that data on licensing department waiting times, for both renewals and new applications, are now being made available to the public. However, that does not go far enough to ensure that police forces take their inefficiencies seriously and put an action plan in place to improve departments across both England and Wales. PEEL inspections take place every year or so for every police force in England and Wales. They include themes such as treating the public fairly, responding to the public, and resources and value for money. Firearms licensing comes under all three categories, yet there is no mention of it in any previously published PEEL inspection.”
“I intervened, and the police acted quickly to reverse the decision, setting up a gold command, and I now receive regular updates from the team. However, that wait is not good enough, especially when the Government are imposing a 133% hike in fees. An inefficient and ineffective licensing department endangers the public. The inquest on the tragic murders in Keyham, Plymouth, revealed that the Devon and Cornwall police firearms licensing department, which had issued a certificate to the murderer, removed his firearm after an assault but, unbelievably, gave it back to him once he had done an anger management course. The department was described as a “chaotic shambles” that could not operate its own risk matrix. It identified the murderer as low-risk, when in reality he was high-risk and should never have received a certificate.”
“It is not in the interests of the public or the shooting community for the wrong people to have guns in their possession. That is why I am proposing the new clause. Members will be aware that the firearms licensing system in the UK is a postcode lottery. With 43 separate licencing authorities, inconsistency in the application of the law, guidance and services is endemic across the system. A quarter of police forces are taking a year or more to process applications for certificates, with delays across the system. Gloucestershire constabulary—the force that I know best—recently put out a statement saying that it was not accepting any new firearm licence applications for two years, due to a lack of trained firearms officers.”
“I rise to speak in support of new clause 41, which is in my name, and in the names of others. It is a very simple amendment that would require His Majesty’s Inspectorate of Constabulary and Fire and Rescue Services to include firearms licencing in their PEEL—police effectiveness, efficiency and legitimacy—obligations. I declare an interest as chairman of the all-party parliamentary group on shooting and conservation, and as a firearms owner. I first thank the Minister for Policing and Crime Prevention for attending our most recent meeting of the APPG to answer a range of questions from our members; we were very grateful for her time. I share her commitment to protecting public safety through sensible firearms law and an effective and efficient firearms licensing system.”
“The billions of pounds that have been announced by the Chancellor are very big rises, and the Public Accounts Committee looks forward to scrutinising that expenditure—I am sure it will be welcomed by those who receive it—to ensure we are getting value for money, but can the Chancellor explain to the House how it will be funded, because debt and tax are at record levels? Can British workers look forward to a summer of expecting more tax increases?”
“Restrictions on aid, fuel, food and even water in Gaza is inhumane and unacceptable. If the Minister cannot get a decision next week to recognise the state of Palestine, will he at least ask for a collective message to be sent to our allies, the Israelis, that these restrictions are unacceptable and that, unless they are reversed, serious consequences will follow?”
“As the Minister has mentioned it, as has my predecessor as Chair of the Public Accounts Committee, the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier), it is now over a year since the Public Accounts Committee produced a report on how sensitive scrutiny could be carried out in this House. This is really important, and it feels as though we are being given the run-around. Will the Minister commit to setting a date when the Government will give a decision on the matter?”
“The Secretary of State has set out an ambitious strategic defence review. As soon as possible after the spending review next week, will he set out a defence investment plan in some detail, so that the Public Accounts Committee can examine whether the funds match the equipment that he has talked about today, and whether the ambitious plan can be delivered and is affordable?”
“Because our prisons are running at about 98% capacity, not only are existing prisoners more likely to reoffend but, sadly, as we allow more prisoners to be released early, more people on probation will do so. Apart from the terrible effect on victims, the Ministry itself estimates that this costs a staggering £18 billion a year in England and Wales. What is the Minister’s policy to help reduce reoffending?”
“I take at face value what the Minister has said today about British Steel having a bright future. However, she did not mention any figures, other than a global figure of £2.5 billion floating around somewhere. Will she tell the House when she expects to publish the accounting officer assessment that is required when public money is committed? We can then test in the Public Accounts Committee whether those rules for spending public money are being adhered to, particularly in terms of feasibility.”
“It is interesting, when sitting in the Chamber, to hear colleagues’ expertise on subjects that we did not know they had expertise in. I wish to draw my hon. Friend back to a slightly different subject, which he was beginning to touch on. Electric vehicles, which of course have batteries, tend to be far heavier than equivalent vehicles with an internal combustion engine. Some of the vehicle combinations that the Minister talked about—for example, he mentioned a vehicle and a trailer not exceeding 7 tonnes gross vehicle weight—would vary in weight depending on whether the car or van was electric. That might affect a person’s decision to change from a vehicle with an internal combustion engine to an electric vehicle.”
