Westminster Hall Sitting of 10 February 2004

Preamble
[Miss ANNE BEGG in the Chair]

Health Funding (Buckinghamshire)
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Ainger.]
9.30 am
Mrs. Cheryl Gillan: I am delighted to have obtained, through the Speaker's good offices, the opportunity to raise the funding of health services in Buckinghamshire. I extend a warm welcome to the Minister. His office telephoned me last week to ask me exactly what subject I wanted to raise. I am afraid that I told it that I wanted him to come to the House with an apology and a cheque book for the people of Chesham and Amersham. I hope that, by the time I have finished, my constituents will get both, but forgive me if my expectation is not high.
I am joined today by my hon. Friends the Members for Wycombe (Mr. Goodman) and for Beaconsfield (Mr. Grieve), and bring apologies from my hon. Friends the Members for Aylesbury (Mr. Lidington), who has been forced to attend to his duties in Northern Ireland, and for Buckingham (Mr. Bercow), who is returning from a mission abroad in connection with his international development portfolio. The five of us had hoped to participate in the debate, but I am glad that three of the five have made it, as I am sure is the Minister.
We are in trouble in Buckinghamshire because, with the approach of the new financial year, virtually every aspect of our health service will be in the red. Whether we look at the mental health trust, the acute trust or the primary care trust, we face a problem. As the Minister knows from his recent visit to the National Society for Epilepsy, even it—one of our country's leading specialist facilities—faces bitter options simply to maintain its facilities and research. About the only success story in health funding in my constituency at present is the wonderful achievement of Amersham plc, which is in the process of being acquired by General Electric. It leads the world in health science and will continue to do so from its headquarters in Amersham, something of which we are rightly proud.
I shall deal with four subjects in turn but, first, I want to place on record my admiration for the hard work and dedication of everyone who works in our local health services. Their morale, to put it mildly, is not great at the moment and I hope that the Minister will appreciate that the problems arise despite the best endeavours of our staff and managers, who do sterling work and stand in the firing line when it comes to bringing bad news to patients and front-line staff alike. The Minister goes back to his office surrounded by civil servants. The local health service officials must face the public, as I saw only recently at a meeting on Chesham hospital, in a way that perhaps he does not.
The first thing that I want to consider is the mental health trust. Since my election in 1992, I have been only too well aware of the issues surrounding mental health
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in my constituency. At that time, a facility was opened at Debenham house in the Chalfonts, and I was given a crash course in the fear and misunderstanding that can occur with regard to mental illness. However, in the 1990s I did not see large numbers being failed by the mental health system. Over the past couple of years, I have noticed that an increasing number of constituents who consult me at surgery have mental health issues. At the sharp end, it is becoming obvious that our resources are insufficient and stretched to breaking point.
By the end of the financial year, even with the most favourable out-turns, our mental health trust will have a £3.6 million hole in its finances. The reasons for the deficit range from an underlying structural problem inherited when the trust was established to the high costs of agency and locum staff, and from an overspend of about £500,000 on drugs to out-of-service placements or extra-contractual referrals, for which the current overspend exceeds £1 million. In addition, it looks as if there will be an overspend of nearly £750,000 on learning disability services.
I am the first to admit that the restructuring announced last week presents a partial way forward. The acting chief executive, Mrs. Jill Cox, whom we have all met, has done a tremendous job. By staying in post much longer than she or anybody expected, she has now negotiated an arrangement with the Oxfordshire mental health trust whereby Julie Waldron will run both trusts side by side. This is not a merger, but it may well provide economies of scale in management. It will not, however, alleviate the deficit or solve the continuing problems, such as the shortage of psychiatrists and nursing staff, and the problems with facilities, such as the Haleacre unit at Amersham general hospital in my constituency, which are in desperate need of improvement and which I believe will close. It will not prevent the possible closure of the brand new paediatric intensive care unit or provide the extra resources to help sick people who are unsupported in our communities when they are most vulnerable.
The Buckinghamshire hospitals acute trust covers three hospitals: Stoke Mandeville, Wycombe and Amersham in my constituency. The accident and emergency units are based at Stoke Mandeville and Wycombe, which, with Amersham, serve about 750,000 people. Amersham was a private finance initiative project initiated by the previous Conservative Government but built and executed under the Labour Government. It is an almost brand new facility, but we are already facing the possible closure of one of its wards—the Misbourne ward.
We have an enormous problem with the recruitment and retention of staff—a problem that will be exacerbated by the restrictions on working hours caused by the European working time directive. Again, agency costs have blown a large hole of about £5 million in the budget. Last year, I tabled questions to the Minister about the cost of the working time directive. His colleague, the Minister of State, the hon. Member for Doncaster, Central (Ms Winterton), gave answers that, frankly, were quite unsatisfactory and did not address my questions at all.
In fact, the total deficit to the acute trust will be upwards of £6 million despite the financial support of £4 million of extra resources from the Thames Valley strategic health authority. My hon. Friend the Member

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for Aylesbury has similar problems. He asked me to make the point to the Minister that a date has still not been given for the commencement of the new buildings at the Stoke Mandeville hospital. Apparently, parts of the hospital were built in the 1940s and are literally falling down. Back in April 2001, plans were confirmed to bring in private investment to improve the facilities. The Government initially delayed the development by gerrymandering in respect of the rules by which the hospital can gain private funding. Despite all the plans made, the Government have still not given the final go-ahead for building to begin. My hon. Friend wants to know when they will give a date and would like the Minister to give one now so that essential work can start on the hospital.
A consultation document has been published entitled, "Shaping the future of your local health services". The deadline for consultation is June 2004, but set against burgeoning financial difficulties, I am convinced that it is driven by concerns about cost and not about patients. My hon. Friend believes that there will be change and that the demands placed on the health service by population changes should be reflected in responses to the paper. He also believes, however, that the document gives few figures and little costing of any changes. As a result, he and I have real fears that there will be a reduction in services. What is particularly striking is that the document gives no cost of the implementation of the working time directive. Recently, however, the trust has been performing well. The reference costs published last week show that we have, and get, excellent value for money. As the Minister knows, however, the problem is that we do not have enough money—a point to which I shall return.
The PCT has been working overtime. This year, one hopes, it will break even, thanks to dedicated staff and really good management across the board. However, it has come at a price to my community. Appleyard, a much needed physical disability respite unit, has had to close. The older citizens' day hospital now opens only four days a week instead of five. Chesham hospital faces possible closure and its beds being moved to Amersham if the acute trust decides that it cannot keep the Misbourne ward open and offers it to the PCT. I suppose that there is also some good news in that the PCT plans to develop new health care facilities in Chesham. It may or may not be possible to build those facilities with beds if the Chesham hospital closes.
The hospital has a history going back 100 years and it is a much-loved institution. I admit that it has passed its sell-by date, as all things do, and that it does not offer state-of-the-art facilities, but we must not underestimate our community's emotional needs. The hospital's place at the emotional and physical heart of the community gives it protected status among my constituents. New beds at a modern facility in Chesham may be acceptable, but a journey to Amersham would be less so. However, I appreciate that that might be the outcome and I cannot prejudge the choices that we shall face as a result of uncertainties at the acute trust.
The situation in Aylesbury is lamentable. The Vale of Aylesbury primary care trust has forecast an overspend of nearly £1.8 million, as my hon. Friend the Member for Aylesbury and many others predicted. Central
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Government's relentless setting of targets has driven health care managers to distraction. With so many compulsory targets, the money needed to implement them is, effectively, ring-fenced, which prevents managers from responding to the needs of the local environment. As a result, many essential services have been sidelined and are not funded adequately enough to respond to local need.
My hon. Friend wanted me to mention the speech and occupational therapy services in Aylesbury, which are woefully underfunded. Similarly, special educational needs are not being met. Such inadequate support might lead to patients requiring more care than they might otherwise have needed.
I cannot predict what my hon. Friend the Member for Wycombe will say about the PCT in his area, but it is in much the same situation as those in my area and that of my hon. Friend the Member for Aylesbury. However, I can predict with certainty that the PCT in my area will face growing demand next year and that it will have a hard time staying out of the red.
The calls on the PCT's funds are growing and underfunding has had a knock-on effect in one final regard. The National Society for Epilepsy has 258 places in residential and nursing homes on the Chalfonts site, as well as 26 assessment beds, which see a throughput of about 270 in-patients and 2,000 out-patients a year. The NSE operates under a service agreement with the National Hospital for Neurology and Neurosurgery. It has the UK's only magnetic resonance imaging scanner dedicated solely to epilepsy, which was paid for entirely out of charitable moneys. The same is true of the 3 tesla machine, which, incidentally, will come from General Electric and will be installed later this year at a cost of more than £1.5 million.
The Government's national care standards requirements mean that all the residential units will have to be updated at an astronomical cost, which will run into millions, but the fees paid by local authorities do not cover the costs of the residential care remit. Funding for the health care of residents falls to the PCTs and the costs are currently well over £800,000 a year, but the NSE receives only £116,000. Assessments are being carried out on the residents and 50 have been completed. The balance is expected to reveal that 29 more residents will meet the criteria for 100 per cent. health care funding. I assume that I do not have to spell out the implications of that to the Minister. No systems have been established to meet the assessed health care costs of those residents and there is an ongoing dispute, but the money will have to be found from somewhere and it will come from the NSE's charitable funds.
Thames Valley strategic health authority says that the PCT in which the resident lived immediately before coming to the NSE should be the funding authority. However, the Department of Health's guidance on responsible commissioners says that where a patient moves away from the area served by their registered GP, the responsible PCT should be determined as the PCT in the area in which the patient has become resident. Matters have still not been resolved, which is adding to the NSE's financial burdens.
In addition, there are immediate therapy needs. The NSE has only one full-time equivalent occupational therapist, one full-time equivalent physiotherapist and

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no speech therapist for a population of 225 residents. That is not good for an institution that is recognised as a centre of excellence by the World Health Organisation.
In practice, the lack of funding has forced the NSE to apply for planning permission for a housing development on part of its site as the only way to plug the gap in funding. The problem is that such a development would breach the green belt, which the Government now favour but which I and my constituents do not. The proposals have aroused much genuine concern among the NSE's neighbours, for whom I have a great deal of sympathy. The Secretary of State has refused funding, which is required largely because of the effects of his regulations. I also have sympathy for the NSE. We do not want to lose the facility, which benefits my constituency and those who suffer epilepsy throughout the United Kingdom and even the world.
The Minister saw the NSE for himself the other day, so I wonder what he would suggest. Will he encourage it to apply for planning permission and to breach the green belt or will he find the funding for that first-class organisation? I hope that he will not duck the question and that he will give us and the NSE the benefit of his advice.
There is a major problem with the finances in almost every aspect of our health service—I promised to return to the underlying problem. Despite all the hard work, carried out across the hoard, to build so-called recovery plans; despite all the economies and restructuring; despite the closure of facilities and the slimming down of others, to the detriment of my constituents and others in Buckinghamshire; and despite the so-called extra moneys that I am sure the Minister will fall back on in his speech, the truth is that we are underfunded and disadvantaged by a formula that is robbing my people in Chesham and Amersham of their rights.
Thames Valley receives 18 per cent. less money per head than the national average and Chiltern and South Bucks PCT receives less per head than the English average, by £150 or more. That is a scandal. The referral rates in Bucks are really low and the reference costs show that the acute trust is below the average at both sites. It could not be more efficient if it tried and the high cost of living means that the below-average funding is harsh to say the least. That is confined not to my area alone, but almost exclusively to the south.
The Health Service Journal confirms that half the English acute trusts are not confident of hitting their year-end financial targets and one in six rated themselves "very unconfident". London and the south-east accounted for all but one of the "very unconfident" finance ratings and—surprise, surprise—those in the north-west were the most confident about their financial out-turns. The Health Service Journal goes on to reveal that the Thames Valley area will have an enormous deficit of £18.1 million, which is on top of the £24 million NHS bank support. Most interesting are the comments of Noel Plumridge, a former finance director, who says that the financial results suggest that there is a problem throughout the south.
Thames Valley has done well in the circumstances, but the consistency of the deficits suggests that the problem is in the south rather than, as Noel Plumridge
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puts it, restricted to the usual culprits. The greater restrictions on the trusts' ability to delay capital spending is storing up problems for the long term, and backdating the consultant contract and the other factors that I mentioned all contribute to the picture. The problem is that those deficits are likely to be increased next year and even the severest of short-term measures is unlikely to remedy the situation. Indeed, what out-turn does the Minister forecast for my health trusts for next year—£36 million or £40 million? He must have a figure in his files and I should like him to share it with us.
I am sure that the Minister will argue that the standard of health is better in the south than it is in the north, and hence that the deprivation factors used by the Department justify the underspend in my area. That is not a valid justification. The needs of the north are not better served by levelling down those in the south. Surely we should be advancing medical services so that those improvements and advancements can be passed to other areas of the country rather than being used to penalise us for having different health requirements.
My constituents are hard working and pay enormous amounts of tax. They are articulate and knowledgeable about what they require in terms of health care. Their voices, too, deserve to be heard. Instead, they are vulnerable to a Government who have decided that they are worth less per head in terms of health care spending than people in other parts of the country. That includes some deprived areas in our constituencies in Buckinghamshire, which the Minister never seems to take into consideration.
I said that I wanted an apology and I think that even the Minister would acknowledge that our people deserve it. However, I also want him to get his cheque book out. It would make a difference if he were even to bring my constituents up to the national average. That might mean that they would not have to wait 13 months to get a hearing aid; that we do not have a bitter battle in my community over projected plans to build at the NSE to meet the Government's requirements; that the Misbourne ward does not have to close; that mentally ill people get the support they need; that we can give patients the therapies that they require; and that we attract and retain the staff we need to serve our community. After all, the community pays for and rightly expects that service.
The Minister will have a long list of successes and figures that show that much more money is going in than ever before. Well, it is not going into my backyard. After all, I am only asking for equality of treatment and a chance to face the new financial year without the inevitable cuts and reductions in service for the most vulnerable in any society, certainly in my experience—the sick. I hope he can give us the hope that we need in Chesham and Amersham and in Buckinghamshire.
Miss Anne Begg (in the Chair): I intend to call the first winding-up speech at half-past 10, so I would be grateful if the two remaining hon. Members divided the time equally, if possible.
9.52 am
Mr. Paul Goodman: It is a great pleasure to see you in the Chair, Miss Begg.

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I congratulate my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) on securing this important debate and on covering the ground so thoroughly. Like her, I pay tribute to the 50,000 or so NHS staff who work in Bucks, and in particular those who work in the PCT, the acute trust and the mental health trust in my constituency.
As my hon. Friend has said, an image of Bucks tends to linger—it may even linger in the Minister's mind—of a rich, lush, wealthy, well-off county. However, the reality in my constituency is somewhat different.
I want to share some figures with the Chamber. The Minister will be familiar with the Government's indices of ward deprivation, which measure some 8,414 wards in England. I want to cite some of those figures relating to wards in my constituency. For child poverty, Booker and Castlefield comes in just outside the top 1,000, at 1,006. For education, the same ward comes in at 886. The housing figures are quite striking. Cressex and Frogmore is at 929, Green Hill and Totteridge at 772, Bowerdean and Daws Hill at 573, Booker and Castlefield at 529 and Marsh and Mickelfield, incredibly, at 256.
It might be hard for some hon. Members who are not familiar with Buckinghamshire to believe that such pockets of poverty and deprivation can exist in the south, but they do. The district has a 12.14 per cent. ethnic minority population, who are disproportionately represented in those poor wards. Many are originally from Kashmir and Pakistan, and do not always speak English as a first language. They have acute health needs.
We know from the census that 8 per cent. of the local population said in 1991 that they had limiting long-term illness. By 2001, that proportion had risen to 12.6 per cent. In 2001, no less than 14,700 people were providing unpaid care to their family, friends and neighbours. That is in the context of rapid population growth in the Thames Valley area.
We have a picture of complex health need, and of a small but important deprived group who lose out when other areas are better funded. Living in pockets of poverty, they are often little better off than others in areas that are, in general, poorer. However, our constituents also have a rising demand for health care. Like my hon. Friend, I am struck by how many of my surgery cases relate to mental health—they might involve a girl who harms herself or has anorexia, or a child with a problem in attending school. The number of such cases is increasing, and they are difficult and expensive to treat.
Returning to the figures that my hon. Friend cited, although funding in Wycombe district is almost £150 a head below the English average, and Thames Valley spending is some 18 per cent. below the English average, I have no evidence that demand in my area is 18 per cent. below the English average. If anything, I suspect that it is average or above.
That brings me to the first of three themes that I want to explore: the effect on funding of the star rating system for hospitals and targets. In the last but one set of ratings, Wycombe hospital was near the top of the list. However, last year its rating fell from three stars to one.
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I doubt whether the average patient admitted to that hospital for successive operations during those two successive years would have come out of the second operation believing that the hospital had declined from being excellent to one that was regarded by the star system as poor, but that was the effect of the trust's missing Government targets relating to finance, cancer, and accident and emergency.
Missing targets is extremely demoralising for staff. I know that, because I was admitted to A and E in the hospital last year for a minor operation, and I had the chance to talk to staff. It has a knock-on effect, which was referred to by my hon. Friend, and it is not happening in a financial vacuum. Buckinghamshire Hospitals NHS trust forecasts an overspend of £4.7 million and the mental health trust an overspend of £3.6 million. The total overspend in the county could be almost £14 million, when the acute trust has to restructure and all hospitals are having to cope with the impact of the working time directive.
Hospital trusts, mental health trusts and PCTs have an obligation to manage their budgets efficiently and effectively. However, the star system and the target regime make things worse rather than better because of their inflexibility. As a knock-on, the PCT is affected if the trust misses targets and therefore loses stars. For example, Wycombe PCT has targets relating to smoking cessation and to acute care. That seems reasonable. However, the targets are given the same weight—the PCT can incur serious financial loss if it misses the smoking cessation target—and it is less obvious why that should be so.
It is not just Conservative Members or Buckinghamshire MPs who think that the star system is too rigid. Oliver Wright, health correspondent of The Times, had an article published on Monday headed "Hospital star ratings to be scrapped". It said:
"The controversial system of star ratings to assess hospital performance is to be abolished in one of Labour's biggest U-turns. Ministers, stung by criticism that the scheme is politically manipulated and does not reflect patient care, have agreed to bring it to an end within two years…Instead, there will be a much looser assessment scheme that will no longer pit trust against trust. Hospitals would no longer have to meet key waiting times targets, which many doctors claim skew clinical priorities, as much more emphasis is placed on quality of care and overall clinical outcomes. The Commission for Healthcare Audit and Inspection, the independent body that will take responsibility for assessing NHS performance from April, is also likely to end the existing regime of regular hospital inspections. In future hospitals would be inspected only when specific problems arose. The changes mean that there will have to be new measures to decide which hospitals are good enough to achieve foundation status…
The move came after intense pressure from Sir Ian Kennedy, the commission chairman, who has made little secret of his distaste for star ratings. He had pressed for them to be abolished immediately, but the Government resisted and a compromise was reached to end the assessments in 2006."
We are used to reading Government announcements in the newspapers before we hear about them in the House, but I would be grateful if the Minister either confirmed or denied that story, which appears to be extremely well briefed. Hon. Members might share my view that it would be pleasant to learn of any such changes from Ministers directly, rather than from the columns of The Times.
My second theme relates to what my hon. Friend said about Haleacre. There is concern about movement of services in my area, with its particular needs, to the

