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Alex Norris (Nottingham North) (Lab/Co-op)
Jeff Smith (Manchester, Withington) (Lab)
The Parliamentary Under-Secretary of State for Justice (Chris Philp)
I am pleased to tell the House that there are currently 47 Nightingale courtrooms in operation, of which 28 are used for Crown court purposes, and we are in the process of extending the operation of 32 of those until the end of March. I am sure colleagues across the House will welcome that. In addition, we are in the process of reopening 60 existing courtrooms in the Crown court estate that had been closed owing to social distancing; more than half have already reopened. When all of that is done, we expect to have about 500 Crown courtrooms available, of which well over half will be capable of accommodating jury trials.
Alex Norris
I am grateful for that answer. We have one such Nightingale court in Nottingham, but the backlogs across Nottingham and Nottinghamshire have grown to be extraordinary, with constituents finding the dates for their cases going to the back end of 2022. That will not do. It is bad for victims and bad for the strength of those cases as memories fade for witnesses and similar. Will the Minister commit to meet me and other Nottingham and Nottinghamshire Members to talk about what more we can do in our community to get the backlogs down?
Chris Philp
The relevant Justice Minister would be delighted to meet and discuss these issues. Naturally, the covid pandemic has had a significant impact on the justice system, but that is why the Government have: invested an extra quarter of a billion pounds in covid recovery; hired 1,600 staff for Her Majesty’s Courts and Tribunals Service; deployed the Cloud video platform that at its peak was hearing 20,000 cases across the system remotely; and had the 47 extra Nightingale courtrooms. I am sure the House will unite in welcoming those measures. Our aim is to get cases heard as quickly as possible.
Jeff Smith
Nationally we have a record high Crown court backlog of about 60,000 cases a result of the court closures and a decade of Tory cuts. Will the Government commit to continuing Nightingale courts until the backlog has cleared? When does the Minister think that will happen?
Chris Philp
First, the number of outstanding cases is principally a function of the pandemic. The hon. Member may be interested to know that in March 2020—before the covid pandemic—the outstanding case load was about 39,000, which the House will be interested to hear was substantially lower than the 47,000 bequeathed by the last Labour Government. I have laid out the investments we are making in court recovery, including the quarter of a billion pounds being spent, and this financial year there is no limitation on Crown court sitting days. The Government’s commitment to hearing these cases is without question.
Mr Speaker
I remind the Minister that the courtroom in Chorley is still available—it is back up for sale.
Danny Kruger (Devizes) (Con)
The Minister of State, Ministry of Justice (Lucy Frazer)
I thank my hon. Friend for his question and for his interest and input in this area. I welcome the findings and recommendations of Richard Oldfield’s report, and in particular his primary conclusion that we should do more to encourage the participation of smaller organisations in the delivery of rehabilitation services. We are looking at how we can use more grants rather than contracts where it is appropriate to do so as well as how to simplify the qualification process and bidding process for the dynamic framework.
Danny Kruger
I declare that I am the founder and chairman of a small charity working in prisons and probation. I am grateful to my right hon. and learned Friend for that answer. I congratulate Richard Oldfield on his report and the Minister on commissioning it. I am pleased to hear about the progress being made. Does the Minister agree that we need a culture change across the justice system, with managers and commissioners being prepared to trust the small community-based organisations that can deliver such good value, and that that entails having a bolder attitude to risk?
Lucy Frazer
I completely agree with my hon. Friend. It is really important that local community services deliver rehabilitative services in the communities that they serve and we are trying to ensure that culture change. Of the 26 organisations delivering rehabilitative services in the unified model, 23 are voluntary and community sector organisations, but we will do more to ensure that those small community organisations deliver services for us.
Antony Higginbotham (Burnley) (Con)
Sarah Atherton (Wrexham) (Con)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
I speak regularly with my right hon. Friend the Home Secretary on the actions our Departments are taking to beat crime. Our joint approach will protect the law-abiding majority, swiftly bring criminals to justice, and ensure that offenders are managed with rigour and discipline. Significant work is already under way to deliver on our beating crime plan, including more joint supervision of offenders by probation and the police, working with other local services.
Antony Higginbotham
I thank my right hon. and learned Friend for his answer. One of the key focuses in the beating crime plan is tackling violent crime, something I wholeheartedly endorse, but we know that this often follows drug offences. Can I urge him to review drug sentencing, because often the sentences that go with drug offences do not act as the real deterrent we need to make sure we do not end up with narco-neighbourhoods across the country?
Robert Buckland
I am grateful to my hon. Friend, who speaks passionately for his community. He knows of course that sentencing guidelines are a matter for the independent Sentencing Council. Indeed, earlier this year it issued revised guidelines for drug offences that reflect many of the issues he raises, including the increased exploitation of children and vulnerable people to facilitate drug offences, changes to drug purity and the types of drugs commonly in circulation. Of course, I will continue to speak with him about these important matters.
Sarah Atherton
As we know, antisocial behaviour blights all our towns and cities, and Wrexham is no exception. I welcome this Government’s strong stance to tackle crime through community sentencing orders. Will my right hon. and learned Friend congratulate Inspector Luke Hughes and the Wrexham town police station on their work, collaboratively with the council and other agencies, to tackle antisocial behaviour as our town has reopened and on championing the sobriety tags?
Robert Buckland
I am more than happy to join in that praise. My hon. Friend is right to highlight the local work that has been going on in Wrexham and in Wales. As announced in our beating crime plan, we are going to be trialling alcohol monitoring tags with prison leavers in Wales later this year. That I think will provide a clear incentive for offenders to control their drinking and ensure swift consequences if their alcohol-related risk is escalating.
Dame Angela Eagle (Wallasey) (Lab)
Surely any beating crime plan worth its name should include fraud. Ministers must be aware that a person is more likely to be victim of fraud than of any other crime, yet according to the Home Affairs Committee, a mere 3% of cases reported to Action Fraud even result in a charge or a summons, let alone a conviction. The system is failing and failing badly. When are Ministers going to do something about it?
Robert Buckland
Well, we are. The announcement of a replacement of the Action Fraud system was made some time ago. That represents just the sharp end of the Government’s response to this growing issue. I can assure the hon. Member that the work that goes on with colleagues in the Home Office on fighting economic crime more generally and fraud is sustained. It involves work with the private sector, particularly the financial services industry, to help to design out fraud. So this is an end-to-end approach, and I can assure her that the work continues apace.
Alex Davies-Jones (Pontypridd) (Lab)
The Minister for Crime and Policing (Kit Malthouse)
The Government committed in the Queen’s Speech to bring forward a Bill to enshrine the rights of victims in law, and the hon. Lady can expect to see a consultation on this issue later this year.
Alex Davies-Jones
As the Minister says, we first heard about this in the Queen’s Speech over four months ago now, and we have heard nothing since. In the year ending March 2020, the crime survey for England and Wales estimates that more than 600,000 women aged 16 to 74 were victims of sexual assault. For these women, who desperately need to see protections enshrined in law, I ask the Minister: when can we expect this legislation on the Floor of the House?
Kit Malthouse
I do recognise the issue that the hon. Lady raises, and she will of course appreciate that we have spent significantly more money on increasing the number of independent sexual violence advisers across the whole of England and Wales. However, she is right to be impatient for the Bill, and as I say, she will see a consultation on this shortly.
Laura Farris (Newbury) (Con)
It is hard for members of the public to feel confidence in the statutory provisions outlawing the rough sex defence in the Domestic Abuse Act 2021 while a young woman such as Sophie Moss can be so violently killed and the perpetrator receive a sentence of just four years. Does my hon. Friend think there is an opportunity with the victims Bill to look seriously at the length of sentence for this kind of homicide, and could I urge him to press the Director of Public Prosecutions as to why so many of these cases are prosecuted as manslaughter, not murder?
Kit Malthouse
That case obviously caused consternation not just in the House but across the country, and Law Officers will be looking carefully at its implications. I am more than happy to consider the issues raised by my hon. Friend during the passage of the victims Bill, not least because we want to ensure that every victim of crime in this country not only gets justice, but sees that justice is done.
Anna McMorrin (Cardiff North) (Lab)
For six years the Government have promised a victims Bill. Indeed, five Secretaries of State have promised that that will be their priority—will this be the one, Mr Speaker?—but meanwhile, victims are left waiting and traumatised, their rights ignored. I recently spoke to the father of a young girl who reported sexual assault two years ago. Delay after delay has meant that the family have been left not knowing when their case will be heard, with no explanation, poor communication, and the young girl having to relive her trauma. We now learn that one-third of victims would not report a future crime because of past experience. Labour has a victims Bill ready to go. Will the Minister work with us to bring that in? If not, will he tell that young girl why the Government continue to treat her as an afterthought?
Kit Malthouse
I think that is a deeply unfair characterisation of the work to which all Ministers, and indeed the professional public servants who are involved in victim and witness care across the country, including police officers, devote themselves every day. Having said that, we recognise that many victims are dissatisfied with the support they get, and they do not necessarily see the victims’ charter writ large in their experience of the criminal justice system. As I said, we will soon be bringing forward legislation to enshrine their rights in law, and a consultation on that matter will be issued in the coming days.
Kate Osborne (Jarrow) (Lab)
The Minister for Crime and Policing (Kit Malthouse)
The maximum penalty for rape is life imprisonment, and already rapists rightly receive significant sentences, with the average sentence in 2020 being more than 10 years. The Government believe that those who commit rape should spend more of their sentence in prison, and under the Police, Crime, Sentencing and Courts Bill, currently before Parliament, we will increase the time that they spend behind bars.
Kate Osborne
In 2019-20 just 3% of reported rapes led to a prosecution—an historic low. It may be that life sentences can be imposed, but of those who received a jail sentence since this Government came to power, almost 3,000 rapists have been jailed for six years or less. How can the Government claim to reassure victims that justice will be served with those appalling figures?
Kit Malthouse
As I said earlier, the average sentence for rape is more than 10 years, and two-thirds of those convicted of that appalling crime receive more than seven years in prison. However, the hon. Lady is right, and as the Lord Chancellor and I have said before in this House, the number of cases of this horrendous crime that get to court are not high enough. I am leading a taskforce, which includes the Crown Prosecution Service and police leaders across the country, to drive that number upwards. We are determined to get more cases into court, so that more victims see justice done.
Rachel Hopkins (Luton South) (Lab)
The Parliamentary Under-Secretary of State for Justice (Alex Chalk)
Our prison officers have done a truly remarkable job during the pandemic, and through their decisive actions and rapid contact tracing, literally hundreds if not thousands of prisoners’ lives have been saved. Although there are no plans to revisit the retirement age, we are pursuing a series of initiatives to boost morale, safety and retention, and ensure that prisons are as secure and rehabilitative as possible.
Rachel Hopkins
The Government have previously stated that because of the higher potential for serious injury and fatality among firefighters and police, they do not consider prison officers deserving of the same pension age protections and the right to retire at 60. With serious violence against staff still plaguing our prisons, does the Minister accept that the message received by prison officers is that they will have to wait until one of their own is killed in the line of duty before their safety concerns are taken seriously?
Alex Chalk
The hon. Lady makes an important point. Mercifully, during the pandemic violence has come down in prisons, which we welcome. It is also important not to make false comparisons. For example, employee contributions for police officers are at 12%, and 14% for fire officers, and 5.45% for prison officers. Of course we keep such matters under review. We made a generous offer in 2017 to bring forward the retirement date when the taxpayer would pay the entirety of employee contributions, but I regret that that was rejected by the POA.
Ellie Reeves (Lewisham West and Penge) (Lab)
Our prison officers do fantastic work keeping prisons and communities safe, and they have gone above and beyond throughout the pandemic. However, the Ministry of Justice’s own figures show that more than 86,000 years of prison officer experience has been lost since 2010. These key workers are moving on to better-paid work that does not involve abuse and assaults on a daily basis. Why, then, did the Government reject the pay review body’s recommendation of a £3,000 uplift for band 3 prison officers? Should we not be giving these key workers a pay rise to recognise their vital work in keeping our country safe?
Alex Chalk
Where the hon. Lady is absolutely right is that retention matters, because having more experience in a prison leads it to be safer and more rehabilitative. However, it is disappointing that she did not note that last year there was a minimum increase in pay of 2.5%, and in fact some officers received up to 7.5%. That was much higher than wage inflation in the economy. We will continue to do everything possible to increase retention, including, by the way, among new officers, many of whom I met over the course of the summer, who would really benefit from increased mentoring on wings to improve morale and retention. We are absolutely committed to that very important agenda.
Paul Holmes (Eastleigh) (Con)
Mr Virendra Sharma (Ealing, Southall) (Lab)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
I acknowledge the grave concerns of judges, legal professionals and beyond, both here and in Afghanistan, which are real and present. My Department continues to work urgently to support cross-Government efforts to provide safe passage for judges in Afghanistan, including by ensuring that individual cases that are brought to my attention are immediately lodged with relevant parts of the system.
Paul Holmes
We have seen some of the most talented legal professionals leave Afghanistan and come to the UK, and they should have a valuable place in the UK when they come here. What engagement has the Secretary of State had with the judiciary and legal professionals on supporting Afghan judges and legal professionals who will come to the UK or have already arrived?
Robert Buckland
I can reassure my hon. Friend that I am in daily communication with the judiciary and the wider legal profession—in fact, I am in daily communication with judiciary in Afghanistan—and I commend everyone for their efforts to support those judges and those who have dedicated themselves to building the rule of law and human rights in Afghanistan. As an example, the noble Lord Wolfson and I have been in regular contact with Mrs Justice McGowan, and we have discussed ways in which the legal community might provide support to help resettle Afghan legal professionals here in the UK.
Mr Virendra Sharma
After raising directly with the Government hundreds of separate cases covering thousands of people, I know of only two cases that have been resolved. What are the Government doing to help refugees from Afghanistan who are facing massive delays in the tribunal backlog?
Robert Buckland
Let me deal with the specific issue of judges and other lawyers in Afghanistan, because that is what I am directly involved with. Yesterday, the Afghan citizens resettlement scheme was announced. That provides a clear route to safety for judges, who are one of the groups to be prioritised under the scheme. Some judges have already been resettled here in the UK, and I will not rest until everyone who fits those important criteria and needs the support and safety of the rule of law is accommodated.
Mr David Lammy (Tottenham) (Lab)
Last month, soon after the Foreign Secretary was found topping up his suntan instead of doing his job, Labour worked with the Bar Council to send to the Foreign Office a list of 126 Afghan judges who were at risk. We received no response, and our only update was seeing the Justice Secretary publicly celebrating the fact that just nine of them have been relocated to the UK. Can he confirm whether the number of Afghan judges relocated to the UK remains in single digits, what the number currently is, and how much higher he expects it could have been if the Foreign Secretary had not been missing in action?
Robert Buckland
I am sorry, but the right hon. Gentleman has not been in touch with me once about these matters directly. I have been working directly with the legal sector, the Bar Council and individual leading members of the profession, virtually daily to try to identify particular schemes and approaches we can take to assist judges, prosecutors and other lawyers in Afghanistan. I would love to see the list he talks about, because I can assure him that I will not rest until we do everything we can to help these dedicated professionals. I will, of course, keep the House updated on numbers as and when they are made available to me.
Mr Speaker
We just need to tone it down a little bit on all sides. I am concerned about some of the language that gets used and some of the accusations that are being made. I am sure we will be able to move on in a much more reasonable way.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
The Minister for Crime and Policing (Kit Malthouse)
The Ministry of Justice and the Home Office are working in close collaboration to beat crime and reduce fear of reoffending. I am the personification of that collaboration. The refreshed integrated offender management strategy is an example of that collaboration, improving working between probation and local police, meaning we can more easily identify persistent offenders in any particular area and take action to stop them from committing neighbourhood crime.
Dr Spencer
I thank my hon. Friend for being the personification of collaboration between the police and the Department. Will he join me in thanking and congratulating my local police forces in Runnymede and Weybridge on the incredible preventive work they have done around offending? Does he agree with me that prevention is better than cure, and could he lay out some of the work they are doing in terms of pre-offending, not just reoffending?
Kit Malthouse
My hon. Friend is quite right to point out that prevention is better than cure. One emphasis I have tried to bring to my mission as a joint Minister between the Home Office and the Ministry of Justice is that we should shift away from enforcement towards prevention as much as we possibly can. For example, he will know that we funded a series of violence reduction units across the country, working with young people well ahead of them moving towards offending or being involved in crime to make sure that they do not. We are also looking at innovative ways to deal with offenders leaving the secure estate to prevent them from offending, such as GPS tags. We are now currently tagging 100% of acquisitive criminals who leave prison in six police forces, soon to be expanded to a further 13, which is proving to be an enormous deterrent to their continuing offending, and is getting them back on to the straight and narrow.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
My constituent had a successful career until addiction took control and she ended up in prison for crimes related to her addiction. She is out of prison, she is not reoffending and she is clean. She is getting her life back. Last year, however, she was raped. The rapist has been convicted, but she has been told that she is not entitled to criminal injury compensation because she has a prior conviction. Is that fair?
Kit Malthouse
I am not aware of the specifics of that particular case. I am happy to meet or correspond with the hon. Lady if she wishes, but it is the case that people who have been convicted of a prior criminal offence are not entitled to compensation through the criminal injuries compensation scheme.
Jonathan Gullis (Stoke-on-Trent North) (Con)
My hon. Friend will be aware that one of the best ways to reduce reoffending is education and work. When I speak to people in Stoke-on-Trent North, Kidsgrove and Talke, one of the things they want to see from people who are currently in prison who may be looking to leave is them not only gaining level 3 and level 4 qualifications, but getting out and working and earning money, whether that be through picking fruit and veg, or digging up roads. Can we see how that can be done through the Ministry of Justice?
Kit Malthouse
My hon. Friend, in his usual forthright way, is quite right and cuts to the heart of the issue. We believe there is a simple formula for success after prison: giving people a job, a house and friend. If we think about it, those three pillars are the foundation of success for most of our lives and so it should be for prisoners, too.
Rachael Maskell (York Central) (Lab/Co-op)
Many people who reoffend are involved in substance misuse and, as a result of that, have a criminal conviction. If a public health approach is taken, that not only diverts people away from crime but gives people a new opportunity for a future. North Yorkshire police are working very hard on diversion. What is the Minister doing across Departments to make sure that a public health approach is taken?
Kit Malthouse
The hon. Lady will recall that we were successful at the last spending round in securing, I think, £85 million to make sure that every single person who left the secure estate with a drug addiction was able to access treatment to help them back on to the straight and narrow. It is worth remembering what a public health approach means. Although there are therapeutic and often medical treatments and services that should be offered to offenders to help them with regard to their offending, at the same time we have to bear in mind that enforcement counts, too. Making sure that we treat them with rigour and discipline and that there is consequence for their non-compliance with the conditions that we put on them post-release from prison is critical to getting the psychology right. We are seeing this, for example, with our GPS tagging. In particular, when we expand the use of sobriety tags to those prisoners who are leaving the secure estate who have had an alcohol problem before, we hope to see that writ large.
Jason McCartney (Colne Valley) (Con)
Tom Randall (Gedling) (Con)
Karl MᶜCartney (Lincoln) (Con)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
The Government recognise the deep distress that is caused when a pet is stolen, and the pet theft taskforce carried out a thorough investigation of this issue. Its excellent report, published earlier this month, contains a comprehensive set of recommendations that will allow us to tackle this issue head on.
Jason McCartney
As a fellow animal lover, Mr Speaker, I know that you, like me, will appreciate the extreme distress that the theft of a much loved family pet can cause, particularly with over 2,000 pet dogs reported as having been stolen last year. These measures cannot come soon enough, so can the Justice Secretary confirm how soon they will be brought forward to tackle pet theft?
Robert Buckland
I reassure my hon. Friend that we are already working on the new proposed offence of pet abduction and that work is already under way with many of the other recommendations stemming from the report, such as the review of microchipping and improvements in the recording of these offences. This will continue and I remind the House that the recommendation of the pet abduction offence is leagues better than the weak amendment proposed by Labour.
Tom Randall
I thank my right hon. and learned Friend for his work on bringing criminals to book with the much needed criminal offence of pet theft. Does he agree that it is important that the sentence for this offence, when determined, will reflect the unique emotional suffering caused by the theft of a beloved pet, and will he ensure that that is reflected?
Robert Buckland
My hon. Friend is absolutely right. The use of the term “abduction” is a crucial reflection of the fact that these are sentient beings; they are not mere chattels or goods. The emotional effect both on the pets and their owners has to be taken into account. I think there is a read-across to animal cruelty and the important reforms that we made recently in increasing maximum sentences.
Karl MᶜCartney
I thank my right hon. and learned Friend for his response and for his recent visit to our Crown court in Lincoln castle, the magistrates court in the city and Her Majesty’s prison Lincoln, none of which are up for sale, Mr Speaker, but the judge’s lodgings are, if you are interested. Pets are not just animals; they are often members of families, and many of my constituents in Lincoln would welcome changes to ensure that we protect our pets to the highest possible degree. As well as strengthening prosecution powers through the pet abduction offence and expanding pet ownership databases, does my right hon. and learned Friend agree that we must educate prospective owners to buy pets only from reputable breeders and potentially encompass farm animals in the same legislation?
Robert Buckland
My hon. Friend hits the nail on the head. The idea that buying an animal by the side of the road or in a garage forecourt for cash is somehow legitimate trade is clearly wrong. I am grateful to colleagues at the Department for Environment, Food and Rural Affairs for doing important work on promoting safer purchasing through the “Petfished” campaign. We will build on that in the way in which we identify and track cases better, improve the recording of keepership data and deal with through-the-loophole breeders, who are frankly responsible for a lot of cruelty and suffering.
Karl Turner (Kingston upon Hull East) (Lab)
I rarely congratulate the Justice Secretary, but I do on this issue because he has eventually agreed with Her Majesty’s loyal Opposition about making pet theft a specific offence. On a serious note, I congratulate all the campaigners on the issue, particularly John Cooper, QC, who has done an awful lot of work on it.
The Justice Secretary knows that when the shadow Justice Secretary, my right hon. Friend the Member for Tottenham (Mr Lammy), tabled his amendment to the Police, Crime, Sentencing and Courts Bill, the Tories rejected the idea of a specific offence time and again; I think I am right in saying that the Justice Secretary’s argument was that the Theft Act 1968 was sufficient. The taskforce has now reported, but I am not clear on when we expect the legislation to take effect. When can we expect those who are alleged to have stolen pets to face the criminal courts?
Robert Buckland
I am always grateful for the hon. Gentleman’s words of wisdom, but I will just correct him in this respect: there was a general agreement that the use of theft legislation to deal with what were more than goods and chattels just was not an adequate way to reflect not just the taking of a pet, but the suffering of the pet and of the owner. That is why abduction is a much better read-across, as he knows from the matter of child abduction, for example.
I take issue with the hon. Gentleman on the point and I challenge him and the Opposition: if the matter is brought forward in the Police, Crime, Sentencing and Courts Bill, which they voted against again and again, will they now support it?
John Penrose (Weston-super-Mare) (Con)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
The Government are currently consulting on a range of reforms to competition and policy in order to more effectively and swiftly address anti-competitive behaviour. The consultation includes many of the recommendations that my hon. Friend made in his excellent report. As part of it, we welcome suggestions from small businesses about how the system can be improved.
John Penrose
The Secretary of State understands that anti-competitive behaviour is just as likely among small firms as among big ones. The effects are terrible: fast-growing small firms that are future world beaters get throttled by slightly bigger incumbents, levelling up is slower and less likely because competition and productivity are much lower outside London, and residents are left with less choice and more vulnerability to rip-offs. Does he agree that the justice system plays a central role in tackling the problem and ensuring that small firms have some kind of redress? Will he therefore look closely at the proposal in my Government-commissioned report for a new tier of local county competition courts?
Robert Buckland
I will be as brief as I can, Mr Speaker. We have read my hon. Friend’s paper with great interest. With respect, I do not think that the way forward is to create a further tier of specialist courts. However, there is much that can be done with colleagues in the Department for Business, Energy and Industrial Strategy to make sure that the overall structure of the competition mechanism is reformed and improved. His point about access to justice is absolutely right: it should apply to small and medium-sized enterprises as much as to individuals.
Allan Dorans (Ayr, Carrick and Cumnock) (SNP)
Chris Stephens (Glasgow South West) (SNP)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
Naturally, I do not disclose the details of my private conversations with Cabinet colleagues, but they and everybody else should be in no doubt that I am, and will continue to be, a very active Lord Chancellor in supporting the rule of law. I use the authority of my office to advise, to warn and to encourage. I am absolutely committed, under the oath I took, to my constitutional duty to respect the rule of law.
Allan Dorans
The Secretary of State will no doubt agree that for any Government committed to the rule of law, respect for international law is as important as respect for domestic law. Will he therefore join me in condemning suggestions by the Home Secretary that she is prepared to break international refugee conventions and turn away boats in the channel? Will he meet her to stress how damaging that action would be to the United Kingdom’s international reputation and credibility?
Robert Buckland
I assure the hon. Gentleman that my right hon. Friend the Home Secretary has taken the fullest and most comprehensive advice on these matters. There is an immediate challenge: we face the appalling exploitation of people by gangmasters and traffickers across the English channel every day. It is absolutely right that she and Home Office colleagues explore every possible lawful avenue to deal with that. That is what this Government are committed to, and there is no question that her actions would come close to breaking international law.
Mr Speaker
Chris Stephens is not here, so I call the shadow Justice Secretary, David Lammy.
Mr David Lammy (Tottenham) (Lab)
Thank you very much, Mr Speaker.
In the middle of a pandemic, the Secretary of State’s Government are prioritising attacking the Human Rights Act and judicial review, disenfranchising millions of voters with the Elections Bill on voter ID, and, now, threatening to break international law to make it harder for asylum seekers, including those from Afghanistan, to find sanctuary in Britain. The new president of the Law Society recently warned that those measures put respect for the rule of law in jeopardy in the UK. What does the Secretary of State say to the president of the Law Society?
Robert Buckland
I think the right hon. Gentleman will find that, across the piece, the commentary that has followed my speech and the introduction of the Judicial Review and Courts Bill has reflected the fact that this is a measured and incremental approach to constitutional reform, as, I am sure, will be the work on the independent review of the Human Rights Act. The idea that somehow I am the most dangerous Lord Chancellor in history is risible. [Laughter.]
Anne McLaughlin (Glasgow North East) (SNP)
None of this is funny. This Government’s disregard for the rule of law is wide-ranging, as we have heard. They are reducing access to justice, planning, for instance, to remove Cart judicial reviews; the Nationality and Borders Bill simply ignores the refugee convention, while the Police, Crime, Sentencing and Courts Bill strips away legal certainty; and the Secretary of State’s own comments to me in this place on 18 May demonstrated his disregard for our international obligations. Can he match my necessarily shortened list with examples that demonstrate the opposite?
Robert Buckland
I am afraid that that is emblematic of the problem that we are facing. Dressing up legitimate political debate as somehow a direct criticism of our adherence to the rule of law is, I am afraid, a regular trick of the left, and I am not going to fall for that sanctimonious list of nonsense. This Government are absolutely committed to the rule of law across our United Kingdom.
Anne McLaughlin
The Nationality and Borders Bill also lengthens the time for which those seeking asylum must wait for a decision, while shortening the time that they have in which to appeal. As we have heard, 22 female judges are trapped in Afghanistan, and neither yesterday nor today have we heard any firm plans to get them out. If they manage somehow to make it here without our assistance, how surprised does the Secretary of State think they will be to discover the complete disregard for them and for the rule of law in that Bill?
Robert Buckland
Again, the hon. Lady is way off the mark. The idea that there is not a clear plan was plainly negatived by yesterday’s statement from the Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins). We have a very clear plan for Afghan judges. If the Scottish National party wishes to conduct a proper dialogue and a proper debate, I shall be interested to hear it; thus far, I do not hear it.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
Robert Buckland
It is for the probation service, through its victim liaison officers, rather than the Parole Board to notify victims of upcoming parole reviews and to ensure that they are able to exercise their statutory rights to make a victim personal statement or request licence conditions. It is understandably distressing when victims are told of an offender’s release, and we are therefore investing heavily in the probation service and its designated professional staff to give them further support.
Liz Saville Roberts (Dwyfor Meirionnydd) (PC)
My constituent Michael McGrath is battling for justice for his family. His sister Rachel McGrath was murdered in a brutal stranger attack by Nicholas Burton in 1997. The trial judge described Burton as merciless and manipulative, and stated that no Home Secretary—as the arrangement was at the time—would ever be likely to allow his release. Rachel’s elderly parents were recently told that Burton would walk free next year. They have not even been able to make a victim statement, and they believe that correct procedure has not been followed. Will the Secretary of State please agree to a ministerial meeting with the family to help to ensure that they have all the information they need, and that their voice is heard and respected?
Robert Buckland
I thank the right hon. Lady for raising that extremely sensitive, distressing and frankly appalling case. Yes, of course I would be delighted to meet the family. May I also make a general point? We—and, in fairness, I think that this applies across all parties—are very keen for victims to be not spectators but participants in these matters, so their voice shall be heard, and we will continue to do everything possible to strengthen that voice.
Sir David Evennett (Bexleyheath and Crayford) (Con)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
The Government have established the independent Human Rights Act review to examine the framework of that Act, how it is operating in practice and whether any change is required. The review is considering the approach taken by our domestic courts to the jurisprudence of the European Court of Human Rights, and it will also examine whether the HRA currently strikes the correct balance between the roles of the courts, the Government and Parliament. It will report back later this year.
Sir David Evennett
I thank my right hon. and learned Friend for that answer and welcome this review, as I think we all do on our side of the Chamber. However, will he commit to an open consultation on any proposed reforms resulting from the independent review of the Human Rights Act?
Robert Buckland
I am happy to commit to that open consultation once we have published the findings of the review.
Patricia Gibson (North Ayrshire and Arran) (SNP)
The Lord Chancellor and Secretary of State for Justice (Robert Buckland)
May I take this opportunity to welcome the Minister of State, my right hon. and learned Friend the Member for South East Cambridgeshire (Lucy Frazer), back to her place in the Ministry of Justice? We are grateful to see her back.
Our pets are valuable members of our families, and we rely on their companionship daily. This has been especially true throughout the pandemic. The reported rise in pet thefts throughout this time has being truly shocking, and the Government are not prepared to ignore the growing concern about this issue. The pet theft taskforce published its report this month, and it contains a comprehensive set of recommendations that would allow us to tackle this issue. Chief among them is the creation of a new offence of pet abduction. I agree wholeheartedly that this is the right course of action because it recognises that pets are more than mere property and distinguishes them from inanimate objects that can be replaced. The new offence also acknowledges that when the pet is stolen, there are two victims, not one. We will look to introduce the new offence when parliamentary time allows.
Patricia Gibson
Does the Secretary of State believe that it is safe or appropriate for prison officers—the invisible emergency service—who by definition deal with the most violent and dangerous criminals across the UK, to be expected to do so up to the age of 68, which is their retirement age? Does he not agree that this completely unrealistic retirement age has negatively impacted on retention and recruitment rates?
Robert Buckland
The hon. Lady is right to raise the retirement age issue. Indeed, the Under-Secretary of State, my hon. Friend the Member for Cheltenham (Alex Chalk), rightly pointed out in answer to an earlier question that there had been two attempts in recent years to resolve this issue. No agreement was reached with the Prison Officers Association, but I very much hope that any future discussions will result in some agreement. We continue to look at this issue, and I want to put on record my warm tribute to the prison service and to the much hidden and misunderstood work of jailcraft that prison officers do, day in and day out, in England and Wales, and indeed in Scotland.
John Penrose (Weston-super-Mare) (Con)
The Parliamentary Under-Secretary of State for Justice (Alex Chalk)
My hon. Friend raises a critical point, and we agree, which is why we have invested £100 million in gate security to ensure, for example, that body scanners can be installed to allow concealed items to be detected, that there is money for counter-corruption, and that rehabilitation and treatment can take place in jail. A time when our jails are completely drug free is something that we aspire to, and we are making important progress.
Alex Cunningham (Stockton North) (Lab)
At the last Justice questions, I raised the issue of the wrongful prosecution and conviction of British citizens under schedule 22 to the Coronavirus Act 2020, an issue that has been publicised by Big Brother Watch, Fair Trials, and The Guardian newspaper. Sadly, the Minister blamed the Crown Prosecution Service and did not promise to correct this injustice, and more people might have been wrongly convicted since then. That said, following our intervention, the Government have expired the schedule. I am grateful for that, but can the Lord Chancellor tell us what action he is taking to quash all the illegal convictions?
Robert Buckland
With respect to the hon. Gentleman, this is not a question of our blaming the Crown Prosecution Service. There is a constitutional principle here. The Crown Prosecution Service is independent, and the Law Officers are responsible for the superintendence of that service. I am sure that his colleague the shadow Solicitor General will be able to ask the Law Officers these questions in the next few days.
Mr David Davis (Haltemprice and Howden) (Con)
Robert Buckland
My right hon. Friend will appreciate that there are ongoing proceedings, including in the civil courts, and the extradition proceedings may be subject to further appeals, so it would not be right for me to comment directly on that case. The SFO is superintended by the Law Officers. However, I undertake to talk to him about the general issues of concern that he properly raises.
Kevin Brennan (Cardiff West) (Lab)
Robert Buckland
I am always keen, as the hon. Gentleman knows, to make sure that the law in England and Wales is consistent. I will, of course, look carefully at that particular issue. The report is welcome as we particularly looked at a read-across to scrap metal and the way in which we banned cash payments there. The evidence is emerging, and we are gathering it as quickly as possible. We will do everything we can, consistent with an appropriate approach, to deal with this type of illegitimate trade in defenceless animals.
Giles Watling (Clacton) (Con)
The Minister for Crime and Policing (Kit Malthouse)
I am extremely sorry to hear about the event in my hon. Friend’s constituency, and I am pleased that he has raised it on the Floor of the House. He will know that, for the last two years, we have made dismantling the county lines business model a key priority of our work between the Home Office and the Ministry of Justice. He will be pleased to know that, following significant investment in the key exporting forces of London, the west midlands and Liverpool—Merseyside police—we have made significant progress. We reckon that we have managed to dismantle about a third of the county lines, but there is still significant work to do. He will be pleased to know that some counties, such as Essex and Norfolk, are showing significant success, but there is still a lot more to do to overcome this pernicious and particularly unpleasant business model that focuses on exploiting young and vulnerable people as part of its way of making money. I assure him that we will not stint over the coming years in trying to eradicate county lines from our country.
Sarah Champion (Rotherham) (Lab)
Robert Buckland
The hon. Lady raises a case that shocks and concerns us all. I would be more than happy to talk to her directly about these issues. As she knows, the law of criminal damage is being reformed in other respects in the Police, Crime, Sentencing and Courts Bill, but I want to make sure that we reflect the often devastating consequences of thoughtless and criminal acts of damage against vital pieces of life-saving equipment such as life belts.
Mark Pawsey (Rugby) (Con)
The Parliamentary Under-Secretary of State for Justice (Chris Philp)
I am extremely sorry to hear of the experience hon. Friend’s constituent has undergone. I can confirm that this area is a priority in court recovery from covid. For example, domestic violence protection orders are being prioritised. In cases where there is a particular vulnerability, the judiciary, in deciding which cases to list, give that careful consideration. As I laid out in answer to the very first question, significant additional resources have gone into the justice system, which have resulted in higher levels of public family law disposals—they are significantly higher this year than last. We are using remote hearing technology and getting extra sitting days organised, for exactly the reasons he mentioned; hearing awful cases such as the one he described remains a significant priority.
Alan Brown (Kilmarnock and Loudoun) (SNP)
Robert Buckland
As I said to the House earlier, the Afghan relocations and assistance policy scheme covered the initial flights out. We have now extended and created a new scheme yesterday, which will cover and make a priority those particular judges. The hon. Gentleman knows that the issues in the country are complex and that colleagues across Government are working out ways in which we can facilitate safe passage, but I assure him that everybody who fits that category will get the warmest of welcomes in this country and that that work goes on daily. [Interruption.] I do not know how many times I can explain this: there is a clear plan and we are getting on with it.
Rob Butler (Aylesbury) (Con)
Prison officers and staff have done an amazing, excellent job of keeping prisoners safe during the pandemic, with much lower infection rates in jails than had been feared. That has mainly been achieved by keeping prisoners locked in their cells, but, obviously, we now need to move beyond that so that they can access education, work and other rehabilitation programmes. So will the Minister tell the House what progress has been made on rolling out vaccines in prisons, which would allow this vital work to resume?
The Parliamentary Under-Secretary of State for Justice (Alex Chalk)
I am grateful to my hon. Friend, who is absolutely right to pay tribute, and let me tell him why. At the beginning of this pandemic there was a prediction that 2,700 prisoners would die in English jails, but the actual figure is under 130. Although every one of those is a tragedy, this is a powerful tribute to the work that those staff did. He makes an important point about vaccination. Every prisoner has been offered a vaccination, although there are some decline rates, which are higher in London, of up to 50%. Every effort is being made to encourage prisoners to get vaccinated, because we could then open up the regime.
Chi Onwurah (Newcastle upon Tyne Central) (Lab)
The Minister of State, Ministry of Justice (Lucy Frazer)
The hon. Lady makes an important point, because if we want to cut crime, we have to reduce reoffending. That means we have to get people who come out of prison a job, they need to get a home and if they are on drugs, they need to get off drugs. This is absolutely what we are doing and in July we launched our £20 million scheme to provide temporary accommodation for prison leavers at risk of homelessness in five probation regions. We are also working closely with the Department for Work and Pensions to ensure that we have work coaches in prison to get people jobs.
Siobhan Baillie (Stroud) (Con)
Last year, the expert Family Solutions Group produced a hard-hitting report called “What about me?”, which focuses on the 280,000 children each year who experience their parents separating. With the divorce Act fast approaching and family courts increasingly stretched, will my right hon. and learned Friend meet me to discuss ideas and some of the report’s identified policy gaps on separating families?
Robert Buckland
My hon. Friend has considerable professional experience as a family lawyer of distinction, and I am more than happy to speak to her. It sounds as if that report complements the family harm report that was published earlier this year and the excellent work that is being done by senior judiciary in the family division to minimise the fight when it comes to the future of our children.
Jeff Smith (Manchester, Withington) (Lab)
Robert Buckland
I am grateful to the hon. Member for raising the Law Commission report. I will write to him to clarify the date by which the commission will publish that clearly important piece of work. There is a shared will throughout the House to take action wherever it is appropriate, and the hon. Member can rest assured that the Government will not slack when it comes to the protection of women and other vulnerable people.
Edward Timpson (Eddisbury) (Con)
I know, Mr Speaker, that you will be exercised by the Public Service Pensions and Judicial Offices Bill that is currently going through the other place, and particularly by clause 103, which will raise the retirement age of magistrates from 70 to 75, thus fulfilling the ambition behind the private Member’s Bill that I introduced in the previous Session. While we wait for that legislation to go through, what other measures is my right hon. and learned Friend taking to get through the backlog of cases in courts, particularly through online cases?
Robert Buckland
My hon. Friend was himself a practitioner of many years’ standing. I assure him that we are using every tool available—including remote hearings, bringing back judges who have recently retired and, indeed, harnessing the entire legal profession—to deal with the number of cases before the courts. The restriction on sitting days has been lifted and colleagues in Her Majesty’s Courts and Tribunals Service are working tirelessly to deal with the case load.
Joanna Cherry (Edinburgh South West) (SNP)
May I return to the case of the female Afghan judges, which I raised yesterday with the Lord Chancellor’s Home Office colleague, the Under-Secretary of State for the Home Department, the hon. Member for Louth and Horncastle (Victoria Atkins)? A female former Afghan judge who escaped two assassination attempts by the Taliban and is now a British citizen contacted me at the weekend to explain the very real and immediate danger that her colleagues face, particularly from dangerous criminals and terrorists who have been released from prison. I am bringing her into Parliament at 5 pm this evening to meet informally with the Justice Committee; will the Lord Chancellor, or perhaps one of his junior colleagues, come to that meeting and meet this lady to hear at first hand how desperate the situation really is?
Robert Buckland
I will of course make sure that my diary is adjusted so that I can do that. The hon. and learned Lady can rest assured that I am getting emails from her colleagues directly to my parliamentary account. These are harrowing tales of harrowing experiences, which is why I meant what I said in my answers earlier. I am very grateful to the hon. and learned Lady.
Mr David Lammy (Tottenham) (Lab)
On a point of order, Mr Speaker.
Mr Speaker
Is it a point of order relating to the questions we have just had?
Mr Lammy
Yes, Mr Speaker.
In oral questions, the whole House expressed tremendous concern about the situation that faces Afghan judges. In response to my question earlier, the Secretary of State for Justice said that he has not been written to by me once about judges in Afghanistan, in reference to my role as shadow Secretary of State for Justice. With all graciousness, I ask the Secretary of State to correct the record: I wrote to him on 16 August—I have the letter in front of me and it is available online—and he replied to me on 25 August.
Robert Buckland
Further to that point of order, Mr Speaker. I am happy to correct the record and, of course, to apologise to the right hon. Gentleman. I remind him that I am more than happy to speak directly to him. He will know that the urgency of this situation means that phone calls and texts are absolutely acceptable, and I would be more than happy to discuss the matter with him in that way. As you know, Mr Speaker, this has been a very busy time, and I hope the House will forgive me if on this occasion I got it wrong. I do apologise to the right hon. Gentleman.
AQUIND Interconnector Project
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text
Stephen Morgan (Portsmouth South) (Lab)
I rise to present a petition on behalf of my constituents concerning the proposed AQUIND interconnector project, which has been signed by more than 6,000 local people. This is a sliding doors moment for the Business Secretary. He has a clear choice: he can either stop this disastrous project, which is mired in cronyism and would be deeply damaging to Portsmouth and our national security, or he can reject my great city’s clear and united opposition, and explain why decisions impacting local communities continue to be made behind closed doors in Whitehall. I urge the city council in Portsmouth to take every possible step if the Secretary of State’s decision, expected next month, goes against the people of Portsmouth. Tonight, in this House, I present 6,200 reasons why AQUIND must be stopped.
The petition states:
The petition of residents of the United Kingdom,
Declares that the planned AQUIND Interconnector Project should not be allowed to be implemented dye to the damage it would cause to the local community without clear benefits, further that the implementation could impact the wider environment; further that ongoing concerns remain surrounding the project company and their Directors.
The petitioners therefore request that the House of Commons urge the Government not to approve the AQUIND Interconnector Project.
And the petitioners remain, etc.
[P002686]
Covid-19 Update
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Sajid Javid)
Mr Speaker, before I make my statement today, I am sure that the whole House will want to join me in offering our condolences to my right hon. Friend the Prime Minister and my noble Friend Baron Johnson of Marylebone on the loss of their mother who sadly passed away yesterday. Our thoughts are with them and their whole family at this most difficult of times.
With permission, Mr Speaker, I would like to make a statement on the pandemic and our autumn and winter plan to manage the risk of covid-19.
Over the past few months, we have been making progress down the road to recovery, carefully and cautiously moving closer to normal life. As we do this, we have been working hard to strengthen our defences against this deadly virus. We have been continuing the roll-out of our vaccination programme, with 81% of people over the age of 16 having had the protection of both doses. We have expanded our testing capacity yet further, opening a new mega-lab in Leamington Spa, and we have continued supporting research into long covid, taking our total investment to £50 million.
Thanks to that determined effort, we have made some major steps forward. The link between cases, hospitalisations and death has weakened significantly since the start of the pandemic and deaths from covid-19 have been mercifully low compared with previous waves. None the less, we must be vigilant as autumn and winter are favourable conditions for covid-19 and other seasonal viruses. Children have returned to school. More and more people are returning to work. The changing weather means that there will be more people spending time indoors, and there is likely to be a lot of non-covid demand on the NHS, including flu and norovirus.
Today, keeping our commitment to this House, I would like to provide an update on our review of preparedness for autumn and winter. The plan shows how we will give this nation the best possible chance of living with covid without the need for stringent social and economic restrictions.
There are five pillars to this plan. The first is further strengthening our pharmaceutical defences such as vaccines. The latest statistics from the Office for National Statistics show that almost 99% of covid-19 deaths in the first half of this year were people who had not received both doses of a covid-19 vaccine. This shows the importance of our vaccination programme, and, by extending the programme further, we can protect even more people. Almost 6 million people over the age of 16 remain unvaccinated in the UK, and the more people there are who are unvaccinated the larger the holes in our collective defences. We will renew our efforts to maximise uptake among those who are eligible but who have not yet, for whatever reason, taken up the offer.
Next, we have been planning our booster doses, too. As with many other vaccines, there is evidence that the protection offered by covid-19 vaccines reduces over time, particularly for older people who are at greater risk. Booster doses are an important way of keeping the virus under control for the long term.
This morning, we published the advice of the Joint Committee on Vaccination and Immunisation on a booster programme. It recommended that people who were vaccinated in phase 1—priority groups 1 to 9—should be offered a booster vaccine; that this vaccine should be offered no earlier than six months after the completion of the primary vaccine course; and that, as far as possible, the booster programme should be deployed in the same order as phase 1. I can confirm that I have accepted the JCVI’s advice and that the NHS is preparing to offer booster doses from next week. The NHS will contact people at the right time and nobody needs to come forward at this point. This booster programme will protect the most vulnerable through the winter months and strengthen our wall of defence even further.
As well as that, we will be extending the offer of a covid-19 vaccine to even more people, as the Minister for covid-19 vaccine deployment announced yesterday in the House—thank you, Mr Speaker, for allowing him to make that statement yesterday. All young people aged 16 to 17 in England have already been offered a dose of a covid-19 vaccine to give them the protection as they return to school. Yesterday, the UK’s chief medical officers unanimously recommended making a universal offer of a first dose of a vaccine to people between the ages of 12 and 15. The Government have accepted that recommendation, too, and will move with urgency to put this into action. We are also seeing great advances in the use of antivirals and therapeutics. Several covid-19 treatments are already available through the NHS and our antivirals taskforce is leading the search for breakthroughs in antivirals, which have so much more potential to offer.
Secondly, testing, tracing and self-isolation have been another vital defence. Over the autumn and winter, PCR testing for those with covid-19 symptoms and contacts of confirmed cases will continue to be available free of charge. Regular asymptomatic testing, which currently identifies about a quarter of all reported cases, will also continue in the coming months, with a focus on those who are not fully vaccinated: perhaps those in education or other higher-risk settings. Contact tracing will continue through the NHS Test and Trace system. We do not want people to face hardship as they carry out their duty to self-isolate, so we will keep offering practical and financial support for those who are eligible and need assistance who are still required to self-isolate. We will review the regulations and support by the end of March 2022.
The third pillar is that we are supporting the NHS and social care. Last week, I announced a £5.4 billion injection for the NHS to support the covid-19 response over the next six months, including £1 billion extra to tackle the elective backlog caused by covid-19. We have also launched a consultation on protecting vulnerable patients by making covid-19 and flu vaccinations a condition of deployment for frontline healthcare staff and wider social care workers in England. We are already making this a condition of employment in Care Quality Commission-registered adult care homes. Although we are keeping an open mind and will not be making a final decision until we fully consider the results of the consultation, it is highly likely that frontline NHS staff and those working in wider social care settings will also have to be vaccinated to protect those around them, and that this will be an important step in protecting those at greatest risk.
Fourthly, we will keep encouraging people to take steps to keep seasonal illnesses, including flu and covid-19, at bay. The best step we can all take is to get vaccinations for covid-19 and flu if we are eligible, so along with our covid-19 vaccination programme the next few months will see the largest flu vaccination campaign that the country has ever seen. Our plan also sets out a number of changes that we can all make to our daily routines, such as: meeting outdoors where possible; trying to let in fresh air if we need to be indoors; and wearing a face mask in crowded and enclosed spaces where we come into contact with people who we do not normally meet.
Our fifth pillar is how we will look beyond our shores and pursue an international approach. Last week, I attended the G20 Health Ministers’ Meeting, where I met counterparts from across the world and talked about the part that we will be playing to lead the global effort to accelerate access to vaccines, therapeutics and diagnostics. As we do this, we will maintain our strong defences at the border, allowing us to identify and respond to variants of concern. It is these defences, and the progress of vaccination campaigns both here and abroad, that have allowed us to manage the risks and to start carefully reopening international travel once again. We have already relaxed the rules for fully vaccinated travellers and I asked the Competition and Markets Authority to review the issue of exploitative behaviour in the private testing market. The review reported last week and I am looking into what further action we can take. On top of those measures, we will be publishing a new framework for international travel. My right hon. Friend the Transport Secretary will be announcing more details ahead of the formal review point on 1 October.
Thanks to the defences that we have built, we have been able to remove many of the regulations that have governed our daily lives—rules that were unprecedented yet necessary. Our plan shows how we will be removing more of these powers while maintaining those that are essential for our response. This includes expiring more of the powers in the Coronavirus Act 2020, such as the powers directing the temporary closure of educational institutions. The remaining provisions will be those that are critical to the Government’s response to the pandemic—for example, ensuring that the NHS is properly resourced, and supporting statutory sick pay for those who are self-isolating.
The plan before the House today is our plan A—a comprehensive plan to steer this country through the autumn and winter. But we have seen how quickly this virus can adapt and change, so we have prepared a plan B of contingency measures, which we can call upon only if they are needed and supported by the data, to prevent unsustainable pressure on the NHS. These measures would be: communicating clearly and urgently to the public the need for caution; legally mandating face coverings in certain settings; and, while we are not going ahead with mandatory vaccine-only covid status certification now, holding that power in reserve. As well as those three steps, we would consider a further measure of asking people to work from home if they can for a limited time if that is supported by the data. Any responsible Government must prepare for all eventualities. Although these measures are not an outcome that anyone wants, it is one that we need to be ready for just in case.
Ever since we published our road map to recovery seven months ago, we have been carefully but cautiously getting this nation closer to normal life. Now we have come so far and achieved so much, we must stay vigilant as we approach this critical chapter, so that we can protect the progress that we have all made together. I commend this statement to the House.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
I thank the Secretary of State for advance sight of his statement. Like him, I want to send my condolences to the Prime Minister and the wider Johnson family at this difficult time.
Infection levels today are actually higher than they were at this time last year, so the test of the Secretary of State’s plan A and plan B is whether we push infections down, minimise sickness and save lives, keep schools open, protect care homes, maintain access to all care in the national health service, and avoid a winter lockdown. He has talked about a plan B. Can he tell us what level of infection and hospitalisation would trigger plan B? Yesterday, Downing Street briefed about a lockdown as a last resort. What, then, is the first resort in combating the virus to avoid a winter lockdown? Will the Secretary of State rule out today local and regional lockdowns like we saw in my city of Leicester, in Bolton and in parts of West Yorkshire last year?
On vaccination, last night we had confirmation of a vaccine programme for children. We welcome and support that. The Secretary of State has now confirmed a booster jab as well. Again, we welcome and support that. But how will he boost vaccination in those areas of the country where vaccine take-up remains relatively low? For example, in Bradford, second doses are running at about 65%, in Wolverhampton at 65%, in Burnley at 69%, and in my own city of Leicester at 61%. What support will be made available to those areas, or others, so that they can boost vaccine take-up?
Vaccinating children is often justified, in my view wrongly, on the basis of its impact on adults and wider transmission. But children and young people would actually benefit further if vaccination rates were increased among adults. Among younger adults—25 to 30-year-olds—it is running at about 55% on a second dose, and among 30 to 35-year-olds at 68%. So what is the Secretary of State going to do to vaccinate more younger adults? What campaign is he going to run to get those vaccination rates up?
What is the plan for those who are immune-suppressed and have shielded throughout this crisis? For example, 1 million cancer patients cannot produce an immune response to vaccines. Will they be offered the prophylactic antibody treatments that are now available, or will they be expected to shield further throughout the winter?
The Secretary of State is right to raise flu and seasonal viruses, but he will know that the Australian flu season has been minimal. That is good for Australia, obviously, but it impacts the ability to collect samples to make an appropriate vaccine for the strain that might hit us. Is he confident of the effectiveness of the flu vaccine to match this year’s strain?
On Test and Trace and wider diagnostics, we are likely to see more flu and RSV—respiratory syncytial virus—and more common colds and coughs. These are viruses with overlapping symptoms to covid, and an increasing range of symptoms is associated with covid as well. Will he look at multiplex testing, which as well as diagnosing whether someone is covid positive also diagnoses flu and RSV? The Academy of Medical Sciences has recommended this.
The Secretary of State said that PCR testing will continue free of charge through autumn and winter. I think that is the first time that a timeframe has been put on free PCR testing. Is he suggesting that we will move to a different system for PCR testing from next spring and summer, where perhaps people will be expected to pay for a test? Could he clarify the Government’s thinking on testing next spring and summer and the rest of the year?
Isolation rules have changed, understandably, but we still need tracing systems. So will local authorities get the resources they need to do contact tracing? For those who need to isolate still, will local authorities have more money in their funds to pay isolation payments? We know that it is such a struggle for those who are low-paid, on zero-hours contracts and so on to isolate.
The Secretary of State has talked about mask wearing and working from home, but he has not talked about ventilation so much. We know that the virus is airborne. We know that workplaces have legal standards about the quantity of fresh air and purified air that is appropriate, so what will he do to drive up ventilation in workplaces and to support public buildings to install the relevant air purification kits, so that people are not effectively breathing in contaminated air?
The Secretary of State did not mention social care. One of the most devastating consequences of failing to protect care homes or to put that protective ring around them was the tragic number of deaths in care homes. The infection control fund ends on 30 September for social care. Will it be extended?
On vaccine passports, will the Secretary of State clarify what exactly the Government’s position is now? What are the Government actually proposing? What will they ask the House to decide? On Sky, he said he was not ruling vaccine passports out. On the BBC, he said he was ruling the idea out. He is now saying they will keep it in reserve. Yesterday, Downing Street said that vaccine passports are a “first-line defence” against a winter wave. What exactly is the position? Rather than zig-zagging all over the place on vaccine passports, can we just get clarity and can the House make a final decision on whether or not we think they are an appropriate intervention?
Sajid Javid
The right hon. Gentleman asked a number of questions, so I will quickly plough through them. We have made clear that plan A is absolutely our focus. It is the situation we are in. Vaccines remain a critical part of it, as do testing and surveillance. I thank him for his support for our vaccine programme, including his comments yesterday. He also asked me about plan B. It is absolutely right that the Government have a contingency plan, and the trigger, so to speak, for plan B, as I mentioned in my statement, would be to look carefully at the pressures on the NHS. If at any point we deemed them to be unsustainable—if there was a significant rise in hospitalisations and we thought it was unsustainable—we would look carefully at whether we needed to take any of those plan B measures. That would be informed by the data, and of course we would come to the House at the time and make the appropriate response.
It is really important to emphasise, as we cannot do enough, the importance of vaccines. We now know from data just yesterday from the Office for National Statistics that, in the first half of this year, 99% of those who died from covid-19 sadly were not vaccinated. That highlights the importance of vaccination.
The right hon. Gentleman asked about people who are immuno-suppressed. He will see that we set out more details on that in the plan we have published today, including treatments that either are currently available or may soon be available. I have mentioned the antivirals taskforce, which is doing great work. There are a number of possible new treatments, and it is something in which the UK is very engaged. He will know that, for those immuno-suppressed people who can take the vaccine, just last week, we announced a third dose as part of the primary treatment. That again is a reminder of the action we are taking. Our advisers are constantly looking to see what more we can do.
The right hon. Gentleman asked about the flu risk. It is a significant risk this year, not least because, for reasons we are all familiar with, there was not much flu last year. There is a lot less natural immunity around in our communities, and the flu vaccine, which is being deployed not only in the UK, but across Europe, has less efficacy than normal, but it is still effective and a worthwhile vaccine, and that is why we will be trying to maximise uptake with the biggest roll-out programme and communications programme that this country has ever seen for the flu vaccine.
On diagnosis, the right hon. Gentleman made a good point, and it is something that we are looking at with covid and flu jointly. On testing arrangements, I think I have set them out clearly in the statement. We have no plans to change the current arrangements, but of course we keep that constantly under review. However, as long as those tests are needed available free for the public, that will be the case. But as I say we will keep that under review.
In terms of infection control in social care settings, a substantial amount of funding is available. We have already made available for this financial year some £34 billion of funding in total for the NHS and the care system for a lot of these extra measures. That is a huge amount of funding. Much of it is going to essential work, such as infection control, and we will ensure that what is needed is there.
The right hon. Gentleman’s last question was about vaccine certification. I think I have made the Government’s position clear. It is not something we are implementing. We are not going ahead with any plans for that. For any Government to do something like that, it would be such a big decision, and it would have to be backed up by the evidence and the data. That evidence is not there, and I hope that we will never be in the situation that it is. To keep it in reserve is the right thing to do.
Jeremy Hunt (South West Surrey) (Con)
I welcome this announcement, particularly on boosters. Yesterday, I asked the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), when we would hear about boosters. Just 15 hours later, the Secretary of State is making a statement. It is almost as if the Government are listening, and it is very good news. Nowhere wants to get back to normal more quickly than the NHS itself.
Will the Secretary of State commit that the backlog in mental health treatment will be treated every bit as seriously as the backlog in physical health? In particular, will he commit that the NHS and the Government will continue to adhere to the mental health investment standard, which says that mental health spending will increase at a higher rate than overall NHS spending, particularly when it comes to the extra money coming from the levy? Parity of esteem is supported by all parts of the House and legislated for in this House. There is a lot of worry in the mental health world that the money from the levy will not reflect the needs of the mental health backlog.
Sajid Javid
First, I always listen to the former Health Secretary. He always has some good advice, and I am pleased that he thinks the Government are moving quickly. He is absolutely right to raise the backlog in mental health. The Government are absolutely committed to parity of esteem. That is not just in law, but in our manifesto. I take this opportunity to reassure everyone who is particularly concerned and who may have raised this issue with my right hon. Friend that that commitment remains. The new funding that will go in over the next three years to help to deal with the backlog absolutely includes mental health funding.
Martyn Day (Linlithgow and East Falkirk) (SNP)
I start by extending my condolences and those of my party to the Prime Minister on his family bereavement. I am also grateful to the Secretary of State for advance sight of his statement, and I echo his call for vigilance and the importance of getting vaccinated. Covid data has shown how few deaths between January and July were among the fully vaccinated and clearly demonstrates the effect of vaccines in driving down deaths, which is a message we all have to take home to our constituencies.
With winter approaching and more favourable conditions for the transmission of the virus, it is welcome that we are extending vaccines to our younger citizens. The news on booster vaccines is also welcome. However, what more does the Secretary of State think can be done to encourage the million people over the age of 60 who have not yet been double-vaccinated to become so? The winter will be a difficult time for many in the UK, with the annual flu wave potentially coinciding with another covid wave. The disruption that that will entail will come immediately after the end of furlough and the universal credit uplift, and at a time of rising fuel bills. Why are the UK Government insisting on ending two of the key measures supporting people through the pandemic shortly before a potentially difficult winter for millions? It is essential that self-isolation remains affordable.
Finally, the UK Government have cancelled the contract with vaccine company Valneva, which was set to produce vaccines for the UK in Scotland, at its Livingston facility. Those on these Benches would be very grateful if the Secretary of State could provide an explanation of why the deal was cancelled before the trials were even completed, threatening jobs in Scotland.
Sajid Javid
I thank the hon. Gentleman for again raising the importance of vaccines. I agree wholeheartedly with what he said about that, and he is right to think about what more can be done to encourage people, and particularly older people—over 60s—throughout the UK to take up the offer. A number of things are being done both here in England and in Scotland to focus on that, including making greater use of family GPs and taking the time necessary to allay hesitant people’s concerns, allowing them to speak to the clinicians to whom they want access to give them that comfort. That work will continue, and we are constantly looking for new and perhaps even better ways to do that.
On universal credit, it was made clear when the Government announced the increase that it was temporary. As it is temporary, it has to come to an end at some point, and the time for that is now. As our economy has—thankfully—started to reopen, job availability is increasing and economic growth has come back, and this is the right time to do that. However, as I said earlier, we must continue to provide the necessary financial support such as that for those who are self-isolating.
Lastly, the hon. Gentleman asked about Valneva. I should be careful what I say as there is a commercial contract, but it might help him to know that I have been in touch with the Health Minister in Scotland, who is fully aware of the situation. We remain in dialogue.
Esther McVey (Tatton) (Con)
Given that figures sent to me by the Secretary of State’s Department show that since the pandemic the number of hospital beds has fallen by more than 6,000, will he assure me that proper additional capacity will be built back into the NHS as part of his plan rather than resorting to hugely damaging lockdowns and restrictions?
Sajid Javid
My right hon. Friend is right to raise the importance of capacity in the NHS. She will know that the reason for the fall in capacity in the first place was to control the spread of the virus and ensure that those in hospital, who are naturally vulnerable in any case, are protected. Hospitals currently have what are referred to as green channels and red channels to try to segregate those who have the virus from those who do not. I assure her that the NHS keeps that under review and would like to get rid of the segregation as soon as possible. When it does, that will increase capacity.
Vicky Foxcroft (Lewisham, Deptford) (Lab)
What are the Secretary of State’s plans for communications with immunocompromised people who do not yet know how effective the vaccine is for them? As my right hon. Friend the Member for Leicester South (Jonathan Ashworth) said, the group accounts for 13.1% of deaths within the fully vaccinated population despite making up less than 1% of the general population. Does he agree that we should be advising them not to return to unsafe workplaces until we know more?
Sajid Javid
The hon. Lady is right to raise this important issue. Throughout the pandemic we have offered advice for those who are immunocompromised and given guidance through clinicians working with the NHS, and that is constantly updated as the nature of the covid threat is constantly changing. As I said a moment ago, we got clear advice that for certain people who are immunocompromised but can take the vaccine—I think it affects about 500,000 people—the antibody response from two doses was not enough and there should be a third dose as part of a primary course. We accepted that advice and acted on it immediately. We will continue to keep that under review and do whatever we can.
Sir Graham Brady (Altrincham and Sale West) (Con)
I welcome the Government’s rethink on vaccine passports and hope that it presages a move to trusting people more to make decisions for themselves. The Secretary of State will know about the evidence that people who returned from green list and amber list countries over the summer had a lower level of covid than those who stayed here. Does he accept that that makes a powerful case for getting rid of the day 2 PCR test for people returning from those countries?
Sajid Javid
My hon. Friend is right to raise that point. That is why we have kept our travel rules relating to covid constantly under review. He may have heard that I referred in my statement to a set of changes that we are looking to make, and my right hon. Friend the Transport Secretary will bring those changes to the House as soon as he possibly can.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
The Secretary of State is quite correctly urging people to get vaccinated. He will be aware that, sadly, certain ethnic minorities have relatively low vaccine take-up, and we see that in my borough of Hackney. Has he considered anything that the Government could do nationally to support outreach to ethnic minority communities?
Sajid Javid
The right hon. Lady makes an important point. We want everyone to take up the offer of a vaccine, and she is right to point out the disparity in take-up in certain communities. The good news is that—I think partly as a response to Government action and especially because of the fantastic people I have come across in London working for Public Health England, who have worked with and reached out to communities to increase uptake—we saw a significant increase in uptake over the summer in the communities to which she referred. That work continues, and it remains a priority.
Robert Halfon (Harlow) (Con)
I welcome the booster programme for the vulnerable as set out by my right hon. Friend, but may I ask him about the vexed issue of parental consent? The NHS website states that it would rarely be appropriate or safe for a child to consent without parents’ involvement and that a parent’s consent must be sought before vaccination. Will he confirm whether the intention is to follow that advice? If not, on what legal basis has that decision been made? The Gillick competence and later case law was intended for a far narrower set of circumstances than a mass roll-out of treatment to otherwise healthy children. If he is to make that decision, there must be parental consent to ensure credibility in the system.
Sajid Javid
I reassure my right hon. Friend that, first, the legal basis that we are following for vaccinations, and for child vaccinations in particular, has been set out since the 1980s and applied by successive Governments for all child vaccinations. The covid-19 vaccine offer will work no differently from the processes currently deployed. That requires, in the first instance, parents to be asked for their consent.
I am told by the school-age immunisation service—the specialists in the school system who work on child vaccination—that there is no dispute between what a child and the parent decide in the vast majority of cases; it works normally. Where there is a difference of opinion between the parent and the child, the service will bring both parties together to try to reach consensus, and only in the rare situations where they cannot reach consensus is it determined through the Gillick competence whether the child in question is competent enough to make decisions regarding their own health. I am told that, in general, the older the child, the more likely there is to be a decision that they are competent enough, but I stress that this process has been followed for decades under successive Governments and we will not be changing it.
Clive Efford (Eltham) (Lab)
We know that the ring of protection that the Government spoke of last year was non-existent and left many vulnerable adults in social care exposed to infection. Will the Secretary of State therefore say what specific resources will be made available for care homes this winter to ensure that they have the staffing levels they need and to prevent the devastating infection rates we saw last year?
Sajid Javid
This year, we have already planned to spend an additional £34 billion on both the NHS and care homes, helping to pay for additional measures such as infection controls and some additional staffing costs. We keep that under constant review.
Angela Richardson (Guildford) (Con)
I echo the comments my constituency neighbour and the Chair of the Health Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt) made in raising concerns about mental health. I am dealing at the moment with a constituent who has been sectioned under the Mental Health Act, but there were no beds in Surrey and she has had to be moved to Kent. Would my right hon. Friend the Secretary of State look at increasing capacity in the most severe cases so that families do not have to undertake such a journey in what is already a difficult set of circumstances for them?
Sajid Javid
My hon. Friend is right to raise that. It is a very difficult situation, as of course I think everyone in this House understands. It is one of the reasons we are increasing capacity—there is new funding and support—and it remains a priority.
Munira Wilson (Twickenham) (LD)
Could I start by extending my condolences and, on behalf of my party, those of my right hon. and hon. Friends to the Prime Minister and his family today?
Children and young people have done everything that has been asked of them through this pandemic, as have their parents, yet children have paid a high price in lost learning and mental health particularly, and they have been an overthought for the Government throughout. It is all very well announcing today that the power to close schools in the Coronavirus Act will be expired—it makes a great headline—but the Health Secretary is well aware that that power was never used previously to close schools; it was just guidance from the Education Secretary. Will the Health Secretary give pupils and parents across the country a cast-iron guarantee today that his Government will not close schools again this winter?
Sajid Javid
I think the hon. Lady would agree that we are as a country in a much better place today with covid than we were even at the start of this year. That is down to many factors, and I referred to a number of those in my statement, but I believe that with the measures we have set out today, we can be confident that our children will not have to go again through the kind of disruption they have seen in the last couple of years.
Mr David Davis (Haltemprice and Howden) (Con)
The distinguishing characteristic of the emergency Coronavirus Act was not so much the new powers, which already existed in the Civil Contingencies Act 2014 and other Acts, but in the fact that Ministers were not required to get them approved by Parliament before implementation, which is one of the reasons for the poor quality of some of the decisions taken in the last year. Will the Secretary of State give an undertaking that any new regulations and indeed any regulations he retains will be put to the House before implementation, including vaccine certification if the Government are unwise enough to pursue that course?
Sajid Javid
I can tell my right hon. Friend that when the Government or any Government make decisions that have such an impact on people’s liberties, even if those decisions are made for all the right reasons—in this case, of course, to deal with this pandemic—they should be working with the House and working with colleagues. On any measures that are significant, of course the Government will come to the House and seek a vote of the House.
Dame Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
The Secretary of State talked about international work, and unless we tackle this issue across the world we are going to be in a pandemic forever. When he was at the G20, he shared with other countries what we are doing to help tackle it internationally, so could he please share with the House what is being done to tackle vaccination rates across the globe?
Sajid Javid
I can tell the hon. Lady that there was significant discussion about that with my G20 colleagues, but not all of them have, let us say, behaved in the same way as the UK in offering donations to poorer countries of vaccines. The hon. Lady will know that we are committed to offering 100 million doses to international friends, and that we have already provided or donated 9.2 million doses, most of those for the COVAX programme. We remain committed to that programme, and one of the things we are trying to do internationally, including through the Foreign Secretary, is encourage more countries to honour their commitments to COVAX and encourage those who have not joined the COVAX commitment to come forward and help in that way.
Dean Russell (Watford) (Con)
Across Watford, we are served by some amazing GP surgeries, including the Manor View practice and its team. However, I am hearing from constituents that some GP surgeries are still not opening their doors to do face-to-face appointments. Would the Secretary of State agree with me that we should encourage those GP surgeries to start opening up to help with the backlog and help see people face to face?
Sajid Javid
Yes, I agree with my hon. Friend, and he is right to raise this. I think everyone can understand why, during the height of the pandemic, GPs could not provide access in the normal way, but we are way past that now. Life is starting to return almost back to completely normal, and as that is happening it should be happening in our GP surgeries too. More GPs should be offering face-to-face access, and we intend to do a lot more about it.
Hannah Bardell (Livingston) (SNP)
The Secretary of State rightly speaks of the importance of vaccines, and Valneva in my Livingston constituency is playing a crucial role in the global fight against covid. Those at Valneva have worked incredibly hard to augment and adapt their work on a vaccine as new variants have emerged, as requested by his UK Government. So, Mr Speaker, you can imagine their shock and mine that its contract to produce 100 million vaccines was cancelled with very little notice or consultation. To compound that shock, there appears to be little clarity and reasoning, and while I will not repeat the rumours printed in the media, does the Health Secretary not agree that this is a shocking way to treat a company that is working tirelessly on a vaccine? Will he meet me to ensure that the future of this site, its work and its workers is secure, and will he rethink this disastrous decision?
Sajid Javid
I have to say to the hon. Lady that I do not agree with her. There are commercial reasons why we have cancelled the contract, but I can tell her that it was also clear to us that the vaccine in question that the company was developing would not get approval by the Medicines and Healthcare Products Regulatory Agency here in the UK, and obviously she is not recommending that we administer vaccines that do not get approval.[Official Report, 16 September 2021, Vol. 700, c. 10MC.] I do understand her point about Livingston and the factory there. That is very important to the UK Government and of course to the Scottish Government, and it is something we will be working on together to see what more we can do.
Dr Luke Evans (Bosworth) (Con)
I have a clarification and a request. On the clarification, I welcome the boosters, but could the Secretary of State clarify whether people who have had the AstraZeneca or the Pfizer will be having the same vaccine or mixing vaccines? On the request, one of the slowest things when it comes to dealing with the Pfizer vaccination is the 15-minutes that people have to wait to see that they do not have a reaction. We should now have the data, so will he ask the NHS to look at whether this could be removed to relieve some of the pressure on those delivering the vaccines over the winter?
Sajid Javid
On the booster programme, everyone on that programme will be offered either the Pfizer vaccine or half a dose of the Moderna vaccine. In the vast majority of cases I think it will be the Pfizer vaccine. On the data that is now available on the 15-minute wait, we are analysing it to see whether we can make any difference to the way in which we administer vaccines.
Jack Dromey (Birmingham, Erdington) (Lab)
Jane Roche from Erdington lost her father to covid and then, five days later, lost her sister to covid. She led the hundreds of families who came to London last week to walk down the memorial wall, calling with one voice for the promised inquiry to take place. They are frustrated because they want not just to know why their family members died, but that no one else should die as a consequence of mistakes made. When will the Secretary of State and the Prime Minister agree to honour the pledge that has been made to meet Covid-19 Bereaved Families for Justice, because those families have a right to be heard at the next stages?
Sajid Javid
The hon. Gentleman is right to raise the concerns of Jane and many others up and down the country and to express her frustration in the way he did. I am certain that, when this inquiry gets going, people such as Jane and many others will have the opportunity to set out their views.
Mr Mark Harper (Forest of Dean) (Con)
First, thank you, Mr Speaker, for granting the statement last night. I think it was important that the House heard at an early opportunity the Government’s decision. Regretfully, there were one or two inadvertent inaccuracies in some responses to the questions, but having raised those with the Minister for Covid Vaccine Deployment, whom I respect greatly, I am very pleased to say that a correction has either been made or is going to be made very quickly. I think it is admirable that the Department has sought to put the record straight at a very early opportunity.
In his statement, the Secretary of State said of those in education:
“Regular asymptomatic testing…will also continue in the coming months”.
My understanding is that there was to be a review at the end of September of regularly testing children who have no symptoms. Is that still going to continue? My view is that we should not be regularly testing children who have no symptoms, only those who have symptoms, and that is also the view of the Royal College of Paediatrics and Child Health. Can I urge the Secretary of State to drop regular asymptomatic testing of children, which I think would be good for their education and good for their mental health?
Sajid Javid
My right hon. Friend mentioned yesterday’s statement. My hon. Friend the Minister for Covid Vaccine Deployment was referring to whether the Department had received advice on boosters from the Joint Committee on Vaccines and Immunisation, but at the time of his statement he was not aware that we had received such advice. As my right hon. Friend says, that was inadvertent, and the Minister has written a letter of correction that will go in the Library of the House today. Asymptomatic testing of schoolchildren is planned to continue this month. I am not aware whether a final decision has been made on whether we will continue beyond that, and that is something on which my Department consults the Department for Education. My right hon. Friend’s general point is that we should end such testing as soon as we can, especially if we believe it is not making much of a difference. Of course we keep the issue under review, and if we continue with it, it must be supported by the evidence.
Dame Angela Eagle (Wallasey) (Lab)
In Wirral there has been a 13% increase in levels of infection in one week, and sadly four people have died in hospital. After a period of there being very few deaths, we now have a much higher infection rate. What level of deaths are the Government prepared to accept from covid before they consider measures to try to prevent the ongoing spread?
Sajid Javid
No one wants to see deaths from any disease, including covid. As we have learned more about covid, everyone understands that it is not completely preventable, but our vaccines are making a difference in Wirral and across the country. There is no level of deaths that I would describe as acceptable, and the job of the Government is to keep that to an absolute minimum. However, there are not just covid deaths, and we must also be alive to deaths from cancer, heart disease and other things. As the hon. Lady will know, at the height of the restrictions many people suffered in other ways because they were not able to go to the NHS, and we must keep that at the front of our minds.
Andrew Selous (South West Bedfordshire) (Con)
Covid has been tough for all health professionals, so will the Secretary of State wholeheartedly condemn the abuse that some GPs have been suffering recently? If vulnerable people are unable to get through on the telephone to their surgery, should it be the clinical commissioning group or the Department that steps in to try to sort that out?
Sajid Javid
I join my hon. Friend in condemning anyone who gives abuse to our fantastic GPs up and down the country. If someone cannot get through to their GP, they should try their clinical commissioning group. If for any reason that does not work, they should please come to the Department and consult Ministers.
Mrs Emma Lewell-Buck (South Shields) (Lab)
The Secretary of State has not delivered a concrete plan today, and there is no real clarity on thresholds for further lockdowns, or details of what draconian and unnecessary powers in the Coronavirus Act 2020 he wants to hold on to. Will he at least say when that soon-to-expire Act will be back before the House for a vote?
Sajid Javid
May I suggest that the hon. Lady reads the plan before she comments on it?
Steve Brine (Winchester) (Con)
I welcome much of what is a sensible plan from the Secretary of State, although I have a creeping feeling that we are preparing to treat flu like covid, more than the other way round. Before we start extending the vaccine programme and boosters, will the Secretary of State get a grip on the creeping issue of people who have had one vaccination in England and another in Scotland, or the other way round, but the two systems are not talking to each other, and people are not getting the benefits of having been fully jabbed? We need to deliver for those who have done what we asked them to do before we deliver vaccines to others.
Sajid Javid
My hon. Friend is right to make that point—indeed, people in my family had that very issue. I know that the Minister for Covid Vaccine Deployment is looking at that matter, and I have discussed it with the health Minister in Scotland. We are working to see what more we can do.
Dave Doogan (Angus) (SNP)
As we go into another winter, placing the welfare of our communities in the hands of health and social care staff, will the Secretary of State reflect on the fact that in England the 3% NHS pay rise does not marry up well with the 4% backdated pay rise in Scotland? Why will he not grant the same esteem to health and social care staff in England as we do in Scotland?
Sajid Javid
When it came to the pay rise to which the hon. Gentleman refers, we accepted the recommendation of the independent pay review body. I think that was the right thing to do.
Greg Clark (Tunbridge Wells) (Con)
Is my right hon. Friend aware that the likely course of the pandemic means that more and more people, vaccinated or not, are likely to be infected by covid, but that levels of protection from the vaccines will keep them from serious disease? Will he say something about the triggers for any future lockdown or other restrictions, and confirm that the expected increase in the transmission of covid will not be among them?
Sajid Javid
My right hon. Friend is right about the importance of vaccines. On any potential triggers, I have not yet today mentioned the importance of being on guard against future variants, especially if there is ever a vaccine-escape variant. No one can rule that out, which is why our surveillance system is so important, and in that situation the Government would have to take further action. We cannot say today what such action would be, but that is the kind of risk against which we need to be on guard.
Dame Diana Johnson (Kingston upon Hull North) (Lab)
Hull has the second highest rate of covid infection in the country, and one ward in my constituency has only 51% coverage of second doses of the covid vaccination. The Secretary of State said that the national average is 81%, and those figures go to the heart of our problems with regional and health inequalities. How will he ensure that we maximise the number of people in Hull who receive the vaccination, so that people in Hull are not left behind in the recovery?
Sajid Javid
Of course no one should be left behind, wherever they are in the UK. The differential take-up of the vaccine can be based on a number of factors—for example, there is definitely a difference in age groups. Working with the NHS, we are trying to tailor our message to convince people about the benefits of the vaccine to those respective age groups, and we also try to do that on a localised basis. If the right hon. Lady has any particular suggestions about Hull, we would be more than happy to listen to her.
Sir Desmond Swayne (New Forest West) (Con)
The Secretary of State retains all the powers of the Public Health (Control of Disease) Act 1984, which were used to take away our liberties without prior parliamentary authority. Will he undertake to review that and to give us a new public health Act?
Sajid Javid
We keep all rules and Acts under review at all times.
Mr Ben Bradshaw (Exeter) (Lab)
The Secretary of State will know from the discussions he describes with international colleagues that although travel in the rest of Europe has recovered to 60% of pre-covid levels, it is a fraction of that in the United Kingdom. When will he scrap the outdated, unnecessary and hugely expensive travel testing regime, save what is left of an industry, and end a situation in which foreign travel has once again become the preserve of the rich?
Sajid Javid
I would say two things to the right hon. Gentleman. First, it is important that we have a system of surveillance, especially for variants across the world. There are different ways to do that. We have chosen a particular path at the moment, and I hope he agrees it is important to have that surveillance. Also, as I said in my statement, we are planning to make some changes to the travel regime, and my right hon. Friend the Transport Secretary will come to the House as soon as he is ready.
Saqib Bhatti (Meriden) (Con)
Time and again I hear from constituents that they cannot get face-to-face appointments with GPs, who I know are under immense pressure. Further to the answer that he gave to my hon. Friend the Member for Watford (Dean Russell), will the Secretary of State elaborate on the work that he and his Department are doing to encourage GPs to give face-to-face appointments to those who need them?
Sajid Javid
Yes, I will. This is an important issue, and we are working on it with the British Medical Association, the NHS, and other important organisations. We can do a number of things, but we are trying to do so by agreement at this point. My hon. Friend is right to raise that issue and, as I said, it is high time that GPs started operating in the way they did before the pandemic, and offering face-to-face appointments to everyone who would like one.
Anum Qaisar-Javed (Airdrie and Shotts) (SNP)
The first issue that the Secretary of State mentioned in his statement was the importance of vaccines. We know that 40% of the world’s population has been single-vaccinated against covid, but only 1.8% of those in low-income countries have been vaccinated, and those countries are not on track to vaccinate their populations until 2023. To be frank, the Government have previously taken a dangerous route with their international policies, such as their anti-refugee Bill for an insular Britain. Will they commit to ensuring that the UK plays its part in vaccinating the poorest nations in the world, first to save lives and secondly to avoid the potential emergence of further covid variations?
Huw Merriman (Bexhill and Battle) (Con)
I know that the international travel sector will welcome the framework. Given that it will come out on 1 October, will that give colleagues, and indeed Select Committees, the opportunity to feed in their ideas on behalf of their constituents? Will the Secretary of State entertain the idea of moving to lateral flow tests, which are cheaper, with only the small proportion of positive cases needing to take a PCR test?
Sajid Javid
I know that these are important issues for the House, and particularly for my hon. Friend, who chairs the Transport Committee. I do not want to pre-empt the statement by my right hon. Friend the Transport Secretary, but I believe that when he makes that statement, my hon. Friend will be pleased.
Mr Alistair Carmichael (Orkney and Shetland) (LD)
Pages 23 and 24 of the autumn and winter plan specify that, as part of plan B, the Government will introduce vaccine passports for all nightclubs, for indoor settings of 500 people or more, which presumably would include this Chamber of 650 Members, for outdoor settings of 4,000 or more, and for anywhere—that is a very big place—where there are 10,000 people. How does the Secretary of State square that with his assertion in reply to the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth), that the evidence on the usefulness of vaccine passports is just not there? If the evidence is not there, why are they part of plan B? The Government’s document also says that plan B could be brought into force at very short notice, so can the Secretary of State give the House some assurance that that will not happen without a vote?
Madam Deputy Speaker (Dame Rosie Winterton)
We need short questions and short answers.
Sajid Javid
We have made huge progress as a country in fighting this virus, and that is why we do not need certification; we do not need the plan B measures that the right hon. Gentleman has just set out. As I made in clear in my statement, while we can keep other measures in reserve, what matters is what we are actually doing, and if we keep making progress against this virus in the way that we are, we will not need any of the things he talked about.
Jason McCartney (Colne Valley) (Con)
It is worth highlighting once again the latest stats from the Office for National Statistics, which show that almost 99% of covid deaths in the first half of this year were of people who had not received both doses of the covid-19 vaccine. That really shows the importance of our world-leading vaccination programme. As we roll out these booster jabs, how will the Secretary of State build on the success of the network of GP surgeries, community pharmacies and volunteers who have helped, particularly in my part of the world, roll out all these covid vaccinations?
Sajid Javid
My hon. Friend is right to raise that. The booster jabs will be hugely important in maintaining protection. The GP networks and the NHS vaccination centres have all been part of our planning for this. Given that these are booster jabs, I think we can move much more quickly than we did with the original doses.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
Parents will quite rightly have questions and concerns, but can the Secretary of State confirm that those questions and concerns should not be directed to school staff or headteachers, even if the vaccination happens to take place in a school building, and that all questions related to the vaccine should instead be directed to the appropriate medical team?
Mr Steve Baker (Wycombe) (Con)
Among other things, my right hon. Friend is keeping covid status certification in reserve, and he is leaving mass asymptomatic testing in place, together with contact tracing. As my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) said, the public health powers are still there, of course allowing the Secretary of State to lock us down at the stroke of his pen without prior votes or any formal way of justifying the proportionality of those powers. When can we expect all those things to be dealt with, so that we can all have the certainty that will come from knowing that, thanks to the vaccine, we are living with an endemic disease, in the way that we live with the endemic disease flu, and we can all get on with our lives?
Sajid Javid
I know that my hon. Friend may not agree with every measure that the Government are keeping in place or have set out, but I hope that he agrees that at least the measures that I have set out—around making sure that we are vaccinating the public, offering vaccines to as many people as possible, having some kind of testing regime, and having some surveillance of the results of those tests to look out for any new variants—are the right measures and the kinds of things that need to be done as we live with covid-19.
Patricia Gibson (North Ayrshire and Arran) (SNP)
We were told by the UK Government that vaccine passports were going ahead, then they were not going ahead, then we were told that they were still the first line of defence against a winter wave, and now the latest position is that they are a definite maybe. We have not seen such dithering since the great confusion over mask wearing, which we can see if we look around this Chamber. How irresponsible does the Secretary of State think that dangerous and confused public messaging is during a pandemic?
Jane Hunt (Loughborough) (Con)
Last Friday, Leicestershire MPs met NHS officials locally. We were told that around three quarters of all those in hospital with covid were not vaccinated. Does my right hon. Friend agree that if we do not want to be in lockdown this winter, all who can get the vaccine should get it, especially in Leicester, where I now understand from the shadow Secretary of State’s comments that take-up is only 61%?
Sajid Javid
I agree with my hon. Friend. Some 6 million adults throughout the UK remain unvaccinated, and we should all do that we can to at least encourage them to think about taking the vaccine, not only to protect themselves but to protect their loved ones.
Rachael Maskell (York Central) (Lab/Co-op)
I am seriously concerned about the hole in the Secretary of State’s defence—taking away contact tracing from public health teams. The data coming through is now completely insufficient to carry out an effective operation locally and therefore to lock down the virus, and not people, in the future. Will he look at that and ensure that local authorities such as York can have that zero data so we can get on top of contact tracing as soon as the data emerges?
Sajid Javid
There are measures that, when it makes sense, we must remove. The reason that we can take a different approach to contact tracing than we did a few months ago is largely down to the high rates of vaccination we are seeing throughout the country. Of course we want them to increase, but as we vaccinate more, that allows us to start removing these restrictions, additional costs and burdens on individual livelihoods. It is right that we take a balanced approach and keep increasing vaccination so we can keep removing other restrictions.
Mr Simon Clarke (Middlesbrough South and East Cleveland) (Con)
I welcome the Secretary of State’s statement. May I raise the plight of care home residents, many of whom have been kept apart from their families and loved ones owing to outbreaks being declared in their home? Obviously, we need to strike a proportionate balance here, but the threshold for intervention by declaring an outbreak is really quite low. Will the Secretary of State commit to looking at that so we can ensure that people can see their loved ones throughout the winter ahead?
Sajid Javid
Yes, I can give my hon. Friend that commitment. He may also be interested to know that, with the booster announcement today, care home residents will be an absolute priority.
Layla Moran (Oxford West and Abingdon) (LD)
Back in June, the Prime Minister committed the UK and other G7 nations to vaccinating the world by the end of 2022 and
“to end this terrible pandemic”.
Can the Secretary of State tell the House how offering a third vaccine to a fully vaccinated, healthy adult in the UK before a first vaccine to a nurse in a lower-income country helps that goal of vaccinating the world by 2022?
Sajid Javid
I do understand the point the hon. Lady makes, but may I suggest that, if she has not yet, she should read the JCVI’s advice on booster vaccines? I think then she might better appreciate the importance of the booster programme.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
I thank my right hon. Friend for his statement. I think we all hope that plan B is not activated, but may I follow up the question asked by my right hon. Friend the Member for Tunbridge Wells (Greg Clark) and ask the Secretary of State to lay out exactly what “unsustainable pressure” means? In his assessment of NHS capacity over winter, where does he see the bottleneck? Is it staff? Is it medication? Is it beds? What work is being done to enhance that capacity?
Sajid Javid
When I talked earlier about unsustainable pressure, it would be things like hospital occupancy, in particular in intensive care units, the admissions of vaccinated individuals versus unvaccinated individuals and the rate of growth in admissions. I know there is a lot there, but I think it is right that there is not one particular trigger and that we take a number of issues into account. I hope my hon. Friend agrees that the Government are right to plan for all contingencies.
Jim Shannon (Strangford) (DUP)
On behalf of the Democratic Unionist party, I convey my sincere sympathies to the Prime Minister and his family on the death of his mum. I thank the Secretary of State for his statement and for his efforts on behalf of us all. Will he confirm that the booster roll-out for the over-50s will be managed in line with the flu jab roll-out, which seems to be facing some delay? Will he further confirm that additional funding is being allocated to GP practices to enable the enhanced roll-out to take place?
Sajid Javid
Yes. GPs do get and will get additional funding to support vaccination programmes, including the flu vaccination programme. In terms of co-administering the covid vaccine with the flu vaccine, if that is what the hon. Gentleman was asking, while the JCVI said that in its opinion there is no reason why that should not happen—it thinks that that can work—in practical terms, mainly because of the 15-minute wait after a Pfizer jab, it will probably happen in very few cases. Regardless, the flu vaccination programme this year will also be a very high priority.
Ruth Edwards (Rushcliffe) (Con)
As my right hon. Friend said, our vaccination programme has enabled us to get almost back to normal. Will he join me in thanking staff and volunteers at Gamston community centre, who have been rolling out the vaccine in Rushcliffe and giving my constituents the best protection they can have against coronavirus?