“In recent years, for every 100 servicemen recruited, 130 have left. That is completely unsustainable. What is the Minister doing to ensure that we retain more troops, with not only the package within our armed forces, but competitive packages in the private sector?”
“I welcome much of what the Bill will do. It will speeding up the planning system, which as a chartered surveyor who has practised in planning is I know desperately needed if we are to get more houses built. However, the one area of the Bill that I have concerns about is what she has just come on to. If local people feel completely overridden by their planning system, they will feel very hard done by. If we are to override local people, we might just as well have a nationally directed planning system rather than a local planning system. Will she think carefully about that balance?”
“On the point about not doing any harm to nature, would the hon. Member’s party support the water companies becoming statutory consultees so that we can ensure that, with any new housing, not a litre of extra sewage goes into our rivers?”
“Q13. Most people would accept that we need more housing in this country, yet so often it is not accompanied by the necessary infrastructure. In my constituency, thousands of houses are proposed, yet without £250 million to upgrade junction 12 of the M5, the inspector is likely to rule our plan unsound. Will the Prime Minister use his upcoming Planning and Infrastructure Bill to see how developer and landowner contributions can more effectively build this vital infrastructure, which would benefit communities up and down the country?”
“The announcement was sneaked out with no notice last night. If the Minister knows anything about farming, he will know that it takes months, if not years, to plan. Farmers had no notice of this. Will he tell us what will replace the SFI, when he will consult, and when it is likely to come into operation?”
“I also congratulate Chris Wormald on his promotion to Cabinet Secretary. These vacancies at the head of NHS England and the Cabinet Office provide an opportunity for completely fresh thinking within the NHS.”
“It exists to protect taxpayers’ money and ensure that their pound is being used effectively. It goes back, I think, to about 1867. Unlike other Committees, we do not take evidence from Ministers; instead, we take evidence directly from permanent secretaries and the most senior civil servants and public sector officials. The National Audit Office provides us with audited accounts and value for money reports, and we produce reports of our own with recommendations to Government to which they must formally respond as part of the Treasury minute. At this point, I pay tribute to Amanda Pritchard, who has recently announced that she will be stepping down as chief executive of NHS England this summer. She oversaw the NHS at a time when it was under so much pressure post pandemic, and I wish her well in her future endeavours.”
“Thank you, Madam Deputy Speaker, for granting us the opportunity to debate this supplementary estimate, which provides an opportunity for all Members of this House to look at the Public Accounts Committee’s report on health and discuss how the money might be spent on different priorities. As the Chair of the Public Accounts Committee, I am honoured to introduce the first estimates debate on the supplementary estimate of the Department of Health and Social Care. I made this application jointly with the hon. Member for Oxford West and Abingdon (Layla Moran), the Chair of the Health and Social Care Committee, and my right hon. Friend the Member for Salisbury (John Glen). As Members of this House will know, the Public Accounts Committee is one of the oldest Committees of this House.”
“Before even getting on to the figures, the NAO confirmed that the level of productivity in the NHS has dropped by around 23% since the pandemic. I simply say that unless that is sorted, any reform that the Government announce will be sucked into the black hole of the NHS without commensurate value for money or results.”
“I thank the Chair of the Health and Social Care Committee for her endorsements of the worthy work that all these individuals have put into the health service. The Department of Health and Social Care is one of the highest spending Departments in the UK, with a total departmental expenditure limit standing at a huge £210.1 billion. I am not sure anybody believes that the NHS is working at optimal productivity. NHS England is the largest quango with the highest budget in Whitehall; however, when allocating funds, it is also one of the few Departments that is making life and death decisions that affect the lives of literally millions of patients and their families. I think it does, therefore, deserve the highest level of scrutiny, which is part of what we are doing today.”
“I do not want to give way to too many people; otherwise, you will reprimand me for taking too long, Madam Deputy Speaker. However, I am, of course, happy to give way to the hon. Lady.”
“In March 2024, the Conservative Government announced that the NHS would receive £3.4 billion of capital investment for digital improvements between 2025-26 and 2027-28, which begins to address the point that the hon. Member for Stafford mentioned. As part of that investment, NHS England committed to achieving ambitious average productivity improvements of 2% per year through to 2029-30. However, those digital improvements, presaged by that additional £3.4 billion, have not yet been fully actioned.”
“There should be a shift towards allowing NHS trusts more control of their own budgets, as clarified in the 2025-26 priorities and operational planning guidance published in January. Moving more funds directly to NHS trusts, ICBs and local systems will improve accountability and give them a level of flexibility about how their funds should be better spent, rather than just focusing on targets and directives. For example, if they were to run a surplus because they had run their operation so well, they could reinvest the money in desperately needed capital projects rather than returning it to Whitehall. That must also go hand in hand with a need to improve productivity. Between 1996 and 2019, the NHS averaged a measly 0.6% a year increase in productivity. Since the pandemic, productivity has now fallen by 23%.”