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centre and north of the county. Marlow day hospital was a facility in which a day nurse gave rehabilitation treatment to patients over 60. Recently, it closed. The patients are to be transferred to the Hayward unit in Wycombe hospital and to the Drake day hospital, which is based in Amersham hospital. I acknowledge that slots in Marlow day hospital were under-used and that all health organisations now want to provide more flexible care. I also acknowledge that the number of patients who, for one reason or another, do not want to avail themselves of transport to High Wycombe or Amersham is small to date. However, it is striking that no notice was given. That caused great stress and upset to my constituents in Marlow. No audit of social benefits provided by the hospital took place. As my hon. Friend said, people in Buckinghamshire—people everywhere—feel emotion about their local health institutions and want to be sure that their feelings are taken into account.
Above all, we cannot be sure that vulnerable people in need of treatment will not simply slip through any gaps in the system. As the director of operations at Wycombe hospital said:
"Saving cash was part of the trust's decision",
so we return to the point about the shortage of money in the area.
There is a similar problem at Riversdale hospital, which until recently had a respite unit to care for patients with early-onset dementia. That has now closed. I acknowledge that not all the patients who used Riversdale came from Buckinghamshire and that there were long-running staffing problems at Riversdale. Again, I also acknowledge that all health organisations now want to provide more flexible care. However, once again no notice was given. Patients were not consulted until after the decision had been made and we cannot be sure that vulnerable people in need of treatment will not simply slip away without getting the treatment that would have been available to them previously.
That is an especially serious problem for carers. I know from consulting South Bucks Carers Association—to whose work I pay tribute—that one of the most pressing needs that carers have is simply that for a break from time to time. Caring for someone full-time, no matter how much one loves them, can grind even the most dedicated carer down. Once again, we are faced with a problem in the Wycombe area, in the south of the county, where relatively immobile and vulnerable people have to go to the centre or north of the county for treatment.
I do not intend to repeat everything that my hon. Friend said about the possible closure of Haleacre. There is the possibility that patients will be sent to the Tindal unit in Aylesbury or to an entirely new mental hospital at Stoke Mandeville, which will deal with the needs of the entire county. Again, we have the problem of a relatively vulnerable section of the population having to go to the centre of the county, from the rest of the county, for treatment. The fact remains that a large number of patients with mental health needs will be from Wycombe, which is the biggest conurbation in the county outside Milton Keynes. There is a strong case for keeping Haleacre open, or even siting a new facility in Wycombe.
When my hon. Friends and I recently spoke with representatives of the mental health trust, I was struck by the fact that, right from the moment when the
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curtains were rolled back at the start to reveal the trust, it was in deficit. No one can claim that the trust is in deficit because it has managed its finances badly or maladroitly—there has been a problem from the start, which is why we are looking to the Government to provide a solution.
My hon. Friend the Member for Chesham and Amersham said that she was hoping for the Minister to apologise and take out his cheque book. I am not absolutely confident that we will get an apology but, although I cannot speak for her, I would be willing to pass that up if I was absolutely sure that the cheque book would come out. Now that she and I have painted a convincing picture, backed up by fact, of the health needs in Buckinghamshire—I am sure my hon. Friend the Member for Beaconsfield (Mr. Grieve) will do the same—I cannot see any reason why our funding should continue to be 18 per cent. below the average, given that our demand is not. We look to the Minister for some answers.
10.7 am
Mr. Dominic Grieve: I am very pleased that my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) was able to secure this debate, which raises a number of important issues, and I am delighted to participate in it. I hope to amplify some points that have been made without necessarily simply repeating what has already been said. I heard nothing from either her or my hon. Friend the Member for Wycombe (Mr. Goodman) with which I disagree.
Members of Parliament are of course in a rather strange position. Unless we make them our specialist area of study, the impression we tend to form of health services is in large measure dictated by those who come to see us with health care problems. I am the first to accept that this can sometimes be misleading. I am quite satisfied that in many areas a very high standard and quality of service is maintained in south Buckinghamshire. The chairman of my Conservative association, having suffered injury and spent some time in Wycombe hospital, came out with nothing but praise for the quality and standard of care that he received. Although the national papers may frequently comment on problems within the NHS, I have very little doubt that, once one is into the system and receiving care, the standard is very good indeed.
However, there remains a problem: there are plenty of examples from my constituents that, certainly in south Buckinghamshire, some people are unable to get the care for considerable periods, and sometimes simply do not get it at all. I will give the Minister some illustrations. A family came to see me with a young child who was showing clear signs of serious psychological problems. He was no longer able to attend school. This was not just a question of truancy or bad behaviour—there was clearly a serious issue. I was horrified by the fact that he was unable to go back to school at the start of the term in January, having missed a great deal of school the previous term, and by July, when his desperate parents came to see me, notwithstanding the fact that they consulted their GP at an early stage, he had still been unable to obtain the full services of the Amersham family and adolescent unit. This was not because the unit had thought their case unworthy of

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attention, but because it was short-staffed. One of the consultants was off sick and there were no substitutes or replacements who could be brought in. By the time I wrote to the Minister to point out my concerns, a child was in a situation that urgently needed intervention, but there had been no intervention for one whole school year. That was at a critical time in that child's life. I am sure that the Minister will agree that that is neither a happy nor an acceptable state of affairs.
We must face up to the fact that, in primary care terms, the local community's perception is that the standard of services is declining. Until two years ago, one of the surgeries in Iver provided a wide range of services, such as physiotherapy, in addition to its GP service. Just before the primary care trust was set up, it was decided that it would no longer be possible to continue with those additional services. I received a letter on the matter, which illustrates the problem:
"You are quite right that the previous physiotherapy service at the Iver Medical Centre was reduced. This was a decision of the then South Bucks Primary Care Group—the responsible body to which this Primary Care Trust is a successor. The Primary Care Group was responding directly to concerns raised by other patients and professionals that the spread of physiotherapy services was uneven and unfair. For this reason, it commissioned a service that was of similar levels for each practice in the area. As the Iver Medical Centre had a higher level of service than others, it experienced a reduced service once revisions had been put into effect. It is unfortunate that, for the Iver Medical Centre patients this resulted in a 'levelling down' of service but I hope you will appreciate this was for the good of the overall service."
I made inquiries, but I could not track anyone who felt that any other surgery in the area had benefited from that levelling-down process. Instead, a centre of excellence that had previously been a fundholding practice had its services reduced. The public perception in the locality was not that anyone local had benefited elsewhere.
In addition to those two examples, I face another local problem: my constituency lies at the very bottom of the county, so it is necessary that some of my constituents cross into other health authority areas for treatment from time to time, one of which is Berkshire, which is part of the new strategic health authority. Notwithstanding that fact, we continue to have what I can only describe as the reverse of a turf war: it is no longer, "Get off my turf," but, "Please come on to my turf and take over the services, which I have difficulty supplying." We see the same thing—the Minister smiles—between the county council and the NHS over the provision of social services. All those examples illustrate the serious underfunding that pervades the entire system.
I have another letter about the provision of adequate mental health care in the area. I do not wish to repeat my hon. Friends' comments on that, but the shortfall in funding in Buckinghamshire, and the problems related to that, mean that mental health is of particular concern to us. The letter concerns a family with a young adult son who has serious mental health problems. He has tried to commit suicide several times, and he clearly has psychotic delusions and needs careful management. Because he lives right down on the border with
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Berkshire, the family must get those services from Berkshire, but no one has the money to pay for them.
The letter illustrates the problem:
"My understanding from recent discussions is that the services in the overlap area include the full range of provision, now including assertive outreach and the Chiltern & South Bucks PCT have recently included that in the Berkshire Trust Local Delivery Plan (LDP) agreement. I will copy this letter to the Chiltern & South Bucks PCT to alert them to the possible confusion about provision you have highlighted and I'm sure they would welcome contact directly from you".
The letter, of August last year, continues:
"You will also probably know that negotiations are currently ongoing between the Berkshire Trust, Chiltern and South Bucks PCT and ourselves with a view to getting the services in the overlap area included in the service agreements we have as a whole Bucks provider. My Trust Board has agreed in principle to take on the responsibility for the area"—
the following is highlighted—
"once the appropriate resources and service transfer arrangements have been agreed.
Unfortunately, these negotiations remain to be completed because there is still no collective agreement over the resources that need to be available, if we are to ensure safe, appropriate and sustainable services are provided under the responsibility of my Trust."
That letter was from the director of strategic planning of Buckinghamshire NHS trust. That is an unsatisfactory state of affairs. Repeatedly, everyone is ducking and diving, inevitably trying to find ways to turn a circle into a square, when that is simply not possible. Ultimately, the background problem is that the funding is not available.
To turn from those particular examples to more general points, which bear repeating, I would be grateful if the Minister clarified whether I am right in saying that per capita expenditure on health care in Buckinghamshire is £405 per annum. In Liverpool, the figure is £900 per annum, while in Scotland I think that the figure is £1,200 per annum, although you may know more about that than I do, Miss Begg. Those are pretty stark figures and they illustrate the absolutely central issue, which is why today's debate is taking place. We are faced with a system that has been devised over time by a Government who have decided that areas such as Buckinghamshire require much lower health expenditure than other areas. The figure for Scotland is distorted by the fact that, overall, Scotland gets a block grant, which it can spend as it likes, that is 24 per cent. higher than the total per capita in the rest of the United Kingdom. For Liverpool, however, the difference is due to a perfectly straightforward governmental choice.
The Minister will of course say that the difference is based on the Government's assessment of need. I do not disagree with that rationale. However, as every consultant in Buckinghamshire with whom I speak points out, need is not demand. Indeed, I understand that there is ample evidence—perhaps the Minister can confirm this—that there are high levels of demand in areas such as Buckinghamshire. That is not because my constituents have all suddenly become hypochondriacs who want either to clutter up their GPs' surgeries or to receive services that they ought not to try to obtain. Rather, the community is articulate.
As my hon. Friend the Member for Chesham and Amersham said, people there pay high levels of tax, they are pretty much aware of the medical services that ought

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to be available and they inquire after the availability of those services. Some people want beta interferon, because they suffer from multiple sclerosis, while others want to make use of more specialist services in the NHS. The principle behind the NHS—this has been the Government's ambition—is not that it is need-driven, but that it is demand-driven by all those who have a need. The Government are creating a situation in which there is a growing gap between the requirements created by the demand and the money that they are making available.
I have always accepted the principle that we cannot operate in a united country without the richer areas paying for the poorer. That is how every sovereign state operates, whether it be the United States, which sends huge sums from California to Arkansas, or the United Kingdom, which sends huge sums of public money from the pockets of the wealth producers in the south-east to disadvantaged areas.
However, we also have areas of disadvantage. My constituency has the 13th most deprived ward in the south-east, as well as the money. I am sure that my constituents are willing to dig into their pockets to raise standards and the level of service for others living in more disadvantaged conditions to the same as theirs, but I do not think that they see it as part of the deal that others should have a higher standard of service, which is what they are getting.
Some may slip off into the private health care system, and to some extent successive Governments have encouraged them to do so, although it is worth pointing out that when there was serious bed blocking at Wycombe hospital during the winter of 1998, the then chief executive said that he was satisfied that one of the reasons was that the Government had removed the incentive for the elderly to have private health care. That was an own goal of monumental proportions in terms of the crisis that it created.
There are other oddities, and I would be grateful to hear more about them from the Minister. It was pointed out to me at a recent meeting with consultants that some current funding measures operating within the NHS are bizarre. As diagnostic and treatment centres develop, the going rate of £262 will be paid for each case seen and diagnosis made. They range from a procedure such as a skin tag being taken, which takes 15 seconds, to a three-hour complete diagnostic assessment. One of the consequences of that bizarre funding system—I hope that the Minister will be able to respond to this—is that there will be cherry-picking as the centres develop, and inevitably hospitals will receive fewer and fewer resources and less income for carrying out the major procedures that others do not want to cherry-pick. By depriving the hospitals of volume, we shall create a system whereby the funding crisis for those that buy into services within hospital trusts will become more difficult.
I would be grateful for the Minister's response, because if that is the route that we pursue, the funding crisis that we are experiencing will get worse. What I want is not an apology, but to know what will happen next. I only have to look ahead to see that our problems will get worse. In the primary care trust allocations for Buckinghamshire, the percentage term increase for children in south Buckinghamshire at 29.2 per cent. is below the national average of 30.8 per cent., so the Government do not seem to have cottoned on to the fact
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that there are long-term funding difficulties, although I accept that in Wycombe the relevant figure is fractionally above the national average, as it is in the vale of Aylesbury, but that will not benefit my constituents.
I would also like to know from the Minister how he will deal with the problem of attracting suitably qualified staff. I realise that there is a problem, but he cannot get away from the fact that Buckinghamshire is a high-cost area. How will recruitment be done? Specialist consultants make the point again and again that the specialist nurses on whom they depend for providing services are leaving to live in London, where the weighting is better, or in lower-cost areas. That simply reflects a difficulty that we have had with virtually all forms of public service provision, including the police. Can he explain the Government's thinking in relation to tackling that problem?
Although each case concerns individual human beings, at the end of the day the issue relates to money. If the national average of overall expenditure were being received I have little doubt that the problems that beset each of the health trusts would simply disappear. I want the Minister to explain not just the short-term future but the Government's thinking in the longer term. We are getting to a point where public tolerance of such disparities will erode. Unless he heeds our comments, there will come a time in Buckinghamshire and other areas of the country when there will be growing resistance in respect of how people perceive themselves to be disadvantaged by the Government's funding formulae.
I am mindful of the Government's problems. They can examine areas of high need and decide that those are where the money should be targeted, but they should be mindful of the consequences for the people who provide the motor force for wealth generation, without whom the Government could not provide such services.
10.26 am
Sarah Teather: I, too, congratulate the hon. Member for Chesham and Amersham (Mrs. Gillan) on securing this important debate. I am pleased that she and the hon. Member for Wycombe (Mr. Goodman) made a point of paying tribute to NHS staff. When we consider such important issues, there is a danger that we overlook their hard work. This is my maiden speech in this place and my first outing as Liberal Democrat health spokesperson, so I am pleased that it concerns the issue of health funding.
Liberal Democrat colleagues on Milton Keynes council are concerned about health funding in Buckinghamshire. Milton Keynes has the fastest growing population anywhere in the country. Under the Deputy Prime Minister's communities plan, it will gain 34,000 new homes by 2016. Even without that growth, the Office for National Statistics seems to have grossly underestimated the population of Milton Keynes. My colleagues on Milton Keynes council have been working very hard with the PCT to redress that balance. Added to that problem is the question of how NHS funding is allocated. On a three-year basis, estimates based on the population in year one may be grossly out of proportion to the eventual population if there is dramatic population growth. There are existing pressures on that health service.

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The accident and emergency service in Milton Keynes was expected to serve 16,000 patients a year, but it treats 65,000. The PCT in Milton Keynes has a projected overspend of £1.8 million, but if that figure is combined with other factors, such as the projected deficit for Milton Keynes general hospital, it may be much higher. That creates real dangers for local services.
The hon. Member for Chesham and Amersham said that her area is funded at a level 18 per cent. lower than the national average. The hon. Member for Wycombe said that poverty levels in his constituency are unrecognised. Perhaps it is a case not so much of changing the formula, but of handing political control to local people. At the moment, the only accountability in the system is a change of Government. If we were to hand over political control and the ability to raise money for local services to local people, political control would exist at a level where people could see that they were making a difference. That would provide real flexibility. Changing the formula will always leave someone disadvantaged and unhappy.
Thames Valley strategic health authority is likely to have an overspend of £11.4 million by the end of the year, but it is not alone. Latest estimates predict that the North West London SHA—the SHA for my constituency—will have a projected overspend of £15.5 million, Hampshire and the Isle of Wight SHA will have an overspend of £27.9 million, and Surrey and Sussex SHA an overspend of £21 million, which is projected to double by the end of the year. There are severe problems throughout the south of England. As the hon. Member for Chesham and Amersham said, it appears that almost half of strategic health authorities in the south are very unconfident or quite unconfident about meeting their financial targets. That is a particular problem within acute trusts and mental health trusts. There is a difficulty with undiagnosed mental health problems. I have seen people in my own surgery with such problems. Not only is that not unique to Thames Valley SHA, but it is not new. That is what is most depressing.
Looking back to January 2003, I found an article in The Guardian, based on a leaked memo, saying that hospitals and clinics in the south-east of England would have to find savings of £60 million by the end of March. That included the SHA that covers Buckinghamshire. We are in the same position a year later. Each year we seem to go through the same cycle of bulimic funding and cutting. It is a nonsense and the enemy of sustainability. Worse, we do not know the extent of deficits within the national health service because there is no consistent reporting scale for financial deficits within the NHS.
The problem is about historic underfunding, and while I have no doubt about the sincerity of hon. Members, the Tories must take some responsibility for that, as must the Labour Government for sticking to the Tory spending plans. Each year we have the depressing cycle of fiddling figures and engaging in accounting sophistry to try to meet the end-of-year balance. The
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result is an NHS focused on meeting debt and political targets rather than on having the flexibility to innovate, which is what it really needs.
Mrs. Gillan: I think the hon. Lady will agree that the usual methods of tackling deficits are proving less successful this year than ever before. I know this is her first outing as health spokesperson, but surely six years after the Labour Government came into office, it is ridiculous to blame the underfunding in Buckinghamshire on the Conservative Governments of 1997 and earlier.
Sarah Teather: I thank the hon. Lady for her intervention, but part of the problem is that the Labour Government stuck to Tory spending plans, so both must share responsibility.
As we heard, five key issues are relevant to the financial pressures experienced by Thames Valley SHA this year. Recruitment and retention is a problem, particularly within the mental health trust in Buckinghamshire. Nationally, agency staff are predicted to cost the NHS £1.4 billion this year, which is £4 million a day—a tripling since Labour came to power. The Government's solution of an in-house agency seems to have had little effect. We need a long-term approach involving more flexible opportunities to pay more locally. That would allow extra payments for the cost-of-living factors within Buckinghamshire. We need to consider factors, such as inflexible shift patterns, which drive many people away from the NHS, as the Royal College of Nursing said.
Mr. Andrew Lansley: It is possible that the hon. Lady is still familiarising herself with her party's policies, but I had not understood that it was Liberal Democrat policy that local NHS bodies should have the discretion to pay outside the "Agenda for Change" flexibilities. Is she proposing that?
Sarah Teather: "Agenda for Change" does not come on line until later this year. It is our policy to have flexibility at a local level to pay more if circumstances allow.
Compensation payments, based on the ombudsman's ruling on continuing care, are also important but have not been mentioned. It is estimated that Thames Valley SHA could face a cost of £8 million. Would it not be much simpler to budget for care for the elderly in the first place and to pay for it rather than having this ridiculous fiasco now?
Another important factor is the drugs bill. About 70 per cent. of prescribing is done on a generic basis. I want the NHS to use its power as a major purchaser to drive down the cost of drugs within the NHS. There are interesting models in New Zealand, to do with reference pricing.
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): Will the hon. Lady comment on the scale of the New Zealand pharmaceutical industry and how much it spends on research compared with the pharmaceutical industry in this country?
Sarah Teather: It is true that the New Zealand industry is much smaller, but that does not necessarily