Sajid Javid
Yes, of course I will. Gamston community centre, and community centres, village halls and so many other places up and down the country, including of course in my hon. Friend’s constituency, have done an amazing job. We still need them to help in our fight against the virus.
Gary Sambrook (Birmingham, Northfield) (Con)
As the Secretary of State may know, in Birmingham, Northfield, just next door to his own constituency, vaccine take-up has been about 75%. Unfortunately, in some parts of Birmingham it has been as low as 47%. Will he join me in encouraging anyone who is hesitant about taking the vaccine to take part in Birmingham City Council’s quick one-minute survey about why they have those anxieties? It is very important that we all understand where those anxieties lie, because, after all, the vaccine is pivotal to our success.
Sajid Javid
Yes, I will join my hon. Friend in encouraging people to do that. It will be a one minute very well spent.
Jack Brereton (Stoke-on-Trent South) (Con)
Across Stoke-on-Trent and Staffordshire, uptake of the vaccine has been very good. I thank all those who have been delivering the vaccine across Stoke-on-Trent in particular. Many 16 and 17-year-olds currently cannot use the online booking system. They have to wait for their GP to contact them or for one of the very few walk-in centres. Will my right hon. Friend look at extending that online booking system to all 16 and 17-year-olds?
Sajid Javid
I can tell my hon. Friend that we keep that under review. At the moment, we have found that the quickest way to encourage 16 and 17-year-olds to take up the offer is through the schools and colleges network, and through GPs in particular. We keep that under review, but he might be interested to know the latest numbers are that over 54% of 16 and 17-year-olds are vaccinated. There is progress to be made, but that is good progress so far.
James Wild (North West Norfolk) (Con)
My local hospital, the Queen Elizabeth Hospital, which as my right hon. Friend knows needs to be rebuilt, currently has 46 covid patients. Is not the best way to ensure that the QEH and the NHS have the capacity to cope with winter pressures to increase the level of vaccine take-up? Will he ensure that evidence of what works in doing that is shared across the country?
Sajid Javid
I very much agree with my hon. Friend. That is one reason why we are constantly publishing more and more information on the impact and effectiveness of vaccines, including the data from the ONS today, which I referred to earlier.
Sara Britcliffe (Hyndburn) (Con)
The Secretary of State will be aware that Hyndburn and Haslingden have faced restrictions for longer than most in the country. Will he please clarify whether local restrictions are being considered by the Government and, if so, what they might be?
Sajid Javid
I was not sure from my hon. Friend’s question whether she was referring only to her own area or more generally in terms of local restrictions. In terms of the plans I announced today, the Government will retain some powers for local restrictions, working with local authorities, if absolutely necessary. If she is interested more in the current situation in her own area, I or other Ministers will be happy to talk with her.
Paul Holmes (Eastleigh) (Con)
Like my hon. Friend the Member for Watford (Dean Russell), may I emphasise to the Secretary of State the amount of anger there is in Eastleigh about not being able to get a face-to-face appointment with a GP? He stood at the Dispatch Box and encouraged GPs to get back to work. If necessary, and if that uptake has not happened, will he instruct them to get back to work, so we can at least have face-to-face appointments for my constituents?
Sajid Javid
I agree with my hon. Friend about the importance of giving patients the choice. Some patients actually prefer not to have a face-to-face appointment. They may be at work and they might like that kind of technology, and that is fine, but the important thing is that for those who want to have a face-to-face appointment it should be made available. The Department and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) are looking at what measures can be taken. My hon. Friend will be more than happy to meet him to take him through some of those initiatives.
Antony Higginbotham (Burnley) (Con)
The NHS and volunteers across Burnley and Padiham have done a brilliant job of vaccinating people, but we know there is still hesitancy about getting the vaccine. That includes not only people who have not turned up or do not want to have the first vaccine, but those who have had the first vaccine but are then hesitant about the second. What steps is the Secretary of State taking to understand why that hesitancy is there and what we can do to try to get people the vaccine?
Sajid Javid
I am pleased that my hon. Friend has raised this issue of where, in a minority of cases, someone has taken a first dose but has become hesitant about the second. In all those cases, people are being individually contacted, often by their GPs or other clinicians, and offered meetings and phone calls. They are being talked to, to try to encourage them to take the second dose. It is really important that in that situation people follow up with a second dose to get the full protection they deserve.
Tom Hunt (Ipswich) (Con)
We have heard a lot about variants and how they can evade the vaccine. It was not that long ago that I was reading a lot about enhancing and tweaking the existing vaccines, and potentially even a universal vaccine that was a kind of a variant-busting vaccine. What are things looking like in that regard, and what is the possible timeframe in which we can release a vaccine that can better protect us against variants?
Sajid Javid
I think it is reasonable to assume that at some point in the future, perhaps as early as next year, there may be what I referred to as bi-variant or perhaps even multi-variant vaccines. The flu vaccine is a multi-variant vaccine, for example. In terms of availability and getting approval from regulators, we are not there yet, but I believe that is the general direction of travel. When we do get there, I think it will be much easier to live with covid-19.
Aaron Bell (Newcastle-under-Lyme) (Con)
My constituents have very much enjoyed getting back to normal in these last few weeks, so I welcome what the Secretary of State said, in particular on plan A. Does he agree that, while we must not be complacent, we must also not be overcautious? To that end, what assessment has he made of the data in the past few weeks and whether it utterly vindicates the Government’s decision to proceed on 19 July, a decision they took in the teeth of some opposition?
Sajid Javid
My hon. Friend is absolutely right to raise that point. Many people, including many in this House, especially those on the Opposition Benches, told us that the decision we made to go ahead with step 4 and remove all those restrictions was the wrong one. Events have clearly shown that we made the right decision. The status of the pandemic at the moment is that cases are steady. We of course have to remain vigilant, but my hon. Friend makes a very fair point.
Points of Order
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Carol Monaghan (Glasgow North West) (SNP)
On a point of order, Madam Deputy Speaker. Yesterday, during the statement on Afghanistan, the Minister with responsibility for Afghan relocation—the Under-Secretary of State for the Home Department, the hon. Member for Louth and Horncastle (Victoria Atkins)—said that
“we have to be very careful about offering either encouragement or support for people who may be in a perilous situation in Afghanistan on making that journey to borders.”—[Official Report, 13 September 2021; Vol. 700, c. 688.]
She also sent a “Dear Colleague” letter, which said the Government
“cannot pursue cases concerning Afghan people in country in the usual ways”,
and asked us to signpost people to gov.uk for the latest information on the Afghan relocation and assistance policy and the Afghan citizens resettlement scheme. It was therefore surprising to hear a Government Member—the hon. Member for Tonbridge and Malling (Tom Tugendhat)—say yesterday:
“I pay enormous tribute not only to my hon. Friend the Minister but to the Home Secretary, whom I was texting barely half an hour before I came into the Chamber about an Afghan who is currently near a border, and she was personally sorting out the transit documents that I hope will enable him to come through.”—[Official Report, 13 September 2021; Vol. 700, c. 690.]
I am very pleased that that individual was able to make the journey, but it seems that we have a two-tier system here for advocacy. I and probably many Opposition Members do not have the Home Secretary’s phone number, so I am wondering how I can raise cases, because I have a large Afghan community in my constituency and I have been inundated with cases of people who are concerned. How do we raise such cases?
Madam Deputy Speaker (Dame Rosie Winterton)
I am grateful to the hon. Lady for giving me notice of her point of order. I am sure she will understand that it is not for the Chair to police how right hon. and hon. Members communicate with one another. However, it is extremely important that all Members can make effective contact with Government Departments and that all Members get responses in good time. I feel that that is particularly true in the case of Afghanistan, where many of the issues are of the utmost urgency. I do expect, and I know the Speaker expects, Ministers to do everything they can to make sure that they and their Departments are responsible to all right hon. and hon. Members. I hope that those on the Treasury Bench will feed back the concern that has been raised.
Layla Moran (Oxford West and Abingdon) (LD)
Further to that point of order, Madam Deputy Speaker. Thank you very much for your answer, because it helped to provide clarification, and I thank the hon. Member for Glasgow North West (Carol Monaghan) for raising the point of order. I share her concern; my office alone is supporting 400 Afghans. I just point out that the “Dear Colleague” letter said that the Government “cannot pursue” these cases and that they would consider
“how this data will be used in the future”,
which seemed to suggest that all the correspondence that MPs have been sending to the Department will not be answered. Furthermore, it says to us not to write to the Department. Is that proper? In my time as an MP—it has been four years now—sometimes letters have been late, but they have always come back.
Madam Deputy Speaker
I thank the hon. Lady for that further point of order. I know that this was raised quite a few times in the urgent question yesterday. Again, I am sure that those on the Treasury Bench will take that point back and ensure that right hon. and hon. Members get clarification about the situation.
Mr David Davis (Haltemprice and Howden) (Con)
On a point of order, Madam Deputy Speaker. I raise this partly for information and partly with regard to the role of the Chair in protecting the rights of the House. We have all the stages of a very important Bill being taken in one day today. This is incredibly unusual. Normally, it is done only for matters that are very urgent—typically, terrorism legislation, with imminent terrorist attacks and so on. The last time that it was done inappropriately was the Data Retention and Investigatory Powers Act 2014, on which you may remember, Madam Deputy Speaker, I took the Government to court and they lost at all levels. I would not like to see something like that happen to the business today. Can you tell the House who approves such a proposal when the Government brings it to the House? Is it the Speaker? Is it the Opposition Front Benchers? Is it an instrument of the House? How does it come to be that we are faced with the option solely of having to take all this very important, very effective legislation all in one day?
Madam Deputy Speaker
I thank the right hon. Gentleman for notice of that point of order. He is a very experienced Member of Parliament and former Minister. The Government have put their proposals for the timetable in the business of the House motion, and it is for the House to decide whether it agrees with the motion. There is the opportunity for the House to disagree with that motion. That is the way it will work today. I am confident that the right hon. Gentleman will have made his concerns clear to the Government and many other people—
Madam Deputy Speaker
The powers that be. That is how it works. The House has the option to reject the motion if it does not like it.
Mr John Baron (Basildon and Billericay) (Con)
Further to that point of order, Madam Deputy Speaker.
Madam Deputy Speaker
I will take the further point of order, but I must say that we do need to move on.
Mr Baron
Very briefly, Madam Deputy Speaker, is there anything that Mr Speaker can do about extending the time that Parliament has to scrutinise this important legislation today? We are raising tens of billions of pounds for a social care reform of which Parliament has had no opportunity to scrutinise the details. In fact, I am not even sure that the details have been supplied. That is the wrong way of going about business in this place and it does not reflect well on us here.
Madam Deputy Speaker
The hon. Gentleman could have tabled an amendment to the business of the House motion and given the House different choices as to how long it wished to spend discussing the Bill. As it is, it is in the hands of the House to decide whether it accepts or otherwise the business of the House motion. I hope that is clear.
Jonathan Ashworth (Leicester South) (Lab/Co-op)
Further to that point of order, Madam Deputy Speaker. May I reinforce the point that the hon. Member for Basildon and Billericay (Mr Baron) just made? If Ministers are going to impose on our constituents a punishing, unfair tax rise, surely a Health Minister must come to the House and explain what that money is actually going to be spent on.
Madam Deputy Speaker
That is obviously a point of a view—it has been expressed previously by Members in different parts of the House—but it is not really a matter for the Chair. I am sure that it may come up in debate. Having said that, I think we should now move on to the ten-minute rule motion.
Non-Disclosure Agreements (No. 2)
Tuesday 14th September 2021
(3 years, 3 months ago)
Commons ChamberRead Full debate Non-Disclosure Agreements (No. 2) Bill 2021-22 View all Non-Disclosure Agreements (No. 2) Bill 2021-22 Debates Read Hansard Text Watch Debate
A Ten Minute Rule Bill is a First Reading of a Private Members Bill, but with the sponsor permitted to make a ten minute speech outlining the reasons for the proposed legislation.
There is little chance of the Bill proceeding further unless there is unanimous consent for the Bill or the Government elects to support the Bill directly.
For more information see: Ten Minute Bills
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mrs Maria Miller (Basingstoke) (Con)
I beg to move,
That leave be given to bring in a Bill to restrict the use of non-disclosure agreements; and for connected purposes.
We have some of the best laws and regulations in the world to protect people from bullying, discrimination and abuse in the workplace, yet we allow scurrilous employers to conceal unlawful wrongdoing through the use of non-disclosure agreements, effectively rendering legal protections that we have voted for in this Chamber null and void. Many hundreds, perhaps thousands, of people a year—people we represent—do not have access to proper protection at work because we are allowing employers, through their lawyers and HR professionals, to cover up wrongdoing through an apparently legitimate means: non-disclosure agreements.
Let us be clear from the outset that most employers value and invest in their staff, knowing that they are their most important asset, and most employees never experience the sort of discrimination, bullying and worse that non-disclosure agreements are being used to cover up. It is absolutely right that employees can be required not to divulge confidential information that they have access to in the course of their employment and almost every employment contract should, and would, contain such provisions. But that is not the same as a non-disclosure agreement, which seeks to silence the disclosure of wrongdoing experienced at work. Non-disclosure agreements were invented by lawyers to protect intellectual property, not to create an atmosphere of secrecy in the workplace.
I believe that the use of non-disclosure agreements is driving the wrong culture in the British workplace—a culture where poor management can be covered up and where the silence of employees who have experienced significant wrongdoing can effectively be purchased, even motivating a small number of employees to vexatiously seek payouts from employers by making spurious allegations. We simply have to break this damaging cycle. My Bill would do just that: it would make it a basic principle of our legal system that no one, however powerful, could buy an employee’s silence if there were allegations of wrongdoing in the workplace.
Putting that into practice is not simple. If an employer is willing to cover up even unlawful behaviour with an NDA, what is stopping their putting pressure on employees to withdraw allegations of wrongdoing in return for a pay-out and an NDA never to divulge what has happened? There is a powerful argument to completely ban NDAs for that reason alone, but we need to look to the legal sector to see whether there is a transparent way to resolve that tension. If not, a ban is the only option.
At the moment, non-disclosure agreements are completely unregulated. They can be, and are being, used to attempt to cover up even criminal allegations; they can even include unenforceable conditions to scare employees away from seeking support or redress from the criminal justice system or the employment tribunal system. My Bill would change that by restricting the use of non-disclosure agreements and ensuring that employees could always enjoy the protection of the law as intended.
I commend the work that the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Sutton and Cheam (Paul Scully), who is in his place on the Front Bench, is doing on the matter, but I know that over the past four years Ministers have faced significant problems in tackling it. Since the #MeToo campaign started in 2017 and the Women and Equalities Committee published its report in 2019, the scale of the problem has been very difficult for the Government to get their hands around. No statistics are published, because people who have agreed to an NDA may feel that they cannot tell a third party that they have undertaken such an agreement. That is why I support Can’t Buy My Silence, the new campaign launched today by Zelda Perkins, which will enable people who have had bad experiences of NDAs to talk publicly about them for the first time, anonymously.
Some people have expressed concerns to me that those who have suffered wrongdoing simply want to get out of the situation and get on with their life. Nothing in the Bill would stop that. If an employee makes an allegation of wrongdoing that an employer will not investigate and resolve, the employee could still accept an offer to leave an organisation in return for financial compensation; the change would be that employers could not demand a non-disclosure agreement, because it would be unlawful. That would be an important step forward.
I welcome the Government’s early indications in the violence against women and girls strategy, which was published in July, that they would review the use of NDAs in universities in cases of sexual harassment. However, if NDAs are wrong when they are used to cover up the sexual harassment of students, why are they not wrong when they relate to the sexual harassment of mature students, members of university staff or people who work in other types of organisation, or when they relate to other sorts of harm?
In acknowledging the harm caused by NDAs, as they have done in the VAWG strategy, I believe that the Government must act consistently and outlaw their use when there are allegations of wrongdoing elsewhere. The Government already have their own evidence, which came through in their 2019 consultation, of the dreadful harms caused to people’s mental health through non-disclosure agreements.
There may be people listening to the debate who are concerned that they have used non-disclosure agreements at work, maybe even to cover up wrongdoing. There may be employment lawyers listening who are concerned that they might face professional sanctions if the law changed. These are really important issues that we need to tackle, because the legal profession needs to resolve the matter and find a way forward. Such fears cannot stop a long-overdue clean-up of UK working practices.
Legislation is already being considered and put in place in California, Canada, Ireland—the list goes on. We cannot be left behind. We need to legislate for change. We can no longer pretend that abuse of the law is not happening; it is happening, and the Government have evidence of that. Parliament must legislate now if we are to ensure that everybody is protected equally at work under the law.
Question put and agreed to.
Ordered,
That Mrs Maria Miller, Mrs Flick Drummond, Mary Robinson, Sarah Champion, Angela Crawley, Kevin Hollinrake, Jo Gideon, Andrea Leadsom, Tulip Siddiq, Mrs Emma Lewell-Buck and Philip Davies present the Bill.
Mrs Maria Miller accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 18 March 2022, and to be printed (Bill 162).
Health and Social Care Levy Bill: Business of the House
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text
Mr John Baron (Basildon and Billericay) (Con)
I will keep my comments brief because I know that they are eating into our time. For the same reason, I will not divide the House, but I reiterate the concern many of us have that today, in haste, we are discussing very important legislation that will introduce a massive tax increase—bigger than that of some Budgets—and yet we do not have details of the social care reforms being proposed. That is not the way to go about business in this place.
In my 20 years’ experience in this place, when we have rushed through decisions, as we are doing today—the measure was announced only last week—it has often increased the chance of big mistakes being made. I know that Ministers on the Front Bench are not listening, but I ask them even at this late stage to consider allowing more time to consider this important matter. If we do not know the detail of what is proposed, how in heaven are we to know how much money to raise for it?
Geraint Davies (Swansea West) (Lab/Co-op)
Further to that point of order, Madam Deputy Speaker—
Madam Deputy Speaker (Dame Rosie Winterton)
Order. If the hon. Gentleman wishes to speak, he can speak, but this is a debate, not a point of order. Does he wish to speak?
John Redwood (Wokingham) (Con)
I support my hon. Friend the Member for Basildon and Billericay (Mr Baron), although I will not press the matter to a Division either; I understand that the Government have a sense of urgency.
I think we need three debates, not one. First, we need a debate about how an extra £10 billion or £12 billion would make a big difference to waiting lists in the NHS; I would like to know the plan for that. Secondly, we need a debate about how we transition the money from health to social care and about what the social care plan looks like. Thirdly, we need an economic policy debate about whether we actually need to raise £12 billion in tax and, if so, whether this is the right tax to raise it with.
I urge the Government, in their own interest, to unpackage all that, at least in their own remarks, and understand that we need to see the cases for their propositions. If I go to a shop, I do not present it with some money and go away being told that in a month’s time I will get a brochure about what I might have bought; I expect to get the goods. Call me old-fashioned, but I would like to see what the goods will be. Would I like waiting lists down? You bet. Would I like people in my constituency to have access to better public social care? You bet, but I want to know that I will get that, and I want to know why the Government think that they need a tax.
Dr Andrew Murrison (South West Wiltshire) (Con)
It is very clear to most of our constituents that, after 18 months, there will need to be a tax rise to pay for service items that the NHS has not been able to provide because it has been dealing with the pandemic. There is also an expectation that we will improve social care, and most people would say that that comes with a price tag.
It seems to me entirely reasonable for the Government to say that they will publish a White Paper to flesh out the finer detail, after consultation, on matters that my hon. Friend the Member for Basildon and Billericay (Mr Baron) and my right hon. Friend the Member for Wokingham (John Redwood) have just described. However, I think we have to assume that it will come with a not insignificant price tag. It is therefore perfectly reasonable for the Government to put this Bill before the House in order to anticipate the funds that will be necessary and a prerequisite for the proposals that we imagine will be fleshed out as part of the White Paper. There is some urgency in this.
Question put and agreed to.
Health and Social Care Levy Bill
Tuesday 14th September 2021
(3 years, 3 months ago)
Commons ChamberRead Full debate Health and Social Care Levy Act 2021 View all Health and Social Care Levy Act 2021 Debates Read Hansard Text Watch Debate Read Debate Ministerial Extracts Amendment Paper: Committee of the whole House Amendments as at 14 September 2021 - (14 Sep 2021)
17:04 - The House divided: - Ayes: 249 / Noes: 327 - Question accordingly negatived.
17:17 - The House divided: - Ayes: 317 / Noes: 256 - Question accordingly agreed to.
Madam Deputy Speaker (Dame Rosie Winterton)
The reasoned amendment in the name of the Leader of the Opposition has been selected.
The Chief Secretary to the Treasury (Steve Barclay)
I beg to move, That the Bill be now read a Second time.
Last week the Prime Minister announced a plan to tackle the NHS backlog, put the adult social care system on a sustainable long-term footing, and end the situation in which those who need help in their old age risk losing everything to pay for it. The Government’s plan will make an extraordinary difference to the lives of millions of people across the country, and it will be funded with a record £36 billion investment in the NHS and social care. In order to pay for a significant increase in spending in a responsible and fair way, the Bill introduces a new 1.25% health and social care levy based on national insurance contributions.
Mr John Baron (Basildon and Billericay) (Con)
We need to give credit where it is due, and the Government are absolutely right to try to grasp this nettle, but many of us are concerned about the haste with which it is being done. Does my right hon. Friend think it is a good idea to raise taxes on jobs ineffectively, and risk choking off an economic recovery before we have even got to know the details of the social care reforms?
Steve Barclay
My hon. Friend, and good friend, has raised two connected points. The first was dealt with earlier in points of order: it is the will of the House that decides the timings of debates, and the Chair addressed that point. As for the second, we discussed it at length during last week’s ways and means debate. We discussed the wider purpose in dealing with the consequences of covid and the backlog in care that needs to be tackled, but we also discussed grasping the nettle in relation to the long-term challenges surrounding social care—challenges that the House has debated repeatedly over many years.
The levy will apply UK-wide to taxpayers liable for class 1 employee and employer, class 1A, class 1B and class 4 self-employed national insurance contributions. However, it will not apply where taxpayers pay class 2 or class 3 NICs. It will be introduced in April 2022, and from April 2023 it will also apply to those working over the state pension age. As my right hon. and hon. Friends will understand, it takes time for Her Majesty’s Revenue and Customs to prepare its systems for such a major shift. That is why, as set out in clause 5, in 2022-23 the levy will be delivered through a temporary increase in NICs rates of 1.25% for one year only.
Geraint Davies (Swansea West) (Lab/Co-op)
Does the Secretary of State agree that in principle hypothecation is to be avoided, and that what we should be doing is defining what spending is financially desirable and economically effective, and then asking a separate question: what is a socially equitable and effective tax regime? Those are two different issues, but we are smashing them together, and we do not even know what we are spending the money on. This is farcical, and it is being done in a mad rush.
Steve Barclay
There is a precedent in the form of what the hon. Gentleman’s party did in 2002-03. I do not think it is fair for him to say it is farcical to do something which was done by the Government whom he supported. He has opened up a much wider question about hypothecation, on which many a former Treasury official has commented, and I think that that is a separate debate; but there is a precedent for the use of national insurance in the way that my right hon. Friend the Chancellor has set out.
Let me stress that all revenues generated by this increase will be ring-fenced and paid not just to the NHS in England, but to NHS Scotland, NHS Wales, and the equivalent in Northern Ireland.
Mr Andrew Mitchell (Sutton Coldfield) (Con)
I have a great deal of sympathy with what my right hon. Friend is saying, and I think the Government deserve considerable credit for grasping this nettle at last, but may I ask for an assurance? When the charge has been introduced, will he ensure that every six months a Treasury Minister comes to the House and tells us what results are being achieved—what money has been raised through the levy and what results have been delivered; in other words, what additional treatment has been achieved—so that we can see and show our constituents why it was right to raise this levy and what they are getting for the money?
Steve Barclay
As a former Chief Whip, my right hon. Friend knows better than most that it is for the House to decide which Ministers come to the House and provide updates. Obviously, in respect of regular fiscal events and others—[Interruption.] It is. The right hon. Member for Leicester South (Jonathan Ashworth) chunters from a sedentary position, but through urgent questions and other such devices it is always for the House to decide which Ministers come here and, of course, there are regular events such as Treasury and other departmental questions. [Interruption.] He chunters but, as I have said, there are many procedures through which updates—[Interruption.] The procedures to which I referred.
Under clause 2, this revenue will be ring-fenced for health and for social care—
Steve Barclay
I will make a little progress. I have taken a number of interventions, including one from my right hon. Friend.
Existing NICs reliefs and allowances will also apply to the levy. That will mean that 40% of all businesses will not be affected owing to the employment allowance. When it comes to individuals, those earning more will pay more. Indeed, the top 14 per cent. of taxpayers will pay about half the revenues. Conversely, at least 6.2 million people earning less than the NICs primary threshold will not pay the levy at all.
Steve Barclay
I am sure that the hon. Lady rises to welcome the progressive nature of that measure.
Catherine West
Does the Secretary of State accept that, if 40% of businesses or employers are not affected, the other 60% therefore will be? What assessment has the Treasury made of the number of jobs that employers will not create because of, apart from anything else, the introduction of this measure at a time when the recovery from covid is fragile?
Steve Barclay
It is not just that the first 40% will not pay anything, as my right hon. Friend the Chancellor mentioned. The next 40% will pay less than 1% of their wage bill, and indeed 70% of the employer contribution comes from just 1% of business. To some extent, the hon. Lady’s point was also picked up by the Monetary Policy Committee in its evidence to the Treasury Committee, when it said, “You should not ignore one half of the policy announcement.” Of course, one needs to look at the spending implications of the measures, not just—
Steve Brine (Winchester) (Con)
In my experience of being a Minister at the Department of Health—with my right hon. Friend, indeed—Treasury Ministers do not like to spend billions of pounds without knowing exactly what they are getting for their money, and rightly so: it is our constituents’ money. We know that there is a very carefully worked out plan that the Secretary of State for Health and Social Care has agreed with the NHS for the catch-up programme. Will the Minister help us to see that published, so that we as representatives can hold the NHS to account for the money that this levy is raising and our constituents are therefore spending?
Steve Barclay
I could probably go slightly further—Chief Secretaries do not like to spend, not necessarily just on any particular area of Government policy—but my hon. Friend is absolutely right about the importance of delivery and how the money is spent, particularly the £8 billion allocated to electives catch-up. Just yesterday I was at a meeting in No. 10 with the leadership of the NHS, discussing that issue with the chief executive of NHS England and other senior health leaders. I know that it is an issue of concern to a number of Members, but ultimately it is an issue of concern throughout the House, because through our constituency surgeries we see the consequence of the backlog in terms of electives. That is, I think, an area of common ground.
Christine Jardine (Edinburgh West) (LD)
Will the Minister give way?
Christine Jardine
The Minister has made the point that we see the impact in our constituencies. Yes, we do, but we are also seeing the impact in our constituencies of the pandemic on business. What would the Minister say to the Federation of Small Businesses, which, notwithstanding what he has just said, believes that
“Business owners who have done all they can to retain and support their staff during the pandemic are now being punished”?
The FSB sees this as a jobs tax, and we will see that impact in our constituencies as well.
Steve Barclay
First, in order to meet the quantum of spend, one needs a broad-based tax. That is a point that my hon. Friend the Member for Wycombe (Mr Baker), who is not in his place, raised in the debate last week. Secondly, I would point to the more than £400 billion—[Interruption.] I do not know why SNP Members are laughing at £400 billion of support. I do not think that this is a point of difference. I think we can all agree across the House that there has been huge fiscal support across the UK through the broad shoulders of the United Kingdom to support business, at a cost of £400 billion to businesses, public services and individuals, and that has a consequence. Most of the business leaders I speak to recognise that, and recognise that the backlog in the NHS needs to be dealt with. I would add the further point that those businesses benefit from the NHS clearing its backlog because it is members of staff in those businesses that are affected.
Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)
What analysis has been undertaken of the long-term sustainability of this policy, which targets working-age people at a time of an ageing population? There will be 10 million extra pensioners within 20 years, which means that the pool of people who are paying in is shrinking in relative terms while demand is increasing.
Steve Barclay
Again, this is why, as is standard practice, my right hon. Friend the Financial Secretary to the Treasury has published the tax information and impact note on the tax change. Of course, that will be dynamic because it will interact with the fiscal forecast that the Office for Budget Responsibility will set out alongside the Budget on 27 October. So that is dealt with in the normal way for measures such as this—
Steve Barclay
I want to make some progress, and I have already given way once to the hon. Member for Swansea West (Geraint Davies).
Let me remind the House why this levy is necessary. As the Prime Minister and the Chancellor have said, the levy will enable the Government to provide additional funding to the NHS so that it can recover from the pandemic. Senior NHS leaders have made it clear that, without additional financial support, we will not properly be able to address the significant backlog in the national health service. However, it is going to take time to get everyone the care they need. In addition, our social care plan will create a dramatically expanded safety net for people in their later life. This means that, instead of individuals having to bear the financial risk of catastrophic care costs themselves, we as a country are deciding to share more of that risk collectively.
Munira Wilson (Twickenham) (LD)
Could the right hon. Gentleman explain to people up and down the country who are either in receipt of care now or will need to start care between now and October 2023 and are facing catastrophic care costs what they are meant to do? Does he accept that there will be a massive cliff edge? Lots of people will try to avoid coming forward for care in the months before October 2023, and there will then be a massive surge. How do the Government plan to deal with that?
Steve Barclay
In a number of ways. First, this fiscal support is not in isolation. There is £33.9 billion of additional support going into the core NHS budget over the five years of the long-term plan. That has had a significant impact. On top of that, significant covid support has gone into the NHS. One of the points that came out of the debate on the ways and means last Wednesday was the interrelated nature of the impact on the NHS and on social care. That is why it is right that we are gripping this issue, but it is alongside the wider financial support that the Treasury has offered.
Several hon. Members rose—
Steve Barclay
Given that we need to progress on to Committee, I shall just point out that this is a permanent new role for the Government and a structural increase in the size of the British state. We therefore need a permanent new way to pay for it. The only alternative would be to borrow indefinitely, but that would clearly be the wrong course of action when our national debt is already at the highest it has been in peacetime. Borrowing even more today would just mean higher taxes in the future.
Richard Drax (South Dorset) (Con)
With money tight, did the Treasury support the appointment of, I think, 43 new executives on £270,000 a year to check where all this money is going?
Steve Barclay
I think one needs to see whether these are roles that are driving efficiency and creating savings elsewhere, or whether they are viewed in isolation. That is why one needs to understand the workforce as a whole, where there are overlaps within the NHS but, above all, how we deliver reform, which is something I know that the Secretary of State for Health and Social Care is passionately committed to doing. That relates to the point that was rightly raised by my hon. Friend the Member for Winchester (Steve Brine) on the delivery of reform in order to maximise the value for money of the spend that the levy will unlock.
Finally, we need to fund our vision for the future of health and social care in this country over the longer term. As the Prime Minister said, with proper funding, we can not only tackle the NHS backlog and expand the social care safety net but afford the nurses’ pay rise, invest in the best equipment and prepare for the next pandemic. We can provide the largest investment ever to upskill social care workers and build the modern, more efficient health service the British public deserve.
Clive Efford (Eltham) (Lab)
It seems to me that we are spending this money twice, so can the Minister tell the House specifically how much will go into the NHS from this increase and how much will go into social care? What I am hearing from him is that we are going to deal with the backlog, which will take us back to pre-pandemic levels. That will leave us with a 2 million waiting list, so can he tell us specifically how much is going into the NHS and how much is going into social care?
Steve Barclay
Of the £36 billion, £5.4 billion is going to adult social care, with the rest going into the NHS or through Barnett. That is over three years.
Dame Andrea Leadsom (South Northamptonshire) (Con)
Does my right hon. Friend think that the Government could consider different bands for frontline staff in the NHS and management staff in the NHS, to get away from the concern that so many of my constituents have that any pay rises in the NHS will be taken up by managers over frontline operators?
Steve Barclay
In the public sector pay agreement that we reached, we accepted the recommendations of the independent pay review body. That is why we decided on 3% and why the NHS was treated differently from other areas of the public sector such as the police and teachers. This recognised the importance of those frontline workers and it was why those under the threshold of £24,000 were carved out. This recognises the point that my right hon. Friend has raised.
In conclusion, this levy will enable the Government to tackle the backlog in the NHS. It will provide a new permanent way to pay for the Government’s reforms to social care and it will allow the Government to fund our vision for the future of health and social care in this country over the long term. I commend the Bill to the House.
Madam Deputy Speaker (Dame Rosie Winterton)
Before I call the shadow Minister, I should say that there will be a six-minute limit on Back-Bench speeches to start with. If anybody wishes to speak, they should catch my eye, and to do that it is important to keep standing. If colleagues have not put in to speak but wish to do so, it would be helpful to let me know. They will have to have been here from the beginning of the debate, and they will be expected to be here for the wind-ups, which will start at approximately 4.45. Bearing all that in mind, I now call the shadow Minister, James Murray.
James Murray (Ealing North) (Lab/Co-op)
I beg to move an amendment, to leave out from “That” to the end of the Question and add:
“this House declines to give a Second Reading to the Health and Social Care Levy Bill because, notwithstanding the need to increase funding for health and social care, the Bill raises money for an approach announced by the Government that fails to set out a plan to fix the crisis in social care, improve pay and conditions for social care workers, or clear the NHS waiting list backlog by the end of this Parliament, while breaking the Prime Minister’s promise that no one will have to sell their home to pay for care; because it lacks a guarantee that Parliament will vote on a social care plan before spending the money it raises; and because it breaks the Government’s promise not to increase National Insurance, raising taxes on employment that will disproportionately hit working families, young people, those on low and middle incomes and businesses trying to create more jobs in the wider economy, whilst leaving income from other sources untouched.”
Today, the Government are pushing through a new tax on working people and their jobs. All scrutiny by the House of Commons of the Government’s manifesto-breaking plans has been squeezed into a single day. As Conservative Members have said, we have just a few hours of scrutiny on this entire Bill, just one week after the Government first revealed their intentions. Why the sudden rush? The truth is that the Prime Minister and the Chancellor are desperate to avoid giving their own side enough time to push back. They want to make sure that, by the time it sinks in with their own MPs what a mistake this tax rise is, it will be too late for their Back Benchers to mount any opposition.
Perhaps it is also sinking in with Conservative Back Benchers that the Prime Minister and the Chancellor are pushing through these plans for a tax rise without having a plan for social care. If we are to believe the Prime Minister, and there is absolutely no reason why we should, he had a plan for social care two years ago. We are still waiting to see it. All we have today is a tax rise for working people and for businesses that are creating jobs.
Catherine West
Does my hon. Friend agree that these problems began in 2010? The NHS’s satisfaction rate in 2009 was 80%, and now it is way lower. In fact, they might have got rid of all the satisfaction surveys so that we do not know what people really think.
James Murray
My hon. Friend makes an important point about the Conservative Government’s impact on the national health service over the last decade, running it into the ground and leaving it in such a state when the covid pandemic hit.
As my hon. Friend the Member for Leeds West (Rachel Reeves), the shadow Chancellor, said last week:
“There are two tests for the package announced yesterday. First, does it fix social care? Secondly, is it funded fairly?”—[Official Report, 8 September 2021; Vol. 700, c. 327.]
Looking at the Bill, it is clearer than ever that the answer to both those questions remains a resounding no.
Gary Sambrook (Birmingham, Northfield) (Con)
On the basis of those two tests, which tax would the hon. Gentleman increase to pay for social care?
James Murray
We are clear that taxes will have to rise to pay for social care, but we are also clear that this increase in national insurance contributions is not the way to raise the money fairly. When it comes to funding the NHS, social care and all our public services, we are clear that those with the broadest shoulders should be asked to contribute more.
This five-page Bill contains nothing at all about a plan to fix social care; it does not even mention a plan. Put simply, there is no guarantee that a plan for social care will be in place even when the levy comes into force.
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I was going to pose this question to the Minister, but he would not take my intervention. Last week I was told by the insurance arm of a major bank that the Government are actively encouraging it to produce insurance products specifically for health and social care. Is my hon. Friend as concerned as I am not only about who is encouraging such developments but about what it means for the acceleration of privatisation not only in social care but in the health service?
James Murray
My hon. Friend makes us think about what we have read recently about what the hon. Member for Yeovil (Mr Fysh) has been saying about a rebate from this tax for those who take out private insurance. Make no mistake, that is a slippery slope towards a two-tier healthcare system.
Dr Andrew Murrison (South West Wiltshire) (Con)
The hon. Gentleman has been speaking for some time, but he has not said what taxes he would raise. Why was it okay for Labour to raise national insurance to pay for healthcare in 2003, when there was not a pandemic and we did not have the scale of social care need that we have today? If it was right then, why is it not right now?
James Murray
The right hon. Gentleman speaks about a tax rise 20 years ago, following a decade of wage growth, and it came with a plan for how the money would be invested. In stark contrast, this Government’s tax rise hits working people after a decade of stagnating wages, after we have been hit by a global pandemic and after years during which where people get their money from has changed. Above all, the Conservatives’ tax rise comes with no promise that it will clear the NHS waiting list backlog in this Parliament and no promise that any money will be seen by the social care sector.
Despite all that has been said, there is no guarantee in the Bill that social care will benefit from the Government’s tax rise. In fact, the Bill explicitly rules out any money going towards social care in the first year, and there is nothing to guarantee that a single penny of this new levy will ever go into the social care sector.
The Association of Directors of Adult Social Services realises this, and it said on Monday that
“it is not clear that there is any new money for adult social care to help improve care and support from April 1st next year… It will not add a single minute of extra care and support, or improve the quality of life for older people, disabled people and unpaid carers.”
As the association rightly points out, this could leave councils with no option other than to raise council tax. Indeed, the Government have admitted that they expect councils to cover increasing need and rising costs. Despite £8 billion having been cut from local council care budgets by a decade of Conservative Government, there is no money for councils that need it now.
In truth, this levy does not set out to fix the crisis in social care. It seeks only to be a political fix for the Prime Minister. I suspect Conservative Members know that, and I suspect the Prime Minister is noticing that his attempt at a political fix is quickly becoming a political headache.
Although some Conservative Members may be worried about how to explain to their constituents that they have broken their manifesto promise and still failed to fix social care, others have a different agenda. The hon. Member for Yeovil, as I mentioned earlier, has been reported as saying that he wants people with private social care insurance to get a rebate from the new tax. As my right hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Health Secretary has said, this looks very much like a “slippery slope” towards a two-tier healthcare system and privatisation.
Mr Marcus Fysh (Yeovil) (Con)
My comments have been misreported. The origins of the Labour movement and the Liberal movement are in trade unions, co-operatives and friendly societies that came together to look after each other. What I am suggesting is that we get money into such systems to help people look after and pay for themselves in older age. There are myriad ways in which the system can be made much more progressive, and I am on their side in trying to make this more progressive than it is at the moment.
James Murray
As the hon. Gentleman is on our side, I look forward to him joining us in the Lobby this evening.
Will the Chief Secretary to the Treasury or the Financial Secretary to the Treasury put it unequivocally on the record that no rebate from the health and social care levy for those with private insurance will ever be entertained? A two-tier healthcare system is the very last thing we need. What the social care sector desperately needs is guaranteed funding and a plan to transform the sector. This Bill delivers neither.
Craig Mackinlay (South Thanet) (Con)
The hon. Gentleman is talking about a two-tier system. Is he saying that the millions of people in the public sector and the not-for-profit sector who have auto-enrolled pensions are rather daft to have a sensible pot under their own name, with the flexibility that it brings? Are you calling millions of taxpayers daft?
Madam Deputy Speaker (Dame Rosie Winterton)
Order. The hon. Gentleman is experienced enough to know that he should not speak directly to another Member.
James Murray
The hon. Member for South Thanet (Craig Mackinlay) knows full well that his question is not relevant to this discussion. We are talking about the NHS and the social care system, and we need reassurance from Ministers that they will not entertain a two-tier healthcare system on the back of comments made by Conservative Members.
We need to transform social care into the service that people want, need and deserve, which is why our plan for social care would include: enshrining the principle of home first; making a fundamental shift in the focus of support towards prevention and early intervention; getting care workers the pay, terms and conditions they deserve—at the very least, a real living wage of £10 an hour—while transforming training to improve the quality of care; and, crucially, making sure that England’s 11 million unpaid family carers get proper information, advice, breaks and the workplace flexibility they need to balance work and caring responsibilities.
Of course, today we are not discussing how to transform social care. We are debating a Bill that introduces a tax rise that may never go towards helping social care, and one that is raised on the backs of working people and businesses that are creating jobs.
Dame Andrea Leadsom (South Northamptonshire) (Con)
What would the hon. Gentleman do about the backlog of 5 million people, as a result of covid, waiting for procedures and operations in the NHS? Does he not want that backlog to be dealt with?
James Murray
The right hon. Lady raises points about the backlog in the NHS. We have had 10 years of a Conservative Government, of whom she has been a key part. She is responsible for the backlog, along with all her colleagues on the Conservative Benches. They should take some responsibility for the mess they have caused.
We know that social care desperately needs more funding, but are the Government raising taxes for those with large portfolios of stocks and shares? No. Are they increasing taxes on landlords who rent out multiple properties? No. Are they going further to tackle large online multinationals that shift their profits overseas? No. The Government have gone for a tax rise on working people and businesses creating jobs.
Last week, the Government tried to soften the blow by claiming that their tax plans are fair because this tax rise on working people is accompanied by a tax rise on dividends. So where is the tax rise on dividends? The Government’s proposal documents last week admitted that that might be legislated for in the next Finance Bill, and indeed there is nothing on raising taxes on dividends in the Bill in front of us today. They are pulling out the stops to increase taxes on working people as quickly as possible, ramming this legislation through in one day, but when it comes to dividends and a tax that the Prime Minister acknowledged last week would affect
“better-off business owners and investors”—[Official Report, 7 September 2021; Vol. 700, c. 154.]
suddenly there is no rush. Let us not fall for the claim that the dividend tax rise will make the Government’s proposals fair. The dividend tax—if it ever happens; we have only the Prime Minister’s word for that, after all— would raise only 5% of the total revenue. Some 95% of the tax bill would land on employment.
If we want to understand the impact of this tax rise on people and their jobs, let us start by looking at the Government’s own view. Their own tax information and impact note on this tax rise was signed off personally by the Financial Secretary to the Treasury and published on 9 September—curiously, this was a couple of days after the Government’s proposals were announced. It says in no uncertain terms:
"There may be an impact on family formation, stability or breakdown as individuals, who are currently just about managing financially, will see their disposable income reduce.”
Five years ago, the Prime Minister’s predecessor began her time in office claiming to be an ally for people who are “just about managing”. Now we have the Government’s own report admitting that they are the ones who will suffer.
The report is blunt too about the impact of this tax rise on businesses. It makes it clear:
“Behavioural effects are likely to be large, and these will include...business decisions around wage bills and recruitment.”
It is there in the Government's own analysis: this will be a tax blow to jobs and wages. Others agree, with the chair of the Federation of Small Businesses saying last week:
“Breaking a manifesto promise by increasing National Insurance Contributions just at the moment when firms are struggling to get back on their feet would be devastating for small businesses and the local communities they serve...If this hike happens, fewer jobs will be created by the UK’s small business community over the crucial months ahead.”
The British Chambers of Commerce agrees, warning:
“A rise in National Insurance Contributions would represent a hammer blow to jobs growth at this crucial point in the UK's economic recovery.”
The CBI president said:
“National Insurance increase will directly hurt a business’s ability to hire staff, at a time when businesses have faced a torrid 18 months and are now fighting crippling labour shortages.”
Do the Financial Secretary and the Chief Secretary think the Federation of Small Businesses, the British Chambers of Commerce and the CBI are all wrong? Perhaps the Financial Secretary will get up to tell me the answer to that. [Interruption.] Sorry, I thought the Financial Secretary was keen to get to his feet to respond to my question. He does not want to, no. He does not want to answer whether he thinks the FSB, the BCC and the CBI are all wrong. Do other Members from his party think they are wrong?
James Murray
Perhaps the hon. Gentleman would like to intervene to answer that question.
Andrew Griffith
I am just wondering whether the hon. Gentleman’s tax primer in low corporate taxes has enlightened him with any ideas of his own as to how his party would propose to fund this. The proposal on the table is a broad-based tax. How would he fund this?
James Murray
We have been absolutely clear that when it comes to funding the NHS and social care, those with the broadest shoulders should pay the most. The idea that this is a “broad-based” tax rise is completely wrong. The hon. Gentleman knows that, we know that and the British public know that. I note that when he got to his feet, he did not answer the question as to whether he thought the FSB, the BCC and the CBI are all wrong. Next time another Conservative Member gets to their feet, I would like to hear their answer to that. I would also like to know whether they think TUC general secretary Frances O’Grady was wrong when she said last week:
“We know social care needs extra funding. But the prime minister is raiding the pockets of low-paid workers, while leaving the wealthy barely touched.”
That is the fundamental unfairness at the heart of this Government’s tax rise.
The Prime Minister and Chancellor are desperate to pretend this is the only way to raise the money, but that simply is not true. A fairer approach would see funding for the NHS, social care and all our public services borne by those with the broadest shoulders—this would include those with incomes from large financial assets, multiple rental properties, and other income from wealth contributing more. But they have not been considered by this Government, who would prefer to hit workers instead.
This Government are landing a tax rise, which they claim will go toward social care, on low-paid social care workers themselves. The truth is that this is a tax on working people and their jobs. This tax rise tells us nothing about how the Government plan to fix social care, but it tells us everything we need to know about the instincts of the Tories when they are in power. That is why it is wrong. That is why we will be voting against this Bill. And that is why Conservative MPs would do well to join us tonight if, come the next election, they want to be able to look their constituents in the eye.
Jeremy Hunt (South West Surrey) (Con)
Select Committee Chairs have to hold the Government to account, but just occasionally they also have to hold the other parties to account. I am afraid that today is one of those days, because the opposition of the parties on the Benches opposite to this Bill does not bear any scrutiny at all. That is not just because Gordon Brown proposed an increase in national insurance in 2002 to fund the NHS or because senior members of those parties have supported NI as a way of funding the social care system as recently as three years ago; it is because for more than a decade the parties opposite have argued, with some justification, that more money needs to go into the health and care, and this Bill will add £12 billion every year into our health and care system. That is more than any wealth tax would generate—to my knowledge, it is more than any of them have been arguing—and it is more progressive than using plain NI, because it is progressive between the generations. That is because, for the first time, working pensioners will be paying this tax, as well as people who pay dividends.
I may not make friends on my side of the House either, because while I commend the courage of a Conservative Prime Minister and a Conservative Chancellor, supported by his team, in doing what we find extremely difficult, for the right reasons—increasing taxes—I fear that if what we have done so far is tough, what is to come will be tougher still. I say that because if you put your hands into people’s pockets and take money out of them, and they do not see visible improvements in the services they receive, they get very angry indeed.
Steve Brine
Will my right hon. Friend use his position on the Select Committee and his vast experience to scrutinise this plan, which I mentioned to the Minister but which I know the Secretary of State has agreed with NHS England and me, as to how exactly they are going to spend every penny of our constituents’ money on this catch-up programme? Will my right hon. Friend’s Select Committee scrutinise that for us?
Jeremy Hunt
As it happens, we are currently conducting an inquiry into how to deal with the covid backlog, so I commit to my hon. Friend, with whom I so enjoyed working at the Department of Health and Social Care, that we will certainly do that.
Clive Efford
I have heard what the former Secretary of State has said about the record on social care, but can he explain what he did to try to prevent the Conservative Government from taking £8 billion out of social care?
Jeremy Hunt
First, we passed the Care Act 2014, which put in place the legislative foundations for the proposals that we are now going to fund. Secondly, I happen to agree with the hon. Gentleman: the social care system has needed more money for some time. That is why it is so extraordinary that his party is to vote against this Bill.
If we are going to take £12 billion a year out of people’s pockets, we need to avoid falling into three traps—and I say this as someone who has fallen into more traps in this policy area than anyone else in this House. The first trap that we need to be careful of is the workforce. If we put an extra £8 billion into the NHS but we do not have £8 billion-worth of additional doctors and nurses to do the extra treatments, the risk is that that money will hit the ground without touching the sides. That is why we need a workforce plan.
The Health Foundation says that the backlog will require 4,000 more doctors and 18,000 more nurses, but we have not had any workforce plan from the DHSC. I suspect that in the short term we will have to relax all the immigration requirements for doctors and nurses. That will not be great for developing countries, but it may well be our only choice. In the medium term, the best suggestion is what my Select Committee and many others have proposed: we should give Health Education England the statutory responsibility to produce independent workforce estimates and create a discipline, a bit like the OBR does for Budgets, to make sure that we are training enough doctors and nurses. That is the first trap.
Jeremy Hunt
I will make some progress, if I may.
The second trap is that we must not inadvertently sleepwalk into another Mid Staffs. People forget that when Mid Staffs happened, NHS budgets were actually going up. There was huge pressure to reduce waiting times and that ended up creating a targets culture in which numbers matter more than people. We have to be very careful that we do not make the same mistake again. I know that my right hon. Friend the Chief Secretary to the Treasury, who worked with me at the Department of Health and Social Care, understands that because of his commitment to patient safety.
The third trap involves social care funding. Although the settlement we are discussing is generous, if we are honest, in the next three years social care will not actually get as much money as it needs. The truth is that there is a risk that the NHS will continue to gobble up the lion’s share after that, which is why it is essential to ring-fence the amount of money that goes to social care after those three years.
Jeremy Hunt
I am going to make some progress, if I may.
Finally, let me say this. We, as Conservatives, criticised the Labour party in the 2000s for pouring money into the NHS without a proper plan. We were wrong to say that the NHS did not need more money, but we were right to say that there needed to be a proper plan. We must learn the lessons of history; that is the least we can do for frontline workers in the NHS and care system.
Alison Thewliss (Glasgow Central) (SNP)
To start where the right hon. Member for South West Surrey (Jeremy Hunt) left off, in the Bill before us this afternoon we have the lack of a proper plan. We have a means of raising taxes, but absolutely no detail whatsoever on how the money is to be spent.
Let me start with a useful note sent round by the Hansard Society, which says:
“Parliament’s scrutiny of financial matters is generally poor, and the treatment of the new Health and Social Care Levy demonstrates many of the worst aspects of both the financial and legislative scrutiny processes: acting at speed with insufficient policy detail available for MPs to consider; important constitutional questions brushed aside; and broad powers delegated to Ministers with a lack of clarity about how they are to be used in future.”
I agree with every single word of that.
Scrutiny and accountability are absolutely key to this issue, because we have been presented with a huge additional spending commitment but no detail whatsoever as to how it will actually be spent on the other side. I know that there are Conservative Members who are extremely nervous about this levy; far be it from me to agree with them, but I am right to agree with them on that, because we do not know how this money is going to be spent. People are incredibly nervous that health and social care will be at the back of the queue when the money is to be spent.
As the hon. Member for Basildon and Billericay (Mr Baron) pointed out earlier, we are considering this Bill in unseemly haste. Is this to do with the election cycle, testing the loyalty of Government Back Benchers or making sure that people are loyal in the run-up to any reshuffle? We cannot see the real reason for this haste. If we could wait, we could see a little more detail as to exactly why we have to proceed in this way. There is also a difficulty in scrutinising the spending of the levy because it is outwith the usual estimates process and the usual Budget process. We cannot have any real clarity in that respect.
Most worryingly of all, the Government have—as they have done in so many different ways—taken back control only to give all the power back to themselves and their cronies. A lot of the work in respect of the Bill will be done through regulations. Clause 4 gives the Government very wide scope to make regulations on this matter later, which means we will lose all sense of scrutiny from this place. It will all go to civil servants rather than to Parliament. That is entirely undemocratic and wrong. Yet again, there is a wide-ranging power grab from this place and in respect of our job as Members of Parliament here. I cannot see the justification for that in the Bill; it would be interesting to hear why Ministers intend to do that.
We on the SNP Benches demand urgent clarity about every penny of Barnett consequentials that will be given to the devolved Administrations. In line with our manifesto, any additional money that Scotland gets will be spent on health and social care, but there must be no attempt by the UK Government to sell Scotland short by clawing back our share through cuts in other devolved policy areas. It would be just like Government colleagues to give money with one hand while pinching money out of our back pocket with the other. The UK Government must give urgent assurances that we will get every penny we are due—as should Wales and Northern Ireland.
Last week, the Secretary of State for Health and Social Care told “Good Morning Scotland” that, ultimately, it will be for the Scottish Government to decide how the money raised is spent, but that is not what the Prime Minister said. In his statement last week, he said:
“Although Scotland, Wales and Northern Ireland have their own systems, we will direct money raised through the levy to their health and social care services.”—[Official Report, 7 September 2021; Vol. 700, c. 154.]
To direct money would be to override the devolved settlement. It would override our Scottish Parliament and our Scottish Government. It is also unclear where it is intended that that money should go. Will it go to NHS Scotland or to the health boards, the integration joint boards or the health and social care partnerships that sit underneath? Will the formula by which funding is distributed in Scotland be disrupted?
We need certainty as to how the money will be spent, and the Bill currently does not give that. All the Bill says is that money will be paid
“in such shares as between health care and social care, and in such shares as between England, Wales, Scotland and Northern Ireland, as the Treasury may determine.”
That means more power for Treasury Ministers, which I am sure they will enjoy having, but less power for this Parliament and even less power for the devolved institutions. It is their right to know how that money is to come to them and how it is spent. We should not get one penny less than we were due.
Many analysts have pointed out that other parts of devolved spending have been cut because of, for example, the Barnett consequentials of the cuts to local government or to justice. Such cuts mean that we get less money coming through, even if the Government like to pretend, through things such as this levy, that there will be more. It is unclear in the documentation published by the Government exactly what the Barnett consequentials will look like. Their plan for social care says that the Barnett consequentials will be £2.1 billion in 2022-23, drop to £1.7 billion in 2023-24 and be £1.9 billion in 2024-25. If the money that comes is going to jump about by such significant amounts over those years, we will not know exactly how things are going to look, what the certainty is and how we can plan. The Scottish Government deserve certainty so that they can plan for services.
Let me highlight some of our other major issues with the proposals, which are a tax on the poorest working people in this country. They are completely unjustifiable on that basis. The levy is disproportionate and unfair. There is a bit of brass neck from Government Members: they howled when Scotland put money on income tax—a progressive system in which those at the wealthier end of things paid a little more into our system for our services in Scotland. They said it was terrible and awful, yet today there is not a peep out of them to complain about the lack of progressive taxation and the fact that Scotland will have to pay for England’s social care crisis, which is completely unjustifiable. This is also a tax on jobs and the recovery. Reflecting on the ONS figures that show that the recovery is now stalling, the Federation of Small Businesses says that this tax on jobs will mean 50,000 more people becoming unemployed. That is 50,000 people losing their jobs as a result of this Government’s incompetence in taxing jobs and the recovery. We really could not make this up. From every angle that we approach this tax, it makes absolutely no sense whatsoever.
I will talk in greater detail about our amendments when we come to the Committee stage, but my reflection for now is that we have Scottish taxpayers paying for England’s health and social care crisis, and an undermining of devolution in Scotland, Wales and Northern Ireland and of the services that our Parliaments are democratically elected to provide.
Christine Jardine
Can the hon. Lady explain how Scottish taxpayers, of which I am one, are paying for this levy? I am confused by the thinking. We either agree with the fairness of the levy or we do not. In Scotland, we would get more than we paid in, so I am confused by her thinking.
Alison Thewliss
The point is that we do not know what we will get out of this. We do not know because it is not clear in the documentation that has been provided. We also do not know what will happen on the other side of that equation—money in other devolved areas could be whipped away from us at our expense. Organisations such as the British Association of Social Workers have pointed out that cuts to local government will fundamentally undermine the social care provision in England. Authorities will not receive anything for three years, which will also have an impact on the money that we have to spend in Scotland.
These moves tax the poorest. They come at the same time as £20 a week is being removed from universal credit. Some 2.5 million people across the UK will be affected by both of those policies at a time when they can least afford it. The tax on jobs will stifle the recovery. Rather than being a Union dividend as Ministers like to try to claim, this is a Union dead end.
Madam Deputy Speaker (Dame Rosie Winterton)
In order to try to get everybody in, I will reduce the time limit to five minutes, and I have been able to warn the next speakers of that. If people do not get in, let me remind them that there is a Committee stage to follow and they might like to bear that in mind.
Mr Marcus Fysh (Yeovil) (Con)
I will not speak for long now because I want to speak at the Committee stage later on.
We all want better health and social care and we understand that that comes with a cost. I am concerned that the plan does not make sufficient provision for allowing the discharge of patients from hospital into social care, which will be so critical when it comes to dealing with the backlog of cases. I want to work with the Government on trying to find ways of getting more money into social care earlier. We will get more money through the health provision for supporting the health needs of patients in residential care, but that is not the same thing. In the meantime, our adult social care system is creaking, with 30% more demand than there was before the pandemic. Many local government leaders are very worried about where they will find the money in the meantime to pay for this.
I rise to speak in support of those who will be affected by this national insurance rise. As we have heard, it is very broad based, but it is not the most progressive way to deal with this matter. I do not like the fact that this is the choice that we have made. It is wrong to be raising taxes at this point, particularly taxes on jobs and employment, when both are so central to spending in the economy. It is ordinary people having the confidence to go out and spend money that makes the most difference to our economic performance. At the end of the day, it is that economic performance that will grow the other tax revenue lines and it is those tax revenue lines that will make the most difference to how much money that we, as a nation, have to spend on these massively important priorities.
I want to compliment the Government, and the Prime Minister personally, for raising the issue of adult social care to the top of the national agenda, because they are absolutely right that we do need to sort this matter out. I also stand here for the people in that system now who are being short-changed in one way or another, whether it is on the services or on the way that the financing occurs. We need to work together, across the House if possible, to find innovative new ways of creating a long-term plan to get that service operating better.
John Redwood
Does my hon. Friend share my surprise that the Treasury can be precise in saying that it needs £12 billion from a new tax when it overstated the budget deficit by £90 billion last year, which shows that it does not have a clue about how much money will come in anyway?
Mr Fysh
My right hon. Friend makes a good point. Yes, it would have been great to have had more detailed context of where we can get to in this economic recovery so that we could know where we were in terms of revenue before we make such momentous changes that affect the aspirations and potential of so many people within the economy. We also need to look at whether this measure will increase costs and cost pressures within the system that we are trying to help. Many local authorities outsource provision of social care to private contractors, and these private businesses will be very much affected by these plans for the tax. We have also heard that the plan will mean that private providers cannot cross-subsidise their state provision of residential care places with private places, which could risk taking capacity out of the system at exactly the wrong moment when we want to get health and social care operating correctly. There are ways of making this measure more intergenerationally fair and I look forward to trying to work with the Government on different and innovative ways of doing that.
Going back to my original point, I think that we marry in haste and repent at leisure. Let me be clear that I am not referring to my own marriage; it is a very successful one and I love my wife dearly. None the less, it would have been much better to have had more time to think about all the ramifications of this Bill and the associated plan. I hope the Government will engage positively with our ideas about how we can evolve things whatever the outcome today.
Dame Margaret Hodge (Barking) (Lab)
I hope that the hon. Member for Yeovil (Mr Fysh) will join the Opposition in the Lobby tonight given what he has just said in his contribution.
We should give credit where it is due. We are starting a debate not on whether we can rescue our broken health and social care services, but on how we do so. These services were damaged not just by covid, but by a decade of savage cuts. Tragically, the Government are flinging away this once-in-a-lifetime opportunity to do something that will endure, that will tackle the underlying problems facing these critical services, and that will be fair to us all—whatever our age, wherever we live and whatever our income.
These shambolic proposals will not meet the needs of the elderly and disabled who depend on social care. They will not properly protect our NHS. They will further ravage struggling local authorities, and the tax proposals are needlessly regressive.
I wish to focus on the tax. The health and social care levy is an unfair hike that will hit younger working people the hardest.
Taiwo Owatemi (Coventry North West) (Lab)
Does my right hon. Friend agree that it is completely unfair that a graduate nurse who works a night shift as an Uber driver now faces a £12,500 tax hike over their working life due to this new levy? That is the reality facing many of my constituents. It is high time that we start calling this measure what it is. This is not a social care levy; this is the workers’ tax.
Dame Margaret Hodge
My hon. Friend makes the point very powerfully. I was going to illustrate it more generally by saying that families whose personal allowance will be frozen, such as the one she mentioned, and who lose the £20 a week from universal credit cuts—the very families that the Government proclaim they want to level up—will suffer.
Do not just listen to me. I am going to re-quote the quotation that my hon. Friend the Member for Ealing North (James Murray) used in his excellent speech. Listen to what the Government’s tax authority, HMRC, says:
“There may be an impact on family formation, stability or breakdown as individuals, who are currently just about managing financially, will see their disposable income reduce.”
Is that what the Government really want?
Half the revenue will be paid by people who are under 45, most of whom will be hit by a 10% rise in NICs. That is regressive. National insurance kicks in at a lower level of earnings than income tax. That is regressive. The self-employed pay a lower rate. That is regressive. Income from assets such as rent from property remain untouched. That is regressive. And squirreled away in the policy document, the Government say that they expect that
“demographic and unit cost pressures will be met through council tax…and long-term efficiencies.”
That means further cuts and a hidden hike of the outdated council tax—a tax that hits those in Barking and Dagenham harder than those in Kensington and Chelsea. That is also regressive.
I am rather tired of being told by the Government that there is no alternative. There are plenty. For a Government committed to fairness between individuals, fairness between generations and fairness between income secured through wealth as well as work, there is a raft of better ways to fund health and social care. Put a penny on income tax and equalise rates for dividend and income tax: £13 billion. Equalise capital gains and income tax rates: £14 billion. Or, as suggested by academics Advani, Summers and others, plug the unfair gaps in national insurance by extending it in full—not just the levy, but all of it—to all investment income and working pensioners: £12 billion. If we scrapped the upper earnings limit and equalised the rates of NICs paid between high and low earners, we would not just raise enough to meet roughly the same amount as the Government propose; we could cut the main rate of NICs by 1.25 percentage points.
This unfair plan is simply not fit for purpose. The numbers do not stack up. The poor will pay for the rich. The young will pay for the old. The struggling tenant will pay for the wealthy landlord. The asset-poor worker will pay for the asset-rich retiree. Make no mistake: these are political choices—choices that fail working people, fail our NHS and fail those in desperate need of quality social care. I cannot support them.
Madam Deputy Speaker (Dame Rosie Winterton)
Obviously we have had one or two interventions along the way, so after the next speaker I shall reduce the time limit to four minutes, but I think that it should be fairly consistent from then on.
Paul Bristow (Peterborough) (Con)
I refer the House to my entry in the Register of Members’ Financial Interests. As a member of the Health and Social Care Committee, I rise to support the Bill and to argue that the money raised by this levy be spent well. I commend my right hon. Friend the Member for South West Surrey (Jeremy Hunt) on his chairmanship of the Committee, in which we are conducting those lessons-learnt inquiries to ensure that our money is spent well. I want to mention three areas; if we focused on them, we could ensure that this money is spent well and get the desired outcomes.
The first is capacity in the acute sector. It is clear that the NHS needs to strike a long-term deal with the independent sector to try to power through the backlog of elective procedures. We are talking about hips and knees, hernias and cataract operations. I read and hear reports, with alarm, that the independent sector capacity that the NHS has bought is being underused—or, if it is not being underused yet, there is a fear that it may well be—because of ideological reasons that the independent sector should not be used and we should be funnelling all these procedures into the NHS. If we do not use the independent sector, we will not have the desired outcomes. We cannot let ideology dictate, as this will ensure that people are left in pain for longer and do not have the right quality of life. We need to ensure that the independent sector is used to its full capacity, so that we can get through this elective backlog.
Similarly, we need to ensure that initiatives such as “Getting It Right First Time”, or GIRFT, are used properly. The NHS has spent money, resources and experts’ time on understanding which procedures work at high volume and low risk. We should use the lessons learnt from GIRFT to deal with the elective backlog. Let us not reinvent the wheel, but let us ensure that we do learn those lessons. Ultimately, these are usually minimally invasive techniques and technologies for procedures that can be done as day surgery, and this will ensure that we power through the backlog and get the elective procedure waiting list under control.
The second issue that the Health and Social Care Committee has heard about is the importance of the diagnostic sector. In the past, I think the NHS has been guilty of focusing on the treatment of conditions, rather than on prevention. If we get the early diagnosis correct and invest in diagnostics technology, we can find out who is at risk of suffering from cancer, heart disease and other long-term conditions before they present at an acute level. It is really important that we invest in that sort of technology, so that we can save money in the long term.
Finally, let me turn to innovation in our NHS in general. I have worked in health politics, if you like, for 20 years. As I said last week, there is a cultural aversion to the private sector, technology and innovation in our NHS. That aversion may be at the margins, but it is at least having an impact, and it needs to be dealt with straight away. If we do not adopt innovation—new technologies, pathways and ways of doing things—we are not going to ensure that this money is spent well.
I would challenge that something that should come out of the health service reforms that we are looking to introduce is the appointment of an innovation officer, or someone who is responsible for innovation in every NHS trust. Let us make it their job. I welcome the fact that we are at last beginning to ensure that the NHS will have a degree of accountability again, and that politicians will have the ability to challenge NHS trust managers to ensure that this money is spent well. One way to do that is by having an innovation officer who is responsible for reform and innovation, ensuring that new pathways are adopted and this money is spent well. If we do not, we could be here again in three or four years’ time, and the money that we want to transfer to social care in due course could have been gobbled up by the NHS, which my right hon. Friend the Member for South West Surrey said was a real risk.
As far as I am concerned, those are the three real challenges: acute capacity; investment in diagnostic capability; and ensuring that innovation is properly recognised in our NHS.
Mick Whitley (Birkenhead) (Lab)
I draw the attention of the House to my entry in the Register of Members’ Financial Interests.
More than two years ago, the Prime Minister promised that he had a plan to fix our country’s broken social care system. It was something that my constituents in Birkenhead so desperately needed—from the elderly people denied the most basic right of dignity in old age, to the dedicated but overworked carers earning less than the minimum wage and forced to turn to universal credit just to get by.
After a decade of brutal austerity measures and chronic Tory mismanagement, there is absolutely no doubt that we need a funding settlement for social care, but the Prime Minister’s announcement last week will have provided no relief to the people I have the privilege of representing. Instead of asking those with the broadest shoulders to contribute just a little bit more, the Government are intent on pursuing an utterly regressive tax on hard-working families and British businesses. Charities working on the ground in my constituency predict that the impending cut to universal credit, coupled with soaring energy bills, will force another 6,500 people living in the Wirral into poverty. Now, many of those families will be bracing themselves to lose even more in increased national insurance contributions, while the very wealthiest in our society are left untouched.
Not only will this tax bombshell make it even harder for thousands of my constituents to make ends meet; it will also deal a devastating hammer blow to many of the small and independent businesses that play such a precious role in the life of our town. It will cost jobs and dangerously undermine a very fragile economy. Let us be clear: this tax hike makes a mockery of the Government’s promises to level up and build back better.
We do need solutions to the crisis in social care, but these proposals just are not fair or credible.
John Redwood (Wokingham) (Con)
I urge the Government to think again about the health plans. On the Treasury figures, this year the health budget in the public sector overall is £230 billion—£64 billion higher than the 2019-20 budget pre-pandemic. I understand that there were lots of one-off and special costs in setting up and dealing with procedures for tackling the pandemic, and I, like everybody else, am very grateful for the work that went in from health staff and experts. But that cost will drop away, so what happens to that money when it is no longer pre-empted by the special costs of the pandemic, and can it not be applied?
I hope the Government will listen to the Chairman of the Health Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), about the need for a manpower plan, because if we wish to clear the backlogs it is quite obvious that more nurses and doctors are going to have to carry out more treatments and procedures. Some of that will be possible through reallocation and improved working of the staff we already have, but a lot of it will require additional recruitment.
I am also very worried about the lack of a detailed social care plan, particularly for my own area of Wokingham. We have a large number of self-payers at the moment. How could I be sure that if we went for this levy scheme, which is still not properly detailed, sufficient money would come from it to a local authority like Wokingham, already under enormous pressure on its social care budget?
I am very suspicious of hypothecated levies. It is particularly dangerous to hypothecate a levy that is a tiny fraction of the budget one is trying to improve. That will give some people the misleading impression that the social care levy will pay for social care, whereas, on the numbers, the levy would be able to match under one fifth of the total public social care budget. Pitted against the huge numbers for the NHS and wider public health budget, that is just over 4% of the total, so it is a very insignificant amount in relation to the huge sums we are already talking about for the health budgets. However, it is a big sum of money when it is broken down and becomes a tax burden on people on quite modest incomes and those struggling in self-employment or trying to get their little businesses going. The last thing they need, when we need rapid growth and a faster recovery, is a tax rise.
The economy does not need sandbagging with austerity economics; it needs promoting for faster growth. It is still below the levels of output before the pandemic hit. Up until this point, the Treasury has been magnificent in making an avalanche of money available to get us through a most difficult time. We have got away with it. It has been borrowed at very close to zero interest. In these unique circumstances, it was possible to take extraordinary monetary measures that one would not normally be able to rely on and would not want to, and I am very grateful that that was done.
I say to the Government: it is too soon to start braking the economy. The growth rate almost disappeared in the last month. I am hoping it is going to look a bit better in the next month or two when we get more opening. But before the economy is completely opened up, and people have stabilised their businesses and repaired some of the balance sheet damage that the pandemic measures did, is not the right time to take money off them. We need more spending power, not less; more demand, not less. If the Government back that, the revenues will come tumbling in to a much greater extent than if we put rates up. Do they not understand that they were £90 billion wrong last year because there was more recovery than expected? They are already £26 billion under this year because there was a fast recovery in the first few months. Do not kill the recovery and you will get the money.
Helen Hayes (Dulwich and West Norwood) (Lab)
I rise to speak as a co-chair of the all-party parliamentary group on adult social care. Since the Prime Minister’s statement last week, I have been in touch with a number of members of the APPG’s working group, which has very wide membership from across the social care sector. There is absolute consensus that the Prime Minister’s plans simply do not deliver for social care. The first clue to this was the total absence of meaningful reference to social care in the Prime Minister’s statement itself. He did not say anything about the importance of adult social care or acknowledge the diversity of the sector and the need to fund care for both working-age adults and older people, nor did he pay any tribute to the hard work and sacrifice of social care workers during the pandemic or to the vital importance of their role.
The social care sector sees through this plan. Our NHS and social care are both in desperate need of additional funding now. Funding one and pretending that that will help the other is an insult to a social care sector full of brilliant, dedicated, highly skilled staff that has been brought to its knees by this Government’s neglect and complacency.
The Prime Minister’s proposals fail to make any commitment to a pay rise for social care staff. One of the members of the APPG working group, not-for-profit care provider Community Integrated Care, recently commissioned a benchmarking exercise to assess the value of social care work compared with other related professions such as healthcare assistant roles in the NHS. Its report, entitled “Unfair To Care”, found that the skills and tasks required by a social care worker employed in a care home were on a par with those of a level 3 healthcare assistant working in the NHS. The healthcare assistant receives a renumeration package worth £30,000 a year, but the social care worker receives just £17,000 on average. The social care sector has 114,000 unfilled vacancies at present—and is it any wonder when there is no parity for social care workers, and when in many parts of the country you can earn more working at the local supermarket than you can caring for our most precious loved ones?
Instead of committing to a pay increase, the Government are penalising the very care workers who are the backbone of social care, hitting them with a national insurance increase and many also with a £1,000 cut to their universal credit. How do the Government think this is in any way fair? Social care workers are not the only valued public servants who will face the punitive consequences of this Bill. Teachers, classroom assistants, social workers, prison officers, youth workers and many others will all face a cut in their take-home pay as a consequence of this wrong-headed plan.
This Government inexplicably persist in ignoring the need for real and fundamental social care reform. The Health and Care Bill proposes to integrate health and social care without reforming social care, failing to give proper voice to the sector or place it on a sustainable footing for the long term, and this Bill raises revenue without specifying how, when or where it will be spent. The Government must also acknowledge the diversity and fragmentation of the social care system, the need for a clear and comprehensive regulatory framework that includes supported living, and the need for a much greater voice for people who rely on social care and much more co-production of support services.
It is deeply regrettable that the Government have chosen to ignore decades of cross-party work on social care. They have chosen to ignore a constructive and serious piece of work by the Housing, Communities and Local Government Committee in 2018 in favour of their own ill-considered and half-baked plan. Social care and our NHS both desperately need additional funding, but this Bill delivers no firm commitment to the social care sector. It is an insult to dedicated social care workers across the country, and I will be voting against it tonight.
Ruth Edwards (Rushcliffe) (Con)
It started with a series of bizarre reports from my grandmother. My grandfather had started to put on his coat in the middle of the night and insist on going for a walk. She found plates of cheese in the airing cupboard, instead of the fridge. It was not long before he needed constant residential care for the last four years of his life. I have always thought that dementia is one of life’s cruellest diseases, both for the sufferer and their family. The reality is that you lose your loved one long before they actually die.
Sufferers of dementia and their families have their lives turned on end, sometimes in quite short spaces of time. The last thing they need is uncertainty and financial worries to add to that. Here in the UK, we have an ageing population—and with that come complex, long-term physical and mental health conditions—which means that the length of time people may require care if they are hit by dementia or similar conditions later in life is increasing, as are the numbers of people needing that care.
It is an urgent problem, yet for decades, Governments of all parties have pushed the issue down the road or to one side. Our health service and councils across the country have started to see the impacts of this increase in demand without an increase in ring-fenced resources. I am therefore glad to see the Government tackling this head on, both with the social care levy set out in this Bill and the planned White Paper in the autumn. Only through a system that encourages long-term planning for social care will we achieve a sustainable care sector.
Like with pensions, we should be thinking about care provision, planning and taking responsibility for that provision from the start of our working lives. We need to change the culture around how we talk and think about care, and this Bill is the first plank of that new platform. It has been written in a way that means that people on higher salaries will pay more. It is also the first part of a broader new care settlement that, as my hon. Friend the Member for Peterborough (Paul Bristow) said, must see reform and innovation throughout the NHS and our social care system, and proper integration between the two, if it is to have public support.
Raising taxes is not something I take lightly, but the public know we have just been through the most unprecedented 18 months in more than half a century. Those on the Opposition Front Bench have criticised the Government for taking two years to put forward a plan. They have taken 24 years, and they still have no plan, unless we are counting the broad shoulders tax, which I am sure we all look forward to hearing more details on. Will it be a tax on income, on assets or on literal shoulders? I wait to see.
Words are easy; decisions are hard. That is why the public voted this Government into office: to make those tough decisions and plan for the long term. That is what we are doing today.
Christine Jardine (Edinburgh West) (LD)
I do not believe there can be many issues on which this House is more intent than ensuring the future of our national health service and social care for the good of every person in this country, but sadly this Government, who have procrastinated over every possible thing for the past two years, instead of taking time to consider this properly are bouncing Parliament into a hurried decision—a decision that has met with condemnation across the country. It is a proposal that the Federation of Small Businesses has described as a “jobs tax”, which the British Chambers of Commerce has described as an “anchor” on jobs growth, and which the Confederation of British Industry has said
“will directly hurt a business’s ability to hire staff at a time when businesses have faced a torrid 18 months”.
But it is much worse than a job tax—it is a tax on nurses, who on average will pay an extra £270 a year. It is a tax on our teachers, police and care home workers—the very same people who have kept the country going throughout this pandemic. It is a tax that will disproportionately hit low earners, at a time when families are already seeing their income squeezed by the pandemic. This is the worst possible time to be hitting families and businesses with a crippling and unfair tax hike. Instead of boosting hiring and spending, it will damage confidence and investment. The Government are not only breaking their promise to the electorate; they risk breaking the backbone of our economy.
Instead of rushing us into this, the Government could have taken the time to have cross-party discussions and come up with a proper, detailed plan, which I believe would have had the support of everyone in this place, because we all want to see a good, sound, constructive plan for the national health service and social care. Sadly, this is not it.
Andrew Griffith (Arundel and South Downs) (Con)
I pay tribute to my hon. Friend the Member for Rushcliffe (Ruth Edwards) for her remarks.
My constituency has a disproportionately older demographic—those who live there are 50% more likely to be over 65 than the national average—but I want to lay to rest the misperception on both sides of the House that social care is simply about the older generation. More than one in three people in the system is under the age of 65, and because younger adults are in the system for longer, spend on them is proportionately greater, so this is not just about a battle of the generations.
I pay tribute to the millions of unpaid carers in society who for years have been papering over the cracks in the system and the capricious nature of continuing healthcare assessments. I have personal experience of some of that as for many years my father was my mother’s unpaid carer and had to deal with that at the sharp end. For that reason, I celebrate the fact that this is a nettle grasped. It is not necessarily the whole solution but it is the start of a package of measures that moves forward a debate that has been stalled for too long. That is one reason why we should all come to the House and use our voice and platform on the hard issues that we face in society.
I applaud the Government on their selection of national insurance, which is the tax with the broadest reach. It is progressive, and that is why so many of our European neighbours have chosen to fund their social systems through similar measures. It is a chimera to think that there is another way—perhaps Opposition Members have been taking medicinal hallucinogenics—because the national insurance take is more than 10 times that of capital gains tax and inheritance tax combined. No mythical tax on wealth will give us anything like what we need to take this issue seriously—and we should take it seriously.
Anthony Browne (South Cambridgeshire) (Con)
Does my hon. Friend agree that it is the height of political cynicism for Opposition parties to campaign repeatedly to increase taxes to spend money on health and social care and then, when the Government introduce such measures, oppose them? Does he think that they should commit themselves to scrapping the health and social care levy once it is introduced?
Andrew Griffith
My hon. Friend, as ever, makes an important point. We should be on a quest for consensus, and it would be useful to hear more from Opposition Members in the wind-ups.
I pay tribute to the many dedicated workers in care homes across my constituency as well as their residents—from Barlavington Manor in the north to Valerie Manor in the south and from Villa Adastra in the east to Westergate House in the west. They are just four of the 28 care homes in my constituency providing fantastic quality care. It would be lovely to see more resources pumped into them as well as their staff.
Let me conclude broadly where I started. This is a down payment on a process of reform in our healthcare systems, building on the innovation that we have seen. However, a health and social care system cannot be managed permanently on an exceptions basis. We need reorganisation, better data and better decision making to build the high-quality health and social care system that both sides of the House want to see.
Madam Deputy Speaker (Dame Rosie Winterton)
Order. Before we move on, I remind colleagues—I am sure they know—that it is very courteous to listen to a lot of the debate before intervening, because many colleagues have sat here from the beginning and are waiting to speak.
Rachael Maskell (York Central) (Lab/Co-op)
Take no comfort, nor relief. Those things you dread will still be true. But now, poorer through life and poorer through death. Through life, you will pay. When frail, you will pay. Disabled people will pay and pay and pay. For what? None of us knows. Time and again, we have been promised that social care plan. Like the emperor’s new clothes, there is nothing to show. But, rest assured, things are about to get tougher, budgets tighter and ends not meeting. That personal debt will grow.
Two weeks ago, there was no plan. The Prime Minister tossed a coin, and this is where it has landed. Now he is rushing through this Bill with no pre-legislative scrutiny, no impact assessment and no plan to fix the care crisis for those already in the system or the 1.5 million longing for help. There is nothing for unpaid carers, and £8 billion has been cut from the system. As ever, the Prime Minister is throwing out the headlines with little thought and then moving on, leaving a path of destruction behind him for someone else to clear up and, in this case, to pay up.
This will not clear the NHS backlog. As we have heard today, the staff shortages are not being addressed, and how can they be in such a short period. Just this weekend, we were 74 nurses short in York. That is the scale of the challenge, and one that the Government have not answered.
A decade into this Tory Government, there is still no plan. We just pay up, and one day we may learn what for. For starters, if someone holds assets above the thresholds, they will still pay £86,000—the vast majority of average care costs—and will still need to sell their home. Then there will be accommodation, if needing residential care, and living costs on top, and no cap until October 2023. This is why we need a public national care service that is free at the point of use and fairly contributed to by all.
With 84% of care home beds owned by private investors, including private equity firms, who are not paying this levy and whose sole purpose is to profit—profit from the frail—it is the social care reform we need that we should be debating today. Just one provider in my constituency made a 25% profit increase ahead of the pandemic, but it will be its staff, who were promised a pay rise while clapped by the Prime Minister, who will now have to pay the levy instead. But we have been denied the opportunity to debate what this nation is paying for.
The Labour party cannot consent. We believe that those who have more, should pay more. Take the London School of Economics wealth tax commission, which reported last December. It found that a tax on assets worth over £500,000 at 5% would draw a pot of £260 billion, which would pay for health and social care and that much-needed pay rise. The tax would be assessed on individuals rather than households, with the rate of tax being 5%, albeit with a standard payment period of five years, allowing a tax rate of 1% to be paid for each of those five years. The amount raised is the equivalent of income tax at 9%. Alternatively, if the threshold was £2 million, £80 billion would still be raised.
That would start another conversation: instead of low-paid workers funding the social care of the wealthy, the wealthy would be funding the social care of all. I ask Members: is this fair? This may not be the full answer, but it starts a different conversation—one that, in rushing through the legislation today, the Government are running away from.
Mr John Baron (Basildon and Billericay) (Con)
I join many Members who have already spoken in wholeheartedly supporting the Government in trying to grasp this nettle, which has been pushed into the long grass for too long by too many Governments of all persuasions. However, I think many of us are concerned about the haste with which this reform—or this funding, certainly—is being introduced. Parliament has little time to scrutinise the details properly, and there are so few details out there. Questions to the Prime Minister only last week, in a letter copied in to the Chancellor and indeed to the Secretary of State for Health, have been left unanswered.
I would ask those on the Front Bench what other types of funding for social care systems have been considered. Have they looked at the insurance-based systems on the continent? Why not a public insurance system, which has many merits? We are unclear about the exact improvements to social care, yet today we are signing off a massive tax increase—bigger than that raised by some Budgets.
I would also suggest that this is the wrong approach to the funding. The Conservative party has traditionally referred to national insurance as a tax on jobs. The Prime Minister, when opposing Labour’s increase from the Back Benches in 2002, called it regressive. He was right then, and I am afraid that he is wrong now in introducing this national insurance contribution tax increase.
The core of my one nation Conservatism is a belief that, in order better to help the more vulnerable and ensure that we maintain low unemployment, we should encourage economic prosperity. Low taxes help businesses, encourage prosperity and keep unemployment down—they certainly help to. Yet here we are, increasing taxes at a time when the recovery is still fragile after the pandemic. This will cost jobs, and it will result in lower pay and higher prices. I also to a certain extent question the fairness of this increase in our national insurance contributions, which will disproportionately fall on the lower paid. Why should wealthy non-working pensioners be exempt? If this were a truly broad-based tax, we would be answering that question, but there is nothing but silence from the Government on that point.
I am concerned about the lack of response from the NHS with all this extra funding going in and the lack of accountability. I was chair of the all-party group on cancer for 10 years. We continue to point out that we are failing to match international averages when it comes to our cancer survival rates. We have a mass of process targets that create myriad bureaucracies, but we are still not catching up when it comes to average cancer survival rates. Only half the NHS workforce is medically trained. We need to address that, because more money alone is not the answer. We need genuine reform that focuses on outcome measures, not process targets. So we need more time to consider the proposals and I will not be supporting the Government in the Lobbies tonight.
Tim Farron (Westmorland and Lonsdale) (LD)
I probably agreed with at least three quarters of what the hon. Member for Basildon and Billericay (Mr Baron) just said. One thing I did not agree with him on was his belief that the Government have grasped the nettle. I believe they have walked past the nettle, barely nodding at it, and the people who will be stung are the people still in social care, the people working in social care, and the people who will disproportionately pay for what the Government are proposing.
Conservative MPs and the Conservative press are concerned about the Prime Minister breaking his promise on taxation, but the promise he has most definitely broken is the one he made during the leadership contest in 2019, when he said he would
“fix the crisis in social care once and for all”.
He has done no such thing; that proposal is not before the House today. There was a promise not to raise taxes. If the Government chose to break that promise, I would be happy to provide them with cover for that. Labour may have dodged the issue, but I am clear that we should raise income tax so that this is paid for by people who have the wealth and ability to pay for it—not by national insurance, which often will disproportionately fall on younger working-age people. What do those people tend to have in common? They cannot afford a home, or at least a house that they own. What will we be asking them to do? To fund those who have a home to have the right to leave it to those who come after them.
Nobody should be forced to sell their home to pay for care. Just a few weeks ago, I was talking to a friend of mine who sadly has cancer. This was a terrible thing to say, but he said, “I feared cancer and I feared dementia, but I’ve got the least bad of the two.” He is living with cancer now. The reality is that, for many reasons, his care is paid for, but for those like my father-in-law, my grandfather and others who suffer from dementia, that care is not provided for. So it is right to have radical reform of social care, but this is not it. It is right that all the parties should get together to ensure we have a common approach to this, but this proposal has been dreamt up and issued as a press release—it is not the reform of social care we need.
This reform of social care does nothing to tackle the 120,000 care assistant vacancies in our country, or to give social care staff the pay and esteem they deserve. One reason there is a crisis is that wonderful people can earn more money stacking shelves than they can caring for our loved ones, of whatever age. This plan will do nothing to give local authorities the money they need to backfill the terrible backlog and black holes that the Government have left them. Again, they are taking unpaid carers for granted and—the hon. Member for Arundel and South Downs (Andrew Griffith) rightly mentioned this earlier—not addressing the needs of those in care who are not of retirement age but significantly younger. This is a massive missed opportunity that will be paid for by people who have the least.
In my community in Cumbria, we are about 10 years above the national average age. We have a smaller working-age population and a disproportionately large population in need of care. We have colossal staffing shortages as things are. This measure does nothing to meet the needs of the people in my community, because it does nothing to invest in the quality and standard of the care that they will receive.
Dr Murrison
I am loth to give the hon. Gentleman an extra minute, but I must ask him how much he would put on income tax. I know that his party was famously keen on putting a penny on income tax, but he has just made a whole load of spending commitments—particularly raising incomes for care staff. I assume he has costed that. If so, will he say how many pennies on income tax he proposes to burden our constituents with?
Tim Farron
We would need to raise income tax to do what the hon. Gentleman’s Government say they need to do in the short term to get through, and then we would have a ring-fenced, bespoke tax that would deal with social care. If people had lived to the age they do now when Lord Beveridge, the fine Liberal who came up with the welfare state and the NHS in the first place, wrote his plan, there is no doubt that social care would have been part of that package, and we would be paying more tax now as a consequence. I say we should be doing what we were doing around Dilnot a few years ago, when we were moving in the right direction, sworking often across the House, and coming up with a package that we would pay for. In the short term, though, we would immediately raise a tax that is affordable and fair and does not just clobber those people on low wages and people of working age. That is the right thing to do.
That is why this measure is not just the wrong way of going about this but a colossal missed opportunity. We were promised something like the Beveridge report, and we ended up with something written on the back of a fag packet. We need something that means people will look back on this generation the way people still do on the generation of politicians post war who built the welfare state in the first place.
Craig Mackinlay (South Thanet) (Con)
In common with my hon. Friend the Member for Basildon and Billericay (Mr Baron), I am wondering—I think many of us are—why we are here today. We have a fiscal event, the autumn Budget, in just six weeks’ time, which would seem to be the right forum to discuss these matters. One cannot help but wonder: why the haste.
We had the Dilnot commission report in July 2011, 10 years ago. Arguably, even then, that was 10 years too late. It was intended to solve the inherent unfairness between two people who were on similar incomes throughout their lives, one who rented and one who bought their home, whereby one lost everything and one got everything for free. That is at the heart of these issues and of affordability in the longer term. I get that, and the Government have to be applauded for finally thinking about these things, but haste is not due at this time.
I am sad that we are just reaching for the tax lever. That is not what Conservatives do. We are going to end up with a tax take at the highest level of GDP for 70 years. Since we are raising NICs—particularly employer’s NICs—it stands to reason that any employer with a pot that they were thinking about using to increase general salaries across their workforce will reduce that pot by 1.25%.