“What I do not think is acceptable is the glacial pace of agreeing priorities and approving final budgets for the local systems. In November, our Committee was shocked to hear that, in the past two years, those local systems—ICBs and others—had not had their financial plans approved by the Department until June and May respectively. That is up to three months after the start of the financial year. How can our poor local systems plan efficiently when these final allocations and guidance are so late? If the Department’s own accounts were finalised much sooner, our local systems would be able to have the money allocated in a more timely way, making wastage and inefficient spending less likely. I welcome the Secretary of State’s prognosis that the NHS is far too big and complicated.”
“The NHS estate, as we all know from our constituencies, is in desperate need of investment, and our capital investment programme is running behind schedule. The problems with reinforced autoclaved aerated concrete have only added to the necessity of upgrading our hospitals, and I hope the Minister will listen to this plea. The latest NAO report on the DHSC annual report and accounts shows that local systems, such as integrated care boards and NHS providers, reported a year-end overspend of £1.4 billion. This has nearly doubled from £621 million in 2022-23. This was despite an extra £4.5 billion of additional funding during 2023-24, which was to support pay deals for non-medical staff, mitigate any impacts from industrial action and provide money to address the costs of new pay arrangements for doctors and dentists.”
“The Department of Health and Social Care’s day-to-day spending—RDEL—is set to increase by £10.9 billion—from £187.9 billion to the main estimate as produced today of £198.5 billion. The capital spending is, however, set to decrease by around £1 billion, from £12.5 billion to £11.5 billion—a decrease of 8%. That is worrying as it shows that more and more funds are being redirected from long-term investment—for example, in the new hospitals to which the previous Government had committed themselves. I welcome the new Treasury guidelines that have stopped the practice of the past few years of redirecting up to £1 billion from capital spending to day-to-day spending. That should help to make more money available.”
“I agree entirely with the hon. Lady. She has obviously been reading my speech— I will cover the announcement later in my speech, at which point she will hear exactly what it says. As I say, the NAO has confirmed that productivity levels have dropped by 23%. I welcome the Government’s commitment to a 10-year plan for the NHS. We have also repeatedly warned that, with an ageing and increasingly sick population, the NHS will struggle to cope with the ever-increasing multiple complex demands of our population. I wish to split this speech into three sections: how productivity could be improved in the NHS; funding; and, as the hon. Member for Stafford alluded to, technical advancements and a shift into community care.”
“It might also include redirecting funds to help manage discharges from hospital. According to the House of Commons Library, the latest data shows that last year an average of 12,340 patients a day remained in hospital despite being clinically fit to be discharged. Even though there is a slight decrease of 1.2% from last year, more can be done to ensure that patients who are well enough can leave hospital for the community and be closer to their families. That will require better working between social care and hospitals.”
“NHS England said that, rather than moving funds, there should be a focus on the role of GPs and how they can advise their patients. However, according to the Royal College of General Practitioners, although more than 90% of patients’ direct experience of the NHS is through primary care and GP practices, less than 10% of the total budget is currently spent on primary care. I say gently to the Minister that we are getting our priorities wrong there. As a Committee, we have recommended that the Government clearly define what counts as health prevention spending within the next six months and track that spending annually. ICBs should be given more flexibility in how they spend their money, which might include redirecting services to more community settings that are closer to patients.”
“They also offer a number of services that could be termed preventive care. As a Committee, we questioned NHS officials on their prioritisation of preventing ill health rather than treating it, thus avoiding much more expensive hospital interventions in the future and a much better patient experience. Their reply was that they had little additional headroom to grow preventive services, yet the public health grant used by local authorities to commission preventive measures, such as health visitors and drug and alcohol services, is expected to fall in value next year by £193 million, despite the Government’s commitment to maintaining it in real terms. I cannot stress enough how I believe that we should be paying much more attention to prevention rather than cure; it is just so important.”
“Community healthcare can take many forms, from GP surgeries and community hospitals to pharmacies, dentists and social care. I fear that when we talk about the NHS budget, we predominantly focus on hospital care, rather than the care that most of our constituents need every day. Indeed, Lord Darzi’s report, which was commissioned by the Government last year, said that “the NHS budget is not being spent where it should be—too great a share is being spent in hospitals, too little in the community, and productivity is too low” This is where I would like to pay tribute to our GPs and all their staff across the country, especially in the North Cotswolds. Our GP surgeries are usually the first point of contact with our NHS, from antenatal services to blood tests and vaccinations.”