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mean that the lessons learned there are not relevant here. A conservative estimate is that we could drive down the cost of drugs by 3 per cent., whereas New Zealand has driven them down by about 9 per cent.
Perhaps most worrying is that Thames Valley SHA has not taken into account a problem that has been identified as a major financial pressure—the delay in implementing the consultant contract, which may cost as much as £5 million. Even when the contract is implemented, it will still be difficult to assess its impact on the health service. At the moment, we count doctors' heads, not whole-time equivalents, so it will be difficult to judge whether the contract will drive down hours.
The last issue of concern is the increased use of accident and emergency facilities, which was mentioned in Milton Keynes. A spokesperson for the Milton Keynes General Hospital NHS Trust said that there was a straight choice between treating patients and meeting financial targets. Ironically, an article in the Health Service Journal last month said that the Government's attempt to make GPs more accessible had made the problem worse because the 48-hour access target had made it more, rather than less, difficult for people to book appointments with GPs.
Buckinghamshire has a variety of financial pressures as a result of historic underfunding and the inflexibility of the funding formula. It is time that we moved away from cyclical debates and considered methods of preventing disease, which would cut the cost of expensive hospital treatments. We should move health care closer to home and hand real control to local government. That would allow a radical integration of health, social services, housing and environment. We could then consider the real causes of ill health and have a national health service—not a national illness service—that would be responsive to local needs.
10.37 am
Mr. Andrew Lansley: I share in congratulating my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) not only on securing this debate but on the manner in which she introduced it. She demonstrated her concern for her constituents and her awareness of their experience of the NHS, both positive and negative. I emphasise in particular the positive support that they give to those who work in the NHS in her constituency. We must understand not only what our constituents are experiencing, but the organisational and financial context in which NHS employees work. Indeed, my hon. Friends the Members for Wycombe (Mr. Goodman) and for Beaconsfield (Mr. Grieve) also addressed that issue, and I, too, wish to touch on it.
A long time ago, and more recently, I became aware of the quality of service delivered by those who work in Buckinghamshire's health services. Nearly 20 years ago, during the winter of 1984, I stayed in Buckinghamshire for some months while Margaret and Norman Tebbit were in Stoke Mandeville hospital. At that time, after the Brighton bomb, we had every reason to be grateful for the remarkable work that the staff did, and continue to do, at that hospital. Three weeks ago, I visited Milton Keynes general hospital and primary care trust, which I shall return to in the context of what the hon. Member for Brent, East (Sarah Teather) said about Milton Keynes.
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My hon. Friend the Member for Chesham and Amersham set out an interesting context for the problems in Buckinghamshire. It is clear that there is red ink right across the Buckinghamshire trusts, from the Buckinghamshire Mental Health NHS Trust, to which she made particular reference, to Buckinghamshire hospitals in general. The Milton Keynes PCT and Milton Keynes general hospital forecast deficits. Something is going on and it is clear that much of it is to do with the relative formula spending share for Buckinghamshire as against need.
We do not need to look far for the solution. I suspect that my hon. Friend already knows that there is hope in our policies because, with respect to the hon. Member for Brent, East, converting the calculation of health spending to a local body and setting up local taxation is not the answer. Inevitably, resource allocation and equalisation measures will distort every effort to achieve that. Putting control in the hands of patients, as our patient's passport intends to do, is the only way to make a difference.
Sarah Teather: Do the Tories have a funding plan for the patient's passport? I believe that it will cost about £900 million in the beginning.
Mr. Lansley: The hon. Lady will have to be patient; she will have to wait only a few days for the plan to become clear.
The patient's passport will put control in the hands of patients, benefiting them through engagement—
Dr. Ladyman: Will the hon. Gentleman give way?
Mr. Lansley: I will when I have finished my sentence.
Patients themselves will be able to engage. The Wanless report says that the engagement of the public with their health care is very important. Such engagement also discloses need rather than relying on formula share, which is especially important where long-term medical conditions such as epilepsy or mental health are concerned.
My hon. Friend the Member for Wycombe mentioned the long-term illnesses experienced by some of the ethnic minority population in his constituency. Those conditions are precisely where direct payment and the ability to control one's health care can empower people. Resource allocation begins to replace formula allocations with disclosed need.
Dr. Ladyman: We cannot allow the hon. Gentleman to get away with fobbing off the question asked by the hon. Member for Brent, East. Whether the figure is £900 million, as she believes, or £2 billion, as I believe, is it not true that the hon. Gentleman's party will put that money, which could have gone into the national health service, into the private sector?
Mr. Lansley: The Minister will also have to be patient. His belief that the figure will be £2 billion is based on a complete misrepresentation of the patient passport. If the scheme has any impact on the resources allocated to the NHS and the private sector, it will simply be to allow what I imagine to be a reduced number of people in the long term to exercise choice outside the NHS in a way

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that does not incur additional costs to the NHS. He makes a different calculation based on the whole cost of the plan and on an exaggerated number of people involved. I will not go down that path.
Sarah Teather: Will the hon. Gentleman give way?
Mr. Lansley: No, because I want to say a few other things.
My hon. Friend the Member for Wycombe raised a couple of important issues. The Minister is keen on asking questions, but he will have to answer some. One question relates to star ratings. Depending on the newspaper that one reads, the Secretary of State is either about to confirm that star ratings will be abolished or about to defend them and announce that they will be maintained. He cannot do both, but it will be interesting to hear the Minister explain the position.
We have made it clear that star ratings should go because they are a crude measure that provides a partial reflection of the situation. It is clear that the loss of some star ratings reflects organisational and financial factors and has nothing to do with clinical quality. As the hon. Member for Milton Keynes, South-West (Dr. Starkey) made clear in the main Chamber, she does not believe that the star rating for Milton Keynes general hospital is an accurate reflection of its clinical quality.
I want to say a word about Milton Keynes, which I visited not so long ago, because its services are trying very hard. I am not sure to whom the hon. Member for Brent, East spoke, but when I talked to people in the accident and emergency department at Milton Keynes it was clear that they had taken exemplary measures over the past few months to deliver what the Government's targets require them to deliver. More to the point, however, they were delivering what they regarded as a better standard of health care for those entering accident and emergency. They did that by innovating. For example, they established a clinical decisions unit at Milton Keynes general hospital. If the staff have one point to get across, as the hon. Lady said, it is that their accident and emergency unit was designed for a fraction of the number of people who are now coming to it.
We cannot explain precisely why the increase in the number of accident and emergency referrals is rising so dramatically, but the capacity of the NHS in Milton Keynes especially—although it illustrates the situation for Buckinghamshire as a whole—in no sense reflects the population and the rising demand. In response to what I heard in Milton Keynes, I said that it is vital that we revisit the whole issue of formula spending shares and how they reflect not only disclosed need in the NHS, but also population changes and characteristics. Staff in Milton Keynes are deeply concerned that although it is possible to go to developers and use the planning system to get money for roads, schools and, to some extent, GPs' surgeries, very rarely does one get money for new hospitals and still less recurrent resources for hospitals. Also, the time lag involved in the work carried out on the 2001 census data means that places such as Milton Keynes are deeply in the red as they try to manage the capacity consequences of existing arrangements.
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My hon. Friends, in particular my hon. Friend the Member for Beaconsfield, who talked about patient experiences, have illustrated what my right hon. and learned Friend the Member for Folkestone and Hythe (Mr. Howard) said yesterday in a speech on the NHS: too often, first-rate medicine is trapped in a second-rate system. We see a lot of that in Buckinghamshire: a second-rate system that is not providing the resources, the capacity or the ability to respond to patients' health needs and disclosed wishes. This issue is not simply about being more efficient with the money available—it was made clear that reference costs, for example at the Royal Buckinghamshire hospital, are below average—but about the ability to reflect the needs of the population. In the short run, it is about that being part of the formula share. In the longer run, it is about shifting to a system, as we propose, that genuinely reflects need and some deprivation indicators when allocating public health budgets. In that way, we can move towards a system that is fairer across the country as a consequence.
I am very grateful to all my hon. Friends and their absent colleagues for their work. I am happy that we have also added something in respect of the problems as they relate to Milton Keynes.
10.48 am
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): I congratulate the hon. Member for Chesham and Amersham (Mrs. Gillan) on securing this Adjournment debate. She and her hon. Friends who represent Buckinghamshire are doing what they ought to do by championing the cause of their constituencies. They make up in enthusiasm for what they lack in accuracy and perspective.
I congratulate the hon. Member for Brent, East (Sarah Teather) on her new Front-Bench responsibilities. I am not convinced that scrapping national pay bargaining and basing the pharmaceutical price regulation scheme on the New Zealand model will be vote winners for the Liberal Democrats, but if she believes that they will be, she is welcome to take that to the country any time she likes.
Sarah Teather: I did not talk about scrapping pay bargaining; I said that there would have to be local flexibility.
Dr. Ladyman: That means scrapping national pay bargaining. That is the opposite of the argument that the hon. Lady and her colleagues deployed a few weeks ago when we debated foundation hospitals. Then, she said that foundation hospitals would pay more and create a two-tier service. She can either hunt with the hounds or run with the fox, but she needs to rethink that.
From the hon. Member for South Cambridgeshire (Mr. Lansley) we heard the first of the new Tory leadership's tax and spend commitments. Whichever way he paints it, the patient passport will transfer money from the national health service to the private sector. I

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assure him that the Government and the country will fight that tooth and nail, and we shall have some enjoyable debates.
Mr. Lansley: Are the Government therefore against spending NHS money in the private sector, at an average of 43 per cent. more than they pay the NHS for the same treatment?
Dr. Ladyman: The difference between the Government and the Opposition is that at all times we adhere to the principle that treatment in the national health service should be free at the point of need. We are perfectly happy for the national health service to buy advice services from the private sector to deliver to everybody in the community, but we are against the system that the hon. Gentleman would introduce, as a result of which many older people would have to spend thousands of pounds of their hard-earned money, with the help of a little extra from their patient passport, to get the treatment they need. If he wants to go down that route, we in the Government are delighted, because it clearly divides the two parties, and at the next election the public will know exactly what they are getting.
Before I focus on Buckinghamshire, I want to establish the general principle that we at the centre do not try to micro-manage the country's health economies. We pass the majority of national health service funding to primary care trusts, which we allow to decide how money is allocated in their areas and how services are commissioned. Therefore, local people are making decisions about the way in which services are configured and money is spent on the different aspects of service. That includes the commissioning of acute services and mental health services. If the balance in Buckinghamshire is wrong, it is in the hands of local people and local PCTs to put it right.
Mr. Grieve: I understand the Minister's point, but I hope that he will be able to deal with the funding disparities nationally, which undermine the argument that similar sums of money per head of population are handed to PCTs to spend as they wish.
Dr. Ladyman: I never implied that similar sums of money were handed to PCTs to spend as they wish. We allocate the money using what we believe is a fair formula. Let me give the hon. Gentleman some examples of the factors that the formula takes into account. If he wishes to intervene and tell me that he disagrees with any of them, he can do so.
The factors include the local population's health need and its level of deprivation; the number of people and the public sector costs in the area; and the rurality of the area, because services must be more disparate in rural areas. The impact on Buckinghamshire of the south-east effect is positive, too. All those factors are taken into account when we allocate funds, and have been when we have allocated funds to Buckinghamshire.
I notice that no Opposition Members are leaping up to say that any of that is wrong. However, the hon. Member for Beaconsfield (Mr. Grieve) had the unusual idea, which I should have thought the hon. Member for Brent, East would have screamed and shouted about, that somehow we should allocate money according not
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to need but demand; because his constituents are more eloquent and more motivated, and therefore demand more services, the Government should hand over more money to them.
Mr. Grieve: Will the Minister give way?
Dr. Ladyman: Let me finish, and then I will give way.
I suspect that the hon. Member for Brent, East has Bangladeshi communities in her constituency. Infant mortality rates in those communities will be nine times that in Buckinghamshire. Is the hon. Gentleman honestly suggesting that, because people in Buckinghamshire are demanding more services, we should be taking money away from deprived communities and giving it to their county? That is a preposterous notion.
Mr. Grieve: I note the tone of the Minister's remarks. I made it clear in an intervention that I fully understand what he says about the question of need. However, I suggest that the Government's formula on need may be missing the point. I have come to the conclusion that there is no correlation between need and demand. If we are not meeting the demand but there is a need for that demand, we will not meet the need in Buckinghamshire.
Dr. Ladyman: The hon. Gentleman makes the same point again. If he has objective reasons for disagreeing with the formula, he should cite them. The hon. Member for South Cambridgeshire, speaking on behalf of the Conservative party, should propose a new formula that could be used by a Conservative Government to distribute money around the country. We would be delighted to look at it—but if it does not take account of need, if it takes no account of poverty and if it does not recognise fairly that many areas have poor health outcomes, we will be delighted to point that out to the public at the next general election.
I shall put the health economy of Buckinghamshire into context. Of the wards in the Thames Valley area, 81 per cent. are in the fourth and fifth least deprived quintiles of the country. Wards in the area of the Wycombe PCT are rated 8,411 in the deprivation indices; the least deprived in the country is rated 8,414. I agree with the hon. Member for Wycombe (Mr. Goodman) that affluence can hide pockets of deprivation. Indeed, 4 per cent. of the wards in Wycombe are in the most deprived category. That is why we need to give the money to local PCTs, which can decide where the need is; they can then ensure that they target the needs of deprived communities.
Mrs. Gillan: I acknowledge the intellectual position from which the Minister approaches the argument. However, he is telling people in Buckinghamshire that they are worth less than half the spending on health care per head than people in Liverpool. I am sorry, but the people of Buckinghamshire are not going to accept that logic. Frankly, the Minister should be interested in levelling up the service, not levelling it down—which is what he is doing by depriving the people of Buckinghamshire of the money that should rightfully be spent on their health.
Dr. Ladyman: I am told that we should be levelling up, and that is exactly what the Government intend doing.

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That is what the formula will achieve. I point out to the Opposition that that is in the context of huge increases in spending in Buckinghamshire. Spending might not be increasing as fast as in some deprived areas, but it is increasing a heck of a lot faster than the Conservative Government would have allowed—and a heck of a lot faster than a prospective Conservative Government would allow.
As a result of the current spending round, Buckinghamshire will see a 30 per cent. increase in spending this year, next year and the following year. An extra £150 million will be going to Buckinghamshire as a result of the Government's spending plans. However the Opposition paint it, vastly more money per head is spent on health in Buckinghamshire now than in 1997.
Mrs. Gillan: It is obvious that the Minister is not going to deal with the detailed points that I and my hon. Friends have raised today. I ask him to read our speeches in Hansard and address each and every point that we and Members who are now absent have made, and to respond fully in writing.
Dr. Ladyman: I am happy to go through Hansard and answer the specific points raised by the Opposition. I am sorry that I have not had time to deal with them all in detail this morning, but—unfortunately—I was limited to 10 minutes.
The important principle that needs to be established is that Buckinghamshire's health economy is receiving huge extra investment. There is no doubt that the challenge is to decide how that funding is to be distributed and managed.

Cannabis Reclassification
11 am
Mr. Nigel Evans: I am extremely grateful for this opportunity to have the first debate about cannabis, post-reclassification. Many of the things that I shall say may not be popular, especially among certain groups. I remember debating the issue with the journalist Melanie Phillips and Keith Hellawell, the old drugs tsar, at the Oxford Union a few years ago. Needless to say, our side lost the vote, but the argument about the dangers of cannabis continues post-reclassification.
Reclassification has meant that, instead of being clubbed together with amphetamines, or speed, and barbiturates, cannabis is classed with tranquillisers and steroids. The Government state that they wish to concentrate their war on class A drugs, but cannabis was never a class A drug, and was always distinguished from crack and heroin. It was always seen, mistakenly in my view, as a soft drug.
"Cannabis is unquestionably harmful, and the dangers associated with its use should be widely known".
Those are not my words, but those of Professor Michael Rawlins, the chairman of the Advisory Council on the Misuse of Drugs, in the council's report recommending reclassification. A document more based on uncertainties and confusion I have yet to read.
Cannabis use has increased over the past 20 years, and there are now roughly 1.5 million users among those aged 16 to 24. The report talks of the acute effects of cannabis use on the brain and the heart and lungs, as well as on other organs. Cannabis constricts blood vessels, leading to higher blood pressure, an increased rate of fainting and an increased heart rate, and can worsen asthma. Cannabis intoxication can lead to panic attacks, paranoia and confused feelings, and in some cases can produce a psychotic state that may continue for some time. Such incidents may, in a few cases, be the start of a long-lasting psychotic illness, usually schizophrenia. Smoking cannabis presents a real health risk, with an increased incidence of bronchitis, asthma and lung cancer, as well as disorders of the heart and circulation. Smoking cannabis may be more dangerous than smoking tobacco, since it has a higher concentration of certain carcinogens. Some severe cases of lung damage have been reported in young people who are heavy users.
Since cannabis use has become commonplace only in the past 30 years, there may be worse news to come. Further research is required, coupled with a public health education programme. Cannabis dependence is reflected in an increasing reliance on the drug and symptoms of withdrawal when users reduce consumption or try to stop altogether. Cannabis dependence was once contested, but has now been established as a genuine problem for which people may seek help.
Unbelievably, everything that I have just said comes from the report that recommended reclassification. I wonder what the report would have had to say for cannabis to have stayed a class B drug. The report is happy to say that the gateway theory is too difficult to state one way or the other, and that the user of cannabis could move on to class A drugs because of peer pressure

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or social deprivation, which I accept. Unbelievably, the report concludes that if people are so well informed about other substances in the class B category, they could go on to those, thinking that they are as harmless or harmful as cannabis. I am amazed at such skewed logic.
I hope that the British Lung Foundation's findings may be a bit more persuasive. The foundation prepared a report on 11 November 2002, "The impact of cannabis smoking on respiratory health". Studies comparing the clinical effects on habitual cannabis smokers with those on non-smokers demonstrate a significantly higher prevalence of chronic and acute respiratory symptoms such as chronic cough and sputum production, wheeze and acute bronchitis episodes. Three to four cannabis cigarettes a day are associated with the same incidence of acute and chronic bronchitis and the same amount of damage to the bronchial mucus membrane as 20 or more tobacco cigarettes a day.
The cannabis smoked today is more potent than the cannabis smoked in the 1960s, when the average content of THC, or tetrahydrocannabinol, was 10 mg. Today the figure is 150 mg, which means that the longitudinal studies carried out in the 1960s and 1970s may not be indicative of the effects of cannabis smoked today. Cannabis tends to be smoked in a way that increases the puff volume by two thirds and the depth of inhalation by one third. There is an average fourfold longer breath holding time with cannabis than with tobacco. That means that there is a greater respiratory burden of carbon monoxide and smoking particulates such as tar than when smoking a similar amount of tobacco.
Cannabis smoking is likely to weaken the immune system. Infections of the lung are due to a combination of smoking-related damage to the cells lining the bronchial passage and the impairment of the principal immune cells in the small air sacs caused by cannabis.
The British Lung Foundation recommends a public health education campaign aimed at young people to ensure that they are fully aware of the increased risks of pulmonary infections and respiratory cancers associated with cannabis smoking. It also recommends that further research is undertaken to take account of the increased potency of today's cannabis and to establish what link, if any, there is between chronic obstructive pulmonary disease and cannabis smoking. I applaud both those recommendations.
I turn to the British Medical Journal. One toxicologist, Professor John A. Henry, talks about the increased THC, but then states:
"Tetrahydrocannabinol has cardiovascular effects, and sudden deaths have been attributed to smoking cannabis. Myocardial infarction is 4.2 times more likely to occur within an hour of smoking cannabis".
He adds:
"More studies of the cardiovascular and pulmonary effects of cannabis are essential".
I back that statement. He has extrapolated a figure from tobacco deaths of 30,000 for cannabis smokers, but chillingly adds:
"Even if the number of deaths attributable to cannabis turned out to be a fraction of that figure, smoking cannabis would still be a major public health hazard. However, when the likely mental health burden is added to the potential for morbidity and premature death from cardiopulmonary disease, these signals cannot be ignored".
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He says:
"A recent comment said that prevention and cessation are the two principal strategies in the battle against tobacco. At present, there is no battle against cannabis and no clear public health message".
Paul Flynn: I hope that the hon. Gentleman is so convinced by his own argument against smoking that from today he stops selling cigarettes from the convenience store in Swansea in which he has an interest—that he will stop his own drug pushing. If he believes that the change in the law was not beneficial, why is it that after 20 years of regulated, policed, licensed decriminalisation of cannabis in the Netherlands, there is less use of cannabis in all age groups and it is often used there in safer ways by ingesting it in ways other than smoking?
Mr. Evans: I am extremely grateful that the crusader on behalf of decriminalisation of, I suspect, any drug has been able to make it to this debate. He always adds the little gibe about the fact that I own a tobacconist's in Swansea. If he is arguing with his own Government that they should ban tobacco as well, at least let him be brave enough to say so. I would recommend to people that, although tobacco is a legal product, they do not smoke, because of the dangers that I have mentioned.
From what the British Lung Foundation and the BMJ have said, I hope the hon. Gentleman understands that this product is different from tobacco. I know that it is thrown in with tobacco and alcohol, but it is not the same. I hope that what I am going to say later will reinforce that argument but also contest some of his arguments about what is happening in the Netherlands. I will let him intervene later if he so wishes.
In November 2002, the BMJ said:
"The link between cannabis and psychosis is well established, and recent studies have found a link between use of marijuana and depression…a three year follow up of a Dutch cohort of 4045 people free of psychosis and 59 with a baseline diagnosis of psychotic disorder showed a strong association between use of cannabis and psychosis. Length of exposure to use of cannabis predicted the severity of the psychosis, which likewise was not explained by use of other drugs…
"A 15 year follow up of an adult community sample of 1920 participants in the United States showed that use of cannabis increased the risk of major depression at follow up fourfold…
"The shown dose-response relation for both schizophrenia and depression highlights the importance of reducing the use of cannabis in people who use it. It was estimated that lack of exposure to cannabis would have reduced the incidence of psychosis requiring treatment by as much as 50% in the Dutch cohort, and is similarly reflected in the Swedish cohort, showing that the use of cannabis increased the risk of schizophrenia by 30%. This large effect is surprising and not yet reflected in an increased incidence of schizophrenia in the population. If true, the use of cannabis will contribute to more episodes or new cases of the illness—food for thought for both clinicians and legislators."
The journalist Melanie Phillips has recently written about the fact that much of what I have just said, and all the studies that point to the mental as well as other ill effects of smoking cannabis, are just being ignored. Sir Michael Rawlins and his committee either did not read all those studies or came at the issue with preconceived judgments that no studies would have altered.
I understand that the Home Secretary agonised over his decision to reclassify cannabis. I hope that he did more than just agonise. In its 1997 manifesto, his party said:

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"The vicious circle of drugs and crime wrecks lives and threatens communities. Labour will appoint an anti-drugs supremo to co-ordinate our battle against drugs across all government departments. The 'drug czar' will be a symbol of our commitment to tackle the modern menace of drugs in our communities."
Sadly, the drugs tsar did not last long. He was sacked, and we have not had a proper annual report for more than three years. I cannot remember when we had a full debate on drugs in general, and not just on reclassification—a debate that we had not so long ago. Keith Hellawell, the former drugs tsar, said that reclassification has produced "a muddle" and undermined police powers in the field.
"Cannabis arrests have been steadily coming down within the confines of the existing law. Why change it, why cause a problem, why cause confusion, and why—I am sad to say—encourage in some respect greater drug taking, particularly by young people, who don't know where they stand?"
He added:
"The real issue is that the Government has given a message that cannabis is less dangerous than it was perceived to be, and they have given that message at a time when every medical institution is saying 'we are worried about the dangers, we don't know sufficient about it, and we believe the dangers are even greater than we perceive them to be at the moment.'"
The Police Federation chairman, Jan Berry, said:
"I am deeply worried that many people will see the reclassification of cannabis today as decriminalisation and we will see a rise in the number of users finding themselves drawn into a life of drugs and crime.
I would rather have seen the time and energy given to reclassify cannabis used more effectively for education and treatment programmes."
The Metropolitan police chief, Sir John Stevens, said:
"I think there is a massive amount of muddle about where we are on cannabis."
He said that he regretted the Brixton experiment. The hon. Member for Vauxhall (Kate Hoey) stated that the experiment in Lambeth led to drug dealers pushing harder drugs into the area, using their cannabis client base.
The Liberal Democrat MEP, Chris Davies, recently said that he wanted people to be able to grow cannabis in their own homes. The front page headline of the Lancashire Evening Telegraph read, "Let's have a cannabis plant in every front room—MEP". Chris Davies really is the most stupidest politician I have ever come across. He is the wackiest by a mile. It is totally irresponsible of him to say that. Youngsters will listen to people like him and think, "Oh, if a senior politician says it's okay, it must be okay."
Stories in recent articles by Melanie Phillips should send a shudder down anyone's spine. They are about the effects of cannabis use, and how it leads to suicides, depression, ruined lives and deaths. She goes through all the science, and like her, I am mystified about why the science is being ignored. I know that many people operating in the drugs field have always been pushing for reclassification. Some, such as Mike Trace, the former drugs tsar's deputy, and Roger Howard, believe that the harm reduction method and a softening of the approach are the right way forward. Melanie Phillips points to the fact that the use of cannabis has doubled
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among Dutch schoolchildren—so that experiment is failing. I know that the hon. Member for Newport, West (Paul Flynn) has different figures, but Melanie Phillips contests what he believes and says that the use of cannabis among Dutch schoolchildren is on the rise.
Kate Hoey: I congratulate the hon. Gentleman on raising the issue. I think that we, as a Government, will live to regret what we have done. Will he comment on the difference between the Swedish approach and the Dutch style? In Sweden, people start off with the clear view that they want a drug-free society. The combination of prevention and education, plus the criminal aspects, has meant that fewer people in Sweden are involved in any drug taking than in Holland and this country.
Mr. Evans: There is the attitude that Sweden is permissive on this, but it is not. Surely we want a completely drugs-free zone and policy in this country, too. It is important to get the right balance. Using the law without education is completely pointless. We are relaxing the law, but we have not quite got the education in place either. That will lead to further problems. We should get both right together. If cannabis is as dangerous as all the experts are saying, surely to reclassify it and place it in the same class as slimming tablets and antidepressants is wholly mistaken, and raises the question why the Government embarked, panic-stricken, on a £1 million campaign saying, "Hold on, cannabis is still illegal," when the message had already gone out. It is ironic, even perverse, that the Government can spend £6.5 million, which they did last year, on anti-smoking advertisements, yet they can find £1 million for a campaign on cannabis.
Paul Flynn: It is a shame that the hon. drug pusher cannot provide anything better than a journalist from the Daily Mail to argue against the recommendations of the Wootton report and the reports of the Select Committee on Home Affairs, the House of Lords Science and Technology Committee and the Advisory Council on the Misuse of Drugs. A range of reports have been published in which the science goes against what he is saying. We now have evidence from the European Monitoring Centre for Drugs and Drug Addiction and from the Council of Europe, saying that the result of the action taken in the Netherlands in separating soft drugs from hard has been the reduction of cannabis use in all sections of society and a reduction in the number of deaths from the use of hard drugs.
Mr. Evans: I thought that the vast majority of my speech was based on science. I referred to the science produced by experts from the British Lung Foundation and toxicologists writing in the British Medical Journal, who are drawing on the Dutch experiment, the New Zealand experiment and the United States experiment. I understand that the hon. Gentleman has a different point of view, but whatever the science on which he and I are relying, surely the right thing to do is to carry out yet more research, which is what the British Lung Foundation and the BMJ want, before we draw conclusions. He is citing contestable science, as I am, but instead of trying to work through the issue and get more research done, the Government have decided to reclassify.

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Surely we need more research and more education. It has been proved that smoking cannabis is much more damaging to the lungs and the heart and carries a greater risk of cancer than cigarettes, yet the Government have just spent £6.5 million asking people not to smoke cigarettes. I find it bizarre that they should reclassify cannabis and send out all the wrong signals. Their drugs policy is a shambles. In my time, it has lurched from strong to weak, from bold to bland, from coherent to confused, and from determined to downright dangerous. We need more research, not woolly thinking. We need to carry out research into the current level of experimentation, not increase that level.
The Government have got it wrong, and the consequences are frightening. Even now, they should have the guts to send out a fresh signal that we will revert to the old policy until all the research has been properly analysed and a fresh committee of experts has reconsidered the issue. Agonising over the wrong decision is simply not good enough. Turning our backs on the science, and therefore on a generation of youngsters, is totally unforgivable.
11.19 am
The Parliamentary Under-Secretary of State for the Home Department (Caroline Flint): I thank the hon. Member for Ribble Valley (Mr. Evans) for securing the debate. Adjournment debates are a good opportunity to discuss a wide range of issues that hon. Members do not necessarily get the time to discuss on the Floor of the House.
In many respects, the hon. Gentleman may be surprised that the Government agree with some of his concerns about cannabis and its effect on health. There are health issues surrounding cannabis, as there around all the class A, B or C drugs that we control. As was mentioned today, there are also issues relating to tobacco, and alcohol could be mentioned in the same breath. In some respects, the reclassification of cannabis has given us the opportunity to discuss the relative harm caused by different drugs, which has been a useful exercise.
One of the reasons why we wanted to address the issue was that before reclassification, cannabis, as a class B drug, was in the same category as amphetamines. Amphetamines are stimulants, and it is scientifically proven that they are more addictive than cannabis and more likely to be linked to psychotic episodes, they cause aggressive behaviour, they are more harmful to the heart, in that they raise blood pressure, and an overdose can be fatal. In addition, they can be injected, and there are many harm issues associated with that. How could we categorise cannabis with amphetamines—suggesting that they do equal harm—and then have a meaningful and credible discussion with those who might be using or thinking of using cannabis, given that it is clear that the harmful effects of amphetamines far exceed those of cannabis?
The Advisory Council on the Misuse of Drugs considered in depth a range of issues. Professor Robin Murray has been very involved in recent weeks in heightening awareness of the link between people who have had mental illness and drug abuse and drug taking—there is concern not just about cannabis, but
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about the use by people with mental illnesses of other drugs, illegal and legal. When I was involved in an interview in which Professor Murray took part he was asked whether, regardless of everything he had said about the dangers of cannabis, he supported reclassification. I think that I am right in saying that his answer was yes. We are discussing the relative harm that drugs can do, and we have never said that cannabis is not a harmful drug. However, our classification has to have substance and signify the relative dangers of different drugs. It must communicate to everybody—to young people in particular—the impact of those drugs.
The advisory council considered the issue in some depth in relation to mental illness. Although it concluded that there is little significant evidence of a causal link between cannabis use and the development of mental illness, particularly schizophrenia, undoubtedly cannabis use can worsen a mental illness that already exists. It is clear that heavy cannabis use can produce a psychotic state, although that is, in most cases, short-lived. Amphetamines can create that state as well, with far more serious long-term consequences.
Kate Hoey: The Minister mentioned Robin Murray. Is she aware that Robin Murray said that the drugs advisory group had nobody on it with expertise in psychosis? It is not addiction but the link with psychosis that is the problem. She has quoted Professor Murray in one context. Will she accept that he criticised the make-up of the committee?
Caroline Flint: A number of people were involved in the discussion, including psychiatrists and psychopharmacologists, and evidence was given by a number of people. There was significant expert input, both from those on the committee and from those who gave evidence to it. As has been mentioned by my hon. Friend the Member for Newport, West (Paul Flynn), the Home Affairs Committee also took evidence on the issue in some depth. Professor Murray, while drawing attention to the relative harm of cannabis for those with mental illness, stood by the view that we need to make the public, in particular those who might habitually use cannabis, aware of the situation. For many, it might be a one-off, or something that does not lead to a regular habit, but there are significant health issues for those for whom the use of cannabis, often mixed with other drugs, is habitual. He stood by what he said, which was that reclassification is the right way forward.
Sir Michael Rawlins, in a letter published in The Times on 23 January, said:
"The Advisory Council…concluded that there is little significant evidence of a causal link, particularly with schizophrenia."
Most of Professor Robin Murray's research was known to the advisory council when it was producing its cannabis report, and it is of the view that any new evidence produced since does not affect the overall weight of evidence, or its conclusions about health risks. That is not to say that we do not continually watch this area. The council examines the evidence for all drugs in all categories.
Mr. Evans: Can the Minister confirm or deny what Melanie Phillips wrote—that Customs and Excise is now not bothered about proactively searching for

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cannabis, that it is interested only in the class A stuff and that it seizes cannabis only when it is looking for other drugs?
Caroline Flint: I cannot comment specifically on that, but I can write to the hon. Gentleman on that point. There have been operations that have resulted in large amounts of cannabis being seized, but he is quite right—often in those situations there may be cannabis as well as other drugs. He may be aware of the announcement yesterday of our intention to set up the Serious Organised Crime Agency. Combating drug trafficking will be an important part of its work. He will be well aware that the maximum penalty for dealing in or supplying cannabis remains 14 years, despite reclassification—another message that we have been keen to get across.
Paul Flynn: My hon. Friend has brought a new voice and new thinking to this issue. Was she as moved as I was by the evidence given to the Home Affairs Committee by Mr. Fergus Gillespie and other parents of young people who have died as the result of the use of heroin? Mr. Gillespie said that the false and exaggerated messages about the danger of cannabis meant that his son and others did not believe the message about hard drugs, and so progressed to them from soft drugs. He was in favour of reform of the kind that the Government have just implemented.
Caroline Flint: Addiction has a terrible effect on a family. Not only do class A drugs damage individuals and families, but many young people are involved in crime to fuel their drug habit. Our criminal justice interventions programme tries to stop the revolving door of people committing crimes to feed their habit, getting into prison and coming out the other side. Whatever different views on cannabis might be expressed in this Chamber today, this Government are spending more money than ever before, to tackle not only treatment issues but the criminal justice issues in this area, which were forgotten by Governments before 1997. That is a welcome change, which has added to
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more public discussion than ever before on the connection between treatment, prison, charging and tackling crime in our communities with those affected by it in an open and positive way. That is the right way forward.
The hon. Member for Ribble Valley mentioned the strength of cannabis. We do monitor that. These issues are dealt with by the Forensic Science Service. There have been reports of levels up to 20 times stronger than 20 years ago, but that is not borne out by the evidence. The data collected by the Forensic Science Service indicates that some new products on the market have THC levels two or three times greater than those of other cannabis products, particularly the home-grown variety, but that is not a matter of course.
Sir John Stevens said that there was muddle. Of course, before any law change there is going to be uncertainty about how it will operate. That is why the Government and police need to communicate the changes effectively, both to the public and to front-line officers, which is what we have done. In the final part of his interview on LBC, he was asked whether he supported reclassification, and he said that he did.
Any change in the law means that we must consider what information we give out. The £1 million that we spent on this campaign was partly to pay for radio and newspaper advertising. That is the cost of some of these public information campaigns, although I have said to the media that if they would like to give us those spots for free we would be very grateful. We must have a credible discussion with people about these different drugs, and in particular we must give young people opportunities to access services. It is important with this reclassification that we talk to those under 18, to find out whether there are other issues that we need to attend to to stop them moving on to other drugs.
This debate over the past few weeks has been very important, because probably more has been said about cannabis than ever before, and that is welcome for public debate and democracy.
11.30 am
Sitting suspended until Two o'clock.

Strategic Waste Authority
2 pm
Dr. Alan Whitehead: Historically, dealing with waste was relatively simple. People put whatever they produced into their dustbin, a man came and collected it and took it away. The same principle applied to industrial waste, by and large, and the main concern for local authorities was to find a new tip when the old one was full. I think that it is fair to say that no recycling to speak of took place except for the marginal effects of totting at tips. I imagine that that is why we still place some 78 per cent. of household waste and some 50 per cent. of our industrial waste in landfill—the modern name for the tip. Frankly, we love our tips, and we are far more addicted to putting waste in them than any other country in Europe.
Over the past few years, waste has become far less simple. We now know that those landfills, and especially completed landfills that have been covered over, give rise to 25 per cent. of the methane produced in this country. Methane is a global warming gas that is four times as potent as CO2. In the tips that produce that methane lies thoughtlessly discarded rotting waste that could, by and large, have been recycled, recovered or reused.
We also know that the ability of the local authority to find another tip, as it would have done in previous years, is seriously constrained. In short, we are running out of holes. The Environment Agency recently estimated that we have about 10 years' worth of conceivable landfill left in London, and perhaps as little as five years' worth in the north-west. Meanwhile, of course, we continue to produce more and more of the stuff. Although the increase has abated a little in recent years, waste arisings are increasing by about 2.5 per cent. a year. Incidentally, that means that even though, as a result of increased recycling, we have marginally reduced the percentage of waste going into landfill each year, the amount of waste going into landfill continues to go up, because of the overall annual increase in waste produced.
As a country, we have so far completely failed to do what we have successfully started to do with energy consumption—decouple increased industrial and consumer activity from waste generation. Since the early 1970s, our primary energy consumption has remained roughly stable, while our gross domestic product has doubled. Waste, on the other hand, has faithfully tracked the increase in GDP all the way. Although we are having some success in recycling waste, there are few, if any, signs that we are about to produce less of it.
Among other things, our inability to deal strategically with the growth in waste makes us slow to respond to and implement the other recent phenomenon in terms of waste: the plethora of European Union directives that have arisen over the past three or four years. In 2001, there was the EU waste packaging directive, followed by the UK waste packaging regulations. In 2002, there was the so-called WEEE directive—the waste electrical and electronic equipment directive—and we followed earlier EU regulations by introducing our own end of life vehicles regulations. In the past year, there was the hazardous waste regulation, the EU ban on whole tyres going to landfill and the introduction of producer
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responsibility obligations for direct mail. In the next year, there will be producer responsibility obligations for batteries and a ban on co-disposal. In 2005, there will be pre-treatment requirements for all waste going to landfill. In 2006, there will be a ban on abandoned shredded tyres going to landfill, and there will be targets for organic waste disposal. The changes from the EU that require the UK to implement waste regulations are all far-reaching, and some overlap.
Mr. David Drew: My hon. Friend will know that the Select Committee on Environment, Food and Rural Affairs is about to bring out a report on the end of life vehicles and waste electrical and electronic equipment directives. I will not go into detail, but it was obvious, from the evidence that we received, that there is some doubt in the industry about whether the Government can deliver what was signed up to, because of the difference between objectives and action. Does he agree, and if so, what would he do about it?
Dr. Whitehead: I thank my hon. Friend for making that important point. There are overlaps between some forthcoming directives and there is a problem with clarity. On the subject of where one directive stops and another starts, a representative of the Environment Agency, who gave evidence to the Environment, Food and Rural Affairs Committee, on which my hon. Friend sits, said:
"The battery in the vehicle: is it caught by the End-of-Life Vehicles Directive? Is it caught by the forthcoming Waste Electrical and Electronic Equipment Directive? Is it caught by the Batteries Directive? Or is it caught by the Hazardous Waste Directive?"
One criticism introduced by a Select Committee from another place, which the Environment, Food and Rural Affairs Committee may be considering, is that the Government's participation in the early stages of the formation of those directives was, by and large, reactive rather than proactive, and that sometimes they considered the consequences only when the process was too far down the line.
The UK's record of transposing EU directives is far from spectacular. There are five cases against the UK outstanding in the European courts for failing to implement waste-related directives on time. Sometimes we implement directives, but do not spot the implications—the recent fridge mountain is a living testament to that—but I am confident that that will not be repeated with the forthcoming directives on end of life vehicles and on tyres. However, there is a general feeling that various Departments are not as coordinated as they might be when dealing with the representations necessary to introduce those directives in the EU and implement them in the UK.
Non-implementation means fines: we may well end up being fined about £180 million a year if we do not make the landfill directive work. If we are to avoid that fine, we must rapidly reduce the amount of waste going to landfill. The Waste and Emissions Trading Act 2003 established a cap on the amount of waste allowed in landfill, and there is now a trading mechanism between those local authorities that are ahead of their targets and those behind them. There is also a rapid escalation of the landfill levy in sight after 2005.