Let us concentrate on NICs. On our first day back at school last Monday, we debated the National Insurance Contributions Bill, which exempts from NICs veterans and potentially new freeport businesses. We have employer’s NIC relief for the under-21s and for those under 25 on apprenticeships. We have an employment allowance to exempt employers from national insurance. That was at £3,000 for all small employers, and it has now increased to £4,000, because exempting employers from national insurance is deemed to be a good thing.
I say to those on the Treasury Bench: please help me. We tend to tax things that are deemed to be bad. We tax things such as alcohol, cigarettes and fuel because we want lower use of them. They are deemed to be bad. Increasing a tax on jobs, something we want a lot of, seems rather bizarre.
I serve on the Public Accounts Committee, and just last week we did an investigation into the Department for Work and Pensions. Last year alone, there was £8.3 billion of fraud and error in its payments out. Obviously, the pandemic had something to do with that, but there is an in-built annual loss of £5.5 billion through fraud and error. That is something approaching half of what we are looking for here to solve these problems.
As Conservatives, we grasp difficult problems. We grasp and understand the problem of an ageing demographic in our populations. On pensions, we did something novel. We could have just reached for the tax lever, but we did not. We introduced auto enrolment pensions, where the employer and the employee contribute and every employee in the land earning above a certain amount has a pot that they can call their own, with the flexibility that that has. To me, that is the type of thinking we should be doing now. I am very concerned that we will just sink another load of tax into the Department of Health and Social Care and hope for a different outcome, when we have been throwing money into these Departments for many years, yet our waiting lists are at the highest ever.
Her Majesty’s loyal Opposition have been howling, “Let’s have wealth taxes.” Well, I am very pleased to tell them that, yes, we have a very substantial wealth tax in play and it is called inheritance tax. It has doubled since 2011, from £2.7 billion to £5.4 billion today, and that will be going in one direction, given asset value inflations and the fiscal drag within the IHT system.
Dr Murrison
Of course, we have also had a wealth tax in the form of the removal of indexation allowance on capital gains tax for some years now, which is very substantial over time.
Craig Mackinlay
I am very grateful to my right hon. Friend for highlighting some of the fiscal drags that have been beneficial to the Treasury. In terms of asset price inflation, which has nothing to do with the activities of the taxpayer, other factors of low interest rates are involved. There are big windfalls coming towards the Treasury, in terms of IHT and capital taxes, which were never really forecast and are now bearing some substantial fruit. So I would have hoped that the Treasury Bench might have thought, “Where are those taxes going? Where are the other losses within the system across different Departments? Are there procurement gains? Are we really saying that the way the NHS is run today is the best way of running it?” I would have hoped that that could have formed the new pot to solve our social care problem.
I am very concerned that this is going to be wasted cash. I am very unimpressed and I will not be supporting the Government tonight.
Fleur Anderson (Putney) (Lab)
I would like to declare an interest, as my daughter is a care worker.
I pay tribute to care workers across the country for all the additional work they have been doing throughout the pandemic, to unpaid carers and to community care services run by amazing staff and volunteers, such as Regenerate-Rise in my own constituency and the Katherine Low Settlement, where I used to work, running services for older people, before I became an MP.
This is definitely a problem that needs fixing, but I am really hoping for another Government U-turn on this issue today. There are 300,000 people on waiting lists for care services. There is a huge disconnect between the NHS and social care services. There are delays in getting care plans, community services are patchy across the country because of different funding and activities for adults with disabilities are being cut across the country, too. Mencap reports that one in three local authorities have closed day services for people with learning disabilities and that 57% of people with learning disabilities no longer receive any day services. Family carers are having to give up work and people cannot lead the full life that they want. There is an increase in isolation and a massive increase in requests for care services. At the same time, there are soaring budgets and shrinking budgets.
I have three problems with the issue today. One is the deferred payment. This is not solving the adult care crisis because it will go to fix the NHS backlog. How will we be able to cut that crisis in future years? In two or three years’ time, there will be increased staff, resources and facilities—absolutely needed after 10 years of underfunding—but how will we cut that in two or three years? This is absolutely a jam tomorrow policy and I do not know how it will work. We need money for adult social care services now. This will really frustrate people who are receiving care as well as those working in the care sector.
Secondly, this is the wrong way to raise the funds.
Back in March, the Chancellor said:
“We’re not going to raise the rates of income tax, national insurance, or VAT…It is a tax policy that is progressive and fair.”
So by his own admission, this is a tax policy that is not progressive or fair. It is taking from the poorest and leaving the wealthiest relatively untouched. It is a tax on jobs and disproportionately on working people. Why not tax dividends, capital gains or income from property?
Some 2.5 million families across the country face a double whammy of a national insurance rise and the £1,000-a-year universal credit cut at the same time. Care workers will not be getting a pay rise. They are promised some changes down the road, but nothing now, and yet they will have a tax rise. The £86,000 cap will still leave people having to sell their house. Inequality will increase and what will the levy fund? Where is the plan?
We need to transform access to care. There needs to be a home-first policy. Prevention is so important and, as I said, we need to join up the NHS with social care policies. One of the biggest frustrations I faced as an adult care worker was that we did not have a continuity of care between the two. It is not just about money; the systems must be reformed. Why should we have to pay for it when we do not know what systems will be changed? This huge tax increase cannot be guaranteed to fix the adult social care problem, because we have not been told what on earth it will be spent on. It is unfair, it will not fix the crisis and I hope to see that U-turn very soon. I cannot support this Bill.
Sir Mike Penning (Hemel Hempstead) (Con)
It is a pleasure to follow many colleagues who have talked from the heart about the great concerns that their constituents and we as family members have about the health and social care framework.
I will be supporting the Bill tonight because, as I said last week, kicking the can down the road, as several Governments have for years and years, is not the answer, but I have a couple of questions that I would like the Treasury Minister to address. I completely agree with the Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt) that if we just throw this money into the NHS and social care, it will not even touch the sides. It will just disappear. Previous Governments have done it up to now, so we have to be really careful about how the money is hypothecated and where it goes.
I am particularly worried that the top management, who earn so much, will not actually address the issues that we are talking about today. Naturally, I pay tribute to all the frontline workers in social care, all of our emergency workers and those in the NHS, but I worry about the decisions that are made and the salaries that some chief executives of trusts are on. Frankly, they are not only miles above what the Prime Minister gets, but miles above what even those in the City get. It is absolutely mind-boggling, so we have to be really careful about that and about the trusts doing what Parliament tells them to do. I know that will be addressed in the Health and Care Bill. We cannot have a situation again like the one I mentioned last week, where the Prime Minister came into my part of the world and said, “You are going to get a new hospital.” That was fantastic news; I put out press releases galore. We have been campaigning for that for years, but what we are going to get is a refurbished Victorian hospital in the middle of Watford. That is not the answer. The trusts need to do what they are told.
I will touch on one other area—dementia—which is the elephant in the room, and which my hon. Friend the Member for Rushcliffe (Ruth Edwards) mentioned. There is a lottery for our constituents and our loved ones when we are trying to sort out the difference between personal care and healthcare when it comes to dementia and Alzheimer’s. What goes on is immoral: one silo, the Department of Health and Social Care, fights against another, the Ministry of Housing, Communities and Local Government, about who might pay for that care. We have seen it in my family, in my constituency and in my surgeries. We have been fighting to appeal. People seem to be encouraged to appeal, so people appeal, but by the time the situation is dealt with, many of our loved ones and many of those in care have passed away. Only then do people win, so something is seriously wrong.
As we look at the extra money that is going in, we must break down the silos and the really immoral way—postcode lotteries are going on around the country today—that we judge who is entitled to healthcare and who is entitled to personal care. Dementia and Alzheimer’s—I always mix up the two—are illnesses, not something that people want or have brought on themselves, yet many people are having to fight to show that they have a condition so that the Department of Health and Social Care might pay for care. I hope that as we look forward we can try to address that. These are difficult conundrums, but we cannot put our constituents with Alzheimer’s or dementia—our loved ones, in my case and that of other hon. Members—in a position where they have to beg because their care relates to a different condition.
Jim Shannon (Strangford) (DUP)
Thank you for calling me to speak, Mr Deputy Speaker. Like many others, I am put in a difficult position by the Bill. I believe that there must be big changes to create an influx into the NHS for the reform that we are desperate for, but I have seen too many broken families who have lost a loved one who was waiting for mental health support, who could have been saved if their cancer diagnosis had come in time, or who are awaiting support to make their child’s educational journey positive, not a hellish nightmare without the support that they need.
I am torn, because I see the need for reform. I see mentally and physically exhausted staff at the end of themselves, trying to meet their obligations in the NHS, and desperate trusts putting up advertisements for off-duty staff to come in because of dangerously understaffed wards. All those things tell me that there is need for reform, but I do not and cannot support this method. I cannot support the middle class and the small businessman bearing the brunt of the cost again. I cannot wrap my mind around the concept that someone earning £15,000 a year will have the same amount taken away in national insurance contributions as someone on £150,000 a year.
I make it clear that I am not a socialist; there is nothing wrong with being a socialist, but I am a capitalist. I believe that the system that we have is important. I understand that big business must have big results to support the big workforce, but I believe that when raising money, the easiest way is not always best.
We must ensure that we do not continue to squeeze the middle class. The Government have not been able to assure me or my colleagues that their proposal is the best way or that it is better than a graduated system whereby those on huge wages paid an extra amount that they would not overly notice, instead of families on the brink having to sacrifice and struggle each day.
I speak to constituents who are earning too much for support but not enough to live comfortably. They are the group who will be most affected, but the burden could and should be more judiciously shared. For those middle-class families, for the small businesswoman employing 11 staff and for the pensioner who has been taxed for their entire life, I do not think that the proposed method is the best one, and I do not feel that I can support it.
From the refusal to lift the child benefit threshold above £50,000, which is preventing families from taking a pay rise for fear of losing the monthly child benefit payment that pays for necessities for their children, to the situation facing pensioners who thought that they had set aside enough to last, only to deal with an increase in the cost of living along with a raid of the pension in their savings account, life is uncomfortable for those who have worked hard and who believed that they would retire in peace. Those people are all willing to make a contribution to the NHS, but is it fair that they should feel the brunt alone? I feel that that is what is happening; it is not right and I cannot support it.
I have one more small comment to make, which is about the £420 million that will be allocated to Northern Ireland through the Barnett formula. Whatever process the moneys come through, I would like to see them ring-fenced, because as Departments bid for funding, there is every possibility that the money will be deflected from doing good to simply being abused. In Northern Ireland, it could be used for the machinations of other parties, while teenagers suffer from eating disorders and while child and adolescent mental health services teams cannot prevent children from hurting or abusing themselves. I have watched as the Northern Ireland Office has been strong-armed into funding endless legacy investigations to the tune of Sinn Féin, which wishes to rewrite history.
I have not heard that the Bill will prevent the misappropriation of central funding, so I cannot support it. That goes against the grain for me, because I believe in the principle of reform. I would welcome reform if a different method of raising funding were put forward, but I simply cannot agree with the Government’s method. I ask them, even at this late stage, to revisit the methodology and allow us all to support our NHS, as people want to, without further squeezing the middle class. That cannot happen.
Martin Vickers (Cleethorpes) (Con)
As someone with naturally Conservative instincts, I am inclined to say no to tax increases, and to greatly prefer the options that allow the Government to create the economic conditions for growth in order to fund our public services. We have to recognise, however, that the expectations of the public are much greater now than they were a relatively short time ago. Whether we approve or not, the Government are now expected to provide more and more services, and the public do recognise that there is a cost to that.
I am a child of the 1950s. At that time, it was expected that the family would look after children—not necessarily just the parents, but the wider family, and the next-door neighbour might be involved as well. Now, however, there is an expectation that the Government must fund facilities for childcare. The same applies to adult care: that, too, was something that families took on. It was a burden, there is no denying that, but one that was expected, and, in the family context, accepted. It was not ideal then, and what the Government are proposing now, I suspect, will also not be ideal. It will have imperfections. Our surgeries will be full of people saying, “My neighbour is getting this and I am not.” We all hear of such anomalies from constituents. There will be the issue of differences in property prices, for example. My part of the world has low property values: for £350,000, one can buy a nice four-bedroom executive property; that is not the case here in the south. There will be anomalies that need further consideration.
Then we need to ask, “How are we going to do this?” The Government need money now. That is the expectation of the general public. Yes, there is a danger that the money could fall into a black hole, but we all have the ability to challenge our local health trusts. My hon. Friend the Member for Great Grimsby (Lia Nici) and I have regular meetings with our hospital trust. We must expect the Government to challenge the NHS senior management at national level, but we all have a role to play. Our local authorities have scrutiny panels that can ask questions, but we as individual Members of Parliament can take part in detailed scrutiny. We want to know what has been done to improve dementia care in, for instance, Grimsby and Cleethorpes. We want to know what has been done to improve cancer care. Is the stroke unit better located at Scunthorpe General Hospital, which is the case in our district? There is much that we can all do to aid the Government, and, more important, to aid and help our constituents.
This is a massive challenge for Governments. Governments have to accept the world as it is, and not as they would like it to be. I urge my colleagues who have expressed perfectly legitimate reservations about supporting the Bill to have a rethink. The Government are delivering on what the public expect. The public know that massive amounts of money have gone into dealing with the pandemic, and they recognise that if they want a better health service—which they all do—and better social care, there is a cost. It is not a cost that I like, but it is the best way forward at the moment.
Geraint Davies (Swansea West) (Lab/Co-op)
The only way to sustainably finance the costs of social care and the NHS for an ageing population is a growing economy, so why is the Chancellor taxing work? He said at the last Question Time that the only way to tackle poverty was to encourage work, but he is taxing work, and specifically he is taxing poorer, younger workers who do not have assets to pay for the care costs of often richer, non-earning, asset-rich people. It is not fair, it is not economically effective, it is being rushed through—it is wrong in so many ways that it should just be scrapped.
Obviously, we need to pay for care costs. It is appalling that one in four people will be hit with massive care costs through no fault of their own, and we need a system that is fair in terms of taxation to pay for that. I am not a great fan of hypothecation, because we should be deciding how to tax in a fair and economically sensible way and setting out precisely what we are going to spend our money on, neither of which has been done. If we want to grow the economy and tax things that we do not want to occur—people have talked about alcohol and cigarettes—we should be tackling, in particular, air pollution. I say this as the chair of the all-party parliamentary group on air pollution. Air pollution costs us £20 billion in lost productivity and health costs, so why do we not have some sort of escalator on diesel? Why do we not have an incinerator tax? The plan is to double incineration by 2030, yet we read from the latest medical reports that a very small increase in NOx massively increases dementia and mental health issues by something like 32%, with an 18% increase in hospital admissions. We have heard new research about ultrafine particulates from incinerators in urban environments getting straight into the bloodstream and causing problems for the heart, the mind and the lungs in particular, but there has been no mention of any of this.
And what about plastics? There will be more plastics than fish in the sea by 2050. We plan to tax plastics at £200 per tonne, but in the EU the figure is £685 per tonne. If we put an extra £400 per tonne on the 12 million tonnes of plastic we produce each year, we would generate £5 billion. Why should we not be able to get a cheaper cup of coffee in a china cup than in a plastic one? That would save the environment.
I support the points that were made by my right hon. Friend the Member for Barking (Dame Margaret Hodge) and others on progressive taxation. Gordon Brown had a national insurance increase all the way up the income scale. Obviously we need a threshold if we are going to use national insurance. Lord Hendy is now putting forward the Status of Workers Bill, which would capture large numbers of people who are currently deemed to be self-employed so that their employers do not have to pay national insurance. In that way, we could have a larger tax footprint, which would be fairer.
Obviously companies such as Amazon should pay more and there should be a transactions tax. Landlords have made capital gains through stamp duty holidays and with interest rates at low levels, and we should also look at a carbon border tax at a time when China is producing more emissions than the United States and the EU combined.
We should tax the bad things—namely, climate change and pollution—not the good things such as work and the economy. On debt costs, the interest rates have been low—they are down £14 billion year on year—and this looks like another attempt to bring down the debt. We must tax the right things, not the wrong things, to sort out the problem.
Dr Andrew Murrison (South West Wiltshire) (Con)
I will certainly be supporting the Government in the Lobby this evening, and the reason is this: in 1948, we instituted a system of socialised medicine, which has the support of all major political parties in this country, for all medical conditions save just a few. They tend to be things such as dementia, the general frailty of old age and associated conditions such as Parkinson’s. Nobody in this place has any cause to hector or lecture on these subjects unless they have had personal caring experience for somebody with that spectrum of conditions, because I can tell them that it alters your perspective dramatically on what is needed to improve services for an increasing proportion of our population. It is no good Opposition Members professing their support for our model of socialised medicine while excepting the growing burden of ill health that tends to attend advanced years. That is chiefly what lies at the heart of this measure today.
If we are all agreed that it is invidious to except dementia and the frailty of old age from the provision that we have celebrated since 1948, we have to find an equitable way of paying for it, and that implies the use of a broad tax base. It is not clear to me from anything that has been said this afternoon that anyone other than those on the Government Front Bench has a clue as to how that alternative balance sheet would stack up. Despite interventions that I have made, I am none the wiser about what their alternative would be. Nobody enjoys taxation. As a Conservative, I loathe putting my hand in other people’s pockets, but there is a general expectation, after the pandemic, that money will have to be raised from somewhere. The only question that I would concede is when should we do that?
I would like to put one or two points to the Minister, having given him my support. We are fundamentally changing the health and social care system by providing this increase in funds and an alternative way of paying for health and social care through a hypothecated levy. It is likely that the social care industry will respond, as all businesses will. I am ever so slightly worried that things like hotel costs will be ramped up, as they are not covered by this, to the disadvantage of our constituents, and that costs will be frontloaded to about, say, £86,000.
I hope that Ministers, in their White Paper and subsequently, will insist on some way of limiting and moderating such frontloading; otherwise I fear that many of the advantages we want for our constituents and their families in this situation will be eroded. We need an indicative sum on, for example, hotel costs. Please do not assume that all within this sector are acting for pure and altruistic reasons. They are businesses and will respond as all businesses do.
I support the levy, as it is the right thing to do. No alternative has been put forward that is remotely credible, and I will strongly support the Government this evening.
Kim Johnson (Liverpool, Riverside) (Lab)
I pay tribute to the social care workers working in care homes and the domiciliary sector in my Liverpool, Riverside constituency.
This country is in the grip of a social care crisis, and this Bill needed to be a watershed moment for the sector. Instead, we have been presented with a package that neither fixes the social care system for service users and workers nor funds it fairly. Unprecedented numbers of staff are leaving the profession, with 600,000 care workers currently earning only the national minimum wage, more than 110,000 vacancies and a massive turnover of 30% a year.
We are in desperate need of a detailed plan to mend and future-proof a system broken by years of underfunding and neglect. Decent pay, terms and conditions for undervalued employees must take centre stage of any serious plan to tackle the deep-rooted structural issues in the social care sector, along with a long-term workforce strategy and improved quality and standards of care.
Instead, this plan does nothing to address the job retention and vacancy problem facing the adult social care sector by improving pay, terms and conditions. Can the Minister tell us what thought, if any, this Government have put into tackling job retention and vacancies in the social care sector?
Despite being the primary commissioner of adult social care services, local government is glaringly absent from the Government’s package. Age UK has called for a big injection of funding into councils’ care budgets, including a social care workforce strategy to meet rising demand and the needs of disabled and older people by widening the criteria for state support alongside a new deal for unpaid, informal carers.
We need a plan to fundamentally tackle the social care crisis through local government bringing services back in house, with proper funding raised by a wealth tax on the richest. Billionaires in Britain got £290 million richer every single day during this crisis. While they were raking in massive profits, millions across this country were struggling to make ends meet and many relied on food banks.
This package will leave a key worker earning £26,000 a year facing a hike in their Nl contributions, on top of a pay freeze, rising council tax, and a frozen personal allowance for income tax—and all this at a time when food, fuel and energy prices are increasing. It is obscene that, after all this, the Tories are pushing through a tax hike that will hit the lowest-paid workers while leaving the wealthy untouched.
The Prime Minister gave a strong assurance that he would fix the social care crisis after a decade of cuts by this Conservative Government, which took £8 billion out of the social care system. This plan does not come close to the additional £7 billion for social care called for by the Health and Social Care Committee, and much of the funds that will be raised risk being absorbed by a resource-starved NHS.
Social care should be universally free at the point of use, just like healthcare. Once again, we see another broken Tory promise. The lip service paid by this Government to levelling up is shown to be just as hollow as their promises not to hike taxes, and I will not be supporting this.
Richard Drax (South Dorset) (Con)
I am a great believer in the Conservative philosophy being probably the simplest of those of all the political parties. We believe in freedom—freedom of the individual and freedom from the state. We believe in low taxes. We believe in hard work and a safety net for those who fall into it. Aping Labour by spending billions of pounds we cannot afford will not fool the electorate for long. The NHS has become a religion—no one dares take its name—but a radical review of health provision is crucial if we are not to pour money into a black hole; we have heard this expression used repeatedly today, but it is a bottomless pit. Without reform, this money, well intended by the Government, will disappear.
Interestingly, and soberingly, the Resolution Foundation estimates that shortly 40% of all government expenditure will be on the Department of Health and Social Care. We repeatedly talk about reform but nothing happens. I was shocked when last week, having finished the debate, I learned that 43 new executives—I think I am right in saying this—are going to be employed by the NHS, on £270,000 each. I just do not know what to say. There are already enough executives in the NHS to run it, so why do we need 43 more, on these huge salaries?
As has been said, we are aiming our fire at business with this NI rise, and we are doing so at a time when the Office for National Statistics shows good news: employment is back to pre-pandemic levels, with more than 1 million job vacancies. That is fantastic news and so this is not the time to raise taxes. Every instinct in me screams for us to lower them, because if we do that, we get more money—that is a fact. There is no doubt that social care and the NHS need more money, but with it must come reform, as I have said. As a colleague said so wisely in the Chamber last week, we will never win the “arms race” with Labour when it comes to pouring money into the NHS. Like any household budget, if we cannot borrow, we have to prioritise what we spend. We have to cut in other areas.
As I said last week, where is the Singapore-style, low-tax economy we were promised once free of the European Union? Where is the narrative on a way forward as this pandemic becomes endemic and life returns to normal? Where is the vision? I sympathise with the Government and the Front Benchers, as these are unprecedented times, but I urge them: don’t go Labour-lite on us now. With our finances in a perilous state, we need to work our way out of this mess, not tax our way out. We need to galvanise our economy. Courage is needed, not hesitancy. Throwing out a sea anchor—I am a sailor and I know what I am talking about—will only create a drag on our recovery. It will not help it.
Let me remind the House, in the few seconds I have left, that we are talking about taxpayers’ money, something that, as Conservatives, we should not squander. I made this point last time, but this is taxpayers’ hard-earned money. Those on this side of the House are responsible for people’s money or we are not Conservatives at all.
Catherine West (Hornsey and Wood Green) (Lab)
I must agree with the hon. Member for South Dorset (Richard Drax) in one regard: we are talking today about not a small tax rise but a whopper. This levy takes us back to 1950s levels of taxation.
The post-pandemic recovery is currently particularly fragile. Usefully, the House of Commons Library sent me the statistics on the jobless figures today—I am sure many other Members have theirs—and in Hornsey and Wood Green there are 6,430 jobless people. That is 4,000 more than pre-pandemic, so the idea that the recovery is secure is for the birds. There is a real question mark in my constituency over job retention following the end of furlough, because the recovery in the service-based economy is yet to take off securely.
What is on the minds of my constituents in Hornsey and Wood Green? First, the likely cut of £20 per week for those on universal credit, which will affect 12,970 households in Hornsey and Wood Green.
Secondly, the two-child limit. If people in Hornsey and Wood Green have large families and rely on the benefit system for some assistance, only the first two children get any help. I am a third child. I do not know how many Members are third, fourth or fifth children, but they should think about their parents cursing them because they were born third, fourth or fifth.
Thirdly, energy bills are about to go up. I am sure the Minister has done his own analysis of the fact that we did not have a windy summer, which meant that the renewables did not do as much as we had hoped. We will be reliant on gas and even coal, which we should not be given all our commitments in respect of COP26. For those reasons, we will see increases in our energy bills this winter.
Fourthly, the potential for higher food costs is on my constituents’ minds—that is, if they can find the food that they like in the supermarkets after the effects of Brexit and covid.
Matt Rodda (Reading East) (Lab)
I am grateful to my hon. Friend for giving way on that very good point. Does she agree that it is fundamentally unfair for hard-working younger people, who face dramatically increased costs of living and high rental costs, to have to pay more than their landlords, who will not be taxed under the Government’s proposal?
Catherine West
My hon. Friend, who always talks about the impact of measures of this sort on those who rent, makes an excellent point. This levy is going to be very difficult for them, yet it will probably not be nearly as hard for their landlords.
Fifthly, the likelihood of a council tax increase is on my constituents’ minds. Why does council tax shoot up under Tory Governments? Because if local government is starved, council tax has to increase to cover local issues. In the case of this measure, the lowest paid will not only be paying for a whopper of a tax increase—the biggest since the 1950s—but will be faced with rising council tax bills and the precept for social care, because this measure will not adequately look after the local government aspect of social care. I declare an interest as a vice-chair of the Local Government Association and a former council leader.
I wish to make two further brief points—
Alexander Stafford (Rother Valley) (Con)
I am listening carefully to the hon. Lady’s interesting speech and her list of what her constituents speak to her about. One of the top issues that my constituents speak to me about is the need to deal with social care and to make sure that older people and people who need social care have adequate facilities and funding, yet I have not heard about Labour’s plan to deal with this important issue.
Catherine West
I am sure that when the shadow Minister, my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare), responds to the debate she will give the full detail of Labour’s proposals.
Let me return to my point about the important elements of reform that we need in local government. First, we need all care workers to be paid the living wage. By that I mean not Mr Osborne’s fake national living wage, which was the national minimum wage, but the real living wage, which in London is now more than £10 an hour but still languishes under £9 in other parts of the country. That must be addressed urgently. We need to look at those wages not least because of the important point that, as my hon. Friend the Member for Liverpool, Riverside (Kim Johnson) said, we are losing so many carers from the care sector. In addition, the Government are mandating vaccinations, and there is a big question mark over whether that is the correct strategy for those workers. Perhaps that is just another policy area where the Government are like a shopping trolley. Perhaps they will do another U-turn tomorrow and we will see that gone, we just do not know.
The other important element is training. Many experts have told me about the importance of training in the care sector, in the NHS, and especially in those dispersed jobs where people are actually working in the homes of those for whom they care and in our care homes. There is a desperate need for training and a proper career path in order to encourage people into the sector. Even the promise on the apprenticeship opportunities for young people to enter the care sector has been deeply disappointing in terms of the figures involved. Very few from the kickstart programme have ended up in the care sector, which desperately needs young people or people who are re-entering the workforce, but they need to be on a proper training path and in a proper career so that we have high quality care.
I hope that Members will search their consciences and think about how those leaflets will look at the next general election. We will be brutal about this, because the measure is attacking those who are least able to afford it.
Duncan Baker (North Norfolk) (Con)
Whether it is speaking about young carers, improving the pay and conditions of our care workers or pushing social care reforms for our older citizens, I have found myself in this place speaking about social care countless times since my election. One could conclude that I am happy that the Government are beginning to tackle this issue. I might be expected to say that as the MP who represents North Norfolk, an area where the social care sector is particularly important given the demographics of my residents.
As I have said to the many people who have asked for my thoughts on this Bill, in my view the prize of fixing social care is far greater in the long term than bickering about how we pay for it. It is regrettable, obviously, that we have to increase tax, but one simply has to be able to recognise the situation that the country finds itself in. The Exchequer cannot keep funding, in the current tax take, £12 billion to £14 billion a year—not to the extent that it has already supported the country to the tune of some £400 billion. Any reasonable person can recognise that. It would be fiscally irresponsible to continue to heap debt upon debt. There is probably no right way of creating the funding that we will require—a way that will satisfy everybody. Equally, there is no wrong way either. As I have not heard of a significant amount of consensus, a marginal rise in national insurance, to which, as we know, employees as well as employers will contribute, has, to a large degree in my constituency, been met with some understanding of the conundrum that we face.
The Opposition were asked time and again about how they would deal with this matter, but the hon. Member for Ealing North (James Murray) would not put a marker in the sand and explain what he would do.
Geraint Davies
I know the hon. Member said that it would be fiscally irresponsible to increase debt, but is he aware that the interest cost of debt per year has gone down by £14 billion because of historically low interest rates? Therefore, at this particular window in time, as we are coming out of a pandemic, would it not be better not to tax jobs?
Duncan Baker
I am sure the hon. Gentleman will remember the old adage that what goes up must come down, and, obviously, it could happen vice versa as well.
This Government have been incredibly financially prudent over the years. Most constituents around the country would say, “Thank goodness that we have had a Conservative Government looking after this country as they have produced one of the best responses to the pandemic in the entire world.”
What constituents want to see now are the tangible changes on the ground and the benefits. What we see today is probably one of the greatest welfare benefits that we have—the fact that there is a cap on how much a person pays in their later life for their care costs and that they will not have to sell their home will create security for a great number of people.
As the White Paper comes forward, I want to say three things to the Treasury and get these points on the record. First, I am a patron for the Holt Youth Project, which is a marvellous young people’s charity in my constituency. It has looked after some 50 young carers throughout the pandemic. Everybody knows that the life chances of young people are significantly affected as a result of looking after a sick or debilitated parent. I want to ensure that we can channel the funding that we get from this levy; there have been many asks today, including for dementia and other incredibly important causes, but please let us ensure that we fund young carers properly.
Secondly, let us ensure that unpaid carers are properly looked after. For those who take the burden off the state to care for their loved ones, the current allowance is £67 a week, at a cost to the Treasury of £3 billion a year. This must be looked at again.
Finally, let me address the recurring problem that we hear about all the time: the shortage of care workers. These people need to have the same high status and high regard as any NHS worker. We have to tackle and get to grips with the skills required to care for somebody with dementia or to give end of life care, and ensure that those care workers are properly rewarded.
Mr Deputy Speaker (Mr Nigel Evans)
To resume her seat no later than 4.45 pm—we will put the timer on—I call Nickie Aiken.
Nickie Aiken (Cities of London and Westminster) (Con)
I am a low-tax Conservative, but I have concluded over many years that if we are to resolve the social care crisis, it is necessary to raise the money to pay for it. I therefore support the introduction of a national health and social care levy. Pandemic or no pandemic, we have to raise the funds somehow. I feel that successive Governments, whether Labour, coalition or Conservative, have failed to address the social care crisis in this country because they were too scared to face the fact that we would have to raise the funds—until now. Well, the Prime Minister has made the brave decision to do it, but with that decision to raise funds must come reform.
I accept that the pandemic has meant that we now have a huge NHS waiting list of more than 5 million people. If we do not address that, it will only increase. I therefore accept that the money, in the first year or so, has to go to the NHS. However, as we have heard from across the Chamber over the last couple of hours, we must have reform. We cannot allow the money to continue to go into what has been described as a black hole.
When I was the leader of Westminster City Council, 40% of my budget was for social care and adult social services. That is an incredible amount of money. We know that people are living longer, whether in their own homes or in care homes. We have to ensure that local authorities are properly funded to provide the frontline services that they do. The Local Government Association claims that there is a gap of more than £2 billion, so I ask the Government to ensure that, in the spending review, local authorities are given the funding they need to address the immediate social care issues that they face.
During the summer recess, I was proud to spend a week looking after my father, who has advanced Alzheimer’s, while my mother had a respite holiday. It was a pleasure, but it was also very difficult. I pay tribute to all those family members who look after their loved ones who have dementia and Alzheimer’s. Our society owes them a huge debt. I hope that the money raised from this levy will go towards helping partners who look after their loved ones with respite care, and towards providing brilliant care workers—whether in care homes or providing care at home—with the pay and conditions that they deserve. Throughout the pandemic, they have shown what a brilliant service they provide.
I support the Government this evening, but I hope that we will see reform along with the tax rise.
Abena Oppong-Asare (Erith and Thamesmead) (Lab)
It is a pleasure to respond to this Second Reading debate on behalf of the official Opposition. I thank all hon. Members for their contributions. As several have said, it is good that we are now debating these issues, even though the Government have provided a short time today.
We have heard some excellent contributions, including from my right hon. Friend the Member for Barking (Dame Margaret Hodge), who spoke about how unfair the new tax is on working families. She also made it clear how many alternatives there are to this tax. My hon. Friend the Member for Birkenhead (Mick Whitley) talked about how the combined impact of this tax and the universal credit cut will push more families in his constituency into poverty. My hon. Friends the Members for Dulwich and West Norwood (Helen Hayes) and for Putney (Fleur Anderson) spoke powerfully on behalf of hard-working and underpaid social care staff, pointing out that the Government are increasing their tax through this Bill. As my hon. Friend the Member for York Central (Rachael Maskell) said, there is nothing in the Prime Minister’s announcement for unpaid carers. My hon. Friends the Members for Swansea West (Geraint Davies), Liverpool, Riverside (Kim Johnson) and for Hornsey and Wood Green (Catherine West) talked about the unfairness in this Bill.
The hon. Member for Rushcliffe (Ruth Edwards) made a powerful speech about her family’s experience with dementia and reminded us about the people at the heart of this debate. Several Conservative Members also called on the Government to think again about this tax rise, including the right hon. Member for Wokingham (John Redwood) and the hon. Member for Basildon and Billericay (Mr Baron). I hope they will join us in the Lobby tonight.
As the shadow Chancellor, my hon. Friend the Member for Leeds West (Rachel Reeves), set out last week, and as my hon. Friend the Member for Ealing North (James Murray) said earlier, Labour has two tests for the Government’s proposals: first, do they fix the health and care crisis; and secondly, are they funded in a fair way? The answer to both is a resounding no.
Gary Sambrook
We have had three hours of this Second Reading debate, and as far as I am concerned, not a single Opposition Member has actually said how they are going to fund their plan and how it is going to be fair, so will the hon. Lady take this opportunity now to tell the House what individual tax Labour would put up to fund it?
Abena Oppong-Asare
I am a bit concerned that the hon. Member has not been listening to the debate carefully. We have made it very clear: if a tax has to be raised, it should be fair across income groups and generations. The national insurance rise fails to pass these tests, and the Chancellor wants us to believe that there is no way to do so. That is not the case. I want to hear from the hon. Member what he is going to tell his constituents about breaking his manifesto promise, and why he has done so. What will he say to the low-paid hospital cleaners who will have to pay this tax when some of the wealthiest people in his constituency will not?
It has become increasingly clear that this Government do not have a plan to fix the social care crisis or to tackle spiralling NHS waiting lists. It is certainly not in this Bill, which only says that the Chancellor will decide how to distribute the revenues between health and care. Even if we look at the broader proposals, it is clear that there is still no plan for social care. Indeed, the Chair of the Health Committee made this point earlier. A promise of a White Paper is simply not good enough. Despite the Government repeatedly stating that they have finally grasped the social care nettle, the small print reveals that only a fraction of this spending will go to social care over the next three years—and even that is not guaranteed.
Of course our NHS needs more funding, not least because the Tories have underfunded it for a decade, but funding without a plan is not an answer. On social care, the Institute for Fiscal Studies has said that
“the extra funding will not be sufficient to reverse the cuts in the numbers receiving care”
since 2010. Under the Tories, billions have been cut from social care despite growing demand, vacancies have soared, and waiting lists have grown ever longer. This sector is in crisis and it needs help now. Instead, the Government are making it wait. The hard-working and underpaid staff in the care sector deserve better than that. As my hon. Friend the Member for York Central said, even with the new cap, hundreds of people will be left with high care costs, with many costs associated with being in a care home excluded completely from the cap. The cap does not even kick in until 2023. For those paying for social care, or those who need it but cannot afford it, this is no help at all. Even when it does start, too many will begin to face charges of hundreds of pounds a week even after they hit the cap.
The Government cannot even guarantee that this new system will prevent people from being forced to sell their home to pay for care. For those who live in the north, where house prices are generally lower, that is even more likely—£86,000 is a big proportion of house values in the north and the midlands. The plan fails on its own terms, and it is not only Labour saying that. Last week, the Conservative chair of the Local Government Association said that the Government’s announcement would make the situation worse because private care providers would face increased tax bills. Let that sink in: the leading Tory voice for local government is not only saying that the proposals will not help, but that they will make things worse, and it is not just him. The hon. Member for Stevenage (Stephen McPartland)—also a Conservative, last time I checked—said:
“The new health and social care levy provides no new money to fund social care for three years. No money for living costs, only personal care costs. Selling your home is just deferred. It is a tax on jobs.”
The Government have no plan for social care and no plan to bring down NHS waiting lists. Instead, all we are left with in this Bill is a manifesto-breaking tax rise on working people and the businesses who employ them—a tax rise that will cost a typical employee an extra £261. I say that again to the hon. Member for Birmingham, Northfield (Gary Sambrook): this tax rise will cost a typical employee an extra £261. It is a tax rise that leaves many graduates with a marginal tax rate of nearly 50% and that comes after this Government are already hitting working families with higher taxes and a freeze in the income tax personal allowance.
That is a triple whammy of taxes on working people, yet the Government have chosen not to extend the health and care levy to rental income, even though 67% of people who own buy-to-let properties are in the top fifth of income distribution. Nor have the Government looked properly at financial assets, stocks and shares, or income from other forms of wealth. The proposed dividend tax rise will raise only £600 million, compared with the £11.4 billion coming from workers and businesses, and it is not even in the Bill. Just £1 in every £20 is coming from dividends, rather than people’s wages, and the Government will not even rule out further tax rises on working people during the rest of this Parliament.
The tax rises could not come at a worse time. A fragile recovery is being put at risk at precisely the time we need businesses to create jobs. Family incomes are being hit by the universal credit cut and rising household bills. In fact, when combined with the universal credit cut, a care worker will be over £1,000 worse off a year. Let me repeat that: £1,000 worse off over a year. The Government’s own tax impact assessment, which my hon. Friend the Member for Ealing North referenced earlier, states:
“There may be an impact on family formation, stability or breakdown as individuals, who are currently just about managing financially, will see their disposable income reduce.”
That just sums up how this Government are treating workers and families.
The impact assessment also states that the new tax will affect business decisions about hiring new workers and putting up wages. It is a tax on jobs, a tax on workers, a tax rise with unfairness at its heart, and a tax rise without a plan. Politics is about choices—Labour would not have made these choices. We cannot support this Bill, and I urge Government Members to remember their manifesto commitments that they each made, to think of the lowest paid in their constituencies and those in desperate need of care today and to do the right thing and vote against the Bill on Second Reading.
Jesse Norman
I thank everyone who has taken part in what has been, with one or two exceptions, a generally constructive debate. I will start with the contribution of the hon. Member for Erith and Thamesmead (Abena Oppong-Asare). She said rightly that politics is about choices, but what choice has Labour given the people of this country? Has it given the people of this country a healthcare plan or a social care plan? Has it given the people of this country any indication of what taxes it would raise? Again and again, the Opposition have been asked by Members not just on the Government Benches, but elsewhere, what taxes they would raise and what their plan is, and there is no plan.
Jesse Norman
There have been 27 speeches, so, if I may, I will continue for a while. I may take an intervention later if we have made a bit more progress.
I feel particularly badly for the hon. Member for Erith and Thamesmead because, when the hon. Member for Hornsey and Wood Green (Catherine West) was asked what Labour’s plan was, she said that her Front-Bench colleagues would address that in their remarks. We waited with bated breath for the moment when they would address the question of what the plan was or what taxes would fund it. I can tell you, Mr Deputy Speaker, that it will need a lot more than £12 billion of health and social care funding to repair the damage from that hospital pass from the hon. Member for Hornsey and Wood Green.
Catherine West
I am grateful to the Minister for giving way, as he mentioned me. The UK economy has seen enormous asset price bubbles, yet not much appears to be getting back from those who have made quite a lot of money over the years through real estate. Why is he taking more money from working people instead of those who have gained enormous amounts—millions—from the asset bubble?
Jesse Norman
I am desperately sad, because I thought the hon. Lady was going to answer my questions about Labour’s plan or the taxation for it. Of course, we would expect people earning that income to pay property and income taxes in the proper way, and, if they are receiving dividends, their tax will go up as a result of the changes that we have made. [Interruption.] I am asked on what basis I say that. It is on the basis of a distribution analysis of the overall package of measures published by the Treasury in the last week, which is available for all Members to read and consult. If they do, they will see that this is a very redistributive package, with the highest-income 20% of households contributing 40 times that of the poorest 20% of households. It is a genuinely progressive policy, and the distribution analysis makes that clear.
Paul Holmes (Eastleigh) (Con)
I do not think that the Minister will mind me saying that he has served in the House for slightly longer than me. In his time, has he ever known a situation in which the Labour party—a supposed party of the NHS—has voted against billions of pounds of investment in the NHS?
Jesse Norman
It is a desperate shame that the Labour party has decided to take this party political position, because this area above all is one where we would expect it to back its own policy priorities. I remind the House that these measures are more progressive than the national insurance contribution rise of 2003 for which Labour Members enthusiastically voted, yet they are not supporting them. I find that extraordinary—[Interruption.] I am asked where my plan is. It is written down, and it is called “Build Back Better: Our Plan for Health and Social Care” That is a plan. The void that exists on the Opposition side is not just a void of a plan but a void of a tax package to pay for it.
Colleagues throughout the House have made the right and proper suggestion and implored the Government to look carefully at how the funds that we are raising can be appropriately spent. We must be careful about that. No Conservative wants to raise taxes, and indeed no Conservative would like to waste money. I want hon. Members to understand that Ministers very much take that on board. As hon. Members will know, we have a health and social care plan coming forward in a White Paper, and legislation is in place to put it on the statute book. That is the position.
My hon. Friend the Member for North Norfolk (Duncan Baker) and the hon. Member for Liverpool, Riverside (Kim Johnson) rightly made a point about younger people and support for care workers. Of course, we have not just the already published plan for jobs but £500 million of new money pledged to support social care workers, including through new qualifications, progression, and wellbeing and mental health support. That is an important part of what we are doing.
There was one Opposition Member who had genuine ideas for taxation that would support social care: the right hon. Member for Barking (Dame Margaret Hodge). She presented a whole raft of ideas. I do not accept the ideas she put forward, for different reasons, and I think the proposal that the Government have put forward is superior as a single, broad-based package of measures that has this progressive, distributional effect, but she came forward with ideas. What a void, what an emptiness, what a vacuity sat around her from the Labour Front Bench and from the rest of her party. I congratulate her on at least trying to answer the question put by the hon. Member for Erith and Thamesmead that politics involves choices; and what was the choice? The right hon. Member for Barking gave us one.
In doing so, however, I think the right hon. Lady erred. There has been some discussion about the tax information and impact note that the Treasury put out last week. Let us be perfectly clear: that is a technical document that relates only to this levy. It does not relate to the overall effect of the package of measures that it funds; macroeconomically, we expect that overall effect to be broadly economically neutral. That is the picture we are presenting, so just to look at the tax side, as the right hon. Lady did, is I am afraid to miss half the point of it. The point was made very well by Ben Broadbent, a member of the Monetary Policy Committee of the Bank of England. He said that
“one should not ignore one half of that policy announcement as far as the effects on the economy concerned”,
and he was absolutely right about that. So what we have is a balanced policy: we have a health and social care plan with a funding package that the House is considering at the moment.
Let me talk a little more about colleagues. I very much support the comments of my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) about the concern that other Members across this House have about the increase in pay at hospital trusts and in some parts of the NHS. That is a matter of concern, and we have to be absolutely clear that that money is being properly spent in the NHS and across hospital trusts. It is a very strong concern of my right hon. Friend the Chief Secretary, because he—like us, like me—is concerned to support not just our NHS, but the taxpayer in making sure that that money is properly spent.
I very much supported the points made by my hon. Friend the Member for Arundel and South Downs (Andrew Griffith) when he celebrated the adult social care workforce. He was absolutely right to do that, and I hope he will be pleased at the £500 million that we have mentioned in that regard.
May I remind the House that, in grasping this nettle, the Government have not just moved forward on an issue that has been outstanding before this House for many years, but have shown how inadequate the Labour party response was to its own royal commission of 1999, from which, as we can see, virtually no social care—no enduring social care—package followed? If you do not like that, Mr Deputy Speaker, let me direct you to the Wanless report of 2006, on the basis of which no sustainable social care package was developed. That situation is changing now. This Government are putting that sustainable social care funding in place. We are doing it with a levy that tracks many other countries that have social care levies in place. This is a progressive, long-term way to address a problem that has remained in front of us, but unaddressed, for far too long, and I commend this measure to the House.
Question put, That the amendment be made.
Health and Social Care Levy Bill
Tuesday 14th September 2021
(3 years, 3 months ago)
Commons ChamberRead Full debate Health and Social Care Levy Act 2021 View all Health and Social Care Levy Act 2021 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Committee of the whole House Amendments as at 14 September 2021 - (14 Sep 2021)
19:23 - The House divided: - Ayes: 56 / Noes: 324 - Question accordingly negatived.
19:39 - The Committee divided: - Ayes: 236 / Noes: 320 - Question accordingly negatived.
19:52 - The Committee divided: - Ayes: 240 / Noes: 320 - Question accordingly negatived.
20:14 - The House divided: - Ayes: 307 / Noes: 251 - Question accordingly agreed to.
The Second Deputy Chairman of Ways and Means (Mr Nigel Evans)
I should explain that although the Chair of the Committee would normally sit in the Clerk’s chair during a Committee stage, I will remain here in the Speaker’s chair while we still have screens around the table, although I will be carrying out the role not of Deputy Speaker, but as Chairman of the Committee. I should therefore be referred to as the Chair of the Committee rather than as the Deputy Speaker.
Clause 1
Health and social care levy
Question proposed, That the clause stand part of the Bill.
The Second Deputy Chairman
With this it will be convenient to discuss the following:
Amendment 8, in clause 2, page 2, line 21, at end insert—
“(1A) HMRC shall publish a forecast of the estimated costs of collecting the health and social care levy for the tax year 2023-24 by 31 March 2022.”
This amendment would require the Government to publish in advance of the levy coming into force its assessment of the extra costs of collecting the levy.
Amendment 7, page 2, line 23, after “cost” insert
“in current or future years”.
Amendment 1, page 2, line 28, leave out from first “as” to end of line 30 and insert
“determined by joint agreement between the Treasury and the devolved administrations of Wales, Scotland and Northern Ireland.”
This amendment would require agreement between the Treasury and the devolved administrations of Wales, Scotland and Northern Ireland as to the shares of the proceeds of the levy that are allocated between health and social care and between England, Wales, Scotland and Northern Ireland.
Amendment 4, page 2, line 29, leave out from “as” to end of line 30 and insert
“determined jointly by the Treasury and the devolved governments of Scotland, Wales and Northern Ireland.”
The amendment would require joint agreement between the Treasury and the governments of Scotland, Wales and Northern Ireland as to how the levy proceeds are to be shared between the four areas and between health care and social care.
Clauses 2 to 7 stand part.
New clause 1—Equality impact analysis—
“(1) The Chancellor of the Exchequer must review the equality impact of this Act and lay a report of that review before the House of Commons within six months of the passing of this Act.
(2) A review under this section must consider the impact of the Act on—
(a) households at different levels of income,
(b) households at different levels of wealth,
(c) equality between different ages, and
(d) impact between the nations of the UK and regions of England.
(3) In this section ‘regions of England’ has the same meaning as that used by the Office for National Statistics.”
This new clause seeks an equality impact assessment of the Bill covering households at different levels of income and wealth; equality between different ages; and the impact between the nations of the UK and regions of England.
New clause 2—Review of economic impact of Act—
“(1) The Chancellor of the Exchequer must review the economic impact in parts of the United Kingdom and regions of England of the changes made by this Act and lay a report of that review before the House of Commons within six months of the passing of this Act.
(2) A review under this section must consider the effects of the provisions of the Act on—
(a) business investment,
(b) employment,
(c) productivity,
(d) GDP growth, and
(e) poverty.
(3) In this section ‘parts of the United Kingdom’ means—
(a) England,
(b) Scotland,
(c) Wales, and
(d) Northern Ireland
and ‘regions of England’ has the same meaning as that used by the Office for National Statistics.”
This new clause seeks an economic assessment of the Bill on investment, employment, productivity, growth and poverty in the devolved nations and English regions.
New clause 3—Review of revenue effects of Act—
“(1) The Chancellor of the Exchequer must review the revenue effects of this Act and lay a report before the House of Commons within six months of the passing of this Act and every 12 months thereafter.
(2) Any review under this section must include an assessment of—
(a) the impact of this Act on revenue derived from—
(i) employment, and
(ii) self-employment; and
(b) the impact of the revenues under this Act from employment and self-employment on the revenues derived from taxation on—
(i) dividends,
(ii) rental income, and
(iii) other forms of personal income.”
This new clause would require the Chancellor to report to the House on the impact of the Act on tax revenue derived from different sources of income.
New clause 4—Review of impact of Act on business—
“(1) The Chancellor of the Exchequer must review the impact of this Act on business and lay a report before the House of Commons within six months of the passing of this Act and every 12 months thereafter.
(2) Any review under this section must provide a separate analysis of the impact of the Act on the operating costs and profits of—
(a) small and medium sized enterprises,
(b) large enterprises solely based in the UK, and
(c) large multinational enterprises.”
This new clause would require the Chancellor to report to the House on the impact of the Act on the operating costs and profits of different sizes of business enterprises.
New clause 5—Review of equality impact of Act—
“(1) The Chancellor of the Exchequer must review the equality impact of this Act and lay a report before the House of Commons within six months of the passing of this Act and every 12 months thereafter.
(2) A review under this section must provide a separate analysis of the equality impact of this Act on—
(a) income inequality,
(b) wealth inequality,
(c) geographical inequality,
(d) inequality between people with protected characteristics (within the meaning of the Equality Act 2010), and
(e) socio-economic status.”
This new clause would require the Chancellor to report to the House on the equality impact of the Act.
New clause 6—Report on levy expenditure shares—
“The Chancellor of the Exchequer must report to the House of Commons at the end of each financial year the share of the levy spent on—
(a) health care, and
(b) social care.”
This new clause would require the Chancellor to report annually to the House on the share of the levy spent on health care and on social care.
New clause 7—Report on levy revenue derived from those in the social care sector—
“The Chancellor of the Exchequer must lay a report before the House of Commons within six months of the passing of this Act, and every 12 months thereafter, containing an assessment of the levy revenue derived from those working in the social care sector.”
This new clause would require the Chancellor to report to the House on levy revenue derived from those working in the social care sector.
New clause 10—OTS Assessment of levy and National Insurance increase—
“(1) The Office for Tax Simplification shall publish by 30 September 2022 a report assessing the advantages and disadvantages of introducing the health and social care levy in comparison to the increase in National Insurance.
(2) The report shall include an assessment of the costs of HMRC in collecting the levy and for employers in complying with their obligations in relation to the levy.”
This new clause would require the OTS to publish by September 2022 its assessment of the merits of the levy in comparison with the increase in National Insurance, including costs of compliance with and collection of the levy.
Jesse Norman
It is a great pleasure to be here today to explain the clauses in this Bill.
The Social Security Contributions and Benefits Act 1992 sets out the earnings and profits on which employees, employers and the self-employed are liable to pay national insurance contributions. Clause 1 of the Bill introduces a new tax, to be known as the health and social care levy, which will be charged on the same basis as national insurance contributions. The levy will be set at 1.25%, and will affect earnings from 6 April 2023 onwards. When individuals or employers are liable for a qualifying national insurance contribution, they will also be liable for the levy. The levy will be payable on the earnings and profits on which those contributions are payable. The qualifying national insurance contributions in question are primary class 1 NICs that employees pay on their earnings, secondary class 1 NICs that employers pay on the earnings of their employees, class 1A and class B NICs that employers pay on benefits in kind received by their employees, and class 4 NICs paid by the self-employed.
This new levy has been introduced to raise funds for health and social care, so it is only right that individuals of all ages who are able to pay should do so. Therefore, individuals over state pension age who would be liable for those contributions were they not exempt will be liable for this levy.
Sir Edward Leigh (Gainsborough) (Con)
If we are talking about an insurance system, can the Government explain why they have ruled out state-sponsored insurance? I can understand why they cannot rely entirely on private insurance—the risk is too great—but Dilnot originally came up with the idea that people could take out insurance when they retired which would be a charge on their house, and they would have to pay it back when they died on the basis of the value of their house. I am not asking the Government to accept these ideas now; I am simply asking whether they have an open mind and are prepared to look at them. This is a complicated matter, and we want to have a real insurance system.
Jesse Norman
In the collective sense, this is a state insurance system, because it is making long-term provision for catastrophic outcomes in people’s health and social care, but the point that my right hon. Friend has made is an acute one. He will be aware that both the King’s Fund and the House of Lords Economic Affairs Committee have looked at private insurance models and concluded that they have severe limitations that would not make them appropriate. Indeed, no country in the world has a purely private insurance model. It has certainly been contemplated by Professor Dilnot, and it is compatible with the thrust of this legislation, that there should then arise a private insurance market, now that some of these catastrophic risks have been removed from the calculus that individuals have to make about their own social care. I hope that that addresses my right hon. Friend’s point.
As I was saying, individuals over state pension age who would be liable for those contributions were they not exempt will be liable for this levy. That means that pensioners in work will now contribute 1.25% of their “NIC-able” earnings, or profit, to health and social care in the same way as working-age employees and self-employed individuals.
Clause 3 discusses in more detail how NICs legislation applies to the levy. However, clause 1 also ensures that when an employer benefits from a zero rate of secondary class 1 NICs, such as employers of people under 21, of apprentices who are under 25, of veterans or of employees in freeports, those earnings that are subject to the zero rate will not be liable for the levy. That will ensure that businesses continue to invest in young people developing strong skill sets, and in those who have served this country.
John Redwood
As I understand it, it is the Government’s wish that the social care levy should appear as a separately identified line item, with that phrasing, on a payslip. Could it also be clear on a payslip that it would represent only a small fraction of social care costs and a tiny fraction of health costs? Otherwise, it could be very misleading.
Jesse Norman
That is a helpful suggestion. I do not think there will be any ambiguity in the language on the slip, but of course it might not be clear that it is not the totality of the funding that goes through Government. If I may, I will take what my right hon. Friend has said as a suggestion and refer it to colleagues.
Sir William Cash (Stone) (Con)
I would like to ask the Minister, as he has such responsibilities across the board, whether he has contemplated the question of public waste in the context of, for example, HS2? If we were to cut that back and to cut back waste generally throughout Government, would that not send an enormously powerful message to the British people that we are not only concentrating on this aspect of public expenditure but balancing it off by making real savings in other areas, given that the Treasury or its economic advisers have said that they have put phase 2a of the HS2 legislation on red watch because it is so impossible to achieve its objectives?
Jesse Norman
My hon. Friend has successfully dragooned a topic that has nothing to do with national insurance contributions or the levy into the debate, but let me reassure him that the Treasury seeks to exercise a hawk-like vigilance over all public spending. I do not think it would be appropriate to think of the response to the pandemic of the past two years as characteristic of the Treasury’s overall largesse, and we look very closely at the spending on HS2, which is the specific responsibility of my right hon. Friend the Chief Secretary to the Treasury and one that I know he takes with great seriousness.
Dr Murrison
The fact that the social care levy will be introduced in 2023 and not 2022, and that in the interim we will have to rely on national insurance, suggests that creating it will involve quite a lot of work and expense. How much is it going to cost to introduce the levy, beyond national insurance? Based on that, we will need to make an assessment as to whether it is worth while putting the 1.25% levy on people who are past state retirement age. If it is costly, we should not do it and simply rely on national insurance contributions. Allied to that, how much does my right hon. Friend think the 1.25% levy is going to raise from people who are beyond state retirement age?
Jesse Norman
That was a series of questions. The payslips that people are given will be generated by their own companies in the large part, and it is therefore important to think not only about the changes that HMRC will have to make but about the changes to be made by companies in order to reflect the amendment to payslips. In the case of HMRC, the Government have clarified in a letter to the Treasury Committee that, although it is very early days, HMRC provisionally estimates the operational costs of implementing the levy at between £50 million and £60 million, which is not nothing but it is not substantial in the context of the overall amount to be raised. I think the final part of my right hon. Friend’s question related to the amount that would be attributed to the over-65s. One would expect that to be relatively modest, because the number of qualifying people will not be enormous and because they generally have a high propensity to manage their work-life balance, meaning that there might be a dynamic effect from the levy. I am not aware that we have put that number into the public domain, but if we have it, I will see if we can publish it, probably at a future fiscal event—at the Budget or thereafter.
The Second Deputy Chairman
Order. Just before Dr Murrison makes a further intervention, can I ask the Minister please to face the microphone? Otherwise, Members will not be able to hear his responses; I have found it difficult to hear him.
Dr Murrison
Just to clarify my thinking on this matter, is that £50 million to £60 million a one-off or a recurring feature?
Jesse Norman
I think it is the set-up cost, although it may be incurred over more than one year. As I say, it is a very preliminary number that we have tried to get for the purposes of responding to the Treasury Committee’s inquiry.
Nigel Mills (Amber Valley) (Con)
My right hon. Friend talks about the advantages of having clarity on payslips about what people are paying for with the health and social care levy. Has he thought about combining the existing national insurance contributions that are allocated directly to the NHS and do not go into the National Insurance Fund? They are around £26 billion each year, which would effectively treble the amount of money in the levy. That would make it much clearer that people are paying all of it towards the health system, rather than having two different taxes doing exactly the same thing in slightly different ways.
Jesse Norman
My hon. Friend rightly points out that an element of NICs is already hypothecated, which is sometimes forgotten by people who are concerned about the hypothecation in the levy. I will take his remarks as a suggestion and reflect on them further. I recognise his expertise in this area, so I am grateful for the intervention.
Serendipitously, I will now address my hon. Friend’s amendment. This amendment asks that HMRC should publish a forecast of the estimated costs of collecting the levy. The published tax information impact note sets out clearly that the operational costs of the levy are being quantified. I have given a preliminary indication, but we will publish the final estimates before the levy comes into effect in April 2022. This amendment is therefore not necessary and I would ask him to consider not pressing it to a vote.
Matt Hancock (West Suffolk) (Con)
Building on the point made by my right hon. Friend the Member for Wokingham (John Redwood), is not one of the advantages of having a separate health and social care levy that, as people’s representatives, we can explain more clearly that if we want to put more money into the system, it has to be paid for? Will that advantage not ultimately help connect people to where their money goes and, therefore, enrich the debate?
Jesse Norman
I think it will, which is why the Government have decided to make this rather important change. It may well be that this is not the end of the story, and in due course the desire for clarity about how money is spent, which is expressed elsewhere in the tax system, might manifest itself in other ways. I do not want to speculate on that, but my right hon. Friend has outlined the importance of accountability, clarity and perspicuity in how money is spent.
Sir Christopher Chope (Christchurch) (Con)
Would it not be even simpler and more transparent if we had a social care levy standing on its own? Is it not the case that the Government do not want to have a social care levy on its own because they know that, if there were transparency, it would be obvious that we were reneging on our manifesto commitment of two years ago?
Jesse Norman
I do not think that is true at all. The reason for putting it on the payslip is so that taxpayers can see that this new tax is clearly represented. If they need reassurance that the support for social care, in their own life and in the life of their family and community, will be long standing and enduring, they need only look at their payslip.
Sir Christopher Chope
If it is about social care, why do we not have an exclusive levy relating to social care? Would that not be much clearer and more transparent?
Jesse Norman
My hon. Friend invites us to think of social care as a completely separate thing, but of course there is a tremendous overlap between social care and some aspects of health. It is important to make sure that the system, which I think all hon. Members realise is too disjointed, is more joined up. This treatment therefore appears to be more appropriate to an area where we want to see more integration.
Jesse Norman
The hon. Gentleman has not featured in the debate so far, so I will make a bit more progress before happily taking his intervention.
Amendment 7, tabled by my hon. Friend the Member for Yeovil (Mr Fysh), seeks to ensure that proceeds from the levy can be used in any tax year. As the Committee will be aware, the levy is designed to mirror the approach of the national insurance system, which has always operated on a pay-as-you-go basis. Indeed, that has been the case since the NHS and the National Insurance Fund were established in 1948. This means that national insurance contributions collected in one year are used to pay for the NHS and contributory benefits paid out in the same year. The pay-as-you-go basis provides a clear precedent for how the levy should operate and that also ensures simplicity and consistency across the NICs system. So I hope that my hon. Friend will not press his amendment, for the reasons I have outlined.
Clive Lewis
On the point made by the hon. Member for Christchurch (Sir Christopher Chope), one reason the Government have used the term “health and social care” is that they have established a principle that people pay at the point of delivery. As we see health and social care begin to integrate, the fear for many Labour Members is that this is a Trojan horse for introducing those payments for healthcare—for the NHS. One of my fears when the Prime Minister spoke of this delivering “profoundly Conservative” outcomes was just that danger.
Jesse Norman
It is helpful to have a diagnosis of why Labour Members might be opposed to or worried by this, but the fear is entirely without foundation. There is no suggestion that the Government wish to create a system that is anything other than free at the point of delivery, and that is the basis on which the Government have always proceeded and proceed now. We are trying to put a longer-term arrangement in place for social care that allows us to bring the same kind of clarity to it that people have enjoyed for many years with the NHS.
Nadia Whittome (Nottingham East) (Lab)
If the Government believe in a social care system that is free at the point of use, why are they not delivering a social care system like that, one like the NHS, which is universal and available to everyone?
Jesse Norman
I do not know whether the hon. Lady heard, but I was talking about the NHS and that has been a founding principle of the NHS, one the Conservative party have always adhered to, and rightly so. What we are doing with the levy is funding an expansion and a development of an existing set of arrangements, and, as I have discussed in relation to the question from my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), the potential to expand that through the use of other mechanisms of support, now that these catastrophic risks have been removed, or will be removed, from people’s lives.
Let me turn to the amendments tabled by the Scottish National party and Plaid Cymru which look to require a joint agreement between the Treasury and the Governments of Scotland, Wales and Northern Ireland as to how the levy proceeds are to be shared between the four parts of the UK, and between healthcare and social care. As for how the levy revenue will be split between the four parts of the UK, this legislation mirrors existing legislation on how NHS allocation is divided between England, Scotland, Wales and Northern Ireland. It is right and appropriate that we should follow that established precedent. The Government will work closely with the devolved Administrations on the implementation of the levy, including on the process for allocating revenues across the UK and on the split between health and social care from April 2023 onwards. It is also worth bearing in mind that the devolved Administrations’ overall funding will continue to be determined by the Barnett formula, so that this process will just determine the element provided by the levy. I hope that the Members concerned will not press their amendments, for the reasons I have outlined.
Alison Thewliss
I do not know whether the Minister has read the note from the Hansard Society on this, but it is concerned by some of the implications for the devolution settlement. It says:
“There is also no requirement in the Bill for the Treasury or the Health Secretary to consult the devolved administrations about any aspect of the process.”
Is that not a cause for concern?
Jesse Norman
The Treasury already consults the devolved Administrations very closely on many aspects of tax policy and there is no reason to think, and the Bill does not suggest, that there should be any other reason for handling this. On the contrary, following an existing hypothecation gives direct support to devolved Administrations that they will be able to receive the Union dividend, which is generated and delivered by this policy.
Clause 2 creates a legally binding obligation to use the funds raised by this levy for the purposes of health and social care, and sets out that HMRC will direct funds to the Secretary of State to be used for the cost of health and social care in England, Wales, Scotland and Northern Ireland. The funds from the levy will be shared between healthcare and social care, and will be shared between each nation in a proportion determined by the Treasury. The Treasury has used the long-standing Barnett formula to fund devolved Administrations and will continue to do so for the proceeds of this measure. Clause 2 goes further and ensures that any interest or penalties that can be attributed to the levy will also be used to fund health and social care. However, any expenses incurred by HMRC in collecting the levy will be deducted from the proceeds, which ensures that HMRC has the ability to collect and police this levy properly. I therefore ask Members to allow clause 2 to stand part of the Bill.
Dr Murrison
On clause 2, in 2014 we passed the Care Act and accepted the Dilnot proposals; slightly less than two years later, we canned the central part of the Dilnot proposals, in that it was decided that local government should in fact have the social care uplift, which had been anticipated in 2014. What certainty do we have that the measures we are passing today will not be dealt with in a similar way if, in two or three years’ time, we find that the pressures on local government are so acute, which they may well be, that we have to can some of the measures we discussed earlier?
Jesse Norman
I thank my right hon. Friend for his question. I think the point is perfectly clear: this levy is intended to be and will be a long-term, permanent funding arrangement to support health and social care. The plan includes a component that is designed to support local government in the delivery of care services without distorting markets that are already in existence. There is no reason to think, and we do not anticipate, that there will be specific issues that cannot be addressed at the time. The commitment to provide a longer-term funding settlement that can be reviewed and considered by individuals when they pay their national insurance contributions, and to do so in a way that gives them comfort that that same settlement will be in place, in a way similar to the state pension system, so that they can plan against it, is manifest. The Government have made that clear.
Clause 3 specifies that any provisions that apply to a qualifying national insurance contribution are to apply to equivalent payments in respect of the health and social care levy. It also sets out the limitations of such provisions applying to the levy.
Clause 4 provides for regulations for the purposes of the health and social care levy to be made under the Bill and specifies the parliamentary procedure that will apply to those regulations.
Clause 5 sets out the transitional arrangements for the measure and specifies that they will apply only for the 2022-23 tax year. Its effect will be to increase temporarily the rates of classes 1, 1A, 1B and 4 NICs by 1.25% for one year. There will be a corresponding temporary increase in the amount of contributions allocated to the NHS by the same amount.
Clause 6 defines various terms used in the Bill. Clause 7 specifies the short title of the Act as the Health and Social Care Levy Act 2021 and states that the levy is payable by or in relation to employees of the Crown. I commend all those clauses to the House.
Let me turn to new clauses 1 and 2, tabled by the SNP, and clauses 3 to 5, tabled by Labour. These new clauses ask the Government to review and report on the impact of the revenue effects of the levy, its impact on business and its impact on equality. I wish to explain why they are unnecessary.
The Government have already provided a number of assessments of the levy’s impact, including a distributional analysis of the impact of the combined tax and spending announcements that shows that lower-income households will be large net beneficiaries from the package, with the poorest households gaining most as a proportion of income. It also shows that the 20% of highest-income households will contribute more than 40 times the contribution of the 20% of lowest-income households.
There is a further assessment in a technical annex in the Government’s plan for health and social care. It sets out the impact on the Exchequer, individuals and businesses and shows that 70% of the money raised from businesses will come from the largest 1% of businesses, while 40% of all businesses will pay nothing extra.
The tax information impact note is a third form of assessment. It sets out the equality impact of the levy specifically rather than of the overall package of measures.
Alex Sobel (Leeds North West) (Lab/Co-op)
As well as on businesses, the levy will have a large effect on the bills of public services. For instance, West Yorkshire Police is looking at having to pay an extra £3 million of national insurance, and for Leeds City Council the amount for directly employed services is also in the region of £3 million. Somewhat ironically, many of the social care services that the council uses are outsourced, so the NICs will push up the cost of those services. What assessment has the Minister made of the effect of the levy on local government and the police?
Jesse Norman
The plan is clear that, to the extent that national insurance contributions are incurred by public bodies, they will be met. The funding is set up on that basis. In respect of local government, extra pressures other than those already contemplated are matters for discussion in the spending review. That is the normal fiscal procedure and the one the Government are following.
I turn now to address the Opposition’s new clauses 6 and 7 on reporting the levy expenditure shares and the revenue derived from those in the social care sector. First, on the share of levy spent on health and social care, the Government already routinely publish data on departmental spending throughout the year, including at main and supplementary estimates, through public expenditure, statistical analyses and in departmental annual reports and accounts as well as data on the revenue raised from individual taxes.
At present, this reporting shows, for example, exactly how much revenue NHS England receives from national insurance contributions. In future, this will show the contribution that this levy makes to the budgets of the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government. There is no need for additional reporting in that context as all the relevant information will readily be publicly available. The Government have already published the amounts that will go to the NHS and to adult social care over the next three years as a result of this levy and will confirm final allocations at the spending review.
Finally, on the levy revenue derived from those in the social care sector, existing data sources do not include or reliably collect data on employment by sector. It is not known which sector an individual works in, only their income types and amounts. I hope that, given these considerations, Opposition Members will not press their new clauses for the reasons that I have outlined.
Let me turn to new clause 10 tabled by my hon. Friend the Member for Amber Valley (Nigel Mills). This would require the Office for Tax Simplification to publish an assessment of the merits of the levy. As outlined in the Finance Act 2016, the statutory role of the OTS is to advise on the simplification of the tax system. To assess fully the advantages and disadvantages of introducing the health and social care levy would require the OTS to consider and comment on choices with far broader policy considerations, including on health and social care, which sit well beyond its remit and expertise.
The OTS functions as an adviser to the Chancellor rather to Parliament and it is for the Chancellor to commission work for the OTS or for the OTS to advise the Chancellor on its own initiative as it sees appropriate. It is not the role of Parliament to commission work from the OTS, though I have no doubt that the Treasury will have taken on board this new clause, and I thank my hon. Friend for tabling it.
The published tax information and impact notes set out clearly that the operational costs for the levy are being quantified and the Government will publish these estimates before the measure comes into effect in April 2022.
Nigel Mills
Does my right hon. Friend have any rough estimate of the cost to business of having to comply with the rules of paying, in effect, a third payroll tax? Does he have any idea of the costs of changing the software to include that levy and of redesigning payslips? All those costs will have to be borne. Does he have any estimate for us before we decide whether we want a new tax or just to increase national insurance as we are doing for the first year?
Jesse Norman
It is true that, just in relation to the levy, business will bear some cost and the existing tax information and impact notes outline that there will be costs to be borne, as one would expect with any tax, let alone a broad-based tax of this kind. The package goes well beyond this, and businesses will be large beneficiaries in many ways from aspects of the package because they will benefit from having a healthier and more secure workforce than they would otherwise have. How one measures that I am not entirely clear, but I take the point that my hon. Friend makes and will, of course, refer it to colleagues. Having said that, I hope that he will not press his new clause for the reasons that I have outlined.
Mr Deputy Speaker (Mr Nigel Evans)
I would just like an indication of who will want to make independent speeches by bobbing—thank you.
James Murray
As we turn to the Bill’s Committee stage, I will address the new clauses tabled in my name and the name of my hon. Friend the Member for Erith and Thamesmead (Abena Oppong-Asare).
We know that social care desperately needs more funding and the Government claim that their Bill today will help to raise some of that money, but the truth is that there is nothing in this Bill that will guarantee a penny going towards social care. I will return to that point when I address new clause 6, but first I want to look at the core measure that this Bill introduces—the unfair tax rise on working people and their jobs. Our new clause 3 would require the Government to report to the House of Commons on the impact that the Bill will have on tax revenue derived from different sources of income. On the one hand, there is income from employment and self-employment, which the Government have chosen to tax hard. On the other hand, as new clause 3 mentions, there is income from dividends, rental properties and other sources of wealth, which the Government have left untouched. We know that the Government have chosen not to raise taxes for those with large portfolios of stocks and shares, and for landlords renting out multiple properties, but the Bill even lacks any mention of taxes on dividends, despite the Prime Minister saying that they would be taxed more. Perhaps when the Financial Secretary to the Treasury responds, he could explain why the Government have chosen to delay implementing a tax rise in dividends until the next Finance Bill or beyond. Will he give us his word that the increase in tax on dividends will definitely go ahead?
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
I am someone who has believed in getting cross-party consensus on the future of social care funding, and who has been calling for a health and social care levy since 2016. Does the hon. Member recognise that there has actually been cross-party consensus on this issue, and that the shadow Care Minister, the hon. Member for Leicester West (Liz Kendall), called for a health and care levy in 2018? How does he reconcile that with his comments just now?
James Murray
Let us be really clear about what the shadow Care Minister, my hon. Friend the Member for Leicester West (Liz Kendall), proposed, because it was entirely different from what is being discussed now. She proposed that the tax should be raised from unearned income, and that it should be progressive and fair between generations, which fundamentally differentiates it from what we are discussing today. If the Government had truly sought to build cross-party consensus, does the hon. Gentleman not think that they would have done better to take some time over the Bill, rather than rushing it through within a week of the proposals first being announced, with limited ability for scrutiny and without any discussion of cross-party consensus about how to proceed?
James Murray
I am going to make some progress now; I have given way to the hon. Gentleman already.
As I said, although new clause 8 has not been selected today, I hope that Government Back Benchers have seen it on the amendment paper and will perhaps raise the matter with their colleagues on the Front Bench.
I hope, however, that there will be a vote this evening on new clause 5, and I urge Government Members to join us in voting for this crucial review of how the Bill will make inequality worse. We know how widespread and deep rooted inequality has become in our country. The latest bulletin from the Office for National Statistics on household income inequality in the UK for the financial year ending 2020 confirms what we all know: the income gap between the richest in society and the rest of the population has widened over the last decade. A tax rise that singles out income from employment can only make this inequality worse, and new clause 5 seeks to expose this.
Not only does inequality manifest between people who may live in the same area, it also creates divides between different nations of a country and the regions within them. In areas where average wages are lower and fewer people get income from other assets, the impact of the national insurance rise and the levy will be more acutely felt. Recent analysis in the New Statesman suggested that within the regions of England, it is people in the north-west and the west midlands who will take the greatest hit to their disposable income as a result of the Bill.
Data from the Office for National Statistics’ wealth and assets survey shows that the south-east is home to well over 3 million adults living in families with net wealth per adult of more than £250,000. That is roughly six times the number in the north-east. A tax increase that ignores income from renting out properties and selling financial assets, and that seeks to fund a plan that ignores differences in house prices and care costs between different regions, is destined to make inequality worse.
Dr Murrison
We are getting more granularity in the proposals that Opposition Front Benchers have in their heads for funding the uplift, which I think we all agree is necessary for health and social care, but can I probe the hon. Gentleman to describe the nature of the landlords or property-based businesses he has in his crosshairs for the levy of the moneys that he has in mind? Does he mean, for example, the mom and pop organisation that has bought a small residential property because it has no public sector pension, for example, and is relying on that for income in old age, or does he have in mind a business like any other business that has large numbers of commercial properties? How much does he think he is going to raise from the alternative that he has suggested?
James Murray
I thank the right hon. Gentleman for his intervention, but I do feel that there is a broad consensus across this country that those with the broadest shoulders should make more of a contribution. It is quite clear from the reaction that people have had to the Government’s proposed increase in national insurance and new levy that this is falling on working people and jobs rather than taking other sources of income from wealth into account.
I have just spoken about the massive impact that this will have on inequality between different regions of the country. I therefore ask Conservative Members to guess how many times last Tuesday, when the Prime Minister announced his approach here in the House of Commons, he used the phrase “levelling up” in that 90 minute statement. It was zero. Last Wednesday, when the Financial Secretary had to take the rap here on this tax rise, how many times did he use the phrase “levelling up” in a six-hour debate? Zero. The truth is that we are a very long way from the levelling-up agenda that we hear, or at least used to hear, so much about.
Of course it is not just workers and the self-employed who will feel the direct impact of the Government’s tax rise in this Bill. This tax rise will hit businesses that want to create jobs too. That is why we have tabled new clause 4 to show the impact it will have on businesses, and on small and medium-sized businesses in particular. There will be no point in the Financial Secretary denying the impact of this measure on businesses creating jobs: it is set out starkly in the Government’s own tax information impact note that he approved last week and that we have referred to several times today. I set out earlier how this note admits that the Government’s approach will impact business decisions around wage bills and recruitment. It goes on to explain how this measure
“is expected to have a significant impact on over 1.6 million employers who will be required to introduce this change.”
No wonder the Government have managed to unite business groups, workers and trade unions against their plans. At just the time when we need to see job growth, and when furlough is ending, the Government impose an extra flat cost on getting people into work. The Federation of Small Businesses has shown that this move could lead to 50,000 more people being left out of work. Yet again, small and medium-sized businesses least able to afford this tax rise will be hit hardest while online multinationals continue to dodge their tax on this Government’s watch.
The Government’s justification for much of the Bill is that they claim the levy will fix the crisis in social care. As we made clear on Second Reading, however, there is no plan to fix social care, nor even a mention of or reference to one, in this Bill. Fundamentally, despite all the rhetoric from the Prime Minister and the Chancellor, there is no guarantee that social care will benefit from the Government’s tax rise in any way at all. In the first year, the Bill explicitly rules out any money raised going toward social care. Beyond that, when the levy comes into force, it is entirely possible that not a single penny of any money raised will ever go towards the social care sector. I know that Treasury Ministers will deny that this is the case, so we ask them and Conservative Members to back our straightforward new clause 6. I note the Financial Secretary’s comment that the new clause would simply require the Chancellor to report transparently and straightforwardly on the share of the levy spent on social care each year so that we can all see what proportion of the money raised is going to the social care sector.
Finally, I turn to our new clause 7. Nothing could sum up the intrinsic unfairness at the heart of this Bill more than the case that this new clause points towards. The unfairness of the Government’s approach is impossible to ignore when we realise that this tax rise, raising money the Government claim will go towards social care, will not see those with the broadest shoulders paying their fair share but instead hit low-paid social care workers themselves. Our new clause asks the Government to be transparent and honest about this by requiring the Chancellor to report on how much revenue the levy raises from those working in the social care sector. This Government’s choices to raise national insurance, to cut universal credit and to freeze personal allowances mean that a social care worker will pay £1,108 more in tax a year. The Chancellor once clapped for key workers; now he is taxing key workers. This will hit working people hard, and we will not let voters forget it.
Mr Fysh
My intention with amendment 7, which I have tabled with esteemed colleagues, was to try to get the Government to focus on a way of looking at the future costs of social care and how to finance them more creatively. I have to ask: if not now, when?
We know that the most powerful way to address costs in the future is to provide for them in the present and to have the power of compounding investment returns over a period of years to meet the liabilities that people have. I am passionate about encouraging the Government to look at ways to encourage people across the board, with progressive incentives in different ways, to make provision for themselves with support from the state.
People think that they pay a contribution into national insurance that rolls up over time and gives them an entitlement to a pot of money—I have heard constituent after constituent talk about that—when we in this place know that that is not in fact the case. In fact, my right hon. Friend the Minister confirmed that that is not the Treasury’s view and that national insurance is a tax collected in-year that must be spent in-year.
There is a big opportunity for reform and innovation that could be useful and get very much back to the ethos behind the Beveridge report and the origins that I spoke to in the Second Reading debate. There was a radical movement trying to help individuals and groups provide for each other. Lloyd George and the Liberal Government’s 1911 Act was about getting national aid into the system in a creative way. I think there is an opportunity for us to talk as one whole House about innovating for the modern world in that way. What was wrong with some of those older schemes and co-operatives, friendly societies and such things in the old days was that sometimes people ran off with the money. That was one reason why there was a need to put more of a national embrace around it and administer it that way. In the modern world, we can do it differently.
All I was trying to do with the amendment was give scope for the Government to think about applying some of the funds from an element of national insurance or something related to it—that is, the levy, which clause 2 sets out—to help incentivise such pooled saving schemes. That is not necessarily insurance or private insurance with a middleman; it could be national schemes or community schemes that are properly co-operative and very low-cost. There are many modern approaches to that in the digital world, such as digital autonomous organisations, where there are no middlemen at all and people do not have to rely on a contract.
That was the pure intent of my amendment, so I am a little disappointed that the Government do not seem to want to engage with it. I urge my right hon. Friend and those on the Treasury Bench to think about ways we might do that in the future, because I can see it as a useful evolution of the policy that might bring people from all parts of the House together in the way I have been describing.
Dr Poulter
I am sympathetic to the point that my hon. Friend is making. In principle it is a very good point, but the practicalities are that the moment we move towards the system that he is advocating, we have to clearly define what is health and what is social care, and that makes the integration of the two systems much more challenging. In the context of better integrating health and social care, has he considered that practical element in putting forward this proposal?
Mr Fysh
I thank my hon. Friend for his intervention. The truth is that, yes, I have thought about that, and I must emphasise that I am thinking about this measure only in terms of social care costs and liabilities. We have heard how residential care living costs will be excluded from the funding produced by the levy. Pooled savings schemes or liability defrayal schemes could easily include such elements and make a really big difference. I am not talking about the costs of healthcare in the healthcare system.
There are ways in which the healthcare system could look at insuring itself against particular outcomes. Sometimes, unfortunate things happen in neonatology, for example, which have a long liability tail in younger people living with healthcare needs. Those are targeted things, but that is completely separate from the present need to get money into social care. That is what I am talking about, and such a scheme could get money into social care more quickly than the plan that we have heard to date.
Dr Murrison
I have been listening carefully to my hon. Friend and what he has said has a great deal of merit. Does he agree, however, that while the Government’s aim is to integrate health and social care, which arguably have been divorced one from the other since 1948, to the great detriment of the people we represent, the system he suggests might exacerbate that problem? That would be in contrast to the provisions of clause 2, which leave it up the Treasury to decide how moneys raised by the levy should be apportioned. Surely it is better that the Treasury can do that so that it can facilitate the integration of health and those elements of social care that relate to care as opposed to residential costs.
Mr Fysh
I do not think that the amendment would remove any of the Treasury’s discretion in clause 2; all it would do is specify that moneys raised could be used either in the current year or against future years’ costs. The Treasury would govern how such schemes worked and how to achieve that integration.
Since I was elected, I have been passionate about the integration of health and social care, and I anticipate that, through such an amendment, the Government could help to get money into the system to help it work well. I hope that the Government will reconsider their request for me to withdraw the amendment. I would love them to adopt it. It would be no skin off their nose to do so; the amendment would just give them a bit more flexibility in the Bill. I look forward to hearing my right hon. Friend the Minister’s response.
This is a probing amendment, and I cannot be confident that the Labour party will support it, perhaps because of their slight misunderstanding of its purpose, so this might not be the time to force the Government’s hand. However, it could be a useful evolution of the national insurance policy, given the direction in which the Government want to go on that.
Stephen Flynn (Aberdeen South) (SNP)
It is a remarkable feat indeed that the Government have managed to unite the left-wing press, the right-wing press, the Unionist press, the nationalist press, pressure groups in favour of ending poverty and pressure groups who want to see businesses excel, all in condemnation of the Bill. Although I do not think anyone in the House doubts that it will once again sail through the voting Lobbies this evening, I would like to put in my two cents for what little it is worth. In that regard, I commend the amendments in my name and those of my learned colleagues.
As colleagues across the Chamber will recognise, new clause 1 seeks to get the Government to provide an equality impact assessment of the effect of this Bill, by age, on people’s wealth or income. The reason they will not accept that, despite the polite remarks of the Minister, as always, is that such an equality impact assessment would put in black and white what all the pressure groups are telling us. Indeed, much of what we have heard from Members across the Chamber throughout today and last week is that the Bill, in its entirety, will hammer the youngest and those who work the hardest in society, but not necessarily those in the south-east of England who have the most to give.
I heard a remark earlier that about 50% of the income that will be generated by this Bill will come from those under the age of 45. It will be coming primarily from younger people, who are the very people whose horizons have been shortened by Brexit, and whose job opportunities, career opportunities and educational opportunities have been hammered by the pandemic. What the Government are seeking to do is impose further challenges to their lives. It is an unforgivable act, but one that they are going to push through with no contrition whatsoever, as far as I can see, and in the knowledge that they also plan to cut universal credit in the coming weeks—a double whammy on those in society who can least afford to face the real challenges in front of them, and an abdication of responsibility of the highest order.
However, it is not just individuals, young people, working people or families who will be hammered by this tax; it is also businesses. That takes me nicely to our new clause 2, which involves trying to get the Government to do an economic impact assessment of these policies. However, they will not do that either, because they know what the outcome would be, as we see in the language being used by business groups. The Federation of Small Businesses has been absolutely clearcut about its expectation that the proposal will force 50,000 into unemployment. It is a disaster for business.
The Tory party was once, when I was growing up anyway, regarded as the party of business. What has happened? Why are we in a situation now in which not only have the Government forced through Brexit in the middle of a pandemic—and businesses are having to deal with the challenges of exporting goods and the shortages of supplies, to pay back bounce back loans before they have even had the opportunity to bounce back, and to deal with the fact that furlough is going to end despite the clear uncertainty facing them—but they are seeking to impose a jobs tax? Where is the justification for that? I encourage any Government Member to rise to their feet and disagree with anything I have said, but they will not because they know that we are right in this regard.
Dr Poulter
I declare an interest as a practising NHS doctor. Will the hon. Member reflect on the fact that the single biggest transformation delivered to health and care in the last 20 or 30 years was when Tony Blair increased national insurance to give a huge injection of funding to improve care for patients throughout the United Kingdom, including Scotland? In reflecting on that, can he see the benefits that will come from this levy for patients in his constituency and all our constituencies in the years to come, because it will make a difference? Will he reflect on the difference that it will make to real people’s lives—improving cancer care, reducing waiting times—and does he see that there is a benefit in that?
Stephen Flynn
I thank the hon. Gentleman for his intervention and for the tone in which it was made, and I shall reflect on two points in relation to what he said. He said that perhaps the biggest change to health and social care was the action of Tony Blair, but I happily disagree with that. In fact, it was in 2016 in Scotland, when we did something that I heard Members discussing earlier at length: we integrated health and social care in Scotland. That was on top of the fact that we provide free personal care for our elderly and so on, and that is in contrast to the situation in England, which has led to the crisis we see before us.
On the hon. Gentleman’s point about finance, which is the crux of this argument, do the ends justify the means? That is the purpose of this discussion. I believe in the ends. I believe our NHS and social care services deserve more money, but I do not believe that this is the right way to do it. That obviously leads to the next question, which is about how we should fund this. I heard Conservative Members—rightly—shouting at the Labour Benches, “What is your plan?”, but what is the cost of Trident? What is the cost of nuclear weapons? Over their lifespan I believe it is between £164 billion and £200 billion. Conservative Members will not say that those weapons should be scrapped, but I will. They should absolutely be scrapped, and we can use that money to fund our vital NHS services. The answer is staring them in the face, but they choose not to look at it because this is about priorities, and their politics and priorities differ massively from mine, and ultimately from those of the people of Scotland.
Finally, amendment 4 goes to the nub of where much of our frustration lies with the Bill, because if we shake it about a bit, this is ultimately another UK Government power grab. They are seeking to tell the Scottish Parliament how it should spend money in devolved areas. Whether they agree or disagree with the national insurance hike, all members of the Committee, certainly Unionist Members, should be concerned about the consequences of the UK Government seeking to impose themselves once again on devolution. I say that not as someone who seeks to defend the Union—by all means continue to do it—but because all the UK Government are doing is driving home the message in the minds of the people of Scotland that they do not respect the devolution settlement and they do not respect the Scottish Parliament.
Nigel Mills
I come at this debate from a slightly different angle. When we first heard rumours of a tax rise to fund health and social care I felt that, given that we had just spent £400 billion to get us through a pandemic, and that we wanted to get health care services to 110% of previous capacity to clear the backlog, we could accept that a tax rise had to be found to do that. I thought there was no other way, given that the economy and tax revenues are still smaller than they were, and that that was the responsible and prudent thing to do. I may not have chosen national insurance, but I accept that it is probably one of three taxes that the Government could have chosen.
My interest is in why, in the long term, we have chosen not to raise national insurance but to have a new tax. I remember that when I was first elected we were keen on simplifying the tax regime. We even had a review into whether we could merge income tax and national insurance, so that we could have one tax fewer, and make it cheaper and simpler to collect. For some reason that I will try to work out, we have now moved on to adding a kind of son or daughter of national insurance to the tax code. I think the only slight difference is that the new tax will apply to the earned income of people over retirement age, where national insurance does not. I do not know how much that will collect—the Minister would not give us an estimate—but I think it is a pretty tiny amount, and I am not sure there is huge advantage in that.
Being a bit of a cynical sort of person I thought that perhaps because our manifesto promise ruled out tax rises we could have a levy, and that people would fall for that, but I am glad we did not take that line. Indeed, the Government were clear that we are breaching our manifesto promise, for justifiable reasons in the circumstances.
