Smaller airports are economic and social enablers. They facilitate vital national and international connections for people and businesses in the UK. The Committee found that Air Passenger Duty (APD) is the principal threat to the smaller airports sector. APD cannot be amended to support people, businesses and regional economies because of the operation of European competition law, while proposals to devolve it to the regions would serve only to spread a patchwork of market distortions across the UK. It was disappointing that the concerns the Committee raised about APD in their First Report of Session 2013-14 on Aviation strategy were ignored by the Treasury. The Committee urges Transport Ministers to pursue those recommendations and the important concerns raised by smaller airports with the Treasury. The Airports Commission will publish its final report on expanding hub airport capacity in the south-east shortly after the general election. The whole country will only be able to share the economic benefits if airlines secure slots to provide services to UK airports outside London. The DfT needs to assess how new slots might be allocated and whether slots could be ring-fenced for domestic services

The Transport Committee welcomes record investment committed to the 'classic' rail network but calls for greater regional balance in spending. Network Rail must also regain the confidence of passengers following recent disruption. The Committee calls for the Government to take responsibility for rolling stock, to address general shortages and ensure there will be sufficient trains to run on newly-electrified lines. The Committee also concluded: (i) Record levels of funding show a welcome commitment to ’classic' rail but this should be set in a longer-term strategic plan for the rail network, which ties into a wider transport strategy; (ii) The overrunning Christmas engineering works were unacceptable; (iii) Network Rail must have adequate contingency plans. They must also work with Passenger Focus and train operating companies to improve communication with passengers when engineering works fail; (iv) In the light of the change of status of Network Rail the ORR must reconsider whether fining a public sector body remains an effective means for the regulator to exert control; (v) Greater transparency is essential around rail spending. Criteria used to allocate spending should be published.

Transport infrastructure in some parts of the UK may get left behind under the new system to be used from next year (2015) to share out central government money for local major transport schemes. The Government has again changed the system for distributing money to local areas for major transport projects, with much more emphasis now on competition for funding. This will not necessarily help regions get a fairer share of transport funding and could make the situation worse. The Government's focus on using competition to bring in private sector funding for projects could disadvantage the regions, where there tends to be less private sector money available compared with London. Those Local Enterprise Partnerships (LEPs) which are well organised and resourced will have an advantage in bidding for funds. Other areas may lose out as a result. In addition, with greater reliance on competitive bidding for funds, there will see more money wasted on failed bids. Strategically significant schemes such as access to ports must not get overlooked. The changes are set against a backdrop where far less money is spent on transport projects outside London than in the capital. Transport infrastructure spending is £2,500 per head in London compared with £5 per head in the north east. This inequality must change. The Committee calls for the new funding arrangements to be reviewed by the end of the next Parliament to ensure that they are efficient and effective in providing funding for the most urgent transport priorities.

In this report looking at policy for improving road and rail access to ports, the Transport Committee urges the Department for Transport (DfT) to become a keener advocate for UK ports. The Government should contribute to significant improvements to strategic networks which also deliver wider benefits - rather than simply expect port operators to pick up the entire bill for measures required to mitigate increased traffic due to port expansion. If the Government chooses to apply European Commission state aid rules in this area more strictly than other EU countries it should explain why it does so. Policy in this area should be applied consistently across the country. While some ports have contributed towards transport schemes to improve access, others have not and the differences in approach have not been explained or justified. Ports should also continue to contribute to local transport infrastructure improvements, following discussions with relevant local bodies. The Department for Transport should demonstrate whether port master plans have had any impact, highlighting good examples of such plans and of how they have influenced decision makers. Finally, the Government should devise a more effective successor to the Waterborne Freight Grant, to stimulate coastal shipping.

15 million NHS patients in England with long-term conditions such as diabetes, arthritis and asthma account for 70% of the annual expenditure of the NHS in England. One projection estimating that the bill for treatment of long-term conditions will require the NHS to find £4 billion more each year by 2016. Increasingly, patients do not have a single long-term condition but live with two or more conditions, complicating treatment and adding to its cost. The Committee strongly supports the development of individual care planning for people with long-term conditions, based on the principles successfully demonstrated in the NHS House of Care programme. Care planning approaches will involve GPs, community health services and specialists sitting down with the patient to draw up a personalised plan for the care required, which includes the support needed to help the patient manage his or her own condition. The challenge, though, of introducing personalised care planning for 15 million people is substantial. The Committee looked at the prevailing view that services to treat long-term conditions should be moved out of hospitals and into primary and community care. To provide effective care for these conditions, services have to be maintained across all settings, from support in the home through to acute specialist care, and many conditions will continue to require specialist services delivered in hospital. Effective management of long-term conditions also requires collaboration with other government providers, such as housing and transport services.

GMC's fitness to practise successfully produces outcomes that protect patients from sub-standard doctors but failures to communicate the reasons for decisions and poor investigative practices have undermined a small number on investigations. The GMC should review its fitness to practice procedures to prevent such mistake. The Committee also found that while it is still too early to judge whether revalidation has been effective there is a worrying approach to the oversight of revalidation. Each designated body has a responsible officer for revalidating their medical staff, but the degree to which the responsible officer will be held to account is unclear. It is imperative that the GMC clarifies the personal responsibility and accountability of responsible officers. There is also concern over the number of responsible officers available to oversee the revalidation of doctors working in primary care. GPs are revalidated not by their own employers but by one of the 27 NHS England local area teams that oversees Clinical Commissioning Groups in England. Just 27 responsible officers will be tasked with overseeing revalidation for approximately 45,0000 GPs in England. The Government's intention had been to give the GMC the power to allow it to appeal decisions made by the Medical Practitioners Tribunal Service (MPTS) in 2014 by using a mechanism in secondary legislation called a section 60 order. The Government now plans to introduce the reform in primary legislation as part of a proposed Law Commission Bill thus meeting with even further delay