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Although those measures will make a significant change, we will still have the problem of what to do with the waste that has not then gone into landfill. I produced some research a while ago suggesting that, as things stand, it is likely that most of the diverted waste will be incinerated—an outcome, as we know, only just above landfill itself in the waste hierarchy.
If we do not incinerate that diverted waste, a large number of waste handling facilities will have to be established over the next few years. The European Environment Agency estimates that, if we are to meet the requirements of the landfill directive, some 27 million tonnes of biodegradable municipal waste will have to be diverted from landfill by 2016. That means that one new management facility able to process 40,000 tonnes of waste will have to be built every week for the next 14 years. To put it mildly, there are legitimate doubts about whether the planning process can accommodate such a programme.
Mr. Barry Sheerman: I am not against incineration as long as it is a balanced part of waste treatment. However, given that on average it takes eight years to get planning permission for an incinerator, are we not in danger of moving to mechanical biological treatment? In most places, this treatment has been thrown to one side—they no longer do it in Sweden, because it is ineffective. These are no answers to the crisis we face.
Dr. Whitehead: My hon. Friend underlines my point. Either we incinerate or we use alternative measures. The incineration process will take quite a while to come to maturity, given the likely development span of the planning process and the resistance in various parts of the country to new incinerators. If we go down a different path—for example, a larger number of smaller plants—the planning process will last for a similar period.
My central point is that we must decouple ourselves from our historic insistence on burying almost all the waste we produce. The consequence of doing so, and of dealing effectively with the waste directive, is that we face a difficult future as we try to reach our targets and produce a different pattern of waste management nationally. For example, my hon. Friend the Member for Huddersfield (Mr. Sheerman) is a substantial expert in the reuse, reclaiming and recycling of materials, which is one of the routes we need to take. We will have to escalate how we do all that at a local level, so that we can take that element of the waste out of the waste stream and away from landfill.
Mr. Drew: When we talk about "recycle and reuse", we often leave out "reclaim". Does my hon. Friend agree that the Government should put reclamation at least on a level footing with reuse and recycling? For example, when any building is taken down, the bricks, wood and any other material should all be made available for use. That material ends up in landfill. If we were to move in that direction, that could only help.
Dr. Whitehead: Indeed, my hon. Friend makes an important point. We normally talk about domestic
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waste, but it makes up only some 7 per cent. of the waste stream. The rest is made up of various industrial and commercial wastes, a substantial part of which are materials arising from activities such as digging up roads and knocking down buildings. Some materials are already systematically reclaimed for reuse— —for example, hardcore is recycled for foundations and road building. Ensuring that such material is systematically made available for reuse and that it is put high up the hierarchy begin to make a difference.
Mr. Sheerman: If there is no focus, no leadership and no strategy, we will again miss opportunities. Wembley stadium was knocked down and destroyed, and all of it went into traditional holes in the ground. The Minister is shaking his head, but that information came from the contractor, who said that the remit was to get rid of it.
Dr. Whitehead: My hon. Friend anticipates what I am coming to. He also emphasises the fact that the way in which we have historically dealt with our waste hangs over into an era in which we know that we must deal with it differently. This is not just a question of changing public recognition of what we do with domestic waste. The public can no longer simply put the rubbish in the bin outside the front door and go back into the house thinking that that is the end of the matter. So also with industrial and commercial practices, someone can no longer decide that a building can simply be demolished, as Wembley stadium was, and the whole of it sent to a hole in the ground.
Sue Doughty: It gets even worse. It is right to reuse such material, preferably as close as possible to the place of generation, but when virgin plywood is used in shuttering and fencing at the Home Office building in Marsham street, not only are we failing to handle what we have, but we are importing wood from dubious sources just to ruin it and throw it away again.
Dr. Whitehead: The hon. Lady makes an important point about the other end of the process. When we have put everything into a hole, too often, with a new building, we then replace what we have put in a hole with material that we need not source as new. We tend to have systems in place that encourage us to do that and discourage us from doing otherwise. Indeed, the point made by my hon. Friend the Member for Huddersfield about the extent to which building material should be available should be underscored with the idea that, just as we consider the percentage of recycled material in products generally, we should consider the extent of regulated recycled materials in new building as part of the building regulations. Again, the way forward may be a method of co-ordinating such matters.
Miss Anne McIntosh: If the hon. Gentleman accepts that the recycling and recovery of waste costs more than landfill, will he put pressure on the Government? Five years after his Government signed up to the landfill directive, they have still not set the standard for treating hazardous waste. Is it not fair to provide a lead to businesses on what standards will apply, to enable them to make the resources and investment available to meet those standards?
Dr. Whitehead: The hon. Lady exhibits psychic powers, because it says here in my notes that there is

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a similar issue with hazardous waste. As she said, hazardous waste must now be separated from non-hazardous waste on disposal sites. Some 450 sites accept hazardous waste, but, depending on the estimate, that will shrink to between 25 and 30 as the directive is implemented. As things stand, we shall probably need urgently to re-provide receiving facilities for hazardous waste that are separate from traditional disposal sites. It is not clear whether a market in which companies invest and open new receiving sites will be enough to bring this change about. The Government will have to consider urgently the need to review the progress of separating out the disposal of hazardous and non-hazardous waste by taking a market lead and through structured change, rather than assuming that the market will fill the gap, as it becomes apparent that those sites are unlikely to be available in the near future.
Local authorities continue to be in the front line of the need for rapid change in dealing with municipal waste. Outside the big cities, they are divided into waste collection authorities and waste disposal authorities. There are many examples of good practice among consortiums of waste management authorities, and many more examples of partnerships between waste management authorities and waste collection authorities. They are, however, often the result of happy accident rather than design. Members who sat on the Committee that considered the Waste and Emissions Trading Bill may recall the problems that arose when trying to write into legislation a requirement that the collection agency should separate out waste in a way that would allow the waste disposal authority to deal with it in the optimum manner.
I hope that I have described the increasing complexity of issues relating to waste and the urgency with which we need to address them. The question is how we deal with the emerging palette of problems and possible solutions, which will require careful planning and a great deal of collaboration and partnership, as well as a rapid increase in momentum over a relatively short period. Currently, we deal with them through various Government bodies nationally and locally. The Department for Environment, Food and Rural Affairs takes the lead on domestic waste, the Department of Trade and Industry deals with elements of the management of commercial and industrial waste, and the Office of the Deputy Prime Minister is responsible for funding local government and relations with it, and for planning waste management. The Treasury has a substantial hand in providing push and pull incentives for waste diversion and minimisation through green tax initiatives. The Environment Agency has a substantial role in the regulation of waste and in the development of hazardous waste inspection and disposal. As I said, various Departments have the role of discussing, negotiating and co-determining European Union directives.
In recent years, there have been substantial Government initiatives on waste, from the establishment of the national waste plan in 2000 onwards. The landfill tax credit scheme was reformed in proportion to the funding. Every year, almost £100 million is redirected to a new sustainable waste
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management programme. A new waste implementation programme—WIP—will be run by DEFRA. It has similar funding behind it, and it will undertake a package of strategic measures that were recommended by the strategy unit's investigation, "Waste Not, Want Not". For some time, we have had the waste recycling action programme—WRAP—which examines the ways in which markets might be provided for waste so that the supply and demand for new products from waste can match up in the future. In addition, there are several local authority programmes and a new delivery team and steering group. A review of the health and environmental effects of waste management and disposal, particularly of incinerators, is also under way.
Positive steps are being taken, but we still do not have targets for minimisation, which is imperative, or a realistic chance of meeting our other national targets for recycling and reuse. Unless we start at the top of the hierarchy in relation to minimisation in the near future, even if we have a better chance of meeting the other targets, we will simply be recycling and reusing it and diverting more waste from the larger arisings as they continue to mount up. Under those circumstances, we would not be able to adapt quickly enough to the changes required by the landfill levy, as my hon. Friends the Members for Stroud (Mr. Drew) and for Huddersfield mentioned.
Therefore, in my view, we need to be able to focus and co-ordinate in a way that we have hitherto failed to do. That is why I believe that the time has come to consider seriously the establishment of a strategic waste authority. The strategy unit report recommended that such co-ordination is necessary:
"A review should be undertaken to assess the merits of focusing all waste policy in one Department".
In their response to the report, the Government accepted that recommendation. They agreed that there should be a review on the merits of focusing the waste policy, and asked the Cabinet Office to carry one out. At the time of the response to the strategy unit report, the review was stated to be due for completion by the end of 2003. We are a little beyond that date—not far, but I anticipate the arrival of the report on that recommendation at a fairly early stage.
I do not envisage that a strategic waste authority would be a vast new quango. It would not require huge new offices, substantial new staff or large amounts of new equipment. It could recruit its staff from existing personnel. It would comprise technical specialists within the Environment Agency policy team, plus appropriate waste specialists from DEFRA. It would have a number of key strategic requirements and perhaps be responsible for the development of a national data reporting infrastructure. We need data to understand where we are now in order to plan effectively for the future, and we certainly do not have them in any way at the level we require.
The strategic waste authority would investigate and improve proprietary technologies in line with best practice and with emission criteria decided by the Environment Agency. It might develop operating standards for those technologies that cover organic and inorganic material processing through gasification as well as mechanical and chemical means. It might develop improved communication infrastructures with

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the Office of the Deputy Prime Minister with specific reference to developing and implementing the introduction of those various technologies in the UK regions. working with established specialists in the planning system to see how that system might accommodate the substantial changes that need to be implemented in waste management systems.
The authority would certainly have a role in agreeing acceptance dates for EU directives, looking at those EU directives early on and considering the implementation timetables in directorate-general XI. It would therefore have a clear strategic function. In doing that, it would not need to second-guess or remove local functions and initiatives. If we are to make the progress that we need to make in changing the nature of waste management, we need local initiative to flourish. Contrary to the view that a strategic waste authority would remove that initiative, having a clear way forward housed under one roof and co-ordinated between Departments would surely encourage it.
Miss McIntosh: Does the hon. Gentleman imagine that such an agency would be housed within DEFRA and act as the interlocutor with other Departments? He appears simply to be recommending that we should have another structure, whereas the message coming from industry appears to be that there is a lack of political leadership. How does his proposal overcome that?
Dr. Whitehead: I disagree with the hon. Lady. The issue that I am attempting to focus on is beyond even political leadership—and I emphasise that there has been rising awareness in the Government of the urgent need to change the nature of waste management in this country. There have been substantial political initiatives. Part of the problem is that the delivery of political initiatives—whatever is decided on, however strong that political will is—tends to be dissipated by the way in which the management of waste is organised. I would envisage that a strategic waste authority would be sited within DEFRA, but would bring together the fractured nature of waste management at a national and strategic level. That is the case I have tried to make today, from what is apparent. The authority would work with the Environment Agency and with DEFRA, but would have a single focus of activity at the centre of the Government, to bring that political will to bear on making the changes with the rapidity that is needed.
No change in our waste management strategy condemns us to a gradually more unmanageable and failing waste system. Eventually, slowly but surely, we will become engulfed in the rubbish we create. We are changing, but too slowly. A strategic waste authority is not in itself a solution—it would not make the change in its own right— but as a method of driving change
forward, quickening the pace and ensuring that the changes made work to the best result, I think we need it. I hope that the Government review agrees. If the review does not agree, perhaps the Government themselves will, having listened to the logic and the compelling case that I have laid before them today.
2.32 pm
Mr. Barry Sheerman: I am delighted to be here to participate in this debate, as I had a speaking engagement in Cardiff this morning and did not think that I could get back in time.
I shall try to be brief. I want to reinforce some of the arguments of my hon. Friend the Member for Southampton, Test (Dr. Whitehead), because he is also one of the small band, at least three of whose members are in this Room, which may be in danger of getting a rather quirky reputation in the House, because we are so interested in waste. A key element of environmental policy should be dealing intelligently with the waste products in our society. I am of a more practical bent than a blue or green skies person. Our old Etonian friend Jonathan Porritt should get on with the blue-sky thinking while we get on with the more practical stuff that can help save our environment and do something about global warming and much else.
Waste is a very complicated matter that goes to the heart of our environmental concerns. One serious worry is that environmental concerns have slipped down the polls every year in terms of public perception and of their priority in the hierarchy of issues in which the population are most interested. Environmental concerns have slipped down, but I can guarantee that, like all these things, they will come back into fashion. The environment will return as a much greater public concern, and the waste sector will increasingly lead into that concern.
I have several interests to declare. I am chairman of Urban Mines Ltd., a not-for-profit organisation that sees the waste flowing from our towns and cities as a new raw material that we mine for new processes to obviate the need to dig holes in the earth's crust and take virgin material. I started the organisation in 1995. It now employs 28 people and is recognised as a leading authority in this area. We help in starting small businesses that use waste as a raw material. I also helped in the plot to establish the parliamentary sustainable waste management group and am a member of Lord Lewis's Onyx environmental watchdog panel, of which he is chairman. We keep an eye on how environmentally sound major waste management companies are.
I know a bit about this issue. In respect of the "joinedupness" that several hon. Members have mentioned, the complexity is amazing. One of the problems with DEFRA is that it has never taken waste seriously enough. Personnel change too fast, so people are not kept in the Department and on the job long enough. When I take my experts into DEFRA, we are lucky to see the same people twice. Indeed, because of the policy of keeping people in a job only so long once they get the knowledge that it can give, they are moved on. DEFRA therefore has a central weakness in understanding waste issues, and I worry when my hon. Friend the Member for Southampton, Test says that the strategic waste authority may be based solely in DEFRA.
Sue Doughty: Does the hon. Gentleman share my frustration about the following issue? What happened to the knowledge in the old Department of the Environment, Transport and the Regions and all the work that it was doing on such things as hazardous

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waste? Where did that knowledge go? Surely it did not fall down a crevasse, because that team moved across to DEFRA, but there has been no continuity.
Mr. Sheerman: I agree with a great deal of that. DEFRA must take the waste sector much more seriously. It is no excuse to keep spinning off back-office operations such as WIP and WRAP—there are many other acronyms—because we know that they are less accountable than DEFRA when they are spun off. If a strategic waste authority is to emerge from the current process of policy making and consultation, we must ensure that it is properly accountable to Parliament.
The DTI plays a major role in how we manufacture things, provide services and products and use raw materials, and in why we cannot use standardised, reworked raw materials instead of taking virgin material. What standards can we lay down for the industry to ensure that alternative raw materials are seen as reliable and as good as what they replace? The DTI has its fingerprints all over waste, and it has often not taken that role seriously enough or been innovative enough when talking to the private sector. Since the European directives have begun to hit, however, the private sector has been far more effective in reducing the percentage of waste going to landfill than local authorities and others. It is the domestic waste stream that has not performed well. Given the right incentives and communications, and of course the tax incentives, industry has responded pretty fast.
The regional development agencies are now very much involved in waste. Because the DTI is largely their agency, every RDA to which one talks is involved. Some do not rank the environmental sector or environmental clusters high enough, but they are involved. The Environment Agency is intimately involved. When it was formed by the previous Administration, many good people in waste left for pastures new because they could see that the agency's priority would be the rivers and that side of the environment. There is no doubt that there was an exodus. Again, valuable people who knew about the waste sector left it.
The Office of Deputy Prime Minister is also involved. If you only knew, Mr. Hurst, how complex it becomes when every so often, in looking for the resolution of a particular waste problem, we have to go to the Office of Deputy Prime Minister and look into the planning process. I shall give an example. This is a Government who want to build new housing in the London gateway as part of a massive expansion of housing in the southeast. One of the people who gave me that information is the head of one of the biggest land banking operations in the country, a company that is part of another business, but has a large amount of property, much of which is unfilled. When the hazardous waste regulations are introduced, it will no longer be possible to put contaminated soil into landfill. It does not take much imagination to agree with my private sector expert that only 20 per cent. of landfill in our country has the capacity to take the material that will now be designated hazardous—contaminated soil. That will mean one of two things: either the development in the London gateway will not be possible or the contaminated soil will be stored throughout the country in goodness
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knows what condition. The problem is serious and affects many of the major developments that the Government are keen to see, such as the London gateway.
As I said, it takes seven or eight years to receive planning permission for an incinerator. The Government were brave and bold in their first couple of years in office, and they had a Minister who said that we needed 170 incinerators to get the balance right—a figure that has moved around a bit. They then saw that incineration might not be so popular with the great British public and retreated from that position as fast as they could, or they were, at least, told to do so. There is an incinerator in the heart of my constituency and I believe that incineration is not an environmental or health problem when it is conducted in accordance with modern standards and European regulations. As part of the solution, incineration is a good answer.
The Office of the Deputy Prime Minister is at the heart of the process and is involved in upgrading the planning regulations that touch on such matters. We cannot ignore the links between planning and the strategic waste authority or between what happens in DEFRA and other Departments, because those things are joined at the hip. Even the Department for Education and Skills is involved. I am concerned with that Department as part of my day job, because I am Chairman of the Select Committee on Education and Skills. Both the high-tech answers to the problem of replacing old plastics with new and the new techniques for dealing with waste will, like any other innovation, come from the research programmes and efforts of our universities.
Such programmes will be conducted in partnership with the private sector—there is the rub. There is so little profit in the waste sector at the moment that many companies are selling out or being taken over. The will to remain is not as strong as one would think. There are some good people in the waste management sector—my hon. Friend the Member for Southampton, Test and I know them well—but they are pretty demoralized because of the ruthless logic that they face.
There is no certainty because of the European regulations. People are asking, "When are they coming in? How fast will they be? How seriously will the Environment Agency implement them? How rigorous will they be? Is DEFRA going to derogate at some stage? What are the rules of competition?" Not only do people not know what to invest in or when to invest, but their bankers will not lend them the money. The problem is easy to identify but much more difficult to solve. The waste sector will not make capital investments in sophisticated equipment, whether it is a materials recycling facility, biological or mechanical treatment methods or anything else, because there is no certainty that such investments will ever make a profit. That goes to the heart of the problem.
I was clocking up the things that my hon. Friend mentioned, and I think that he left out Customs and Excise, which is also intimately involved in this issue. The landfill tax is increasing by £3 per tonne, thank goodness, although we all heard on the bush telegraph that the increase was going to be £5. The Treasury was quite keen on the increase, as was DEFRA, but the CBI went to the Department of Trade and Industry, which