Perhaps we are trying to create some clarity, thinking that if people can see a hypothecated tax, they can see how much they are paying for health and social care and they will understand and value what is happening, except of course we are raising by this levy £12 billion a year or so—a tiny fraction of what we spend on the NHS, let alone social care—and people will see a social care levy on their council tax bill. In fact, this money is not even the biggest part of national insurance that will go to the NHS; as I said earlier, £26 billion a year—roughly 2% of the national insurance contributions in each class—already goes directly to the NHS and does not go down the usual route of national insurance funding. I am not sure that we are going to get the benefit of clarity for people about what they are paying.
Jesse Norman
I am afraid that I must correct myself. It is actually £40 million to £50 million, rather than £50 million to £60 million. I was relying on an imperfect memory.
Nigel Mills
Perhaps the Minister was building in some optimism bias, as the Treasury normally does to other people’s forecasts, and going for £50 million to £60 million to make sure. I do not know whether that is the cost of building the systems to enable the returns to be made, or to enable the systems to collect or chase the money, or whether there is going to be some ongoing annual cost; I assume that there will be some ongoing annual cost in trying to chase compliance too. However, we do not have an estimate for how much we are going to be imposing on business to pay this tax.
I imagine that this will be a separate tax that is not collected in the same way—the same box—as national insurance. I assume that there will have to be different parts of the payroll returning different calculations, which will require every software provider to change all their software coding to cope with it and to add in the new amount that is being paid by people over retirement age who do not normally pay national insurance. All that will cost time and money and need testing and compliance, and then we will have to check whether employers are following it and chase them for the money.
I suspect that there will be quite a large up-front cost for all that work to be done, and then a reasonable annual cost to ensure compliance, so there is a first-order question whether we are raising more by quite rightly taxing people over retirement age on their earned income—this 1.25%—than we are having spent on obtaining that. From the Minister’s remarks, I am not convinced that the answer will be positive, so in actual fact, we are creating a whole new tax to raise less money than it costs to collect it, for no real advantage other than a presentational one.
John Redwood
My hon. Friend is such an expert on this. Has he probed or got anywhere with finding out how much consequential tax loss there might be from the national insurance rise, or the care tax rise, itself? Presumably, there are some losses that will have to be offset, so gross will not necessarily be net.
Nigel Mills
I assume that my right hon. Friend is right that, if we reduce the number of people in work or reduce their pay rises, that will work its way through the system. The Minister may be better placed than I am to work out an answer to that question.
The nub of my argument, and the reason for amendment 8 and new clause 10, is that we have 18 months before the new levy comes into force—we accept that we cannot bring it into force in six months’ time, presumably because it is so hard to get the systems in place, and that we have to raise national insurance for the first year and move to the levy after that—so perhaps if we had all the information in front of us in the next six months or year, we could make a choice whether to go ahead with the new levy for the small amount of extra income, or whether to stick with the national insurance rise and find other ways to explain to people what they are paying their taxes for.
I think the Minister accepted that HMRC will publish its estimate, and I am sure we could find a way of getting an accurate estimate of the cost to business of complying with the levy. We could then take an informed decision before we finally introduced the levy. I think that would be a positive step in tax policy. However, if we really believe that we want a separate levy to show what people are paying directly for health and social care, I think that we should move the existing 2% of national insurance that goes directly to the health service into the levy, so there is one hypothecated payroll tax that goes to the NHS on people’s payslips, rather than it being hidden in a part of national insurance. I cannot see any reason why, if we go down the line of introducing a new health and social care tax, we would not want to have all the hypothecated payroll taxes going into the NHS or social care to get any of the advantages of that.
I will not be pressing my two new clauses to a Division, but I urge the Minister to give some serious consideration—I suspect he did not know about this new levy until around about last weekend, when it was probably dreamt up in No. 10 as a way of selling a tax rise—to using the 18 months he has before the levy comes in to try to work out whether the costs of collecting it are worth the small change. If he really does think there is a compelling argument for charging people over retirement age national insurance if they stay in work and are earning, let us charge them the full rate, rather than 1.25%. I cannot see how we can justify that they do not pay the existing 2% that goes to the NHS but they do pay the 1.25%. There seems to be no logic in that at all to me, so perhaps we should think properly and coherently about the tax system. Let us have the full rate in that situation.
Let us have a decision when we get around to the Budget in 2022. Is going ahead with this levy going to raise more money than it costs? If it is not, let us just leave it on national insurance where it will be sat at that point. That would be a more coherent way of running our taxes.
Nadia Whittome
With your permission, Dame Eleanor, I will speak to new clauses 3 and 5, tabled my hon. Friends the Members for Ealing North (James Murray) and for Erith and Thamesmead (Abena Oppong-Asare). New clause 3 requires the Chancellor to assess the impact of the Act on tax revenue from different sources of income and new clause 5 calls on the Government to publish an equality impact assessment of the Act.
Dame Eleanor, given that even in Committee this has been a wide-ranging and broad debate, I hope you will allow me to set out the context of those new clauses. It is people in poorly paid jobs who will bear the brunt of the national insurance increase, at a time when in-work poverty is already at a record high. How can it be right to ask those who are already saddled with extortionate housing costs, poverty wages and mountains of debt to pick up the tab for this Government’s failures on social care? To put it simply, the Government are choosing to protect the interests of the wealthy who fund them at the expense of low-income workers and renters. While landlords and the super-rich who are hoarding wealth and housing pay nothing under this new tax, my constituents will be having their pockets raided.
Since 2010, under this Government’s watch, £7.7 billion has been cut from social care budgets. If I could sum up this policy—if we can call it a policy—in one word, it would be “unfair”: unfair on the working people who are funding the tax rise; unfair on the care workers who will not see their pay and conditions improve; and unfair on those relying on social care, whose needs will continue to be unmet. Figures released this week show that nearly 70,000 people in England could die waiting for social care before these changes even come into force.
If the Government were interested in fairness, they would tackle the soaring housing costs, low-paid jobs and inadequate benefits that my constituents are facing. Instead, their policy agenda is fuelling inequality and impoverishment. As we heard from the hon. Member for Aberdeen South (Stephen Flynn), 2.5 million working households will be hit by the cut to universal credit and the increase in national insurance. Working families will be losing, on average, over £1,000 next year. Meanwhile, the furlough scheme is ending and evictions are resuming.
There is, however, a group of people who have benefited from the pandemic—who have done very well, in fact: British billionaires. They have increased their wealth by over £100 billion. That is why now is the time to get serious about taxing wealth. The Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), said earlier in the debate that this tax hike would raise more than a wealth tax, but I am afraid that that is not true on any measure. City A.M.—this is City A.M., not “Das Kapital”—calculated that one wealth tax option would be to tax wealth progressively between £1 million and £10 million, with all wealth beyond £10 million taxed at 3%. That would bring in a total of £55 billion over five years. Alternatively, the economist Richard Murphy calculated that, if wealth was taxed at the same rate as income, that could raise up to £174 billion a year.
Will the Minister explain why none of those options was considered and what the Treasury makes of those calculations? And perhaps the Chancellor could explain to us, as a multimillionaire, why he cannot dig deep into his own pockets and why it has to be my constituents—in fact, all our constituents—instead. I think that this House and working people across the country deserve to know why a wealth tax was dismissed in favour of a tax on the poorest and the lowest paid, and what is more, to fund a plan that will not even work.
We have heard during this Committee that the Government’s excuse for not ring-fencing the money raised for social care is that health and social care are interlinked. I agree, to an extent, and that is why, to fix our social care system, we need a national care service, like our national health service, which is free at the point of use. We need to redesign the system so that the needs of care users, for want of a better word, and care workers are at its heart. The money to do that is there but it is in the pockets of the richest and it is the political will from this Government that is sorely lacking. Anything less than a national care service, funded by a tax on wealth, not on workers, would be a great disservice to the people we are elected to this place to represent.
John Redwood
I have worries about hypothecation. I thought the Treasury used to be against it and it is a difficult doctrine to make work well, because it is not always the case that a particular tax just happens to raise the right amount of revenue for a particular purpose, or if it does in one particular year, that may not be true in a future year because the revenue may grow too slowly for the purpose, or the purpose may become less popular and the revenue may exceed what is needed. I have always favoured the Treasury orthodoxy—I am not always someone to support Treasury orthodoxy—that it is better that we have a very big general pot into which we collect the taxes, and then we have general distribution based on tightly argued issues between Government Ministers and Departments on what their spending priorities are and the minimum amounts that they need to spend to get good results in their leading areas.
However, now that Ministers are treading the boards of hypothecation for the first time in this interesting way, I advise them that it is a very good rule, if they wish to sell the idea of hypothecation, that the tax revenue that they collect should pay for the thing that they are attaching to the hypothecated revenue. My big worry about this hypothecation is that the sum of money for social care—when we eventually get to that point after three years—collected by the so-called social care tax will be only about one fifth of the actual costs of social care to the public sector. Of course, there are additional costs to private individuals as well and I would not want my constituents to be misled. I have already had emails from constituents saying, “As the Government seem to be pressing ahead with this social care levy, I assume that I will no longer be asked to make any contribution through my council tax to social care”. Being an honest man, I have written back and said, “No, you can’t assume that at all. Social care is going to need a lot of money and I don’t think the idea is that the council tax levy part of it, or the need for that, will suddenly disappear.” So I think one does need to look again at hypothecation. If, for example, we wish to have hypothecated taxes to pay for the current costs of health, as identified by the Treasury for the current financial year, we would need to say that all income tax, all capital gains tax, all inheritance tax and all stamp duty—in other words, all income and wealth taxation—were already going to pay the large sums required for health in this year’s public budgets. Maybe we could start by renaming income tax and all the wealth taxes as a health tax, which would give people some idea of the scale of expenditure that we are talking about. There might then be a more interesting and useful debate to be had.
Dr Murrison
I am listening carefully to my right hon. Friend. Does he share my concern that there may be an element of gaming by the social care sector, in so far as hotel costs are clearly exempted? Our constituents who may be listening might not be fully aware of that. There is a real possibility and risk that the sector will seek to enhance and embellish those costs so that they become a bigger and bigger proportion of the total take. Does that not need to be made explicit? Does my right hon. Friend think that in the White Paper process that we are about to embark on, there would be merit in limiting that cost in some way to ensure that the potential market exploitation of the Bill’s proposals is avoided?
John Redwood
I was with my right hon. Friend until his last recommendation. He had pre-empted what I was going to say next: that we need greater clarity about the three different kinds of costs that an elderly person can face.
All of us in this House agree that we believe in a health service that is free at the point of need, so that any elderly person, like anyone else, has complete entitlement to completely free healthcare if they need GP or hospital treatment. That is not in dispute. However, as my right hon. Friend has just reminded the Committee, it looks as though these proposals also say that if an elderly person is living in a care home, the board and lodging, or the hotel costs or whatever we like to call it, are not part of that kind of treatment, so if the person has money, they will have to pay for those.
I find it difficult to say that we need to pre-empt the possibility of care homes wishing to charge a bit more for that hotel accommodation, because there could be good reasons for their needing to do so, and the law is a very clumsy instrument when it comes to intervening in thousands of decisions that individuals and businesses have to make about what is a fair price. I do not think that there should be absolute price control, because it might be a period when wage costs or food costs had gone up, which the care home needed to pass on—or the care home might be improving the quality of what it was offering, in which case it would be mutually beneficial, or at any rate perfectly reasonable, for it to pass on that cost.
Dr Murrison
My right hon. Friend is being very generous in giving way. May I just clarify my intent? It would be reasonable to have an indicative cost. After all, in the case of most of our constituents who are living in a residential set-up—we are talking, basically, about a bedsit—what is usually involved, in my experience, is fairly basic food and some heating. The cost of that is not enormous, and it is the sort of thing that we would be expected to fund in any event were we living in our own homes; probably rather more so. Would it not be reasonable to have an indicative amount that it is felt reasonable for homes to be charging people—particularly, I have to say, if they are being funded through local government?
John Redwood
I do not think that that is possible at all. Property costs vary to an incredible degree across the country. Levels of staff provision are different in different homes, the quality and level of service are different, and the needs of individual residents are different. Some are in relatively good health, and do not need to find the back-up or assistance that others require. What I want to see—and I think that we need to debate this more than we have so far—is better quality for everyone who needs end-of-life care or time in a nursing home. My right hon. Friend has suggested that some are quite basic, and I think we need to worry about that and work at it.
For me, the big care problem is whether it is adequate. I am not quite as worried about the family finances as I am about the experience of the elderly person and whether it is good enough, and, where the state is the sole funder or a substantial funder of the care, whether we are doing a good enough job in allowing a reasonable quality of care in terms of staffing numbers, training of staff and staff wages. When elderly relatives in my family have been in care, we have always wanted to make sure that the staff were well remunerated, rewarded and motivated, and had proper training, support and back-up from the care home, because I wanted them to be well looked after.
There is a much happier environment if the people working in the home are proud of it and have, for instance, a decent career structure. I therefore think that we need to be very careful about a cost-down or standard-cost approach. We need to understand the variety of life, but we also need to make sure that those who rely entirely on state support, or who may be becoming more reliant on it under the Government’s likely policy, will none the less look forward to a reasonable standard of care, and that the people who work with them and for them are treated well by employers who respect them and offer them a career structure, proper training, decent support and all those other good things.
In conclusion, I hope the Government will look again at some of these points to ensure that there is no muddle over the true costs of these services and the contribution that the tax will make, if they insist on it, because it will be quite a small contribution as a proportion of the whole. Will they also look at a big care issue that does not get enough attention in the Bill, which is the quality of the care? That leads immediately into the quality of the experience for the employees, their career structure and their ability to create good atmospheres in care homes that are of a high standard. Can we also have a bit more thought and more information on what this will mean for individuals going into care homes and their supporting families? I am afraid that I still do not have a clear explanation to offer my constituents as to what their experience would be under these proposals.
Richard Burgon (Leeds East) (Lab)
I am speaking in support of new clause 3, which would require the Chancellor to look at different taxes to raise income. There are many other ways to raise this money and, in particular, I believe that we need to look at ways to tax wealth rather than taxing working people. Wealth in this country is concentrated among the top 1%, so instead of imposing a tax bombshell of £12 billion a year on working people, the Government could focus on the wealthy. They choose not to; instead, we have a tax system rigged in favour of those who already have wealth. They pay lower taxes than the millions who have to go out to work to make a living. The truth is that the Government’s proposal makes that situation even worse, and that is not right. The Government could reform capital gains tax, so that instead of lower taxes for wealthy people, that money could be used to fund social care, but they choose not to do so. They could raise many more billions of pounds by a direct wealth tax on the richest 1% with assets of more than £5 million, but they choose not to do so.
I am backing new clause 3, because there is always an alternative. That the Government refuse to back such alternatives speaks volumes. Aneurin Bevan once said that socialism was the language of priorities, but conservatism is the language of priorities too: the priority of safeguarding the wealth of the super-rich and sticking the boot into working people. This is the same old Tory party, attacking working people and defending the wealthy. We have heard a lot in this debate about so-called tough choices, but when politicians speak the language of tough choices, it usually means that they are taking the path they think is easiest. The truth is that the Government are taking the easy choice: not levelling up but kicking down and taking a hands-off approach to the wealth of the super-rich. There are alternatives, and that is why I am backing new clause 3.
Mr Richard Holden (North West Durham) (Con)
I thank the hon. Gentleman for giving way, and I would also like to welcome the hon. Member for Nottingham East (Nadia Whittome) back. It is great to see her back on the Opposition Benches. There is a similarity between what the hon. Gentleman is saying and what those on the Government Front Bench are saying; at least they are both putting forward proposals. He is putting forward a wealth tax and the hon. Member for Aberdeen South (Stephen Flynn) proposed the scrapping of Trident, but the Government are at least being honest in saying that people are going to have to pay more through national insurance: £907 a year for a Member of Parliament and £80 a year for somebody on the national minimum wage. Has the hon. Member for Leeds East (Richard Burgon) managed to convince those on his Front Bench to be as honest as he and the Government are in coming forward with an actual proposal for what they would do?
Richard Burgon
I had actually finished my remarks, but I would be happy to take this up with the hon. Gentleman on another occasion if he so wishes.
The Chairman of Ways and Means (Dame Eleanor Laing)
I have to say I was not quite sure about that. I thought that the hon. Member for Leeds East (Richard Burgon) had finished, but the hon. Member for North West Durham (Mr Holden) nevertheless managed to make his intervention. He may indeed have wanted more, but the hon. Member for Leeds East read the mood of the House very well.
Sir Christopher Chope
It is a pleasure to follow the hon. Member for Leeds East (Richard Burgon). He talked about alternatives, and perhaps I can throw out a possible alternative that he might think reasonable. Why should the very rich have unrestricted access to a free NHS?
Whenever that is raised by Conservative Members, Opposition Members object to the idea and say that it would undermine the principles of the NHS. I do not expect him to answer that question, but I throw it out there because it is another alternative that could be considered.
Richard Burgon
It is useful that Members on both sides of the Committee are coming clean with all sorts of ideas. I would assert the principle of universalism—universalism of the welfare state and universalism of the NHS.
Sir Christopher Chope
I thought that might be the hon. Gentleman’s response. Today we are talking about social care as well as healthcare, and the principle of universalism does not apply to social care because it is and will continue to be the subject of means-testing.
The Government talk the talk of integrating health and social care, and I had an exchange with my right hon. Friend the Minister on this subject. He justifies having a health and social care levy on the basis that they are interdependent. If they are interdependent and we are moving towards an integrated scheme, why do we not apply the same principles to both NHS healthcare and social care? We could have means-testing for healthcare, in the same way as we have for social care, or we could not have any means-testing for social care, in the same way as we do not have any means-testing for healthcare. If we are going to merge the two schemes, we need to resolve those anomalies. I am afraid that everything that has come out of this short debate shows that the Bill is a muddled fudge that perpetuates the distinction between health and social care but does not meet the challenge I put to the Minister: why not have a distinct social care levy?
Is it reasonable that we should have co-payment in the NHS? If so, it would generate an enormous amount of additional income. We essentially have co-payment on prescription charges, ophthalmology services, dentistry and, increasingly, audiology services. The idea that we should have co-payment more widely, so that people who can afford it contribute, say, half the cost of an orthopaedic operation, seems to be anathema to the Government. I do not understand why, if they want to get more money into the system.
Our system differs from most overseas systems. We are not spending more on healthcare in this country, but we are spending more on publicly funded healthcare and not enough on privately funded healthcare. I would like to see a Government strategy to encourage more investment by ordinary individuals in the healthcare system. I have a private Member’s Bill on co-payment coming up in the new year, but perhaps before that we might be able to get some movement from the Government on these principles. We have co-payment in the social care sector. If it is all right in the social care sector, why is it not all right in the healthcare sector? We are excluding hotel costs—the board and lodging costs—from the £86,000 social care threshold, but we do not charge any hotel costs to rich people who are in hospital. Why not? There does not seem to be any logic in that.
I am glad it looks like the Minister will have a long time to answer these points and the other important points raised by my hon. and right hon. Friends. If we are going to have a complete review and fundamental change of outlook on health and social care, we need to meet those challenges. What is the answer as to why we do not charge hotel costs for millionaires in hospital? That would introduce more income into the service and bring it into line with what happens with social care.
Those questions remain to be answered, but there are a whole lot more besides. I was looking at the Official Report of an exchange in the other place yesterday evening. The Parliamentary Under-Secretary of State for Health and Social Care, Lord Bethell, said that
“we recognise that family carers play a vital role. When we announced an additional £4.5 billion over three years for social care, it included a commitment to take steps to ensure unpaid carers have the support, advice and respite they need.”
We know that there are about 1.6 million unpaid carers, and that was leading them to believe that there was some sort of dividend around the corner for them. However, Lord Lilley picked up on that point and asked the Minister to
“confirm that…there would be only £1.5 billion a year going to social care from the large increase in national insurance”.
Obviously, that is correct. He then asked the Minister to
“confirm that nearly half of that will be absorbed by the need to pay for the extension of free social care to those with valuable homes…That means that nothing will be left to help domestic carers.”
That was a perfectly straightforward question, and as it was not answered in the other place last night, I hope that the Financial Secretary can answer it tonight. The answer that that Health Minister gave—perhaps the Treasury has a better view on this—was that
“the maths that my noble friend has done is a little bit premature.”
I did not think that maths could ever be premature. He continued:
“The White Paper will come out later this year; it will spell out the precise financial arrangements, and I am looking forward to that.” —[Official Report, House of Lords, 13 September 2021; Vol. 814, c. 1130.]
The Minister was implying that he did not really have a clue as to what was going to be in it when it came out. That is an example of the muddled thinking, the failure of the Government to answer precise questions and the very dangerous policy of raising expectations among our constituents that somehow they are all going to be able to relax and spend all their hard-earned savings and use their houses for themselves without having to contribute much towards the long-term costs of social care.
May I throw out a suggestion arising from that exchange in the other place last night? If we have 1.6 million people providing free care for their loved ones, why are we choosing to impose upon them an extra levy, an extra tax? Surely it would be reasonable—clause 4 enables this to be done by subsidiary legislation—to exclude those who are looking after their loved ones, doing the right thing and saving the state a lot of money. We could say, “In return for doing that, you will be exempt from the 1.5% levy.”
Sir Christopher Chope
I am delighted to see that my right hon. Friend thinks that is a good idea. I hope we will get some nodding soon from those on the Front Bench, but I have looked there in vain so far.
Anybody who speaks in a debate such as this is open to the challenge as to how they would pay for this. That challenge was put across the Dispatch Box today by Conservative Members to Opposition Members, and answer came there none. I have an anecdote to share with the House. Probably around a fortnight ago I was talking to a former very senior aide at No. 10. He said that one great thing that has come out of the covid-19 emergency is the sure knowledge that we can manage with 25% fewer civil servants in government without any detriment to the quality of government. That came from a senior adviser at No. 10. How many fewer civil servants does my right hon. Friend the Minister think we can have without any detriment to the public service?
John Redwood
My hon. Friend is making an interesting speech. Does he think that as a lot of civil servants now find they can work pretty well from home, we do not need all these expensive offices and perhaps ought to be surrendering leases?
Sir Christopher Chope
That is another excellent idea. I am grateful to my right hon. Friend for the suggestion, but I fear that the Government are so focused on spending money that they have lost any incentive to try to control expenditure, which I thought was the Treasury’s job. It takes me back to Geoffrey Howe’s first Budget. The Conservatives had become a national Government on the back of very high socialist spending and a popular rebellion against socialist waste and high taxation. In his first Budget, Geoffrey Howe emphasised: “Finance must determine expenditure”. That message has now been lost by the Government, who are saying that expenditure must determine finance. Our Government—I say “our Government” advisedly—have reverted to the old socialist tax and spend philosophy in which expenditure determines finance. I hope that my right hon. Friend on the Front Bench will explain why he thinks that to change our philosophy fundamentally is consistent with Conservative values.
My final point is about the Barnett formula. The Bill recites a restatement of the fact that the Barnett formula is there and says, “Isn’t it fair?” My constituents are incensed at the unfairness of the Barnett formula, which results in their paying higher taxes so that the people of Scotland can receive higher public services, with much more spent on those services in Scotland than is spent in England, financed by our constituents in England. Why, when we should be looking at issues that relate to expenditure, are we just saying that the Barnett formula is going to apply? Will my right hon. Friend the Minister say what will happen when the Barnett formula is reviewed or abolished, as surely it must be because it has outlived its usefulness? The House of Lords did a comprehensive demolition job on the Barnett formula, which was brought in years ago as a stopgap—a plastering over of some cracks—and has now almost reached the status of some religious doctrine.
My right hon. Friend the Minister will not be able to persuade me to do other than vote against this Bill’s Third Reading, because introducing it is a chronic mistake by the Government, and it is even worse that we should be imposing taxes without explaining how we are to spend them. But let me leave that on one side. I hope that my right hon. Friend, wearing his Treasury hat, will be able to explain exactly what the Government are doing to help to constrain and reduce waste in public expenditure, whether it be by getting rid of leases on surplus buildings; by sacking staff who are not productive; by introducing the long-promised cap on exit payments; by stopping the obscene salaries that are paid in much of the public service; or by addressing the problem of all these bureaucrats in the health service who seem to squeeze out productive activity, for whom we are having to pay dearly and are going to have to pay the highest taxes in our lifetimes. Those are the challenges that the Government must face up to if they are to be able to recover not just my support, but the support of so many Conservative activists up and down the country.
Jesse Norman
I thank colleagues for their contributions to the debate. It has been very wide ranging—especially the last speech—occasionally touching on the subject of the Bill and the clauses and amendments in it.
Let me start with the hon. Member for Ealing North (James Murray) who speaks for the Opposition. He asked why the dividend tax has not been brought in. The answer to that question is that it does not fall under a national insurance contributions Bill. Dividends are subject to a separate dividend tax regime. That is a tax that is already in existence and it will be handled, as the Government have already made clear, in the course of the forthcoming Finance Bill.
The hon. Gentleman asked questions about levelling up and multinationals’ tax avoidance. I think he is aware that the Government’s approach to levelling up is extremely manifest, most recently in the work that we have done with the UK Infrastructure Bank, which is specifically dedicated to net zero and levelling up and which has just recruited a world-class new chief executive. On the case of multinationals, he has obviously forgotten that the Government have been in the vanguard of the G20 and the G7 in arranging and leading on a new settlement on Pillar One and Pillar Two multinationals’ tax avoidance.
The hon. Gentleman repeated his untrue claim from the earlier debate that these measures contain no new funding for social care. In fact, as the Chief Secretary to the Treasury said a few minutes before he first said that, the measures contain £5.4 billion to support social care, which is in the plan. In case he missed it, it is in paragraph 36 of the plan. It is no wonder that those on the Labour Front Bench do not think that we have a plan if they cannot be bothered to read the plan that we have actually published.
James Murray
To be absolutely clear, the question that I was putting to the Minister was: where in the Bill is there a guarantee that a single penny of this new levy will go to social care?
Jesse Norman
The Bill is designed to fund the plan and the plan has been published. The plan is perfectly explicit as to where the money is going with regard to social care and how much is going to social care. It is in paragraph 36. The hon. Gentleman only needs to look at the plan to see it.
My hon. Friend the Member for Yeovil (Mr Fysh) tabled a probing amendment and explained the background to his own amendment 7, and I thank him for that. I mean him no disrespect when I say that the Government have taken the amendment on board, and will take it on board, but I still ask him to withdraw his amendment.
The hon. Member for Aberdeen South (Stephen Flynn) talked airily about unfunded social care plans controlled, as it were, by England over Scotland. Nothing could be further from the truth. The truth is that Scotland has social care plans that are underfunded. Audit Scotland said that more money was needed. The Independent Review of Adult Social Care in Scotland said that more money will need to be spent over the longer term. Unfortunately, he also ignores what has been accurately described by the Prime Minister as the Union dividend from which all the devolved Administrations will benefit.
My hon. Friend the Member for Amber Valley (Nigel Mills) asked the important question of why a new tax. It is important to focus on this. The reason there is a new tax is that this is a fundamental change in how we have been thinking about social care. Andrew Dilnot himself has said that he does not think it inappropriate to have a new tax funded to support this.
My right hon. Friend the Member for Wokingham (John Redwood) talked about Treasury concern with hypothecation, which remains intact. There is already an existing level of hypothecation within the national insurance contributions system and this plays off that. The hon. Member for Nottingham East (Nadia Whittome) went into a long diatribe, in which she accused the Government of seeking to protect the richest people in society, to which the only simple answer is that that is absolute nonsense. I think she missed the debate on Second Reading, but if she read the distributional analysis, she would see that this package means that the 20% of highest income households will contribute 40 times the amount contributed by the least well off 20% of households. It is also worth pointing out that the highest earning 14% will pay roughly half of all revenues. Even the Wealth Tax Commission, which is independent of Government and dedicated to the idea of arguing for a wealth tax, acknowledged that the UK is on par with G7 countries as regards a wealth tax. Under a more inclusive definition—one that includes, for example, stamp duty land tax—the UK is near the top of the G7 countries in terms of a wealth tax.
My right hon. Friend the Member for Wokingham talked about hypothecation; I perfectly understand that. He also mentioned gross net revenues. These are net revenues—revenues that have been calculated net of the effects. The detail is set out in the technical annex to the published plan.
The hon. Member for Leeds East (Richard Burgon) revisited some of the themes set out by the hon. Member for Nottingham East, but I am afraid no more persuasively.
My hon. Friend the Member for Christchurch (Sir Christopher Chope) went on a glorious canter, or possibly a ramble, around various public spending concerns. I fully appreciate his concerns. Very little of what he said actually bears direct relation to the levy, but let me address the parts that do. He asked why there is no distinct social care levy. Of course, it is possible to claim, as I did, that there is a need for greater integration between healthcare and social care, without suggesting that the funding for those things needs to be handled in exactly the same way across both. This provision blends the funding in a way that is felicitous for both elements.
My hon. Friend argued vigorously for co-payment. I take his arguments as I am sure he means them and look forward to seeing his Bill. He also mentioned millionaires in hospitals. He is right that maths is eternal; our noble Friend Lord Bethell may have been referring to the fact that calculations are not eternal, but may be in time and premature.
Sir Christopher Chope
In the Conservative party manifesto almost two years ago, we promised that we would reform social care at the same time as promising that we would not increase VAT, national insurance or any other taxes. If it had not been for the pandemic, how would we have dealt with the challenge of reforming social care without raising taxes? Surely one way of doing it would have been to reduce public expenditure elsewhere.
Jesse Norman
It is very hard for me to comment on such a remote hypothetical, but the fact of the matter is, as the Prime Minister said, no political party had a pandemic in their manifesto and we have to deal with the situation—
The Chairman of Ways and Means (Dame Eleanor Laing)
Order. I would be grateful if the Minister would address the Chair.
Jesse Norman
I am so sorry, Dame Eleanor. I am rightly chastised and thank you for that point.
My hon. Friend the Member for Christchurch asked why the Barnett formula applies and what will happen once it is abolished, but once again he takes the Committee to the outer reaches of speculation. The fact is that it does apply and it has thoroughly beneficial effects for the devolved Administrations as regards this piece of legislation.
With that, I ask those who have tabled amendments and new clauses to withdraw them. I commend the Bill to the House.
Question put and agreed to.
Clause 1 accordingly ordered to stand part of the Bill.
Clause 2
Destination of proceeds of health and social care levy
Amendment proposed: 4, page 2, line 29, leave out from “as” to end of line 30 and insert “determined jointly by the Treasury and the devolved governments of Scotland, Wales and Northern Ireland.”
The amendment would require joint agreement between the Treasury and the governments of Scotland, Wales and Northern Ireland as to how the levy proceeds are to be shared between the four areas and between health care and social care.—(Alison Thewliss.)
Question put, That the amendment be made.
Jesse Norman
I beg to move, That the Bill be now read the Third time.
I am grateful to all right hon. and hon. Members who have participated in the passage of this landmark legislation. I would like to remind the House, if I may, of the Bill’s provisions and its overarching goals. We may talk loosely of it as being based on national insurance contributions, or indeed as being a national insurance contributions Bill, but it is of course a separate Bill to introduce a 1.25% health and social care levy based on national insurance contributions.
The levy will be introduced in 2022. In 2022-23, it will be delivered through a temporary increase in NICs rates of 1.25% for one year only, with all revenues generated being ring-fenced and paid to NHS England, NHS Scotland, NHS Wales and the equivalent in Northern Ireland. Then, from April 2023, a formal legal surcharge of 1.25% will replace the temporary increase in NICs rates, with revenue ring-fenced for health and social care only. The levy will also then apply to those working who are over the state pension age.
The levy will enable the Government to tackle the backlog in the NHS. It will provide a new, permanent way to pay for the Government’s reforms to social care and will allow the Government to fund our vision for the future of health and social care in this country over the longer term.
I reiterate my sincere thanks to all Members who have engaged in our series of stimulating debates on the measure. I commend the Bill to the House.
James Murray
I thank the Clerks for their excellent and particularly rapid help with amendments to the Bill.
Today, the Government have been determined to push through their tax rise on working people and their jobs as quickly as they possibly can. The Bill contains nothing at all—not even a reference or mention—about a plan to fix social care, and it fails to guarantee that a single penny of the new levy will ever go towards the social care sector.
On Second Reading, the Opposition attempted to push for a guarantee that Parliament would vote on a social care plan before spending the money that the Bill raises. The Government rejected our attempt, and I am sure there are many Conservative Members who feel deeply uncomfortable about the position in which they find themselves.
While the Bill lacks a plan for social care or any commitment that a plan will ever be in place, or even that any of the money that the levy raises will ever go to social care, it does include a tax rise—a tax rise that hits working people and businesses creating jobs. We know what that will mean for people across the country: combined with the cut to universal credit and the freeze in personal allowances, hospitality workers, teaching assistants, supermarket workers and social care workers stand to lose more than £1,000 next year.
Members do not have to take my word for it. The Financial Secretary admitted the impact that this tax rise will have in his own tax information and impact note, which set out in no uncertain terms that people who are just about managing financially will see their disposable incomes fall. The Conservative party has united the Federation of Small Businesses, the British Chambers of Commerce and the CBI against its plans. They all agree that this represents a blow to jobs growth at a crucial point in the UK’s economic recovery. Last night, the Financial Times published its view that the “Tories must regain trust as the party of business”—which seems to be an understatement, to say the least.
The Government’s approach will hit businesses creating jobs, and it will disproportionately hit working families and young people. It will hit those on low and middle incomes. It will hit people in some parts of the country more than others. But when we tried to push Ministers in Committee to come clean about the unequal impact of their tax rise on different people and across the country, or to be transparent about how it would hit social care workers themselves, they refused. The Prime Minister, the Chancellor and the Conservative party simply have their fingers in their ears.
Finally, the Government have refused to accept throughout today’s debates, and indeed throughout the last week, that there is any alternative to their tax rise. The Prime Minister and the Chancellor are desperate to pretend that this is the only way to raise the money, and that simply is not true. A fairer approach to funding the NHS, social care and all our public services would see those with the broadest shoulders—including those with incomes from large financial assets and multiple rental properties, and other income from wealth—contributing more. The Government have refused to consider those options, and would prefer to hit workers instead.
The simple truth is that there is no plan to fix the crisis in social care. There is no plan to improve the pay and conditions of care workers, no guarantee that any of the money will go toward social care, no guarantee that people will not have to sell their homes for care, and no plan to clear the NHS waiting list backlog during the present Parliament. All that we have is a tax on working people and their jobs. It tells us everything we need to know about the instincts of the Tories when they are in power, and that is why we will be voting against this Bill.
Alison Thewliss (Glasgow Central) (SNP)
Let me first take the opportunity to thank the Clerks, who give us so much support in putting together amendments to the Bill, which arrived at such short notice. I thank Scott Taylor and Salma Saade in our research units, who also helped, and my hon. Friend the Member for Aberdeen South (Stephen Flynn), who did so much in Committee.
This is a Bill and a tax without a mandate, in Scotland or even in England, since it is a breach of a Tory manifesto pledge—a pledge reiterated by the Chancellor at the time of the Budget. The Health Secretary has said that it is for the Scottish Government ultimately to decide how money is spent, but the Prime Minister said that the UK would direct money raised by this levy to the devolved institutions, and the Chancellor is on record as saying that the UK Government have the right to do this. The truth—the legal truth, because it is in the Bill—is that the Treasury may determine how this money is spent in Scotland. That is a fundamental undermining of the devolution that we fought so hard to get. Within the Bill, Ministers can even change what they like in regulations later, so even what we agree today may not be the principles that the Government will go by later on.
This is a tax on the people of Scotland to pay for England’s social care crisis. It is a tax on young people and lower earners to pay for the wealthy. It is a tax on jobs, undermining recovery at a time when we need to be thinking about getting people into work, not making it harder for businesses to employ them. It is also a tax on the many who have been completely excluded from UK Government support throughout the pandemic and who are now going to be hit by this increase. It is also a power grab. It is another Tory power grab on devolution. This is not a Union dividend; it is a Union dead end, and we on the SNP Benches will not support this new Tory poll tax.
Question put, That the Bill be now read the Third time.
Business without Debate
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text
Delegated Legislation
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text
Madam Deputy Speaker (Dame Eleanor Laing)
With the leave of the House, we shall take motions 4 to 9 together.
Motion made, and Question put forthwith (Standing Order No. 118(6)),
Public Health
That the Health Protection (Coronavirus, Restrictions) (Steps etc.) (England) (Revocation and Amendment) Regulations 2021 (SI 2021, No. 848), dated 14 July 2021, a copy of which was laid before this House on 15 July, be approved.
That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) Regulations 2021 (SI 2021, No. 851), dated 15 July 2021, a copy of which was laid before this House on 15 July, be approved.
That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 2) Regulations 2021 (SI 2021, No. 864), dated 17 July 2021, a copy of which was laid before this House on 19 July, be approved.
International Immunities and Privileges
That the draft Conference of the Parties to the United Nations Framework Convention on Climate Change (Immunities and Privileges) Order 2021, which was laid before this House on 8 July, be approved.
Financial Services
That the Money Laundering and Terrorist Financing (Amendment) (No. 2) (High-Risk Countries) Regulations 2021 (SI 2021, No. 827), dated 12 July 2021, a copy of which was laid before this House on 12 July, be approved.
Licences and Licensing
That the draft Alcohol Licensing (Coronavirus) (Regulatory Easements) (Amendment) Regulations 2021, which were laid before this House on 8 June, be approved.—(Rebecca Harris.)
Question agreed to.
Petitions
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text
Stephen Morgan (Portsmouth South) (Lab)
I rise to present a petition on behalf of my constituents concerning the proposed AQUIND interconnector project, which has been signed by more than 6,000 local people. This is a sliding doors moment for the Business Secretary. He has a clear choice: he can either stop this disastrous project, which is mired in cronyism and would be deeply damaging to Portsmouth and our national security, or he can reject my great city’s clear and united opposition, and explain why decisions impacting local communities continue to be made behind closed doors in Whitehall. I urge the city council in Portsmouth to take every possible step if the Secretary of State’s decision, expected next month, goes against the people of Portsmouth. Tonight, in this House, I present 6,200 reasons why AQUIND must be stopped.
The petition states:
The petition of residents of the United Kingdom,
Declares that the planned AQUIND Interconnector Project should not be allowed to be implemented dye to the damage it would cause to the local community without clear benefits, further that the implementation could impact the wider environment; further that ongoing concerns remain surrounding the project company and their Directors.
The petitioners therefore request that the House of Commons urge the Government not to approve the AQUIND Interconnector Project.
And the petitioners remain, etc.
[P002686]
Haworth Post Office
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Robbie Moore (Keighley) (Con)
I rise to present a petition on behalf of my constituents in Haworth and the wider Worth valley to save Haworth’s much-loved post office. I would also like to draw the House’s attention to a separate petition on the same issue, which has been signed by 6,911 people and which I wish also formally to present tonight. I fully endorse these petitions, which state that the Post Office Ltd must not close Haworth post office on Main Street, which provides a service used by thousands of local people.
The petition states:
The petitioners therefore request that the House of Commons urge the Government to encourage Post Office Ltd to keep Haworth Post Office open.
And the petitioners remain, etc.
Following is the full text of the petition
[The petition of the residents of the constituency of Keighley and Ilkley,
Declares that the Haworth Post Office is a very busy post office and convenience shop needed not only by the elderly in the nearby flats but also by many of the businesses on Main Street itself; further that the elderly cannot walk down to the bottom of Haworth and need this facility; and further that many businesses use Main Street branch for parcels which we understand cannot be taken into the new co-op facility.
The petitioners therefore request that the House of Commons urge the Government to encourage Post Office Ltd to keep Haworth Post Office open.
And the petitioners remain, etc.
[P002688]
Scunthorpe Driving Theory Test Centre
(3 years, 3 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Holly Mumby-Croft (Scunthorpe) (Con)
I am thankful for the opportunity to hold this debate and to talk about the Driver and Vehicle Standards Agency’s decision to close Scunthorpe’s theory test centre. This decision affects both my constituency and that of my constituency neighbour, my hon. Friend the Member for Brigg and Goole (Andrew Percy). We work together when issues affect our areas and we are as one on this important issue. I thank him for his work, along with the many constituents and businesses that have contacted us both over recent weeks.
Before I start, I declare an interest: like very many others, I have a family member who is about to take their theory test.
Ever since theory tests were made mandatory in 1996, we have had a test centre on Doncaster Road in Scunthorpe, near Berkeley Circle. It has served residents and supported driving instructors and driving schools in Scunthorpe for generations. The staff there have worked incredibly hard to cater for the high demand that we have seen this year in particular. I did my own theory test there almost 20 years ago.
Over the summer, the news that the test centre was closing left residents frankly none too chuffed, and I am in agreement with them. It is absolute nonsense. As my hon. Friend the Minister knows, the service is run by the DVSA, so initially we approached its chief executive. My hon. Friend the Member for Brigg and Goole and I were both told that the closure was the result of a contractual change following a review of the allocation of centres nationally. I understand that this is an effort to create a more even distribution throughout the country, which is fine in theory, but it turns out not to be that good in practice for people who live in the Scunthorpe constituency.
We were told that the decision was based on the use of sophisticated population-mapping software, and that throughout the UK people will be able to travel to theory test centres within 40 miles if they live in a rural area and within 40 minutes if they live in an urban area. I am sure the Minister will comment further on that when she responds. To put it simply, it seems to me, reading between the lines, that a computer has had a crack at working it out and come up with the idea that my constituents can go to Grimsby, Doncaster or Hull for tests. I have even heard York suggested, which is particularly crackers.
Given that we are talking about residents who are not yet able to drive themselves, travelling to places other than Scunthorpe presents obvious problems. For example, a resident travelling from Scawby would need to take a 38-minute journey on the No. 4 bus into Scunthorpe town centre, then walk for seven minutes to Scunthorpe station, take a 39-minute train journey to Grimsby Town, and then walk for nine minutes to the theory test centre. When waiting times are taken into account, it is a journey of roughly two hours and 20 minutes each way. This means that one of my constituents might have to travel for up to four hours and 40 minutes to get their test—and it takes me only three and a half hours to drive from Scunthorpe all the way to Parliament.
From Howsham to a test centre, it is two hours and 18 minutes each way by bus and train; Cleatham residents will be set back three hours altogether; from Manton, it is a two-hour-and-40-minute journey to the Doncaster test centre; and from East Butterwick, it is 80 minutes via bus and train. I think most people would agree that those are ridiculous journeys for anyone to have to make to access a theory test—and nor is it practical when residents are given limited time slots in which to take their test at a busy test centre.
My constituency is a mix of rural and urban areas and, for us, being able to pass our driving test is a necessity, not a luxury. I have been contacted about this issue by instructors, disabled residents, young people and their parents, all of whom are concerned about the financial costs and wasted time resulting from the DVSA’s decision. In particular, a constituent has raised the worries of her partner. He has certain disabilities that she says would make him unable to make the journey to a test centre further away.
Even if residents are able to travel out of the county for a test, I have experimented multiple times trying to book one. You have to queue to get on the website and it repeatedly crashes. After you finally get past that stage, unsurprisingly, there is very little availability.
By taking away our test centre, the DVSA’s decision will slow down how quickly people can pass their tests and this will limit access to labour market opportunities. Even if residents are fortunate enough to have someone to drive them to their test appointment, it is not exactly smooth sailing.
One of my constituents got in touch with me just today to share her frustration at the current situation. Her daughter unfortunately failed her first theory test in Scunthorpe earlier in the summer and had to rebook to secure an appointment in Doncaster on 1 September. Having encountered traffic and parking issues on the journey, they ended up being 10 minutes late for the appointment, despite having set off an hour early. Her daughter was turned away, wasting time, fuel and a test slot—not to mention the time off work that mum had to take. Their next appointment—the first one they could get—is booked for the middle of October in Lincoln, 60 miles away. My constituent is planning a “test run” the weekend before to ensure that there is no repeat of the previous situation.
Martin Vickers (Cleethorpes) (Con)
I thank my hon. Friend for giving way and for the speech that she is giving, which highlights a growing problem. Being in the neighbouring constituency, many of my residents in Barton-Upon-Humber and the surrounding area want to use the Scunthorpe centre as it is more convenient. Does she agree that, when the Minister replies, we hope to hear the positive outcome that the Scunthorpe centre will be retained?
Holly Mumby-Croft
I wholeheartedly agree. We very much hope to have a positive outcome to this, as it is a genuine problem for residents in my constituency and in my hon. Friend’s constituency.
I cannot believe that the system developed by the DVSA has considered these common issues. Even people who can get a lift need a local, reliable option. I hope that the Minister will be sympathetic—I am sure she will be. This Government have spent tens of millions of pounds on levelling up areas such as Scunthorpe. We have secured £21 million locally in our towns fund deal and £10 million via the future high streets fund. Work has already started on a £50 million improvement to our hospital and, alongside the Humber freeport plans, we have seen huge investment over the past 18 months. I am really proud of the work that is being done with regional and national partners to secure these opportunities for residents in areas such as Scunthorpe. I am sure the Minister will agree that it is important for all residents to have the opportunity to benefit equally from the levelling up that we are seeing in those areas.
The locally elected Conservative councillors in Scunthorpe are also keen to keep this vital local facility. They have not sat around whingeing about the situation; they have put forward a really good solution. The leader of North Lincolnshire Council, Rob Waltham, stepped in and offered to provide an alternative location in Scunthorpe Central Library. When that offer was rejected, he came back with another suggestion, committing council staff to invigilate the tests.
We are doers in North Lincolnshire. If we had the computers and were given the instructions, we would do it ourselves, but, unfortunately, all these sensible suggestions have fallen on deaf ears. Every attempt that we have made to fix this situation has been unsuccessful. There has been no real justification, no meaningful engagement and no effort to understand how this will impact on people’s lives. There is a clear local need. The test centre serves 100,000 people at a time of continued and increased demand. Quite frankly, there simply is not any excuse to take our test centre away.
I have always believed in the spirit of working together with colleagues to benefit Scunthorpe. I know that, in all circumstances, Ministers such as my hon. Friend want to do all they can to help. Therefore, after a long day, I thank the Minister for her time and leave her with three clear requests. Please will she look into why all our reasonable attempts to improve the situation have been fobbed off, including North Lincolnshire Council’s offer to provide support? Please will she commit her Department to ask the DVSA urgently to review this decision, and meet me and my hon. Friend the Member for Brigg and Goole to discuss the issue? Lastly, please can she ensure that future decision making on this level will be subject to meaningful consultation and review, and take into account its real-life impact on local people?
The Parliamentary Under-Secretary of State for Transport (Rachel Maclean)
I thank my hon. Friend the Member for Scunthorpe (Holly Mumby-Croft) for securing this important debate. She is ably supported by my hon. Friend the Member for Brigg and Goole (Andrew Percy), who I understand has been very active on this issue. I also pay tribute to my hon. Friend the Member for Cleethorpes (Martin Vickers), who I am pleased to see in his place.
My hon. Friend the Member for Scunthorpe is right to draw the attention of the House to the real-life impact of these issues, because we are aware that they affect young people,; and we all know how much young people have been affected by the dreadful pandemic that we have all been suffering through. She is also right to draw our attention to the Government’s levelling-up agenda and the benefits that it has brought to her constituency. Of course, we all wholeheartedly support that. I will try to answer my hon. Friend’s questions and set out some of the detail behind the decision. As she knows, these matters fall under the responsibilities of our noble Friend Baroness Vere, who has written to my hon. Friend, but she would of course be delighted to meet her further to give her yet more details about the issue.
The requirement to undertake a driving theory test before a practical driving test is set out in the Motor Vehicles (Driving Licences) Regulations 1999. It is important to assess the learner’s knowledge and understanding of the rules of the road. The DVSA’s priority remains to deliver a theory test that ensures that candidates have the correct knowledge and understanding to be able to drive safely on our busy modern roads.
As my hon. Friend is aware, what has led to the situation in her constituency is that the DVSA has launched a new driving theory test service for England, Scotland and Wales. This service applies to theory tests taken from 6 September 2021. As she highlighted, in order to remove the dependency on a single contract and supplier, under the new system third-party suppliers will deliver the actual test to the public, so the DVSA has created a new test centre network that is divided into three geographical areas: region A covers Scotland, Northern Ireland, the north-west, the north-east, Yorkshire and the Humber; region B covers Wales, the west midlands, the south-west and the south-east; and region C covers the east midlands, the east of England and London. Under the new system, changes were inevitably made to the theory test centre estate when the contracts were awarded, but the DVSA has ensured that 100% of the population of Great Britain can travel to a theory test centre within 40 minutes or 40 miles.
Holly Mumby-Croft
I was born in Scunthorpe, and I have lived either in Scunthorpe or very locally to it for all of my life, so I can tell my hon. Friend that it is simply not the case that people in some of the further out areas of my constituency are able to access a theory test centre in the times that are being quoted by the DVSA. The on-the-ground situation is simply not in accordance with what the agency is saying.
Rachel Maclean
My hon. Friend is right to make reference to her local knowledge. I obviously do not represent Scunthorpe, so she is the expert on that. I assure her that the geographical criteria were calculated using industry-leading software—the same software that was used to determine the location of the Nightingale hospitals and vaccination centres to ensure that people had access to life-saving treatments.
Holly Mumby-Croft
I thank my hon. Friend for explaining the software. When software gives us information, but on a human level we can see that that information is not appropriate and the software has not worked, is there the possibility that a person could look at the details and perhaps overrule that decision?
Rachel Maclean
I applaud my hon. Friend for her determination in putting forward her constituents’ concerns. For the record, we know that Grimsby is 37 minutes or 27.5 miles via the A180 from Scunthorpe, or 38 minutes by train. Doncaster is 38 minutes or 25.7 miles away via the M180 or the A636, or 30 minutes by train. There are appointments next week in both Grimsby and Doncaster.
Holly Mumby-Croft
Yesterday I myself attempted to book appointments. I made multiple attempts on the website. There was a queuing system to get in so we watched a little man run across the screen until we got into the website. When we did, it repeatedly crashed. I have also tried previously to book appointments and it was incredibly difficult to find them, because these theory test centres are swamped with people from places like Barton-upon-Humber and my surrounding villages in Scunthorpe who are trying to get those appointments.
Rachel Maclean
Again, I absolutely commend my hon. Friend for raising the practical problems. I am of course sorry to hear that she has experienced that. We keep the whole system under review, because we want to have good availability for people to take these very important tests. If I may proceed with the rest of my remarks, perhaps that will help her to understand some of the context of the decisions.
It is right that we ensure that 100% of the population of Great Britain can travel to a theory test centre. That was the fundamental criterion. However, the contract has been awarded to more than one company, so the DVSA is able to increase accessibility to the theory test. That means that the number of theory test centres is increasing from 180 to 202 across Great Britain. That increased number of test centres has meant that there is a more even distribution of locations, which has made theory tests more accessible, especially to those in remote areas of the country.
However, as my hon. Friend highlighted, increasing a more even distribution made it inevitable that the location of some theory test centres would change. The DVSA appreciates that those who had a local theory test centre under the old arrangements would prefer, naturally, to have kept it under the new ones. However, the DVSA believes—as do I, of course, as a Minister—that the approach of ensuring that the ask is the same of all candidates across Great Britain is the fairest outcome. But I can assure her that as populations and road layouts change over time, the DVSA will continue to review the travel time and distance to understand whether any changes are needed to the test centre network.
My hon. Friend highlighted the test centre in her constituency that has closed. The nearest theory test centres for candidates in Scunthorpe are both within the performance measures. I appreciate that she has some concerns about that, but I set it out for the record. The travel distances to both those test centres are in line with those across Great Britain. There is strong availability for candidates, with over 1,000 test appointments at Grimsby and Doncaster in September, and there are plenty more slots available throughout October and November, so I do hope her constituents can book their tests. Most people only need to travel to the test centre once—hopefully they will pass—and other test centres available to service the area are located in Hull, York and Lincoln, which may suit some people but not all. Candidates can use the “Find a Theory Test Centre” service on gov.uk to locate an alternative centre.
I want to come on to the point that my hon. Friend made about the offer from her council. I very much appreciate that they are doers. I have seen that in all the work that she has done for the local area. She is a fantastic champion and she has got on and done so much already in the short time that she has been here. The council has put forward a suitable location in Scunthorpe. The DVSA appreciates this offer, but as it awarded three regional contracts for the conduct of the theory test some time ago, and testing has now begun under those contracts, it is not possible to change them. That means that the DVSA is unable to accept North Lincolnshire Council’s offer, as it could be challenged as changing the procurement rules under which the DVSA awarded the contracts. There could also be a risk of an allegation that the supplier in that region was effectively receiving state aid because it would potentially have reduced delivery costs—something not available to other suppliers.
I have listened to my hon. Friend’s concerns but I am confident that the new theory test arrangements give a good service for her constituents and a fairer service for everyone. I hope that with some of the engagement that have been able to give her today, and the offer of further engagement from my noble Friend, I have been able to offer some reassurance to address her concerns.
Question put and agreed to.
Draft Introduction and the Import of Cultural Goods (Revocation) Regulations 2021
(3 years, 3 months ago)
General CommitteesRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Chair
Before we begin, may I encourage Members to wear masks when they are not speaking, which is in line with current Government guidance and that of the House of Commons? Please also give other Members and staff space when seated and when entering and leaving the room. Members, please send your speaking notes by email to hansardnotes@parliament.uk. Similarly, officials in the Gallery should communicate electronically with Ministers.
The Minister for Digital and Culture (Caroline Dinenage)
I beg to move,
That the Committee has considered the draft Introduction and the Import of Cultural Goods (Revocation) Regulations 2021.
It is a great pleasure to serve under your chairmanship, Mr Hosie.
This short but important statutory instrument will bring clarity and certainty for the United Kingdom’s museums and art market. It will remove from the statute book those provisions of EU regulation on the introduction and the import of cultural goods that became UK law as retained EU law at the end of the transition period, but which are now either redundant or legally deficient. It will not affect existing provisions in UK law to protect cultural goods or our ability to tackle the illicit trade in cultural goods.
To put the instrument in context, EU regulation 2019/880 on the introduction and the import of cultural goods aims to tackle the illicit trade in cultural goods and to prevent the proceeds of that trade from being used to fund terrorism. The regulation came into force on 28 June 2019, but not all of its provisions became applicable on that date. In particular, one provision, known as “general prohibition”, which prohibits entry into the EU customs territory for cultural goods that were unlawfully removed from the country in which they were created or discovered, did not begin to apply until 28 December 2020. Provisions that require importers of certain cultural goods to present an import licence or an importer statement to guarantee the legal provenance of the goods will only become applicable from 28 June 2025 at the latest.
At the end of the transition period on 31 December 2020, only those provisions of EU law that had already become applicable by that date became UK law as retained EU law, that is those provisions which became applicable when the EU regulation came into force together with the “general prohibition” provision.
The provisions requiring import licences and importer statements did not become UK law, and there is therefore no legal obligation for us to implement them. We have always made it clear that we would not implement them if there was no legal obligation to do so. Many of the provisions are redundant, however, because they create obligations in relation to the EU or relate to measures to prepare for the introduction of import licences and importer statements. The “general prohibition” provision has become legally deficient and cannot be enforced in UK law. It relates to the “introduction of cultural goods”, which is defined in the regulation as
“entry into the customs territory of the Union”
and Great Britain is no longer part of the EU customs union, so it cannot be applied to Great Britain. We have therefore decided to address that legal deficiency and at the same time remove the redundant provisions from the statute book by revoking the regulation.
Why revoke the general prohibition for the rest of the UK? Even if the provision were not legally deficient in the manner I have described, it would still raise issues of concern and create complexity and confusion for importers and for our customs and border authorities. That confusion would arise because the provision applies to almost all cultural goods created or discovered in non-EU countries, regardless of their age, value or date of export. It would be possible to address those issues, but we consider that that is not necessary because we already have sufficient legal powers to tackle the illicit trade in cultural goods and the import of cultural goods that have been unlawfully removed from another country. Those powers are set out in existing domestic law and in some cases also derive from our obligations under international law.
The effectiveness of our existing legislation has been demonstrated very clearly. Even this year, in July, we returned to Bulgaria more than 1,000 archaelogical finds that had been looted and unlawfully removed from the country. They were found and detained by Border Force at Dover, and the person who attempted to import the goods was given a two-year prison sentence. Earlier this year, we also returned to Libya a statue that had been unlawfully removed from the country. It was found and detained by HMRC at Heathrow. Those are just a couple of recent examples, but in the past few years, thanks to the diligent efforts of our police, customs and border authorities, we have been able to return a significant number of cultural objects to the countries from which they were unlawfully removed. The prosecution of all those cases was possible using our existing law, without the need for the general prohibition in the EU regulation. In view of that, we consider the general prohibition to be unnecessary.
The change we are making today will provide clarity and certainty for those importing cultural goods into Great Britain, and it will ensure that there is no confusion as to the rules and requirements. Primarily, it will not mean that we are any less able to prevent the import of unlawfully removed cultural goods. For that reason, I commend the instrument to the Committee.
Alison McGovern (Wirral South) (Lab)
It is a pleasure to serve under your chairship, Mr Hosie.
I thank the Minister for her opening remarks, which explained the delegated legislation’s context. To many, it may seem that this is a niche subject, but the Minister and I believe that despite that, it is very, very important. We have a global role to play in the protection of our culture and history. As the Minister said, the diligent work of police forces and border authorities makes sure that the illicit trade in cultural artefacts can be stopped, and that is crucial. At the end of day, a visit to a museum tells our story and its artefacts are part of our culture and heritage that we wish to hand on to generations to come. The instrument before us is part of a legal structure that protects those artefacts.
It has been a very challenging year for everyone in the world of culture, so tidying some of the legal loose ends as a means to bring greater clarity is a good thing. Museums, art institutions and those in the art world badly need that clarity and stability. I hope that the instrument will play its part in delivering that.
We should be proactively trying to do better, however, and I wonder whether the Minister and the Department for Digital, Culture, Media and Sport have considered a Law Commission review, given the complexity of all the different regulations and the shift post-Brexit. Its purpose would be to bring together the myriad complex bits of relevant legislation. We ought to consider future legislation to provide a more simple and straightforward system of enforcement.
As I said, some people may consider that this instrument relates to a minor matter, but there is nothing more important than our history and heritage.
Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)
It is a great pleasure to serve under your chairmanship, Mr Hosie. I would have been tempted to vote against the regulations, but in the circumstances, I will settle for a short moan.
I agree with the Minister and the shadow spokesperson that the regulations relate to hugely important issues, first because they relate to the protection of valuable and culturally significant items and secondly, because they help to stymie the funding of terrorism and the activities of organised crime. However, the various criticisms of the draft instrument raised when it was debated in June in House of Lords are yet to be addressed. In that debate the process was described as rushed and the word used was “cavalier”, and I tend to agree with that criticism. In fact, we are only getting to debate the SI today because the Joint Committee on Statutory Instruments expressed concern about the use of the negative procedure. I think it is important that we have the opportunity to debate the instrument today.
Ministers are using a power to make technical fixes to retained EU law, but it has been acknowledged that it would have been open to them to make a small tweak to the retained EU regulations rather than repeal them entirely. What is suggested today is way beyond a technical fix—in some respects, it is a full-blown change in policy. Arguably, that change should not be made using such powers, and, indeed, made only after a thorough consultation and scrutiny of alternative proposals. Perhaps that should be conducted by the Law Commission, as the shadow Minister suggested.
I am happy to accept that there may be problems with the way in which the EU regulations operate, but they should be studied and detailed proposals for reform should be suggested, rather than the SI before us. Proper consultation and policy scrutiny would have avoided the various questions and issues raised in the other place. In fact, it is not even clear exactly how our rules and processes will differ after this SI comes into force, because our domestic laws will revert to depending upon a right hodgepodge of international conventions and different Acts of Parliament. The Minister said that the SI will provide clarity and certainty but actually complexity and confusion will come back into force.
As I understand it, the rules are not always brilliantly enforced in the UK and they require little by way of active checks. That brooks no criticism of those involved in the difficult work of enforcement, but it is a criticism of the hodgepodge of rules with which they have to contend.
Their lordships also highlighted that there will be different rules in different parts of the United Kingdom. Part of that difference is a legitimate function of devolution, but very significantly, part of that is a function of the Northern Ireland protocol, which has yet to be mentioned. It would be helpful to know how different will the respective regimes be in Northern Ireland and the rest of the UK. Is there not a danger that those differences risk providing a back door to certain illegal trade?
Regardless of that lack of clarity, there is a strong suggestion that we will revert to a slightly weaker system. An example provided by Blue Shield UK was cited in the House of Lords debate. It was argued that without the retention of the EU regulation, we will revert to a position where it would not be illegal to import into the UK an Egyptian cultural object on grounds that it was illegally exported from that country, despite Egypt having national legislation to that effect. Under the domestic regime to which we are reverting, one would have to show that that object was stolen for any problem to arise with its importation.
There seems to be a suggestion that we are reverting to rules that are different and weaker, and therefore at risk of damaging our reputation. My simple point is that before we go repealing EU regulations there should be proper consultation on what should replace them, and a consolidation of all domestic and international rules that apply here. In that way we can be clear about what exactly will be different about the new system, and we can scrutinise it properly.
I have had my moan and in the circumstances I will not press the matter to a vote, but I would be interested to hear what the Minister has to say in response to some of those questions and criticisms.
Caroline Dinenage
I thank both Members for their contributions, in particular the Opposition Front-Bench spokesperson for her support.
As I said in my opening remarks, the Government believe that the statutory instrument will provide clarity and certainty for the UK’s museums and the art market. This has been a difficult 20 months for them, and this change is something that we can do for them. It will allow them and their partners and clients to bring cultural objects into Great Britain without any unnecessary fear that they will be delayed or detained at the border because of any unsupported claim of unlawful removal from another country at some point in the distant past.
Myriad domestic law and international conventions apply, and it is a complex matter and something that the Law Commission may be requested to study at some point. However, our existing legislation offered robust protection to cultural good before the general prohibition provision came into effect. I cited two examples from just this year to show how that law continues to be effective.
In response to the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East, revoking the regulation will not mean that we cannot prevent unlawfully removed cultural goods from being imported into the UK. We already have the powers in domestic legislation to bear down on such illicit trade and to take proportionate action where it is necessary, and there is evidence that cultural goods found at our borders or in our country have been unlawfully removed. We feel that the powers are effective and in recent years we have returned a number of cultural goods to countries from which they had been unlawfully removed. There is absolutely no reason why that practice will not continue. In cases where an object raises concern, we can detain it and deal with it accordingly under existing powers and procedures.
In response to the hon. Gentleman’s query about Northern Ireland, the EU regulation will continue to apply directly to Northern Ireland by virtue of having been added to annex 2 of the Ireland/Northern Ireland protocol. The general prohibition already applies to the imports of cultural goods into Northern Ireland, including from Great Britain. The requirement for import licences and importer statements will also apply in due course, but revocation of the EU regulation from UK law will not affect that.
I commend the statutory instrument to the Committee.
Question put and agreed to.
Ministerial Corrections
(3 years, 3 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text
Education
(3 years, 3 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Sam Tarry
I wonder whether the Secretary of State and the Minister could aim higher in their grades next year. Last year we saw U-turns, not just on teacher assessments, but on the broken algorithm. Residents and teachers in Ilford South would really like some assurances in the year ahead that instead of dithering and delaying—like almost every other decision over the last 18 months—we will actually get clarity from the Education Secretary and his team, and that they will learn from their mistakes and provide a contingency plan in case exams cannot go ahead as normal in 2022.
Nick Gibb
It is, of course, our intention that exams will go ahead in 2022. They are the fairest method of assessing young people. As I have said, we have already announced the details of adaptations to those exams to ensure that they are fair. We are also working with Ofqual, as the hon. Gentleman would expect, on contingency plans in case it does not prove possible for exams to go ahead safely or fairly, and those plans will be published shortly.
[Official Report, 6 September 2021, Vol. 700, c. 6.]
Letter of correction from the Minister for School Standards, the right hon. Member for Bognor Regis and Littlehampton (Nick Gibb):
An error has been identified in my answer to the hon. Member for Ilford South (Sam Tarry).
The correct answer should have been:
Nick Gibb
It is, of course, our intention that exams will go ahead in 2022. They are the fairest method of assessing young people. As I have said, we have already consulted on the details of adaptations to those exams to ensure that they are fair. We are also working with Ofqual, as the hon. Gentleman would expect, on contingency plans in case it does not prove possible for exams to go ahead safely or fairly, and those plans will be published shortly.
Health and Social Care
(3 years, 3 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Mark Harper (Forest of Dean) (Con)
I listened carefully to the Minister’s answer to the Chair of the Health and Social Committee, and perhaps I may press him a little. He said that the Government have received only interim advice from the JCVI about the adult booster campaign, but this morning outside the House the Prime Minister said that the booster campaign would be going ahead and had already been approved. Have the Government received the final advice from the JCVI about the adult booster campaign, which it said could be different from its initial advice? Have the Government made a decision about the details of the adult booster campaign and whether it is indeed going ahead?
Nadhim Zahawi
I am grateful for my right hon. Friend’s important question. We have received interim advice from the Joint Committee on Vaccination and Immunisation, which we have published, and it has now received the Cov-Boost data. The interim advice was about vaccinating the most vulnerable with a booster for covid and for flu. It is advising a two-stage process, and stage one is to offer the booster vaccines to those in the old 1 to 4 cohorts plus the immunocompromised, and then to groups 5 to 9. That is the right way to proceed. We have not yet received its final advice. It could be different to the interim advice, but boosting preparations are well under way. Clearly that final advice is predicated on which vaccine delivers the highest level of protection and durability.
[Official Report, 13 September 2021, Vol. 700, c. 768.]
Letter of correction from the Minister for Covid Vaccine Deployment, the hon. Member for Stratford-on-Avon (Nadhim Zahawi):
An error has been identified in my response to my right hon. Friend the Member for Forest of Dean (Mr Harper).
The correct response should have been:
Nadhim Zahawi
I am grateful for my right hon. Friend’s important question. We have received interim advice from the Joint Committee on Vaccination and Immunisation, which we have published, and it has now received the Cov-Boost data. The interim advice was about vaccinating the most vulnerable with a booster for covid and for flu. It is advising a two-stage process, and stage one is to offer the booster vaccines to those in the old 1 to 4 cohorts plus the immunocompromised, and then to groups 5 to 9. That is the right way to proceed. As far as I am aware, we have not yet received its final advice. It could be different to the interim advice, but boosting preparations are well under way. Clearly that final advice is predicated on which vaccine delivers the highest level of protection and durability.
Building Safety Bill (Third sitting)
(3 years, 3 months ago)
Public Bill CommitteesRead Full debate Read Hansard Text
The Chair
Before we begin, I have a couple of preliminary announcements. I encourage Members to wear masks when they are not speaking, in line with Government guidance and that of the House of Commons Commission, and to give each other and members of staff space when seated and when entering and leaving the room. Hansard colleagues would be grateful if Members could email their speaking notes to hansardnotes@ parliament.uk. Please switch electronic devices to silent. Tea and coffee are not allowed during sittings.
We will now hear oral evidence from Sarah Albon, chief executive officer of the Health and Safety Executive; Peter Baker, chief inspector of buildings at the Health and Safety Executive; and Graham Russell, chief executive officer at the Office for Product Safety and Standards. Before I call the first Member to ask a question, I remind all Members that questions should be limited to matters within the scope of the Bill, and that we must stick to the timings in the programme motion that the Committee has agreed. For this session, we have until 10.15 am. May I start by asking the witnesses to introduce themselves for the record?
Peter Baker: Good morning, everyone. I am Peter Baker, chief inspector of buildings at the Health and Safety Executive.
Sarah Albon: Good morning, everyone. I am Sarah Albon, chief executive of the Health and Safety Executive.
Graham Russell: Good morning, everyone. I am Graham Russell, chief executive of the Office for Product Safety and Standards within the Department for Business, Energy and Industrial Strategy. I am responsible for building the construction products regulator.
Mike Amesbury (Weaver Vale) (Lab)
Q
Sarah Albon: That is a very broad question. I will bring Peter in on some of the technical aspects of scope. It gives us a real opportunity to take a holistic approach to the management of safety in buildings, from the very beginning of the design phase, through building and into occupation. It is important to recognise that although there is rightly a lot of focus on the taller buildings that are in scope for the special gateway process and the safety case process that will go on once buildings are in occupation, there are many other aspects in the Bill around improving the competence of those who work in the various aspects of the industry and in oversight of that, and around the wider built environment, that will apply to all buildings and all professionals working across the industry. It gives the foundation for a real sea change in the improvement of safety in the built environment in this country.
Peter Baker: To add to that, if you take a step back and look at the findings from Dame Judith Hackitt’s review about poor culture, attitude and behaviour of the industry, the lack of accountability of individuals, the lack of resident engagement, and all the things that were found to be wrong with the system as it stands, the Bill covers off all those points and, in fact, goes further in a number of areas. I am fairly confident that the Bill, as currently structured, addresses all the key points that Dame Judith raised in her report.
Graham Russell: If I may add to that, the products that go into those buildings are the foundation, if you will, of the safety approach, culture and regulation that we have just heard described. It is our responsibility to make sure that those products are what they say they are and that they are properly labelled and traceable, and the Bill makes provision for that through the schedule and then through statutory instruments.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
Q
Sarah Albon: I think there is always a balance between what industry needs to do and what the overarching regulatory regime seeks to do. From my perspective, it is important, in addressing the cultural issues, that we recognise that, ultimately, it is not the regulator or Government who will lead to a sea change in behaviour, but industry. It is therefore important that the responsibility for driving improvements, and for ensuring that people have the right kind of competence and do the right thing, rests squarely with industry, as well as the ownership of safety within individual buildings resting squarely with the owners of the buildings who are responsible for safety within them. They are the only people on the ground who can, day in, day out, ensure that things are being managed properly and that people are competent and are appropriately fulfilling their duties and obligations under the law.
Peter Baker: I would add that it will be set out in the legislation that a building safety manager is required. As Sarah said, the key thing for me—we have seen this with other workplace health and safety requirements—is that, although the building safety manager will have an important role on a day-to-day basis in effecting the safety, engaging with residents and so on, the accountability for the accountable person who is ultimately responsible for that building is not inadvertently delegated to the building safety manager, so that the BSM effectively takes on the ownership of the risk. That should be firmly with the accountable person, because they are the individual or the company that has the resources and the capability to really manage the risk.
Graham Russell: This is not an area for me.
Ms Rimmer
Q
Peter Baker: Having a competency framework is really quite important for a lot of the safety-critical roles in the regime, for a number of reasons. One is to make sure that there is a consistent level of competence, performance and behaviour among the individuals who undertake a lot of those important roles. That is not just the building safety manager but the client representative, the contractors and everyone involved in the lifecycle of a building.
A framework is key to ensure that the important things are part of a person’s training and induction. You would never be able to set a series of requirements to cover every aspect of a job, so a framework is an important first step, but it also provides flexibility for duty holders to have a whole range of other roles associated with that building safety function.
Ms Rimmer
Q
Sarah Albon: There are a number of new roles, as well as a requirement for increased competency and a range of other existing roles, that thread right the way through the Bill. It is inevitable that there will be a significant focus on the need to get new people to join various professions and to have training and experience available to people. It would be unrealistic to suggest that it will be without problem in terms of training and getting new people. Having said that, there has been a lot of notice that the new functions are coming, and there has been a lot of focus already in the industry on the need to improve the overall safety of buildings and the regime.
There is no reason why owners of buildings and senior people working in the industry need to wait for the Bill to be finished before they start driving up the skills and competence of the people working for them. Fundamentally, this piece of legislation will put in a new framework that requires people to meet certain standards, but they can be working on that already. Certainly, in the engagement that Peter and other colleagues from the HSE and the Department have had with the industry, we have encouraged and pushed them to get on with it and start ensuring that they have the right degree of skills available to them, and they are thinking now about who they need to train and how they need to support their staff with a view to the Bill coming in.
Peter Baker: One thing I would add is that a lot of organisations in the social and the private sectors already have individuals and companies that help them support the management of their buildings. I do not necessarily see the BSM role as something very new and necessarily too daunting. It can be part of a transition from what currently happens. If organisations are managing the risks in their buildings well through their existing arrangements, it could be quite an easy transition to the building safety manager role. I would stress, as I said, that it is key for the BSM not to be seen as the duty holder and to own the risk—that should firmly be with the accountable person to ensure the buildings are safe.
Ms Rimmer
Q
Peter Baker: Absolutely. Dame Judith recognised the need for cultural shift, particularly in the design, build and refurbishment of new builds. There are a number of provisions in the Bill around the gateways and the design and build, and there is a strong emphasis on improving competence right across the built environment. It is important to remember that the Building Safety Regulator will not just regulate high-rise buildings but will have other functions of stimulating and encouraging competence right across the built environment, which is one element of improving the culture of the construction industry and the landlord and housing provider industry.
Graham Russell: I think your point about culture goes right across the sector. What we have seen in evidence given to the public inquiry on Grenfell Tower and in other contexts reveals that a cultural shift is required. The points that colleagues have made about responsibility having to sit with the industry applies as much to the industry of creating the construction products as it does to the building industry—it is one system and one sector. It is clear to me that we must address those cultural issues. Regulation is important as it provides a framework and a set of expectations, but it is behaviours that have to change. In that sense, what we are embarking on through the Bill, and the work that we are doing with our colleagues, is addressing that culture.
Ian Byrne (Liverpool, West Derby) (Lab)
Q
Sarah Albon: I will try to answer on those different aspects. The first question was whether HSE is the right home for the new regulator. Whenever the Government consider setting a new regulatory framework, they need to consider whether it would be appropriate to set up an entirely new body or if an existing body has the requisite skills and competence to deliver. When thinking about that, a number of different aspects will be in officials’ and Ministers’ heads: they will need to think about the landscape of the existing bodies, the work that the existing bodies have on and any impact of taking on new responsibilities. There is often an advantage to be had in terms of speed of set-up if an existing body is used, as well as efficiencies in some of basic support services, such as not needing a second HR function or finance team.
In the HSE, we have a lot of experience in dealing with hazards and helping duty holders to really think through and manage the risks that are present in their environment, always with the onus being on the owners of the risk to manage it. That will fit well with the ethos of this new legislation—the real ownership of risk needs to sit with the owners of the buildings and they need to be held to account to ensure that they keep their buildings safe at all stages, from design all the way through to occupancy.
In the HSE, we have a lot of competence in dealing with that and with holding duty holders to account, as well as many years of working closely with the building industry through our role as a workplace regulator and thinking about the risky environment for people who work in the construction trades. We already have a lot of relationships, and the organisation has had success in significantly improving the safety of workers in the construction industry. For all of those reasons, it is entirely understandable that the Government look to HSE to set up this new regulatory function, and it is a decision that has the strong support of my board and senior executive team.
On resourcing, it is a new function and we will look for new resources. All public sector organisations are about to go through a spending round. We are aware that there may be real constraints, but my experience so far in working with the Ministry of Housing, Communities and Local Government has been that it has been able to prioritise this both in terms of the number of officials working on the Bill and directly. That is relevant to HSE in giving us the money that we need to establish the function and start working on it. It has been clear to me through the conversations that we have had with MHCLG officials about funding that this is a significant priority for Ministers and officials.
Do we have all of the competence that we need right now? We definitely need to build up more competence in fire risk assessment. We have started to do that: we have already recruited some people to assist us as gateway 1 went live, and we will continue to build on that level of expertise and recruit and train as the Bill goes through and we move into implementation.
Ian Byrne
Graham?
Graham Russell: It is not for me to comment on your question, apart from to say that I have worked with the HSE in various guises for 30 years and have the highest regard for its competency and abilities. Beyond that, I think the key question for me is the distinction between regulating products and regulating building safety. That was a decision that Dame Judith Hackitt gave advice on. She suggested separating that in the way that the Bill does, and that then leaves us with a responsibility. We are a product regulator—we regulate consumer products, machinery products and so on—so in that sense it brings our expertise to bear. We have the same challenges in building new competency in new areas, and we are working hard on that.
Brendan Clarke-Smith (Bassetlaw) (Con)
Q
Sarah Albon: I will probably bring Peter in to talk in a bit more detail. I think the broad answer is yes. I suppose that we intend to use the enforcement tools in the same way that we would want to use, and do use, the enforcement tools that we currently have. The best form of regulation is changing the behaviour of the duty holder so that they are doing the right thing in the first place. Clearly, it is important that you can and do take action when there has been a failure, but enforcement is necessarily always cleaning up after somebody has done something wrong. Our absolute focus and emphasis on workplace health and safety—it will be the same in this new regime—is to try to get duty holders to do the right thing in the first place so that residents and, currently, workers, are not put at risk awaiting enforcement requirements. Peter, do you want to say a bit more about the tools that will be available to you?
Peter Baker: We will have a mixture of both civil and criminal tools. We have been working very closely with MHCLG on the preparation of the Bill and the legislative package from our perspective, to make sure that a lot of the tools that we will have under the Bill reflect the sorts of enforcement tools that we have under the Health and Safety at Work etc. Act 1974, which are well tried and tested.
It is also important to remember that one of the step changes or real differences about the Bill in terms of regulation is the gateways. Unlike now, a duty holder will need to demonstrate at the pre-construction phase that they have all the wherewithal to build a safe building, and to demonstrate how they are going to comply with building regulations. The Building Safety Regulator will be able to say yes or no at that point and, potentially, prevent a development from going ahead unless all the necessary steps, safety management systems, and checks and balances are in place. It is not just a case of being able to serve enforcement notices, although they will be available to us; this is very much a permissioning regime similar to high hazard industries where the regulator can say yes or no at critical stages in the build and occupation of a building.
Brendan Clarke-Smith
Q
Peter Baker: We clearly will not know for certain until the Bill emerges from the parliamentary process but, as I say, we see this as a key step change in the regulatory regime, particularly in the occupation phase. It applies very clear responsibilities to the accountable person to manage the risk, and it leans very heavily on other major hazard industries and safety case regimes. In principle, the responsibility will be on the accountable person—the landlord, the building owner—to demonstrate to the regulator and other stakeholders, as part of a licensing and certification process, that they have identified the critical fire spread and structural risks in a building, that they have all the management systems that they need to manage those risks, and that, where they have identified gaps, they have a plan to fill them.
I also stress that this process is not just to satisfy the regulator and then to be put on a shelf. The safety case is going to be quite a fundamental part of a duty holder’s management system and of managing the risks associated with their building.
Shaun Bailey (West Bromwich West) (Con)
Q
Sarah Albon: If I can come to the second of those questions first, I guess that ensuring that the transition is as smooth as possible is about planning, but it is also about recognising that there are various aspects to the Building Safety Regulator, and we can bring on board those different aspects at different stages. We are already ramping up the engagement that we have with industry, for example. We are starting to do some key work reaching out to residents and resident groups, so that we have greater engagement with them and really understand the range of issues and concerns that they have, and so that those relationships are well built before the Bill goes live. Of course, the planning gateway 1 process has already gone live, so we are able to create the team around that and learn from it.
We have done various structural things within HSE, leaning heavily on our existing construction team, which has years of experience of working with the construction industry, influencing the importance of change not just day to day on different building sites but at a senior key level across the industry, and engaging with key players to ensure that that happens.
I confess that I have completely forgotten the first part of your question, so could remind me what it was?
Shaun Bailey
Q
Sarah Albon: As with anything else, there will obviously be some key measures of success on service delivery to those people who are trying to build and occupy buildings. You will be familiar with some of those from any other public service. That will be about the quality of the work we do and the speed at which we can turn things around, ensuring that we are not slowing things down, that people are still able to build high-quality buildings and to occupy them, and that we are giving the right kind of service.
Beyond those important day-to-day metrics, it will also be about looking back in a few years’ time and seeing that culture of safety in buildings as being as integral and as important to HSE as the culture of workplace safety that we have built over the years. Together with the board, we have already started to think about how we can ensure that there is as much emphasis on that aspect of the work as there is and has been for the past many decades on workplace health and safety.
Shaun Bailey
Does anyone else have anything to add to that comprehensive response?
Peter Baker: On the softer side of things, a measure of success for me, having had experience of introducing and improving our workplace health and safety regimes, is that engagement with the duty holders is absolutely key. They need to feel as though this is not being done to them but that they are engaged in and part of how this system is going to operate from day one. That is important. It is also crucial that residents feel that they are part of how this system is being developed and that we have engagement strategies associated with residents. We really need to build the confidence of residents in this system, and we have to see signs of that from a very early stage.
Daisy Cooper (St Albans) (LD)
Q
Sarah Albon: I think that some of our comfortable nature is probably from the way we have worked so closely with the Department as the thinking on the Bill has developed. We in HSE have certainly had considerable input and worked very closely with officials in the Department to help to frame the legislation and meet some of the challenges. I guess that part of our comfort is therefore from having worked on it now for a considerable time.
Inevitably, there are various other stakeholders who will have read the legislation for the first time relatively recently and will still be working through how it works. One key thing that we want to do as the legislation goes through and as we ramp up towards taking this role on is working with the stakeholder groups out there and helping them to understand how the legislation is intended to work and will work, how we will work as a regulator and what they need to do to make sure that the various roles within their organisation are appropriately filled and appropriately managed.
As Peter said, we are very clear that the overall responsibility has to sit with the accountable person. There are some other key appointments within the system, and they will need to make sure that they have the right people working for them, working directly in buildings and within their organisation. For us, the key success factor is that the accountable person needs to be the person who genuinely feels accountability for ensuring that the people who live in the buildings for which they are responsible are safe. They need to be able to take action to do that.
Daisy Cooper
Q
Peter Baker: As a regulator, having absolute clarity over who the duty holders are is key; clearly that is something that you have identified and need to explore through the parliamentary process. In terms of an outcome, it is right that the Bill needs to assign roles and responsibilities absolutely clearly. That is an outcome that I would expect, because at the end of the day I am going to be responsible for enforcing the legislative package.
Having said that, as this is starting to stray into all sorts of areas of building ownership and leasehold law, which is incredibly complex, I can understand—having been involved with MHCLG in developing the package—how difficult the challenge must be for the Bill writers to get this absolutely right. All I can say from my interactions with MHCLG is that it really has wrestled with all the issues and tried to make the duties and responsibilities as clear as it possibly can, but clearly that is something that your Committee will need to explore.
Daisy Cooper
Q
Peter Baker: My view is that MHCLG has done what it can to make the roles absolutely clear, as the Bill stands. The challenge is making sure, through guidance, support and engagement with all the stakeholders who will be touched by the Bill, that they understand the intention behind it all and the outcomes that we are trying to achieve.
The Chair
I think Graham Russell wants to come in.
Graham Russell: I was going to return to the very first part of Ms Cooper’s question, which was about the level of comfort we feel about the arrangements and the situation more generally. I do not think that “comfort” is a word that we have been using very much in either of our organisations about a situation in which, clearly, people have suffered enormously and the regulatory system has not protected people. That is why we are part of the mechanism that will deliver the Bill.
I think that it is incumbent on all of us to make significant change. We need a more robust regulatory system, better checks and a better testing environment, and we need to build the confidence that Peter has spoken about—confidence for residents, but also confidence for the industry that it is doing the right thing. We face a major challenge and the Bill is really important, but it is a framework.
In terms of the complexity of governance, obviously you have probed one particular part of that, but because this is a system that delivers safer outcomes, every part of that system must work. It is incumbent on us to make sure that it works, so we need to fit the different aspects together. From my point of view, that particularly includes local authorities and their ability to work closely on the ground with local suppliers, and the proof of that will be whether we can create and deliver a system and then give people confidence that that system is providing what has not been there in the past.
Ruth Cadbury (Brentford and Isleworth) (Lab)
Q
Peter Baker: The Building Safety Regulator will have an important role of encouraging competence right across the built environment, not just to do with high-rise residential buildings, although clearly the focus of the regulatory activity of the BSR will be on that area. We have already started work setting up an interim competence committee, ready for the statutory competence committee when the Bill receives Royal Assent and is implemented. We as the BSR will have an important role in holding the ring on all of the competence development work that the industry has been leading since Grenfell, and making sure that that is all absolutely proportionate—that it is targeted at the right activity and at the right people. We will have quite a key role in making sure that that whole system of competency across the built environment is appropriate.
When it comes to support, I can only talk from my own experience of competencies in other high hazard regimes. In the past, organisations such as the Construction Industry Training Board and sector skills councils have also played a really crucial role, both through supporting the regulator and supporting their industry sectors in developing the detail and the systems for ensuring those levels of competencies, as well as providing some suitable checks and balances so that the competence frameworks are absolutely targeted at the right thing and people do not waste time, effort and money improving competence in areas that are not necessary. It is a dual role for everybody associated with the built environment to really lean into improving the competence right across the sector, and that is not just for high-rise residential buildings: the same applies in the workplace, in terms of workplace safety and making sure that people are competent in that area.
Ruth Cadbury
Q
Sarah Albon: At the end of the day, as you say, we just have to accept the complexity in this country—and, I suppose, most developed countries. You could wish that everything was simple; for us as a regulator, and no doubt everybody else trying to regulate in that space, it would be so much easier to do that if the world were different, but the reality is that mixed use of buildings is probably more common than not, particularly in urban areas, and particularly in these larger buildings. It is not uncommon at all to see a mixture of commercial premises—some of which may be relatively hazardous in themselves, such as petrol stations—with residential and office premises. We must just accept that complexity, accept the facts and ensure that those who are responsible in those buildings know that that changes the hazard present and the risk profile in the building. It becomes even more important that people who have responsibilities in that space take them seriously and ensure that what they are doing is bespoke to their circumstances.
One of the reasons HSE is so keen on the safety case regime, which, as Peter said, we have operated successfully in various other high-hazard environments, is that it drives people’s responsibility for taking an approach that is not about saying, “Have I complied with a whole list of things I should comply with?”, but rather saying, “Have I thought seriously about safety in my environment and the things I am responsible for? For sure, if there is a list of things I need to comply with, that might be part of it, but have I really thought about what could go wrong? What are the factors that could create some kind of additional hazard? How am I managing those things, and how do I ensure that, every day, I am properly and proactively thinking about and taking care of the people for whose lives and wellbeing I am responsible?”.
Safety and safety management is not something you do once and then stick it in a file until you are reviewed; it is something you should be thinking about every day, all the time, because the hazards present and the behaviour of people in an environment are constantly changing. You need to manage safety in that environment of constant change, where different behaviours or threats could constantly come in.
Ruth Cadbury
Q
Sarah Albon: Judith Hackitt’s report showed that height is a reasonable proxy for there being additional risks that people need to think about. At the end of the day, a regime such as this needs to start somewhere, and we as the regulator need a manageable and understandable pool of the riskiest buildings, where our work can start. Also, we have been talking about the importance of duty holders understanding what they are obliged to do, whether they are inside or outside a regime. For all those reasons, height is a well understood and clean starting point, but the Bill envisages that over time it may be appropriate for Parliament to return to the question of what is within scope of the higher risk regime, and to think about changing the boundaries if new evidence comes to light.
Peter Baker: Other legislative provisions will still apply to a number of those buildings, particularly workplaces such as hospitals and hotels. The Regulatory Reform (Fire Safety) Order 2005, which is about to be amended by the Fire Safety Act 2021, will still apply, so the fire risk issues will already be dealt with through that provision. The Government have also extended the new regulatory regime to hospitals and care homes during the design and construction phase, to ensure that the buildings that emerge from new build and large-scale refurbishment processes are built to standard and are safe.
Graham Russell: The provisions for the construction products apply across all buildings. For example, on cladding, in terms of safety, it would not matter which building it was going on to.
The Chair
We have six minutes to go, and I have two people I still want to get in. That is just to alert you.
Siobhan Baillie (Stroud) (Con)
Q
Graham Russell: Hitherto, the broad product safety regime has not applied to construction products unless those construction products are also sold to consumers. The Bill seeks to address that, and to apply to construction projects the same principles and approach that apply to product safety, which, although they are not without problems, are building a good rate of success. I think that is right.
On the second part of your question, there is good practice in areas such as medicines and healthcare products. The great thing we see there is a risk-based approach in which we recognise that different products create different levels of risk, and we therefore regulate them differently and put in place additional requirements. In the construction products area, there has not been an effective underpinning of that system. Although the designated standards approach has sought to deal with the highest-risk products, we have not had an essential safety requirement that means that every product must be safe. The Bill provides for that, which is really important.