“Without significant productivity gains, the NHS will not substantially reform waiting times and achieve the best value for the large amount of money that we spend on it. On average, there is a 4% real terms increase in our spending each year, when the economy is growing by only 1%, which is unsustainable in the long term. If we go back to 2013, the Health Secretary had set the NHS a challenge of going paperless by 2018. Clearly, as we all know, that has not happened, because the NHS is still using fax machines. In a digital age of AI, that lack of modernisation produces a risk to both patients and employees in the NHS. Investing in better technology would help with the Government’s ambition to shift more care into the community.”
“The 2025-26 priorities and operational planning guidance stated that the NHS organisation “will need to reduce their cost base by at least 1% and achieve 4% improvement in productivity.” I understand that these figures are hard to pin down due to the NHS still negotiating with bodies such as the ONS on the definition of productivity and how it can be measured. I say to the Minister that, even if the numbers are disputed, we have still not seen a plan for how these productivity gains can be achieved, and the Committee believes that NHS England has produced unrealistic estimates. We need to have a realistic estimate from the Department of what productivity gains can be achieved over the next few years.”
“I also understand that it was due to staff sickness, absences and the then ongoing workforce industrial action that affected most patients last year, making targets more difficult to meet. I do not know about other hon. Members, but I am still getting emails from constituents whose appointments and operations were cancelled at the last minute due to that industrial action and who are still waiting for their procedures to be rearranged. Along with staff, technology plays a big role in improving efficiency and productivity.”
“The hon. Gentleman is exactly right. The NHS employs an enormous number of staff—more than 1 million people, I think—and their conditions of work are really important if we are to retain them. That does mean that their mental health needs close attention, especially when they have problems. If the NHS cannot help with mental health issues, who can? The hon. Gentleman has hit on a really important point. One reason that productivity is not improving more is that there are 19% more staff in the NHS, but they are seeing only 14% more patients. At our hearing, NHS officials stated that this was due to more complex and acute health needs, meaning longer stays in hospital.”
“It should not be a postcode lottery, as exists now. With more joined-up thinking between different parts of the NHS, the patient experience could be better. However, without substantial increases in productivity, increased spending on preventive care and public health, and a better functioning social care system, our NHS will never be able to operate at the optimal level with world-leading standards.”
“The hon. Member makes an extremely powerful point. I am coming to the conclusion of my speech, which is on precisely that point. The social care system is not working in this country. It is a political football that keeps being passed from one Government to another. I understand that the Government have committed to another review of adult social care and that we should not expect results until at least 2028; for many of our elderly patients, that will be too late. The funding of social care is rising exponentially. There needs to be more focused and joined-up thinking from the DHSC, NHS England and local authorities on how they can support those who need help to be discharged from hospital in a timely manner and live in their own homes for a longer period than they might otherwise be able to do.”
“I am sorry to intervene on my deputy, who does an excellent job on the Public Accounts Committee. In the last Parliament, before he joined the Committee, we went to Denmark, where they do precisely what he is talking about: give chemotherapy treatment to people in their homes where they have a history of not reacting to it.”
“As I did in my speech, I ask the Minister to consider producing a productivity plan, so that, without all the arguments with the Office for National Statistics and everybody else, we can see the DHSC’s best estimate for productivity gains over the next five to 10 years, and can start to see how such goals will be met. In such a productivity plan, modern digital technology will be really important. The Minister skated over one word that I am really concerned about, which is “cyber”. We had a wake-up call with WannaCry two or three years ago. The NHS has some very important personal data, so it is vital that we move towards modern machines that can withstand cyber-attacks better than some of the analogue equipment in the NHS. It has been a great debate, and I am sure that the Minister will have plenty to think about.”
“I shall be brief. I thank the Minister for her very comprehensive reply, and I congratulate her on her new role. I also congratulate everybody who spoke in this debate; there were some excellent speeches. Can I ask the Minister to thank her officials for appearing before my Committee? It is very much appreciated. I also thank the members of the PAC, a very hard-working Committee that produces two major reports a week, and in particular my deputy, the hon. Member for Sheffield South East (Mr Betts). To sum up, as I said in my speech, productivity is the key to long-term reform of the NHS. Increasing funds at 4% per year in real terms when the economy is growing at only 1% in the long term is unsustainable, so something has to be reformed in the health service.”
“I, too, thank the Deputy Prime Minister for ending the uncertainty around the Gloucestershire county council elections taking place this May. Bearing that in mind, will she set out a clear timetable for those two-tier counties such as Gloucestershire as to when they are expected to provide proposals on any wish to change? Will she also confirm that the county council elected in May this year will serve a full four-year term of office?”