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said in turn that the CBI would not wear that rate. I have never understood the logic of that position, but down the rate came to £3. That is not enough, but it is still better than under the previous regime.
A great deal of money is flowing in from the landfill tax, and the amount will get bigger each year. We can do something creative with that resource, but we will not solve any problems if we fritter it away on small, back-office operations such WIP and WRAP. We must do something much more dramatic. Customs and Excise has a hand in the matter, as does the Treasury. The people who will have to make the decisions are the Chancellor's advisers. To get to the heart of the matter, one has only to go to the Treasury and to talk to Ed Balls about what he considers the proper regime for environmental taxation, the level of landfill tax and much else. Indeed, the Economic Secretary to the Treasury actually knows something about the subject. I have seen the eyes of Ministers responsible for the environment and environmental taxation glazing over when I have mentioned such things, but this Minister understands it and I have great respect for him.
I was disappointed by No.10's policy discussion paper, which was not what any of us had been hoping for. However, No. 10 knows about the issue and has its sticky fingers on it. As a member of the Liaison Committee, I said to the Prime Minister last Tuesday that whenever the Government get into difficulties in delivering policy, we can see that the weakest link is the sharing of responsibility across many Departments. The Education and Skills Committee knows how complex it is to assess the skills deficiency, as skills are covered not only by the Department for Education and Skills, but by the Department for Work and Pensions, because it has a responsibility for Jobcentre Plus, the new deal, intermediate labour markets and so on. Furthermore, the Department of Health is involved in a massive amount of training, the DTI has a great role in skills and so on.
It is difficult to deliver co-ordinated and focused policy on skills, but waste is an even more difficult matter. That is why my hon. Friend is absolutely right to say that we need a strategic waste authority. We have been saying that for some years and nobody has listened, so I am heartened to learn that the proposal is being seriously considered. I would like a big, freestanding strategic waste authority with real powers to be based in a proper part of the country—in Huddersfield, in my constituency. That would be much better than locating it in Banbury. What on earth is WRAP doing there? The same applies in Guildford, which does not need the authority as much as we do.
Sue Doughty: While I do not support the proposal for a strategic waste authority, I point out that, if one were established, Guildford would be an interesting location for it, given that people there want a waste strategy. We might disagree about incineration, but we do not disagree about the need for a strategy.
Mr. Sheerman: I am reminded that, during Prime Minister's questions, the hon. Lady's predecessor used to talk about "inner-city Guildford". I used to scratch my head and think that that was an interesting concept.
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As well as a strategic waste authority, we need some refreshing, joined-up government. It must be joined up, because the problem will otherwise get worse. We do not need derogation, which would be awful, and we know that the motor for change is in Europe. If we expected local authorities to be at the cutting edge of progressive and innovative methods of dealing with waste, we would wait for results for a very long time. A few take recycling rates seriously and adopt innovative approaches to waste strategy, but the former chief executive of a major metropolitan authority has told me that when groups of chief executives in some regions get together, waste is at the bottom of the agenda. It is not sexy or interesting and it is not taken seriously. The people recruited by local authorities to deliver policy in that area are not often the most exciting on the management team. A crisis is waiting to happen, and the situation is getting worse all the time. I think that the Minister knows how bad it is. As a pragmatic, open-minded chap, he will also know that something dramatic must be done to tackle the problem.
The last issue that I want to raise is the Environment Agency. Although it plays a tremendous role, it could play a much bigger one and it needs to be freed up. In Sir John Harman, my old council leader in Kirklees and Huddersfield, the agency has a great leader and chief executive, and he has a really good team. I can imagine a re-energised DEFRA and a liberated Environment Agency with a bit more independence from the Department. Why on earth can the Minister not cut the agency free so that it is much more independent and can give the Government a bit more grief? I can also imagine a strategic waste authority working closely with its partners. If such arrangements existed, we could get rid of all the bits and bobs that have been created over time to put a sticking plaster on the problem. All the evidence suggests that a joined-up solution requires joined-up government, and a strategic waste authority is the appropriate answer.
2.51 pm
Sue Doughty: I congratulate the hon. Member for Southampton, Test (Dr. Whitehead) on obtaining the debate. The issue greatly exercises those hon. Members present and, I think, much of the public, who ask what we are doing about waste and how we decide what to do. Although I do not agree with his solution, his analysis is absolutely right: no change is not an option. This is a matter of urgency and we must deal with some grave issues.
The proposal was, I think, born out of frustration, and the speeches that we have heard so far have been characterised by frustration. By implication, if DEFRA, as the Department that holds the ring on the issue, were doing its job properly, there would be no need to call for a strategic waste authority. However, I cannot buy into the idea of setting up another quango, whether or not it is part of DEFRA. In any case, quangos eventually split off and disperse. What we need is political leadership.
In its May 2003 inquiry on the future of waste management, the Select Committee on Environment, Food and Rural Affairs said:
"We are concerned that Defra still appears to lack the capacity, the vision, the sense of urgency and the political will to break the mould and bring about truly sustainable waste management."

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Setting up a strategic waste authority would cause more delay and give the Government something to hide behind. Hazardous waste has been mentioned. One of the big problems faced by members of the Environmental Audit Committee when we asked the Secretary of State for Environment, Food and Rural Affairs about that before Christmas was her incredible complacency. As I said, we need leadership, not another body to carry out the necessary tasks.
The hon. Member for Huddersfield (Mr. Sheerman) mentioned the Liaison Committee. When the Prime Minister was asked about the environment, he parried the question and moved on to the next one—the issue is not on his agenda. That remains the case and setting up an alternative organisation will not change that.
The point about the dead hand of the Treasury was eloquently made, and I, too, would have raised it. Setting up a new agency will not remove that dead hand. We can have report after report, difficulty after difficulty, but if the Treasury will not pay, nothing will happen. The problem is the lack of co-ordination. One of the key roles of DEFRA and, to an extent, the Department of Trade and Industry is to implement EU directives and regulatory measures, such as the WEEE directive. Indeed, progress towards sustainable waste management has been driven by the EU. Usually, EU measures come through, we change a few words, call them Bills and implement them, but at the same time we duck the opportunity to introduce a proper waste Bill.
The Environmental Services Association said in evidence to the House of Lords European Union Committee that the UK's implementation of European waste law has occasionally been chaotic. I cannot disagree. We learned from an answer given on 2 February 2004 that the Department for Environment, Food and Rural Affairs has met only seven of the 55 transposition deadlines for an EU directive. I am not sure that a separate strategy unit would change what is going wrong with regard to waste-related failures and the four-year derogations that we are having to use for the landfill directive targets. Fortunately, the Minister was not in post at the time of the refrigerator fiasco, so we can quickly move on from fridges to other things, such as hazardous waste.
I have been bidding for a separate debate on hazardous waste for several weeks. It would take a full hour and a half to debate that subject. As we still have not seen a draft proposal, industry is not able to invest in new sites and facilities. Indeed, the final regulations on what business should be doing to manage the problem will not be finalised until after they are supposed to have been implemented. The final regulations will come into effect in September 2004, yet the provisions are required to be implemented by July.
The Minister says that every now and then we can build a cell in a landfill site. I understand that the only time it was ever tried it was so expensive and difficult, and so impossible to run, that no one wants to do it again. Shanks has looked into the problem, but it has no intention of putting cells into landfill sites to take hazardous waste.
Another problem is that such a solution would allow only for non-reactive waste. The Government do not know how much hazardous waste is non-reactive. I was told this in a written answer:
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"The Special Waste Regulations 1996 (as amended) do not require producers of special or hazardous waste to record whether or not waste being produced or disposed of is non-reactive." —[Official Report, 6 January 2004; Vol. 416, c. 265W.]
However, we have solutions that are supposed to deal with that.
We need a clear legal framework, with long-term regulatory certainty, before we can invest in the sites and the necessary technologies. Is DEFRA going to review its approach to the implementation of EU directives to ensure that industry has sufficient lead time? We are chewing the carpet and not getting anywhere because of DEFRA's lack of strategy.
As the hon. Member for Huddersfield said, there is a lack of co-ordination between Departments. How much is being done to ensure that producers design waste out of their products and processes? The Department of Trade and Industry had to be told by the strategy unit that it needed to look at the British Standards Institution standards on recyclates because the standards supported by the DTI worked against their use. The Department also failed to co-ordinate with the Environment Agency on the WEEE directive, which led to unacceptable delays in producing the information needed for businesses to plan and implement their strategy. Another problem was the failure to coordinate with the ODPM on planning reform, although I shall not say much about that because it has been well covered and the point well made. We need clear guidance and we want it to balance local interests with the need for communities to take responsibility for their own waste. Those are also problems for us to address.
On green taxes, why did it take so long for the landfill tax escalator to be speeded up? Why did it take so long to reform it so that the income could be directed to sustainable waste projects? Why do we not have an incineration tax? Those are Treasury questions, and something should be done about them.
The failure to ensure sufficient and secure funding for the waste management sector is another problem. Again, I doubt whether a strategy group or an agency would achieve that. We need to double the money that we spend on domestic waste to levels similar to those in other European Union countries. It is no wonder that we fail. We do not invest to succeed; we underinvest to fail. Then, irony of ironies, we have to pay the fines when we fail and we waste money.
There is a funding gap. The Environmental Services Association believes that we need to double the money spent on the management of domestic waste. Do the Government accept, however, that they need to increase funding? If they think that is wrong, what do they think should be happening? Those are leadership issues, not necessarily agency issues. Have they made a real estimate of the number of facilities needed? We get some answers but we need to meet those commitments. We have already got to the concept of waste management and discussed the number of facilities, the different types of facility and whether they are for fridges, clinical waste or hazardous waste, but where is the money coming from?
Local government and the Environmental Services Association would again favour a permissive power for local authorities to use direct charging for waste services. When combined with the variable charges for

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the amount or content of waste, that could be a valuable driver for recycling and waste minimisation. We must find out whether it could work. There were plans for a pilot scheme, but what has happened to it? We want to know why local government cannot be trusted to make decisions on the matter. There are stoppers in the system. Innovative local authorities say, "Could we do this?", but they are not getting the support.
We do not see much progress on waste. The items that have been introduced have not explained the lack of progress. I do not understand how a strategic waste authority would solve the problems when leadership is so absent. I am not against DEFRA; my husband worked for it in a senior position until just before I was elected. I know some of its people very well and I want the Department to be allowed to succeed and get on with what it should be doing.
For a long time we have had excuses, such as the loss of expertise when the Environment Agency was set up. However, it has been established for nine years and the Government are only now recruiting staff to DEFRA to deal with the problems that it has been unable to tackle. The hon. Member for Southampton, Test suggested that staff need to be recruited. If it is true that there is a shortage of staff and that people poach each other's staff, I should like DEFRA to be given the opportunity to train, develop, promote and recruit good staff to strengthen its team so that it can move forward instead of remaining inert.
When a quango is set up, there is a new body, chief executive, premises, including newly rented premises from some other organisation, new letterheads and a pension scheme. DEFRA has too many quangos and I cannot understand how one more is a good idea.
Mr. Sheerman: Perhaps the hon. Lady misunderstands the point that my hon. Friend the Member for Southampton, Test and I made. We want to get rid of some existing quangos and replace them with something effective.
Sue Doughty: I thank the hon. Gentleman for that. If we could identify the quangos that should go and those that should take schemes under their wing, there would be a case for some responsibilities going to them. I am not convinced that they would solve some other problems within the Government, however. I take his point that there need not necessarily be a new organisation, but a reformed one. Similarly, some duties could be passed on to the Environment Agency.
Tribute was paid to the agency and its management. I share in that tribute. At its inception, it could have been a weak organisation that concentrated mainly on rivers, water and sewage. It has grown in ability and expertise and has gained the respect of us all over the years. It is one of the few non-governmental organisations about which I would say, "Let it grow more," because of the quality of its work in placing checks and balances on the Government, business and the community and its leadership.
DEFRA needs to be run much better. The House of Lords European Union Committee examined the development of waste policy in Europe. Its report said:
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"The UK has a poor record of influencing EU waste policy. It needs to operate at a more strategic level."
It went on to call for a
"far greater level of collective working within Government, overseen and co-ordinated by a dedicated unit at the centre with the task of ensuring clear accountability to successes and failures."
I agree with that. DEFRA must be responsible for coordination. It is not in dispute that more integrated coordination across the Government is required.
Britain fails to negotiate European directives on the one hand and then fails to implement them on the other. Somehow we must find the energy to go back and negotiate with the European Union. We must develop single points of information for stakeholders. The Office of the Deputy Prime Minister seems to communicate with councils and others effectively. Any council that has received a letter about potential capping of the council tax knows how quick off the mark the ODPM is on such matters. The quality of communication and publications from DEFRA and the Department of Trade and Industry—for example, the WEEE directive—could be improved. A common approach is needed and the Government must work cross-departmentally. Another agency would well and truly guarantee that the Government will lose the plot, if they have not already done so.
3.6 pm
Miss Anne McIntosh: I congratulate the hon. Member for Southampton, Test (Dr. Whitehead) not just on securing the debate but on securing it at a timely juncture. However, I ask him and the Government to look cautiously at the model that he outlined, given that the Government are studying another agency, the Strategic Rail Authority, most carefully. That agency, which was set up by the Labour Government, has fragmented the industry even further and may be disbanded. My starting point is to ask why he wants to create a new agency when the Government are probably considering streamlining existing agencies in other areas.
Mr. Sheerman Mr. Sheerman rose—
Mr. Alan Hurst (in the Chair): Order. The hon. Lady is not giving way.
Miss McIntosh: Thank you, Mr. Hurst. I was most interested in the comments of the hon. Member for Huddersfield (Mr. Sheerman) and would like to respond to some of them later.
The industry makes a clear point—the hon. Member for Guildford (Sue Doughty) touched on this—that the Government, and the Departments that were identified in the contribution of the hon. Member for Huddersfield, are not demonstrating joined-up government or political will and leadership. Why would the Government consider a new authority now? How would they pay for it? I understand that £1.5 million has been suggested for the first year, presumably to set up the agency. Where would the money come from? Would it involve additional funds for the Environment Agency or would it be taken from its budget or DEFRA's? Several hon. Members spoke at great length about the role of the Environment Agency. From its website, it

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appears that the additional responsibilities should lie with it, working as it does under DEFRA's umbrella. The website states clearly that the agency's role is to regulate waste management through a system of licences.
Waste is material that people discard at home or at work because it is no longer needed. I was struck by the answer on tonnage given by the Minister for the Environment. In a recent reply, he stated:
"According to the most recent Municipal Waste Management Survey, about 28.8 million tonnes of municipal waste were collected in 2001–02. Of this, about 22.3 million tonnes were disposed of to landfill, 2.5 million tonnes were incinerated, and 3.9 million tonnes were recycled." —[Official Report, 4 February 2004; Vol. 417, c. 906W.]
The Government have a dilemma, as there is an increasing gap between the amount of waste sent to landfill and the amount allowed under the landfill directive. The Minister will have picked up on that concern, which was expressed by several hon. Members.
My first question to the Minister is, why is there a need for a new waste authority? I want to know why we cannot strengthen the waste unit, as I would prefer, possibly under the Environment Agency. What would the additional cost of £1.5 million cover? Would it cover purely the introduction of additional bureaucrats, or would some of the bureaucrats be officials brought in from other Departments? Where will the money come from—an increase in the budget for DEFRA, or its existing resources? In the latter case, funds would be diverted from other projects.
The hon. Member for Huddersfield identified a very confused situation. Let me focus on some agencies. DEFRA leads with the responsibility for waste policy in England, and has residual responsibility for co-ordination across the UK. The Treasury leads on fiscal instruments. The DTI leads on producer responsibility and policy relating to industry. The Office of the Deputy Prime Minister leads on planning issues in relation to land use and local government. Not many colleagues have focused on the role of local authorities, but they are the key delivery partners when it comes to making a success of the Government's waste strategy, and they face a confusing array of policies and funding streams.
Will the Minister respond to what he understands the concerns of the industry to be? I understand that it has identified three. It wants more regulatory certainty and a greater lead-in time, so that it can make the required investment that we have identified. It also needs more funding. That funding has to come from central Government and the industry itself. Finally, it needs a less complicated and more streamlined planning process. That would allow UK waste companies to invest in the thousands of new facilities that will be required.
Is the Minister aware that the European institutions are about to agree the amended directive on packaging and packaging waste? By 31 December 2008 at the latest, the UK will be required to recover a minimum of 60 per cent. of waste, in terms of waste volume, or to incinerate it in incineration plants with energy capability. Between a minimum of 55 per cent. and maximum of 80 per cent. of waste, by weight, should be recycled. In relation to incineration, we might have regard to what is happening so successfully in countries such as Sweden and Denmark. They have a deservedly
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high reputation for being committed to green environmental policies, and they incinerate large quantities of their waste. I understand that most of the incineration is smokeless and that most of the incinerated waste benefits the local community through distance warming. Has the Minister's Department given some thought to that? The lead-in, in terms of planning policy, to what would presumably be a new style of plants in the UK would be substantial.
The hon. Member for Southampton, Test is a brave man. He is the only person to date who has recommended a specific strategic waste authority. In evidence from the Environment Agency that was included in the report by the Environmental Audit Committee, it was stated that the strategic waste authority
"could be a single body",
or that there could be
"provision for enhanced roles for one or more existing organisations."
Neither the Environment, Food and Rural Affairs Committee nor the Environmental Audit Committee recommended the establishment of a single strategic waste authority. I agree with all those who have expressed their concerns about the plethora of legislation coming from the European Union, and the implications for the waste industry and waste management when it comes to recycling, incineration and landfill.
On the debate on Wembley, I was led to believe at my local tip that wood is the single most difficult product to dispose of. It cannot easily be recycled and used in other buildings.
I reiterate that what is lacking is strong political leadership, and it is far more important to develop that than to focus on restructuring. That is precisely the viewpoint expressed by the industry. The model of the strategic waste authority may not necessarily be the best; we could beef up a separate unit within DEFRA or, more specifically, within the Environment Agency. We look to the Minister to demonstrate that the Government have the necessary political will.
3.15 pm
The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Mr. Ben Bradshaw): I congratulate my hon. Friend the Member for Southampton, Test (Dr. Whitehead) on securing the debate and apologise that my hon. Friend the Minister for the Environment could not be here to reply. As I am sure hon. Members are aware, he is the Minister responsible for waste, but he is otherwise engaged in a debate in the Chamber on an Opposition day on the environment in general. He sends his apologies.
I am afraid that I am not sighted on some detailed questions, and in particular those from the hon. Member for Vale of York (Miss McIntosh). I will ensure that my hon. Friend writes to her with answers to those questions and those of other hon. Members which, having had a very short time in which to brief myself on the subject, I am not in a position to answer.
My hon. Friend the Member for Huddersfield (Mr. Sheerman) rather unkindly suggested that people concerned with waste are quirky. He may feel quirky, but this is a serious subject. Having listened to the

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debate it is obvious that it is not only serious but complex, as one or two other hon. Members have said. That came through in the fact that there are a number of different ideas on the way forward—an indication of the difficulties that would face any Government trying to get to grips with this important environmental problem.
I would like to outline where the Government have made some advances, on which my hon. Friend the Member for Southampton, Test was generous enough to touch. We have made waste one of our Department's six key priorities. One of the most exciting areas where progress is being made is in the increase in recycling figures. We are finally beginning to see the fruits of those policies, not only in the hard work of local authorities but in Government action. Initial estimates suggest that England had a recycling and composting rate of 15 per cent. in 2002–03, with an increase of about 2 per cent. on 2001–02. That means that we have broken the 1 per cent. increase barrier for the first time, which is very encouraging. With a similar increase in 2003–04 we will meet our target of 17 per cent. for that year.
Although we still have a challenging target to meet in the next couple of years, my officials were confident this morning that it is achievable. Some local authorities are already achieving it, and we anticipate an increased rate of improvement in the coming year once the benefit of some recent and new initiatives is realised. They include, as Members have said, the national waste minimisation recycling fund and the waste implementation programme, about which I shall say more in a moment.
The landfill directive targets on the horizon also present a test. However, we are making good progress in developing the landfill allowance trading scheme. Building effective working relationships is an essential part of that work. Hon. Members touched on where responsibility for waste lies. Currently, the strategic lead lies with DEFRA, with the DTI leading on some producer responsibility initiatives. The Environment Agency, sponsored by DEFRA, is responsible for regulating waste management facilities and other bodies, including the ODPM, the Treasury and of course local authorities, are all important in the development of policies.
My hon. Friend the Member for Huddersfield complained that this is a classic example of where many Departments are responsible for a particular issue. It is not unique: yesterday we were discussing a number of complex issues involving the tragic circumstances in Morecambe bay and the practices of gangmasters. I know from the experience within our Department that making progress on those issues is not always straightforward because the questions involve and impinge on the responsibilities of a number of Departments.
The Waste and Emissions Trading Act 2003, which was granted Royal Assent in November, provides for a unique system of tradable landfill allowances for waste disposal authorities across the UK. The system, known as the landfill allowance trading scheme, is intended to help England to meet the targets set by the 1999 landfill directive to reduce the amount of biodegradable municipal waste we send to landfill. This is one element
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of DEFRA's waste implementation programme, which is rolling out a number of initiatives recommended in the strategy unit report. Others include waste minimisation programmes and the expansion of home composting.
We are also providing support to develop new infrastructure for recycling and associated education programmes. We are improving our data and carrying out research on waste management to provide a sound evidence base for policy development, implementation and monitoring. We are introducing incentives to encourage the take-up of alternative technologies for waste treatment. The programme team is working with local authorities and stakeholders across the whole supply chain. A high-level steering board, which brings together senior figures from industry, local government and central Government, and retailers, has also been established to drive forward the implementation of the programme.
Further measures announced in the Government's response to the strategy unit report include a commitment to raise landfill tax by £3 per tonne in 2005–06, and at least £3 per tonne in each year thereafter, up to £35 per tonne. The Government have established a hazardous waste forum, and we are introducing regulations under the EU animal by-products regulation, setting out rules for composting catering waste. As hon. Members will be aware, the Government have increased the environment, protective and cultural services block funding to local authorities, part of which is for waste management. The increase announced at the last spending review was 1.3 per cent. per year, in real terms.
Miss McIntosh: We are all most grateful that the Minister has been able to respond to this debate. Is he able to give us a global view on what the Government's priorities are? Do they intend to show the political will to respond to the industry's needs, to comply with the EU directives, or rather set up another quango and more bureaucracy?
Mr. Bradshaw: I shall get on to that in a moment. The Government are interested in policies and structures that work and that contribute to the amelioration of this very serious problem. The fact that we have made it one of our six strategic objectives is significant, as is the fact that we are investing ever more extra resources in this issue. I shall come on to the structural question shortly.
The Government also recently announced a £20 million extra grant for 2004–05 to help with some spending pressures arising from waste management for local authorities. Linked to these central-local government relationships is DEFRA's work with the ODPM, including work on the development of the planning system. Enabling adequate and timely provision of waste management facilities will become even more important as the demand for such facilities increases. My Department is closely involved in the revision of PPG10—the planning policy guidance note that sets out national planning policy on waste management. The revision is part of the Government's drive to streamline planning policy to give greater clarity in terms of the outcomes to be achieved. The ODPM expects to consult on a draft of the new planning policy statement in the first half of this year.