When we try to diagnose what has gone wrong in the past, we can sometimes see a latticework through which things are thought to have fallen. Whether that is right or wrong, if you have an essential safety requirement approach, you give people that opportunity. By having that requirement, you ensure that people cannot run to that place—every product must be sound. There are additional provisions for high-hazard and high-risk products, but you have that underpinning, and that is what the Bill provides.
Kate Osborne (Jarrow) (Lab)
Q
Sarah Albon: As Peter and I have both briefly said, we absolutely recognise the importance of residents’ voices. We have already started working with a small panel that can help us engage appropriately with residents. We will be reaching out much more formally in the coming weeks and months to a much wider group of residents, to fully understand what they need from us as the new regulator, and to understand how they want to work with us, how they need us to behave and how we can design the new regulatory regime in a way that has residents and their voices and needs at its heart. We absolutely recognise that that has been one of the failings in the past.
For us, that starts with listening, and making sure that, in as many different formats and locations as possible, we go to residents and hear what they think. We recognise that means we need to think about the different languages that are spoken and the accessibility issues.
It is very easy these days to assume that everybody is online and wants to email you, but we know that is not true. We are planning events in community locations, and are going to the residents. We recognise that one size does not fit all, because the resident community is as diverse as the population of the United Kingdom. We need to respect that and not impose our preferred ways of working and engaging on that group, but should rather let them come to us and shape how we work and engage, so that we hear from as many different voices as possible.
We have tried to do that over the years with workers, with a degree of success. That would be the analogy. When HSE goes to any business premises, it of course wants to speak to the managers and those who have responsibility for ensuring safety, but we also always try to engage directly with the workforce, so that we hear from them at first hand what it is like to be part of that work environment and can triangulate—can see if what we are being told by the duty holder matches up with the experience of the workers. That will be really important.
There is not just the business-to-business relationship of us talking to duty holders. We need to listen to the needs of residents and be responsive to them. Crucially, we need to take on board their feedback on their day-to-day experience of their duty holders, the way that their buildings are managed, and how they are kept safe in their homes.
Kate Osborne
Thank you. That is really helpful.
Peter Baker: The residents will be hardwired into our governance. We will have a residents panel under the Bill.
The Chair
I am afraid that brings us to the end of the time allotted for the Committee to ask questions. I thank our witnesses on behalf of the Committee.
Examination of Witnesses
Richard Silva and Kieran Walker gave evidence.
The Chair
We will now hear oral evidence from Richard Silva, executive director of Long Harbour, and from Kieran Walker, technical director of the Home Builders Federation. We have until 10.45 am for this session. I ask the witnesses to introduce themselves for the record.
Kieran Walker: Good morning, I am Kieran Walker, technical director for the Home Builders Federation. I have worked in the house building industry, most notably for public limited company house builders, for the last 17 years. I joined the HBF in the last two and a half years.
Richard Silva: Good morning. I am Richard Silva, the executive director of Long Harbour and our associated company, Home Ground. We invest in and manage 190,000 leasehold interests across England and Wales.
Daisy Cooper
Q
“We all know that these problems have been caused by historic regulatory failures, dating back decades. We need to be careful that the solution doesn’t simply absolve the Government of its responsibilities and pass them on to consumers, whether that’s existing or future residents.”
If that is not the solution, then what do you think the solution should be?
Richard Silva: Thank you for the question. It goes to the heart of our role in this sector. As a freeholder, we do not develop, build, design or sign off on these buildings. We effectively, under the new regime, take ownership of them post gateway 3, when they are fit for occupation. The Bill, in many respects, is an excellent starting point and provides a good framework for looking forward. The problem is, what are we going to do about the existing stock that is in a mess? Our view is, simply, that there are three areas where this should be addressed.
The Government should be commended for trying to fix a problem that successive Governments have caused through a defective regulatory regime, whether that is from a construction perspective, or by signing off on materials and building systems. In that context, I think the Government should underwrite the process of fixing the existing stock.
That is not to say that taxpayers should foot the bill for everything. The Government should take responsibility —they are starting to do that through the presentation of this Bill—and then look at recourse from those who created the mess. The Government’s culpability lies in the regulatory regime and the failure there, although there are bad actors in the construction industry and the product manufacturing industry, and the Government should go after them to recoup as much of the investment as needed to bring existing stock up to standard.
There is a final and third point that will be less popular from a leaseholder perspective, but it is important to articulate. When investigations are made into an unsafe cladding system in a defective building, and the cladding is taken off, other historical problems will be identified. Not all of those are caused by shoddy workmanship or defective materials; they may be due to a lack of investment in the life cycle and maintenance of those buildings. We advocate a mandatory reserve regime—a bit like in the States—in which a periodic assessment is carried out independently, not by the managing agent or building owner, which in this context could be a commonhold association, a residents’ management company or right-to-manage company, or a freeholder, but by an independent assessor, who looks at short, medium and long-term requirements for reserve funding and regular life cycle maintenance for that building. The leaseholders then contribute to that over the super-long term, based on various apportionments under the service charge regime.
This is a long-winded answer, but it is an important point. For example, every 25 years, a block of flats will need a new roof; it is not a building safety issue, but a maintenance issue. If someone lives in that block for 20 years and then sells, but no provision has been made, is it fair for the buyer to be hit with a massive bill a few years later, when they have not enjoyed the life cycle of living there? Anyone who owns a property should make that provision, and it should be mandated as opposed to voluntary.
Mike Amesbury
Q
Richard Silva: If you are referring to whether building owners should pay to fix the existing stock, a distinction should be drawn between the responsibility for maintaining the existing stock and the liability to pay; I covered the liability to pay in my previous answer. The responsibility should absolutely lie with the accountable person, under the new regime. Historically, the accountable person has been either the freeholder, where there is a two party lease, or, where the building is resident-controlled—as roughly two thirds of our portfolio is—the RMC or the RTM. In the future, when the Law Commission’s proposals are brought into legislation, it could be the commonhold association. They are responsible, with emphasis on the word “responsibility”, for the maintenance and repair of buildings. It is a complicated answer, but it does go to the Building Safety Bill, and the question of who will be accountable in the future.
It is an interesting debate. We have to ask ourselves whether members of an RMC or a commonhold association have time, expertise and willingness to do that work. Certainly, our research suggests that people do not want to do it, for a whole bunch of reasons. Forget criminal and civil liability—it is about having the time. People have other things to do. In the context of the Bill, among the wider Government reforms on leasehold, we need to focus on the fact that the role of the freeholder will become redundant. That is unambiguous from the leasehold reform agenda proposed. That means that the work done by my building safety team—it includes chartered fire engineers and surveyors—for the leaseholders and at no cost to them, save a modest ground rent, will become redundant. So this part of the Bill needs to be really carefully looked at. Who wants to do this role, absent the professional landlord?
Kieran Walker: I would be inclined to agree with Richard on the accountable persons piece, moving forward. If I understood the question correctly, you are really asking whether costs are fair and proportionate for historical issues and for historical defective buildings. It is very difficult to answer, if I am honest with you. As has been mentioned already this morning, you have some really good practice going on in the industry in terms of the developers and construction companies, and you have some culprits in there as well. We know that as a trade body and as an industry. Similarly, the manufacturing process and the manufacturing companies also have some culprits.
It is difficult, therefore, to nail down whether costs are fair and proportionate. Obviously, as of next year, our industry will feel the impact of the residential property developer tax, as well as the building safety levy. Time will tell whether that is fair and proportionate. Obviously, the building safety levy is subject to consultation at the moment. I think that closes in mid-October and we are busily compiling responses to it. Within that scenario, some companies, responsible persons and organisations will pay part of, some of or none of the building safety levy, while others will pay the full residential property developer tax as well.
Time will tell whether costs are fair and proportionate, but I certainly think that things are moving in the right direction in respect of the Bill itself and in terms of levying costs.
Ms Rimmer
Q
Richard Silva: It is a very good point. We engage with a lot of the managing agents who manage our blocks on a day-to-day basis and I think that there needs to be clarity on this point in the Bill. A separate regime for levying a charge to residents living in a block comes with cost and complexity; people need to understand what it is for.
It is a difficult one. There is service charge legislation in existence. There is a regime for it, with all of the reasonableness tests, information, budgeting, finalising of accounts and so on. I think that is probably quite a neat place for the building safety charge to become a specific sub-item within the overall service charge budget. Then, you are not really giving residents extra information—they are not understanding what the extra charge is really for—and it also helps to mask any chasm that might be in place between life-cycle maintenance and building safety maintenance, and where there is a crossover. It can become a bit ambiguous.
So long as the regime is clear, understood and, frankly, does not increase the financial burden on people living in their own homes, that is where the focus should be.
Ms Rimmer
Q
Richard Silva: The way that I read the Bill, the historical costs are, to be frank, left firmly at the door of the leaseholders, so it does not protect them at all. Again, this goes back to my first answer to Daisy Cooper: there are probably more equitable ways of trying to get the existing stock up to scratch.
Once all of the stock is where it should be, with a full suite of goals and a set of further information, with a clear and unambiguous accountable person and a building safety manager appointed—let us assume that it will take 10 or 15 years to get all of that infrastructure in place for existing stock—I think that the regulator’s role will cover all stock, whether existing or new build. But the transition period is really important—there is not enough clarity in the Bill, frankly.
Ms Rimmer
Q
Richard Silva: There is lack of detail at this stage. Clearly, the service charge legislation gives residents that means of redress and the ability to query and question stuff. If that is replicated in the building safety charge regime, wherever that sits ultimately, whether in this Bill or other existing legislation, hopefully that will be fit for purpose.
Theo Clarke (Stafford) (Con)
Q
Richard Silva: The Bill is an excellent framework in lots of different areas, but it is a framework. As Justin Bates said in his evidence last week, it is a good and admirable starting point but there are lots of areas, lots of limbs within the Bill, that, quite understandably, because we cannot foresee every situation, will need to be dealt with as specific areas are developed and understood, consultations undertaken, experts work with MHCLG officials, and so on, to bring precise details of policy forward. I am not an expert in the certification and qualifications arena, but you have heard from the previous panel and you had fire experts last week.
What I do know is that, in our business, meaningfully and more explicitly post Grenfell, but for longer than that— in our resident engagements, we interact with 90,000 residents every year at some level—we have put in place a specific and dedicated fire life safety team in HomeGround. In that team, there are chartered fire surveyors, ex-London Fire Brigade officers, building surveyors and a small legal team. Their role, in collaboration with our estates management team, is to work closely together.
Our estates management team will basically audit all the managing agents who are responsible for the day-to-day running of our blocks around the country. Where there are clearly some deficiencies in, for example, fire risk assessments or, frankly, poor stewardship by the managing agent—that happens in all industries—our fire life safety team will go in and work with the managing agent to put special measures in place to get that building fit for purpose. That comes at a cost. Some of these things, by the way, are just bad life-cycle maintenance stuff—things that should have been replaced five years ago. That is a legitimate cost for the residents who live there.
That team has been inundated over the past 18 months. We have been trying to secure funding from the building safety fund and the ACM cladding remediation fund, which are very welcome funding pools, to get the bigger picture and to get the higher-risk buildings fixed. We have gone out and hired the best people we can find—by the way, it is a tough market out there, because not a lot of people are qualified to do a lot of this stuff—but until there are more specific guidelines from the regulator and the regulatory regime on what the qualifications need to be, I do not know whether they are fully qualified or not.
Kieran Walker: I would reinforce the point that Richard has just made. As we have seen with the communal wall service—the EWS1 form and the cladding external wall system—and its evolution since July 2019, it has been difficult to get hold not only of people but of people who can then be insured to carry out things like EWS1 surveys or fire assessments in the first place. There is a real shortage of people out there who are able to undertake that. Again, to reinforce Richard’s point, it is quite ambiguous as to exactly what qualifications are needed/accepted if we are going to undertake the assessments.
Theo Clarke
Q
Kieran Walker: For me, our membership and our industry, it would be the gateway 2 side. The Bill proposes that all information for gateway 2—meaning, in effect, post-planning, post-reconstruction and moving to detailed design—be submitted early doors, at the initial stage. Historically, the industry works with a number of contractors, suppliers and designers, and tenders information on a live basis. In order to get all that information delivered up front as developers enter gateway 2, quite a bit of information will have to be designed and procured at risk during that transition between gateway 1 approval and going to gateway 2. Within that, given the subcontractor market and potential changes in materials due to imports, exports and price fluctuations, you could end up having to revisit change management and the gateway 2 process and to go almost in a circular manner back to the regulator to seek change and improvements.
We would like to see—as we currently see, to a certain extent—a number of approved inspectors in the industry where we have a staged planned submission and staged planned approval process based on your sub-structure, superstructure, finishing trades, mechanical, electrical, finishes and cladding.
Ian Byrne
Q
Kieran Walker: I will answer the first question first, if I may. I certainly think that the Bill will change the culture of the industry and make clearer the key stages— the milestones—for people in the process of building the buildings in scope or tall buildings. In the past, quite ambiguous information has been submitted and responded to in the planning stage, which does not necessarily regulate, mandate or cover key items such as vehicle access tracking or incumbent water pressures in the proximity of those buildings.
Within gateway 2, I think we will see a lot more stringent approaches to material information and detail design being submitted to the regulator. That is a positive thing. In terms of duty holders and clear lines of responsibility, I definitely think that that is positive. As an industry, we support that clarity and those clear and mandated lines of responsibility and communication. I think we will see an improvement in the industry as a whole, and the key to that is the fact that we have this clear framework.
It is difficult to answer your question about special purpose vehicles, to be honest. I am not trying to avoid an answer, but we do not necessarily have much information on special purpose vehicles. How they are regulated and administered is quite varied. We have worked with a number of special purpose vehicles in the past, but going back to my first point, I think that the Bill will make lines of responsibility and regulation a lot clearer for them, to avoid the potential and opportunity for them to disappear as soon as the keys are handed over to the final property in the block.
Ian Byrne
Q
Richard Silva: On the second point about the special purpose vehicles, whoever incorporates an SPV to develop a higher-risk project that the Bill is aimed at, ultimately the regulator will say yes or no. It is the regulator and the regulatory regimes for gateways 1, 2 and probably 3 —fit for occupation—that will ultimately say, “Yes, this process has worked. That SPV is fit for purpose and will deliver a solid product.”
The problem is what happens in the future if, God forbid, something slips through the net of the regulatory regime or fails. When these things do fail, you know about it only over time. The Bill extends the provisions of the Defective Premises Act 1972 so that you have 15 years to go after developers, as opposed to six. That is all well and good, but in the real world it will have limited or minimal impact—it will be the same—for anybody who needs to take advantage of that new provision.
The Bill’s proposed regulatory regime is robust—details will follow, obviously—but ultimately, the regulator can have sanctions on it. If a large plc housebuilder that has, historically, built mixed-used, large-scale developments—high-risk buildings, in the context of the Bill—through a series of SPVs, the regulator will have to have an opinion on that, I am afraid.
Selaine Saxby (North Devon) (Con)
Q
Kieran Walker: I think the key lessons are really about getting information and clear lines of communication as quickly as possible. The introduction of the Bill is, as I have mentioned, welcomed by our members and the industry as a whole, because it gives clear a framework and responsibility for duty holders, as well as a process that I do not think we have had in the past. I do not think that is necessarily the fault of industry. In the past, it has almost been an assumption that A will follow B will follow C—that is part of the lessons learned. Mistakes have been made in the past, not just in the house building industry but across the piece, to be honest. The main lesson learned is that we should perhaps have had that framework sooner, but hindsight is a wonderful thing—we are where we are in that respect. Would you mind repeating the second part of the question, please?
Selaine Saxby
Q
Kieran Walker: I think resource and expertise are a big part of this, as is generally having clear and defined methods and processes in perpetuity for the handover of buildings. In the past, we have seen quite loose arrangements in that respect, from developers to management agents. I also think that expertise and training the skills in the sector are important, not just in the latter ends of the building management side, but within local planning authorities, so that planning officers and planning departments understand better the implications of tall buildings, whether from an access perspective, an evacuation perspective or any other matter.
In the detailed design phase, as we will see moving forward, we will need to upskill very rapidly the expertise and resource within the regulator itself, because it is a very complex niche of the market—tall buildings, fire and structure are not just a black-and-white area; it can be quite grey. The upskilling of the workforce, from professionals right down to skilled trades, is one lesson that I think we can all learn.
Kate Osborne
Q
Kieran Walker: There could be more—I would be keen to see more and our industry would be keen to see more. There is probably more to come through secondary legislation on the duties of key roles and responsibilities, as well as on the golden thread. I agree that we could see more there.
Kate Osborne
Q
Kieran Walker: Subject to resource and expertise being there from the regulator’s perspective, I think the industry is ready. Gateway 1—the planning stage gateway—was introduced on 1 August. Developers that are now constructing or going through planning submissions, or that are in the planning process, will be complying with gateway 1 as we understand it. I am not seeing that developers are suddenly baulking at the issues. A lot of the information in gateway 1—
The Chair
Order. Kieran, I am sorry to cut across you, but I am afraid that that brings us to the end of the time allocated for the Committee to ask questions. I thank our witnesses on behalf of the Committee.
Examination of Witnesses
Councillor Jayne McCoy and Andrew Bulmer gave evidence.
The Chair
We will now hear oral evidence from Councillor Jayne McCoy, deputy leader of Sutton Council and chair of the Housing, Economy and Business Committee of London Councils, and from Andrew Bulmer, chief executive of the Institute of Residential Property Management. For this session, we have until 11.25 am. Please will the witnesses introduce themselves for the record, starting with Andrew, remotely?
Andrew Bulmer: Andrew Bulmer, chief executive of the Institute of Residential Property Management. The IRPM is a professional body of 5,000 members who are qualified to various levels from level 2 to level 4. They manage big scary residential buildings, both leasehold and in the build-to-rent sector. We do not have firms as members. Our membership is confined to individual professionals.
Councillor McCoy: Good morning, I am Jayne McCoy. I am here representing London Councils.
Daisy Cooper
Q
Daisy Cooper
Jayne first, please.
Councillor McCoy: London Councils feels that the scope of the Bill needs to be expanded. We think that the focus on height is a rather rough approximation of risk. As we know from experiences in Bolton, in Samuel Garside House in Barking and Dagenham, and in my ward, Worcester Park, we have had fires in buildings under 18 metres that would have resulted in loss of life if it had not been for luck—it was a matter of minutes. We know that there are fire safety risks in buildings under 18 metres. We think that height should not be the only approximation for risk.
We think all new buildings—so all heights—should be covered by the Bill. For remediation purposes, we think a risk assessment tool should be applied to look at the holistic assessment of a building. I think a tool is being developed in response to the Fire Safety Act that could be adapted and used for this measure.
Andrew Bulmer: In conjunction with the Fire Safety Act and noting that this Bill now extends its tentacles to below 18 metres for some limited functions—fire risk assessments and identification of a responsible person—the scope of the Bill is wider than it was and I feel it is a good place to start.
Mike Amesbury
Q
Councillor McCoy: A lot of additional clarification is needed regarding the accountable person, the building safety manager and their responsibilities. A lot of detail is required. We need that detail and clarification because the industry, including councils in particular, needs to gear up to meet those responsibilities. Until they know what those responsibilities are, they cannot effectively gear up and commit the resources.
In particular, I would talk about the skills within building safety management. There is a lack of skills out there at the moment. There is a lack of resource out there at the moment. We cannot recruit as a council. My council cannot recruit to building control at the moment because people are not out there. Until we have clarification about what the skills are, and a framework for that, we cannot build up the capacity and skills needed. I would also flag that councils need the resources to be able to do that, because an awful lot of burdens are falling on councils.
Andrew Bulmer: I concur with the councillor. There is a lot of detail in the regulations, especially when it comes to the role of the building safety manager. We would like to see the regulations brought forward. They can either go in the Bill or be introduced promptly. Until then, we are operating a little one-handed. We are anxious to prepare and gear up for this, but without that information we are struggling.
That is one thing that is missing from the Bill; the other is protection for leaseholders from historical building safety defect costs. We understand that the Bill has to be written in a way that allows the reasonable costs of safety maintenance going forward to be recovered. That is fair and reasonable, but at the moment there is no protection for leaseholders from existing building safety failures that they did not cause.
Ms Rimmer
Q
Councillor McCoy: We have some concerns. You are right that timeliness is key. It reflects the points that I made earlier about having time for industry to gear up. There needs to be a proper, informed transition period. That is London Councils’ view. There needs to be a transition period that allows time for the capacity to be built. It needs to be fully funded, and there needs to be prioritisation within it. Obviously, we are very keen to see the safety measures implemented as soon as possible, but there needs to be a prioritisation of high-risk buildings in the meantime. That goes back to a holistic assessment of those buildings. We think that we need a transition period of about five years, and we need that clarity as soon as possible.
Andrew Bulmer: I am relatively unexercised about whether it is done through enabling legislation or written in from day one; what I am exercised about is getting the regulations delivered quickly. We are trying to prepare for the future regime. Dame Judith Hackitt called for a culture change and we, as an organisation, are driving that hard into our membership. They are receptive, and wish to adapt and move to the new regime as quickly as they can. It is difficult to prepare without the information, so I am less concerned about the mechanism; I am just concerned that we need to see the rules.
Ruth Cadbury
Q
Andrew Bulmer: I will lead with that one, Chair. I think that question was directed at me. I will come back to what needs to be in the Bill. The commentary behind this is that there is a clear and understandable push through the Law Commission and through the work being done by Government to vest the freehold or commonhold interest or the management of the development in the hands of the residents themselves, who thereby have democratic control over their development, and we find the logic of that compelling. The challenge is that it means those residents will be in charge of their own affairs. We can see in the example of Miami—the building that collapsed there—that the residents association was challenged in terms of its competence to manage the building safely. That does not mean that we abandon the adventure. I think we progress with it, but we progress with our eyes open and that means we have to support those directors.
I would like to see a support mechanism for directors who wish to actively manage their own affairs, so they can feel supported and get guidance where they need it. There would also need to be support for those directors in terms of quality assurance of their suppliers. For building safety managers, for example, it is important there is some form of a register of quality assurance. We would like to see the managing agents they will depend on being regulated as per Lord Best’s RoPA report.
In the Bill, there would need to be the option for directors to decide if they choose—purely optional—to appoint an external director to take on the role of the AP or principal accountable person. The danger is that lay directors will look at the risks involved, and they will all step back and not take up directorships. That is already happening and is already a significant problem.
Every property manager will tell you that it is difficult to get directors to come forward these days as the responsibilities become clear. When the responsibilities of the Building Safety Bill are made clear to those directors, we expect it will be difficult to get people to take up those responsibilities voluntarily, unpaid and without the necessary expertise or competence to fulfil them. The ability to appoint an external director would be likely to mean overriding the articles of association of the development and implying covenants into the leases to enable the external director to be paid for. It would require protections for leaseholders from a director who went rogue. These provisions would need to be in the Bill to enable leaseholders to outsource their responsibilities to a professional if they chose to do so.
Daisy Cooper
Q
Councillor McCoy: Yes, London Councils and the Local Government Association have worked with MHCLG all through the process since the Grenfell Tower tragedy to help shape the legislation. Obviously, a lot of the time we are responding to things, but we are trying to feed in and push. I would flag up at this point that London Councils would like to see a wholesale review of the building regulation framework.
At the moment, the Bill addresses and improves the existing regulation. We have been pushing quite hard for a wholesale review across all the legislation, which is a bit more in line with the Dame Judith Hackitt report. However, we have been working closely throughout to assist and get the best out of this, and, yes, we have been working with the Health and Safety Executive. We are quite pleased with our progress so far and the way it has been coming across to the HSE.
We would like to see a requirement that the HSE works with the local authority’s building control regulator, local councils and the fire authority in the first instance—that they call on their expertise—because that helps us as London Councils to build our capacity and resources. That is important, as are the resources to go with it, and I do not think we have had any firm commitments to those resources. We keep making the case that we are going to need to bring those resources forward. I would just emphasise that making this Bill deliverable and achieving its aims of improving building safety cannot be done without the staff and skills required, and we cannot upskill without the funding to do that. To make it practically deliverable, it needs to be fully funded.
Ruth Cadbury
Q
Andrew Bulmer: The wider comment on the PI insurance market is that it is in serious difficulty, and has been for some time. Any professional who is giving advice on building safety, especially fire safety matters, is having their premiums either severely increased, cover withdrawn entirely, or significant restrictions placed upon them, so accessing any professional on a fire safety matter at the moment is problematic. You used the phrase “duty holder”: if that were to refer to an RMC, for example, I cannot comment on PI insurance for RMCs. I think that is something that requires further investigation.
Ruth Cadbury
Q
Andrew Bulmer: I see problems arising in so far as it is complex, and I can see litigation taking place as to who is the principal accountable person. That said, I am struggling to see what a better model could be. We may have to live with the complexity.
Mike Amesbury
Q
Councillor McCoy: Yes, particularly in relation to the scope of buildings within the gateway scheme. At the moment, buildings that followed a permitted development are not covered by that, so we particularly want to make sure that all buildings are covered by the gateway process, otherwise a raft of buildings are out of that scope. It also needs to align with any future legislation: the planning reform White Paper contains some serious concerns for us, because it effectively puts swathes of large areas into permitted development and takes them out of the regime. The gateways have to apply to all buildings, or all new buildings.
Rachel Hopkins (Luton South) (Lab)
Q
Andrew Bulmer: The building safety charge is problematic. The fact that payment can be demanded within only 28 days will make it difficult for a leaseholder to investigate and mount a challenge. You should not challenge until you have sought further understanding. Then, if you are not happy with the information that you have, you need to mount a challenge, but 28 days is not long, so there is a problem with that.
The building safety charge itself is a flawed concept and we would like to see it gone. Running a separate service charge regime means that there will be additional tasks, which means additional costs, and it will be the leaseholders that end up paying for that. Introducing a new regime also introduces a lawyers’ charter. The existing service charge regime is decades old. For many decades we have found ourselves testing the meaning of words in different circumstances, and much of service charge law is case law. If we introduce a new regime, we restart the clock.
Also, we have an existing service charge regime, which I know is not perfect—far from it—but health and safety matters will be included in that, so we will be in a situation where the resident will receive two different bills: the building safety charge for health and safety, fire safety and structural, and then another bill for a whole service charge, which will include other health and safety works, as well as any remediation that the building safety charge regime has brought up. The consumer will be nothing but confused while paying for a more expansive and complex regime. What I would prefer to see in the Bill is the existing service charge regime finessed in a way that brings more standardisation and clarity to the consumer about what the Bill includes.
Ian Byrne
Q
Andrew Bulmer: If you have a professional third-party landlord, it would be reasonable; that is their job. If you are a lay director of an RMC and you are the principal accountable person, you may be a highly intelligent and thoughtful individual—perhaps a surgeon or the lead violinist at the London Philharmonic Orchestra—but you are not a property expert. It takes two to three years to qualify as an IRPM member just to level 4, and it is a complex thing. I do not see how the majority of lay directors will truly have the knowledge and competence to be able to discharge their responsibilities. They will be heavily dependent on advisers. If we are going to be democratic and empower our people to be masters of their own destiny, which I support, we need to make sure that they are protected. I would like to see a quality assurance regime for the building safety manager and for property managing agents, who will be the go-to people for recommendations and for all matters property. I would like to see them regulated.
Ian Byrne
Q
Councillor McCoy: It is essential that there is an accountable person. Trying to find somebody to hold to account for some of the failings that have gone on has been problematic. There needs to be clarification about whether that will be an individual person. It can be an organisation or a representative of the organisation, particularly where councils are landlords, but we need to know who that person will be. Will it be the chief executive or the housing portfolio holder? We need clarification about who that should be. Obviously, they will need to be supported with expertise and skills, and I would expect them to rely on external sources for that expertise; it is important. There are also issues with special purpose vehicles, which have quite complex ownership. To ensure that the work is done and someone is held responsible for getting it done and for ensuring the building is safe, there needs to be a clear line of accountability.
Kate Osborne
Q
Councillor McCoy: That is a key concern of London Councils. We welcome the additional powers that have been put in here, but we do not think they go far enough, especially given that, when you are trying to deal with safety issues, you want to deal with them quickly. At the moment, if people are not co-operative, you have to take people to court and get the access that way. It places some responsibilities on residents, but for an accountable person to be fully accountable for the safety of the building, it has to cover all areas.
We have a problem currently. A leaseholder of a flat in a large building could have all sorts of problems within the flat that, in theory, compromise the safety of the whole building. No one can be accountable for that if they cannot even access the property, so we think that needs to be looked at and worked on with the industry in order to figure out how to address that problem. Without those powers, a person cannot really be held accountable.
Andrew Bulmer: We take a similar view. Ultimately, you are balancing safety against somebody’s right to deny access to their home, and Ministers must decide whether you have to have a court order to go in. That is how it is written now. Getting a court order can be slow, expensive and obstructive, but perhaps that is the right approach if we are to respect people’s rights to the privacy of their own home. From a property manager’s point of view, being purely selfish, it would be much easier if the Bill were written so that we could just go in, but we must recognise that that is potentially an infringement of liberty, and that is for Ministers to decide.
Shaun Bailey
Q
Councillor McCoy: Embedding a culture of the tenant’s or resident’s voice being heard is important. That is the key thing, and it is probably not addressed sufficiently in the Bill. We have heard feedback about ensuring that the tenant’s voice is there. The Government giving a strong line that the tenant’s voice should be heard is what the industry needs in order to listen. We think councils are reasonably good at doing that, although not all are perfect, but we want to protect and talk to our residents and tenants, and engagement is a key part of that. My view is that there should be a clear ambition and steer in the Bill that the tenant’s voice should be heard, so that any issues of fire safety raised are taken seriously, maybe with a formal process involved.
Shaun Bailey
Q
Andrew Bulmer: You use the word maximise; I would use the word optimise. We are working with HSE on the customer engagement piece, and it is quite interesting. We have voices that say, “We want as much communication as possible,” and others that say, “Actually, we don’t want to be communicated with all the time. Just go and do your job.” Different audiences and different individuals will want communicating with in different ways, so I think the challenge for the industry is how we communicate in a way that meets the various needs of our customers.
If you look back at property management through the ages—I am going back many decades—a property manager was a servant of the landlord. The culture shift towards consumerism within the leasehold sector is now all but complete. Long since now, property managers very much understand that it is service charge payers who are paying for the service, and that they are the customers. That is a culture that is well embedded now in the majority of the industry. While we have seen examples of poor practice—like you, I have seen them myself—the direction of travel toward good practice is encouraging. I can certainly say that our members will be keen to understand the outcomes of the HSE project on customer engagement.
The Chair
If there are no further questions, I thank the witnesses for their evidence. The Committee will meet again at 2pm this afternoon, back in the Boothroyd Room, to continue taking oral evidence.
Ordered, That further consideration be now adjourned. —(Scott Mann.)
Health and Care Bill (Fifth sitting)
Tuesday 14th September 2021
(3 years, 3 months ago)
Public Bill CommitteesRead Full debate Health and Care Act 2022 View all Health and Care Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 14 September 2021 - (14 Sep 2021)
The Committee divided: - Ayes: 6 / Noes: 9 - Question accordingly negatived.
The Committee divided: - Ayes: 6 / Noes: 9 - Question accordingly negatived.
The Chair
Before we begin, I have a few preliminary reminders for the Committee. Please switch electronic devices to silent. No food or drink is permitted during sittings of the Committee, except for the water provided. I encourage Members to wear masks when they are not speaking, in line with the current Government guidance and that of the House of Commons Commission. Please also give each other and members of staff space when sitting and when entering and leaving the room. Hansard colleagues will be grateful if Members could email their speaking notes to hansardnotes@parliament.uk.
We now begin line-by-line consideration of the Bill. The selection list for today’s sitting is available in the room. That shows how the selected amendments have been grouped together for today. Amendments grouped together are generally on the same or a similar issue. Please note that decisions on amendments take place not in the order they are debated but in the order they appear on the amendment paper. The selection and grouping list shows the order of debate. Decisions on each amendment are taken when we come to the clause to which the amendment relates. Decisions on new clauses will be taken once we have completed consideration of the existing clauses of the Bill. Members wishing to press a grouped amendment or a new clause to a Division should indicate when speaking to it that they wish to do so.
Clause 1
NHS Commissioning Board renamed NHS England
Justin Madders (Ellesmere Port and Neston) (Lab)
I beg to move amendment 18, in clause 1, page 1, line 5, at end insert—
“(1A) The Board of NHS England shall be made up of—
(a) a Chair appointed by the Secretary of State,
(b) five other members so appointed of which—
(i) one shall be appointed to represent Directors of Public Health,
(ii) one shall be appointed to represent the Local Government Association,
(iii) one shall be appointed to represent the interest of patients,
(iv) one shall be appointed to represent the staff employed in the NHS, and
(v) one shall be appointed to represent the Integrated Care Partnership.
(c) one further member shall be appointed by the Secretary of State after being recommended by the Health Committee as a person with appropriate knowledge and experience,
(d) executive members as set out in Schedule 1 of the Health and Social Care Act 2012.
(1B) In making the appointments in (1A) (a) and (b) above the Secretary of State must have due regard to—
(a) the need to ensure diversity and equality of opportunity and must publish a list of at least 5 persons considered for each appointment and the reasons why the particular individual appointment was made, and
(b) that no person who could be perceived to have a conflict of interest by virtue of their current or recent employment or investment holding in any organisation with any role in the delivery of services to the NHS may be considered for appointment.”
This amendment changes the makeup of the Board to acknowledge its new role in the integrated NHS and bringing representatives as non-executive members on the Board as with integrated care boards.
The Chair
With this it will be convenient to discuss the following:
Clause stand part.
That schedule 1 be the First schedule to the Bill.
Justin Madders
It is a pleasure to serve under your chairmanship today, Mrs Murray, and to serve on the Bill Committee.
The amendment was moved in my name and that of my hon. Friends. The Minister whom I shadow is helpful—we will see how helpful during the course of proceedings—and we start in a spirit of optimism. I am grateful for the support of my colleagues on the Opposition Benches who, between them, contribute some relevant and highly knowledgeable experience. They are all passionate, as we all are, about the national health service and the care system, which are the subject of the legislation.
With your indulgence, Mrs Murray, I take this opportunity to make a few short points about the general context of the legislation. First, this is an important Bill. It could easily have been two or three pieces of separate legislation, so it requires proper consideration. We have a concern about whether enough time has been allocated to deal with everything in the detail that we would like, but we will do our best to get through it. We intend to make our contributions short but relevant and, we hope, persuasive.
Secondly, we share the apparent desire of the Government to repeal the worst aspects of the disastrous Lansley Act. Many of our amendments will be directed at trying to ensure that, in doing so, the baby is not thrown out with the bathwater. Thirdly and finally, as stated by the chair of the British Medical Association in the evidence sessions last week, we remain of the view that the Bill is the wrong Bill at the wrong time.
The amendment seeks to define the composition of the board of NHS England to align better with what we see as the new requirements set out elsewhere in the Bill. In looking at the issue of who should be on the board, we all ought to agree that it should not be open only to the friends and relatives of Ministers. Board members in our view should be subject to more independent assessment of their value and must pass at least some fit and proper test to avoid obvious conflicts of interest.
The amendment would ensure that the key influences on the board come from public health, local government, the patients themselves and the staff, without whom the NHS does not exist. At this point, I take the opportunity to place on the record, as I often do, Labour Members’ thanks to those in the NHS who have been so magnificent, not just over the past couple of years but over many years. They deliver a service that is rightly a source of great national pride. They deserve a seat at the table, as do patients. The Bill does not do enough to amplify the patients’ voice. We will be discussing a number of amendments over the coming weeks by which we will hope to change that.
We also need to look at what NHS England mark 4 will be required to do if the Bill becomes an Act. Other parts of the Bill deal with the powers and duties of this new version of NHS England, originally the NHS Commissioning Board. It is, in many ways, the pinnacle of the reversal of the Lansley position. The new NHS England does not bear much resemblance to what was envisaged under the Health and Social Care Act 2012. That is a good start, but one aspect of the Lansley view—that the NHS requires some degree of operational independence—has been shown to have some merit. Every clock is right at least twice a day, and we have found the one piece of the 2012 Act that proved to be correct. We will discuss some amendments later on to limit the power of Ministers to interfere with those who we believe should be operationally independent.
The new NHS England is pretty much in place anyway, as a result of the actions of those managing the NHS over the last few years. They desperately and very innovatively at times tried to find ways to circumvent the edicts of the 2012 Act, while Ministers looked on passively. It has been an unusual and interesting passage of time in the history of the NHS. We have seen legislation simply ignored and Ministers have allowed that to happen. It is little wonder, given the experiences of the 2012 Act, that many of the NHS witnesses we heard from said they wanted as little prescription as possible. They have had their fill of prescription. We would differ, I think, on the level of prescription necessary in the Bill.
New NHS England will be an amalgamation of the old NHS England, Monitor and the NHS Trust Development Authority. It will commission some specialist services. It will be the regulator, regulating a market that no longer exists. It will performance manage both commissioning by the integrated care boards, which, for the purpose of brevity, we will refer to as ICBs, and the provision of services by trusts and foundation trusts. I am afraid that how that wide range of responsibilities sits with the role of the Department is as vague as ever. The ability of Ministers and others to interfere and micromanage depends on whether the rest of the Bill survives in its current form.
Above all, the board oversees the operational running of the NHS, shaped by the mandate, which gives the direction of travel. Perhaps the most crucial policy change is that new NHS England sits at the top of the system, based on the integrated care boards as the major commissioner of services. That means who sits on the board is highly relevant.
The explanatory notes and the Government pronouncements about the new integrated bodies strongly assert that the role is to drive the reintegration of the NHS, repairing the worst of the fragmentation caused by Lansley and, I hope, once and for all, ending the obsession with marketisation, which has been shown to be a failure. We need board members on NHS England who might be seen to be more in tune with the new philosophy of partnerships and collaboration—not markets and competition, not business leaders, hedge fund managers, marketing experts.
In the new world, we want the NHS to be bound by its core principles—comprehensive, universal, free and funded from general taxation. That is a topic that we may touch on later; it may also be discussed in other business of the House today. What should be valued in board members is that they have some record of commitment to those principles. They should have some claim to be aligned to the new values, which favour a stronger role for patients; the public to have influence; a view that the NHS is contributing to reducing inequalities, as well as improving wellbeing; and the greater alignment of NHS services with local government.
The current make-up of the board is, put simply, the chair plus five other non-executives, all appointed by the Secretary of State, and then of course the appropriate executive directors. This amendment deals only with the non-executive directors. Given the huge importance of the NHS, it is appropriate that the chair and at least some of the non-executive directors are appointed by the Secretary of State. We will concede that. In another world, perhaps they could be elected in their own right, but we will not be travelling down that road on this occasion. However, we cannot ignore some of the headlines over the last 18 months and the huge media coverage of quite blatant abuse of patronage in appointments in the NHS more generally in recent years. Cronyism, I am afraid to say, has become a default position, and we think that has to be challenged.
To be fair to past Ministers, the NHS itself can also appoint people for the wrong reasons, moving out disgraced leaders if they go quietly, only for them to re-emerge somewhere else in the system. If the NHS is an organisation—it is a stretch to use that term after the mess created by the 2012 Act—appointments should accord with the highest standards of fairness, and inclusion is notably absent, so let us change the approach. Let us set the tone from the very top and enshrine in law the kind of people whom we as a Parliament would like to see—not, of course, specifying individuals but setting out in general terms some of the main interest groups that contribute towards the NHS and that we think should be at the very top table.
The amendment therefore seeks to give some direction to the Secretary of State in making these appointments and to ensure that at least one non-executive director is put on the board through a genuinely independent process and is not simply placed there by the Secretary of State. The kind of representative appointments that we set out in the amendment should, in our opinion, really be the standard. We would hope to see a similar standard adopted for the ICBs. We should appoint people who can really contribute to the future, with direct experience across the board in terms of the integration that the Bill seeks to achieve. The amendment also sets out how the Secretary of State must appoint suitable people and be able to justify their appointments against some sort of standards.
I hope that the Minister will at least acknowledge that some of the recent questionable behaviour around appointments needs to be addressed. No doubt he will refute the allegation of cronyism, but he cannot deny that there is at least a very strong perception that that is what has happened with some appointments.
In conclusion, I draw attention to how the NHS has already, effectively, blatantly put up two fingers to this Committee and anything we might decide, because it has already decided for itself how it will appoint people to roles within the new integrated care boards and has appointed some already, with the remaining positions, as we have seen from newspaper headlines, up for advertisement. That does not actually do us any favours, because Parliament has not decided that that is what we want to do, but we will see whether we get to that point later. That is all I have to say on the amendment.
The Minister for Health (Edward Argar)
It is a pleasure, once again, to serve under your chairmanship, Mrs Murray. I fear—predict—that there will be occasions when the shadow Minister, the hon. Member for Ellesmere Port and Neston, and I may not be entirely of the same mind, but it is a pleasure, as always, to serve opposite him on this Committee, because I know that even where we may disagree, the debate will be measured and reasonable. I will address the amendment tabled by the shadow Minister and, in the same speech, clause 1 and schedule 1 stand part if that is appropriate and in order.
As has been the practice on numerous occasions in these Committees, I will start by expressing a view shared by all members of this Committee. It has already been expressed by the hon. Member for Ellesmere Port and Neston, and we join with him in expressing our gratitude to those who work in our NHS and in care services and—as he and I have often said in this place—all those, including in local government, who work in this space and have done amazing work over the past year and a half particularly.
As ever, the hon. Gentleman picked his example carefully in citing some of the witnesses whom we heard in oral evidence. As he will know, the overwhelming majority—possibly with only two exceptions—stated that this was the right Bill at the right time, albeit they may have picked up on particular clauses or elements. They did state that this was the right time for this legislation.
As the shadow Minister has set out, amendment 18 in his name and those of his hon. Friends seeks to make changes to the make-up of the board of NHS England, the provisions for which are currently set out in schedule A1 of the National Health Service Act 2006. It also outlines conditions that should be met in relation to the appointment process. I share his view that it is vital that robust governance arrangements are in place for overseeing public appointments. It will not surprise him that I refute his assertion that in the case of NHS England board appointments there is a so-called cronyism or a suggestion that any of those people are appointed on anything other than merit. However, I believe that those strong and robust governance arrangements are already in place for managing appointments to the board of NHS England. Those appointed already are deemed to be fit and proper people to hold those appointments.
The existing provisions, which the shadow Minister alluded to, setting out the membership of the NHS England board in the National Health Service Act 2006, provide the flexibility required for the fully merged NHS England to lead our more integrated health and care system. The clauses we will be addressing this morning in this part of the Bill reflect the evolution of NHS England and NHS Improvement and what has happened on the ground since they were originally formed. With this, we seek to create a legislative framework that catches up with where they are and is permissive, rather than prescriptive. That is something else the hon. Gentleman and other members of the Committee will have seen from the evidence sessions. Witnesses were clear that the Bill struck the right balance between permissive and prescriptive.
As we look to continue the fight against the covid-19 pandemic and, in parallel, prepare for the recovery of our health and care system, it is imperative that the most suitably experienced and knowledgeable candidates are appointed to the Board. I know the shadow Minister will share that sentiment. Unlike appointments to integrated care boards, the appointment of the chair and non-executive members of NHS England are rightfully public appointments made by the Secretary of State and managed in line with the governance code for public appointments and regulated already by the Commissioner for Public Appointments. The appointments are made on merit in a fair, open and transparent manner and in line with that governance code. They also require due regard to ensuring they properly reflect the populations they serve, including a balance of skills and backgrounds, supporting the Government agenda of promoting more diverse public sector organisations and board appointments.
The role of non-executives on public bodies includes helping set the strategic direction for the organisation, ensuring the organisation meets the highest standards of good governance and holding the executive to account for day-to-day business delivery. They come from a variety of backgrounds and bring a valuable range of skills and experience to a board position. It is important to note that they are not routinely or normally appointed to be representative of a particular sector or group. They are on the board in their own right and their independence in that context is paramount.
All public appointees are expected to uphold the standards of conduct set out in the Committee on Standards in Public Life’s seven principles of public life, as included in the code of conduct for board members of public bodies, and they must adhere to that. The code sets out clearly and openly the standards expected from those who serve on the boards of UK public bodies and includes a clear process for managing any conflicts of interest. The Commissioner for Public Appointments regulates those appointments to ensure they are upholding the values of that Government code and works with Government to encourage candidates from a diverse range of backgrounds to consider applying for such public appointments.
Finally, while I share the shadow Minister’s view that it is hugely important to have diverse representation on the board of NHS England and to ensure that diverse voices and viewpoints are reflected, the duty under section 13H of the 2006 Act already requires NHS England to actively
“promote the involvement of patients, and their carers and representatives”
without the specific need for a named non-executive patient representative. It is clear that comprehensive processes and codes are already in place to regulate public appointments such as those we are discussing in the context of clause 1 and amendment 18, as well as schedule 1, including on diversity, conflicts of interest and conduct in office. I emphasise once again that the role of non-executive members is not that of representing a specific or particular sector, which could be at odds with the independent and broad approach they are required to bring to the role.
I now move specifically and briefly to clause 1, which changes the legal name of the NHS Commissioning Board to NHS England, and also to schedule 1, which contains consequential amendments where the changes will take effect in another Act. Since 2013, the NHS Commissioning Board has been operating under the name NHS England, and I think it is fair to say that that is how all of us in this room, and the public, know it, rather than by the slightly clumsy name of NHS Commissioning Board. This move reflects what the public already regard as the body’s name. The organisation, including the new functions provided to it by the Bill, will continue to operate under the name NHS England; this clause aligns the legal and technical name with the operational and publicly used name for clarity, and updates associated primary legislation.
Justin Madders
I am grateful for the Minister’s response, although disappointed that he does not agree with my amendment; I fear that may be a regular experience over the next few weeks, but we will carry on in hope rather than expectation.
As a final response, I would like to reflect on the kind of people we currently have on the board of NHS England. This is not meant to be a criticism of them at all—they are all very experienced and talented people—but their experience is not in healthcare; it is mainly in things such as retail or finance. They clearly have great qualities, but if hon. Members look at what is in our amendment and the kind of people we say ought to be at the top table, it is clear from the past 18 months how critical a role those people play.
Take, for example, the directors of public health. They have been the unsung heroes of the pandemic. I certainly know my local director of public health much better now than I did at the start of 2020, and he has been absolutely magnificent. He has always been available and, along with just about everyone else in the public sector, the amount of work that he has put in is phenomenal. That breadth of knowledge and experience deserves a seat at the top table.
Similarly, there should be a representative of the Local Government Association. Obviously there is some overlap with directors of public health, but local government has been magnificent, as the Minister noted, during the pandemic. We know that the vaccine roll-out, for example, and the ability to dispense tests quickly have been down to the agility of local authorities working in partnership with the NHS and the voluntary community sector.
There should also be a representative for patients; it seems a little odd that their voice is not at the top table, and I say the same about a representative for the staff. We talk a lot in here about how much we value the efforts of the staff, but we should put that into practice by acknowledging that they deserve a voice at the top table.
Clearly, the Minister will not accept the amendment, so I will seek to withdraw it, but I think we have made our point clearly about the kind of people we think should have a say in how NHS England is run. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 1 ordered to stand part of the Bill.
Schedule 1 agreed to.
Clause 2
Power to require commissioning of specialised services
Justin Madders
I beg to move amendment 36, in clause 2, page 1, line 9, at end insert—
“(1A) In subsection (1), leave out “it” and insert “the Secretary of State”.”
This amendment, with Amendment 37, NC20 and NC21, restores the duty on the Secretary of State to provide or secure the provision of services to that in the National Health Service Act 2006.
The Chair
With this it will be convenient to discuss the following:
Amendment 37, in clause 15, page 13, line 18, leave out “it” and insert “the Secretary of State”.
This amendment, with Amendment 36, NC20 and NC21, restores the duty on the Secretary of State to provide or secure the provision of services to that in the National Health Service Act 2006.
New clause 20—Secretary of State’s duty to promote health service—
“(1) The National Health Service Act 2006 is amended as follows.
(2) For section 1 (Secretary of State’s duty to promote comprehensive health service) substitute the following—
“Secretary of State’s duty to promote health service
(1) The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—
(a) in the physical and mental health of the people of England, and
(b) in the prevention, diagnosis and treatment of illness.
(2) The Secretary of State must for that purpose provide or secure the provision of services in accordance with this Act.
(3) The services so provided must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.””
This new clause would restore the wording of section 1 of the NHS Act 2006, concerning the duties of the Secretary of State regarding the promotion of the health service, to its original form, before it was amended by section 1 of the Health and Social Care Act 2012.
New clause 21—Duties on the Secretary of State to provide services—
“(1) The Secretary of State must provide, in England, to such extent as he considers necessary to meet all reasonable requirements—
(a) hospital accommodation,
(b) other accommodation for the purpose of any service provided under this Act,
(c) medical, dental, ophthalmic, nursing and ambulance services,
(d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as he considers are appropriate as part of the health service,
(e) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as he considers are appropriate as part of the health service,
(f) such other services or facilities as are required for the diagnosis and treatment of illness.
(2) For the purposes of the duty in subsection (1), services provided under—
(a) section 82A (primary medical services), section 98C (primary dental services) or section 114C (primary ophthalmic services), of the NHS Act 2006, and
(b) a general medical services contract, a general dental services contract or a general ophthalmic services contract,
must be regarded as provided by the Secretary of State.”
Justin Madders
These amendments and new clauses are significant because, if accepted, they will put an end to the seemingly endless arguments that we saw during the passage of the 2011 Health and Social Care Bill. There is a whole shelf of books pointing out the changes in wording in what became the Health and Social Care Act 2012, and how they marked the end of the NHS as we previously knew and understood it. Allegedly expert barristers—although I have never met a barrister who did not claim to be an expert in something—wrote articles about how that new wording changed everything. On the other hand, the Government explained that they had changed nothing, and had simply put the reality on the ground into words.
David Lock QC, a genuine expert on NHS law, said that this technical change attracted considerable and possibly misguided criticism, but it did not involve any substantial change in practice. However, as reported by the noble Lords, it caused considerable confusion and suspicion. This confusion revolves around what is included in the NHS; what defines the comprehensive NHS; and how services required for the NHS are to be provided. Over time, the NHS has had many different structural solutions for providing these services, and indeed we are on yet another iteration of such a solution—we will see how long this one lasts.
The debate on that change of wording took up days of the Public Bill Committee’s time—or, should I say, the first of those Committees, as they had two goes at it on the last occasion. Let us hope we do not suffer a similar fate. Following that, there were hours of debate in the other place. The issue was then considered by the Constitution Committee, and some sort of compromise emerged, with insertion into the 2012 Act of what became, in the end, section 1(3) of the National Health Service Act 2006, as amended, which said:
“The Secretary of State retains ministerial responsibility to Parliament for the provision of the health service in England”—
we hope that that is always the political reality, no matter the wording used in the legislation.
The extra wording proposed in new clause 20 sits within section 1 of the 2006 Act, and states:
“The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—
(a) in the physical and mental health of the people of England, and
(b) in the prevention, diagnosis and treatment of illness.”
I will not read out the whole amendment, but I want to compare that section of the wording with that of the founding National Health Service Act 1946, which says:
“it shall be the duty of the Minister of Health to promote the establishment of a comprehensive health service designed to secure improvement in the physical and mental health of the people…and the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services”.
We have this curious word “promote”. To my mind, promoting puts a positive onus on the Secretary of State, but if he has a duty to promote a comprehensive NHS, how exactly should he do that? In 1948, did Nye Bevan drive up and down the street with a megaphone, urging people to go and see their doctor? Today, it would probably mean the Secretary of State sending out a tweet to do the same—although, given what we hear about GPs’ workloads, they would not thank the Secretary of State for that. Or does this duty mean that when we are in the Chamber, and some rogue Member claims that we should abandon the NHS and move to some kind of insurance-based model, the Secretary of State should leap up and promote away?
Over the past few years, even before covid, we have seen more and more people going for private treatment because waiting lists are so long. We know that whatever is decided in the legislation in the main Chamber today, those waiting lists are not going to reduce significantly for some considerable time. Is it in fact the case that the Secretary of State is not complying with his duty to promote the NHS by allowing these waiting lists to grow and grow, thereby forcing people to secure alternative provision? The word “promote” can have multiple meanings, and I can think of a few Secretaries of State who have lamentably failed to promote the NHS, and should probably not have been promoted in the first place.
The contentious bit of this issue is really about what makes up the NHS. It was claimed about the Lansley Bill, and has been claimed about this Bill, that the change in wording implies that people would be denied access to treatment from the NHS because, for example, an ICB decides to exclude a particular service, and there is no duty on the Secretary of State to stop that happening. A few points are clear enough: the Secretary of State promotes the comprehensive NHS, but does not provide it. The boundaries of what the NHS actually is change over time, as we all know. Social care is now outside the NHS, although that will probably alter slightly over the next few years. The National Institute for Health and Care Excellence can redefine the boundaries; primary care trusts and clinical commissioning groups could exclude treatments on a whole range of different criteria that, while they may not have admitted it, did amount to an exclusion; and of course, advances in medical science mean that many things that were not available in 1946 and, indeed, could not possibly have been conceived of during the original Act, are available now on the NHS. Those boundaries are never entirely clear, and it is often up to the courts to draw out a decision about what healthcare amounts to.
However, in the 2006 Act, there was at least a bit of definition in clause 3:
“The Secretary of State must provide throughout England, to such extent as he considers necessary to meet all reasonable requirements—
(a) hospital accommodation,
(b) other accommodation for the purpose of any service provided under this Act,
(c) medical, dental, ophthalmic, nursing and ambulance services,
(d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as he considers are appropriate as part of the health service,
(e) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as he considers are appropriate as part of the health service,
(f) such other services or facilities as are required for the diagnosis and treatment of illness.”
I could go on, but I hope Members will take my word for it that this is very similar language to that of all the previous NHS Acts, going back to 1946. That is essentially what new clause 21 seeks to reassert and confirm for the purposes of clarity, so that where there are subordinate bodies such as PCTs, CCGs or even NHS England, those duties are very clearly set out at the top and can then percolate down.
Under the current Bill, the ICBs have a responsibility to provide services for a defined population that is phrased much like the above definition, but there is no duty on the Secretary of State to provide throughout England; in other words, there is nothing specific to say that the duty on the Secretary of State should be delegated to ICBs, which we say there should be. Our intention is to restore the position that the duty is placed on the Secretary of State, which he then delegates down to NHS England, ICBs and so on. We could spend a lot of time on this, as our predecessors have, but I do not think that will be the best use of our time, so we have attempted to avoid going down that particular rabbit hole with a straightforward amendment, with what I hope has been a straightforward explanation.
The Lansley changes were made to align with the NHS structures that the then Secretary of State introduced, which were essentially market structures, distancing the Secretary of State in the sense that they were unlike anything the NHS had done previously, which was part of the reason why there was so much debate about them. That is why in 2015, 2017 and 2019, we made it clear in my party’s manifesto that we would reinstate the duty to promote and deliver the NHS, so there would be no doubt that it was a public service and could be restored to that footing. Our argument is that for simplicity, we should restore the duties to those of the pre-Lansley era, to reflect that the Lansley experiment has failed and we are in a new world—a new world with the old wording, which we wish to reinstate. Let us keep it simple, save everyone a lot of work and go back to the old wording, so that there is no doubt about where the duties and responsibilities lie.
Karin Smyth (Bristol South) (Lab)
I support the words of my hon. Friend the Member for Ellesmere Port and Neston. The Government would be wise to take note of the proposal. As my hon. Friend said, many hours, days and weeks have been spent by not only Members of Parliament, but expensive lawyers and lots of concerned constituents across the country, arguing—as I have often thought myself at times—a slightly nuanced point, which is lost on people. I have absolutely been persuaded, however, that it is important to restore that duty. If the Government are rightly binning the Lansley Act, the amendment is an obvious one to consider and accept, as it puts the duty absolutely beyond doubt.
Running throughout the Bill, as we will discuss over the next few days and weeks, is a real problem of clarity and accountability. We should not let the Bill out of this place while it leaves that lack of clarity on duties, responsibilities and accountability for the NHS to decide, along with local government. There is a balance between permissiveness and diktat, and starting with clear duties on the Secretary of State would help. Later, we will discuss how the Government seem to want to give the Secretary of State enormous power to interfere in the most minute aspects of healthcare in our constituencies, something that concerns a great many people, organisations and the NHS itself.
If the Government are serious about rehabilitating themselves as the supporter of the NHS following the Lansley Act, an amendment to clarify that absolutely central role would be a wise thing to accept.
Edward Argar
Amendments 36 and 37 and new clauses 20 and 21 are in the name of the shadow Minister and his colleagues. I do not believe that what is being proposed reflects the reality of the role of the Secretary of State or what it should be, which is a strategic oversight role with the ability to intervene when necessary to ensure accountability. The hon. Gentleman might correct me, but I think he cited Mr Lock, who said that there was no substantial change in practice. That goes to the heart of why I am unpersuaded by the amendments.
As the hon. Gentleman knows, the idea that the Secretary of State himself provides services has not reflected the reality of the structure of the NHS for many years, not least since 2003-04 with the introduction by the Labour party when in government of foundation trusts as independent entities in the health system. That purchaser-provider split, long established in the NHS and retained in the Bill, allows some of the health services in England to be provided by those such as NHS foundation trusts, which are legally distinct from the Secretary of State.
In the years since those changes, and as the many vigorous debates in Parliament since and during the passage of the 2012 legislation have demonstrated, there has rightly been no loss in the strong sense of governmental accountability for the NHS felt by Governments of all parties and by parliamentarians. As the proposers of this group of amendments have themselves been among the most eloquent and capable colleagues in holding Ministers and Government to account for the NHS, I find it slightly strange that they feel that their amendment is necessary.
At the time of the 2012 Act, as the shadow Minister alluded to, there was a great deal of debate in the other place on the value or otherwise of this wording. Eventually, the noble Lords concluded that it was better for the law to reflect the reality of the modern NHS. However, it remains the case that the Secretary of State has a firm duty to continue the promotion in England of a comprehensive health service in practice. He does this through setting the strategic direction and his oversight of NHS England and the other national bodies of the NHS, and in the future, subject to debates in this place—I do not want to prejudge what the Committee and the House may determine on those clauses—through the extra lever of the proposed power of direction. At all times, he remains responsible to Parliament for the provision of the health service in England.
NHS England also has a duty to arrange for the provision of services for the purpose of the health service in England and a concurrent duty to promote a comprehensive health service. Integrated care boards will, subject to parliamentary approval of the Bill, also have functions in relation to arranging the provision of services.
I understand the point that Opposition Members are seeking to make with the amendment, but it is entirely unnecessary as law. The Secretary of State has the duty to promote the competence of the health service in practice. He is accountable to Parliament for the comprehensive health service, and I believe that local NHS leaders and NHS England are best placed to know what is needed to serve individual communities.
This goes to the heart of what I suspect will come up a number of times in our debates in this Committee, which is the extent to which the legislation should be prescriptive, or permissive and flexible. I suspect the shadow Minister and I will disagree on where the balance should lie, in a number of areas. We believe that the Bill strikes an appropriate balance.
The shadow Minister talked about flexibility in redefining the boundaries of what the NHS does. Throughout the history of the NHS, there have been tweaks along those lines. The Labour party introduced charges for glasses and dentures; the Conservative party introduced charges for prescriptions shortly afterwards; the Labour party abolished them, and then reintroduced them two years later. I use those examples because I think we should be wary about being overly prescriptive in primary legislation.
Clause 2 makes a number of amendments to the power allowing the Secretary of State to require NHS England to commission certain prescribed services. It ensures that the Secretary of State can still require NHS England to commission specialised services and facilities, but recognises that aspects of the commissioning might be carried out by other NHS bodies through joint or delegated working arrangements or by directing integrated care boards to provide those services.
Specialist services are commissioned to support people with a range of complex and rare conditions. Those services could involve the treatment of patients with rare cancers, genetic disorders, and complex medical or surgical conditions, for example. As such, it is right that NHS England has overall responsibility for the services and can decide whether they might be better delivered through joint or delegated working arrangements or through directions to ICBs—I am happy to adopt the shadow Minister’s suggested shorthand, otherwise we will be taking a very long time repeating the same words on multiple occasions.
The clause also removes the requirement of the Secretary of State to consider the financial implications for CCGs—to be replaced with ICBs—when requiring NHS England to commission certain services. The change focuses the decision about categorisation of specialised services on the complexity and impact of the service and the ability of ICBs to support commissioning services for their populations, reflecting the fact that ICBs are significantly larger than CCGs and, correspondingly, so are their financial resources. In some circumstances, NHS England may request that a service is no longer nominated as a specialised service or facility—that could be used, for example, as the technology improves and it becomes more appropriate for it to be commissioned by an ICB instead. The clause inserts a new provision in the NHS Act 2006 which requires the Secretary of State to provide reasons for any refusal to requests from NHS England to revoke provisions requiring NHS England to commission specialised services.
I therefore encourage the shadow Minister not to press his amendment to a vote.
Justin Madders
I am grateful for the Minister’s comments, not least the promotion he inadvertently gave me by referring to me as shadow Secretary of State. We should have a Division on that, should we not? I understand what the Minister is saying, but our aim with this amendment is to reflect the new reality. No one has really got to the bottom of why the wording came out in 2012, but we are clearly moving back into a pre-Lansley era and the end of the marketisation, so we should go back to the previous wording. In terms of the services and duties in our new clause 21, I do not think the Minister said he disagreed that any of them should be provided. I am trying to do him a favour here and help him to avoid the Bill being bogged down in the Lords. If it comes back in ping-pong, we will quote the relevant new clause and say, “This is something that could have been avoided.”
I understand that the Minister does not want to be too prescriptive. He is right that the Bill will centre largely on the right balance between permissiveness and prescriptiveness, and we will no doubt have disagreements on that. I have tried to be helpful to him, but he does not want to accept that assistance on this occasion, so I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Clause 2 ordered to stand part of the Bill.
Clause 3
NHS England mandate
Justin Madders
I beg to move amendment 19, in clause 3, page 2, line 12, leave out paragraph (e) and insert—
“(e) after subsection (6) insert—
‘(6A) The Secretary of State may revise the mandate should urgent or other unforeseen circumstances arise.
(6B) If the Secretary of State revises the mandate, the Secretary of State must publish and lay before Parliament the mandate as revised with a written explanation of the urgent or other unforeseen circumstances that justify the revision and an impact assessment of the proposed change.’”
The Chair
With this it will be convenient to discuss amendment 20, in clause 3, page 2, line 30, at end insert—
“(6) No mandate may be laid before Parliament unless the Secretary of State has supplied a statement on how the mandate will be funded.”
Justin Madders
These amendments to clause 3 deal with the mandate to NHS England. The mandate was part of the changes that were introduced to attempt to distance the role of Government and Ministers from the sound of the bedpans dropping. We can talk about how much the Secretary of State should be involved in that, but we will focus our comments on the mandate today.
What we saw was, in effect, an artificial distinction—one that, like so much else in the last piece of legislation, has largely been subverted or ignored. Despite the intentions, Ministers still try to micromanage and sometimes interfere, for what we would describe as political reasons, and the mandate has rumbled on. During the tortuous passage of the Lansley Bill, the Government had to concede that the Secretary of State remained politically responsible to Parliament for the NHS, which, as we have just discussed, has always been the reality.
It would be brave, however, for someone to suggest that the mandate has had the same level of parliamentary scrutiny. The mandate is presented to Parliament each year, but is that anything other than a ritual? I do not think Hansard records energetic and fierce debates about the mandate, although I am happy to be corrected by the Minister, if he can point me to a particular section.
The idea of the mandate is not entirely without merit. It is good that the NHS knows what is expected of it, and we all agree that it should be free from sudden announcements or other surprises—such as the Secretary of State announcing that the following week all NHS staff would have to wear face coverings before informing them that that was what was required. That is just one example from an extreme situation, but the point is that we all crave certainty. The mandate is an attempt to provide that; and without it, it is unclear how accountability works.
As was clearly articulated in last Thursday’s evidence session, the NHS welcomes the mandate’s ability, in theory at least, to give it stability and enable it, if possible, to plan for the medium and long term. I am sure we could have a debate on whether that is indeed what has happened; it is pretty clear in recent times that, for genuine reasons, that has not been possible. However, most experts would suggest that the NHS would benefit from stability and the ability to plan over at least a three or five-year period without lurches in policy and—crucially and pertinently given today’s business in the Chamber—with a degree of funding certainty to match the requirements.
Dr Philippa Whitford (Central Ayrshire) (SNP)
I wish to make one simple point, following what the right hon. Member for Ellesmere Port and Neston has said, which is that the annual funding of any health system based on the tax year—I can speak to this, having spent more than three decades on the frontline—means that clinicians will inevitably be contacted in January or February and asked, “What equipment do you need? You have to obtain it by 31 March.” Providers of medical equipment will happily admit that prices go up in the first quarter of the year and then drop, so this hand-to-mouth method actually costs all health services massive amounts of money. Simply being able to smooth that out so that we know what is coming several years ahead would save millions of pounds on procurement and allow that money to be directed to clinical care.
Karin Smyth
I echo the comments of my hon. Friend the Member for Ellesmere Port and Neston. The mandate is important. It is awaited by clinicians and managers in the health service as it affects how they are to operate in the forthcoming year. Often guidance arrives the week before Christmas, as I remember from my time in the NHS, so we were starting to plan for the very short term, which really is unhelpful. It is a regular statement intent, and it is a way in which the public can see what is happening or is due to happen to their services.
My hon. Friend the Member for Ellesmere Port and Neston quoted from the King’s Fund’s written evidence, which mentioned the
“multiple plans and strategies in each ICS”
and the need for a “more ‘local’ place level”. As we heard in our evidence sessions, this is already a very confused picture, and one that we are going to try to navigate our way through. Although I do think that there should be greater permissiveness, so long as it is accountable at local level, the mandate gives us a degree of accountability at national level, on the Government’s intent, published in their stated aims, and that gives the general public and taxpayer confidence.
On our amendment about 18 weeks, that target was often criticised as not being clinically referenced. It was brought in after the then Conservative Government talked about an 18-month target being highly ambitious for people waiting to be seen clinically—some of us are old enough to remember those dreadful days, to which we have returned. Now, we could argue whether 18 weeks was the right number, but it was something that drove up standards of care, and it meant that the NHS said to the taxpayer, “We accept that you deserve a better standard of care and treatment, and it is completely unacceptable to be on a waiting list for 18 months to two years”—it was often longer. It focused minds, drove service redesign and made clinicians go back over their lists, because if someone has come on to a list two and a half years earlier, many things would have happened and, sadly, in many instances that person would have died.
By supporting our amendment, the Government would show that they are ambitious for the NHS and the people it serves. If the Minister is not prepared to support that 18-week commitment, what is acceptable to the Government? We and all our constituents know that waiting lists were rising out of control before the pandemic, and that the target had not been met for several years. Clearly the pandemic has exacerbated the situation, but let us be clear that targets not being met was a pre-pandemic problem.
We hear utterances from the Government in the newspapers about what they think about the targets—“nonsensical” is what the Secretary of State said at the weekend. The targets were put in place to give people confidence that their taxes were funding a service that they could hold to account in some degree, and it drove some positive behaviour. It will take a massive effort to get waiting lists down, so what discussions has the Minister had with clinicians and managers about the loss of targets? Why would he not support putting that target back in the Bill? The long waiting lists are miserable for everyone concerned. They need to be published. We need to let people know what they can expect from our service. I strongly urge the Minister to accept the amendment, or at least its intent. If he is not prepared to do so, what does he think is an acceptable length of time for people to be on a waiting list?
Edward Argar
The hon. Member for Ellesmere Port and Neston is having a good day; I promoted him to shadow Secretary of State and I think the hon. Member for Central Ayrshire made him a member of the Privy Council, so he is doing well this morning. Although we may resist many of his amendments, I take the point that he did not table them from a partisan perspective but genuinely approached them with sincerity. He mentioned that on a previous occasion the Bill Committee had to be run twice. Fond of him as I am, I think both of us would prefer not to have to do this twice together.
Justin Madders
I thank the hon. Member for Central Ayrshire for promoting me to the Privy Council. At this rate I will be Prime Minister by lunchtime and supreme leader of the universe by the end of today’s sitting, in which case the Bill will no longer be required.
The hon. Lady made an important point about the effect of annual budgets and, frankly, the opportunism that follows from those providing services. We know that happens in all sorts of sectors, but the amendment sets out very clearly why a longer-term footing is needed. What the hon. Lady referred to was a boom-and-bust approach, but we will leave such terms to history.
My hon. Friend the Member for Bristol South articulated clearly some of the challenges as well. She made the point about accountability, which really does matter. As she said, there is a theme throughout the Bill that accountability is somewhat missing. I am grateful for the Minister’s explanation of the impact assessment—better late than never. The White Paper was issued in January and the Bill had its Second Reading in July, so there has been plenty of time to get everything sorted.
The amendments seek to stop the Government’s propensity to announce policy by headline and then work out the detail later on. The Minister has helpfully said—he will correct me if I am wrong—that the mandate will be fully funded, and we will make sure that he commits to that. We probably do not need to press amendment 20, but we will press amendment 19 to a vote. We think the Government intend to move towards a longer-term plan for the mandate on an annual cycle, but the legislation as it currently stands does not prevent it from becoming stop-start, and there will be circumstances when it will be necessary to change within year. It is important, for reasons of accountability, that that comes with some conditions attached.
The Minister said that we are trying to take away flexibility from the Secretary of State, but we are not. We are trying to encourage accountability alongside flexibility. We accept that there will be circumstances in which the mandate will need to be changed in urgent situations and we would not want to impinge on that, but if the Secretary of State has the power to move things forward in that manner, he should be accountable to Parliament when he does. Again, we are trying to be helpful and assist him. We hope he does not have to do it very often, but if he does issue a mandate in urgent circumstances he will want to know what the impact will be on the NHS. He will want to know that the funding is there and that the NHS has the capacity to deliver the demands placed on it. Those are questions that any member of the Department will ask, so we hope to put in the Bill what ought to happen in practice. It is important enough to press the matter to a Division.
Question put, That the amendment be made.
Alex Norris (Nottingham North) (Lab/Co-op)
I beg to move amendment 21, in clause 4, page 3, line 5, at end insert—
“(d) health inequalities.”
This amendment would modify the triple aim to explicitly require NHS England to take account of health inequalities when making decisions.
The Chair
With this it will be convenient to discuss the following:
Amendment 22, in clause 4, page 3, line 5, at end insert—
“(1A) In making a decision about the exercise of its functions, the health and well-being of the people of England must be NHS England’s primary consideration.”
This amendment would assert that duties to patients come above any other (e.g. organisational) considerations.
Amendment 23, in clause 19, page 18, line 13, at end insert—
“(d) health inequalities.”
This amendment would modify the triple aim explicitly to require integrated care boards to take account of health inequalities when making decisions.
Amendment 24, in clause 19, page 18, line 13, at end insert—
“(1A) In making a decision about the exercise of its functions, the health and well-being of the people it serves must be the primary consideration of an integrated care board.”
This amendment would assert that duties to patients come above any other (e.g. organisational) considerations.
Amendment 25, in clause 43, page 47, line 32, at end insert—
“(d) health inequalities.”
This amendment would modify the triple aim to explicitly require NHS trusts to take account of health inequalities when making decisions.
Amendment 26, in clause 43, page 47, line 32, at end insert—
“(1A) In making a decision about the exercise of its functions, the health and well-being of the people it serves must be the primary consideration of an NHS trust.”
This amendment would assert that duties to patients come above any other (e.g. organisational) considerations.
New clause 13—Secretary of State’s duty to set targets on population health and reduction of inequalities—
“(1) The Secretary of State must, at least every five years, publish a report setting targets on—
(a) the improvement of the physical and mental health of the population, and
(b) the reduction of health inequalities.
(2) The Secretary of State must publish an annual report recording progress against the targets in subsection (1).”
Alex Norris
It is a pleasure to serve with you in the Chair, Mrs Murray, and to make my first contribution to the proceedings. It will perhaps give my hon. Friend the Member for Ellesmere Port and Neston a chance to bask in his new-found responsibilities, while I pick up the cudgel with the Minister. I am afraid I do not have such luxury as he does.
This group of amendments relates to health inequalities and to the priority that we give to the health of the nation, rather than the structures that serve the health of the nation. I will go through each amendment in turn, but I want to talk about a couple of themes that cover them all.
I strongly believe that addressing health inequalities ought to be a foundational priority of any Government of the day. What could be crueller than having such a significant element of a person’s future—how long they will live, how long they will live in good health and what diseases they are likely to acquire—preordained at birth? That has always seemed cruel to me.
Government are not a passive part of that process. The decisions that are taken in this place play an active part in those inequalities. For example, the decisions taken later today and on universal credit will widen them. We should seek to use this Bill as a turning point in our battle against health inequalities in this country. This should be the Bill in which we say that the national health service, and those who need it locally, must be central to addressing health inequalities in this country and that the Government will resource them properly to do so.
It is not a moment too soon to do this. The legacy of this decade of austerity, which my hon. Friend the Member for Ellesmere Port and Neston talked about, is that for the first time in a century the increase in life expectancy has stalled. What does it say about us, the most technologically advanced generation in history, that the increase in life expectancy stalls on our watch?
Within that there is a yawning gap in healthy life expectancy between those who live in the best-off and the worst-off communities. On the basic life expectancy measure the gap is 10 years, but on healthy life expectancy, measured by the age at which people have their first disability, the gap is 18 years between communities like mine and the communities that are best off in this country. How sad that is; how sad is what it says about us.
As the 2020 Marmot review concluded,
“health is getting worse for people living in more deprived districts and regions, health inequalities are increasing and, for the population as a whole, health is declining…the country has been moving in the wrong direction.”
Again, we heard evidence about that in the evidence sessions of this Committee. We ought to use this Bill as a moment to do something about it.
These inequalities are not just about socioeconomic status; they are about race as well. Research by the King’s Fund shows that
“people from the Gypsy or Irish Traveller, Bangladeshi and Pakistani communities have the poorest health outcomes across a range of indicators.”
Covid has shone a light on both race and socioeconomic background as drivers of inequalities. We entered the pandemic thinking it would be a great leveller and that the virus would not know people’s postcode, job or ethnicity. Actually, we quickly learned that that was not the case and that someone was twice as likely to die from covid if they lived in the most deprived communities. A man from a black African background is nearly four times as likely to die of covid as I am. Those inequalities, and how they played out, whether in housing, in occupation or pre-existing health, offered a breeding ground for the virus. That is devastating for individuals, but it is worse for all of us, because it has spread and strengthened the virus. Those health inequalities are bad for everybody.
Just before I turn to my amendments, I should also say that it is strange, given that half of all health inequalities are driven by smoking, to see a Health and Care Bill that does not talk about smoking at all. I hope that when we get to part 5, where some of the public health elements are found, we might collectively do better there.
Amendment 21 seeks to address the point about inequalities by adding to the triple aim for NHS England as set out in clause 4. The triple aim for the national health service is a good thing. It shows the system and those who work in it and lead it, whatever their role, what we want them to prioritise. The three strands of that triple aim are noble: the health and wellbeing of the people of England, the quality of service provided and the efficiency and sustainability of resources. However, that is not robust enough to ensure not just due regard for health inequalities but strong action.
I will not prejudge what the Minister will say, but I suspect he may say that promoting the health and wellbeing of people in England is the aim that covers inequalities. That is an important pursuit, but it is not explicit enough. It is just about general improvement. For example, we hope the Government would expect to see a resumption in the increase in life expectancy. That would be a general improvement in the health and wellbeing of the people of England. The problem with that is that it would not address the point about healthy life expectancy. There would be general and maybe even aggregate improvements for possibly a great deal of the population, but not enough to deal with the extraordinary and growing gaps for others. I think we ought to want to do something about that.
Accepting the amendment would mean the Government would send a signal to NHS England that tackling health inequalities ought to be at the centre of its mission. A quadruple aim may not be as elegant as a triple aim, but it is important that tackling health inequalities is recognised in the Bill. I know that the Minister wants the legislation to stand the test of time. He suggested I said something from a sedentary position about multiple pieces of legislation, which I genuinely believe I did not, but we ought to say that we are here because the 2012 Act was so bad. That there have been nine years since that Act is not a strength on the Government’s part; it is a weakness that they have defended something that has not worked for a long period of time. If we want the Bill to stand the test of time, then we ought to say what we want the health service to do. By putting that in the Bill, we would do that.
Amendment 22 also addresses the triple aim and creates a hierarchy within. High-quality and sustainable services are important, but when commissioning decisions are being made at a national level, as happens with NHS England, and those decisions affect our constituents, we do not want equal weight being given to organisational considerations. The whole point of the Bill as explained on Second Reading is to move to an integrated system that is built around the health and care needs of the population, rather than around organisational boundaries. We all recognise where that butts up in our casework and the frustration that that causes for us and, more importantly, for our constituents—those who have to make multiple calls to arrange care for loved ones and so on. If that is our purpose here, we want health and wellbeing to come first. The amendment seeks to do that and says that the primary aim of the three is the health and wellbeing of the population. If that means that there is a knock-on effect on political decisions on funding, as discussed in the previous set of amendments, so be it. It will be for the Government of the day to ensure that NHS England has the resources to do that well.
I draw the Minister’s attention to the very recent precedent in the Medicines and Medical Devices Act 2021, the Bill Committee for which took place in this room or an identical one. I was a member of that Committee, as were the hon. Member for Bury St Edmunds, who is not in her place at the moment, and the hon. Member for Erewash. When we discussed the triple aim of that Bill, I moved an amendment to prioritise patient safety over all other considerations, because I thought that was an uppermost consideration. It was originally rejected in Committee, but the Government brought it back in later stages, which was the right thing to do. Rather than waiting to bring this back later, we could address it today. I would be very interested to hear the Minister’s comments on that.
Amendment 23 is a counterpart to amendment 21, but it operates at local level. Whereas amendment 21 applied to NHS England, amendment 23 applies to local integrated care boards—to say that, as part of their responsibilities, they must take inequalities into account. Of course, all the arguments that I have made for NHS England also apply here, so I will not repeat them, but this is quite a profound case at local level. From the written evidence, the hearings and the contributions from hon. Members throughout the Bill’s stages and elsewhere in this place, we can see that there is considerable anxiety that we will end up devolving fixed financial settlements down to the integrated care system level. That suits Ministers, because it means that they can devolve financial responsibility so that the Treasury can know what it is spending on a certain function, but all the tough decisions that get us to that point have to be taken at local level. I do not think that is a dystopian scenario, because that is literally what we do with social care already in local government.
The Government know that they do not resource local authorities sufficiently. As a result, social care is squeezed. What happens in those circumstances is that the systems start to worry about running out of money. The hon. Member for Central Ayrshire made a point about end-of-year capital that I recognise from my time in local government, but it works in reverse—when Christmas comes about, there is a spending freeze on everything, and the chief executive of every council in the country ends up reviewing every purchase of more than about a fiver. That is the reality for the systems, and local commissioners will be pressured to think in the interest of resourcing their system, rather than tackling health inequalities. That runs straight into the argument for amendment 24, which is a counterpart to amendment 22 and which says that the hierarchy within the triple aim ought to apply at an integrated care system footprint.
In paragraph 44 on page 18 of the explanatory notes, the Government have told us that the purpose of the triple aim duty is to
“require organisations to think about the interests of the wider system”.
I get that, but I do not think it is quite right, because the primary responsibility is to think about the interests of the wider population. It flows from there that the best way to address the health needs of the population is a system-based approach, which is the Minister’s central argument for this entire piece of legislation—so organisations have to think about each other. However, the primacy is the need of the population.
Perhaps the Minister will say it is axiomatic that health systems will prioritise the wellbeing of their community above everything else, but I do not think it is inconceivable at all that at some point in any given year—never mind at some point in the future—system leaders in one of those footprints will feel distressed about their finances and may take the wrong message, or perhaps the wrong bit of cover on a commissioning decision, about putting population wellbeing in the same tier as system sustainability, as if those two things could be co-equals and, if in tension, could be resolved either way. I do not think that is right, and I would be interested to hear the Minister’s view on that.
Amendment 25 requires health trusts to pay regard to “health inequalities”. Again, it is a counterpart to amendments 23 and 21, and it is for the same reasons as for NHS England and integrated care boards, so I will not repeat those arguments.
Amendment 26 is a counterpart to amendments 24 and 22, requiring the prioritisation of population health and wellbeing at trust level, for the same reasons that I have just mentioned. Again, I will not repeat those arguments.
Dr Whitford
I rise to support these measures. The longer those of us who work in the NHS spend on the frontline, in particular as a breast cancer surgeon in a specialist area, the more we realise that we are constantly catching someone who falls, instead of building a handrail to stop them falling in the first place. Anyone who works in health or social care recognises that health inequalities are a major issue, going right back to the Marmot report of 2010, the Black report and, indeed, many decades. Therefore, they should be a priority at every single level.
The public have a real appetite to see a different approach after covid, because they are aware that covid was not a leveller. It absolutely hit the weakest, most vulnerable and poorest communities. To change the prioritisation to health and wellbeing is also critical. More money is spent picking up the pieces than investing in health in the first place. That is often the health of children; we should try to tackle child poverty and the issues that come from that.
I took part in a report in 2016 that heard from the UK Faculty of Public Health that the UK loses 1,400 children a year before the age of 15, as a direct result of poverty and deprivation. It is clear that the aim of the Bill is not just to take away the appalling section 75. It is to drive integration and the health of the local population. That should be set as a key priority, if the aim is to come out with an approach of putting health in all policies, within local government, the ICS boards and the NHS.
Karin Smyth
I concur with the comments of the hon. Member for Central Ayrshire and my hon. Friend the Member for Nottingham North. The hon. Lady referenced the Black report, which first got me interested in working in the health service. I was shocked that, after all those years, the NHS had not improved the dreadful health inequalities that much of the population, including my own constituents, suffered. Here we are 40 years later, and we still have some really quite shocking health inequalities, even in the wealthy city of Bristol.
This is a really important point. We learned a lot in the pandemic, and hon. Members spoke about meeting their directors of public health recently. I have known my director of public health in Bristol for some 20 years because we have worked together over that period. I supported the movement of DPHs into local authorities. I think that was the right move, although the lack of funding that followed has made their job really difficult, and we have not made the improvements we should have made, as my hon. Friend the Member for Nottingham North outlined.
There is real enthusiasm among clinical and financial leaders for some of the movement in the Bill to bring organisations together in integrated care partnerships or ICSs—wherever we think the power will be—to look at population health. Financial directors I have talked to have said, “This is the direction we need to be going in. We need not to be looking just at our own institutions.” There is a will with the Government, but not including health inequalities is a major mistake. I appreciate that when they drafted this legislation, they were perhaps not thinking in that form, but a number of organisations have asked for that addition to be made.
The pandemic required us to talk closely to our clinical leaders, and it really educated people in individual specialties, who are not terribly knowledgeable about health inequalities—perhaps we think they should be. Even in terms of our understanding of where vaccines have been successful and unsuccessful, and how different communities receive information and engage with local health and care services, the pandemic has been a wake-up call and a good education for many of those leaders. We need to capitalise on that.
I know that drafters do not like to change things, but if we were to put addressing health inequalities in the Bill, as we seek to do, it would focus the Government’s drive on place-based commissioning and service delivery, and send a message to the powerful acute trusts—which at the end of the day run the money, and still will—that addressing health inequalities and looking at where and how their services are delivered to the most vulnerable will be a really positive outcome for the entire system. I therefore support the pursuance of the amendments.
Hywel Williams (Arfon) (PC)
To encourage the Minister to accept the amendment, I point out that addressing health inequalities would coincide with the Government’s stated aim of levelling up, so there is a happy coincidence there that might persuade him. Health inequalities are reflected geographically, and large parts of the country clearly suffer from them more than others. That pertains to England, but were I standing in the Senedd in Cardiff, I would say the same about Wales. That is slightly off the point, but there we are.
Edward Argar
I am grateful to the shadow Minister and all other hon. Members who have spoken for the expertise that they bring to this debate. It is one of the quirks of this House that lawyers are hon. and learned Members and members of the armed forces are hon. and gallant Members, but we do not have an equivalent for those who serve in the medical profession. Perhaps we should think about that.
I am very grateful to hon. Members for bringing this debate to the Committee by tabling these amendments, which relate to the important issue of health inequalities, in the context of the new triple aim duty set out in the Bill. Even though we may not reach the same conclusions about the best way to do it, it is right that we debate this crucial issue in Committee.
With your consent, Mrs Murray, and that of the Committee, I will start in reverse order with new clause 13, and then work my way through the amendments of the hon. Member for Nottingham North. The new clause would place an additional duty on the Secretary of State to produce a report setting targets on the improvement of the physical and mental health of the population and the reduction of health inequalities.
I appreciate and understand the intention behind the hon. Gentleman’s new clause. He is right: health is the nation’s greatest asset. Preventing ill health, improving people’s health and wellbeing, and tackling long-standing inequalities are all fundamental to the economic and social strength of our country. However, the creation of a new statutory duty to set the type of target identified in the new clause is not necessary, in the light of the existing duties on the Secretary of State around improving public health and seeking to reduce health inequalities, as provided for in the 2006 Act. I may not agree with everything in it, but I pay tribute, where it is due, to the Labour party. Labour Members will hear a number of references to what is in that Act and to the retention of what is in that Act in many areas.
Of course, ICBs, too, have duties to have regard to the need to reduce health inequalities whenever they are exercising their functions, to promote integration where it would reduce health inequalities and to set out how they will tackle health inequalities in their plans.
I hope I can reassure members of the Committee that the Government are already taking strong action in these areas and that there are already a number of targets relating to improving the population’s health that cannot be met without addressing those underlying inequalities. For example—I know that this is something that the hon. Member for Nottingham North feels very strongly about—we cannot achieve our existing commitment to a smoke-free generation by 2030 if we do not address as a priority the needs of those people and populations with the greatest levels of need and help people to give up smoking. He is right, and this involves the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds. I suspect that when we reach the latter parts of this legislation that are about public health more specifically, this issue may feature, rightly, in the Committee’s discussions again.
To support our strategy to improve the population’s health and reduce health inequalities, at the beginning of October we will launch the Office for Health Improvement and Disparities within the Department. We have also announced that we will create a cross-Government ministerial group with a remit specifically to identify and tackle the wider determinants of poor health. Our broader focus on levelling up, to which the hon. Gentleman alluded, recognises the wide range of factors such as good jobs, homes and local environments in which we can take pride, alongside a range of other factors, that all support and interact with our physical and mental health.
In contrast, I fear that the new clause, although I can see its intent, could make it more difficult for us to swiftly focus on ensuring that such inequalities are identified and acted on. Had we a fixed, five yearly set of targets to work towards, I fear that it would introduce more rigidity, rather than the agility and flexibility that we seek in meeting the changing assessments of what underlying health inequalities must be tackled as a priority. I hope that I can persuade members of the Committee, although perhaps not all of them, that a five-year fixed plan is potentially inflexible and is not necessary in the context of this legislation.
I turn now to the amendments that relate to the duty known as the triple aim. Amendments 21, 23 and 25 would add a fourth limb of tackling health inequalities for NHS England, ICBs and NHS trusts. As I have stressed, we do recognise the importance of tackling health inequalities, but again, we do not feel that the amendments, however well intentioned, are necessary. As we have discussed, there are existing statutory duties on bodies in this area, many of which relate specifically to health inequalities. NHS England and ICBs will have to have regard to such duties alongside the limbs of the triple aim. NHS England will also have to consider such duties when it produces the guidance on the triple aim.
The triple aim is compatible with and conducive to addressing health inequalities and furthering the delivery of these duties. Indeed, tackling health inequalities is a theme that runs throughout the duties. Having organisations consider the wider effects of their decisions will, we believe, encourage greater collaboration and engagement with communities on how best to meet their needs, which in turn will assist with tackling health inequalities nationally, but also flexibly at a local level.
The triple aim duty requires consideration of the health and wellbeing of the people of England. As the shadow Minister alluded to, that would also include consideration of the health and wellbeing of those who are not accessing health services. Similarly, it is a key element of the second limb of the triple aim—the improvement of the quality of services—to consider those areas where services are in most need of improvement. We expect guidance from NHS England to make clear how bodies can discharge the triple aim duty in a way that is fully commensurate with the reduction of health inequalities.
Alex Norris
Turning briefly to the points made by colleagues, the hon. Member for Central Ayrshire made the same arguments I did about patient safety and the Medicines and Medical Devices Act 2021. She made very good points about the health and wellbeing amendments, and I thought she was right to say that there is a real public appetite, now in particular, to tackle inequality. I do not think the public would be surprised to see the Government enter this space.
The hon. Member for Arfon made a similar point about whether levelling up is a political slogan or a public policy programme. It is very hard at the moment to find evidence for the latter, but this would be a really good piece of evidence for it. It is not just a north and midlands versus south issue. As my hon. Friend the Member for Bristol South said, there are some constituencies, like my own, where every single super output area would be in the hardest pressed decile in the country. However, there are many more where there is a greater range—they have some of the poorest parts of the country, but they also have some of the best off. This is something that ought to be at the top of the priority list for every integrated care system in every constituency.
On new clause 13, the Minister said that five years is too rigid. He almost suggested that the Government might outperform. I will believe it when I see it, but there is no evidence from the last 11 years to suggest that that is in any way a risk. Nevertheless, if he brings this back with a two, three or four-year time period rather than five, I will be the first to join him in the Division Lobby to support it.
On amendments 21, 23 and 25, the idea of a “fourth limb” made it work conceptually—I quite like that. What I did not give much succour to was the idea that inequalities lie somewhere else on the statute book, in a way that health and wellbeing and organisational sustainability do not, and therefore it would not need that co-equivalence because it already exists. I did not agree with that point at all.
On the point about inequalities being part of the guidance, I suspect that that will not be the last time that is said in this Committee. Guidance is guidance; legislation is legislation. One of those is an awful lot more powerful and eminent than the other. My view is that if we want to send a clear signal about something, we do not take it out and stick it in the guidance.
I do not give much succour to the point about elevating one of the triple aims either. The Minister said that that would undermine the triple aims. He talked again about the interest of the wider system, but I think all of us are more interested in the wider population. One of those clearly comes before the other. The needs of the one flow into how to organise the system. To organise a system that is supposed to come together in the interests of population health, I would really like to think that population health is more important than the system. I am not sure about the idea that, as a result, worse decisions would be made, and I would be interested in hearing an example. I have to say that that point did not resonate with me.
I am conscious of the reply from the Minister and, indeed, of the time, so I will not press new clause 13 and amendments 22 to 26. However, I do wish to push amendment 21, because if we are talking about NHS England—that totem of healthcare in our country—I really think we ought to send the signal that health inequality should be one of its priorities.
Question put, That the amendment be made.
Edward Argar
The clause places a new requirement on NHS England to consult and involve carers and representatives of those individuals to whom health services are provided when exercising its commissioning functions. NHS England is currently required to involve and consult individuals to whom healthcare is provided when carrying out its commissioning functions; the clause extends that existing requirement to consulting with their carers and representatives as well. We want to ensure that we have a health and care system that is accountable and responsive to the people who rely on it.
The clause recognises the immensely important role that carers and representatives play in supporting our health and care system, and ensures that our legislation remains in step with current practice within that system. I therefore commend the clause to the Committee and hope that all Members feel able to support it.
Justin Madders
I am sure we are all excited to get this one passed—I am certainly not going to oppose it. However, I have a couple of questions of clarification.
Health and Care Bill (Sixth sitting)
Tuesday 14th September 2021
(3 years, 3 months ago)
Public Bill CommitteesRead Full debate Health and Care Act 2022 View all Health and Care Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 14 September 2021 - (14 Sep 2021)
The Committee divided: - Ayes: 4 / Noes: 9 - Question accordingly negatived.
The Committee divided: - Ayes: 4 / Noes: 9 - Question accordingly negatived.
The Committee divided: - Ayes: 5 / Noes: 9 - Question accordingly negatived.
Justin Madders (Ellesmere Port and Neston) (Lab)
It is a pleasure to see you in the Chair this afternoon, Ms Elliott.
We were left on a cliffhanger before lunch. I was about to ask the Minister some questions. He might have preferred the advantage of having two and a half hours in between to think of an answer, but I am sure he will cope. Actually, it is a fairly straightforward question, so I hope for a fairly straightforward answer.
The clause refers to carers and their representatives. Will the Minister clarify who that is? Is that carers’ groups or, for example, someone who might hold power of attorney? That is really the only comment I wanted to make on clause 5.
The Minister for Health (Edward Argar)
It is a pleasure to serve under your chairmanship, Ms Elliott, I think for the first time in Committee.
To answer the shadow Minister briefly, I certainly envisage that the clause encompasses those with power of attorney, because in effect and in law they are the legal representatives of individuals who do not always have capacity to speak for themselves. In that context, I also hope that we will see carers’ organisations, as well as others who do not necessarily have power of attorney but act as advocates or representatives for individuals, having their views heard and taken into consideration. I hope that gives the hon. Gentleman some reassurance.
Question put and agreed to.
Clause 5 ordered to stand part of the Bill.
Clause 6
Support and assistance by NHS England
Question proposed, That the clause stand part of the Bill.
Edward Argar
The clause confers a power to provide assistance and support to NHS foundation trusts, NHS trusts and other persons providing services as part of the health service in England to work to secure continuous improvement in the quality of the provision of such health services and their financial sustainability. That new power replaces a range of existing support functions sitting with NHS England and the NHS Trust Development Authority. In particular, it replaces the function of the NHS Trust Development Authority to take steps to assist health service providers as conferred by directions. It also replaces the existing power of NHS England to support clinical commissioning groups and primary care providers, which enables NHS England to provide direct financial support to integrated care boards and providers within the scope of the provisions, and to provide other support and assistance to all those bodies exercising functions within or part of the health service.
The clause is an example of the positive improvement that the merger of NHS England, Monitor and the NHS Trust Development Authority will bring to the health service. It will allow NHS England to take such steps as it sees as necessary to identify and address areas of concern early, while also providing support to leadership and guidance where required to shape the services that are delivered for the greatest benefit of patients. I therefore commend the clause to the Committee.
Justin Madders
The Opposition will not oppose the clause, but I have one or two queries that we hope the Minister will be able to answer. Obviously, it is a broad power. I assume that the reference in proposed new section 13YA(1)(a) to “person” relates not just to individuals. Perhaps the Minister will expand on what that is meant to cover.
Also, specifically, at proposed new subsection (3), on integrated care boards and the provision of financial assistance, as we remember from the evidence sessions, there was not a great deal of clarity about the costs that NHS England anticipated might be incurred as a result of the legislation. Will the Minister assist us by providing some estimates of that, as well as whether the powers under clause 6, including the financial assistance, are subject to any limits or reporting requirements back to the Secretary of State, and whether Parliament would have a role in that at any point?
Proposed new subsection (2) talks about providing
“employees or any other resources of NHS England.”
The Minister said that “employees” could include secondees. I think it is clear from the guidance that certain roles on the ICB should not have any, for want of a better description, conflicts of interest or hold any other roles within the wider NHS. I want to make sure that the Minister is clear that that requirement is not going to cause us any difficulties.
Edward Argar
I am grateful, as ever, to the shadow Minister for his succinct questions. I will try to address them all in turn. He referenced the term “person” in proposed new subsection (1). It is a legal definition. In the context of the services provided—I mentioned primary care—it could be a GP practice. Having gone through the drafting with officials, my understanding is that it is a legal term and does not alter what is currently possible.
I may take the questions slightly out of order, and I hope he will forgive me. On proposed new subsection (2), I think he was referring to subsequent new clauses and amendments he has tabled around ICBs, who the suitable persons to sit on them are and the management of conflicts of interest. I suggest to him that, given the amendments he has tabled, the most appropriate time to discuss those issues would be in the context of how we do or do not further refine the definitions around memberships of ICBs. The Committee will reach that on Thursday, I suspect. On reporting and transparency, I entirely share his view and reassure him that I expect transparency to play a key role when public moneys are spent this way.
Finally, on proposed new subsection (3) and the cost to the NHS and the Exchequer, no specific limits are stated in the legislation, but, obviously, any assistance provided would need to meet the purpose set out in the Bill and be transparently awarded. I hope that gives him some reassurance, but I am always happy to revert to him if he wishes to follow up on any detail—either now or in writing.
Question put and agreed to.
Clause 6 accordingly agreed to stand part of the Bill.
Clause 7
Exercise of functions relating to provision of services
Question proposed, That the clause stand part of the Bill.
Edward Argar
I am getting my exercise today in bouncing up and down in my seat. Clause 7 enables NHS England to direct one or more integrated care boards to exercise certain NHS England functions and to fund the exercise of those functions. This relates to NHS England functions such as the commissioning of specialised services, health services in justice settings and armed forces settings, primary medical services, dental services, primary ophthalmic services, pharmaceutical services, and any of the Secretary of State’s public health functions that are exercisable by NHS England on his behalf. In future the intention is that ICBs be responsible for the majority of health service commissioning in England. This approach will ensure that decisions about services are made closer to the patient and in line with local population needs, enabling greater integration in the way that services are arranged and delivered.
Clause 7 ensures that NHS England has the appropriate powers to make sure we achieve our policy objective, by allowing flexibility for ICBs to take on these additional commissioning responsibilities as delegated functions from NHS England. We intend that this can be used by NHS England to delegate primary care functions while ICBs mature, before we transfer them fully to ICBs at the appropriate time using clause 16 and schedule 3, which we will debate in due course. This will allow NHS England to keep a closer watch on how ICBs are discharging these functions, and managing the transition, before they are fully delegated to and embedded in ICBs.
The Secretary of State will have the ability to make regulations under this clause, meaning that, where appropriate, certain conditions or limitations can be placed on NHS England’s power to direct ICBs, including the ability to prescribe functions that the power does not apply to at all. Any directions issued by NHS England under this clause must be published. I know that the transparency point is one that the shadow Minister has raised on a number of occasions, so I reassure him that they must be published ensuring that such directions are made transparently, and that responsibilities between NHS England and ICBs are clearly set out.
This clause is essential to give NHS England the flexibility, and the appropriate mechanisms, to delegate the commissioning of these services when the time is right to do so. Therefore, I commend it to the Committee.
Justin Madders
We will not be opposing this clause. Clearly, as the Minister has set out, it is necessary to enable the functioning of the health service.
I have one question about the powers under proposed new subsection 13YB(4), which are effectively prohibitions on the ICBs from delegating arrangements further. Will the Minister set out what circumstances are envisaged, if any, where this power may be necessary? There will obviously be delegations, not only to the services listed there, but to place-based organisations. In that situation, what does the Minister see the role of the ICBs as? Will it be the ICB itself that delivers those functions, or will it be another body?
Karin Smyth (Bristol South) (Lab)
Further to those points about clarity around the exercising of powers, the move to give NHS England that power is entirely sensible. The medical, dental, ophthalmic and pharmaceutical services have had a lower profile in our constituencies over the last few years, as I think we would all agree. It is important to give them the profile they need to be integrated into the system, because they have certainly not been so far.
The evolution of delegating that power to CCGs came late in the day, and remains muddled around the commissioning of primary care services. Therefore, while allowing the delegation of function is entirely sensible, it is not clear, as my hon. Friend the Member for Ellesmere Port and Neston has said, when or how that delegation will be sought. I think the Minister was referring to the involvement of the Secretary of State, but I am not sure in what circumstances the Secretary of State would be doing that, and why this would not be when NHS England, or NHS England regions, decides that the ICB is of a maturity to accept commissioning responsibilities.
One assumes that NHS England believes that at the moment some of those putative organisations are mature enough already; will some of them start doing that on day one, six months in or a year in? How will we know and how will they be resourced to do it? Is it a transfer of power? How NHS England and the local ICB, without representatives of medical, dental, ophthalmic and pharmaceutical bodies, will be taking that on board is all very opaque.
Alex Norris (Nottingham North) (Lab/Co-op)
My hon. Friend has a local Mayor, but my community does not. If someone lives in Greater Manchester there is a Mayor, but in other places there may not be. We have a very asymmetric model of local devolution. Does she agree that an asymmetric model of devolution, where some ICBs had certain powers and others did not, would be undesirable and may create more confusion than it solves?
Karin Smyth
My hon. Friend makes an interesting point about asymmetrical power and who does what. I may differ slightly, in that I think that that may suit local circumstances, but the judgment about what a mature ICB is, and which powers it should be responsible for, has been made behind closed doors and according to criteria about which we know nothing. The professionals in those services certainly deserve to know better.
Edward Argar
The hon. Lady is absolutely right about the importance of trying to join up different primary care services and the commissioning arrangements. There has been, under Governments of all complexions, a fragmentation in that, with some services commissioned nationally and others locally, and the Bill gives us an opportunity to create a more coherent, place-based commissioning approach.
On the specific point the shadow Minister asked about proposed new subsection (4) and the
“direction under subsection (1) to include provision prohibiting or restricting the integrated care board from making delegation arrangements in relation to a function that is exercisable by it by virtue of the direction”,
my understanding is that it is a pragmatic clause, basically limiting the ability to sub-delegate further. We would envisage this being a consensual and collaborative approach between us and NHS England in the region, and of course the Government would be guided by NHS England.
In the nature of having to make regulations in this House to do it, the wording reflects the fact that it will be the Government laying those regulations, but we would envisage that being guided and led by the NHS. As the hon. Member for Bristol South rightly said, the NHS region will often be the best place to advise on the readiness or otherwise of different ICBs at different stages in the process.
Karin Smyth
Would somebody be able to appeal to the Secretary of State if they disagreed with that delegation, for example?
Edward Argar
My understanding is that there is no formal right of appeal in this context. I suspect that dispute resolution and formal rights of appeal is something we will come back to in other contexts.
Clause 7 ordered to stand part of the Bill.
Clause 8
Preparation of consolidated accounts for providers
Question proposed, That the clause stand part of the Bill.
Edward Argar
Clause 8 places a duty on NHS England to prepare, in respect of each financial year, a set of accounts that consolidate the annual accounts of English NHS trusts and foundation trusts. The transparency of financial reporting across NHS providers will be diminished without this provision, as the consolidated provider accounts collate the financial reporting of all NHS trusts and foundation trusts to give an NHS provider position that is laid before Parliament, and has been since the 2017-18 financial year.
In addition, NHS England has a duty to provide a copy of the consolidated accounts to the Secretary of State and the Comptroller and Auditor General, and a duty to lay copies of the consolidated accounts and the related report before Parliament. To ensure adequate financial scrutiny, the Secretary of State has the power to give directions to NHS England on the principles and methods to be applied in preparing the accounts and their content and form, and can direct that the accounts must be accompanied by any reports or information deemed necessary. The Comptroller and Auditor General must, as their responsibilities stand currently, examine, certify and report on the consolidated accounts and send copies of the report to the Secretary of State and to NHS England.
The provisions set out in this clause not only provide continuity to the system but place in law strong levels of oversight relating to both NHS trusts and foundation trusts. That ensures the transparency that we would all wish to see and the robustness of the process and procedures governing financial health at a local level. This clause is an important way of ensuring NHS England discharges its responsibilities as system regulator in delivering appropriate and adequate stewardship of the health system and, ultimately, public money.
Justin Madders
Again, we will not oppose the clause, but I have a query about the powers under proposed new section 65Z4(4), particularly in the context of what the Secretary of State said at the weekend about targets being a lot of form-filling and nonsense. It seems rather odd to give himself powers to direct trusts to provide any reports or information that he requires when, clearly, the Secretary of State gets all sorts of information and reports from the NHS at the moment. Could the Minister say what he is not receiving at the moment that he thinks the powers will allow him to ask for?
Edward Argar
I consider proposed new subsection (4) to be purely pragmatic, as there will be circumstances with individual trusts and situations where clarifications to accounts or data may be required. Therefore, it is prudent to give the Secretary of State the power to ask for further clarification. He will be accountable to Parliament for how the money is spent, so it is entirely appropriate that he has explicit power, given by Parliament, to ask for information over and above the de minimis specified in the Bill, to ensure he can be completely transparent with Members and the public more broadly.
Question put and agreed to.
Clause 8 accordingly ordered to stand part of the Bill.
Clause 9
Funding for service integration
Question proposed, That the clause stand part of the Bill.
Edward Argar
Currently, one of the objectives of the Government’s mandate to NHS England—a process we discussed in Committee this morning—is that an amount of the annual sum paid to NHS England must be used for service integration. In practice, that must be contributed to the better care fund. The better care fund is the national policy driving forward the integration of health and social care in England. However, as we have discussed, other provisions set out in clause 3 will remove the requirement for a mandate to be published every year. As a result, the mandate will no longer be an appropriate vehicle for setting an annual ring fence for service integration. Therefore, the clause will put in place a new power to allow the Secretary of State to direct NHS England to ring-fence an amount of its annual allotment for health and social care integration through the better care fund, to continue the work of that fund and to direct it on how that amount should be used.
The change will have no impact on the operational policy intent of the better care fund; the provision will simply ensure the better care fund can continue to be set annually, notwithstanding changes to the mandate, which will not be made annually in the future, should this legislation be passed. The better care fund has enabled and improved co-operation between health and social care partners at local level. It is therefore important for it to continue. This clause ensures that that will happen, regardless of proposed changes to the mandate.
Further minor amendments are made to NHS England’s corresponding power to enable it to require that an amount of the sum paid each year to an integrated care board be used for service integration. That power exists currently in relation to clinical commissioning groups, and the amendment seeks to ensure that the better care fund continues to operate effectively once ICBs are established.
Justin Madders
Again, I will not detain the Committee for long: I just have a question for the Minister. The more we get into the Bill, the less permissive it appears to be. I have no doubt that will still be used by the Minister in defence against various amendments we will move later today. Given that we have been told that the role of ICBs is to direct health systems in their local areas, it is not at all clear what the situation is if the powers under this clause require them to set aside a certain amount of money for service integration, but doing so would mean a reduction in service elsewhere in the system. How would that dispute be resolved? Who would have the final say?
Edward Argar
As I made clear in my remarks, the clause does not so much direct ICBs specifically; it is primarily about setting aside an amount of the annual sum paid to NHS England to go to the better care fund, which is then allocated. This technical change will have no impact on the operation or policy intention of the BCF, and it should not have an impact on ICBs’ ability to operate. The intention is simply to make sure that as we move away from an annual mandate with an annual financial settlement for the BCF, we can still set an annual amount to go to the BCF so that it can continue its work, and for that to then be allocated to systems.
Question put and agreed to.
Clause 9 accordingly ordered to stand part of the Bill.
Clause 10
Payments in respect of quality
Question proposed, That the clause stand part of the Bill.
Edward Argar
The clause removes the Secretary of State’s powers to make regulations about payments by NHS England to CCGs in respect of quality. We are not abolishing quality payments, but in future they will be made to integrated care boards rather than CCGs—hence the change. However, the current clause conflicts with clause 37—General power to direct NHS England—which provides the Secretary of State with broad powers to give directions to NHS England. Clause 10 removes the power to make regulations setting out the principles or other matters that NHS England must consider in assessing any facts in relation to payments to a clinical commissioning group. However, clause 37 will allow the Secretary of State to use the general power to direct NHS England if required, including in relation to quality account. That will give additional flexibility to shape quality payments in order to better incentivise quality, reflecting our priorities and changing circumstances.
I reassure the Committee—I am not sure whether the shadow Minister will take the reassurance, but he may do—that there is no intention to use these powers frequently, but they will ensure that we have a robust legislative framework that is flexible and responsive enough to support the health and care system in future, in the event that such powers are needed. If Ministers were to direct NHS England in this area, they would be required to do so in writing, ensuring that the direction is in the public interest, and to publish that direction. That will ensure transparency, so that Ministers can be held to account. I suspect that we might return more broadly to that underpinning principle when we come to debate further clauses relating to it in the coming days. I commend the clause to the Committee.
Question put and agreed to.
Clause 10 accordingly ordered to stand part of the Bill.
Clause 11
Secondments to NHS England
Question proposed, That the clause stand part of the Bill.
Edward Argar
I have only a couple more of these clauses before the shadow Minister will have his turn with a few amendments.
Secondments can be an extremely useful way of bringing key expertise and resource into an organisation at short notice. We have seen the benefits of such a flexible approach in a number of organisations, including NHS England, and particularly during the pandemic. The clause builds on the practical importance of secondments and makes it clear how they can be used by NHS England, by amending schedule A1 of the National Health Service Act 2006, which sets out the constitution and membership of NHS England.
The Bill has given us an opportunity to provide NHS England with powers to appoint secondees across the organisation and use them in the same way as its own employees, and it allows secondees from specified NHS bodies and health arm’s length bodies to be appointed to NHS England’s board. The power to allow employees from specified NHS bodies to be seconded to NHS England and appointed to its board will allow those individuals to exercise NHS England’s functions on the board’s behalf, in the same way as other board members.
As we continue the fight against the covid-19 pandemic and, in parallel, prepare for the recovery of our health and care system, it is imperative that NHS England has access to the most suitably experienced and knowledgeable candidates for executive roles, and that those holding the roles be part of the important decisions that the system will face. The clause will assist NHS England in doing just that.
The clause also includes a regulation-making power, allowing the Secretary of State to make it clear that a reference to an employee of NHS England in the context of the National Health Service Act 2006 should include people seconded to NHS England, should that be considered appropriate in future. That power will ensure that the legislation assesses the continued effect of operation of secondment arrangements throughout NHS England. Any regulations—again, I hope that this offers some reassurance to the Opposition Front Bench—made under that power would be subject to the affirmative procedure in the House, so I commend the clause to the Committee.
Justin Madders
I will not repeat my earlier comments about secondees and ICBs, because we will pick that up later. In our evidence sessions, the role of the healthcare safety investigation body and its independence from NHS England was raised. Is the Minister comfortable that that role will not be compromised in any way by the requirements of the clause?
Edward Argar
I assume—and the hon. Gentleman will probably shake or nod his head—that in this context he is referring both to the Care Quality Commission and HSIB—[Interruption.] Yes, I am reassured and confident that the provisions in clause 11 will not impact negatively in any way on the ability of either safety organisation to conduct inspections and do the work that we envisage them doing. In the case of HSIB, we may return to that when we discuss the relevant clauses. I believe that what is proposed remains consistent with their specific roles, responsibilities and obligations and what we are seeking to achieve for patient safety.
Question put and agreed to.
Clause 11 accordingly ordered to stand part of the Bill.
Clause 12
Role of integrated care boards
Question proposed, That the clause stand part of the Bill.
Edward Argar
The clause replaces section 1l of the National Health Service Act 2006, which sets out the general function of clinical commissioning groups, with new section 1l, which sets out the general function of integrated care boards. It provides, in a similar way to CCGs, that ICBs have the function of arranging for the provision of services for the purposes of the health service in England. As a result, ICBs will now be the new commissioner responsible for the majority of health service commissioning in England. Later clauses will set out the details of the services that ICBs are responsible for commissioning, but we intend that they should include those currently commissioned by CCGs and some that are commissioned by NHS England, as we discussed in relation to a previous clause, such as primary care, dentistry, pharmacy and optometry services.
The clause is crucial to establish ICBs as the new key commissioners for the NHS in England in future. Our proposals bring together leadership across the health and care system, and without the clause ICBs will simply not have a clear purpose. It seeks to manage effectively in legislation the smooth transition from CCGs to ICBs, and I commend it to the Committee.
Justin Madders
Obviously, we will spend time this afternoon discussing ICBs, so I will not discuss this clause in particular. I will draw attention to proposed new section 14Z26, especially the proposals in subsections (2) and (3) for integrated care boards, which effectively allow clinical commissioning groups to determine their own processes to consult on ICBs. We do not think that the consultation process has been adequate—indeed, it has been non-existent in some situations—but we will probably return to the question of ICB geography later in this sitting.
Question put and agreed to.
Clause 12 accordingly ordered to stand part of the Bill.
Clause 13
Establishment of integrated care boards
Justin Madders
I beg to move amendment 49, in clause 13, page 8, line 34, after “board”, insert
“NHS trust, NHS foundation trust, trade union, patient representatives and local authority”.
This amendment would ensure that trusts and local authorities are consulted before any changes are made to the number, shape and size of ICSs.
There are two big themes on integrated care and the White Paper in the Bill and associated documents. Our points are aligned with those of local authorities, using the integrated care partnership as the vehicle to bring the planning of services, such as social care and housing, into the wider framework. It is also the development of the concept of place.
Local government, as we know, does place; the NHS probably does not do it in quite the same way. The clue is in the name. The “local” in local government means that it has always done community engagement; it already has to integrate multiple public services around the needs of a defined population. It is fair to say that the NHS has operated in a very different way in the past and can appear to have a different geography for every service that is accessed.
The Bill settles on 42 as the magic number of areas that the NHS is divided into, which could be influenced by “The Hitchhiker’s Guide to the Galaxy” and the ultimate question about life, the universe and everything. That might make more sense than what has been put forward so far as the optimal configuration for the integration of services. The view of many of those who we have spoken to is that 42 is too many for the commissioning of most acute and tertiary services, and too big for the commissioning of primary and community services and social care. Like a lot of things, it is a compromise. It is a fudge. It is an accommodation between competing interests and views.
There is very little explanation in the Bill—in fact, we have zero explanation—about how place will work. We need to understand more about that from the Minister. How will place fit into the commissioning framework? I hope we can have some further guidance in the Minister’s responses. For us, the concept of place is just that—a concept. It is not really pinned down or articulated clearly in the legislation.
As Members will be aware, the NHS has had local government as its key partner in healthcare from the outset. That is recognised by various bodies. For a long time, boundaries were not an issue. We sometimes forget just how intimately involved the NHS and local authorities were at the outset of the NHS. That has obviously changed over the years. It would be fair to say that the current integrated care system boundaries are really a product of the NHS and the way that they have been imposed implies a great weakness in the whole Bill. It is supposed to be about integration between local authorities and the NHS, but it is almost all about what the NHS wants and what it thinks is the best outcome. It should have been co-produced with local government, not presented as a fait accompli. Is the Minister able to tell us how much local authorities and mayoralties were involved and consulted in the design of ICS boundaries?
There is a dilemma here. In our view, starting this way, with boundaries that do not always reflect the natural communities that they are meant to serve, will store up problems. We are less than impressed by what has happened to date, and while we might well be stuck with the 42 configuration that we have now, that does not mean that we agree with the process. I use the term “process” in the loosest possible way. We do not believe it should be a template for the future. Amendment 49 seeks that, in future, any changes in ICS boundaries should be decided in consultation and conjunction with trade unions, local authorities and trusts, and that they are consulted before any further changes to the shape or size of ICSs are made.
The problem we see is how the big acute trusts fit into the system. It has been a problem faced in places such as Scotland and Norway, which are further down the integration pathway. As would be expected, the big trusts dominate, but while they might take 80% of the budget, the vast majority of interactions for the patient are in primary and community care and, of course, in social care. All of those sit far more comfortably in the local authority footprint, as the National Health Service Act 1946 accepted. It is even simpler to consider place in terms of districts and wards or even super-output areas. Those terms are all very familiar to local government, and local authorities already take them into account when they consider how to deliver their services. When the Pandora’s box is opened, we assume place is aligned with something that has already been defined, and we do not try to invent yet another new geography, as has been attempted with ICSs.
I would like to hear from the Minister what the impact might be of further revisions to the boundaries. I understand that Ministers have looked at that and they have apparently changed some but not others, without publishing any real rationale. I note that there have been some cosy fireside chats, after which various changes have emerged. That reminds me of how the Conservative party used to anoint its leader, but it is hardly a transparent or open way to do things.
Let us do the job properly, transparently and openly. No ICS should have a boundary that has not been agreed with all the relevant local authorities. I have had some information from the Minister in reply to a written question about discussions that he has had with hon. and right hon. Members, and I am grateful for that. However, I am still waiting to see all the evidence and civil servants’ recommendations that he had to hand when he made his decisions. One of the main themes during the evidence sessions was the concern that the Secretary of State and Ministers could make decisions for party political, or other less than noble, reasons. Of course, I do not accuse the Minister of doing that, but when decisions of this magnitude are taken in this manner, such questions will be asked.
Whenever we have changed the boundaries of parliamentary constituencies, there has been an extremely lengthy process. When my own local authority, Cheshire West and Chester, came into existence, I recall that regulations were approved by Parliament. I know that because I lived through the trauma of that change; for the record, I should state that my wife is a member of that local authority. The point is that the contrast between what happens with that sort administrative border change and what has happened here is stark. I should also make it clear that I have another hat on. As the Minister will know, there have been many discussions about the ICS area in Cheshire and Merseyside, and, as I understand it, the configuration will be reviewed within the next two years. I am sure that the hon. Member for Eddisbury agrees with me that any decision on that should be made with more transparency than we have seen to date, not less.
As an aside, it is probably worth saying that if we pretend that everything can be resolved on a single footprint, we fail to acknowledge that there are regional arms of what is pretty much a national ambulance service, some trusts operate multiple services across clinical commissioning groups, and even tertiary services are commissioned by NHS England for large population areas. Acute care will not be commissioned at place or even ICS level, so we need to think about a simple place-based model for the rest. In terms of transaction volumes, the vast majority of care services, and indeed wider public services such as education and housing, are already provided on a local authority footprint.
At this point, I will mention our proposals for elected chairs, which I will come to shortly. With the right boundaries, it would be a lot easier to enact that. Proper co-location brings healthcare into line with the rest of the public services—local authorities, police and fire. It makes no sense at all for ICS boundaries not to be coterminous, and I do not think the Minister should disagree with me on that. The boundaries need to match those of combined authorities and mayoralties, and they should be set by local authorities and their partners, not just by the NHS. In terms of transactional volume, the vast majority of patient care interactions are in primary, community and social care, and for the patient they are all classed as local.
This veers into a bigger debate about devolution, mayoralties and combined authorities. The trend is one way. If we start with a blank sheet of paper, the answer is obvious: align along existing populations and boundaries. This matter should have been discussed well before the switch from sustainability and transformation partnerships to ICSs; indeed, that should have been done when the STPs were formed. That was the time to develop a proper and open process and deal with concerns. That is history now, but at least with this amendment we may be able to avoid repeating those mistakes.
Edward Timpson (Eddisbury) (Con)
It is a pleasure to serve under your chairmanship on this Bill Committee, Ms Elliott. I rise to speak on the amendment, not to support it, I am afraid, but I do want to show some sympathy with the arguments the Opposition have raised about the way ICSs have come into being and particularly about their size and population.
As was hinted at by the shadow Minister, the hon. Member for Ellesmere Port and Neston, this is where we have a shared experience of the shadow integrated care system in Cheshire and Merseyside, which has, I think, been through four different leadership teams in the last five years. Concerns have been raised with us, by local government but also by many working in the health service in and around Cheshire and Merseyside, about how the construct of this ICS will impact on their ability to deliver local place-based healthcare.
On size, the majority of the evidence we have had in the sessions to date has suggested that the formulation of ICSs needs to have a level of flexibility and permissiveness. However, we also need to be cognisant of the fact that there are populations that will need to be served differently, based on past experiences of borders that already exist. Cheshire and Merseyside will to cover 2.6 million people—that is over eight times the size of some ICSs. It will incorporate 9 CCGs—more CCGs than that, but in Cheshire itself it has moved from four to one as recently as April 2020. There will be 19 NHS provider trusts and 51 primary care groups. It is going to be an almighty body trying to make sure we deliver healthcare at the very local level as best we can.
If that is not done well and there is not the right level of scrutiny, transparency and accountability, the number of bodies on the Cheshire and Merseyside board, for example, could end up being 63 if every body that falls within that geography and that has asked to be on it has a place at the table.
We contrast that with the example of Gloucestershire. We had evidence from Dame Gill Morgan, who is the chair of that ICS, which is one of the much smaller ICSs. In one of our evidence sessions, she was very clear from the experience that she had had:
“If you have a really large ICS and you are trying to do it all, you are so distant from patients, citizens and clinicians that you will never have the contact. Place, in those bigger systems, has to be where you begin to pull those things together, by getting the right people to engage and developing the right level of trust.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 129, Q177.]
Where that will be vital in an area such as Cheshire and Merseyside is on my second point, around population. The ICS will incorporate a huge and diverse population across the Liverpool city region and Cheshire. Those who have only a cursory knowledge of that part of the world will not be surprised to hear that, within it, there are very different health populations, needs and inequalities. The concern that has been raised with myself and other local representatives is that, over time, there is a risk that that might have an impact on some of the priorities, and where they sit within that large area, as well as on what allocations that might bring to deliver the right level of healthcare.
In one of the unitary authorities in Cheshire—Cheshire East Council—somewhere between 55% and 70% of its overall budget is spent on social care. It is so important that these bodies have an integral role in making sure that the place-based services match what they know is needed within their own budget.
There has been some amelioration of that issue, by virtue of the local authority representation on the integrated care board—I think it has two representatives. I was pleased to see in my hon. Friend the Minister’s written statement on 22 July that as part of the boundary review of the ICSs, which has been referred to, Cheshire and Merseyside will have a period of two years where the current arrangements will be reviewed. I seek assurance from the Minister that that review will have veracity and deep-rooted scrutiny of the performance of the ICS during that period, to ensure that it does not fall into the trap that some of the larger ICSs could do unless we have the balance right between the role of local government and local healthcare providers, alongside this larger organisation, which will have to encompass a huge range of demands and pressures on its time and resources.
I have every confidence that my hon. Friend will ensure that the exercise is fruitful, that in Cheshire and Merseyside—particularly in Eddisbury and in Ellesmere Port and Neston—we end up with a better system than we have, and that our patients and residents will be able to get the healthcare that they need when they need it, irrespective of where they live.
Dr Philippa Whitford (Central Ayrshire) (SNP)
It is important to recognise the changes that the NHS in England has been through over the past 20 years, moving from about 100 strategic health authorities to primary care trusts, too more than 200 CCGs, to STPs and now to this. Witnesses in the ICS session said that although some were making great progress, it was those with boundary difficulties that were falling behind. The Bill talks about population health and wellbeing, but local government drives a lot of those things: housing, active transport, social care or what the town centre looks like. It is therefore important to get the boundaries right, or in a few years’ time there will be yet another upheaval.
In Scotland we got rid of trusts and went to health boards in 2004, and we have had 17 years of stability since then. If people keep moving around who they are connected with, the Government are breaking relationships and expecting people to form new ones. This is not a minor thing. I would like the Minister to explain what the basis was for deciding the number, the size and the geography of the boards. Was some formula used? Trying to get that right will be a major influencer of the outcome of the whole policy.
Karin Smyth
Ms Elliott, you were not with us last week when I bored the Committee about how many different jobs I had done in the NHS over the 20 years to which the hon. Member for Central Ayrshire referred. I feel as if I have lived and breathed that journey from the health authorities’ commissioning function through to primary care groups and primary care trusts. Much like the hon. Lady, I was prompted to come into this place by the Lansley Act—the Health and Social Care Act 2012. We all knew on the ground that, as was warned of and as has now been shown, it was completely nonsensical. It was never going to work, and it was hugely detrimental to the progress of securing better health in an efficient and effective way—more so than anyone could have imagined. I came here in 2015 for a bit of a quieter life—that has gone well for me!
Locally, I objected to the geographical footprint—we do not want to get into the footprints, but they are important to local people. The Bristol, North Somerset and South Gloucestershire footprint makes no sense to anyone apart from the chief executives of the local trust, because it is about acute sector flows and absolutely nothing else. That is why it is disappointing that we have not, for example, added health inequalities to the triple aim, because that would force such bodies to look at something more than the bottom line of those large acute sector trusts.
Dr Whitford
On that issue, when one of the amendments was turned down earlier, the Minister suggested that there was already a responsibility to deal with health inequalities that sits within the NHS. Yet, after 70 or 80 years, we have failed to do that, so do we not need not such priorities in the Bill? They need to be taken into account in shaping the ICSs.
Karin Smyth
I completely agree and, as I said, in that sense it has been refreshing to talk to financial directors locally. People who go to be finance directors in NHS organisations have healthcare in their hearts—they want to see only good healthcare and good outcomes—and some of this forcing together of clinicians, finance directors and other managers to look at population health is welcome. They recognise that the way in which the current funding model works—we will come on to the tariff—often stops them doing that, so adding in health inequalities would help. For the moment, we have lost that argument in Committee, but we will see how we get on in future.
In essence, where we have got to now is large CCGs coming together. That is what they are: they are rebranded CCGs. The wording in the Bill has been cut and pasted from 2012. I have other words for describing them: they are an NHS cartel. The CCGs commission and the big providers in that group all decide locally how the NHS cake should be cut—we will come back to that in future amendments. They are accountable neither nationally nor locally. That is deeply problematic. Even the partnership bit, as I think we established last week, is a committee of the ICB, although the Minister may want to clarify that. Sir Robert Francis did question whether that was the case. That goes to show that the architecture is really unclear.
The ICBs are creatures of the NHS, and well done to it for getting that on the statute book—almost—but this is essentially the same model. Therefore, as the hon. Member for Central Ayrshire alluded to in talking about the past 70-odd years, we need something better. The danger is that, as before, these bodies have no real discretion over spending; mostly, they are just the conduit for payments to existing providers. There is no real clout or sight of where we develop new services. They have very few levers to pull to drive innovation or service improvement.
All Members should be concerned about how we get that innovation and how we drive service improvement into the system. We need the ICBs to be better. They need to attract and retain the highest quality management or they will fail. They need to be perceived by the public as relevant and they need visibility. They must be the place where ambitious managers seek to work. They have to be the powerhouses, because they are the controllers of the money. They need good managers if they are to have an impact. They need to have local relevance—we will come back to that in future amendments. I am keen to support the amendment tabled by my hon. Friend the Member for Ellesmere Port and Neston about elected chairs and non-executive directors. Being held to account by the NHS region is very unhelpful.
In relation to Healthwatch, Sir Robert Francis—we should certainly take note of someone of his stature—told us the other day:
“All organisations currently in the NHS have directors of engagement and communication. I suspect that, with the best will in the world, most of them see it as their job to defend the organisation. This is not about defending an organisation; it is about welcoming constructive comment from the public and responding to the needs that people communicate to them.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 150, Q212.]
We can disagree on how that happens, but some of our amendments are designed to help that happen. This cartel is deeply problematic for all hon. Members locally.
As commissioner organisations, accountability does matter. No one is going to walk down the street saying, “Save my CCG” or “Save my ICB” while carrying a banner to save their local hospital. But CCGs control over £75 billion of taxpayers’ money, and they will continue to spend that sort of money. In my area, it is upwards of £1.5 billion or £2 billion. That dwarfs the council’s budget; it totally dwarfs the police’s budgets, yet we allow it to be done in this way. Even as a Member of Parliament with 20-odd years in the health service, I have sometimes found it almost impossible to find out who is accountable when a constituent comes to me with a particular issue. That is why I have focused on accountability and good governance.
In the proposed new organisations, who will be hauled up when something goes wrong? Who reports to the Public Accounts Committee? If the budget is inadequate, who decides what is cut and what is closed? If the boards are making those kinds of decisions, we need to know who appoints them. How do we know that they are independent? How can we remove them if they do not perform? If big decisions are planned, how do we know? What restrictions, if any, should constrain our right to know? The Bill should spell out those things. All our witnesses, and reams of written evidence, are grappling with that issue.
Politically we might disagree with the centralisation of the NHS and the diktat as opposed to the permissiveness. I am definitely on the more localised, permissive side. I think we need good managers and good clinicians to lead and develop our health services and to be accountable for that money. They must be really accountable.
I hope that in his reply, the Minister will take the opportunity to push back on some of the negative language about administrators and managers in the health service. There is a very good article in The Spectator. I commend it to him, if he has not read it. Why would we have doctors and senior consultants on the phone to these 5 million patients, trying to reschedule their appointments? Who is going to go and fix the boiler? The list goes on and on. We need to make these organisations the beacon of good quality management.
Edward Argar
I am grateful to hon. Members for their contributions on the amendment. I may disappoint the shadow Minister—I will not accept it. I hope he will let me address why and deal with some of the questions that have been raised.
The amendment would place a requirement on NHS England to consult relevant NHS trusts, foundation trusts, trade unions, patient representatives and local authorities before revoking or varying an ICB’s establishment order. We consider it unnecessary, because under clause 13, proposed new section 14Z25, NHS England is already required to consult any integrated care board that is likely to be affected before varying or revoking an integrated care board’s establishment order. Given that each ICB will have a strategic view of the health service and population needs in its area, and given that ICBs will have members from different NHS trusts and local authorities, we consider that they remain the best-placed bodies to bring those views together to reflect opinion on what is an appropriate boundary or establishment area.
Section 13Q of the NHS Act 2006 already places a duty on NHS England to involve and consult the public in the planning of commissioning arrangements, including in respect of any planned changes to commissioning arrangements. That includes, for example, if NHS England plans to change the range of health services available to the public or the manner in which they are delivered. That ensures the voices of residents and patients—those who access care and support—as well as their carers are properly embedded in decision making.
I draw the Committee’s attention to the requirement in clause 13, proposed new section 14Z26, for CCGs to consult any person they consider as appropriate on the first ICB constitution. That constitution will also be required to set out the process for making further amendments to the constitution.
Turning to the points raised by the shadow Minister and other hon. Members, the boundaries on which we are seeing the footprint put forward at the moment effectively reflect the evolution of STP and ICS boundaries to this point. They reflect local authority boundaries. By and large, the majority of ICS boundaries reflect one or more upper-tier local authorities. That was the criteria set by the Secretary of State. There are some exceptions, which I will turn to in a moment. I will also turn to the comments from my hon. Friend the Member for Eddisbury.
As the shadow Minister will be aware, the previous Secretary of State set out a process where he wanted a presumption in favour of coterminosity—the shadow Minister appeared to be supportive of that—unless there were exceptional circumstances in a particular area that justified an exception being made. The principle of coterminosity is something that was argued against, in some cases, by Opposition Members—not Front Bench spokespeople, as far as I am aware, but Back-Bench Members of Parliament—and by some Government Members, in respect of where there should be specific exceptions.
The process, which was touched on, was entirely consultative. Local authorities were fully involved in those discussions. The local NHS was fully involved in the discussions. There were also what could be referred to as cosy fireside meetings, involving Members from across the House, reflecting their right as Members of Parliament representing their communities to write to and engage with Ministers, to reflect their views. There was a multi-layered approach, with the local NHS and local authorities working together to come up with recommendations, and then Members of Parliament having the right, as all Members do, to lobby Ministers and put forward their perspective on behalf of their constituents. The approach was transparent, as my hon. Friend the Member for Eddisbury alluded to. We published a written ministerial statement, setting out for the House what had been decided, and we showed the flexibility and pragmatism that I think those consulted would wish to see.
In the areas where exceptions were made—the east of England areas and Frimley—contrary to what the hon. Member for Bristol South said, these are some of the most exceptionally high-performing ICS areas. That is one of the reasons why we decided not to go for coterminosity, because those systems are working well, with established relationships with local authorities, acute trusts and primary care. We took the view that we should not disrupt something that is working well—if it ain’t broke, don’t fix it. That will not stop it being reviewed in future, should the local system feel that that would be appropriate. That was a pragmatic approach to the issue.
My hon. Friend the Member for Eddisbury raised the issue of Cheshire and Merseyside ICS—I know that this will also be of interest to the hon. Member for Ellesmere Port and Neston, given the geography of his constituency. The ICS did meet the coterminosity test of one or more upper-tier authorities being coterminous, but I know that hon. Members on both sides of the House have raised concerns about its size and about the differences between Cheshire and Merseyside proper, and between different parts of the area, and suggested whether it should more appropriately be split into a larger number of smaller coterminous ICSs.
In a sense, the reason that split did not take place goes exactly to the heart of what the shadow Minister was saying, which is our determination to engage widely, consult local authorities and the local NHS, and come up with a set of rigorously tested proposals. This was—for want of a better way of putting it—a late addition to the work being done earlier this year, because it was already coterminous and the commission was to look at things that were non-coterminous. However, in the light of representations made by my hon. Friend the Member for Eddisbury and others, the Secretary of State was clear that it should be reviewed.
Two years was deemed an appropriate time in which to do that review, to allow that consultation with Members and others, and so that it did not straddle—subject to the passage of this legislation—the establishment of ICSs just at the time they were coming into being, and we could do that preparatory work properly. I can give my hon. Friend the Member for Eddisbury the assurance that this is a genuine and rigorous review process. When I emerge from this Committee room, perhaps I may, with Members on both sides of the Committee, discuss further what that looks like and how that might most effectively be carried out.
What that process has shown up, however, is that there is rarely a 100% consensus from all local authority partners and the local NHS on exactly what the right solution is where there is not coterminosity and we are moving towards it. That is why I am cautious about some of the language that has been used thus far, which essentially appeared to imply that we would have to have consensus, and that one part or other of the system would have, if not a veto, a right to put the brakes on changes. Were we to go down that route, I fear that, given different perspectives in different local authorities and areas, we would run the risk of paralysing any possibility of change. I think the right balance needs to be struck.
Karin Smyth
I hear what the Minister is saying, but on that basis—I think this is fundamental to all of this—why would we have local authorities or unitary authorities making any sorts of decisions? That is how local people exercise their democratic will. Bringing forward proposals in order to persuade sometimes results in a bit of stasis, but ultimately someone has to decide and break the deadlock, and the concern, as we come to some of the other amendments, is about how one does that. Local people should be able to have that in a transparent way.
Edward Argar
The approach that we have adopted thus far, which I believe is appropriate, is that we have that with local authorities and the NHS, but ultimately it is the Secretary of State who balances those in the case of these boundaries, and he is accountable to this House, so that strikes an appropriate balance. In the case of the East of England areas, certainly, we did have a very strong divergence of views as to what the right boundaries would be. It would be wrong if either local authorities or the NHS had the right to say, “No, it’s this.” That is where we have to have those views put forward together so that they can be considered in the round.
On the final point that the hon. Member for Bristol South made—I may have missed some points, but this is an important one that I want to put on the record—she is absolutely right to highlight the value of the work done by managers and administrators, or whatever title is used to describe them, sometimes pejoratively by some commenting on this matter. She is absolutely right about the value of their work. There is an analogy that I use all the time, with a much-hackneyed quote that Members will know: John F. Kennedy going to NASA, shaking the hand of the janitor and saying, “Thank you for putting a man on the moon.” What sits behind that goes to the heart of what the hon. Lady was saying. The NHS is a team. Without effective managers, people who can engage, and people who can manage budgets and ensure financial transparency and accountability, and without planning and people who make sure that patients are called and appointments are rescheduled, those on the clinical front line, if she will allow me to put it this way, would not be as effective at doing their job. It is not an effective use of a clinician’s time to ring up a patient to rearrange an appointment. Similarly, it would not be an appropriate use of the time of a highly skilled manager or administrator to be performing some other task. We have got to make sure that we have the right people in the right places, with the right skills.
The final point I would like to make again goes back to a point that the hon. Member for Bristol South made, about accountability. I think it was Amanda Pritchard, chief executive of the NHS—forgive me if it was Mark Cubbon, the chief operating officer—who highlighted, in asking who was accountable, that the ICB is an NHS body, working in partnership with the local authority, that is accountable for the funds it spends, which are voted on by Parliament. That is why it has an NHS official and there are routes of accountability up through the NHS to NHS England, and ultimately to the Secretary of State and this House. That is the structure of the NHS that has evolved over the past 70-plus years. I think that the hon. Lady sought—quite rightly—to press and challenge me on whether we think that evolution is the right approach, or whether we need to take a step back and challenge some of those assumptions. She is right to do that, but in this context, which involves the management of public money, the structures and accountabilities are correct.
I am sorry to disappoint the shadow Minister, as I fear that we will not be able to support his amendment. I hope he will not press it to a vote and that I have gone some way towards addressing the points made, particularly with regard to ICS boundaries and processes followed.
Justin Madders
We have had a fairly wide-ranging and useful debate. A number of issues have arisen that we will return to as the Committee makes progress. I am disappointed that the hon. Member for Eddisbury could not come on board; perhaps I should not have made my little dig about barristers this morning, otherwise he might have been more inclined to support us. I noted the sympathy he expressed and I think he articulated very well his knowledge of the geography of the area and why there are concerns locally about proper accountability in such a large area.
The irony of the whole debate, of course, is that we are discussing the Bill today, but before we have even got to the end, we know that the Cheshire and Merseyside ICS may not survive two years. Before the Bill has even become an Act, some of its constituent parts may be reorganised in future. We will see what happens on that, and I look forward to engaging with the Minister in that process.
Let us not forget that the genesis of what is before us was the STPs. How were they put together? I think local NHS leaders were sent a missive about three days before Christmas to say, “Can you give us an idea of what you think the most optimal design of your local NHS would be? By the way, we would like the response back by the end of January.” As we know, the NHS is traditionally extremely busy at that time of year, and Christmas is hardly a good time to be engaging with the wider public sector or indeed the community, but that was where the genesis was, and that is where the Cheshire and Merseyside STP and now ICS came from. It would be interesting to know how many of the 42 areas have changed since that original geography back in, I think, 2017—perhaps even 2016. It was clearly then, as it still is, a creature of the NHS, not the communities it represents.
Dr Whitford
Does the shadow Minister think that the fact we have heard today that Cheshire and Merseyside could be reviewed as quickly as in two years’ time might undermine some of the commitment on the ground? If people feel that it will all change again in two years, the engagement may be weakened.
Justin Madders
I thank the SNP spokesperson for her intervention. That is undoubtedly a risk. It is possible we end up with two or three areas out of that review. I hate to think it would get any bigger.
In terms of what people think is their relevant community, Merseyside has a metro Mayor now with very clearly defined geography, and Cheshire is a different area. As my hon. Friend the Member for Bristol South said, people do not take to the streets with banners saying, “Save our CCG!” I suspect the majority of people do not even know what a CCG is or the area that it is meant to cover. I suspect even fewer people know what an ICS is and what area it covers. That will definitely have to change if we are to have a truly integrated health and social care system.
The point made by my hon. Friend the Member for Bristol South about the defensive culture at times, alluded to by Sir Robert Francis, is a valid one. We may touch on that in the HSSIB elements of the Bill later on. She was asking the right questions—how can the board be challenged, and who is it accountable to? Those are points we will have to come back to, because there is, to our mind, a clear democratic deficit in the way these bodies have been structured.
Finally, the Minister referred to his guiding principle of coterminosity except in exceptional circumstances. Cheshire and Merseyside is coterminous, it is just coterminous for more than one local authority—and some pretty big ones at that—so I do not necessarily think that coterminosity is the answer.
The Minister referred to proposed new sections 14Z25 and 26 in regard to the duties to consult with members of the ICB. Some of the people named in amendment 49 might not actually be on the ICB, because they are not included in the legislation at the moment. We will come to our amendment on that in due course, and we might be able to change that. In proposed new sections 14Z26, CCGs must
“consult any persons they consider it appropriate to consult”.
That could be everyone and no one. I do not intend to press this to a vote, but I hope the Minister has taken on board several points that will lead to an improved process in the future. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Edward Argar
I beg to move amendment 10, in clause 13, page 9, line 44, leave out from beginning to end of line 12 on page 10 and insert—
“(1) NHS England may, in connection with the abolition of a clinical commissioning group under section 14Z27, make a scheme for the transfer of the group’s property, rights or liabilities to NHS England or an integrated care board.
(2) NHS England may, in connection with the establishment of an integrated care board, make a scheme for the transfer of property, rights or liabilities to the board from—
(a) NHS England,
(b) an NHS trust established under section 25, an NHS foundation trust, or
(c) a Special Health Authority established under section 28.
(2A) NHS England may, in connection with the variation of the constitution of an integrated care board or the abolition of an integrated care board, make a scheme for the transfer of the board’s property, rights or liabilities to NHS England or an integrated care board.
(2B) The reference in subsection (2A) to the variation of the constitution of an integrated care board is to its variation by order under section 14Z25 or under provision included in its constitution by virtue of paragraph 14 of Schedule 1B.”
This amendment adds a power for NHS England to transfer property, rights and liabilities (including rights and liabilities relating to a contract of employment) from certain NHS bodies to an integrated care board on its establishment: see new subsection (2). In consequence, new subsections (1), (2A) and (2B) restructure material currently in subsections (1) and (2).
Edward Argar
Both the amendments are technical ones. Amendment 10 amends proposed new section 14Z28 of the National Health Service Act 2006, which provides NHS England with the power to make transfer schemes to transfer property, rights and liabilities in connection with the establishment of, abolition of or change in the constitution of ICBs or the abolition of CCGs. The amendment widens the power to make transfer schemes when establishing integrated care boards, so that transfer schemes may include transfers from NHS England, English NHS trusts or foundation trusts, or English special health authorities.
We are widening the scope of those schemes to reflect further work done by NHS England, which has noted that a small number of people currently working in those bodies may need to transfer into ICBs. It is of practical importance for NHS England to be able to make transfer schemes that will ensure a smooth transition when ICBs are established, and for all the staff who may be transferring to newly established ICBs to be fully protected by such schemes.
For all but the most senior staff transferred from elsewhere in the NHS, I assure the Committee that NHS England’s employment commitment to continuity of terms and conditions, even if not required by law, will apply fully. That commitment is designed to provide stability and remove uncertainty during the transition. It is also possible for NHS England to use the schemes to transfer property and liabilities currently held by those bodies to ICBs on their establishment, although again we expect that to be rare in practice.
Proposed new subsections (1), (2A) and (2B) in the amendment restructure material in proposed new subsections (1) and (2) of the clause as drafted. That simply reflects the technical legal redrafting. The amendment therefore does not change the bodies that can be covered in transfer schemes relating to the abolition of CCGs or ICBs, or the variation of the constitution of an ICB. Those bodies continue to be CCGs, ICBs and NHS England.
Amendment 11 is consequential upon amendment 10 and is also simply a technical change. They are technical, but important amendments to ensure—and to be clear—that staff rights, liabilities and properties are in the right places in the NHS when we introduce ICBs into the system, and that the right protections are in place.
Amendment 10 agreed to.
Amendment made: 11, in clause 13, page 10, line 13, after “(1)” insert “or (2A)”.—(Edward Argar.)
This amendment is consequential on Amendment 10.
Justin Madders
I beg to move amendment 38, in clause 13, page 11, line 10, at end insert—
“Accountability
14Z28A Reporting: duties on integrated care boards and the Secretary of State
(1) Integrated care boards must report annually to the Secretary of State on their actions and policies and the outcomes for patients of the services they commission.
(2) The Secretary of State must prepare and publish a report each year on the actions and policies of integrated care boards and the outcomes for patients of the services they commission and must lay a copy of the report before Parliament.
(3) A Minister of the Crown must, not later than one month after the report has been laid before Parliament, make a motion in the House of Commons in relation to the report.”
It is a pleasure to move the amendment in my name and that of my hon. Friends. The heading is “Accountability” and, as I am sure the Minister will have picked up by now, we think that accountability needs to be turbo-charged in the Bill. The new commissioning bodies, the ICBs, are directly accountable to NHS England and therefore on to the Secretary of State. That was explained by Amanda Pritchard when she gave evidence last week. Each year, the ICB has to prepare a report on how it has discharged its functions and specialist duties under the various headings—improvements in quality, public involvement and so on. It has to report under lots of headings. One has to wonder how it will be able to pick priorities from all that, but that is a matter for the ICB.
ICBs must also publish their plans. The NHS, in the form of NHS England, will then assess the performance of each ICB against how it discharges its functions. Presumably, that will be at least in part with reference to those plans.
The amendment, in essence, would add the accountability of the Secretary of State to what we would describe as a fairly cumbersome but necessary regime of performance management. The slant of the reporting in the amendment is less steeped in the kind of bureaucratic tick-boxing that we understand that the Secretary of State is not a fan of, and what has to be reported is outcomes to patients--perhaps, the thing that matters most.
In the recent comparative survey by the Commonwealth Fund, the NHS lost its top slot and went down to No. 4. It was close, but not close enough. Despite usually coming top, it does badly on one of the key metrics that goes into the assessment—patient outcomes. We do well on ease of access but not so well on outcomes, which is a sad reflection. The amendment makes outcomes a priority over other factors. While the ICBs may have much to say on the day-to-day running of the NHS in the area, the ultimate responsibility for the whole system lies with the Secretary of State, even though on a day-to-day basis it may be NHS England that does the real leg work of performance management. In its new integrated form, NHS England performance manages various trusts and foundation trusts. It also runs the failure regimes for them if needed.
Ways of managing providers are well developed, but most of the skills necessary to monitor whole system performance have been lost to some extent, as management capacity in commissioners has been nibbled away. That brings me to the current weakness in holding providers to account on outcomes. Payment by results was a euphemism, as the results did not matter: the process was the determining factor. Reports on outcomes, as with on patient satisfaction, are absolutely necessary. If any system is to be taken seriously, it must seek to improve. ICBs should not see this as added bureaucracy: they should see it as reporting vital elements of healthcare. I draw particular attention to the reference in proposed new subsection (1), which refers to outcomes specifically, because we do not believe that gets as much prominence as it should.
Leaving aside the desire to produce the right reports for the Secretary of State, there is also an issue about how to make ICBs more accountable to their communities—we will touch on that later. Giving them sight of a nice glossy annual NHS report will not be very enlightening, and it will not help communities understand what has been done on their behalf, even if they recognise the NHS as part of their community.
Dr Whitford
Is the hon. Gentleman talking about clinical outcomes? One of the issues is having national clinical standards against which every unit and every area should be able to benchmark itself. In Scotland, we have standards for 19 of the commonest cancers, which are continuously audited. I was directly involved in developing the breast cancer ones in 2000. We have data that goes back over two decades, which means we can see improvement. It is clinical outcomes that need to be the focus, and they need to be agreed nationally: it should not be for every local ICS to decide what it measures and how. Otherwise we cannot say, “We are getting rid of variability, we are saying that a patient with this disease in Newcastle will get as good treatment as they would in Liverpool or Wolverhampton.”
Justin Madders
The hon. Lady is right; we still have a national health service and we should have national standards, and they should be tagged to clinical outcomes. Of course, it would be down to the individual ICBs to deliver against those outcomes, but it is right that those performance measures should be comparable across different areas.
A robust system of reporting is easier to understand and is probably the most important thing from a patient’s perspective. It is so important that it should land on the Secretary of State’s desk. We will talk later about how ICBs can be more accountable to their communities, but this is very much about how ICBs can be accountable to this place. I hope the Minister will accept the amendment.
Karin Smyth
I rise to support the amendment, particularly in relation to outcomes. The Government do not accept having reducing health inequalities as an aim. In my round-up of 20 years of CCGs and all the rest of it, the driver over the past 15 years has been to put primary care at the centre of those organisations, recognising that 90% of patient contacts are within primary and community services.
We heard from representatives of GPs last week, and I have spoken to my local medical committee as well. They are very fearful—we can dispute whether the evidence exists for whether clinical outcomes are better as a result of these organisations’ being supposedly primary care-focused rather than dominated by the acute trusts, and whether that actually worked, but as a policy intent the Government are very firmly moving away from that position—and wondering what their real outcomes would be.
Were the Government to move along the lines suggested by my hon. Friend the Member for Ellesmere Port and Neston, a regular review of and look at outcomes in our local areas would perhaps help with that particular problem and highlight the driver that we need from community and primary care, as well as just looking at the financial dominance of the large acute trusts.
Edward Argar
It is a pleasure to rise to respond. The shadow Minister, the hon. Member for Ellesmere Port and Neston, is now having to do a lot of bobbing up and down with his amendments, and I am grateful to him for tabling this one. I fear he will not be entirely surprised that we cannot accept it, but I will try to explain to him at least why, and why I urge him not to push it to a vote, although obviously he will be the judge of that.
The amendment, as the shadow Minister has set out, would place new requirements on integrated care boards to report annually directly to the Secretary of State on their actions, and a duty on the Secretary of State to prepare and publish an annual report for Parliament specifically on the actions of the ICBs. It would also require a Minister of the Crown to propose a motion in the House of Commons in relation to the report no later than one month following its being laid in Parliament.
We entirely agree with the shadow Minister that there should be strong lines of democratic accountability from ICBs to Parliament. I hope I can give him at least some reassurance that the Bill already provides for much of the transparency and accountability that he is understandably seeking. The provisions in the Bill will create clear lines of accountability for ICBs to NHS England; they will be accountable through NHS England to national Government and ultimately, therefore, to both Houses of Parliament.
Proposed new section 14Z26 of the National Health Service Act 2006 already places a duty on ICBs to prepare an annual report explaining how the ICB has discharged its duties, particularly in relation to its activities to improve the quality of services, reduce health inequalities and have regard to the effect of its decisions on, and its involvement with, the public.
The report must also explain how the ICB has exercised its functions in accordance with its proposed forward plan and capital resource plan, as well as the steps it has taken to implement any joint health and wellbeing strategy. NHS England will also have the ability to give directions to ICBs concerning the form and content of the annual report, meaning that it could stipulate further reporting requirements for ICBs as necessary where information might be lacking. The report must be provided to NHS England and must be published
I hope the Committee will agree that that is already a comprehensive reporting requirement. Further, under proposed new section 14Z57, NHS England is also required to undertake annual performance assessments to review how each individual ICB has discharged its functions, including how it has delivered on its statutory duties. The Secretary of State will have the power to issue statutory guidance concerning performance assessments, meaning that national Government will be able to influence the methods and requirements of assessment if necessary. Again, NHS England must publish the results of each performance assessment, meaning that the public will have open access to information concerning the performance of their ICBs.
I hope the Committee will agree that the Bill therefore already provides much of the transparency and accountability that the hon. Member for Ellesmere Port and Neston is asking for, and that further duplicative reporting requirements would risk creating new and unnecessary bureaucracy. In respect of the ability of the House to scrutinise, he knows, and Opposition Members know, that they have many opportunities to table debates on a wide array of subjects. He and his colleagues have held me and other Ministers to account, not only in these Committee Rooms but on the Floor of the House in recent months, on a whole array of subjects. With the information I have set out that will already be published, for not only the House but the wider public to read, absorb and consider, there is scope for the hon. Gentleman or any other hon. Member to table a debate in which such reports can be considered if they so wish. I believe that that provides for sufficient transparency and accountability, and I encourage the shadow Minister not to press the amendment.
Justin Madders
I understand what the Minister is saying. We still say there is not enough emphasis on outcomes and accountability to Parliament, but, as he has pointed out, there are other avenues that we can use to pursue those matters. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Question proposed, That the clause stand part of the Bill.
Edward Argar
The clause, as we have touched on in the various discussions on amendments already, inserts new chapter A3 into the NHS Act 2006, which contains a number of duties and functions in relation to the new integrated care boards. A new duty is conferred on NHS England to ensure that ICBs cover England and details the required process for establishing the ICBs.
The clause also makes provision for abolishing clinical commissioning groups, transferring staff, property and liabilities to ICBs, requiring the constitutions of ICBs to be published and requiring ICBs to make arrangements for managing conflict of interest effectively. The clause is essential for delivering on one of the core objectives of the Bill—creating statutory ICBs as a means to take an ambitious, collaborative approach to planning and delivering integrated health and care services in England. The clause will establish a smooth transition from CCGs to ICBs, providing clarity and consistency for patients as we move to these new arrangements, as well as creating continuity of employment for NHS staff.
Edward Argar
Yes, of course. I know the hon. Lady has a great interest in this.
Karin Smyth
I hope the Minister will address my earlier comments about the policy direction of primary and community care being front and centre in the last 15-odd years. This is a very different beast. I think that has perhaps not come out in the debate. These are very different bodies, and I wonder how he will make sure that the majority of patient contacts and the majority of the work that is done in the health service is not lost in the new organisations.
Edward Argar
I hope that I can reassure the hon. Lady. Although these organisations move beyond the CCG model to be much more collaborative, with more partnership working with local authorities and others, and the genesis of the new model is to bring those two parts together, there is no intent for, and I do not believe the practical consequence of this would be, a diminution in the voice of and the need to pay heed to primary care. She is absolutely right. For the vast majority of our constituents, the front door to the NHS is primary care services. The majority of their appointments, their consultations and their engagement is with primary care services. That voice is hugely important. I see that continuing to be front and centre.
The Bill brings together a range of other NHS system providers and the local authority. We may come back to the point when we discuss further amendments. I emphasise what we heard in the evidence sessions, which is that the membership requirements are de minimis. There can be increased numbers of voices for primary care on these boards, as Dame Gill Morgan mentioned in the way she is managing Gloucestershire. That may not fully satisfy the hon. Lady, but I hope I can reassure her that I am in the same place as her in recognising the importance of primary care and that the expertise that has grown up in understanding local communities is vital in framing a system that works effectively.
In requiring ICBs to maintain and publish registers of the interests of their members and employees—I expect we will return to this point in the future, in a different guise—the clause is an essential part of guaranteeing the integrity of each ICB’s decision-making processes. It will ensure that any potential conflicts of interest are declared promptly by individuals and managed effectively. As a result, the public will be able to trust that decisions are made in a fair, transparent manner, in the best interest of the ICB’s local population. I commend the clause to the Committee.
Question put and agreed to.
Clause 13, as amended, accordingly ordered to stand part of the Bill.
Schedule 2
Integrated care boards: constitution etc
Justin Madders
I beg to move amendment 48, in schedule 2, page 119, line 18, at end insert—
“(c) the process by which any proposed changes to the policies of the clinical commissioning groups within the area for which the integrated care board is established will be consulted upon and agreed.”
This amendment would require ICBs to be clear about how they would make changes in clinical policies and established models of care that have already been established and are applicable to patients in the area for which the integrated care board takes responsibility.
We are certainly getting a good workout this afternoon, Ms Elliott—hopefully the Minister will now be able to catch his breath.
As the hon. Member for Eddisbury suggested earlier, we have seen a rapid reduction in the number of CCGs in Cheshire and Merseyside—there are now nine, but there were more than that not so long ago—and it is one of the biggest ICSs, if not the biggest, in the country. I am not going to take the Committee through the angst on that again, but even with sensible coterminous boundaries, quite a lot of ICSs will have more than one progenitor CCG.
Under the old regime, every CCG had its own plans, policies, care pathways and models of care. For example, many had different rules about gluten-free products being available on prescription, and most Members will be acutely aware of the manifest unfairness of the postcode lottery for IVF treatment. The number of cycles people were entitled to and how old they had to be to access treatment all depended very much on where in the country they lived. It is tempting to say that, rather than having all that variation, we should just level up—the Government’s catchphrase of the day—but that of course will not always be possible, and there will be variations in CCG policy that we cannot easily equate into one optimum outcome or standard, so how do we go about moving the many into the one?
The amendment would add a requirement that, in drawing up the initial constitution CCGs, which of course should be aware of the issues, make a start on place-based approaches, but there is an important job to do on harmonisation at the outset, and that is important for patients and the public. It will be contentious. We can all imagine the outrage if something that is offered in one CCG but not another is then removed from everyone in the process of forming an ICB. These are possible changes that we will see over the next 12 to 18 months, and they will be a real test of how responsive and engaged ICBs are in their local communities. We may indeed see people holding banners with ICBs on them if things are not handled well.
In the amendment, we say that the process of harmonisation or variation should be arrived at only after proper consultation. That fits in with the duty, which we have talked about already, on harmonisation, public involvement and consultation. It also highlights a gap in the specification for the job of producing the initial constitution for each ICB, which is given to the relevant CCG. As I have pointed out, it is very much up to them to decide who they consider it appropriate to consult. We want a much stronger and clearer commitment to consultation on changes that might affect patient care on the face of the Bill.
Edward Argar
As ever, I am grateful to the shadow Minister for tabling the amendment in order to air this issue in Committee. I fear that I may have to disappoint him once again; it seems I am getting into a habit, although perhaps at some point I will suddenly surprise him.
We agree that it is right that there is appropriate consultation when making decisions about commissioning policies and care. The shadow Minister set out very clearly, as he always does, some of the reasons for that. I hope that I can give him some reassurance that the Bill already provides for much of what he is seeking in terms of outcomes. In clause 19, new section 14Z44 of the National Health Service Act 2006 already places a duty on integrated care boards to involve and consult the public in respect of the planning of commissioning arrangements, including on any planned changes. That would include, for example, plans by an ICB to change the range of health services available to the public or the manner in which they are delivered. This will ensure that the voices of residents, patients and those who access care and support, as well as their carers and representatives, are properly embedded in ICB decision making.
Schedule 2, which concerns the constitutions of integrated care boards, states that ICB constitutions must specify how the ICB plans to exercise its functions, including the duty to involve and consult the public. ICB constitutions must, moreover, specify the arrangements that the ICB will make to ensure transparency in that decision making. NHS England will ensure that they are appropriate and include the relevant provisions.
Under clause 13, and new section 14Z25 of the National Health Service Act 2006, NHS England will need to approve the constitution and make an establishment order for the ICB. In that respect, new section 14Z26 goes on to make it clear that NHS England can reject a proposed constitution if it is inappropriate. I hope that that offers some reassurance to the shadow Minister, and helps underline our commitment to ICBs being as transparent and as involving of patients and the public as possible. I encourage him not to press his amendment.
Justin Madders
In light of what the Minister has said, we will not press the amendment to a vote. I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Justin Madders
I beg to move amendment 31, in page 119, line 28, leave out from “for” to end of line 29 and insert
“an initial chair to be appointed by NHS England, with the approval of the Secretary of State, for a period of no more than 2 years and for subsequent chairs to be elected by the voters in the area for which the integrated care board is established in accordance with regulations made by the Secretary of State for that purpose.”
This amendment would require the first Chair of each Integrated Care Board to be appointed by NHS England, with the approval of the Secretary of State for a period of no more than 2 years and for subsequent chairs to be chosen through local election.
The Chair
With this it will be convenient to discuss the following:
Amendment 50, in page 119, line 29, leave out
“, with the approval of the Secretary of State”.
Amendment 51, in page 119, line 29, at end insert—
“4A The constitution must provide for all members of the integrated care board to be consulted, and for any views expressed to be taken into account, before a chair is appointed.”
Amendment 52, in page 120, line 2, at end insert—
‘(1A) The constitution must provide for all members of the integrated care board and of the integrated care partnership to be consulted, and for any views expressed to be taken into account, before a chief executive is appointed.”
This amendment would ensure the involvement of the integrated care board and the integrated care partnership in the appointment of the ICB chief executive.
Justin Madders
Amendment 31 is about the ICB having an elected chair. Amendment 50 relates to the Secretary of State’s approval to remove the chair from the ICB, amendment 51 relates to consultation on an ICB chair’s appointment and amendment 52 relates to ICB and ICP members and consultation on the ICB chief executive’s appointment. I hope there were not too many “ICB”s and “ICP”s in that statement, but I will now set out some detail on the intention behind each of the amendments.
I would like to make some general points about integrated care boards. I would also like to put some specific amendments to a vote—unless, of course, the Minister does surprise me, and concedes on some of these points. Many things have been said about ICSs, ICBs and ICPs that do not appear in the Bill. In discussing this matter, some care has to be taken in distinguishing between what is actually in the Bill as it stands and what is not. In particular, the NHS document on the ICS design framework came out in July. Is anything in that document to be regarded as interpretation of the Bill? Perhaps more pertinently, is anything in the design framework ruled out by the Bill or inconsistent with it? There is a huge contradiction in all this. Many actions have already been taken, such as fixing boundaries and appointing chairs, that presume that this Committee does not have a say—that this Committee is not going to change anything. That is almost contempt of Parliament, but we are where we are. No doubt the Minister will be able to justify why he feels it necessary to instruct the NHS to get on with these things before legislation has been passed. To be fair to him, that is what they have been doing for the past five years as they have been trying to avoid Lansley, but we are in a different world now.
For us, the most significant issues are ICB composition, ICB constitutions generally, and the vexed issue of what people on an ICB actually take responsibility for. In each of those areas, we have tabled specific amendments. As we know, ICBs are the latest in a long line of commissioning models: we have had GPs, PCGs, PCTs, larger PCTs, cluster PCTs, CCGs, merged CCGs, and now ICBs. Just maybe, if we do not get this right first time—if we have to keep reinventing the wheel—the problem here is that it is always the NHS making decisions about itself. Various retrospectives have shown that CCGs and PCTs have had virtually no impact on the design of services, or in terms of innovation or better allocation of resources based on need, and it is certainly difficult to show that they have had much impact on outputs. It is worth pointing out that in some cases, these ICBs will be allocating billions of pounds of public money—in theory, at least—so when we are talking about a multi-billion-pound venture, it has to be free of vested interests. It has to be open and transparent in a way that, I am afraid to say, has not been a hallmark of the Department in recent years.
We know that many of the NHS witnesses said in their evidence that they did not want more prescription. As we have already touched on, we are probably going to have some debate about where on the spectrum we land in terms of prescription, with one end being a totally prescriptive environment and the other being a totally permissive one. As it stands, the Bill is too close to the permissive end, in this area at least; as I have already said, we do get some prescription when it suits the Department in other areas. We consider that prescription is not an imposition: it is a vital safeguard to make sure that things are done correctly, and that there is proper accountability of roles and positions. Legislating for the removal of conflicts of interest to ensure that these bodies are more representative and accountable is not a frivolous or minor matter. These are not optional matters: they are fundamental in a democratic society. We should take this opportunity to widen public and patient involvement and end what is increasingly looking like a much more internal model than perhaps was envisaged when the White Paper came out—a pattern, I have to say, that is possibly being set from the top.
In our view, each ICB should have an elected chair so we are going to push amendment 31 to a vote, because we believe it is a really important principle that we should be exploring further. There are two justifications for that, the first of which is negative: we simply do not trust those who make these appointments. We have seen far too many family members and friends appointed within the wider NHS who, it would be fair to say, have not come with CVs that obviously lend themselves to being part of the NHS family. In fact, the NHS has already announced who the chairs will be for two thirds of these ICSs, showing a complete disregard for the work of this Committee, particularly when it was decided that councillors did not even need to apply. There are a number of former councillors on this Committee, not least myself, the shadow Minister, and the Minister himself. Perhaps we might not be the best people to judge who could go on those bodies as chairs, but I certainly think that councillors have a legitimate claim to be suitable people in a number of circumstances. We need to take control of this; we need to have a democratic system.
The positive argument for electing someone is that it signifies that there is some accountability. It also speaks to a trend that we want to see continue moving forward, improving genuine representation of the public and of patients. We have elected police and crime commissioners, and we increasingly see Mayors and other elected figureheads having growing powers over services in defined geographies. We have already touched on how ICSs may not mean much to people in the street, but if there is someone at the top who has been elected by the people of an area, that gives everyone a sense of ownership and identity—there is a tangible body there that they have some stake in.
Let us take the example of Cheshire again, as it is the one I am familiar with. The annual budget for the police authority is in the region of £200 million. We of course do not have sight of the equivalent for the ICS at the moment, but let us say it will be significantly more. Cheshire CCG’s budget is about six times that at the moment, and we have to throw in the whole of Merseyside on top. To my mind, we will have a rather unsatisfactory situation where someone is directly elected to represent our interests in police and crime, but no equivalent in health, where billions and billions more is spent.
We recognise that this is a departure from what has been worked on in the NHS to date, which is why the amendment would allow for a period of two years from the initial ICB appointment to enable the Government and probably the Minister to work through the detail of how elections would work, and the precise role and powers of a democratically elected chair.
As a country, we are being told constantly that we are taking back control. That should be put into practice. Local communities should be given a real say in who runs their health services. Throughout the evidence sessions, it was far from clear with which individual the buck stops.
Amendments 50, 51 and 52 reflect our concerns about the frankly arrogant way that the membership of ICBs has been formed to date. If we do not get our wish for a directly elected chair, we still think there is a clear need for more local accountability for the appointment and removal of ICB chairs. As the Bill stands, there is a danger that the chairs are answerable only to the Secretary of State—not to the partnership, not to the community and not to the patients.
Why does the Secretary of State need to approve the chair? Is the chair there to represent the Secretary of State or to represent the ICB? As we have already covered, there is a less than glorious record on appointments by the Secretary of State. Let us take him out of the equation and ensure, as amendment 51 would do, that members of the board are consulted and their views taken into account before any chairs are appointed. After all, we would not want them to be appointed and then not have the confidence of the other board members. One of the questions that is hanging in the air is what would happen in the situation where the chair does not have the confidence of the board. There does not seem to be any clear mechanism for dealing with that situation, which we hope would not be a regular occurrence.
We could have the absurd situation where all those who work with the chair on a daily basis simply did not think that the chair was leading the organisation as they should, but because the chair retained the confidence of the Secretary of State—someone who might meet the chair once a year, if they were lucky—they remain in post. I think we can all see that that would be a very unsatisfactory situation. What does the Minister say should happen in that scenario? What would happen if members of an ICB or ICP clearly object to the appointment of a chief executive? If the Minister does not have an answer to those questions, perhaps he could support our amendments, although I may be tempting fate in even suggesting that.
Will the Minister at least set out what role his Department will have in such situations? What does he define as failure for an ICS? In what circumstances would NHS England terminate the appointment of a chief executive? How will removing the chief executive lead to improvements if, for example, the reason for “failure” is systemic issues around workforce and funding, which we will be coming on to later on? Let us make sure that the system works properly from the outset and that the leaders in it have the confidence of all those who work within it.
Karin Smyth
I will speak mainly to amendments 31 and 50. The case for an elected chair of an ICB is very strong. As my hon. Friend said, if we accept the need for an elected police and fire commissioner, why not for health? The amounts of money we are talking about and the influence on people’s daily life dwarf those even of my local council. That is what people on the boards will be responsible for. Social care is still provided through a democratically accountable local authority, so why not healthcare?
We are moving towards the NHS budget overall accounting for up to 40% of general Government spend—that is what we are looking at for the next few years. It seems to go against the grain of everything else—elected Mayors, devolution and so on—for Conservative Members to allow that quantity of Government funding from the taxpayer to be out in communities without any kind of more local democratic control. There would also be a lot more confidence that the days of crony contracts favouring friends, families and donors had been well and truly left behind were there independent heads of the ICBs. I do not know if the Secretary of State has as many close friends as the last one, but letting him make the appointments is not something that Conservative Members will want to defend.
We should therefore be electing a local health commissioner. The amendment reasonably allows a two-year period for the organisations to get established—they have enough to do at the moment—but it would then start to take away some of the problems that the Government will get into with their proposals for the integrated care board chairs. On the make-up of the boards, too, the Bill is a good opportunity, should they wish to take it, for the Government to move away from the terrible scenarios of the past few years in particular. That argument was made cogently this morning by the Minister himself, in terms of NHS England having non-executive directors, people of independence and so on as part of its board, and it can well and truly be made about these new local bodies.
We do not need to go back to the 1990s, when trusts were first invented. Friends and families were put on to those bodies, which were stuffed with worthies, with business people favoured over local people with strong links to the community. Surely we can learn from the past 20-odd years and from the past couple of years in particular. Place is central to what the Government are trying to achieve and is the general policy direction of the Minister’s Department and many others, so it has to mean something and it has to be accountable.
We will come later to some of my amendments on a good governance commission, for which I hope to gain Government support; on having fit and proper tests for people to be scrutinised as suitable to come on to the boards; and, without wanting to throw back to the past, on bringing people in from the community to make the ICBs reflect their local community. In all seriousness, in our sad political situation, most ICBs will be headed up not by people are particularly sympathetic to Labour, so this is not a partisan point. It is, as the Minister started to say about NHS England itself this morning, about having people with the right qualifications—some clinical, some not. Let us have some clear criteria for how we want the boards to be governed and the sorts of people we want on them.
As I said earlier, the Government have got themselves into a real mess with accountability and with how much work the Secretary of State is doing, given how much is put on his desk—this sort of circular NHS accountability thing—so the amendments are trying to offer the Government a way through that follows their general policy direction. That was raised by NHS Providers in its written evidence
“to make crystal clear the relationship between trusts and ICBs, and how the statutory accountabilities of trusts, foundation trusts and ICBs align. There also needs to be clarity within the legislation on how the roles and responsibilities of the current NHS England and NHS Improvement…regions, ICBs, ICPs, trusts, foundation trusts, health and wellbeing boards…places, provider collaboratives, neighbourhoods and primary care networks…will all fit together.”
We would all like to understand how that works, even those of us who follow such things.
I am not suggesting that an all-powerful elected chair will get that, but at least that skilled person bringing together the multiplicity of organisations, groups and people for the local community would be a figurehead who needs to understand and grapple with the issues. The chairs would need to be trusted and highly skilled. In that way, there can be further accountability back up the national system, either through NHS England or the Minister. Let us take all that away from the Secretary of State’s desk—he is going to be a terribly busy man over the next few years. Let us help him out.
The Government should support this and similar amendments to try to bring local accountability much more to the fore. That, in turn, would allow local people, who are expected to spend huge quantities of their taxes on health—increasingly so over the next few years—to be very clear about what the money funds, what they get for their money and how they can hold people accountable.
Edward Argar
The shadow Minister, the hon. Member for Ellesmere Port and Neston, said that his amendments would give me two years to work through this, if necessary. I am grateful for his confidence in my longevity in this post—only time will tell.
I am grateful for the opportunity to address amendments 31, 50, 51 and 52, which were tabled by the shadow Minister. I fear that I may not surprise him on this set of amendments. Under the Bill as drafted, the chair of the integrated care board will be appointed by NHS England, as he and other Members have highlighted. It is therefore rather disingenuous to suggest that friends and cronies will be appointed. This is an NHS England appointment, with approval from the Secretary of State. I am not quite sure what is being suggested about those at NHS England, but I suspect it is rather unfair.
The chair will be appointed by NHS England, with approval from the Secretary of State. That reflects the fact that the ICB is accountable to NHS England and, through it, to the Secretary of State and, ultimately, this House. That goes to the heart of the comments made by the hon. Member for Bristol South on the balance to be struck between having local flexibility and accountability, and recognising that this is a national health service and the way in which it has evolved. The accountability mechanisms are also national to reflect that.
In answer to the hon. Lady’s questioning, the chief executive of the NHS, Amanda Pritchard, said very clearly of the ICBs:
“In the proposed future structure, they would be accountable to a combined NHS England and NHS Improvement structure. At the moment, we operate that through seven regions, and then through to the national NHSEI executive. We are, in turn, accountable to Parliament.”––[Official Report, Health and Care Public Bill Committee, 7 September 2021; c. 20, Q21.]
Amanda Pritchard was very clear that it is the integrated care board that carries that national statutory responsibility on behalf of the NHS, hence why we have structured the accountability requirements as we have.
That chain of accountability has been at the heart of the NHS since its inception. There is a difference, which I know all Members recognise, between the DNA—for want of a better way of putting it—of social care provision, which has evolved through the link to local authorities, and the NHS, which has a more vertical, national structure. That goes to the heart of the different DNA of those two complementary—vitally complementary—parts of the system. We have to remember that history.
That is reflected in the clear belief, which is shared across both sides of the House, that in various ways the Secretary of State is ultimately accountable to this House and, through that, to the public for the performance of the NHS. It is therefore only right that once NHS England has made the appointment, the Secretary of State, who is ultimately accountable, should give final approval for the appointment of the chair. It is an important role in the ICB, as I am sure all Members would agree, and it is right and proper that the Secretary of State ensures that the appointment is appropriate. That is why, I fear, we cannot accept amendment 50, which would remove that mechanism.
At this point, it might be helpful to address the shadow Minister’s point about councillors. We need to draw a distinction between their role on ICPs and on ICBs. ICBs are the NHS accountable body for the spending of public money. As is already the case, the NHS is clear that it does not approve of dual accountability, so when someone is directly accountable for the spending of NHS money, they are required to have that as their role and to not have multiple roles. That applies to the chair and the chief exec, as is consistent with current practice. I discussed that at some length with the chief executive of the NHS when she was chief operating officer. Quite rightly, given my background and the shadow Minister’s, I sought her guidance and that is the conclusion we reached.
Amendment 31 suggests that the chair of the ICB should be appointed via local elections. That brings in a new element to the accountability relationship, which, again, could give rise to the perception of conflicting accountability routes, given that the genesis of how the NHS is currently structured has been as a national health service. The amendment risks introducing a degree of tension into that relationship. Given the importance, as the hon. Member for Bristol South rightly said, of having the right, highly skilled and able people in all these roles, it is appropriate that the mechanism we propose seeks to balance local knowledge and national accountability.
The shadow Minister or perhaps the hon. Member for Bristol South—forgive me if it was—asked what happens if there is discord within an ICB or challenges to the authority, capacity or capability of an individual chair. Essentially, we come down to the constitution of the ICB. Paragraph 8 of schedule 2 sets out how that would work, and NHS England will be producing guidance. Ultimately, NHS England will have the power to remove a chair should issues arise that necessitate that, but there will be further guidance on how that would work and what thresholds there might be.
The hon. Member for Ellesmere Port and Neston raised an important point: what is the mechanism in the hopefully unlikely event that that should occur? Chairs are subject to normal recruitment processes, and NHS England’s approach to appointments has been to work with the existing ICSs, including both NHS providers and local authorities, to ensure that the chairs appointed are high quality, credible and have the confidence of their local systems. Similarly, to ensure democratic involvement, ICBs have strong duties in relation to public and patient involvement, and local authorities must appoint, by right, a representative to the ICB.
Before I turn to amendments 51 and 52, the hon. Gentleman raised some challenge about the design document, its status and whether it appeared to prejudge the House’s deliberations. I want to reassure him: the key word in terms of that document is that it is in “draft” form—it is not formalised, and it is not the final document, because he is right. However, it does allows the non-statutory ICSs to be given a degree of guidance to continue their evolution, rather than all work stopping while we deliberate. Should the House pass the legislation that means ICSs become statutory, that document would have greater force. However, we are not seeking to pre-empt or pre-judge the will of the House. In fact, even with that caveat, the hon. Gentleman will be aware that we did not publish the document in draft until after Second Reading. That recognised again that we wanted the House to have a say on the principles before we even published documents in draft form and that we are cognisant of the need to show respect to the House’s democratic processes.
Amendment 51 would mandate that NHS England consult with the board before appointing a chair, and amendment 52 would require the chair to consult with both the board and the integrated care partnership before appointing a chief executive. We fully accept the importance of both the chair and the chief executive having credibility among system leaders and the population they serve. That is why NHS England is working closely with local authorities, NHS bodies and others in the appointment process.
The Bill, at its heart—again, we will come to the question of balance—aims to strip out needless bureaucracy by removing processes that we believe add little in terms of ensuring high-quality or safe care and that could get in the way of collaborative, smooth decision making. The amendment to formally require consultation on the appointment of the chief executive would create an unnecessary formal requirement, as well as potentially duplicative work, given that we would anticipate this happening informally anyway, and having due regard to that.
We believe that the approach taken in the Bill ensures both patients and the public have a strong voice on ICBs while also ensuring that the accountability arrangements set out by the chief executive in her oral evidence are maintained upwards as well, to the House and the Secretary of State. I therefore ask the shadow Minister to consider not pressing all his amendments to a vote.
Justin Madders
We have had an interesting debate, and I think we have seen the stark differences in approach. Certainly, Labour colleagues see the proposal as an obvious thing to do. As my hon. Friend the Member for Bristol South said, the NHS will account for about 40% of all Government expenditure, so it seems obvious to want some kind of accountability for how it is spent on a local basis. The Government have decided to split the NHS up into 42 areas, so this seems an obvious thing to do, but I appreciate that the Minister comes at this from a completely different perspective. It might say something about the culture of the NHS and perhaps the insularity in how it does things.
When the Minister talked about not being here in two years’ time, he was of course referring to the inevitable promotion that he is due. Perhaps he will be promoted to the Home Office, in which case he will be dealing with police and crime commissioners. Perhaps at that point he will be persuaded of the benefit of having locally elected individuals responsible for services. Of course, we did not have police and crime commissioners until the coalition Government decided to import them from America, and although there is certainly a degree of scepticism about them, if they are a good thing for policing, I see no reason why the NHS should not embark on a similar route.