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The DTI, which leads on the implementation of the waste electrical and electronic equipment and end of life vehicles directives, and DEFRA, which works with it on the implementation of these directives, are committed to a more cross-Whitehall project team approach. Both have dedicated project teams and interdepartmental advisory groups, with the body of best practice starting to grow.
I turn now to the question of the overall responsibility for waste, in response to the strategy unit report. The Cabinet Office was commissioned by DEFRA to carry out an internal review of existing arrangements and consider the scope for improving the co-ordination of interdepartmental responsibilities for waste policy. A limited consultation was undertaken with interested parties, and the review will consider the views of all the respondents. That means not just a single person—quite a lot of respondents made the same point as my hon. Friend the Member for Southampton, Test. The strategic waste forum's proposals for a strategic waste authority will be considered, alongside all the other responses. The review began in December, is well under way and will conclude in the spring. I am not sure of the reasons for the delay, but I will happily find out and inform my hon. Friend.
Mr. Sheerman: It is very important that we also get the planning guidance. What is the ETA on that?
Mr. Bradshaw: I am afraid I do not know, but again, I will find out and write to my hon. Friend.
I listened with interest to the vision outlined by my hon. Friend the Member for Southampton, Test detailing how he envisages such a strategic body would work. As he explained that, I was thinking about the review going on within and outside our Department, under Lord Haskins, and the recommendations he has made. Some points that he made about the value of separating policy from delivery and having a single strategic body consider a particular policy had considerable weight. As I said at the beginning of the debate, I am not an expert on the matter, but I shall certainly take those points back to my hon. Friend the Minister for the Environment, who leads on the issue.
The hon. Member for Vale of York slightly jumped the gun by assuming that there are already plans to set up such an authority. She even talked about an amount
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of money. We have not got that far yet. We are still waiting for the report on the work of the Cabinet Office committee—perhaps she knows more than I do.
Miss McIntosh: To satisfy the hon. Gentleman's curiosity, the source of the figure is the excellent House of Commons Library note, in which I discovered that the Government have confirmed that the amount of £1.5 million will be available. Perhaps it illustrates lack of joined-up government if his Department does not know where that is coming from.
Mr. Bradshaw: The Cabinet Office is reviewing the responsibilities for waste generally. It is considering proposals from others as part of its review. The £1.5 million referred to is the additional administrative resource that DEFRA is contributing to the establishment of the waste implementation programme to help local authorities to meet their landfill directive targets. I hope that that is helpful to the hon. Lady.
Dr. Whitehead: Will my hon. Friend underline the fact that if a strategic waste authority came into being it is precisely such programmes that would be subsumed within it, rather than it being an additional expense, with new staff and costs?
Mr. Bradshaw: I take that point, but I was going on to say that whatever the view one takes of my hon. Friend's suggestion for a strategic waste authority—my hon. Friend the Minister for the Environment is open to persuasion on the matter—there would still have to be an interface with other Departments, devolved Administrations and external stakeholders.
It is often difficult to know where the boundary lies between products and waste, and the priority for our Department is to ensure that these relationships are forged and reinforced now and maintained in the future. The way in which we work could, without exaggeration, be described as already acting as a virtual strategic waste authority. It may not work perfectly, as several hon. Members have said—[Interruption.] My hon. Friend the Member for Huddersfield is laughing at the notion of a virtual authority, but I think he is being unkind.
I would also suggest that the significant increase in resources that my Department has dedicated to waste is one element helping to ensure that relationships are improved. I am grateful to my hon. Friend the Member for Southampton, Test for raising the topic for debate. We have sympathy in the Department for the aims of his proposal, and we await the outcome of the Cabinet Office review with great interest.

Duchenne Muscular Dystrophy
3.28 pm
Kevin Brennan: This is the second time that I have secured an Adjournment debate on the issue of research into treatments and a possible cure for Duchenne muscular dystrophy, but I make no apology for returning to the subject for a second time in the Chamber. I do so not only because this is a terrible disease of which people know little, and which many have never heard of, although it is of a similar prevalence to better known conditions such as cystic fibrosis, but because I believe, as do many of the young people and parents who are affected by the disease, that for the first time in many years there is genuine hope of an effective treatment, and perhaps even a cure. More importantly, that belief is shared by many eminent scientists working in the field, to the extent that they are setting aside their traditional differences and, in many cases, their individual pursuits, to pull together and to pool their efforts to find a treatment and perhaps eventually a cure for Duchenne muscular dystrophy. Perhaps the only thing that they lack is adequate resources for undertaking the necessary research to unlock the prize of a treatment and eventual cure for the disease.
Duchenne muscular dystrophy is the result of a gene defect that causes the body not to produce a vital substance called dystrophin. Without that substance, muscle cells become weaker and gradually waste away. The condition is regarded, wrongly, as relatively rare. In fact, it affects about one in every 3,000 boys throughout the world, although there is some dispute about the exact figure. In other words, every Member is likely to have constituents who are affected by this disease. I certainly have such constituents. This is a very cruel disease —if it is appropriate to attribute a human trait to the result of a genetic lottery.
Most parents who are affected believe that they have a healthy baby son, as any normal parent would, until the symptoms begin to emerge when the child is a toddler. I say "most" because a test, which is now carried out routinely in Wales, can inform parents of the presence of the disease while the child is still an infant. That can be very important, because parents may want that information if they are planning to have more children. The test may help them to take decisions about their family in future.
Whenever the diagnosis is made, the result is the same. Boys with Duchenne muscular dystrophy can expect to be wheelchair-bound by the age of 11 and to become progressively more disabled throughout their teens as their muscles gradually waste away. At this stage of their lives, the availability of the latest high-tech wheelchairs can have a huge impact. Many of these boys are high achievers in school and do very well in their studies if they have the right support. According to parents to whom I have spoken, however, the availability of such wheelchairs varies greatly throughout the country. I ask the Minister to look into that issue.
In their final years, young men with Duchenne muscular dystrophy will require 24-hour care, night-time ventilation and feeding support. Although improved ventilation helps to extend life, the disease is
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fatal. Young adults are likely to die in their early 20s as a result of heart or lung failure as the vital organs become too weak to sustain life.
The disease is often hereditary, but it can also occur by spontaneous mutation, so even very careful genetic screening could not eradicate it completely. My interest in the disease arose when my constituents, Nick and Janet Caplin, brought their son Saul to my surgery a couple of years ago. It was very hard to believe that the lively toddler whom they brought to see me had, as they put it, a death sentence on his head. Nevertheless, he had been diagnosed with the disease, and Nick and Janet helped to set up a charity, Parent Project UK, to campaign with other parents and families affected by the disease for even more research into treatments and eventually a cure. They have now moved out of Cardiff, West, and it is a testimony to both the closeness of the parental network of Duchenne muscular dystrophy sufferers and its prevalence, which makes my point that the disease is not that rare, that their home was bought by another couple from Cardiff, West, Lisa and Gareth, whose son loan also has Duchenne muscular dystrophy. This is an extremely poignant week for that family, because it is the first anniversary of Ioan's diagnosis, which was made through the screening to which I have referred.
No one could fail to be moved and inspired by the courage and humanity of couples such as Nick and Janet and Lisa and Gareth, and of many other families whom I have met through my interest in this terrible disease. Sympathy is not enough, particularly now that the scientists are telling us that new developments offer hope for sufferers of Duchenne muscular dystrophy. Since the previous debate on the subject, Parent Project UK, the Muscular Dystrophy Campaign and the Duchenne Family Support Group, the three main charities with an interest in the condition, have got their act together and joined forces to act as a catalyst for more research to be undertaken into the disease. It is highly commendable that they have pulled together to try to make progress and to maximise the synergy that they can obtain from working together.
Last September, a group of us met Lord Warner at the Department of Health. I went along as chair of the all-party group on muscular dystrophy, which was set up as a result of my meeting with Nick and Janet. It was a fruitful meeting and an exciting research proposal was put together. There was a fairly stiff deadline, and I pay particular tribute to Jenny Versnel of the Muscular Dystrophy Campaign for her work in burning the midnight oil to submit the proposal by the deadline. The proposal was put together to bid for £2.5 million of funds that were set aside and earmarked in the Department of Health's commendable genetics White Paper. which was published last year. It is also commendable that the money was set aside specifically for research into single-gene disorders such as Duchenne muscular dystrophy.
I understand that the bid is under consideration and that it is going through peer review, so the Minister is probably limited in what he can say about it at this time because it will be considered with all the other bids for that money. Before a final decision is taken. I want to emphasise to him what a successful bid would mean to the morale of families affected by Duchenne muscular

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dystrophy, as well as of the scientists who formed the consortium, joining together centres of excellence from around the United Kingdom.
Let me illustrate the calibre of some of the people involved who are champing at the bit to get on with the research project. The project will be overseen and managed by the highly regarded Professor Kay Davies at the university of Oxford, and individual parts of the research will be undertaken by Professor Francesco Muntoni at Hammersmith hospital; Professor Kate Bushby at Newcastle medical centre; Dr. Qi Lu at Imperial college, London, who is a tenured member of the research staff of the Medical Research Council; Dr. Dominic Wells, reader at Imperial college, London; Professor George Dickon at Royal Holloway college, London, with Dr. Ian Graham of the same institution; Dr. Matthew Wood, also at the university of Oxford; and Jenny Versnel, whom I mentioned earlier, the head of research at the Muscular Dystrophy Campaign. Many of those eminent researchers came to a conference organised by Parent Project UK and the Muscular Dystrophy Campaign in the autumn, which I attended.
Recently, Professor Terry Partridge of Imperial college, who is also part of the consortium, came to the House of Commons to address the all-party muscular dystrophy group. At that meeting, at which many parents of boys affected by Duchenne were present, he said that he was usually extremely cautious about raising hope, particularly with regard to something like Duchenne muscular dystrophy, because it would be cruel to raise anybody's hope about a certain piece of research. However, he saw real promise in the approach suggested in this research proposal, perhaps for the first time ever.
I want to outline what the research proposal involves. In recent years, studies undertaken in mice and on human cells in the laboratory have shown that it is possible to produce a sort of molecular patch that could enable dystrophin to be produced in muscle cells, which would modify the form of muscular dystrophy suffered by the boys. If the technique were successful —all the evidence from the laboratory and the experiments involving mice suggest that it could work and is promising—it would modify Duchenne muscular dystrophy into the much less serious Becker form, which would considerably lessen the symptoms, because in the Becker form of muscular dystrophy some dystrophin is produced. The quality and length of life of boys suffering from Duchenne muscular dystrophy would therefore be greatly enhanced. The scientists believe that up to 60 per cent. of Duchenne muscular dystrophy sufferers could benefit from the treatment.
The principle has been established, but the scientists need the financial support to advance the research to human trials. The project submitted to the Department of Health would do the following: first, it would improve the design of the molecular patches; secondly, it would find the best delivery techniques to the muscles; thirdly, it would do further tests in animals and Duchenne muscular dystrophy human cells in the laboratory; and, fourthly, it would carry out the first human safety trials and see whether functional dystrophin is produced by that technique.
For those involved in Duchenne muscular dystrophy, including parents and researchers, this is the first flicker of light at the end of a long and dark tunnel. The
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possibilities of genetic research to do good, correctly identified in the Government's White Paper last year and too often overshadowed by media scare stories about cloning and so on, give hope where before there was only despair, but I cannot emphasise enough the need for that hope to be kindled.
To giant pharmaceutical companies, Duchenne muscular dystrophy is a rare disease, because their definition of rarity is anything that is unlikely to yield an easy profit. That is why it is so vital that the Government, through Department of Health White Paper money and the Medical Research Council, support this vital work. The scientists to whom I have spoken are convinced that the project will have spin-offs in other areas and for other genetic disorders.
This is not the only line of research. We believe that £20 million should be spent over the next few years to support other promising research projects in this area too. However, this £2.5 million is on the shelf, ready to run, and it is backed up by all the charities and the all-party group, and has 18 of the nation's top scientists ready to carry it out. I believe that it deserves to be funded in full.
Finally, I hope that the Minister will ask the Secretary of State to make time in the near future to meet the families of boys with Duchenne muscular dystrophy, as his colleague Lord Warner did last September, so that he can hear their stories, listen to their concerns, understand their plight and, most importantly, do whatever he can to help them.
3.45 pm
The Parliamentary Under-Secretary of State for Health (Dr. Stephen Ladyman): I begin, as always, by commending my hon. Friend the Member for Cardiff, West (Kevin Brennan) on securing the debate. Those congratulations are well deserved. As he said, he has raised the subject before, has remained close to it in recent years and continues to work hard to press the Government on it. I welcome the opportunity to bring him up to date on the state of the issues raised.
My hon. Friend asked whether the Secretary of State would meet the families of children with Duchenne muscular dystrophy. I have no doubt that he would be happy to do so. He meets people who suffer from all manner of long-term conditions. However, he needs no convincing of the importance of the issue. That is why he was so enthusiastic about launching the Government's genetics White Paper. He is committed to doing everything that we can to deliver aid, support and, where possible, cures for such distressing illnesses. This is a distressing condition. As my hon. Friend said, boys with this genetic disorder have a very limited life span.
Voluntary organisations active in the area, such as the Muscular Dystrophy Campaign, Parent Project UK and the Duchenne Family Support Group, should also be congratulated on their work. It is important to raise public awareness of that dreadful disease and I hope that initiatives such as "The Right to Survive" will help to achieve that objective. I know that my hon. Friend will continue to do everything he can to ensure that people are aware of the issues involved.
As my hon. Friend said, Duchenne muscular dystrophy is an inherited severe and progressive muscle wasting disease. It is estimated that about 100 boys with

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Duchenne muscular dystrophy are born in the United Kingdom each year and that about 1,500 known boys with the disorder are living in the UK at any one time. It affects around one in 3,500 male births every year. It is caused by a genetic disorder characterised by progressive weakness and degeneration of the skeletal or voluntary muscles that control movement. Most boys with the disease will be in a wheelchair by the age of 10.
My hon. Friend will be pleased to know that among other things in my portfolio is responsibility for community equipment, including the wheelchair service. I heard what he said and am aware of the patchiness of the wheelchair service around the country. I assure him that I am already looking into that and trying to devise ways to improve it. I hope that he will pass that message back to the parents and the boys themselves.
Tragically, there is no effective cure or treatment for Duchenne. I understand, therefore, why the families of patients with Duchenne muscular dystrophy call for a greater research effort to be applied. Indeed, the Government are committed to investing money in genetic research.
Genetics offers enormous potential to improve our health and health care. Increasing understanding of genetics will bring more accurate diagnosis, more personalised prediction of risk, and more targeted and effective use of existing drugs. It will give us new gene-based drugs and therapies as well as prevention and treatment regimes tailored according to a person's individual genetic profile.
Unfortunately, market forces tend to militate against industry funding trials for rare disorders and inherited disorders. None the less, there remains an unmet need for effective, less burdensome treatments, and an estimated 750,000 patients in the UK suffer from incurable single-gene disorders. Gene therapy offers hope for those people and, to address that, the Department of Health supports gene therapy research into single-gene disorders.
As with any medical research, it is not possible to predict accurately when such treatments might become available or which approaches will ultimately prove effective. That is the nature of research. However, I share the hopes of the many parents, carers and patients that gene therapy will become a viable treatment for inherited disorders such as DMD, although we should not build up expectations and must realistically expect those outcomes to be a decade or more away.
I am aware that researchers have submitted a bid for funding for Duchenne muscular dystrophy research, the bid that my hon. Friend so eloquently described. He is right; I am not in a position to announce whether that bid has been successful. All I can tell the House is that the commissioning group for gene therapy research has met and considered the proposals. The outcome of the commissioning group's deliberations must remain confidential until the funding for each successful applicant has been agreed, and that has not yet been achieved.
My hon. Friend will recall that in April 2001 we announced £30 million to develop specialised genetic services. We have made further funding available for
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this important area. In June 2003, the White Paper "Our Inheritance, Our Future —realising the potential of genetics in the NHS" set out the Government's commitment to developing genetics knowledge, skills and provision within the NHS by investing more than £50 million over the next three years.
Kevin Brennan: I understand that the Minister is unable to discuss the outcome of the deliberations on the applications, but is he able to give any idea when the announcement might be expected on the final outcome?
Dr. Ladyman: I cannot give a precise date, but it is relatively imminent—weeks rather than months.
The White Paper details the following commitments: £3.5 million to fund 90 new grade A trainees in laboratory genetics and the equivalent of 10 full-time trainer posts; up to £18 million capital to upgrade NHS laboratory facilities in England; up to £1 million in information technology for genetics laboratories in the genetics testing network; £2 million of start-up funding over three years for other initiatives to bring the benefits of genetics to mainstream clinical areas; up to £2 million of start-up funding over three years specifically for primary care genetics initiatives; £4 million to fund pharmacogenetic research on existing medicines; £500,000 to pilot near-patient genetic testing in the NHS; £1.5 million to fund a range of research projects in the area of genetics-based health services; £3 million to support gene therapy research on single-gene disorders; £2.5 million for cystic fibrosis gene therapy research; and £4 million to provide access to clinical grade gene therapy vectors.
The emphasis for Department of Health funding is "translational", which means bringing the benefits of research to the clinic. Our vision is for the NHS to lead the world in taking maximum advantage of the safe, effective and ethical application of the new genetic knowledge and technologies for all patients as soon as they become available. In time, we should be able to assess the risk that an individual has of developing disease not just for single-gene disorders such as DMD and cystic fibrosis, but for our country's biggest killers—cancer and coronary heart disease—as well as those, such as diabetes, that limit people's lives.
The potential in genetic research is immense. While genetics will never mean a disease-free existence, greater understanding of genetics is one of our best allies in the war against disease. I hope that, over time, research will provide a breakthrough in the understanding and treatment of genetic diseases such as DMD.
The main agency through which the Government support medical and clinical research is the Medical Research Council. That independent body receives its grant-in-aid from the Office of Science and Technology. It is, however, a long-standing and important principle of successive Governments that they do not prescribe to individual research councils how they should distribute resources between competing priorities. That is best decided by researchers and research users.
The MRC spend relevant to DMD research for 2001–02 was around £2 million. That included two major groups of researchers: those of Professor Kay Davies at the MRC functional genetics unit in Oxford and Professor Terry Partridge at the MRC clinical

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sciences centre based at Imperial college in Hammersmith. Research projects are also being carried out on muscular dystrophy and basic underpinning work that could apply to all forms of the disease. The MRC does not, as a rule, earmark funds for particular topics; research proposals in all areas compete for funding. When appropriate, high-quality research in the areas that we are promoting may be given priority in competition for funds, but research excellence and importance to health will continue to be the primary considerations in funding decisions. In addition, it is important to note that while prevalence of a particular condition is one important factor, the MRC's funding decisions are set largely on the scientific opportunity and the likelihood of significant development.
There are, of course, other lines of research that may help in the future, especially with long-term conditions. The report by the chief medical officer's expert group, "Stem Cell Research: Medical Progress with Responsibility", was published in 2000. This recognised that the early research on stem cells is exciting and provides a real hope of new treatments becoming available in a few years for people with chronic diseases.
The Government are investing an additional £40 million in stem cell research in 2004 to 2006. We believe that stem cell research offers enormous potential to deliver new treatments for many diseases for which there are no effective cures. The Government are therefore funding the creation of a national stem cell bank. The first of its kind in the world, it will hold all types of stem cell as a resource for researchers. The Science and Technology Committee, in its recent report on the work of the Medical Research Council, welcomed the stem cell bank and called it
"a world leading venture that we wholeheartedly support."
The Government want research to use all sources of stem cells, including embryonic stem cells. It is far too early to know where useful results will come from. That position is supported by published scientific findings. Any activity that involves the use or creation of an
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embryo outside the body—be it for treatment of infertility or for research—is permitted in the UK only under a strict system of licensing by the Human Fertilisation and Embryology Authority.
In February 2001 we announced the development of a national service framework for long-term conditions. NSFs are set out in the White Paper, "The new NHS". They are intended to set national standards and define service models for particular services or care groups. This NSF will have a particular focus on the needs of people with neurological conditions and brain and spinal injury. We are also clear, however, about the fact that it must tackle some generic issues that affect a wide range of people with long-term conditions and their families and carers. We hope that work to establish standards for neurological conditions will provide patterns of service provision that have wider application and will also benefit people with non-neurological conditions.
I hope that my hon. Friend agrees that the Government are sympathetic to the needs of patients with Duchenne muscular dystrophy and other longterm conditions and that we are backing that sympathy with real effort and resource. There has been progress since we last debated the subject. The initiatives I have described—the genetics strategy, the important work under way in the research field, developments in stem cell research and the national service framework—will help to make life better for patients with Duchenne muscular dystrophy, their families and their carers.
I am sorry that I cannot give my hon. Friend the answers that he wants on the the exciting research project that he described, but I hope that we have them for him soon. I certainly assure him, the parents and all sufferers with Duchenne muscular dystrophy that the Government have every sympathy and want to do everything they can to help them, both with the services that make their lives better and with the research to ensure that there are effective therapies in the not too distant future.

Media Intellectual Property Rights
3.58 pm
Tom Brake: I am aware that in the next minute or so we are due to have a Division, so I hesitate to embark on the meat of what I am here to say. I welcome the opportunity for this debate. What was most interesting as I drafted my speech was the fact that though I have held many debates in Westminster Hall over the past seven years on a whole range of constituency issues—local train services, local hospital provision and so on—no issue has ever seen me receive as many approaches from different organisations as this one. The issue is clearly of interest to the media, so one would expect them to pick up on it and contact hon. Members seeking to raise it in Parliament. However, intellectual property rights are also a hot topic for the industry as a whole, which is why I have been contacted.
I told the Minister that the main purpose of this debate is to raise an issue that a constituent has brought to my attention. However, because a number of organisations that are concerned about such matters as counterfeiting have made approaches to me, I seek to raise some more general industry issues. I apologise if he has not had much notice of that and shall quite understand if he needs to respond to me in writing on those issues at a later date.
4.1 pm
Sitting suspended for a Division in the House.
4.14 pm
On resuming—
Tom Brake: There are a number of general issues that I shall raise, but in the first part of what I say I shall focus on one constituent's case. I am going to describe it as Alan Brunwin v. Chatsworth Television's "Busy Buses" children's programme. In 1988–89, my constituent wrote a series of children's stories called "Hoppy the Hopper Bus". He sent his work to, he estimates, about 40 television production companies to try to get it animated for television. He also let a number of local people—myself included—see copies of it, with copies of the bus characters that he had devised for the proposed animation. One of the people to whom he had shown his stories told him in February last year that they were being screened on Living TV under the name "Busy Buses".
Having seen pictures on Chatsworth's website and compared them with pictures that Mr. Brunwin has drawn of his bus characters, I can say that there are clear similarities. He says that a large number of people in the media knew of his work, given that he had circulated it widely. On learning that it was being broadcast on Living TV, he wrote to the channel immediately, and it replied saying that the stories had nothing to do with it, and that he should talk to Chatsworth TV about the matter, which he did the following day.
Mr. Swan, who is Chatsworth Television's solicitor, made contact with Mr. Brunwin allegedly saying that he did not represent Mr. Terry Ward, who is the writer and creator of the "Busy Buses" programme and a company
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director of Chatsworth Television. The solicitor asked my constituent to send him proof that Chatsworth Television had copied his work. Apparently, three hours after this contact was made, Mr. Ward made contact with my constituent and informed him that the solicitor had contacted him, and he then told my constituent that he had no more to say on the matter. The solicitor told my constituent in that initial contact that he had no relationship with Mr. Ward, but within a matter of hours it was confirmed that he did. Because of that fact, my constituent does not feel able to trust that company.
Subsequently, Mr. Brunwin sent a number of e-mails demonstrating what he believes to be sufficient proof that he had the idea several years ago, and that there are clear similarities between his work and that of the "Busy Buses" programme. He received frequent replies from Mr. Swan, but they stressed that there was insufficient evidence and that the only point at which the company would engage in further discussions with my constituent would be if he employed a solicitor to take up his case—something that he is not in a position to do. Mr. Swan and Chatsworth Television then told him that they would have no further contact with him.
Mr. Brunwin also had concerns about the BBC's involvement in the case, stating that one of the 40 recipients of his proposal was a BBC producer, but the BBC said that it had no knowledge of the proposal. However, he has found that BBC Worldwide sells "Busy Buses" books and DVDs all over the world. He raised the matter with the then director-general, Greg Dyke, in August 2003, and was apparently told that an investigation would be carried out into his claims, but apart from a telephone call from the director-general's office asking whether the BBC had been in touch with him—to which the answer was no—there has been no further progress on that matter. No doubt that will be one of the tasks that the new director-general will have to take on.
My constituent has tried to initiate contact with Chatsworth Television, but it seems his e-mails are going into a black hole. He has set up a website called "Justice for Hoppy", in which he sets out his version of events and challenges the company to take issue with it if it disagrees with the content. It is worth noting that it is alleged that last year Mr. Ward, the director of "Busy Buses", sent him an e-mail, saying:
"I hope we can sort this matter out amicably."
My constituent has interpreted that as a concession on Chatsworth TV's part that it had prior knowledge. Otherwise, why would it respond in that way, given that most of the contact had been simply to rebuff him?
It is clear from the description that I have given that this case can be resolved only in court, as there are allegations and counter-allegations. I believe that my constituent would welcome that, because he feels that it is the only way in which the matter can be sorted out.
What options are available to ensure that such altercations do not arise, and that if people develop an idea, they maintain rights over it? I want to quote, first, from issue 8 of Media Magazine. I am indebted to Sean Egan, the writer, who has set out what actions he thinks writers can take to ensure that they maintain rights over an idea that they have developed. My constituent's case seems to fall neatly into the description that he gives of an

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"aggrieved writer, having submitted material to a broadcaster or producer on a speculative basis and having heard nothing or been rejected, finds that a television show is broadcast by the same company"—
there is a problem about being able to make a clear link between Chatsworth TV and the material sent out by my constituent, but a link could possibly be made through third parties—
"which is similar to, or at least bears a strong resemblance to, the writer's original material."
There follow a number of tips that people should seriously consider, such as registering the material in one form or another or putting their name on the cover page. Mr. Egan also suggests that they should try to enter into a confidentiality agreement when they enter into correspondence with possible broadcasters or producers. If they cannot do that, letters should be clearly marked "In confidence". They should keep an accurate record of when the material was started, when it was sent out and whom it was sent out to, and should ensure that it is as detailed as possible. There are measures that people can take to reduce the risk of such disputes occurring, although it is not clear whether they would be sufficient to stop a dispute of this kind.
That is the main focus of what I want to say, but as I said before the Division, other industry issues involving intellectual property rights have been drawn to my attention that I want to touch on briefly, including counterfeiting, the ownership of formats and the power relationship between large corporations such as the BBC and small independent producers. In some ways that last point mirrors what my constituent alleges happened to him, where someone with more clout took over his idea. That is what independent producers say happens in relation to the BBC.
Those issues may have been addressed by the Communications Act 2003, and I should be grateful if the Minister said today or later whether he believes that the core principles of the code of practice are working well. They include

"that a reasonable timetable is applied to negotiations…

that there is sufficient clarity…about the different categories of rights to broadcast…

that there is sufficient transparency about the amounts to be paid in respect of each category of rights".

There are a number of matters running from (a) to (g) in the code of practice that need to be addressed. We need to know whether the feedback that the Minister is getting from the industry confirms whether the code is up and running and working well.
It could be argued that the idea proposed by my constituent might fall into the category of a format. Typically, however, programmes such as "I'm a Celebrity, Get Me out of Here!", which are described as format programmes, can be transferred to another country in a very similar format or production. It would be interesting to find out the Government's thinking on the issue, particularly as the UK industry producing such programmes is very strong. The matter clearly has very significant financial implications for the industry.
Others have looked at the matter. The Minister may be aware of a speech given by Dr. Miriam Meckel, Permanent Under-Secretary for Europe, International
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Affairs and Media in the state of North Rhine-Westphalia in Germany. I will forgive him if he is not. In her speech, she gave a definition of a format as
"the core idea of a programme, the main framework and structure and all the characteristic features that make a show what it is."
She believes that the way to solve the problem is to
"hand the matter over to the European Union. This would ensure both that the issue was finally addressed and a solution found, and that the legislation would be uniform across Europe. Individual reforms in each country would only lead to an array of different rules and regulations which could leave some countries at a serious disadvantage."
I hope that the Minister will be able to clarify whether her strategy is a way forward for formats.
The idea of Europe as the way forward is not necessarily a commonly held view in the industry. One of the organisations that contacted me prior to the debate was the Alliance Against Counterfeiting and Piracy. It is quite concerned about the negotiations of the draft EU copyright enforcement directive, about which I knew nothing until about 12 hours ago. It is particularly concerned that the directive will leave UK businesses exposed and that it will impact negatively on their ability to protect intellectual property.
The alliance has three specific concerns: the proposals will hamper the ability of UK businesses to take appropriate action against intermediaries found to be infringing intellectual property rights; the proposal for intermediaries to be entitled to claim for compensation is an issue, given that that is already permitted under civil procedure rules; and the proposal to eliminate a rights holder's ability to seek double damages from an infringer seems dubious. Its view is that the penalties for counterfeiting are not sufficient and must be made much tougher, but it is worried that they will not be. Its concerns are exacerbated by the 12 accession states, which may not have the same regard for intellectual property rights as the existing EU members. I would appreciate either a written or a verbal response to those concerns.
There is no doubt that copyright law needs to catch up with the 21st century. A lot of business is about ideas rather than concrete designs and new inventions. To promote potential UK creative talent, we must clarify copyright law and we must safeguard and enforce intellectual property rights. In that way we could avoid controversies such as those generated by the "Busy Buses" programme. I hope that the Minister will be able to explain how that can be done.
4.30 pm
The Minister for Energy, E-Commerce and Postal Services (Mr. Stephen Timms): I congratulate the hon. Member for Carshalton and Wallington (Tom Brake) on securing the debate, which raises some important issues and the particular concern of his constituent, as he explained. The Government are acutely aware of the need for effective protection of intellectual property rights in material created for and exploited in the media nationally and internationally.
It is also important that that protection should be balanced with the interests of others in society, whether from the perspective of freedom for users of protected

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material to make reasonable use of it for purposes of reporting, education, study and so on, or from that of enabling legitimate competition, or for other reasons. That balance has to be maintained in the Government's approach.
The most important form of protection in relation to the media is copyright. There are ever more challenges to the protection of intellectual property with the advances in digital technology in recent years, particularly through the internet. The hon. Gentleman is right to draw attention to the scale of the new issues that arise as a result of its spread, but provided that intellectual property protection keeps pace with technology development, the new and emerging environments also provide new opportunities for creators and producers to exploit and benefit from their material.
UK copyright law, as enshrined in the Copyright, Designs and Patents Act 1988, was already relatively well adapted to meet many of the challenges of technology. Of course, much has changed since 1988 and it is now the case—as the hon. Gentleman mentioned—that UK copyright law, like that elsewhere in the European Union, is strongly influenced by EU legislation. Since 1992 there have been seven directives in this field.
The most recent directive on copyright in the information society was implemented in the UK last October. It strengthens the protection of copyright in the digital environment. In particular, although the original UK legislation already gave rights owners extensive rights to control electronic dissemination of their material, the directive has required an amendment to the law to make those rights more clear and comprehensive.
The internet and services that deliver material on demand to consumers are important. The directive means that rights owners now have greater legal redress against those who seek to defeat technological measures such as copy-preventing devices. Rights owners need to be able to use such devices to protect their property, given the possibilities for unlimited copying and dissemination that modern technology affords.
The directive also provides for a number of exceptions to rights in areas where limited use of copy right material without permission should be permissible. The need for an essential balance between the interests of rights holders and the users of copyright material has been recognised for a long time in UK law. We have welcomed the recognition of that balance in the copyright directive and as far as possible we have preserved existing exceptions in the new regulations.
Last year we brought into force two new exceptions to copyright specifically designed to benefit visually impaired people who have difficulty reading copyright material in the form in which it is produced. Those new exceptions mean that difficulties and delays in obtaining copyright clearances will no longer be a bar to the production of much-needed alternative formats of copyright material, such as Braille or audiotape, by organisations such as the Royal National Institute of the Blind and the National Library for the Blind.
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I do not make those points because they are specifically relevant to the case of the hon. Gentleman's constituent, but it is useful to place those concerns in the context of the recent changes to the law, because they illustrate our commitment to ensuring that rights are kept up to date, that they are enforceable and that their scope is balanced against the interests of others in society. That is particularly relevant in ensuring that copyright law continues to be balanced against the need to permit appropriate competition.
On the case that has been drawn to hon. Members' attention today, I need to make the point that copyright does not protect ideas as such. Such protection could be seriously anti-competitive. Many of the new programmes on television, and new ways of presenting material more generally in the media, might not have been possible if copyright protection had extended to an idea. For example, the idea of a cartoon based around characters of a certain broad type is not protected by rights that would prevent others from producing a different cartoon based around the same type of characters, and in our view it should not be so protected. The idea of a children's cartoon involving buses with faces is not protected by copyright any more than the idea of a book about trains with faces is protected by copyright.
Were copyright to protect such ideas, we probably would not have been able to enjoy both Warners' Daffy Duck and Disney's Donald Duck, or Warners' Sylvester and MGM's Tom. Creativity has always been inspired by what has gone before, and always will be. The cycle ultimately benefits us all by leading to a richer range of new media and other creative products, as those examples amply illustrate.
Tom Brake: My constituent's allegation is not so much that he had an idea, but that he had story lines, pictures and characters, and therefore that he had something with much more content to it than an idea.
Mr. Timms: I accept that point entirely. Copyright certainly does provide protection for sufficiently elaborated original expressions of ideas. A fully developed cartoon involving buses with faces that has not been copied from someone else is likely to be a copyright work that attracts all the rights granted to copyright owners, which enable the owner to act against those who copy that protected work without permission.
Copyright is infringed only if one person has copied from another's work. It is perfectly possible for two people working completely independently to create very similar cartoons. In that case, both could attract copyright protection and the creation of neither one would infringe the rights relating to the other. In the case that we have been considering this afternoon, it would be necessary to show that the cartoon known as "Busy Buses" copies at least a substantial part of the "Hoppy the Hopper Bus" series. Not only is it necessary to show that "Busy Buses" incorporates material that is the same as at least a substantial part of "Hoppy the Hopper Bus", but it has to be shown that that is the result of copying rather than independent creation. It is for the person alleging infringement of copyright to prove both those things. As the hon. Gentleman said,

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that would need to be done in the courts, where the burden of proof is that the evidence must show those things to be true on the balance of probabilities.
I have explained that copyright protection for media ideas is not appropriate, given the anti-competitive effect, but when someone has come up with a new idea
that is not yet in the public domain, it is possible—the hon. Gentleman mentioned this point—to use the protection arising from the law of confidence to have a right of action against those who pass the idea on to others without permission. In this case, I think that it is too late, but it may be helpful for others to be reminded that they could agree non-disclosure on the ground of confidentiality with those to whom they disclose their new idea, when the idea is not yet in the public domain. A breach of that agreement could be pursued as a breach of confidence.
The hon. Gentleman raised more general issues. He is absolutely right that the dramatic and spectacular growth in use of the internet, which is continuing, poses new challenges for copyright law, and that we must ensure that the law keeps pace with the changes. Many companies already trade online successfully. We welcome very much the enthusiasm with which media companies use the internet to disseminate information widely and quickly. The UK's creative computer games industry is one of the strongest anywhere. The internet offers many opportunities for the content industry, and those opportunities will certainly develop further as broadband is increasingly used.
There are also threats to content industries from the development of the internet. A mature debate is needed about both the opportunities and the threats. I am aware of some issues that the hon. Gentleman raised—for example, the concerns about the EC draft directive on enforcement of intellectual property rights raised by the Alliance Against Counterfeiting and Piracy. Those concerns have informed our recent approach to negotiations on that proposal. We hope that an
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acceptable and workable solution on intermediaries and damages can be achieved as a result of those discussions. On the relationship between the BBC and independent producers, we hope that acceptable voluntary solutions can be found. We keep that matter closely under review.
The protection of formats is a difficult issue that has been examined in the past. It is not clear at this stage that further protection beyond that already available is needed. Again, we do not want to introduce legislation that would be seriously anti-competitive. However, we recognise that that issue also must be kept under review.
All content industries, including media interests, are concerned about illegal use of their material online. We are committed to effective enforcement of intellectual property rights and have taken several steps on that in recent years, including as part of the UK implementation of the copyright directive to which I referred improving the structure for enforcing rights. The protection given by intellectual property rights is an important part of the framework to encourage innovation and wealth creation, but rights that cannot be enforced are of no value.
Enforcement of rights must be pursued differently, depending on the circumstances. Lumping together commercial piracy on the one hand and private copying on the other is unlikely to be helpful in the longer term. Private downloading of material that has been put on the internet illegally is an infringement of rights, but it does not constitute a criminal offence. Efforts to increase the understanding of and respect for intellectual property rights, particularly copyright, is not helped by branding illegal downloaders as pirates. We must educate consumers about the downside of sharing copyright works over the internet, but we must not accuse them all of being criminals.
It being sixteen minutes to Five o'clock, the motion for the Adjournment of the sitting lapsed, without Question put.