I envisage some tension between those who sit on an ICB who have some democratic mandate, perhaps from the local authority, and those who do not. Would they be seen to have greater legitimacy? Would their vote carry more weight than other ICB members, because it could be argued that, in the eyes of the public, it would? I think that we are storing up problems for further down the line. If we are to see this levelling up—this renaissance of place—in towns and cities up and down the country, we will need a focal point in all our public services, and none is more important than health and social care.
The Minister suggested that those involved in NHS England might not be appointing people in the most straightforward manner. I was certainly not implying that in my comments, because, as he conceded—this makes me wonder why he is not prepared to support amendment 50—all these appointments still require the approval of the Secretary of State. That is the bottom line. If that is not necessary and the Minister has full confidence in NHS England to make the right appointments, we do not need the Secretary of State’s approval, so the Minister can support amendment 50.
Turning back to amendment 31, which I will press to a vote, we think that a focal point of local accountability is vital. When something goes wrong, when decisions are made that people are unhappy about, or when people just want answers, they need a figurehead that they can go to. They need someone they can hold to account at the ballot box, as is our democratic tradition in this country. I do not think that they will get that with ICBs. If the Minister does not support the amendment, I really think this will be a missed opportunity, and I hope that in future years he will think again on this point.
Question put, That the amendment be made.
Alex Norris
I beg to move amendment 32, page 120, line 26, in schedule 2, at end insert—
“(d) at least one member nominated by the mental health trust or trusts that provide mental health services within the integrated care board’s area;
(e) at least one member nominated by the Directors of Public Health that serve each local authority within the integrated care board’s area;
(f) at least one member nominated jointly by any NHS trust, NHS foundation trust and local authority that provides social care services within the integrated care board’s area;
(g) at least one member nominated by the trade unions representing the health and social care workforce that serves the integrated care board’s area;
(h) at least one member appointed to represent the voice of patients in the integrated care board’s area.”
This amendment would require integrated care boards to have members nominated by Directors of Public Health, mental health trusts, social care providers and trade union representatives and a member representing patients.
The amendment seeks to enhance the prescribed members of the integrated care board. We have not been able to move the Minister on the chairing, but I hope we might be able to do a bit better on the board members.
These are exceptionally important roles. The decisions that these bodies make will shape communities and lives. As we have heard, the boards will be accountable for spending hundreds of billions of pounds of public money. We are banking on their leaders taking good care of that very profound responsibility, and taking integration from an academic concept, or something that is seen in some places, to a real-world idea across the country. That is a big ask, and we need the very best people on the boards and the best range of voices.
Prior to coming to this place, I was a system leader in my local health system. I chaired my health and wellbeing board for a number of years and led my council’s health and care functions. That dual responsibility is hard, because our every instinct is to think “system first”—certainly in local government, because we know that the best prize and the best step changes in the wellbeing of the community come when organisations work together. We know that, but we also butt up against the grinding realities of one-year budget cycles and diminishing financial resources, so we find ourselves in one meeting—a board meeting perhaps—where we are desperately trying to move forward the cause of integration, or the common cause of the shared vision in a community, but we know that when we get back we have to meet finance colleagues in local government, and there is a reality to that.
That duality is really hard. I always likened it—people rolled their eyes in my health and wellbeing boards, and they may roll their eyes in this Committee too—to playing for an international football team, because people come from their clubs, but they come together for a common purpose. They wear a different shirt. The reason that matters is that they do not forget who they were previously—none of that goes away—but in that moment, they are trying to work in a common cause and put aside any of the parochial or local differences they have. That worked best with a balanced and diverse set of voices and experiences around the table, and I do not think that the Bill supports the appointment and assembly of a balanced and diverse set of voices.
The more I have listened to the Minister, the more concerned I have become about that issue, because on two occasions he has characterised integrated care boards as essentially NHS fund-holding bodies that therefore sit within the NHS accountability structures. I absolutely agree that that is true, certainly in this schedule, but in that case, is this not just a bigger CCG with an integrated care partnership moored to it? What really is different here?
We have said throughout—and have been told that we are wrong, and perhaps overly cynical in saying so—that this is an NHS reorganisation Bill, not an integration Bill. I am afraid that the Prime Minister rather weakened Ministers’ arguments by saying that there needs to be an integration White Paper, which I thought was an extraordinary indictment of this legislation. If this is a Bill regarding integration, who is integrating with who? There do not seem to be multiple parties; there seems to be a single party, perhaps with different elements and slightly different email addresses, but still with broadly the same accountability structures. At this point, this does not feel like integration.
In the previous sitting, the Minister described the current composition of the boards as a de minimis one, and said that there could be more members. I hope there is an expectation—he might address this when he replies—that generally, there would be more than the five people currently set out. Paragraphs 3 to 7 of schedule 2 set out the minimum of five members who will form the integrated care boards: the chair and the chief executive—there must be two of them—and then one member to represent all the NHS trusts, one person to represent primary care, and one person to represent all the local authorities in the area. The first time I read about those three ordinary members, I thought, “Those poor people.” One person to represent all the trusts in an area? One to represent all the local authorities in an area? Goodness me, that is a challenge.
I understand that the Minister is not keen to be overly prescriptive beyond what is in the Bill, and that there is a desire to strike a balance between being permissive and being prescriptive—trust me, nobody gets more frustrated with people in London telling people in Nottingham what to do than I do. However, given what is in the rest of schedule 2, I think the Minister is in danger of undermining that argument.
As we have heard, paragraph 4 says that only NHS England can choose the chair; paragraph 5 says that only NHS England can remove the chair; paragraph 14(2)(a) says that NHS England can vary the constitution of a local integrated care board; and paragraph 14(2)(b) says that NHS England can stop any other amendments to that constitution. We should not give too much succour to the idea that this part of the Bill is going to be particularly permissive, and that there is not going to be prescription in there. Of course there is, because we want local communities to shape their planning and their approaches, but we also think that there are minimums—I think we could find a level of commonality relatively easily—and we want to establish them as a backstop. Obviously, we have five here, but I think we ought to go a bit further.
As such, my amendment suggests five other members, the first of whom would be a representative of a mental health trust or similar. Again, if the Minister thinks I am wrong or that I have misunderstood this, I would be keen to hear from him, but I think it is exceptionally unlikely that the ordinary member chosen to fill the role described in paragraph 7(2)(a) on behalf of NHS trusts in a particular integrated care board footprint would not be from the biggest acute trust in that patch, or at least from one of its acute trusts. Our big hospitals are the gravitational centres of a local health system. They are totemic to a local population, they are massive financially, and they are exceptionally powerful in terms of soft power in a community. That means that there is one place and that place is gone, so once again, there is nothing for mental health.
We talk so often in this place about the need for parity of esteem between mental and physical health, but this is an opportunity to demonstrate that in practice, and we are not taking it. Beyond the fact that we ought to be putting mental and physical health on an equal footing, so many of the knotty issues that we will want local health systems to tackle will be rooted in issues relating to mental ill health, so I think there needs to be a voice at that table that can give balance to the decision making.
Edward Timpson
I am grateful to the hon. Gentleman for giving way, and I understand his desire to try to push the agenda of some very important parts of our healthcare system, including mental health. Is he cognisant of the evidence that we heard from Dame Gill Morgan, who has already set up an ICS and who has perhaps done some of the testing for us on what works best? She said:
“In our case, we will have mental health and social care around the table, not because we are told to but because we could not imagine how we could do our work at a local level without having those people feeling that they are full partners and sitting around the table.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 133, Q186.]
Does the hon. Gentleman think it is important that we listen and learn from the experience to date in order to ensure that—to use the hon. Gentleman’s football analogy—we do not have too many people on the pitch? The analogy falls down, because it is possible to have only 11 on a football pitch. The danger is that we end up with too many people, which is unworkable and unmanageable.
Alex Norris
I am grateful for that intervention—I am going to stop at 10. That evidence actually supports the point the I am making. When we heard that evidence, the witness said that it was automatic to them, but of course we would want someone from a mental health background and someone from a social care background. I completely agree. What I am saying is that if that is so clear and obvious, which I believe it is, why on earth would we not put it in the Bill? It was clear and obvious enough that we wanted to have someone on behalf of local authorities, and that we wanted someone on behalf of primary care. If it is clear and obvious in those cases, it is clear and obvious in these, too. That was my reasoning, and it was obviously echoed in the evidence submitted by the Royal College of Psychiatrists and the Mental Health Foundation. That is the first thing I want to say about the amendment.
The second relates to a director of public health drawn from that patch. Goodness me—as my hon. Friend the Member for Ellesmere Port and Neston said this morning, if anyone has proven themselves under fire over the last 18 months, it is our incredible DPHs. With a unique combination of knowledge, training, local insight and cross-system relationships, they have done an extraordinary job for us in pulling together our approach to the pandemic. We should be using that to pull together our approach to all sorts of big issues that we face in our local communities.
The DPHs are the human embodiment of our communities’ joint strategic needs assessment. They bring that to life, and they could bring that to the table. If we want our system leaders to go beyond their organisational concerns when they go into their integrated care board meeting, who better than the person who develops the insight into system need? The DPH is exactly the right person. They also provide an invaluable director-level connection to all the departments of the local authority that have such a profound impact on the wider determinants of health—housing, leisure and planning. What a wealth of knowledge, and what connections, they would bring to the table.
Thirdly, the amendment provides for a designated social care representative. The stated aim of the Bill is to drive integration and to foster collaboration between health and care partners. I really want that to be the case, rather than this being just a reorganisation Bill. It is a 135-clause Bill, and two of the clauses are about social care, so it is not unreasonable to say that perhaps there is an imbalance. Rather like the much-hyped social care reform and funding plan that the Government are discussing downstairs at the moment, the clauses in the Bill neither reform nor, in the main part, fund social care. Again, social care is left trailing behind. It has been battered for 11 years and, as a result, we see rationed care, dreadful terms and conditions for staff, and services that are just not fit for what they were supposed do. If the Bill really is about fostering collaboration, social care ought to be explicitly represented.
I am conscious that there is a nominated local authority representative under paragraph 7(2)(c) of schedule 2, but that person will already have quite a lot on their plate. They will have to represent the broader views of the entire local government family. Nottingham and Nottinghamshire is probably one of the simpler planning footprints in the country, but it is still 11 counties, and representing all those views at once is very difficult. It is too much—and not credible—to represent not only 11 council chief executives, but 11 directors of adult social care and children’s social care, as well as all the other functions of the local authority. A social care lead, who convenes the social care leads in the given geography, would give the ICBs the specialist knowledge and insight to create and foster the environment for a true partnership between health and care.
Fourthly and penultimately, amendment 32 would replace the staff voice through recognised trade unions. As has already been mentioned, our health and social care services are well served with amazing staff. They are our experts. They are the people who feel things on the frontline and who know, when they go, “Here we go—here’s a new initiative”, whether it is practical and rooted in real-world experience. They have that very direct experience of population health and how it is changing over time.
The staff are the ones telling us about the fractures in the health and care system that make their jobs harder—the fractures we are supposed to be dealing with. They were the ones—boy, should we have listened to them then!—who told the Government very clearly what the impact of the 2012 reforms would be on the system and about the greater fracturing of the system. They were not listened to then, but they should have been and they should be now.
Prior to coming here, I was a union organiser. I know one thing for sure: senior management always think they can speak for the staff, but I am afraid they generally cannot. That is not a criticism; their lives at work are very different. The health and care family is better served when all aspects are covered, rather than some speaking for others. If we are going to develop really significant plans at these boards, the discussion would be incredibly enriched if the voice of the frontline was there, to sense-check things, to highlight things that are working already and the workarounds that staff develop as time goes on, and to assist on planning as well. There is an awful lot they could contribute.
Finally, and crucially, let us have a representative of the patient voice. The whole reason why any of us come to this place is that we want to give communities a voice. We think that is important. The key way we do that is to listen to people. If we do not, we do not do very well for very long.
We want our communities to have brilliant health and care services, but sometimes we make it harder for them to tell us what they want. We have tremendous mechanisms for finding out. The evidence of Sir Robert Francis from Healthwatch was particularly pertinent on not just using numbers, but the wealth of qualitative information. Let us have someone who is an expert by experience and who can draw on and bring that with them, and speak for thousands of other experts by experience. We must believe that they have as much to contribute as senior leaders. Not only would they bring insight, but it would give legitimacy to decision making, which is something that we have real concerns about, as we have said on discussion on multiple groups of amendments.
Those are the extra five members we are suggesting. If anyone listening at home is keeping score, that means five members—the chair, the chief executive, the acute lead, the primary care lead and the mental health lead—who owe their employment fundamentally to the NHS, and five—the local authority lead, the DPH, the social care representative, the staff representative and the patient representative—who do not.
If the Bill is about integrating and not about a restructure and reorganisation that involves the big acutes taking on the rest of the system, that might be quite an elegant balance. Of course, local systems could seek to augment that, which would be a matter for them, but this would be a very solid foundation, which I think enriches the board. I look forward to the Minister’s response.
Dr Whitford
I, too, rise to support the amendment. This is probably one of the most important amendments so far. In the witness discussion, we came back time and again to which voices would be on the ICB and would be able to influence. I agree that, with all the talk of parity of esteem, it seems incredible that there would not be a voice representing the importance of mental health on the board. Similarly, with the talk of moving to population health and wellbeing, there is a need for directors of public health to agree policy and to feed in information about the underlying health inequalities, life expectancy and so on in the local population. Not to have a social care voice when what the Government say is that they are trying to integrate the NHS with social care seems quite bizarre.
The NHS and social care are both services delivered by people for people and having both the workforce and staff voice, and the patient voice, is therefore important. On the staff voice, the “Learning from Scotland’s NHS” report from the Nuffield Trust highlights that the success of both the Scottish patient safety programme and the Scottish quality improvement standards was driven by the fact that frontline staff were involved as drivers, champions and developers from the word go. These programmes have been able to run over years, building on experience that is then shared with other sectors and specialities. It is important to get this part of the Bill right, or else priority will not be given to integration, population health or wellbeing. Of all the things that have been discussed so far in Committee, and through the witness statements, this amendment is one of the most important.
Edward Argar
This is an important amendment because it goes to the heart of the debate we have been having about permissive versus prescriptive, and where the appropriate balance is. I suspect we slightly disagree on that—perhaps a little less than one might suppose—but I am grateful to the shadow Minister, the hon. Member for Nottingham North, for bringing this amendment forward. It gives us the opportunity to start getting into that permissive versus prescriptive debate. At the outset he raised the recent announcement by the Prime Minister about integration; it will not surprise him when I say that I believe this creates the foundations of that integration, on which we can continue to build in the coming years.
In respect of the specifics of the amendment, schedule 2 sets out minimum membership of the integrated care board. That is the key element here. It will need to include members nominated by trusts, foundation trusts, persons who provide primary medical services in the ICB area and local authorities. As we heard in the witness sessions, this is very much de minimis—it is not what will happen; it is the baseline, above which each system can go if it wishes to reflect local needs and priorities. We have heard the quote from Dame Gill Morgan about how she is approaching it, but we have also heard from Richard Murray of the King’s Fund, who said:
“You could easily criticise the degree of permissiveness; you could criticise the degree of direction in there. The question should be, ‘Can anyone come up with a better one?’ We have not been able to do so, so I think it is a balance well drawn.”––[Official Report, Health and Social Care Public Bill Committee, 09 September 2021; c. 127, Q173.]
I appreciate that shadow Ministers may take a different view because they feel they have come up with a better balance. However, I highlight that evidence before I go into my answer.
Dr Whitford
Obviously, Dame Gill Morgan is quoted as saying that no one could evenly remotely think of setting up an ICS without primary care voices—and these other voices. Are all interim ICSs that have developed so far following the same model as she is? Is this totally intuitive, and therefore to be relied on, or should it actually be laid down? The voices listed in this amendment are central.
Edward Argar
The hon. Lady and I have spoken about “Learning from Scotland’s NHS” before; as she will know, we are not dogmatic and are always happy to learn from Scotland’s NHS—as, I am sure, it is happy to learn from England’s NHS. That is to the benefit of everyone, and I am very grateful to her for inviting me on Second Reading to come and visit Scotland and see it on the ground, which I hope to do.
The reality is that the ICSs at the moment, on a non-statutory footing, are at different stages of development, different stages of evolution and reflect different approaches. One of the things we are seeking to do here is to put a non-restrictive degree of prescription around this—if that is possible—to get a degree of consistency, but not to be too prescriptive.
Dame Gill Morgan leads one of the more developed ICSs. I do not think what she is saying would be unrepresentative of the attitudes and approaches adopted by ICSs more broadly. I should say ICBs, as the hon. Member for Bristol South rightly highlighted the importance of reflecting careful use of the terminology in the evidence sessions—she caught my eye, and I have corrected myself now. I think we strike the appropriate balance here, and I suspect we will see ICBs going further in their membership, but that flexibility is able to reflect local circumstances.
Edward Timpson
I wonder whether my hon. Friend the Minister could assist the Committee with a question on the evidence given by Louise Patten from the ICS Network, who said that, on top of the five mandated board positions in the Bill,
“a further five will be in the mandated guidance from NHS England.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 134, Q186.]
Is that something that the Minister has been sighted on? If so, do we know what those positions are? I fear that the hon. Member for Nottingham North might have to start to move to a substitutes bench to get enough people around the table, based on his amendment.
Edward Argar
I am pleased that I do not see any signs of the hon. Member for Nottingham North moving to the substitutes bench any time soon. However, my hon. Friend is absolutely right. I do not want to pre-empt the detail of the guidance, but, as Louise Patten said, the whole purpose of this is to provide the ability to further supplement what is on the face of the legislation with guidance that the ICBs will have regard to.
Justin Madders
Perhaps the Minister can help me. When I read the guidance, I understood that it meant that there would be at least 10 individuals on any ICB. Does the Minister think that is the correct number?
Edward Argar
The key focus for this amendment is what the legislation sets out in this clause, and that is the five positions—that is what we want to specify on the face of the legislation. I will come to the detailed guidance, but first I will go through a few of the remarks from the hon. Member for Nottingham North in support of his amendment.
At the heart of the issue is our desire for the provisions of the Bill not to be too prescriptive regarding the membership requirement, beyond that proposed statutory minimum. The guidance is a different matter from what is in the actual legislation; we want the statute to specify that de minimis. We believe that it gives the right approach and balance, having key voices and local flexibility to add voices—including those the hon. Member has proposed, but others as well—and that it reflects the evidence given by Martin Marshall, who said that the boards have to be kept to a workable size to be able to make decisions effectively. Again, that is permissive.
I come back to the point that local ICBs can appoint more members, should they wish to do so. They can go significantly beyond the legislative minimum requirements if they so choose. Therefore, we do not believe that prescribing further membership is necessary. Of course, schedule 2 states that ICBs will need to publish details of their membership in their constitutions. Under clause 13, proposed new section 14Z25 of the National Health Service Act 2006, NHS England will need to approve the constitution proposed by each ICB. Again, we come back to that approval process.
Justin Madders
Of course, the evidence from the Gloucestershire ICS was that of course those individuals—some of whom are included in our amendment—would be on the ICB. From our perspective, it is clear that all the individuals we have named are critical players in any local health system. Could the Minister set out which of those included in our list, if any, he does not think would be appropriate to sit on an ICB?
Edward Argar
I think that all add value, but equally, in some circumstances, we see different local arrangements; in some localities, some people fulfil more than one role or sit in different places.
The hon. Gentleman asked me to cover his specific point about the guidance before I conclude: the guidance will not prescribe additional roles in the same way that legislation prescribes or mandates, but it does seek to set out best practice, highlighting what would be deemed to be best practice—drawing on experiences such as Dame Gill’s, I suspect. We would expect that ICBs would pay due heed to that guidance, alongside their de minimis legal and statutory obligations.
If in time, when those ICBs are up and running, it becomes clear that that approach needs strengthening and that we need to add further requirements, regulation-making powers in schedule 2 will allow the Secretary of State to do so at a later point. We believe that it is right to start at this de minimis point in the Bill. It reflects our view, which I have articulated throughout, that we must not attempt to over-legislate at this stage on the composition of ICBs, letting them evolve as effective local entities, to reflect local needs. It may not fully reassure the hon. Gentleman, but there is a mechanism whereby further changes could be made in future, although we do not believe that will be necessary.
The amendment takes a different approach, which is essentially more prescriptive and less permissive. I do not dispute the sincerity of that approach, but it comes down to a matter of where we feel the appropriate balance should be struck. I fear that, although the shadow Minister and I are quite close to one another in our region of the east midlands, we are slightly more distant in respect of the amendment, but I am grateful to him for affording the Committee the ability to debate a key point of principle in the approach to the Bill.
Alex Norris
I am grateful to the hon. Member for Central Ayrshire for her contribution and for sponsoring our amendment. She spoke about the way staff have not only improved patient safety and the quality improvement programmes, but made them stand the test of time. We are sometimes in danger—the Bill is a good example—of building things that do not stand the test of time and keep being changed, and she went through all the various situations. If we pass any test, it should be that one. The amendment is certainly one way of improving our chances on that.
I am grateful to the Minister for his comments, too. I understand the de minimis point, but I still cannot envisage a scenario in which we would not want a mental health rep on the board. I live in undoubtedly the best place in England—in Nottingham—but we still have mental health problems and need mental health leaders. If we need mental health reps, and we certainly do, I think that everybody probably does.
The Minister’s response did not quite address the point about balance. The balance of the five members is four NHS and one non-NHS. The whole business maxim is no mergers, only takeovers. If the provision is really about integration and partners coming together on an equal footing to improve the population’s health, everything that we have heard so far does not fit with that. What we have heard so far is about organising this round with the terms of reference that NHS England wants, and if local communities and local authorities wish to be part of that and know their role within it, that is absolutely fine. I think we should aspire to do better, so I will press the amendment to a Division.
Question put, That the amendment be made.
Alex Norris
I beg to move amendment 30, in schedule 2, page 120, line 26 at end insert—
“(2A) The constitution must prohibit representatives of GP practices with active Alternative Provider Medical Services contracts from becoming members.”
This amendment would mean that the only GPs able to participate in integrated care boards would be those whose practices are on the standard General Medical Services (GMS) contract.
The Chair
With this it will be convenient to discuss the following:
Amendment 33, in schedule 2, page 120, line 26, at end insert—
“(2B) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to integrated care boards.”
This amendment prevents private providers of healthcare services from becoming members of integrated care boards.
Amendment 27, in clause 20, page 29, line 9, at end insert—
“(4) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to integrated care partnerships.”
This amendment prevents private providers of healthcare services from becoming members of Integrated Care Partnerships.
Alex Norris
We have not had success with chairs, and we have not had success with who should be on the board, so we move on to who should not be on the board. Let us see whether this alternative tack might prize the Minister away from not giving us his support.
The amendment would mean that representatives of GP practices with alternative provider medical services, or APMS, contracts were prohibited from participating in integrated care boards. That would mean that, under schedule 2, they could not provide that primary care representative.
Let me briefly explain the context. The vast majority of practices—nearly 70%—operate under the general medical services, or GMS, model. That is the standard contract and the most usual model of partnership whereby a CCG or NHS England contracts with a local general practice. Another quarter or so operate on personal medical services, or PMS, models. There is a little more flexibility for commissioners to tailor to local need—this is not agreed as a standard contract like the GMS at national level—and again the arrangement is with a local practice. However, these are not particularly en vogue; they are being phased out, I understand.
That leaves the remaining portion, which is on APMS. That is a much more flexible contracting model and very much a child of the previous decade. Here, commissioners can contract with organisations other than GPs or GP partnerships, and can contract, for example, with private companies.
APMS contracts—without that GP requirement and with shorter durations—offer the easiest way for large private companies to take over practices. Those are companies motivated by profits, rather than their patients, and their having a voice on the board would run contrary to what I am sure Members on both sides of the Committee seek to achieve. I would say it was contrary to the triple aim of the Bill.
However, this is a model on the march and one that could change general practice beyond recognition. My colleagues and I do not think it should exist, but we will make our case on that when we deal with clause 16 and amendments 28 and 29, so I shall have to keep the Committee in suspense. The amendment would mean that a representative from such an APMS partnership could not be part of the ICB and could not fill that place.
As my colleagues and I have made clear previously, we think it paramount that the Bill put patients front and centre. For many patients, using the health service begins and ends with their GP for big parts of their life. The GP is someone they have known for years, someone they can trust and someone who plays an active role in and knows their community.
The pandemic has created some access issues, but the care that people have received is still exceptional. The latest GP survey found that 89% of patients said that the healthcare professional they last saw was good at listening to them and giving them enough time, 88% said that that healthcare professional was good at treating them with concern, and 93% said they were involved as much as they wanted to be in decisions about their care and treatment. Our local GPs are really good and do the job really well. It is not much of a stretch to think that those are the sort of people that the public want speaking for them in these ICB structures. That would be very welcome.
We also know that, whether my supposition that the ICBs are going to be really big CCGs is right or not, CCGs had significant involvement from primary care clinicians and the ICBs will have less. That is definitely a point beyond contention, but there is still a reserved place on the board. However, this is a perfect opportunity for local GP leaders to fill that space, and with regard to APMS contracts, I do not think that those representatives will provide that same involvement.
I appreciate that the numbers will be relatively small—indeed, this might be quite unlikely to happen—but we should bear it in mind that APMS contracts do not require a GP to be a contract holder. They do not offer the same benefits to an ICB as a general or personal medical services contract holder, who is contractually required to be a GP. That is a significant difference. This position on the board should bring important perspective; it should not be wasted.
This is about two things: first, showing the best possible voice and secondly, putting a stop on creeping privatisation. Ministers have been at great pains earlier in the process, and certainly on Second Reading, to say that this is not about privatisation. Well, this is a very good chance to prove that.
Justin Madders
I would like to speak to amendment 33, which is grouped with amendment 30. I will try to address the real concerns that were so eloquently described by the British Medical Association. It said that there are huge risks and absolutely no benefits from having out and out private companies sitting on integrated care boards. Nothing in the Bill remedies that conflict to allow those companies to sit on integrated care boards at the same as allowing them to comply with their statutory duty to their shareholders in manner that anyone could feel comfortable about.
We know that spending in the private sector before the pandemic in 2019-20 was £9.7 billion. I accept that those figures before the pandemic are probably the fairest to cite, but that sum is still double what it was a decade earlier under the last Labour Government. We have seen the creep from the private sector in recent years and we need to put an end to that.
Amendment 33 is not about the amount spent on private providers but about who runs the NHS, not just who profits from it. For us, there is a complete and utter incompatibility between the aim of a private company and what we say should be the aims of the NHS and ICBs. I can do no better than refer to the evidence of Dr Chaand Nagpaul, who last week said:
“We forget at our peril the added value, the accountability, the loyalty and the good will that the NHS provides. We really do.
We only have to look back at the last year. Compare the vaccination programme run by the NHS and delivered by NHS staff to Test and Trace. Even with Test and Trace, compare the £400 million that Public Health England had to the billions that went to the private sector, and local public health teams reached 97% of contacts compared to 60% for the others. I am saying that it does matter. Your local acute trust is not there on a 10-year contract, willing to walk away after two years. It is there for your population; it cannot walk away.” ––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 90, Q113.]
Those final words sum up our concerns perfectly. Put a company on the board and their interests last as long as their contract. Of course, their interests may not be the same as the NHS’s during that period anyway. With that clear and, we believe, unanswerable concern about conflicts of interest there must be a solution in the Bill. As it stands, there is not, and that is what amendment 33 seeks to remedy. We hope that the Minister recognises the opportunity that this presents and goes one step beyond his colleague, Lord Bethell, who said in response to a written question:
“We do not expect independent providers to have seats on the ICB.”—[Official Report, House of Lords, 18 August 2021; Vol. 814, c. 56.]
What he expects and what is actually in the legislation is not the same.
We have already seen in the south-west private providers lining themselves up to have a big say in how local NHS systems are run. If it is the Government’s position that they do not expect private companies to sit on the board, do they say that because they do not believe it will happen, or because they do not want it to happen? If they do not want that to happen, they should support the amendment. If they do not support it, and if they refuse to join us in trying to legislate to stop private companies getting involved in the running of the NHS, all the people who believed that the Government were determined to increase private sector involvement in the NHS will be entitled to say, “We must be right.”
When presented with the opportunity to put a halt to further private involvement, not only did the Government not support the proposals from Labour, but they actively voted against them. All the words about what the Government expect will count for nothing because when it comes to the crunch, the Government will have sided with the private companies, some of which, let us not forget, have actually sued the NHS when they have not got their own way. Is that the kind of collaboration and integration that we want to see in ICBs? Remember when Circle walked away from Hinchingbrooke because the contract was too tough. Was that in the spirit of joint working? No, it was not. We should be absolutely clear in this Committee and support the amendment that says that private companies should not be running or having a say in the running of ICBs.
Dr Whitford
Although this was described as an evolutionary piece of legislation that would not involve a lot of upheaval for the NHS, it actually does. It is a significant piece of legislation, but it represents a missed opportunity to go back to a unified public NHS with integrated care bodies as the main structure. They are responsible for spending billions of pounds of public money, but the system will still be a transactional one based on a purchaser-provider split and tariffs. We will talk further about how can inhibit development.
If we are to have a purchaser-provider split, we have to have a split. We cannot get away from the conflict of interest inherent in having private providers who seek contracts to deliver care sitting on the very board that makes those decisions, or on the partnership board that will develop the strategy. That is a conflict of interest. It should be resolved, and the amendment should be supported.
Edward Argar
With your indulgence, Ms Elliott, I will turn to amendment 33 first. Integrated care boards will be NHS bodies, whose membership consists, at a minimum, of individuals appointed by NHS providers, providers of GP services and local authorities that coincide with the ICB. Any perceived risk of privatisation through the ICB membership provisions is, I believe, entirely unfounded—and, I feel bound to add, potentially unfair to the many public servants in the NHS who work for ICBs. Although service provision—I emphasise the word “provision”—by the independent and voluntary sectors has been, and continues to be, an important and valuable feature of this country’s healthcare system under successive Governments of all political complexions, it was never the intention for independent providers, as corporate entities, to sit on integrated care boards, nor for an individual to be appointed there to be a representative of such an interest in any capacity.
People must therefore be assured that the work of integrated care boards is driven by health outcomes, not by profits, and I am sure that there will be a consensus on that principle across this Committee. That is why there are already safeguards in place to ensure that the interests of the public and the NHS are always put first. The ICB chair has the power to veto members of the board if they are unsuitable, and NHSE has the power to issue guidance to ICBs in relation to appointments as part of its general guidance-making power. That sits alongside the robust requirements on ICBs to manage conflicts of interests, and NHSE’s wider duty to issue guidance to ICBs.
I turn to amendment 30, which seeks to exclude individuals whose GP practice holds an alternative provider medical services contract from being made a member of an ICB. APMS contractors include some private and third-sector organisations, but also some GP partnerships. These contractors include, for example, social enterprises and partnerships that provide services to homeless people and asylum seekers. This amendment would potentially prevent some individuals from being on ICBs, on the basis of the type of NHS GP contract that their practice holds.
I do appreciate the intent behind the amendments, namely the desire to avoid the appearance, and potentially even the risk, of privatisation and conflicts of interest. However, the effect would be to limit the ability of primary medical service providers to appoint an ICB member who might best meet the requirements of the local population, by reducing the diversity of GPs who could be appointed. While I can understand the intent behind them, I fear that these amendments do not do what they seek to do, and they would have unintended consequences. I will turn to those shortly.
We recognise that the involvement of the private sector, in all its forms, in ICBs is a matter of significant concern to Members in the House, and we are keen to put the point beyond doubt. However, having taken appropriate advice, I am afraid that that these amendments would not cover a number of scenarios—for example, lobbyists for private providers, or those with a strong ideological commitment to the private sector—and they would therefore not be watertight
As it stands, these amendments may well not offer the robust assurance that perhaps hon. Members intended. Therefore—this is where I may surprise the hon. Member for Ellesmere Port and Neston—to put this matter beyond doubt, we propose to bring forward a Government amendment on Report to protect the independence of ICBs by preventing individuals with significant interests in private healthcare from sitting on them.
As hon. Members will know from their attempts to draft these amendments, avoiding unintended consequences is not a simple matter. If appropriate, I would be happy to engage with either the hon. Member for Nottingham North or the hon. Member for Ellesmere Port and Neston in advance of Report. We may not reach a consensus, but, as they both know, I am always happy to have a conversation with them.
The Government are firmly committed to the founding principles of the NHS. We recognise the importance of its values, and the public service ethos that animates it. It is by no means our intention to allow private sector providers to influence, or to make, decisions on spending on the commissioning board—the ICB—and the spending of public money. The Bill does not allow that, but we will look to see whether we can find a way to put that unfounded fear to bed once and for all with an appropriately worded amendment that does not have unintended consequences.
Although I appreciate that much the same motive underpins amendment 27, it is worth considering why the integrated care board and the integrated care partnership are different bodies. The decision to create integrated care partnerships came from discussions with a number of stakeholders who revealed a strong case for the creation of a committee to consider strategically not only the health needs but the broader social care and public health needs of a population. It is not a body like the ICP, as we have heard, which will be directly accountable for the spending of NHS monies.
We therefore do not intend to specify membership for the ICP in the Bill, as we want local areas to be able to appoint members as they think appropriate. To support that, we have recently been working with NHS England and the Local Government Association to publish an ICP engagement document setting out the role of integrated care partnerships and supporting local authorities, integrated care boards and other key stakeholders to consider what arrangements might work best in their areas.
We would expect members of the ICP to be drawn from a very wide variety of sources and backgrounds, including the health and wellbeing boards within the system; partner organisations with an interest in health and care, such as Healthwatch; and potentially voluntary and independent sector partners and social care providers at that level, as well as organisations with wider interests in local priorities, such as housing providers.
To exclude independent providers from both the ICB and the ICP would, I fear, risk severely reducing the extent to which all parts of the broader health and care ecosystem could be drawn upon in the ICP context. It would exclude valuable expertise and would, for example, prevent social care providers who provide a small amount of domiciliary care to the NHS from sitting on the ICP. Furthermore, the ICP will not make commissioning decisions or enter into contractual arrangements that are binding, or make decisions about who gets funding allocations. Those are functions conferred on the ICB, hence the distinction that I make.
I therefore believe that membership of individuals from independent providers on the ICP does not present a conflict of interest in the way that hon. Members have asserted, certainly in the context of the ICB. I suspect that we may debate that further in the coming weeks, but taken with the ICB and the comments that I have made, we believe that this provides the right balance between recognising the distinctive accountabilities and responsibilities of the NHS, local authorities and other partners, and strongly encouraging areas to go further in developing joint working.
I hope that what I have said provides some reassurance to Opposition Members, and that they will be willing—I see them nodding—to engage with me to see whether we might find a greater degree of consensus. I should also say that I will obviously speak to the Scottish National party spokesperson on this as well, as I have done throughout. I addressed my remarks to the shadow Minister, but of course I extend that offer to her. I hope that on that basis, the Opposition Front-Bench spokesman will consider withdrawing the amendment.
Alex Norris
If the Bill is about collaboration, we ought to model that here. Given that very gracious offer, I am very happy to beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
The Chair
We now come to amendment 33 to schedule 2, which has just been debated. Justin Madders, do you wish to move the amendment formally?
Justin Madders
In the light of the Minister’s concessions, we wait with interest to see what we can work together on to achieve the aim that appears to be shared across the Committee, so we will not move amendment 33.
Ordered, That further consideration be now adjourned.—(Maggie Throup.)
Building Safety Bill (Fourth sitting)
(3 years, 3 months ago)
Public Bill CommitteesRead Full debate Read Hansard Text
The Chair
We will now hear from Martin Boyd, chair of the Leasehold Knowledge Partnership, and from Dr Nigel Glen, chief executive of the Association of Residential Managing Agents. I remind colleagues that we have until 2.45 pm for this session. Would the witnesses introduce themselves for the record, starting with Martin?
Martin Boyd: Good afternoon, everyone. My name is Martin Boyd. I am chair of a charity called the Leasehold Knowledge Partnership. We also act as the secretariat for the all-party parliamentary group on leasehold and commonhold reform.
Dr Glen: Thank you very much, Chair, and thank you for the opportunity to present today. My name is Nigel Glen, the chief executive officer of the Association of Residential Managing Agents, a not-for-profit trade body with about 325 members who manage about 1.6 million leaseholds between them.
Mike Amesbury (Weaver Vale) (Lab)
Q
Martin Boyd: No. You have heard two witnesses already tell you that the National Audit Office has reached the view that it will not actually work very often. The problem is that there are limited circumstances in which you can apply the Defective Premises Act. It seems like a welcome idea, and of course it is—six years is not sufficient—but there are very few leaseholders who are going to be able to take action using that facility.
Dr Glen: I would concur with that. If you think about the practicalities of lay leaseholders taking on a plc on a block-by-block basis, just having the financial capability to do that, let alone the expertise and the time, is beyond them. It is one of those things, I hate to say, that sounds good, but in the real world will be very difficult and does not help.
Mike Amesbury
Q
Martin Boyd: No, there is very little. We were aware of one London site that began to go down that route, but the developer agreed to settle before court proceedings were served.
Dr Glen: Likewise, I concur on that.
Ian Byrne (Liverpool, West Derby) (Lab)
Q
Dr Glen: I will start off on that one, seeing as Martin started on the last one. No, if you look at it, there are many aspects of it that will not protect. Inside the impact assessment, you will see that the cost is an estimated £200 per leasehold per annum, which does not sound much, but for some people that is the difference between having food on the table and not. Also, outside of that is the cost to remediate any defects that could be found, and I believe the estimation there was £9,000, of which only a third—33%—was the external wall system. Let’s say the building safety fund covers that: that potentially still leaves £6,000.
There is also the issue of the additional layers that are being put in: a building safety manager is not going to be a cheap resource. One of the things that we would be very keen on is a consideration of this. We are absolutely for increased safety, but we have to make sure that people can afford it, and that it is proportional as well. There are quite a few aspects of this that are going to be an unpleasant surprise for many leaseholders. I am a leaseholder: it is going to be a surprise for me as well when it finally comes through.
Martin Boyd: The Government have said from the outset that leaseholders should not pay. This Bill ensures that even if there were some possibility that they might not have to pay before, they will now. It is a very regressive system. It may be okay if you own an expensive million-pound flat in London, but if you have a £120,000 flat that you bought somewhere up in the north-east or north-west, and particularly if you are a shared ownership buyer, it is going to destroy your life.
Ian Byrne
Q
Martin Boyd: Unfortunately it begins, “I wouldn’t start from here.” We have got ourselves into a very difficult position, principally because the Government did not react quickly enough in 2017, so we now have huge problems with the housing market. It is very difficult to sell flats. There is a great deal of uncertainty about what is going to happen. We thought we had just got used to the external wall system and we are now moving towards EWS being replaced by the British Standards Institution publicly available specification 9980. Any market needs confidence, and at the moment we are not doing anything to get that confidence.
What has happened in other countries, which seems to be slightly more successful, is for the Government to make decisions about which buildings they think are of higher risk and which are of medium and lower risks, and prioritise the work. In some instances here, we are remediating low-risk aluminium composite material buildings more quickly than ACM buildings that are still fully clad 51 months after Grenfell.
Daisy Cooper (St Albans) (LD)
Q
Dr Glen: It follows on from what Mr Byrne was saying about how do you think we can get around this. At ARMA, we have always said, right from probably a week after Grenfell, that time is the issue and not the money, and that we should get people safe first and worry about who pays later—but here we are four years later and we are still dithering around about exactly who should pay and who should not.
For me, because of the scale, the only way to get people safe is for Government to put the money forward to forward fund it, because other schemes might require a time delay while funds are brought in or while disputes go on. However, I do not think the Government or the taxpayer should pay in full. There is some culpability where, for example, having oversight has failed, but there are instances where the Government and the taxpayer have nothing to do with it and should not foot the bill.
Let us get people safe first by providing that funding, and then find out who should pay, perhaps people who have pushed forward products that are not fit for purpose or people who have constructed badly. There will be instances, I am afraid, where leaseholders might have to pay. If we have a 15-year-old building, we have taken the cladding down and sadly the concrete is 15 years old, it is going to need some repair work. It is nobody’s fault apart from Father Time. In that instance, maybe the leaseholders should pay for that. It is a different question if they might not be able to, in which case let us have some grants available.
I am staggered that four years on from Grenfell I am answering the same questions with the same answers. That is why we support the polluter pays Bill, because unlike some other amendments we have seen in the past that show that leaseholders should not pay, which we absolutely agree with, it provides a route to pay. One thing about leasehold service charges is that if there is no money there you cannot do anything. Finding people who should not pay does not help remediate the buildings. It just makes it more difficult, in a way.
Martin Boyd: We put forward a proposal last year for a levy scheme to introduce £12 billion into the system. It was a project that was primarily developed by a former Bank of England economist, and the proposal was that the money would be provided. and then would begin to be repaid after five years. The Government would have five years to decide who should contribute, and that would obviously be a mixture of the developers and the material providers, and possibly even the leaseholders—who knows?
Unfortunately, at the time the Government wanted to develop their own levy scheme, so we have the proposed £2-billion developer levy, but that does not get us enough; we still need to put £12 billion to £15 billion into the system. It cannot come from the magic money tree. We need to have a rational policy. Leaseholders have been screaming for ages that they want a solution. None of them thinks that the taxpayer should pay for this. Perhaps some do, but most of them are realistic in accepting that we need to find a financial solution that gets us out of the mess, because if we do not the housing market will stay in crisis for years.
Daisy Cooper
Q
Martin Boyd: On the specific “polluter pays”, we have not seen the detail yet, so we do not know. The difficulty, as has been referenced in a number of witness statements to the Committee, is that a lot of the developers have used special purpose vehicles, so we do not know yet what proportion of the market would be able to recover from this anyway. The building in which I have a flat is 20 years old. I have to accept, in reality, that even if my developer had done something wrong it is rather stretching things to think that I could go back and take action against them.
Dr Glen: It is a very complex situation. If it wasn’t, we would have found the solution a long time ago. Is it perfect? No. Is it a good start? Yes, and I am very happy with good starts.
Siobhan Baillie (Stroud) (Con)
Q
I was interested in your point about grants, Dr Glen, because ultimately we know that quite a lot of businesses have gone bust. Your proposal that we effectively get the taxpayer to foot the bills upfront, knowing that there will be a big gap potentially, is a problem. I am just playing devil’s advocate. On your point about grants, you are suggesting that the taxpayer pays. That is a point of concern for people who are not affected by this and are thinking about the overall financial purse.
Dr Glen: I understand that. The specific example that I was using for grants was that we strip a building down, take the cladding off, look at the building and say, “Oh my gosh. Something has happened to the concrete.” I completely understand why the Government should not be making every building as new. It is the practicality, because the way that service charges work means there is no profit margin in them. If there is any leftover at the end of the year, you give it back. If there is a deficit, you demand it.
This is the problem: let us say that you, Siobhan, are a leaseholder in a particular building, and I say, “Terrible news: we’ve found that there’s a bit of problem with the concrete, so we need to do some work on that. It’s not applicable for the building safety fund because it’s nothing to do with the cladding; it’s just Father Time.” If you then say, “I’d love to—I can understand where you’re coming from—but I just don’t have £2,000,” what do we do? If you do not pay, the others should not pay for you surely, so suddenly I am £2,000 short. That means that I cannot do anything as a managing agent, because I cannot place that contract. I am talking about short-term mechanisms to mean that we can get that building safe. That is why it is a complex situation with no absolute way forward.
On should the taxpayer pay—I am a taxpayer and would like not to pay—it is undeniable that, under successive Governments, there have been changes in regulation where, perhaps, a developer has said, “I would like to put this material up—it’s not cheap— can I?” and the local council has said, “Yeah, it’s fine”. That same local council and, in fact, sometimes the same person, is now saying, “Actually, you shouldn’t have done that”. Is it right that the developer or whoever in good conscience who did what they thought was right at the time should pay, or is that something where we should say, “Sadly, there are some things that taxpayers should front up for”? It is a very complex situation. I come back to it again: there is no single solution. The only one I can see is to let the Government pay now and then figure out how to get the money back later.
I would like to think a bit further than that. This will not be the last issue we have in housing over the next decades. Let us form this fund, so that when whatever it is that next comes up, whether it is something toxic that we did not know about or something else, money is in the bank so that we can start moving on these things straightaway. Let’s think forward as well.
Martin Boyd: I have a letter sitting here from officials in December 2017, after we had written to Ministers saying it is very urgent that Government intervene early on or we will end up with leaseholders going through a rather nasty experience that will drag on for years. I did not think at the time it would be so many years. The assumption was that, well, of course, the law will allow you to take your building owner, as we keep saying, to court and make them pay. It has not happened. The law was never ever going to make that happen.
The statements that we made have been made in Parliament too, and said that building owners should do the right thing. It is not what the law says they should do. They are under a fiduciary duty to represent the interests of their company. If you happen to own ground rent investment and therefore are deemed to be the building owner, which will only represent possibly 1% of the property value, or even less, how on earth are you expected to pay to remediate the cladding? It was never, ever going to happen. Grants have been the only way the system would work from the very beginning. I think it is still the only way that we have left.
Mike Amesbury
Q
“to protect leaseholders from historical remediation costs”,
and then it was “unaffordable costs”. Does this Bill do that? What key things are missing from the Bill?
Dr Glen: No, I do not think it does, because the Bill says that historical costs can be levied on the leaseholders at 28 days’ notice et cetera. I heard in an earlier session about whether that would really help. It could increase costs, because we will have two separate charges now. We might want to touch on that later. No, it does not. There are some amendments around. As we said, the polluter pays is part of the amendments, because we need to try to figure out where the money is coming from. I go back to my earlier statement: the only way I can see it happening, unless we are going to be here in four years’ time still discussing this, is something big like Government—I think the Government are the only size that can do this—to make sure that we front-fund pay. Then, absolutely, Government should figure out how to get the money back to protect the taxpayer. So I do not think it does it, in short.
Martin Boyd: I agree. I have nothing to add to that, it is just not going to do it.
Ms Marie Rimmer (St Helens South and Whiston) (Lab)
Q
Martin Boyd: No. Judith Hackitt said the problem is that we need a fundamental culture change in the industry, but I have to defend the industry. If you are providing into a market that says, “You have liability for a product for two years. After that two years, the liability moves over to a warranty scheme for another eight years, and then after that you walk away scot-free,” how does that encourage developers to produce high-quality products? The Bill reinforces that because, again, we have a new homes ombudsman. For two years, we are not proposing to change in any way the idea that somebody builds a building, keeps quiet for two years that they have problems with it, and then says, “I’m sorry, Mr Customer, you are not protected by the normal Consumer Protection Act rules because this is a property, not a toaster.”
Ms Rimmer
Q
Dr Glen: I do. As we discussed earlier, if you look at the Law Commission reforms on enfranchisement, right to manage and promoting commonhold, you see that a drive of Government is for self-determination of a block. Looking at future blocks, where you have lay boards trying to unpick something that happened 12 years ago with a plc developer, I do not see that as a realistic scenario, so I do not think the Bill works.
The other issue is that there are many things in the Bill and in the Hackitt reforms that are admirable in helping, protecting and improving safety for new builds going forward, but what on earth do we do with the 4.6 million-plus leaseholds that we currently have?
Martin Boyd: May I add one thing? We have a problem in this country. If you buy a leasehold flat that is new, it is never surveyed. You do not have a survey of that building. In other countries that have a commonhold system, part of the conditions of the initial purchase is that a completely independent survey is carried out that validates that the building has been created to a reasonable standard. We are proposing part of that within the Building Safety Regulator, but there does not seem to be a final sign-off that says, “Here you are, Mr Customer. We have checked the building for you as the customer.” That would make things an awful lot easier than creating yet another ombudsman, who in reality will do like most other ombudsmen do, which is reach some small decisions but find it very difficult to reach big decisions.
Shaun Bailey (West Bromwich West) (Con)
Q
Martin Boyd: A similar issue cropped up during the passage of the Water Bill, where it was argued that leasehold properties should be excluded from the protections of Flood Re because it was a commercial policy taken out by the freeholder. Everyone in the leasehold sector tried to explain to the Government at the time that that is not how it works. The bills are all being paid by the leaseholders; it is just that the landlord is deemed to pass this on.
The difficulty we have with freeholders in the leasehold system—you heard from Richard Silver this morning—is that they have no interest whatsoever in the quality of the building. It makes not a cent of difference to their profit line whether that building is falling down or is in pristine condition. The only people who are concerned about it are those who live in it. The freeholders will say, “We have a long-term interest in the estate,” which is rather interesting because Long Harbour has been in existence for less time than we have, and we have not been around for a huge amount of time. I have owned my flat for twice as long as Long Harbour has been in existence. So you have the problem that until we move to a commonhold structure, you have a conflict of interest between somebody deemed to be the building owner, who is only interested in how they make a profit from the building. and all the people who live in the building, who want to ensure that it works for them. Some will want to reduce costs, some will want to invest for the future, but they will all have an interest in the building and about the fact that it is in good condition.
Dr Glen: As I mentioned earlier, it is a very complex situation. If we look at the portfolio of ARMA members, where we know who owns the building—is it leaseholder-organised, with residential management companies and right-to-manage companies, or is it third-party landlord? —in 60% of the cases we know about, there is a leaseholder structure. So when you say the landlord should pay, in many cases that is going to be the leaseholders, because they actually own the freehold.
I remember an interesting discussion I had with a colleague of yours, Hilary Benn, about the idea of a compulsory purchase order. We took him through the economics. As Martin alluded to earlier, you see this big building and you think “Gosh, that must be worth a fortune,” whereas in fact it is really a financial instrument. The value of that to the freeholder is typically what the ground rent is over a certain period of time. If the ground rent is £200 and there are a hundred units there, that is £20,000 a year. So if you go to somebody and say, “Unless you pay £2 million to remediate this building, I will compulsory purchase order you,” and that somebody is thinking, “Well, I only get £20,000 a year,” that person will kiss you and say, “Give me market rate, CPO me, and you have now just taken on a £2 million problem.”
So although it sounds good, I do not think that is the route. The danger is that by saying “Ooh, yes, we can get the freeholders to do it,” unfortunately all that means is that it gives false hope because there is not that bucket of money there. So again, be careful, because many RMCs and RTMs are also the freeholder and we do not want to put them in the firing line either.
Shaun Bailey
Q
Martin Boyd: I have to declare an interest in this. When we started the meetings in Parliament in 2014 that looked at commonhold again, we were quite agnostic. The view was it had failed in this country, and we were quite surprised when we got to our first meeting and while the officials all told us “No, the market does not want this,” the whole sector told us that the Government had messed up the legislation; it did not work. So the initial big developments that were started in Milton Keynes had to be stopped halfway through because the law just could not cope.
I do not think that there is ever a way of joining the interest of the landlord and the tenant; very often, they have fundamentally opposing interests. I am part of the landlord of our site. We bought our site from our previous landlord for £900,000 in 2013, after several years of court battle. The site is worth about a quarter of a billion pounds. We still hold our freehold on the books at £900,000, but it is now actually worth diddly squat, to use an inappropriate phrase, because we commuted the ground rent. We therefore do not have an asset in the freehold. All the asset is held within the flats. We have a structure that copes within the leasehold system, but it would work much more effectively if it was a commonhold system.
Shaun Bailey
Q
Dr Glen: I am a bit wary about looking at the ownership structure, simply because if we waved a magic wand and all those buildings were today commonhold, everybody living in them would be in exactly in the same position. It does not solve anything. You can argue, “If it was commonhold, they could maybe sell some air space and generate a few million,” but that is sort of selling the family silver. You could do that to put new boilers in.
More generally, there are things that legislation can do. I am a big fan of mandatory, independently set reserve funds because buildings deteriorate after a time. Naturally, people say, “You want me to pay for something that won’t happen for 25 years. I’m going to be out of here in five, so I don’t want to pay towards that.” We see that when dealing with boards, which naturally look at whether they can put a sticking plaster on something rather than committing to major expenditure. Other things can be done to help.
How can you resolve the relationship between landlords and leaseholders? As Martin says, sometimes their interests are diametrically opposed, and they are within the organisation. I am painfully aware of many RMCs—my firm almost used to do nothing but RMCs—where you have a dichotomy between the buy-to-lets, who want the minimum service charge possible, and the people who live there, who want the place to be nice and cleaned every single day. You will still get that conflict. The problem is people who are not related living together in close proximity. Communal living is one of the issues. I do not have an answer for you.
Daisy Cooper
Q
Martin Boyd: Unfortunately, my view is that the residents’ voice section of the Bill and the HSE’s current work is the weakest element of the whole process. The Government have not dealt with the issue of the residents’ voice particularly well for a very long time. There is no system at all in either the social or the private sector for the proper representation of everyone’s interests.
As we said, the landlord is obviously sitting in conflict. Under the Bill, I get to sit in conflict with my leaseholders because I have become the accountable person. Under me, I have a responsible person—one of Nigel’s managing agents—who will employ the building safety manager. With my landlord’s hat on, I am liable if things go wrong, but I have no responsibility for any of the costs. All the residents have full responsibility for the costs, but no control. It is only because I am a landlord and a leaseholder that we get that common interest. In both the social and private sector, we have had landlords who have undermined effective resident engagement for decades.
Early in the Bill’s passage, we set out a proposal for a formalised system to create a residents’ group on every site, and the view at the time was that that sat outside the Bill’s purview, but there is no point in setting up a system for cosy little decisions to be made that filter down to the residents, where you hand them a nice little infographic saying, “Please don’t store petrol in your flat.” That is what has been done. The social sector best practice group has produced an infographic, and one of the diagrams says, “Don’t keep petrol in your flats.” Well, if that is our view of the intelligence of people who live in flats, we have a very, very long way to go.
We need to take a very different approach to resident engagement, and what I have said to officials is that, rather than take a top-down approach—assuming that we call the landlord the top of the system—it should start at the bottom with people who actually live in the buildings. Give them the facility to organise themselves and represent their common interests.
Dr Glen: As a managing agent, I would much rather deal with a representative committee of residents than each resident individually, because obviously time is involved in that. It would be nice to think that those residents will represent everybody—that would be nirvana—although it will not always be the case.
This is a really difficult issue. It is always a surprise that people do not realise that managing agents often do not know who the resident is. Somebody will hide the fact that they are sub-letting, for a variety of reasons. They might not want the taxman to know that they are receiving rental income. They might not want to pay a sub-letting fee, or they might not bother to get around to it.
It is difficult to engage with residents when you do not know who they are, but capturing their voice means we have to do that. We also have to filter it. I will give you an unfortunate example that I read about on LinkedIn over the weekend. A firm that specialises in out-of-hours said that they had had a complaint from a gentleman. It was about an issue that did not need instant attention, because that would cost four times as much and he could wait until Monday. The firm received 155 phone calls from that person over two days, most of which were abusive.
Something I put in my paper was that we need somehow to figure out how to filter this. The example I gave was someone saying, “It’s a bit dark in this corridor.” Is that a complaint? Is it just ruefully saying, “My eyes are getting old,” or do I, as a managing agent, have to log that, report it to the regulator, track it and bring in somebody to install new lighting at the cost of £2,000 that weekend? I do not know.
This is a difficult area to get into, but the more we, as managing agents, can get a collective response, the less admin you are doing trying to deal with absolutely everybody.
Ruth Cadbury (Brentford and Isleworth) (Lab)
Q
Martin Boyd: The answer on whether it is fully clear—I think we would fully agree on this—is that when you get into complex sites with mixed private, social sector and commercial, you are going to have a number of accountable people, a number of responsible people and, potentially, a number of building safety managers. The potential for conflict there is enormous.
The issue I have with the Bill is this: I can accept that you want to make me accountable if I get something wrong, but the Bill, if we use the analogy of cars, is trying to make me responsible for the fact that Mercedes produced a diesel engine that broke the rules. I did not design the building. I did not build the building. I am responsible, and fully accept I should be responsible, if we do something wrong with the management, but we, effectively, are non-exec directors. At any large site, that is how it will be.
Residents do not run their own building unless it is very small; they will contract and employ a professional managing agent. In turn, there is no such thing as a building safety manager at the moment. I do not see why they are needed at all in the occupation phase, because what a professional property manager does is contract a relevant expert when they are needed. If the air conditioning system, the lift system, various plant and machinery or the fire alarms need to be updated, they will go out to a relevant expert.
The idea that we are somehow going to put that expertise in one individual and that they will make the decisions is just going to cause conflict. The property manager will be trying to budget for how they plan to look after the building for the next five years, and the building safety manager will have a different set of priorities. As far as I understand it, the building safety manager wins—so what happens if the building safety manager spends all the money and there is nothing left for the property manager to spend? The answer is that they will just have to put up their bills, so we will have one set of building safety charge bills getting bigger and bigger, and another set of normal service charges getting bigger. It will cause problems.
Dr Glen: A big worry for me about the impact of having an accountable person, particularly where there are lay boards, is, to put it succinctly: who in their right mind would agree to be a director with that level of accountability? What are we going to do in those circumstances?
We have talked about potentially bringing in professional directors—that is one possible route, if the lease allows it, and that would be a cost, again. That is going to be an issue, I believe, for anybody in their right mind taking on that level of responsibility. What this might mean is that there are no leaseholder-led boards—they might appoint a professional who then appoints and instructs the managing agent accordingly, but you might see residents’ management companies and right-to-manage companies disappearing.
Martin Boyd: I think there is a risk, because if you want to make me responsible for Mercedes, you need to put me in charge of Mercedes. I am not going to do that, so I am stuck. People who sit on the boards of RMCs usually consider the matter quite carefully. You are taking on a serious responsibility, helping to look after the lives of other people. But you are doing it as a non-exec.
I make it clear to the rest of my board on regular occasions: “You do not interfere in operational matters.” We employ professional managing agents to do that. I think that the legislation needs to be structured to allow that non-exec position to continue because if you want to say, “I am suddenly going to make you criminally liable for matters you don’t control,” Nigel is right: who is going to be stupid enough to take that role? More importantly, a representative of the Association of British Insurers will be speaking to you in a while and I think you are going to struggle to find anyone who will insure that role or those of the building safety manager and the responsible person.
The Chair
If there are no further questions, I thank the witnesses and we will move on to the next panel.
Examination of Witnesses
James Dalton, Steve Wood and Dr Sarah Colwell gave evidence.
The Chair
Q
James Dalton: Good afternoon. My name is James Dalton. I am the director of general insurance policy at the Association of British Insurers.
Steve Wood: Good afternoon. My name is Steve Wood. I am the chief executive of the National House Building Council.
Dr Colwell: Good afternoon. I am Sarah Colwell, the director of fire suppression testing and certification at BRE Global Ltd.
Daisy Cooper
Q
“Although the frequency of fires over the last 10 years has decreased, insurers have seen a significant increase in the damage and costs from fire spread”.
I do not believe we have heard that from anyone else in our evidence so far. I wondered whether you could tell us a little more about that, particularly in terms of what kind of emergency status fire remediation should have attached to it and what the impact of the increase in damage and costs has had on the insurance industry and on leaseholders.
James Dalton: The insurance industry has been calling for a significant period, including well before Grenfell, for significant reform to the building safety regulatory framework, including in terms of fire safety. Over the last decade, we have seen a reduction—with the exclusion of Grenfell, obviously—in the overall number of lives lost in fire. I think the Government statistics will bear that out. Over the same period, however, the insurance industry has seen a significant increase in the overall cost of fire claims, including but not exclusively from residential buildings.
If I include all commercial fires—in warehouses, commercial premises and residential building blocks, for example—there has been a significant increase in the cost of fire, but we suspect that one of the reasons for that is that, as we now know, fire spreads much more quickly than had previously been anticipated in the context of such things as modern methods of construction, including all the issues that you have been hearing about in the context of cladding in particular, and wider fire safety defects that we have found in the post-Grenfell world.
Daisy Cooper
Q
James Dalton: The significantly increased cost of fire is obviously passed on to all premium payers through increased premiums. For leaseholders in the post-Grenfell world, there have been very significant increases in the cost of insurance for some of the buildings that have been identified as most at risk.
I and the insurance industry particularly empathise with all leaseholders who have been affected, and we have worked hard to ensure that where buildings have not been able to access insurance, we have tried to facilitate insurance. The sad reality is that, in the absence of a quicker remediation programme, those leaseholders will continue to face increased insurance premiums.
Ruth Cadbury
Q
James Dalton: I would say that it is not just residential; it is in a number of buildings. If you think about the significant increase in online shopping, for example, which has driven the development of very large non-compartmentalised warehouses: those are very significant fire risks because they lack the structures internally. It is a problem that the insurance industry is cognisant of both here in the UK and internationally.
Ruth Cadbury
Q
James Dalton: I am not aware of issues in other jurisdictions. It is not fair to talk about the UK as a whole, because Scotland has a different regulatory framework, but I am aware that in the UK there are policy issues that we as an industry have long been calling for—for example, the mandatory installation of sprinklers in all new buildings, but particularly those that house and protect the vulnerable such as schools or care homes. Frankly, it is beyond belief that it is not mandatory to include sprinklers in those buildings when they are newly constructed. I am conscious that I am probably not answering the question, but I do not have any information and I would not want to mislead you. I can follow up in writing with research done by colleagues, if that would be useful.
Selaine Saxby (North Devon) (Con)
Q
James Dalton: I thought you might be sick of hearing from me!
Let us start with what is good about the Bill. I think there is a lot in the Bill to welcome in the context of Dame Judith Hackitt’s golden thread of information. The devil will be in the detail, so we await with interest the secondary legislation that will underpin the Act. A lot of the technical detail is going to be there, and our industry along with many others will want to analyse and scrutinise that legislation.
What is missing from the Bill? If I am honest, we do not understand why the framework does not apply to buildings under 18 metres. Fire does not affect just those in buildings over 18 metres—it affects all buildings. Some of the most egregious examples of buildings that have been covered in cladding, with woeful fire protection mechanisms, are under 18 metres. We certainly think that the Committee should carefully consider applying the provisions of the legislation to buildings under 18 metres.
Steve Wood: I would support what James said. There is a lot that is good in the Bill and the NHBC supports the principles of the Bill. In terms of what is missing, it places a single Building Safety Regulator across the whole sector, private and public, and we suggest it is important that the regulator appoints to building control bodies on the basis of competence—not whether they are from the public or private sector. That is an area we are concerned about.
We welcome the single regulator, but please appoint to building control on the basis of competence; otherwise, there could be real issues in terms of capacity and confidence in the sector, which might slow down new home building and potentially lead to less safe buildings. From the previous session, and reinforcing what James said, there is still quite a lot of detail to work through in the secondary legislation. That includes details around accountable persons. Given all the people involved in the design and construction phases of developments, particularly complex developments, we should work harder to get accountabilities clear where we can. There is more to work through on product certification as well, but someone on the panel will be more of an expert on that than I am, I suspect.
We welcome the Bill, but there are a few areas that need to be worked through to get it right. The principle should be to build right first time to avoid these issues. There are big structural challenges in the industry to do that, and that is where the focus should be.
Dr Colwell: I would agree with the previous panellists: it is a welcome Bill with a lot of good frameworks and overarching challenges within it. We would all agree that, as practitioners, the devil will be in the detail as to how that actually comes into place. Going forward, we welcome the introduction of the competency roles, and the understanding of building materials and the role they play within the structure.
Throughout this process, one of the things that has been commented on frequently is the golden thread. The one thing that we are seeing and hearing throughout these sessions is that the thread is more complex, and is potentially a network or a web. As such, the legislation that supports this—the secondary and the line part—needs to be clear that it does not end up conflicting, but rather carries the whole process through and leads us to safe buildings.
Ian Byrne
Q
James Dalton: The answer to that is probably best delivered by technical experts. From an insurance industry perspective, there is no doubt in my mind that a building in which there is a fire and in which that fire is put out much more quickly than would otherwise be the case in the absence of sprinklers would probably, first, save lives, and secondly, result in significantly less damage to the building from fire. In that context, I suspect those buildings would be cheaper to insure.
Ian Byrne
Q
James Dalton: As I said in an answer to a previous question, the insurance industry has long argued that it should be mandatory for new build buildings—in particular those that house vulnerable members of our community such as care homes and schools—to have sprinklers.
Ian Byrne
Q
Steve Wood: I support what James said. I think it should be more risk-based in terms of the approach and it should be part of the planning and sign-off on any new development. I do not think we should draw up arbitrary lines on sprinklers by height or floors. It should be risk-based.
Ian Byrne
Q
James Dalton: As we made clear in our written submission to the Committee, the professional indemnity insurance market internationally and particularly in the UK—especially in construction and building—has very significantly hardened at the moment. That is due to a range of factors.
One of the things we want to understand in more detail from the secondary legislation in the Bill is the specific regulatory requirements on those professionals involved in managing a building because that has an impact on whether, the extent to which and the price for professional indemnity insurance that could be available.
As I said in answer to a question on this in the pre-legislative scrutiny of the Bill, now is not the best time, frankly, to be introducing new requirements on new professionals in building and construction from a professional indemnity insurance perspective. The industry wants the detail and I am committed to working with my insurance company members to understand what the availability and cost of professional indemnity insurance might be once we have the detail.
Ian Byrne
Q
Dr Colwell: From BRE’s perspective as training providers in this field, we welcome the clear definition of roles within that, but the thing that goes hand in hand is to understand the scope and the levels that we are expecting within that competency to enable the insurers and end users to be able to benchmark the suitability of that training.
One of the things we look forward to in further legislation and also with the support of the regulator itself is looking at where each of those roles begins and ends. We heard it being said in the previous session how those sometimes do not necessarily join up and people make assumptions about where something begins and something ends. Also, within that, how are we going to take that training forward? How are we going to measure that training? Are we going to make them professional qualifications or managed qualifications? Is there an overarching syllabus that we would expect each of the roles to answer to or will it be left to training providers to interpret the guidance given in the legislation to deliver appropriate training around those points? That is an area that we would seek to build on.
Ian Byrne
Q
Dr Colwell: As part of the development work, we were part of the working group 8 looking at competency development. We are actively working with the regulator coming in on that and also within the Department as to where we would like that to go forward to.
Mike Amesbury
Q
James Dalton: Sure. There are two different types of insurance in play in your question. On the cost of buildings insurance, it is important to note—I think I heard this in the previous sitting—that the Bill is prospective. It is not retrospective except for the provisions that I will come to in a second. Will safer buildings be built as a result of the Bill and all the accreditation and certification, in terms of the golden thread? Buildings should be safer as a result. As I said to your colleague, safer buildings should be cheaper to insure, and that insurance should be more available.
On your question about the Defective Premises Act 1972, that issue is about liability insurance, not buildings insurance. The challenge in that space is that, without there having been consultation, the Bill retrospectively extends the period of liability from six to 15 years; some insurance policies will have excluded liability over and above six years. I do not know who is going to pay for the period between six and 15 years, when there is found to have been negligence. There may not be an insurer that is on risk to cover that liability. That is the big concern from an insurance industry perspective. Other insurance policies potentially would come on risk. Then we have a question about whether it is fair and reasonable to amend the Act retrospectively without consultation.
Kate Osborne (Jarrow) (Lab)
Q
Dr Colwell: An initial reading of the Bill in its current form suggests that the answer is no. Work will be required to ensure that we are clear on the standards being applied and how those are being used in the framework. We also need provision for going from testing to third-party certification, to ensure that we have the provenance following through on the products being used and the context in which they are being used.
The Bill lacks a little clarity. As mentioned earlier, the detail will probably have to sit in a secondary framework if we are to ensure that we get to the level of implementation that gives us a clear playing field.
Daisy Cooper
Q
James Dalton: May I comment briefly on the buildings insurance point? I should have been clearer in my answer and said, “All other things being equal.” I do not know what the insurance premium tax will be on the commission of buildings insurance, or what the wider regulatory environment will be like, tomorrow, next year or in five years’ time. All other things being equal, the Bill should, overall, decrease the cost of buildings insurance. It is a very difficult question to answer.
As I said in my previous answer, some insurance policies will be clear. There will be some insurance policies where the businesses in question that were insured no longer exist, for whatever reason. The question then becomes how those affected leaseholders and/or building owners will exercise their rights under the extension. To answer your question, in my experience insurance litigation can be complex, expensive and lengthy.
Daisy Cooper
Q
James Dalton: On the question of the extension in the Bill, in some respects the answer is: “Let’s see what happens as a result of this process and the wider parliamentary process.” At the moment, we have significant concerns about the extension of the limitation period from six to 15 years. Once Parliament decides and legislates, and once the Act becomes operational, we will need to see what the ultimate regulatory framework looks like, and what the implications are from an insurance industry perspective. This is an issue that we are actively working on. It was, shall we say, a surprise for us to see this in the legislation. As I said in my previous answer, it had not been consulted on, so we are working through the potential implications, both from a regulatory and legal perspective, and that process is ongoing. I would like to answer your question, but I think it is too early to say.
Steve Wood: One complication is that there is too much scope for different interpretations by professional people of the existing regulations. That is why there needs to be much greater clarity in the Bill—to remove or minimise that risk. For example, competent people looking at the same external wall system could draw different conclusions about compliance with the building regulations. We have to avoid that, because it creates uncertainty. It does not help confidence in the industry, and certainly not professional indemnity insurers, when you have that sort of situation, because you are not sure what risk you are exposed to as an insurance company. That is why we have to remove the ambiguity in the legislation and make it crystal clear. The challenge that the whole industry and everybody has—regulators as well—is dealing with this legacy issue while trying to build a better future.
The Chair
If there are no further questions from Members, I thank the witnesses on behalf of the Committee.
Examination of Witness
Mr Matt Wrack gave evidence.
The Chair
We will now hear from Matt Wrack, general secretary of the Fire Brigades Union. We have until 4 pm for this session. Could the witness please introduce himself for the record?
Mr Wrack: Hi, I am Matt Wrack. I am the general secretary of the Fire Brigades Union.
Rachel Hopkins (Luton South) (Lab)
Q
Mr Wrack: I think it will improve the building safety regime, and we welcome elements of it. Our assessment is that it does not go far enough. It is a welcome turn after decades of deregulation in public safety and building safety. Our union, which represents frontline firefighters, and our members who work in fire safety specialist teams have often felt like a voice crying in the wilderness on many of these issues for decades. We have objected to the growth of commercial interests in setting standards in the testing regime, and the approach to enforcement—often, regrettably, led by Ministers of different parties. We welcome the turning point in the Bill; it will help to clarify roles and responsibilities. We certainly welcome those elements.
Rachel Hopkins
Q
Mr Wrack: We have questions about the resources for the HSE. Whether it has the appropriate skills and expertise is a matter for it to discuss with the Government, and if it does not, it needs to be supported in delivering that. We have concerns about the scale of reductions in, for example, HSE inspectors; they have been reduced by something like a quarter over the past decade. The whole issue of resources runs through this debate on building safety. While we welcome the move towards regulation, that regulation has to be resourced adequately, including in the HSE. That is a key issue the Government will have to address.
Rachel Hopkins
Q
Mr Wrack: I think this will become clearer as the Bill is implemented. There is an obvious point for fire and rescue services around what is meant by the obligation to co-operate with the regulator. Again, fire and rescue services have been subject to unprecedented reductions in staffing numbers over the past decade. That will raise questions about resources when it comes to their ability to co-operate with the requests of the regulator. In the impact assessment, there are suggestions of additional funding for fire and rescue services for that function; we would question how those figures have been drawn up and whether they are adequate.
Under the proposals, if, because of resource implications, a fire and rescue service could not provide assistance, the regulator has the ability to go to another fire and rescue service—or, failing that, to the private sector. We object to the role of private sector providers in that. If we have a problem with resources in the appropriate public service, then those resources should be provided.
Ian Byrne
Q
Mr Wrack: Picking up on a point made in the previous session, we find the idea of a differential regime based on height somewhat illogical. In fact, the more I think about it, the more I think it would make sense to have a single system that is understandable to everyone, a single set of accountable people, and a single mechanism for making complaints and addressing problems.
There clearly is an issue around height in relation to building safety. As we put in our written submission, we do not agree with the 18-metre cut-off. We and others have said that if there is to be a height measure, a more logical one would be 11 metres. There are clearly differences between the fire risks in a traditional two-storey house and those in a purpose-built block of flats, where there are specific challenges. Some challenges are general across all forms of purpose-built blocks of flats; some of them apply at particular heights.
Clearly, there are additional challenges once you get to very tall buildings. They range from the ability of firefighters to fight a fire and rescue people to the importance of the internal building safety measures, such as the provision of dry rising mains, fire lifts and so on. All those things will be affected by issues such as the height of the building. As I think the National Fire Chiefs Council has said, it is a complicated issue because there are other factors, such as what has been done to the building and whether the building has been altered from its original design and construction. Lots of things need to be considered. Height in itself can be a bit arbitrary, and in our view the wrong height measure has been chosen.
Ian Byrne
Q
Mr Wrack: I was previously a firefighter in the London Fire Brigade—I have been in this position since 2005—and I think there is a problem with culture. I have lived through a decade in which the endless mantra from senior civil servants and Government Ministers of both parties has been that fire is a declining risk, and we can therefore afford to reduce our emphasis on fire safety. That was very clearly a theme that we heard for more than a decade. I think it fed through into the fire service itself, and senior managers and chief officers accepted that mantra. As I say, we were often a lone voice opposing that approach. That has allowed corners to be cut, and for deregulatory approaches to be taken. It has allowed standards to be cut. Over two decades, we lost something like 40% of fire safety inspecting teams. Then, of course, along comes Grenfell Tower, and people wake up to the fact that we have not been properly addressing risk.
To pick up a point made earlier by a representative from the insurance industry, one of the big problems in relation to fire safety and building safety in the UK is a complete lack of horizon-scanning. A question was asked about fires in the UK and elsewhere. The truth is that there have been warning signs from fires elsewhere. Clearly, you cannot necessarily draw an immediate analogy between a building in Europe or the middle east and one in Britain because the regulations may be completely different, but there were warning signs about external cladding systems, including in the UK. Regrettably, we have not had structures in place that allowed various professional voices, whether of construction specialists, building control specialists or fire safety officers, to discuss emerging risks and identify how we address them. I think a deep complacency about fire safety has emerged, particularly over the past two decades. Grenfell, hopefully, is a major turning point on that.
Mike Amesbury
Q
Mr Wrack: A single system of regulation would be better than what is proposed. I understand that there may be a need for a phased approach, but I am not sure that is what is in front of us. I think that the 18-metre cut-off point is incorrect, too. There should be a move towards an elimination of private-sector interests in building control. The idea that people can choose their own building control system is wrong, and appears wrong to many people. Finally—this relates more to the background to the Bill—resourcing is a huge issue for us in the fire service, for local authority building control, and for the HSE.
Ms Rimmer
Q
Mr Wrack: We welcome the commitment in the Bill to driving up standards. Regrettably, we in the union attend inquests, sometimes on the deaths of members of the public and sometimes on deaths of our members. There have been incidents in which our members have died and it has emerged that the fire risk assessor in the building had no qualifications. That is quite shocking. It is a sign of a deregulated sector.
We welcome the drive to improve and professionalise standards operating in a whole number of areas; if you listen to the shocking evidence to the Grenfell Tower inquiry, you find it relates to fire safety awareness among architects, to fire risk assessors, and to building control. We have from day one opposed the privatisation of local authority building control. If you listen to the evidence from Grenfell, there have been unprecedented cuts in local authority building control teams. That was reflected in the harrowing evidence given to the inquiry by an individual who reported that his team had been slashed completely. He kept a notebook by his bed because he could not keep up with the scale of work.
If we are to take building safety seriously, we need to provide adequate resources to those organisations tasked with delivering it, and that needs to improve standards. In the fire and rescue services, cost-cutting has reduced fire safety specialist teams and the provision of training. In the fire and rescue service, over the past 15 or 16 years, there have been reductions in training across the board—from the initial training that firefighters receive on joining the service to the training they receive when they enter specialist teams, such as fire safety departments—and, in our view, reductions in standards. If we are talking about driving up standards, we need to invest in the provision of adequate training and support for people to adopt those standards.
Ms Rimmer
Q
Mr Wrack: One of my roles, unfortunately, is to attend, participate in and support inquests and other inquiries. In virtually every inquest on the death of a firefighter we have ever dealt with, certain common themes emerge: command and control, resources and training. There are clear requirements under the Health and Safety at Work Act, which relates primarily to the internal workforce, and a raft of other legislation for public bodies such as the fire and rescue service to provide adequate standards in their outward-facing responsibilities to the community.
Ms Rimmer
Q
Mr Wrack: It certainly will improve, because the current state of affairs is pretty abysmal. For us, one gap in fire safety and building safety policy is the lack of the broader structures that used to exist in the British fire service, from 1947 to 2004, whereby various stakeholders came together to look at legislation, changes in the built environment, training requirements and so on, and could develop best practice in the sector. We used to have the Central Fire Brigades Advisory Council. That no longer exists and, as a result, there is a big gap in fire safety policy development in the UK.
It may be that the building advisory committee can play some of that role—precisely how that will unfold is a bit unclear, but it might play that role to some extent. But yes, the Health and Safety Executive potentially will improve things. As I mentioned, the key issue is resources.
Ms Rimmer
Q
Mr Wrack: We would oppose the approach taken that enabled desktop sign-offs to be conducted. I am not clear whether that would be enabled under the Bill once it has been implemented, but it certainly should not be.
One of the problems highlighted by Grenfell is the weakness of the testing regime. The ability of manufacturers and developers, in effect, to design their own tests goes against the normal, everyday, common-sense approach to testing that people expect. You do not design your own MOT for your car; you go to a registered MOT provider and they test it for you. You do not choose your own driving test examiner; they are appointed for you. I would argue that in areas where a lot of money is involved as well as huge issues of public safety, you should have stricter systems of regulation, not more lax ones.
Brendan Clarke-Smith (Bassetlaw) (Con)
Q
Mr Wrack: I think we welcome both as steps forward. As I say, hopefully this is a turning point in the debate on public safety and building safety in Britain; however, I do not think there has been the relief on the financial pressure on fire and rescue services that I mentioned, and that runs as a theme throughout this.
I do not see how you can cut in the London Fire Brigade, for example, 25% of your fire safety inspectors and not think that that will have implications for public safety. Something like 20% to 25% of fire safety inspecting officers have gone over the past 11 years, and something like 40% over the past 20 years. That is a very significant reduction, and it clearly will have, and has had, an impact on the ability of fire and rescue services to conduct the level of inspections or audits that people would want them to undertake. We welcome that legislation and this Bill, but—you would not expect us to say any different—we think it should go further.
Shaun Bailey
Q
Mr Wrack: First, I welcome the accountable person role. I think that is a step forward, as one of the problems that we have had in terms of building safety is identifying who the relevant party is. It will create big challenges for various bodies in local government, and certainly for the fire and rescue service because there clearly are large numbers of such buildings—although they are concentrated, particularly with the 18-metre limit, in particular parts of the country.
It will create a significant challenge for the London Fire Brigade, for example, to monitor and keep adequate records of who the relevant accountable person is, and the relevant building safety manager who sits underneath them once the building is occupied. There are lots of operational challenges. Those points have been made by the National Fire Chiefs Council and others. I will keep banging on that it does raise significant resource implications, inevitably, for us.
Kate Osborne
Q
Mr Wrack: There are loads of things that come out of that. Building construction is always changing. A long time ago, as recruit firefighters, we were taught about building construction, but that was the building construction of the time—of the 1970s and ’80s. Things have changed and as I say I do not think that enough horizon-scanning goes on about the emerging risks in how we build and alter buildings, and what we put in them.
On the question of furniture, again, my union has a very proud record. We led campaigns, including here, about foam-filled furniture and requirements to provide measures to address the impact that it was having in domestic fires. However, what is emerging today is a growing concern, across the world, around the contaminants that might be involved in fire-suppressing materials within foam-filled furniture—you solve one problem, but you may create another. There is a lot of work to be done.
On research, again, I think one problem that we have in the UK is a low level of public research into fire safety matters. Over the decades, we have worked with people at the BRE and so on, but much more needs to be done on that front. The fire risks are changing; the materials that we put into and on to buildings have changed, so they affect how buildings react in a fire.
Kate Osborne
Q
Mr Wrack: There are other regulations covering office buildings. One big thing that has been highlighted by Grenfell is the difference in standards between high-rise residential blocks and an office block of an equivalent size.
In an office block, you would have far different fire safety measures, including two stairwells, regular fire safety drills and so on. Those do not exist in purpose-built blocks of flats, because those blocks were designed to deliver compartmentalisation—they were built to contain the fire within the flat of origin. What has happened in recent years is that that has broken down. I think that residential blocks are different from non-residential blocks. Whether two is the right number, I do not know.
Daisy Cooper
Q
Mr Wrack: That sort of structure is precisely what is needed. The post-war legislation effectively created the modern fire service. It introduced such a body, called the Central Fire Brigades Advisory Council. It included the Home Office, the inspectorate, chief fire officers and the trade unions. We had a very close relationship with researchers at what became the BRE, the fire service college. It was a joined-up way of thinking about the risks of fire, but was eventually criticised for supposedly being slow. Looking back, I think that criticism was very badly placed. I look at how they responded to a fire in 1958 where firefighters were killed; within weeks, guidance was issued.
I must say that it takes much longer today to get a change, and firefighters on the ground are hugely frustrated at the slow pace of change post-Grenfell. In the 1970s, we did have bodies that were looking at the emergence of high-rise blocks of flats, and their implications on fire safety and firefighting. We do not have those anymore.
Then Grenfell came along. We had warning signs. We had cladding fires in Melbourne and Europe. My own union came to the House after a fire in 1999 to warn about cladding systems, so as long ago as 1999 we were making warnings about the new systems that were being put on blocks of flats, which created the risk of the fire spreading up the outside of the building, yet in the intervening years very little has been done to address that risk; to improve the knowledge on the part of firefighters on the ground; or in any way to prepare for what that might mean for the people living in those blocks of flats.
There has been a complete lack of joined-up thinking for more than two decades on fire safety, and I appeal to people to think about how that could be put right.
The Chair
If there are no further questions, may I, on behalf of the Committee, thank the witness for his evidence? I am going to suspend the sitting for 10 minutes until we can fire up our next witness on Zoom. Thank you very much.
The Chair
Q
Eric Leenders: Certainly. My name is Eric Leenders. I am the managing director responsible for personal finance at UK Finance. I am also a non-executive director, senior independent director and chair of the risk committee at the Buckinghamshire Building Society and a non-executive director of Registry Trust Ltd. I think it would be helpful for the record to also record that one of my staff, a senior adviser in my team, is a non-executive director on the New Homes Quality Board, which of course has some relevance to and may bear on the conversation we will have in just a minute.
The Chair
Thank you. The sound is still a bit faint, so if you could make a point of speaking up, we would all be grateful. We are going to start with Shaun Bailey.
Shaun Bailey
Q
Eric Leenders: I think our primary interest, like the rationale for drafting the Bill, is to ensure adequate safety and protection for homeowners, so we all buy into that. To the extent that the Building Safety Bill gives voice to homeowners and perhaps particularly to leaseholders, we think it is very important. There are some details of the Bill we are likely to come on to discuss where other experts can support homeowners and leaseholders, particularly regarding safety standards. Our primary interest as lenders, of course, is to ensure that homeowners, particularly those who require mortgage finance, are able to afford the borrowing they take on, and that includes potential remediation costs if they are necessary for particular properties. Work in the Bill and work undertaken by the Ministry of Housing, Communities and Local Government outside the auspices of the Bill are helpful in that regard.
Mike Amesbury
Q
Eric Leenders: Experts are probably better placed to consider the dimensions of the Bill, but I did mention the work that the MHCLG has done, which looks to support those who have been classified as cladding prisoners. I understand that in working through the detail of the support for those in properties of 11 to 18 metres, it was found that there could be some complexities in the security arrangements for any lending and the allocating of responsibility for any lending to a property or an individual or leaseholder and so on. The Bill could provide a platform for some of those technicalities to be worked through so that there is a sound legislative footing.
Rachel Hopkins
Q
Eric Leenders: Yes, and I think there are also some protections for leaseholders where the amount of remediation exceeds £250. That is welcome. The 28 days is potentially challenging—I am thinking of the staff in our organisation paid on a monthly 31-day cycle—so there could be a little more time for individuals to pay. Salaried individuals in particular are predominantly likely to look in the Bill for support. Increasing that timeline might be helpful.
Ian Byrne
Q
Eric Leenders: That is quite a difficult question to answer. The first point to make is that the housing stock is of the order of 28 million to 30 million properties, and only about 9 million have mortgages; you could perhaps add another couple of million for buy-to-let properties, so about a third of the overall housing stock would be affected. The composition of the housing stock is about much more than the most at-risk properties. What the Bill looks to address, based on the input from the fire experts, is a risk-based approach that would potentially look to address higher risk properties above 18 metres—there are probably about 1,400 or 1,500 of those properties in the UK. The impact on the overall market might be relatively modest, but the chief point is that for individual homeowners and those that have mortgages—those constituents—the impact is significant and is more than financial. It also has an emotional consequence as well.
Ms Rimmer
Q
Eric Leenders: We see two sides to this. One element is the extent to which there is a discrete building safety charge; the other is the extent to which that is combined perhaps with a service charge. There are pros and cons to both approaches. The overarching issue for lenders is the extent to which the pre-existing commitments—not just the loan commitment but individual household budgets—would remain affordable if there are additional remediation costs. As I mentioned, I know that the MHCLG team has been very thoughtful about that consideration in relation to introducing loan support for properties between 11 and 18 metres. There might be some read-across in the context of the detail of the Bill.
Ms Rimmer
Q
Eric Leenders: I think it goes some way to doing that. It is quite difficult for me to give you a direct answer on that specific question, because clearly one issue is cladding external wall systems and, equally, we are aware that there could be remediation requirements around, say, fire systems and internal remediation works as well. I am unfortunately unable to give you a categoric answer on that point.
Ms Rimmer
Q
Eric Leenders: That is a very astute observation. We have found that aspect of the Bill quite complex and technical. To the extent that the intent is to avoid those retrospective costs, one dimension that we have been considering and have not necessarily been able to clarify is where a property was built prior to the enactment of the Bill but the issue was identified after its enactment. Some further scrutiny is probably required on that aspect. Our overarching view would be that it should be very clear for homeowners and leaseholders to understand where they might have a potential liability, and therefore this retrospection point is really quite important in that context.
The Chair
If there are no further questions, I thank you, Eric, on behalf of the Committee for your time and for your evidence.
Examination of Witnesses
Alison Hills and Steve Day gave evidence.
The Chair
We will now hear from Alison Hills, an affected leaseholder, and Steve Day, a campaigner on the polluter pays principle. We have until 5 pm for this session. Would the witnesses please introduce themselves for the record?
Alison Hills: My name is Alison Hills. I am a solicitor who is personally affected by the building safety crisis. I have also been very active in the campaign on behalf of a number of leaseholders, and I have spoken to a number of leaseholders across the country.
Steve Day: Hello, everyone. I am Steve Day. I am also caught up in the cladding crisis—a £30 million bill for 118 flats. We basically felt we had to fight it, and that has led to where we are today. Thanks for hearing us.
Daisy Cooper
Q
Alison Hills: Sure. The first point I would make is that the Building Safety Bill offers completely inadequate protection for leaseholders. Throughout the ping-pong process of the Bill, leaseholders across the country were repeatedly informed that protection would be forthcoming in the Bill, but it is clear that that is not the case.
Personally, I could be facing a bill of between £150,000 to £200,000 if funding is not forthcoming from either developers or the building safety fund. That could result in bankruptcy and the loss of my career as a solicitor, because my professional qualifications will be automatically revoked if I become bankrupt. I know there are a number of solicitors, accountants, and other professionals who are in the same situation.
Daisy Cooper
Q
Steve Day: Yes. I live in south-east London, in a development called Royal Artillery Quays. We had a £30 million cladding bill, have £1.7 million of internal firestopping issues, and a builder that says that we are timed out with the Defective Premises Act 1972 and the Latent Damage Act 1986 because we are 17 years old, and our 15-year hard stop in latent defects times us out. We are very angry.
My brother is here today. We are doing a start-up and do not have enough money for one salary. It is devastating to have to fight a developer that claims it has no legal liability, even though we found multiple breaches of the BBA certificate on the external wall system. I went around with a fire engineer with an endoscopic camera to see all the holes in the firestopping above every single flat. I am sickened.
I have had to help people in the development with depression. One of my neighbours had to talk someone out of suicide. I am sure my brother will not mind me saying that it has been challenging—running a small business start-up, and trying to fight a developer and come up with a statutory scheme to stop everyone else from doing this.
I urge you to recognise that full redress is not just something that we want—a “nice to have”. You will hear more evidence on it, but think about it this way: if you, as Parliament, do not intervene now, this will happen in decades to come. There is a race to the bottom in construction. I was on holiday, and after The Times article that came out last weekend backing the polluter pays Bill, I did not really want to be next to a senior member of the construction industry for my holidays. However, he was very understanding and said to me, “Well, yes, there is a race to the bottom. Yes, the cheapest contract always wins. Yes, the building control that looks the least at the defects is the one that gets the contracts.” We have to stop this. Levies and taxes is letting them get away with it. We have to step in. That is what I am asking you to do today.
Mike Amesbury
Q
Steve Day: I am glad that you have asked about SPVs, as that is obviously a point of contention for our scheme. First, we are creating a statutory scheme—we are writing the law and Parliament is intervening. We would go after the parent companies when there is a relationship there. In the case of an SPV, we would try to establish that relationship. Remember that there are two parts to polluter pays—I do not know if you have seen the diagram. One part is to get the responsible parties to pay in full if we can. If we cannot find anyone—this is your first answer—we go to the levies that we have on the construction industry and the ancillary bodies such as cladding manufacturers and so on, who have all been part of the problem, as we heard in the Grenfell inquiry.
We can do a better answer than that, though: parent company liability. You might say, “Is that possible?” The UK Competition and Markets Authority can hold parent companies liable for the anticompetitive conduct of their subsidiaries, and can hold both the parent and subsidiary company jointly and severally liable for the payment of fines resulting from the anticompetitive conduct of the subsidiary. It has been done. If you want to look further afield, in German law, Konzernrecht holds parent companies liable for obligations of controlled subsidiaries; that has been done in Germany. Some say that British companies will not be attractive for investors if we do this parent liability, but it seems to be working in Germany. Hopefully, that gives you a little more colour on why we want to do this.
Ultimately though, take a step back from the legality. I am very grateful for Daniel Greenberg’s help and his 20 years of experience as parliamentary counsel; he is operating in a private capacity pro bono, because that is how much he believes in the Bill. He is not at all worried about this liability; he thinks it can and should be done. We have a simple, cost-effective and fast mechanism; a statutory scheme that will make those responsible pay, and their parents. Is that okay, Mike?
Mike Amesbury
Q
Steve Day: Do you mean just extending the limitations in the Defective Premises Act?
Mike Amesbury
Yes.
Steve Day: First, you cannot take a parent company to court if they do not exist or you do not have the relationship. That is where we need the Government to step in with a statutory scheme, because we need to establish the ability to make that connection. Ultimately, we need the Government to step in with a statutory scheme, which they did for asbestos, so that when people do not come to the table, we fall to a statutory scheme. This is a unique situation. We need the Govt to step in because the law is failing us. Extending limitations is a problem, because people may not have the standing to take their developer to court. They might not be in the contract; they may not have the money or the time; they may have mental illness as a result of suffering we have had already.
Alison Hills: May I come in here? I am a litigation lawyer; housing is not my area of speciality but I have some insight into the litigation process. The Government seem to think that they have solved this crisis by extending the limitation periods under the Defective Premises Act. I respectfully suggest that is far from true. First, as leaseholders, we do not own the property and we have no leg to stand on to pursue any legal action. Secondly, as we heard from two very prominent lawyers last week, there are a number of problems under clause 124, which could result in extensive litigation before we even get to remediation.
Thirdly, the Bill as drafted does not help when buildings are over 15 years old, it does not help in situations where developers have become insolvent, and it does not help in my own situation, where the developers and the freeholders are part and parcel of the same legal entity, so in essence they would have to sue themselves, which is not going to happen. That is why the polluter pays Bill is the most cost-effective way forward. It is simple and clear and provides an effective solution that avoids years of litigation that leaseholders simply cannot afford.
There was a case recently of Aviva Investors and Shepherd Construction, where Aviva Investors tried to pursue action for £4.5 million relating to a block of student flats. The litigation was unsuccessful, and the judge stated in that case that
“There is no pleaded case that a duty of care was owed by Shepherd to future owners of the property”.
If huge rich companies like Aviva cannot have a successful litigation against these developers, what chance to the little leaseholders have, who have no leg to stand on and no funds to do so?
Steve Day: One final point, if that is okay?
The Chair
Fire away.
Steve Day: There is another complication of the limitations extension, and that is basically the risk of a two-tier system. We have been discussing this with the polluter pays Bill team. There are bilateral investment treaties that have settlement provisions. We are concerned that if a foreign national were to use one of those provisions for international arbitration, especially in the case of a developer not existing in the UK—and these foreign investors are investors, leaseholders in UK property—they may be able to use that international arbitration and get compensation from the UK Government, where UK nationals will not be afforded such a privilege. That would be a shame if the developers do not exist and foreign nationals can use these international arbitration treaties when UK nationals cannot.
Daisy Cooper
Q
Alison Hills: First of all, once we had our intrusive survey undertaken, we had a waking watch implemented on is, which was at a cost of £400 per leaseholder. I have to say that a whole new crisis has been created as a result of the advice note and the EWS1 process. It is ineffective, it is placing leaseholders under an unacceptable level of financial risk. Personally, I felt more unsafe while they were in the building. They were undertaking activities such as smoking underneath flammable cladding. They were falling asleep. This sounds awful but they were peeing in our car park. We have also heard stories of other leaseholders across the country where single females have been harassed by them, which is completely unacceptable. That is just the first point, which is on waking watch alone.
In addition, we have had to pay increased service charges, which amounts to an extra £200 a month each. Our insurance has absolutely skyrocketed. I have heard of a leaseholder based in a block in Runcorn where it has increased by 1,400%. People are going bankrupt as a result of these interim measures alone, and that is before we even get to the remediation costs. As we have seen already, Hayley Tillotson was a leaseholder who has gone bankrupt as a result of these extortionate costs.
Leaseholders’ finances are being completely wiped out. It is completely unacceptable to put us under this level of financial risk and burden—in the middle of a pandemic as well, one might add, which only adds to the financial and mental health distress. There have already been reported suicides as a result of this crisis. I have to say that my mental health has seriously deteriorated, to the point that I have had to move out of my flat, because I could not sleep, eat or concentrate. It was an horrific situation to be in. Those are the sorts of things that are happening, and that is before we even get to any remediation costs.
Steve Day: Our service charge has doubled because of the waking watch and insurance. It is due to lack of trust in building regulations. The insurers do not trust, the lenders do not trust. That is devastating when you are doing a start-up as well. I do not have the salary that I used to have, and I do not have the savings I used to have because they have all gone on service charge. That is a huge risk.
Let me tell you something else. It is not just about the money for waking watch. I think we forget what it is about. Can you imagine people staring at your home 24/7 because they are so concerned that there is going to be a fire? Can you imagine what that does to you? You go to sleep wondering what on earth these people are doing staring at your building, going up and down the stairs. They are doing their job but their job is very concerning. They are so scared that they might miss it that they are checking things and all the rest of it. Then, there are some who do not do their job. You are in a total stress, non-stop.
It is all to do with the root cause. This is where I come back to the simple scheme that we have come up with. Let us restore trust in building regulations. EWS1s, PAS 9980s—it is a new way of showing building regulatory compliance, because the trust has gone from the lenders and insurers. Let us restore that trust. Full redress is the only way to do it. This is a unique situation, the costs are high and we need you, Parliament, to step up and put in this scheme.
There is so much support for the scheme—you will see that because we will put it out there to you guys as much as we can over the next few weeks. It is growing: we have bishops behind it, the Earl of Lytton and the Intermediary Mortgage Lenders Association. You have heard that the Association of Residential Managing Agents backs it and we have quite a few people that I cannot remember, but I am happy to write to you.
The support is only going to grow, because as we go through the Grenfell inquiry and we see some of the things that come out, maybe in module 6, full redress will come up again and again. If you want to give out loans to people and you let the industry off with a levy, they will never forgive you, because you did not go for full redress when you could have, and that is what I urge you to do.
Yes, it is unusual to have a leaseholder here coming out with a statutory scheme, but it is not just me—there is a load of experts helping me, all for free, because they believe passionately that we cannot let a levy system and a loan system go in when we have not tried full redress. It is possible, it is simple and it is fast, and we are working hard to limit the judicial review risk to the Government. We will be sending Mr Pincher and his team a new draft from Daniel Greenberg as soon as we can and hopefully getting something in to them, and then we can update you.
Alison Hills: I alluded to this earlier, but this is a very complex issue. There is liability against a number of parties—not just the Government for poor regulation, but developers, manufacturers, people such as Kingspan who mis-sold their products, insurers, Buildmark warranty providers. There are so many people involved here, but it is glaringly obvious that this Bill contains no repercussions at all for those people. The only people who have been legally held to account are the innocent leaseholders. As I see it, the fundamental role of Government is to protect victims and hold perpetrators to account, but this Bill does the exact opposite of that, and it is unacceptable.
Ms Rimmer
Q
It seems to me that polluter pays is the only suggestion that can go forward. We are not saying that the present Government are responsible for all this, but do you know of any other way than the polluter pays mechanism? Is it New Zealand that has the public safety emergency, where the Government have addressed that? It does not seem able to be addressed. Has anyone put forward to you any other schemes or other ways of addressing this? There are hundreds of thousands of family units in these properties—I do express my sympathy; I sincerely empathise and sympathise—but this simply must be addressed.
Alison Hills: Yes, thank you. It does have to be addressed. Obviously, there are the McPartland-Smith amendments, which protect leaseholders to some degree. There are some very helpful amendments—for example, the imposition of implied terms in residential building contracts to ensure that all buildings are adequately designed, comply with building safety regulations and use materials of satisfactory quality. New clause 5 also creates accountability for future builders by importing consumer rights protection into housing law. I fully support the amendments and new clauses, and I think they should be implemented in the Bill, but in terms of how to get the most amount of money from those responsible, the polluter pays Bill is the way forward, because it ensures that the right people are held to account and building safety regulations are adhered to in future. Obviously, Steve has worked very hard on this over the last nine months, so I will pass over to him at this point.
Steve Day: I think the building safety charge is another sign of not trusting building regulation compliance. The heart of polluter pays is not just to solve the crisis now; it is to restore trust in building regulation compliance. We have a set of functional regulations. B4 requires that
“the external walls of the building shall adequately resist the spread of fire”.
It should be very possible, then, with the approved documents, to show and to prove whether someone is liable for those defects.
We are getting very confused in this crisis. We need to bring it back to the two boxes of developments. We have one where the builders just did not keep to the regulations. We do not need to worry about the quality of the regulations—they just did not keep to them, not using the right fixings. Metal should be on firebreaks but they used plastic. Some are missing firebreaks. It is very simple stuff, which is very unappealable and very easy—low-hanging fruit. That is the box of not conforming to the regulations at the time—guilty. Not guilty, for the developers and the manufacturers, is the other box where the regulations were complied with at the time, but post Grenfell those regulations have changed. It is almost a retrospective liability, changing the goalposts. That is a failure of regulation, so that is where the public money would come in.
All we want is £5.1 billion of public money. We do not want to go to the Treasury unless we have to. We want to get that pot as big as possible for all those defective buildings—it is simple stuff, remember, such as fixings, adhesive pattern, firebreaks and so on—to make that £5.1 billion go further. That is what we are doing. I hope that our proposal shows that we have thought about how this might work with existing precedents. There is some discussion on whether the Environmental Protection Act 1990 and the apportionment process could be open to judicial review, because you might say, “If you’ve got a set of percentages and you’re just giving x per cent, y per cent, and so on, that could be open to challenge.” We have listened to that and we are working with Daniel Greenberg on a different, and much simpler, approach, which we will make you aware of, that will not be open so easily for judicial review.
We also heard Mr Pincher’s comments in the Chamber on how many determinations we have to do. Remember that we are proposing that it is a public body, potentially under Homes England, and we have a de minimis limit. We do not have the reports that MHCLG has but we have a mechanism. It can set what the de minimis limit is before we have those determinations, and then basically there is a control mechanism for how this works. We have created the scheme so that in the primary legislation the scheme requirements are set out. It has to be in place six months after Royal Assent, but we do not prescribe exactly all the parts of the legislation; that will be done in subordinate legislation. We are prepared to do that work as well, because that is how much we believe in this.
I cannot answer all your questions on this today, but Daniel Greenberg has said that when the conference season is over, we will book a meeting room in Parliament and invite MPs and peers to come and hear our proposal, with the depth required so that you can scrutinise it properly. Perhaps the Earl of Lytton might come and help as well.
Siobhan Baillie
Q
I want to move you slightly off the redress issue. We have heard witness evidence today that, over two decades, multiple Governments of all colours have failed to address building safety issues. That is high rises and all sorts of things.
This Government are genuinely trying to do their best with the Bill, and we have had evidence that says that it is moving quite a few mountains and is proportionate. You are so expert in this area—although I am sure neither of you want to be such—what do you know about the accountable person part of the Bill? It is suggesting that for a block there would be somebody who would be in charge of things such as fire safety certificates and the gas certificate. They would be the point person. We have heard evidence today from the Fire Brigades Union that was really positive about such a role in terms of the person that they can contact, and similarly the management agent said it was really good to have a single person as a point of contact. We have also heard evidence that no one will take on that role—because it has so many duties and responsibilities that no one will be interested. What is your view? I fear that you two may be that role because you are so expert. Knowing your kind of neighbours, do you think somebody would take that role on if the Bill is enacted?
Alison Hills: First and foremost, there is a lot of information in the Bill about an accountable person, a responsible person, but there does not seem to be a clearly defined role for each of those roles and responsibilities. I think that needs to be done. Secondly, our management agents already have a certain amount of responsibility in terms of building safety. As leaseholders, we do not want to be in a position where we are potentially paying twice for the same service. The Bill needs to contain clear definitions of the responsible person, the accountable person, the management agent and the role of the leaseholder. In my view, each of those roles needs a clear definition.
Siobhan Baillie
That is really helpful.
Steve Day: I know that I am coming back to what I have said before, but for me it is about trust. If we are having a building safety charge, that is because we do not trust that our buildings are safe. It was fine before Grenfell, and maybe that is not a great thing to say, because the regulations and enforcement were not there. If the enforcement is there, I am really hoping that we can go back to paying a very reasonable service charge and getting a very reasonable service.
I think we really need to look at this Building Safety Bill from the point that if we put in for redress, if we had that big stick to whack all those responsible for not installing things right, can we restore trust in our building? This Building Safety Bill could then be made a little simpler and a little cheaper for those who are living in blocks, and maybe we can just reform everything. That is my view.
Siobhan Baillie
Q
Steve Day: I think there is a role for having someone responsible. A lot of these blocks have a concierge. I would say first, “Is there an onsite concierge?” If there is, maybe something could be done there. If not, a lot of blocks have a small committee of four or five people who might take on that role collectively. It seems a lot to put on one person—that’s my initial thought. If we want leasehold to survive—I am not sure where I stand on leasehold and commonhold yet, but I do not think commonhold solves the bills, and I think they will still come. If I am going to try to get someone to cover, I don’t know, say fire door replacements and so on, I have got to go and negotiate that if I am in commonhold. Let us make sure that we make leasehold as economically viable and fair as possible, and I think you can only do that by coupling that with building regulation.
Siobhan Baillie
Q
Alison Hills: Yes, I have to say that I think that would be helpful. When we found out about all the defects in our building, it was in the middle of lockdown, so we were stuck for 24 hours a day in a flat that was potentially unsafe. All these videos started coming out on Twitter about Grenfell, the fires and Kingspan. It was absolutely horrific, from a leaseholder’s perspective: people were genuinely frightened to send their children to sleep at night.
I cannot reiterate enough just how difficult that period was. That was one of the reasons that I made the decision to move out; I am lucky that I had that choice, but many others do not have it. Many are still putting their children to sleep at night in a building where they do not feel safe. Leaseholders absolutely need more support with that. They also need more mental health support, because we are just relying on each other at the moment. There is a very good cladding community, and the leaseholders have been a brilliant support—my MP Daisy, who is on the Committee, has been a brilliant support as well—but I think that the Government need to take more responsibility to support their constituents with the mental health impact. I cannot reiterate enough how difficult it has been.
Steve Day: I think that leaseholders supporting each other is one thing, but you have to remember that the building safety fund has asked us to create all these reports showing all the defects. Unless someone comes and fixes those defects, the horse has bolted. The building safety fund reports show all these missing fire barriers, cavity barriers and internal fire stopping. If you check approved document B, getting the fixings wrong has a material impact on the fire rating of the external wall system.
Unfortunately, you have turned millions of people into fire experts. We now know what ADB says, and we now know that a small difference in the render thickness of our external wall systems can have a material impact on the fire rating. We know, when we look at the safety certificate from the British Board of Agrément for 100 products across the UK, that not meeting the exact specifications contravenes the certificate; the head of the BBA confirmed that, and I am grateful to him.
We know all that and we have all that information, yet not only have we been left to pay for it all, potentially, but we have all the worry of it. You cannot put that back in the box unless this is remediated. Unfortunately, in the leasehold community, we have been exposed to an awful lot of fire safety evidence that would lead us to believe that we are not in safe homes. Until the remediation is done, I just do not think that we can put it back in the box.
Alison Hills: I have not specifically been asked a question about this, but another problem is that the building safety fund process has been very difficult. The fund only covers some defects in some buildings. We have been told that we are eligible, but we still cannot get any of the fund because there are a number of onerous contract terms. MHCLG and our managing agent have been at loggerheads over the contract terms for almost the past year, and we are in limbo with a huge potential bill of £200,000 hanging over our heads. That is just not an acceptable position to be in—we simply should not be in that position.
Ruth Cadbury
Q
Alison Hills: First of all, I do not think that there should be any height restrictions to the building safety fund. We have seen videos in which the 18-metre figure came up because the people making the decision did not have time to come up with a better figure. There does not seem to be any reason behind the 18-metre rule. The materials are still flammable in buildings under 18 metres; they can still catch fire, as we have seen.
In my view, the building safety fund needs to cover all heights of building and all defects, not just cladding. I have spoken to a shared owner in the London Olympic park who does not have any cladding on his building, but who is facing an £80,000 bill just for missing fire breaks and insulation. That is just an unacceptable position to be in. There are a number of fire safety defects that do not relate to cladding, and they should absolutely be covered.
Steve Day: I would say, “Have a look at the materials.” We all accept that ACM cladding, linked to Grenfell of course, is dangerous, but you may not have realised that the Victorian Building Authority conducted a test last year and concluded that expanded polystyrene, because of very rapid vertical fire spread, ultimately creating fire pools that go down as well as up—not the pools, but the fire—was as dangerous as ACM. Why do we have this categorisation that ACM is the only dangerous cladding when EPS has been proved by the VBA to be as dangerous? That has implications on the 8414 tests because everyone knows that the grate is at the bottom of the rig. How do you test downward fire spread if the grate is there? It will just test upward, so there are issues there.
This is why I am always talking about trust. We need to get back to trusting our materials. We need to get back to having a large stick if the cladding manufacturers mis-sell products. In the aftermath of the Grenfell fire,181 samples failed combustibility tests. We need a big stick. The building industry and the construction industry are showing that they cannot be trusted, unfortunately. That is why we need full redress.
Ruth Cadbury
Q
Alison Hills: Again, I think there needs to be clear definition in the Bill of how often access will be granted and for what reasons, how much notice will be given, and who will come into the property. There are so many unanswered questions in leaseholders’ minds at the moment, and it needs clear definition in the Bill, in my view. Otherwise, it potentially brings up privacy issues.
Steve Day: Get rid of the gas boilers as quickly as we can. They are not great on high rises.
Ian Byrne
Q
I want to touch on residents’ engagement. It is hugely important. We saw that with Grenfell, and what was missing. Earlier witnesses said that the residents’ engagement section of the Bill is potentially one of the weakest parts. How do we strengthen residents’ voices, and the imbalance of power that exists? How would you reflect what residents need within the Bill to ensure that their voices are heard?
Steve Day: We need to have very good transparency from our managing agents. Often we cannot see the reports that are about the safety of where we live. We cannot see the accounts to see that they are spending the money correctly. We are given a very high-level aggregate view that often does not check out to what we are paying, so that side of things needs to be transparent. There needs to be a lot of thought towards how residents are engaged as well. Not all residents have the inclination to get together and form a committee. How do you handle that? Do the managing agents pick on one person and say, “You’re responsible for it”? I think that could all be strengthened.
Alison Hills: Luckily, in our block, our managing agent has been very forthcoming. We have regular meetings with them every two weeks. That position is quite lucky, but it took a lot of work to get to that point. A lot of leaseholders across the country have managing agents who do not share information, fire risk assessments and even evacuation plans. We have seen, particularly for disabled leaseholders, that some blocks do not have any evacuation plans at all. I think that is completely unacceptable.
Information sharing is the key point. Residents do have a right to see this information. It affects their lives; it affects their health and safety; and it affects their mental health. They need to know what to do in the event of a fire; they need to know what the defects are; and they need to know what the next steps are. As I said, my managing agents have been good with that, but many others have not.
Daisy Cooper
Q
Alison Hills: Yes, I think that would be very useful for residents. There are residents from all walks of life in all heights of building, and it is important that all their voices get heard. We are lucky: in our particular block, we have a very active residents committee; we are a very engaged set of leaseholders. But others might not understand about their building’s defects; they might not realise the whole situation that is affecting leaseholders. There are some, even in different blocks in my development, who do not realise the repercussions of the Building Safety Bill. I think this is just about information sharing and making sure that every block has a voice and every leaseholder has a chance to have their say. That is absolutely crucial.
Steve Day: One thing that would have helped me with my investigations was the BBA certificates. It is charging hundreds of pounds to get that, and it is often very difficult. I think we have a right as residents, if we have this massively large building, to know what the safety certificate says about our external wall system, so I say: let’s put it all online. The BBA, I am sure, can get its money in other ways. Also, if we are trusting the construction industry to keep to regulations, and if a development does get judicially reviewed with our redress scheme, I would say: let’s have Parliament put the information online, perhaps in a brief form—the judgment and the fact that that developer thinks that plastic fixings are fine on firebreaks. Let’s put it online, on a parliamentary website or some form of official site, so that a development has the ability to shame the developer, the construction or the cladding manufacturer if they choose to basically say that something unsafe is safe. I think we do need something like that.
Alison Hills: One of the positive aspects of the Bill is that there is a clause about mandatory keeping of records. That is absolutely crucial. It needs to be done—absolutely. Our developer cannot find the plans, for example, for our building. And that has happened across the board. There are so many leaseholders I have spoken to where they cannot contact the developers and they have just lost all the paperwork. How do you lose the building work paperwork? It just does not make any sense. But if there is a centralised system, it cannot get lost; it is all there, in black and white. And any leaseholder who wants to see it should have that right, because it does affect them. It is their home at the end of the day, and they need to know what the building safety issues are with their flats.
The Chair
If there are no further questions, may I, on behalf of the Committee, thank the witnesses for their evidence today? That brings us to the end of today’s sittings. The Committee will meet again on Thursday, for line-by-line scrutiny of the Bill. May I ask Committee members to leave the room promptly by the exit door and while observing social distancing? Thank you very much.
Ordered, That further consideration be now adjourned. —(Scott Mann.)
Westminster Hall
(3 years, 3 months ago)
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Black Maternal Health Week
(3 years, 3 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Mr Philip Hollobone (in the Chair)
Before we begin, I encourage Members to wear masks when they are not speaking, in line with current Government and House of Commons Commission guidance. Please also give each other and members of staff space when seated and when entering and leaving the room. Members should send their speaking notes by email to hansardnotes@parliament.uk. Similarly, officials should communicate electronically with Ministers. I now call Bell Ribeiro-Addy to move the motion.
Bell Ribeiro-Addy (Streatham) (Lab)
I beg to move,
That this House has considered Black Maternal Health Week.
It is a pleasure to serve under your chairmanship, Mr Hollobone. I am thankful that we are able to have this debate, which follows from an e-petition debate that was held in April after the petition received over 180,000 signatures. MPs were given the opportunity for the first time to debate a petition calling for improvements to maternal mortality rates and healthcare for black women in the UK.
I would also like to take this opportunity to thank Tinuke and Clo from Five X More, as well as Elsie Gayle, whose tireless campaigning efforts have forced this issue on to the agenda. They have not only provided us with the opportunity to discuss the issue but given a voice to many black women who have experienced a traumatic pregnancy or birth and to those families who have lost loved ones.
For too long the statistics had pointed towards a glaring disparity in black maternal health experiences, and for too long nothing was said. We now have a Black Maternal Health Awareness Week, during which we can highlight the disparities and discuss ways in which we can make pregnancy a safe experience for all, regardless of skin colour.
Members will by now be very familiar with the statistics surrounding black maternal healthcare and mortality, but they bear repeating. In the UK, which is one of the safest countries in the world in which to give birth, black women are still four times more likely to die in pregnancy or childbirth. Black women are up to 83% more likely to suffer a near miss during pregnancy. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Miscarriage rates are 40% higher in black women, and black ethnicity is regarded as a risk factor for miscarriage. Black mothers are twice as likely to give birth before 37 weeks of pregnancy.
The situation for women and birthing people of mixed heritage and Asian heritage, unfortunately, is not much better, with those of mixed heritage being three times more likely to die in pregnancy and childbirth, and Asian women two times more likely. Asian babies also have a 55% increased risk of stillbirth and a 66% increased risk of neonatal mortality.
However, we all know that racial disparities in health do not begin, and certainly do not end, there. Despite these statistics, despite the number of reports and studies that have been produced in the last year and before, and despite being aware of the glaring disparities in maternal healthcare, we still have no target to end them.
Jim Shannon (Strangford) (DUP)
I thank the hon. Lady for giving way. The statistics are alarming and disconcerting. That black ladies are four times more likely to die in childbirth is shocking. Does she agree that the Government and the Minister now have a responsibility urgently to outline steps to address this? The hon. Lady has outlined the issue, but we want to see what the response will be to make it better.
Bell Ribeiro-Addy
The hon. Member is absolutely right. With disparities such as these and no clear way forward, that is what we are hoping to hear from the Government. With all the information that we have, it is clear that the response is not good enough.
In the USA, where there is also a glaring disparity in maternal health outcomes for black and ethnic minority women, the Government have actually begun to take steps to address the problem. In April, the White House issued its first ever proclamation on black maternal health. President Joe Biden declared a Black Maternal Health Week, to take place annually from 11 to 17 April.
Kirsten Oswald (East Renfrewshire) (SNP)
The hon. Lady is giving a very powerful and important speech. I wonder whether she is aware that research from the USA shows that when black and Asian women do not have pre-existing medical conditions, do have English as their first language and come from middle-class backgrounds, they still have worse outcomes than comparable white women. Does the hon. Lady agree that there is something more going on here, making it all the more pressing that this Government here understand and act?
Bell Ribeiro-Addy
I thank the hon. Lady for that timely intervention. She is absolutely right; that shows that this is clearly about racism. It is important that we look to what other countries that also clearly have issues with racism are doing to tackle it.
Alongside the Black Maternal Health Week proclaimed by the White House, the Biden-Harris administration has outlined several action plans specifically looking at addressing maternal health issues. Through the American Rescue Plan Act 2021, $30 million has been reserved for implicit bias training for healthcare providers, as well as a provision that will allow states to expand post-partum Medicaid coverage from 60 days to a full year.
How have our Government responded in comparison? In response to a question I asked one of our equality Ministers, I was told that there was no target because the numbers were not high enough. Our Government have responded with poorly rolled-out plans that actually exacerbate the issue by ignoring the problem altogether. The NHS long-term plan aimed at providing continuity care for women across the country seemed, on paper, like a really good starting point to improve maternal health outcomes. However, a whistleblower at Worcester Royal Hospital has said that, in reality, it has created a two-tier system for pregnant women. To create the new team of continuity carers, midwives have had to be pulled from the hospital’s core staff, leaving the hospital unit without enough specifically trained staff.
Nickie Aiken (Cities of London and Westminster) (Con)
A constituent of mine, Jade Sullivan, has been in touch with me to share her own experiences of disparities in maternity care and outcomes for black women. Her testimony was incredibly powerful, and I hope to be able to meet with the Minster soon to discuss that in more detail. Does my hon. Friend—I am sorry, I should say the hon. Member, although I hope that she is also my friend—agree with me that we need a clear plan with targets to reduce disparities in maternal health outcomes that actually outline the specific actions needed to improve safety for black mothers and their babies?
Bell Ribeiro-Addy
I thank the hon. Member because I absolutely agree that that is what we need, but we also need to make sure that these plans are well thought-out and well resourced. As the whistleblower from Worcester pointed out, with the new plan, the ward could often end up being short of five or six midwives per shift. Meanwhile, those with a continuity midwife who are, according to the whistleblower, actually lower risk, are jumping ahead and delivering their babies because the midwife is available straight away.
A system that is supposed to help reduce the rate of stillbirths and maternal mortality has, through its poor implementation, resulted in a two-tier system whereby higher-risk pregnancies are made to wait for deliveries. For example, a woman in need of an urgent caesarean section may have to wait while women with a planned or elective caesarean section are seen first.
Recently, the Health and Social Care Committee’s evaluation of the Government’s progress against their policy commitments in the area of maternity services in England rated the Government’s continuity care commitment as inadequate and in need of improvement. That is simply not good enough. While figures also suggest that the number of women from disadvantaged backgrounds who are likely to experience a high-risk pregnancy are now receiving continuity care, and those numbers are increasing, it is clear that the Government are not on track to meet the target of rolling out their continuity of carer service model to 75% of the most vulnerable groups by March 2024. Without adequate funding and staffing, the two-tier system that has played out in Worcester will continue.
Other measures introduced by the Government to improve maternity healthcare seem to ignore the racial disparities altogether. On 4 July this year, the Department of Health and Social Care announced that it was committing £2.45 million to improve childbirth care. Of that, £2 million was to be allocated to test the best way to spot early warning signs of babies in distress, and the remaining money was allocated to developing a new workforce planning tool for maternity medics, including helping trusts to tackle other inequalities, taking into account local factors such as birth rates, the age of the population, the socioeconomic status of the area, and geographical factors. Those are all important, but at no point in this announcement was there any reference to tackling ethnic disparities in maternal healthcare, despite all of the information we have heard over the past few years in particular.
I ask the Minister why the decision was made to omit a reference to ethnic disparities when research clearly highlights ethnicity as a factor in maternal health outcomes, so much so that a series of papers released in The Lancet regarded black ethnicity as a risk factor for miscarriage. In fact, the only other intervention I have heard has come from the National Institute for Health and Care Excellence, which was to recommend inducing black women at 39 weeks—another tone-deaf response. There have been loads of responses from throughout the sector that really drilled down on what the problem was with this. Christine Ekechi, the co-chair of the Royal College of Obstetricians and Gynaecologists’ race equality taskforce, said that
“Stratifying risk by race alone is a blunt tool to use, and although highlighting higher risk is important, it does not move our understanding further as to why this group of women are at greater risk…Women should always be able to make informed decisions about their own health and care based on real evidence.”
This suggestion was not based on real evidence.
The Royal College of Midwives warned against “blanket approach recommendations” and argued in favour of “personalised care”, saying that
“Black, Asian, mixed, and ethnic minority women face a constellation of biases when accessing maternity services, often experiencing poorer quality of care and lower satisfaction. Introducing an intervention that is singling out women on ethnicity alone, when there are likely to be large differences in health status and values within the group could itself be considered discriminatory.”
Mars Lord, who is a doula and birth activist and started the Not So NICE campaign with her colleague Leah Lewin, said that the recommendations were already affecting black people’s mental health. She said that she had been in contact with
“dozens of black and brown pregnant women and birthing people who are fearful about their birth because they are not seeing any choices”.
Thousands have signed a petition urging the Government to reject the guidance from NICE.
It is clear that without a proper plan to end racial maternity health disparities, the Government are telling black, Asian and ethnic minority women and birthing people right across this country that they do not care: that our pregnancies, our children and our experiences do not matter. If the Government want to show that this is not true—if they want to prove that they care about the experience of every pregnant woman—they have to start, first and foremost, by setting a target to end these maternal health disparities.
When the Minister responds, I want to hear that the Government have set a target to end racial maternal health inequalities. I want to hear that they have a timeframe for when they would like to see these gaps closed and reduced, and exactly how they plan to do this, and I want to hear that the Government have heard what black women have been saying about our experiences of maternal healthcare and how they have often resulted in negative outcomes and traumatic experiences. I also want the Government to say that they will engage with black women to improve our experiences of maternal health services, and that they will be implementing the Joint Committee on Human Rights’ recommendations on black maternal health, as well as those included in the Health and Social Care Committee’s report, “Safety of maternity services in England.”
Finally, when the Minister responds, I hope to hear that the Government intend to launch an inquiry into institutional racism and racial bias within the NHS, as well as within the medical education field. Stereotypes about the pain tolerance of black people, our cultural beliefs and practices, and our perceived understanding of the medical system all contribute to the negative experiences black women have had in maternal services, and they definitely contributed to mine. It is certainly an uncomfortable view to take that medicine, or our fantastic NHS, may operate within a framework that has institutional racist bias, but if we are going to improve the maternal experiences and outcomes of black women, we have to address the racial stereotypes that cause them. We are not going to get there by burying our head in the sand and pretending that these racial injustices do not exist, or that they are not so bad. The colour of a woman or a birthing person’s skin should not impact the experience that they have of maternal healthcare services, their chances of a successful outcome or, in fact, whether they live or die. It is a sad fact that this happens in our country—in the sixth largest economy in the world, in one of the safest places to have a child—so we are calling on the Government to help improve those maternal experiences for all women.
Caroline Nokes (Romsey and Southampton North) (Con)
I put on record my appreciation to the hon. Member for Streatham (Bell Ribeiro-Addy) for having led the debate today and for her incredible work on this important and sensitive issue.
Alongside me, she is a member of the Women and Equalities Committee. We have been privileged to listen to the evidence of black and mixed-race mothers about the experiences that they have had in giving birth and in supporting their family members in giving birth. We have heard some real horror stories of lost sisters and lost daughters, because their maternal health outcomes have been worse than the outcomes that my hon. Friends the Minister and the Member for Cities of London and Westminster (Nickie Aiken) and I would have had.
It is wrong that in 21st century Britain we can still expect black and mixed-race women and women from ethnic minorities to have such a massive disparity of experience. The Five X More campaign has done some incredible work. In the Select Committee, we have been lucky enough to do roundtables with them, and to listen to their experiences, their recommendations and the changes that they believe would make a real difference.
Those stories have been difficult but important to listen to. The thing I took away was how fed up those women were about having to repeatedly tell the story. They feel that they are not being listened to, that there is no change and that they are not seeing action, when actually, as the hon. Member for Streatham has pointed out, the statistics are so stark that this should be driving immediate and rapid change.
In November last year, the Joint Committee on Human Rights discussed targets. I can sometimes be a bit sceptical about targets and think they do not necessarily always drive the right outcomes and behaviours, but this is a clear case where I think that they would and where I want to see the Government have real ambition to set a target and a timeframe, so that we can see that four times more disparity driven down and ended. It is crucial that we try to do that in a very rapid timescale.
There have also been clear recommendations from the Health and Social Care Committee. Indeed, the Government should be responding to them imminently. Can the Minister update us on that in her response and give us an indication about whether the Government will embrace those recommendations?
I am conscious that my hon. Friend the Minister has done good work on the subject and last year set up a forum designed to bring together experts in the field to meet key stakeholders, to consider and to address the inequalities for women and babies from different ethnic backgrounds and socioeconomic groups. We cannot shy away from that. We also have to look at some of the intersectional challenges, and ensure we are looking not just at race but at the socioeconomic situation.
Can the Minister outline how that forum is assisting policy making? It is crucial and we want to understand what role those experts are playing in feeding into Government to drive policy change. Can she indicate how often the forum has met and what the key recommendations have been? How quickly will those recommendations be acted upon, if indeed they will be acted upon?
One challenge that we heard at the Women and Equalities Committee roundtables was about research. Many experts felt that there was already a great depth of research that had been done, that the knowledge was there and that perhaps further research was not needed. In April this year, we heard that the Government had commissioned the policy research unit in maternal and neonatal health and care at the University of Oxford to develop an English maternal morbidity outcome indicator, which is not easy to say. That is crucially important. We want to see how that indicator is working and when we expect it to be rolled out. I would like to hear the Minister today update us on that work and give us some indication as to whether she is any closer to committing to a target for reducing the deaths of black women in childbirth.
Towards the end of her contribution, the hon. Member for Streatham spoke about continuity of care, which is crucial. We know very well that if there is continuity of care during pregnancy then the birth outcomes would be better for both mother and child. The NHS long-term plan included targeted support around continuity of care, with an aim that by March this year most women would receive the sort of crucial continuity that we are calling for. That was a target that was set, so I would very much welcome the Minister’s updating us on how that is going. We heard from the Health and Social Care Committee that the targets for continuity of care were inadequate and in need of improvement, so perhaps we can have an indication of how the Government will achieve that.
The hon. Member for Streatham finished her speech with a commentary on institutional racism in the national health service. I was really struck—I was going to say this time last year, but perhaps it was a bit earlier—when we took evidence in the Women and Equalities Committee on how much worse the outcomes of covid were for people from black, Asian and minority ethnic communities. One of the messages that we heard from healthcare professionals from black and Asian backgrounds who were working in the NHS was that they were scared to speak up. They were scared to tell their stories to line managers about the pressures that they faced when working in our NHS. In many instances, they felt exposed to racism if they asked for perfectly reasonable adaptations or changes, or for greater levels of personal protective equipment. It is absolutely wrong in the 21st century that we have people working in our health service who are frightened to speak up.
I was struck when we took evidence during the roundtable discussions with black and minority ethnic mothers, and indeed with experts—we heard from Christine Ekechi, who is the most incredible woman, and from the doula Mars Lord, to whom the hon. Member for Streatham referred. They made a really important, shocking and, in many ways, depressing point: too many black women and their partners were not being listened to during childbirth. They were trying to convey how they felt and the worries they had when they felt that things were going wrong. Mothers going through childbirth were scared and instinctively felt that something was going wrong, and they told us repeatedly that they were not listened to. In a 21st-century health service in the sixth largest economy in the world, that is simply not acceptable.
Florence Eshalomi (Vauxhall) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mr Hollobone. I pay tribute to my constituency neighbour, my hon. Friend the Member for Streatham (Bell Ribeiro-Addy), for her powerful opening speech and for the work that she has been doing to lead on this really important issue.
The theme for this year’s Black Maternal Health Awareness Week is “changing the narrative”. We have to change the narrative. There is a call for a sea change in the outcomes for black women during pregnancy, and in finding ways to empower black patients to advocate for their health. We have known for years that women of black, Asian and mixed heritage face significantly higher maternal and prenatal mortality rates, and that women from black and minority ethnic backgrounds discover many conditions during their pregnancy. I discovered that I had fibroids at my first maternal scan during my first pregnancy. As an expectant mother, that brought a level of fear and anxiety—what would happen to me and my baby? In most cases fibroids can be unharmful, but in a small number of cases they can cause complications for the growth of the child and for both mother and baby during labour.
Unfortunately, we know that black and minority ethnic women are sometimes not listened to during the course of their pregnancy, and that there can be unconscious bias as a result of the structural inequality and institutional racism in our healthcare system. As my hon. Friend the Member for Streatham highlighted, Professor Knight suggests in the MBRRACE-UK report that a number of black and ethnic minority people face microaggressions, which means that symptoms can be indicative of complications that are missed, and that they are not given the attention they need. The “changing the narrative” campaign helps to empower black women to make their voices heard on this issue. It is crucial that their voices are listened to, and that their experiences are heard. I pay tribute to Five X More for the vital work that it has been doing to lead the campaign and, most importantly, to get the Government to listen to the many voices of the black and Asian women who are suffering in this area.
As a mother to two young children, who were born just across the river at St Thomas’ Hospital, this issue is close to my heart and those of many of my constituents in Vauxhall. More than 1,000 Vauxhall residents signed the petition urging the Government to pay close attention to this issue and to improve health outcomes and maternal rates for black women in the UK. Compared with white European women, black African women in the UK are 83% more likely to suffer near-misses in childbirth, and black Caribbean women are 80% more likely to do so. My two children were very stubborn and did not want to come out; in the end, they had to be evicted by C-section. My first pregnancy was fine: I was induced, it did not work, so the C-section was the next day. My second pregnancy did not go so well. Having gone through a C-section, I did not want that again. I tried to explain to the doctors that my body did not respond to induction and that if they just gave me time, the baby would eventually come out. Everything did not go to plan and I was rushed to theatre for an emergency C-section.
Panic, fear and the unknown, added to the fact that they had not been able to contact or locate my husband, meant my body froze and rejected the epidural. I heard the doctor’s words that I would have to go under general anaesthetic. I asked, “What? I am going to be put to sleep and you are going to deliver this baby. What if I don’t wake up?” I was lucky because I did wake up, after many hours. A number of black women are not as lucky; they do not wake up. It is important that we listen to black women and the experiences of all women, because they know their bodies best.
During the debate earlier this year, alongside the petition in April, the Minister would not set a target around black maternal health:
“We cannot set targets until we know what we are trying to achieve through those targets and what we need to address.”—[Official Report, 19 April 2021; Vol. 692, c. 172WH.]
We know that black women in the UK are four times more likely to die in pregnancy and childbirth; women of mixed heritage are three times more likely; and Asian women twice as likely. Those statistics paint a clear picture of the problem we need to solve. It is now five months since we last discussed this issue in the House. I have one question for the Minister: what research has been done to set the target, so that we can measure the progress to end this disparity? If none, what steps is she taking to gather the data urgently to tackle this problem as soon as possible? One death is far too many. It is important that we listen to those women and address this issue urgently.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
I am grateful for the opportunity to speak in this important debate on an important subject. I congratulate my hon. Friend the Member for Streatham (Bell Ribeiro-Addy), who made it possible. In particular, to speak in Black Maternal Health Awareness Week feels right and appropriate.
For all mothers-to-be, pregnancy is a challenging time, as I remember. Pregnant women feel vulnerable as their bodies are changing. For a first-time parent, in particular, the uncertainty of parenting can be daunting. It is very important that all mothers-to-be have access to high-quality services. Many do, thanks to our NHS. Our NHS is staffed by so many dedicated professionals, who provide exemplary support for many new mothers.
I want to make it clear that this debate is not designed to berate or admonish hard-working NHS staff. In fact, many staff in maternity services are black. Nevertheless, as colleagues have said, the extraordinary disparities in black maternal health cannot, and must not, be ignored any longer. I am aware that the Government do not like to talk about racial disparities, but Ministers can scarcely blame black women themselves for the disparities in maternal outcomes for black women.
The time is now for the Government and those in charge of the NHS to take these issues seriously. As Members have said, statistics show that black women in the UK have a fourfold higher increased possibility of dying in pregnancy, compared with their white counterparts. Disparities in mortality rates extend to babies as well as mothers. Mortality rates remain higher for black, black British, Asian or Asian British babies. That must have something to do with the disparities in the whole area of the maternal experience.
As a number of Members have said, these statistics show that there is a major problem in maternal health. So, the question is this: what are we going to do about it? To NHS managers and commissioners who may listen to this debate or read the transcript of it, I would ask: how will you ensure that black women are listened to? A number of Members who have spoken in this debate have made the point that black women, however confident and educated they might be in other circumstances, do not feel that they are listened to when it comes to the maternal experience. How will we close the pain gap, to ensure that black women are not left to suffer without the pain relief that apparently is readily given to white mothers?
The 2019 NHS Long Term Plan is a start, but it lacks concrete steps to address this disparity. It makes no mention of addressing disparities even in the administration of pain relief, among other things. I am hopeful that the Minister will touch on these issues when she responds to the debate.
So I say to the Government: what is the plan to address these disparities? What explanation can be given for them? Ministers have said in the past that we no longer see a Britain where the system is deliberately rigged against ethnic minorities. If they believe that, what will they do about the disparities in maternal outcomes?
If the Government and those managing our NHS wish to close this gap, they have to put black women at the centre of their thinking and listen to what they say about their experience, both after and during childbirth. That means that there must be clear and binding targets, data collection and monitoring to support and judge progress on this issue. It also means funding for new and existing projects to tackle this disparity and to take the measures that I and others have outlined.
I thank campaigners, such as those at Five X More, who have worked so hard to ensure that this matter is not forgotten. Black women and their babies deserve better. At no point in any woman’s life does she feel more vulnerable than in childbirth, and black women should not have to believe or understand that they will have a poorer outcome simply because of the colour of their skin and their babies’ skin.
Anne McLaughlin (Glasgow North East) (SNP)
It is a pleasure, Mr Hollobone, to serve under your chairmanship today.
I start by paying tribute to the hon. Member for Streatham (Bell Ribeiro-Addy) for securing this debate in Black Maternal Health Week. Clearly, she is determined that something will be done to change this terrible situation, and rightly so. Persistence very often pays off and I am sure that she will persist until change comes. I also know that this is a very personal matter for her and nothing that happens in the future can change what happened to her and her child. The fact that she keeps fighting so that the situation changes for others says much about her and I am more than happy to offer her my support.
Just as the hon. Member and others will keep raising this issue, so should we all keep raising it again and again, as others have today, until it is no longer true that black women are four times more likely to die during pregnancy and childbirth than white women. I repeat that: four times more likely to die. Women from mixed backgrounds are three times—
Kirsten Oswald
To highlight what my hon. Friend is saying, it seems to me that it is inconceivable that the general public know about this issue. If people understood what a huge disparity in maternal health outcomes there is for black women and for mixed race women, I feel sure that there would be a huge outcry. It is really important that the Minister takes that point on board and takes every step possible to deal with this terrible blight.
Anne McLaughlin
I completely agree with my hon. Friend. It is up to the many Members of this House who are not already doing it to do it, and those of us who are doing it must keep repeating over and over again that black women are four times as likely to die during pregnancy and childbirth as white women. For women from mixed backgrounds it is three times as likely, and for Asian women it is twice as likely.
The reason we need to keep saying that is that, despite the fact that the inequality and disparity in maternal and newborn health has been highlighted for many years, we still do not fully understand why it exists, as we have heard, and we do not have the targets that we need to tackle it. The right hon. Member for Romsey and Southampton North (Caroline Nokes), the Chair of the Women and Equalities Committee, of which I recently became a member, said that the statistics are so stark that there should be immediate change. She called on the Government to meet ambitious targets rapidly, and I completely agree.
In the previous debate on this matter, I focused on some of the shocking statistics that MBRRACE-UK highlighted in its confidential inquiry into maternal deaths; I shall repeat some of them. For every 100,000 women who gave birth between 2016 and 2018, 34 black women, 25 mixed ethnicity women and 15 Asian women died, compared with eight white women. Behind those numbers are people—women and babies. Compared with babies of a white ethnicity, black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death, and the gap has been widening since 2013. So there are these tiny human beings—boys and girls—who never got a chance at life. There are grieving fathers and husbands. There are whole families and whole communities.
In addition to the higher mortality rates, other concerns include the number of near misses and the number of times that women have felt that their voices have not been heard because of their skin colour. The hon. Member for Vauxhall (Florence Eshalomi) described a terrifying experience, when she must have felt completely powerless. That is wrong. I was shocked to hear many stories of mothers denied pain relief or left to suffer with undiagnosed post-partum conditions. I know that these things happen to women who are not black—it is always wrong—but for someone to be treated differently because of their skin colour surely compounds the problem. Just as we would research and address any medical causes of these things, we must research and address this issue. I echo the calls of the hon. Member for Streatham for the Government to address it.
As someone who is white, it took me some time to learn that people who are black just know when someone’s behaviour towards them is because of their skin colour. It is hard to explain. It was hard for me to understand at first, and obviously it is harder for me as a white woman to explain it because I do not experience it, but I have no doubt about it. I encourage everyone who does doubt it to really listen to what black and Asian mums are saying and trust that they just know.
NHS GP Dr Adwoa Danso has pointed out that instances of medical mistreatment have impacted on black, Asian and minority ethnic communities’ faith in the health services, and we saw that when it came to getting the covid vaccine. There is a further suggestion that, as the majority of migrants are disproportionally black, Asian and mixed ethnicity, the Home Office’s hostile environment immigration policy makes public services incredibly difficult to access. The right hon. Member for Hackney North and Stoke Newington (Ms Abbott) talked about the hostile environment and has campaigned hard against it for many years.
Women seeking asylum have been blocked or refused by reception staff acting as gatekeepers, often in conjunction with expectations or experiences of prejudice and discrimination. The hostile environment also leads to decisions such as taking women seeking asylum out of supportive communities and into places such as the so-called mother and baby unit in Glasgow, where tiny babies are put in tiny rooms with not even enough room to crawl. The frustrating thing for me as an MP representing Glasgow North East, in a country where we have our own Government, is that our Government can do nothing about it because all the decisions about it are taken down here in Westminster.
Anne McLaughlin
Absolutely. The right hon. Member for Romsey and Southampton North mentioned evidence from the Women and Equalities Committee. I was not on the Committee at the time, but NHS staff gave evidence saying that they felt unable to speak up. A number of years ago when I was a Member of the Scottish Parliament, I met with a group of South African nurses, and they were astonished that they were able to meet with a parliamentarian, because they thought it was not their right to be represented. They told me the things that were happening to them in their jobs in the NHS, and they certainly needed someone to support and represent them, so, yes, I do completely agree with the right hon. Member for Hackney North and Stoke Newington.
Maternity Action research found that, just like staff who were too afraid to report, black and minority ethnic women tended not to report negative experiences, and they were less likely to be treated with kindness by health professionals or spoken to using terms they could understand. Although data has not been collected recently, a 2007 confidential inquiry into maternal and child health found that between 2003 and 2005 10% of all maternal deaths were women who could not speak English. As we heard earlier in an intervention from my hon. Friend the member for—Eastwood?
Anne McLaughlin
It is Eastwood in the Scottish Parliament. Forgive me, Mr Hollobone. As my hon. Friend said, studies in America show that even among women who come from fairly well-off backgrounds and who do speak English, black and Asian women are still disproportionately affected.
If I worked in maternity care in the NHS and heard someone like me saying these things, I would naturally feel defensive. Instead, what I ought to do is think about it, read up on it, question myself—and I do regularly—and really listen to what people are saying. I have no doubt that the vast majority of healthcare workers care deeply about the people they work with. The debate is more about the system itself and the inbuilt structural inequalities. For those who may be watching and do not know this, if we say the health service is structurally racist, it does not mean it is populated by racists: it means the way in which it is structured is for white people from certain backgrounds. It takes into consideration their needs, culture and language, with very little flexibility to take into account anyone else’s. Changing the structures makes them more flexible, and that is what the debate is calling for, in addition to addressing the very specific problems that have been talked about. After all, our NHS is not a white person’s NHS, it is an NHS for everybody.
I had decided that I was only going to speak for five minutes, and I think if I had not taken interventions then I would have done, but I think it is worth saying why I had decided that. I wanted to give the hon. Member for Streatham longer—and I know she will want to say a few words at the end—because, even though I have ended up taking 10 minutes, I do believe that part of offering support is saying less and listening more.
Mr Philip Hollobone (in the Chair)
We now come to the Health Minister, Nadine Dorries. After the Health Minister has spoken, Bell Ribeiro-Addy will have a few minutes to sum up.
The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)
It is a great pleasure to serve under your chairmanship for the first time, Mr Hollobone. I thank all Members who have taken the time to attend the debate, in particular the hon. Member for Streatham (Bell Ribeiro-Addy), who I have heard speak before about her experience on this issue. I think she is incredibly brave to campaign and highlight the issue in the way she does. I thank her for her thoughtful considerations. I know that she is holding my feet to the fire as well as the Department’s, and that is a huge assistance in pushing the agenda forward within the Department of Health and Social Care.
I stand responding to the debate as a brand new grandmother of 18 days. The delivery was not uneventful, and the baby arrived early, which is a similar story to that of the hon. Member for Vauxhall (Florence Eshalomi) at St Thomas’. Having given birth myself three times, I understand in a very raw way the pressures that all women experience, and I lived through just two weeks ago how emotional and incredibly frightening it can be when things do not go to plan.
This is the second annual awareness week we have had to highlight the disparities for black women in maternal health outcomes in the UK.
Florence Eshalomi
Congratulations to the Minister, it is always a joy to see more children and grandchildren. I am still getting to grips with motherhood with my four-year-old and six year-old. The statistics clearly show that the maternal death rates, and negative experiences, of black and Asian women are higher, but this does not negate the fact that some white women also go through similar experiences. Does the Minister agree that improving the maternal health outcomes of one group will improve the outcomes for all groups?
Ms Dorries
The hon. Lady is absolutely right. I am very proud of the work that we have done in the Department of Health and Social Care, and in the NHS, to improve maternal outcomes for everyone, particularly over the last few years. The statistics speak for themselves. However, I will focus on the issue of black women and maternal health, because there is a great deal that we have done since the hon. Member for Streatham had the last debate. I am looking forward to informing her about the work that has been undertaken since then. I thank her for instigating this debate, and I hope that she continues to hold our feet to the fire. It is important that people do raise this issue, as she does, as often as possible in Parliament.
In response to the incredibly articulate speech by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), it is right to raise the report by the Health and Social Care Committee, which I will respond to next week. A number of the questions that have been asked today will be included in that response, so I will not steal my own thunder—I will wait to provide a response next week.
I thank the co-founders of the Five X More campaign, Clotilde and Tinuke, and all the health care professionals and organisations who campaign to raise awareness of this week. I have visited Tommy’s maternity unit three times now, and the hon. Member for Streatham is right to raise the point that the majority of staff, doctors and midwives are black. I am incredibly impressed with the way that Tommy’s addresses this issue; they are pioneers in addressing maternity inequalities and outcomes, and they do fantastic work. I pay tribute to Tommy’s, and all hospitals, who I know are putting their weight behind reducing maternity inequalities and outcomes—Tommy’s is certainly at the forefront of that work. My granddaughter was born at Chelsea and Westminster hospital, so I thank them too—they are pretty amazing as well.
This debate comes a few days before this year’s World Patient Safety Day; the theme this year is safe maternal and new born care. It provides an opportunity to mark the progress made across the system in improving outcomes and safety, but also to recognise that further work is needed. At its best, NHS care offers some of the safest maternal and neonatal outcomes in the world. However, the disparities that exist between black and white women in pregnancy and childbirth experiences are unacceptable. I am committed to both reducing this disparity in health outcomes, and improving the experience of care.
We cannot beat around the bush any longer on some of the reasons why we experience these inequalities. They are complex, and there is no one answer as to how we can address this subject. Personal, social, economic and environmental factors all play a part; we must address the causes of disparities to improve outcomes and experiences of care. I was delighted that last week NHS England and NHS Improvement published their equity and equality guidance, which responds to findings that maternal and perinatal mortality show worse outcomes for those in black, Asian and mixed ethnic groups. They invested £6.8 million in the guidance to improve equity and equality action plans, and implement targeted and enhanced continuity of care.
We know that pregnancy lasts around 40 weeks. However, when a woman walks into a hospital to give birth, those 24 or 48 hours—however many hours she is in hospital—are not what wholly contributes to her experience of the healthcare sector, or her outcome. A lifetime approach is needed to address some of the reasons why some women are more at risk of poorer outcomes than others. We know that there are many health issues that contribute to poorer outcomes in pregnancy, including alcohol, obesity and smoking. The chief medical officer recently published a report that showed that, in some of our seaside towns, 25% of women are smoking at the beginning of pregnancy. I think the figure was that 22% were still smoking by the end of their pregnancy. There are inequalities and health disparities that we really need to address.
For that reason, we have established the newly formed Office for Health Improvement and Disparities, which launches on 1 October, to target those health disparities, including racial and ethnic disparities in health, and to improve pre-conception health to support women to be in their best health throughout pregnancy.
Ms Dorries
I will just finish the point on the office of disparities, because it is quite important. It is a huge step to establish an office that will actually deal with this particular issue. It will tackle inequalities across the country, and will be co-led by the newly-appointed deputy chief medical officer, Dr Jeannelle de Gruchy.
The office will be a vital part of the Department of Health and Social Care, and will drive the prevention agenda across Government to reduce health disparities. I hope the hon. Member for Streatham welcomes the establishment of this new body to tackle the top preventable risk factors for poor health, which include obesity, unhealthy diets, lack of physical activity, smoking and alcohol consumption. Equity and equality guidance will also be issued.
It is a huge step to look at those lifetime health experiences that contribute to what happens at the point of delivery and throughout pregnancy. Until we improve, and look at what happens before, using a lifetime view of health that includes women’s experiences of health throughout, then tackling what happens when they walk through a labour ward door will continue to be very difficult.
Ms Abbott
I think everyone present welcomes the establishment of the new office. The Minister has mentioned obesity, alcohol and smoking as risk factors in pregnancy; I take it she is not suggesting that the disproportionate outcomes we have for black women are because we are more likely to be obese, smoke or drink.
Ms Dorries
Absolutely. The office will look at all pregnancies, and the negative contributing factors. I believe that one in four women—black and white women—who present in labour are obese. That has an incredibly high risk factor during labour, so it is to address inequalities across the board. My right hon. Friend the Member for Romsey and Southampton North mentioned socio-economic groups, and the disparities they experience: smoking, alcohol and other negative factors that contribute during pregnancy are across the board, and they need to be addressed. That is the reason why the office has been established.
The cessation of smoking during pregnancy was something we campaigned on a lot in the past. I have noticed, probably since we passed the legislation to ban smoking in many places, the emphasis has almost come off the importance of not smoking during pregnancy. The CMO’s report highlights that, in some areas of low socio-economic grouping, 25% of women are starting pregnancy smoking. That highlights the fact that we need to put more emphasis on, and focus on, those health disparities.
Anne McLaughlin
Maybe I am misunderstanding, but this Office for Health Improvement and Disparities is going to look at things like smoking—you can stop smoking and can be supported in that, and you can stop drinking and can be supported in that—and I think all this is really good, but people cannot change their skin colour. Will it be looking at how ethnicity impacts on women’s and babies’ chances?
Ms Dorries
Absolutely—across black, Asian and mixed ethnic minority groups as well. The point has been made today that black women do not feel listened to. We hear stories of complaints about pain, prolonged labour and other issues, and black women just do not feel as though they are being listened to in that environment. The core finding of the Cumberlege report, which addressed mesh, sodium valproate and Primodos, was that women are not being listened to, and black women probably even more so in the maternity setting. That issue for women, black women, Asian women and women from mixed ethnic backgrounds needs to be addressed. Women have to be listened to.
Turning to covid-19 and vaccinations, covid-19 has further exposed some of the health and wider inequalities that persist within our society. While considering disparities in the context of the pandemic, initial data suggests that vaccine uptake among ethnic minorities is lower than for other groups. Covid-19 vaccines are recommended in pregnancy. Vaccination is the best way to protect against the known risks of covid-19 for women and babies, including admission of the woman to intensive care and premature birth of the baby.
New findings from a National Perinatal Epidemiology Unit-led study showed that of the 742 women admitted to hospital since vaccination data has been collected, only four had received a single dose of the vaccine and none had received both doses. That means more than 99% of pregnant women admitted to hospital with symptomatic covid-19 are unvaccinated. That is quite stark.
Caroline Nokes
On that point, will my hon. Friend reassure me and all Members that the Government will keep pushing the crucial message that the vaccine does not affect fertility or pregnancy, and that it is important for pregnant women and women of childbearing age to get the vaccine?
Ms Dorries
Absolutely. My right hon. Friend has done it for me, but I absolutely encourage women to get the vaccine because 99% is a huge figure. There is a basis of mistrust. The reason why many black women do not access some of the health services they should do before pregnancy is because they do not feel listened to and they do not feel they can trust their practitioner. The message of “Take the vaccine” must be pushed.
I will finish by taking the opportunity to urge women to continue to access maternity care and to stress that pregnant women should never hesitate to contact their midwife, maternity team or GP, or to call NHS 111 if they have any concerns. That also applies if parents are worried about their health or the health of their newborn baby. I urge expectant mothers to have their covid-19 vaccination as soon as possible. I do not think we can give out that message often enough.
Bell Ribeiro-Addy
I will try not to take up too much time. I am pleased we have had such a full discussion this morning. I know many Members across the House wanted to participate, but were unable to attend. I take confidence in knowing there are many Members in the House who are committed to reducing racial disparities in maternal healthcare.
I want to start by thanking Members who have contributed to the debate and I apologise for any mispronunciations of constituency names. Starting with some simple ones, I thank the hon. Member for Cities of London and Westminster (Nickie Aiken) and the right hon. Member for Romsey and Southampton North (Caroline Nokes) for pointing out how much black women do not feel listened to. The fact about socioeconomic groups was key. I also thank them for pointing out that, because of racism that exists in our society, 70% of black people in this country live in the poorest areas. That definitely has an impact.
I thank my hon. Friend the Member for Vauxhall (Florence Eshalomi) for sharing her experiences. It will be of great encouragement to her to know that St Thomas’ Hospital where she had her two wonderful children—they are my mates—has undergone five times more training than others and many of the midwives have done it, which is great. There are other NHS trusts like Croydon Health Services NHS Trust, which has put together a campaign called HEARD that is meeting these needs, taking steps and training in the gap where it has not been asked to train, and it should be congratulated for that.
My right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott) made the point that we cannot blame black women for the situations that they find themselves in. Sadly, that is what happens, regardless of confidence, education and socioeconomics. As my right hon. Friend rightly pointed out, this does not always change outcomes, something which the hon. Member for East Renfrewshire (Kirsten Oswald) also pointed out.
I thank the hon. Member for Glasgow North East (Anne McLaughlin) for her frank comments about race and the articulate way in which she described exactly what institutional racism is. If only we had that level of understanding right across the House, I believe that this country would be a different place.
I also thank the Minster for her response and congratulate her on the birth of her grandchild. I thank her for committing to ending racial disparities. I think that this new body sounds like a positive thing, but I am concerned that, despite the new body and what it is going to tackle, it is still unclear whether the Government have understood that institutional racism is a serious factor affecting these outcomes and have made a direct commitment to changing that, especially in the light of the race report.
Ms Dorries
I have intervened, Mr Hollobone, because I think we have time. I probably should have also mentioned the Maternity Inequalities Oversight Forum, which is due to meet again next week. I do not want to give the impression that the new office which we are launching on 1 October will replace all the other work and everything else that we are doing. The Maternity Inequalities Oversight Forum still meets and, on the question about how it informs policy, it works hand in hand with the board of equalities and disparities. As the hon. Lady knows, we also have the patient safety board.
I can assure her that at all meetings, when we talk about maternal inequalities, the situation is something which has to be addressed and turned around in whatever way we can. This is why the Office for Health Improvement and Disparities is being established. We have to turn around the dreadful, appalling figures which pertain solely and uniquely to black women’s experience of maternity. I want her to understand that all the rest of the work is still going on, because this remains a focus in the Department. I urge her to keep calling her debates and to keep raising the issue, because it helps to drive things forward and helps us to develop acceptable and welcomed policies. I thank her for recognising the work of the disparities and inequalities board; it is just another tool that we put into the box to help fight a much bigger problem that we have to solve.
Bell Ribeiro-Addy
I thank the Minister, but my main point was that while the work is ongoing, given what has been said in the past about institutional racism, will it be with a recognition of how it affects our various bodies, not least the NHS? Accepting that point, which many of us do not believe has been done before, is key to making sure that we get the outcomes that we need overall.
As many Members know, this topic is particularly close to me and is not always easy for me to talk about. Many of those engaged in the campaign to end racial disparity in maternal health care experienced the same thing. When we detail our past events and the experiences, we do not do so to gain sympathy. We do so to give a voice to the hundreds of black women each year who have similar experiences, and in the hope that our stories will help to spur the change needed so that black women no longer face negative outcomes and the negative treatment we so often face. Bringing children into this world should not be a matter of life or death. We have a duty here, particularly with what we are tasked to do every day in our work, not just for the mothers who do not survive the dangerous birth experiences but for the many who go on to experience trauma.
I hope that the Government have been spurred into further action. I will continue to hold the Minister’s feet to the fire, since she sounds as if she enjoys it. I call on the Government to do a lot more: to ensure that we have proper data collection; to increase the support available for at-risk women; to implement the recommendations of the Joint Committee on Human Rights report “Black people, racism and human rights”; to identify those barriers to accessing maternal mental healthcare services and increasing the accessibility of mental health services after miscarriage and traumatic maternal experiences; to engage with black women in improving their experiences of maternal health services; and to commission a review of institutional racism and racial bias in the NHS and medical education to address the learned stereotypes about black and ethnic minority women that impact us so much.
By committing to those steps, the Government can demonstrate that they are serious about tackling racial disparities. Members have heard me say it before, and I will say it again: the colour of woman’s or a birthing person’s skin should not have an impact on their health or the health of their baby. The sad reality is that in this country it does, and while the Government appear to hear and are making some headway, I really want them to listen. I believe that they will truly have listened only when we have those targets and those very clear mechanisms to end institutional racism in our health service.
Question put and agreed to.
Resolved,
That this House has considered Black Maternal Health Week.
High Rise Social Housing: Reducing Fire Risk
(3 years, 3 months ago)
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Christina Rees (in the Chair)
Before we begin, I encourage Members to wear masks when they are not speaking, in line with Government guidance and that of the House of Commons Commission. Please give each other and members of staff space when seated and when entering and leaving the room. Members should send their speaking notes by email to hansardnotes@parliament.uk. Similarly, officials should communicate electronically with Ministers.
Andy Slaughter (Hammersmith) (Lab)
I beg to move,
That this House has considered reducing fire risk in high rise social housing.
It is a pleasure to be here under your chairship, Ms Rees, and to speak about the subject at last, because I have been trying to obtain this debate for some time. It is a shame it clashes with the Building Safety Bill evidence session, but that shows how important these issues are to the House, and they will remain so for a considerable time.
The human tragedy of the Grenfell Tower fire was apparent from the morning of 14 June 2017 as the world woke up to the horrifying images of people killed in their own homes in a particularly savage manner. Four years later, the scale and depth of that tragedy are only now being explored. The Grenfell inquiry is still years from resolution, however, interim investigations, such as the Hackitt report, have provided some clue to the comprehensive failures in the building industry. The Government have been slow to legislate, but earlier this year the Fire Safety Act 2021 was passed and Parliament is currently considering the Building Safety Bill.
Much focus has rightly been on the priorities for action, such as the removal of flammable cladding from the exterior of tall buildings and who will pay for the huge remedial costs, in particular whether the costs should fall on leaseholders given they had no knowledge of the risks they were taking on and do not have the means to meet bills that, in some cases, are higher than the price they paid for their homes. Members may wish to raise these issues and others today, but my purpose in requesting the debate was to highlight two aspects of the crisis exposed by Grenfell that have not received sufficient attention. It is not by coincidence that they both relate to social housing.
Anyone who watched Daniel Hewitt’s distressing documentary, “Surviving Squalor: Britain’s Housing Shame”, on ITV on Sunday night and saw some of the conditions social housing tenants are living in in 2021 would have been sickened by how far the sector has fallen from its post-war pride and ambition. I am sure every Member present has horror stories of neglect, under-investment and poor service to relate, but Grenfell has exposed how the failure of some Governments to invest and of some landlords to show a duty of care has become a threat not only to the quality of life of millions of tenants and leaseholders, but to life itself.
In the second part of my speech, I want to deal with the causes of fire in social housing, especially electrical fires, and why more is not being done to prevent them. First, I want to comment on the consequences for social housing landlords and tenants of the costs of undertaking fire safety works. This morning, Inside Housing—all of us, particularly the Government, should be grateful for its investigative work throughout this crisis—published a story that One Housing, one of the G15’s supersized housing associations, recorded a deficit of £25 million for the last financial year. In the same year, it spent £27.3 million on fire safety work to its stock.
Over the next five years, One Housing expects to spend £200 million on such works. Clarion, another of the G15, estimates it will spend £150 million in the next four years, and in total the 12 biggest housing associations will spend an estimated £3 billion over the next decade. Yes, that is right: 12 housing associations will spend £3 billion when the Government’s total building safety fund stands at £5 billion, and the National Housing Federation says the total bill for the sector will be £10 billion. Clarion told me that it expects to receive £5.4 million from the BSF of the £150 million it will spend. That shortfall is significant, not only for the association as a housebuilder and landlord, as we shall see, but for its leaseholders. Like most associations, it will try every other source of revenue, including builders, developers and the BSF. If all else fails, it will bill the leaseholders. Tenants lack even that mitigation; there is no BSF for them. The majority of the costs social landlords must bear will come from their existing income streams—mainly rents—or from diverting funds from other services, from repairs to new developments. Expect more Daniel Hewitt documentaries in the years ahead.
I contacted the main social landlords operating in my constituency that are tackling significant remedial works with a series of questions, including how much they were spending on remediation. The London Borough of Hammersmith and Fulham said it will apply to the BSF but
“the remainder is from the Housing Revenue Account.”
To its credit, it added that
“leaseholders are not being charged”.
Catalyst says that
“overall, we expect to invest over £109m remediating our high-rise portfolio”.
It has secured £22 million from the BSF, but will charge leaseholders where grants are not available. Shepherds Bush Housing says that
“the total cost of our building safety programme is estimated to be over £40m”.
For buildings under 18 metres, or where grant is not forthcoming, it is concerned that it may have to pass on costs to leaseholders. Notting Hill Genesis estimates a bill of £41 million for the last financial year, and will pass on costs where third-party funding is not forthcoming.
Almost every landlord said the unrecovered costs of fire safety works will impact significantly on core functions and other duties. That means fewer, slower repairs and fewer staff to manage properties and to liaise with residents. Members who already have a full inbox of housing casework will groan, as will tenants and leaseholders, at the prospect of a continued rapid decline in the resources and services available.
The most shocking effect will be on development programmes and new home building. Shelter estimates the need for 90,000 new social homes a year. Last year, 6,000 were built. Earlier this year, the Financial Times carried a report based on evidence from Clarion, Peabody, Network Homes and the L&Q group—four of the biggest landlords—that the number of affordable homes built over the next five years would fall by 40% as a direct consequence of fire safety works. Small and medium-sized associations have even less room for manoeuvre. Shepherds Bush Housing estimates a 50% cut in the development budget and less planned maintenance spend.
Ms Karen Buck (Westminster North) (Lab)
My hon. Friend is quite right to focus on the implications of these costs and how they will affect the repairs and development programmes. Does he also recognise an additional issue that the Government have not addressed over a number of years? Local authority housing contains a high proportion of leaseholders within that stock. Even where a local authority wishes to carry out fire safety works, as was the case in mine, the fact that there is no clarity about the right to go into leasehold properties and to require leaseholders to have the works done means that it does not even get the fire safety works carried out, and many tenants are left at risk as a consequence.
Andy Slaughter
As always, my hon. Friend is on top of her brief. That is a very important point that the Minister and shadow Minister may wish to address. Many people who looked at the Building Safety Bill think that the provisions for access are inadequate or overly bureaucratic, and simply will not work. We have already seen that happen with the problems that Wandsworth Council has had with retrofitting of sprinklers, where there is resistance from leaseholders. There has to be a way, as with gas safety and so on, of ensuring that where the safety of the occupants of a block as a whole is at risk, it is possible to carry out works in a comprehensive way.
Tulip Siddiq (Hampstead and Kilburn) (Lab)
I want to make a point about mental health and the impact of the cladding scandal. I would like to read something from one of my constituents who lives in a dangerously clad building:
“When I look outside my window, I see Grenfell Tower on the horizon. I have lived in this area for years and what happened on that night pains me very much to this day...And now to think that I, like them, live in an unsafe building and that I face an unknown but certainly very high bill to fix it gives me great anxiety.”
Does my hon. Friend agree that this is a hell that no one should go through?
Andy Slaughter
That is absolutely right. It is a triple whammy. There is the fear of living in an unsafe building with one’s life potentially at risk; there are the huge, unaffordable costs I have already mentioned; and there is the extra feeling of being trapped because one’s property may have a nil value, so it is impossible to move on with one’s life, start a family and so on. It is difficult to imagine a previous crisis with such an impact on so many people, and frankly that is why the Government’s response so far has been inadequate.
Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)
As usual, my hon. Friend is making some excellent points, and I totally concur with the comments made by my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq) about the mental health impact—I have heard similar things from my own constituents. In that regard, I praise the work done by Cardiff Council, particularly Councillor Lynda Thorne, in responding very quickly to the crisis in the council-owned blocks by taking action and carrying out the additional tests necessary to identify the problem; I also praise the Welsh Government for making £10.5 million available for social housing, which has benefited 12 blocks, including some in my constituency. But the problem remains, in that the Welsh Government still do not have clarity from the UK Government on the available funding for consequentials. As a result, they are unable to move forward with the wider building safety and fire safety funds that would operate for other social clients and those in the private sector affected by the same mental health difficulties as those social clients.
Andy Slaughter
That is another excellent point. I realise I am being quite critical of social landlords. We have to be, because sometimes they fall down on their duty quite spectacularly, as the documentary showed. However, I am glad that my hon. Friend has reminded us that most social landlords—councils and housing associations—are trying their best for their tenants and leaseholders, some of whom are very poor or have particular vulnerabilities. Whoever their tenants are, those landlords can only work with the tools at their disposal. The systematic cut in the housing subsidy over the last 10 years and the additional pressures that will continue, not just from fire safety, but from retrofitting in relation to carbon reduction, mean that we are often asking them to do the impossible—you cannot get a quart into a pint pot.
It is very easy for the Government to pass the buck, and that is exactly what the Housing Secretary did in the Hewitt documentary. “Nothing to do with me, guv”, he said, when asked about the fact that he, or his Government, had cut the budget of local authorities by 40% over the past 10 years.
Sir George Howarth (Knowsley) (Lab)
I congratulate my hon. Friend on securing this important debate. Does he agree that the sources of anxiety that others have referred to inevitably lead to mental health problems? And does he agree that it is time to bring this to an end by introducing a scheme to address all of the concerns people have as comprehensively as possible?
Andy Slaughter
I agree with my hon. Friend. We are talking about very large sums of public money, but we are also talking about both a moral duty and resolving a practical problem, which we seem to be very bad at in this country; look at the contaminated blood scandal, and how it took decades for the inquiry to take place and, hopefully, to reach an outcome. The Grenfell inquiry is under way. I hope that the Government will accept its recommendations and that they will provide a full response not only to that individual tragedy, but to the problems we are talking about today. However, there is a lot that the Government can do in the meantime. The Building Safety Bill is supposed to be a major tool in that respect, yet there are major gaps in it.
I said I would have very few questions for the Minister. The deal is that he answers them, but we will wait and see what happens. I have just one question in closing the first part of my speech. What will the Government do to prevent the effective collapse of the social housing sector as a provider of new homes? That is what we are looking at over the next five to 10 years if the full costs, apart from the small amounts that are payable from the current building safety fund, fall on to social landlords, tenants and leaseholders.
Electrical safety is an issue that has particularly concerned me for some years. Grenfell Tower, Lakanal House, Shirley Towers and Shepherd’s Court—the last in my constituency—were among the worst fires in high-rise buildings in the past 12 years. All were social housing, and the first three led to the deaths of residents or firefighters. They had something else in common: they were all caused by electrical appliances—a fridge freezer, a television, a light fitting and a tumble-dryer. That should not be a surprise. Each year in England, 54% of all household fires are caused by an electrical source of ignition. This is not unique to social housing. Private sector rental property also has a poor history of providing and maintaining safe electrical items. Fires in the home can be fatal for the people who live there, but they can quickly turn into a catastrophe when they happen in high-rise blocks.
Increasingly, hard-pressed families across the UK rely on cheap or second-hand electrical items in their homes. They seek out deals for electrical goods online. Retailers such as Amazon, eBay and Wish host independent sellers, some of which have been found to be selling fake or faulty electrical goods. Just as Grenfell exposed the poor standards of building regulation and inspection, events such as the recall of more than 5 million Whirlpool tumble-dryers have shown that consumer safety in this country is in a parlous state.
With trading standards services cut to the bone and almost no national co-ordination, in 2018, mainly as a result of the Whirlpool fiasco, the Government set up the Office for Product Safety and Standards. However, that body has a budget of only £14 million a year. In the words of the recent National Audit Office report,
“There are gaps in regulators’ powers over products sold online, local and national regulation is not well coordinated despite improvements, and the OPSS does not yet have adequate data and intelligence…Until it establishes a clear vision and plan for how to overcome the challenges facing product safety regulation and the tools and data needed to facilitate this, it will not be able to ensure the regime is sustainable and effective at protecting consumers from harm.”
That simply is not good enough. Consumers are put at risk at every point by unsafe electrical goods, and less well-off people suffer the most as they rely on cheaper models and second-hand or reconditioned equipment.
The Shepherd’s Court fire on Shepherd’s Bush Green on 19 August 2016 was caused by a Whirlpool tumble-dryer being used according to the manufacturers’ instructions, despite a serious known fault. We need better standards of manufacture. Plastic-backed fridges like the one that started the Grenfell fire had long been banned in countries such as the United States. We need registration of electrical goods to allow effective recall when faults are discovered. Typically, only about 20% of goods are recalled in that way. In the absence of those policy changes, which I am afraid the Government show no sign of making, we need regular inspection of electrical appliances.
Private tenants are protected by a legal requirement that landlords ensure all electrical items are tested for safety every five years, but social tenants are not. That needs to change. Given what I said earlier, I am not advocating inflicting additional costs on social landlords. I know from its brief for this debate that the Local Government Association is concerned about that, and thinks that the onus should lie on manufacturers. I do not disagree with that—if we manufactured safer products, we would not have so many failing inspections and so many recalls—but in the absence of that happening, the Government must support social housing providers to carry out these essential tests. They must make that a legal requirement and recognise the costs involved.
I am pleased to say that there are some positive signs here. The Housing, Communities and Local Government Committee recommended five-yearly checks in its prelegislative scrutiny of the Building Safety Bill, and the Government’s social housing White Paper last November conceded that,
“Safety measures in the social sector should be in line with the legal protections afforded to private sector tenants.”
That is all we asked, but the Government did not accept amendments to the Fire Safety Act 2021 on those lines when I proposed them in Committee. Undaunted, I introduced a presentation Bill earlier this summer—the High-rise Properties (Electrical Safety) Bill—and no doubt we will try again in the Building Safety Bill. When I say “we”, I mean in particular Electrical Safety First, which has led on this issue, but I should add my thanks more generally to the London Fire Brigade, Which?, Leigh Day Solicitors, and the all-party parliamentary groups on fire safety and rescue and on online and home electrical safety, which have also been active and vocal on many of these issues.
All I ask from the Minister today is an indication of the Government’s intent, or otherwise, on introducing electrical checks in social housing to prevent future Shepherd’s Courts or, indeed, future Grenfells.
Much more could be said about the type of modifications needed for social homes that go beyond cladding. Many tower blocks were built in the 1960s and 1970s. Social housing providers recognise that those homes must be brought up to current standards, but they need support to do that. Fire doors need to be replaced, sprinklers installed, windows inspected, fire alarm systems updated and new evacuation routes for disabled people established.
It is also important to think about the people who live in social homes across the UK. Due to the stability that social housing can provide, along with affordable rents and adaptable properties, elderly and disabled people make up a large proportion of social tenants. Evacuating a burning building is difficult enough, but for tenants across the UK who are elderly or disabled, it can become impossible.
Much social housing is overcrowded, especially in London, which is also the location of 55% of buildings over 11 metres in height. Where someone lives and who their landlord is should not be risk factors when it comes to fire safety. If the Government do not increase the building safety fund to include funding for all necessary remediations, including to social housing, the cost of such remediations will primarily fall on leaseholders and tenants, and social housing providers will be forced to use money that would have been ring-fenced for the building of new social homes.
At a time when the housing crisis is growing, it is scary to think that some of our biggest providers of social housing may not be able to afford to build homes in the future. It is clear, therefore, that the issue of fire safety in social housing is not an isolated one; it will have far-reaching consequences if we do not get this matter right.
On behalf of the tenants and leaseholders of Factory Quarter, Sharp House, Ainsworth Court, Oaklands Court, Invermead Close, Fraser Court, Kelway House, Sulgrave Gardens and many other blocks in my own constituency and many, many more around the country, I ask the Minister, and indeed the Government as a whole because this issue goes across several Departments, to ensure that we are at least moving in the right direction—that is to say, to ensure that social housing provides good quality, affordable and safe housing for people across the UK.
Christina Rees (in the Chair)
I do not think we need concern ourselves at the moment with time limits for speeches.
Dr Kieran Mullan (Crewe and Nantwich) (Con)
It is a pleasure to serve under your chairmanship, Ms Rees, and I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing this debate.
In my constituency in 2019, we experienced a terrible fire at the Beechmere retirement complex, which destroyed the building and left more than 150 people without their homes and with their belongings ruined. I pay tribute to Cheshire Fire and Rescue Service for its work in tackling the blaze and to the local residents who stepped in to help evacuate people. We still do not know the cause of the fire and I regularly meet Cheshire Fire and Rescue Service to push it to conclude its investigation, but I also understand why it wants to take the time to make sure that if anybody needs to be held to account, they are.
Although the debates about fire safety have rightly focused on high-rise buildings and cladding, we must not miss opportunities to improve fire safety more widely, and I will focus on two things today: the use of timber in buildings and going further with building safety in certain types of building.
The use of timber in buildings has increased enormously in popularity in recent decades, because it is seen as being more eco-friendly than other materials, and certainly there will be social housing developments that are made from timber-framed buildings. The building that burnt down in my constituency—the Beechmere retirement complex—was a timber-frame building and what happened seemed to reflect what has happened in many other fires in similar buildings made of timber.
There is a wealth of long-standing concerns about the use of timber, and not just in relation to external frames. In 2002, the newly built Yarl’s Wood prison was half burnt to the ground after a small fire started by rioters spread out of control. In their submission to the inquiry into the fire, representatives of Bedfordshire Fire and Rescue Service made it clear that they thought the timber-framed nature of the building made the fire difficult to control. That same inquiry found that the decision not to install sprinklers at Yarl’s Wood was wrong, specifically because of the wooden frame.
Blazes in Croydon and Peckham in 2007 and 2009 caused severe damage to blocks of flats with wooden frames. In 2010, a London Assembly report recommended tighter regulations on timber-framed buildings. A 2012 Department for Communities and Local Government review identified clearly that fires in timber-framed buildings result in more fire damage, and an insurance industry review claimed that fires were more likely to occur in such buildings.
In 2014, the Health and Safety Executive released an open letter to everyone involved in timber-framed construction after a spate of fires, including at the University of Nottingham, where a £20-million laboratory burned down mid-construction. The HSE is clear that fire risk for timber-framed buildings is particularly high during construction and during any post-construction work.
Where are we now? When it was built in 2008, the Beechmere retirement complex held the record for the largest timber-framed construction in Europe. This country now holds the record for the world’s largest timber-framed building: a 10-storey, 121-unit development in Hackney. There are particular concerns about how post-completion works and modifications in timber buildings can easily destroy fire safety measures. We must ensure that that risk is properly managed.
I urge the Government to go further by mandating additional safety measures for timber buildings, beyond those that apply just to buildings of a certain height and to buildings with timber in external walls: a wider use of sprinklers, extra precautions at even lower heights, more prescriptive measures for safety checks after any work is carried out on a building, and any further measures that we should be taking.
We have to think more carefully about restrictions based on building use. It is proportionate to make specific mandated additional requirements for buildings such as schools, care homes and social housing complexes that house vulnerable people, when we know that people will struggle to evacuate. One such requirement would be for sprinklers. I and my colleagues on the all-party parliamentary group on fire safety and rescue have highlighted that automatic fire sprinklers are compulsory in new care homes in Wales and Scotland but not in England, and the same is true of schools.
Research conducted by the National Fire Chiefs Council found that, in almost 1,000 fires over five years in buildings where sprinklers were fitted, the sprinklers controlled or extinguished blazes in 99% of cases. When it comes to schools, it is not just about the loss of life; it is about the loss of time in a classroom that occurs when fire damage means that repairs have to be made or new facilities installed.
Finally, I would like to make a brief point about the work of the APPG. It has advised me that the Regulatory Reform (Fire Safety) Order 2005 states that the premises’ risk assessment should adapt to technical progress and reduce the overall risk within buildings. However, we have much simpler non-worsening conditions under regulation 4(3) of the Buildings Regulations 2010, which states that, when the work is complete, it should be
“no more unsatisfactory in relation to that requirement than before the work was carried out.”
Those two measures are contradictory. I am of the opinion that the Building Safety Bill and the Regulatory Reform (Fire Safety) Order 2005 need to be harmonised, so that the principle of risk assessment adaptation over time is incorporated.
I know that the Secretary of State wants a dynamic, responsive system that is not overly prescriptive. However, at this stage, when we cannot yet know what the new regime is going to deliver in terms of better decision making on a building-by-building basis, we should be more cautious and risk averse. We should have an approach that mandates specific measures, such as sprinklers, for certain building types and additional measures for certain building materials, such as timber, regardless of building height. High-rise social housing is one area where that can apply, but there are many others. I look forward to hearing the Minister’s response.
Florence Eshalomi (Vauxhall) (Lab/Co-op)
It is a pleasure to serve under your chairmanship, Ms Rees. I pay tribute to my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this important debate on fire safety in social housing—a vital but often overlooked element of the building safety crisis.
It is hard to know where to start my reflections this afternoon, other than with the tragedy of Grenfell Tower. The images of the fire are seared into our national consciousness, and they serve as a painful reminder of the decades of negligence towards social housing in this country. My thoughts are with all those who lost their lives.
As somebody who grew up on a council estate in Brixton, I know how important it is that safe and good quality accommodation is considered a basic human right. Yet for years, too many social housing residents have been expected to live in substandard housing and buildings that fall into gradual disrepair, while their pleas for improvements go unheard. The fire at Grenfell, in which 72 people lost their lives, was a direct result of callous inaction. That must never be allowed to happen again, yet more than four years on, I still fear that it could.
My constituency of Vauxhall is one of the most densely populated in the country. It has many similar high-rise tower blocks with social tenants. Just since being elected in 2019, I have been approached by residents in over 32 separate developments who have been told that their block poses a fire risk. The scale of this fire safety crisis remains enormous. With every passing week, more and more people are plagued with the uncertainty of finding out that their home is potentially unsafe. Imagine having to live in a home like that. However, the Government’s refusal to take control of identifying unsafe buildings means that we still do not know how many there are in this country, or where they are.
The current building safety crisis, which goes far beyond the cladding system, is a consequence of decades of regulatory failure under Governments of different political compositions. Figures from Electrical Safety First highlight that electricity caused 14,000 house fires in England alone, accounting for more than half of all accidental dwelling fires. Every year, thousands of people are injured in their homes due to electrical accidents or incidents, which, in some tragic incidents, mean that people lose their lives. The Building Safety Bill is a welcome opportunity for the Government to strengthen electricity safety protections for social tenants in high-rise buildings.
I hope that the Minister will agree that, in order to reduce the risk of fires in high-rise residential buildings, it is essential for all those properties to undertake mandatory electrical safety checks. Currently, private tenants in high-rise buildings benefit from this check, whereas social tenants do not receive the same legal protections. That is a scandal. Electrical safety requirements should not be based on someone’s tenure.
The LGA has been calling for councils and the fire service to be given effective powers, with meaningful sanctions, to ensure that all residents are safe, including those in social housing. The first duty of any Government is to keep their citizens safe. I therefore urge Ministers to lay out a plan to ensure that, as a national priority, every potentially dangerous building is identified and fixed. We are the sixth-richest nation on Earth, and there can be no more excuses. We cannot sit by as people continue to live in unsafe buildings. We must end the scourge of unsafe housing once and for all.
Jonathan Gullis (Stoke-on-Trent North) (Con)
It is a pleasure to serve under your chairmanship, Ms Rees. I commend the hon. Member for Hammersmith (Andy Slaughter) for securing this especially important debate.
Like many others, I want to briefly reflect on Grenfell Tower. My partner has recounted to me, very emotionally, the impact that the fire had on her, on her colleagues and on the pupils who she taught at a nearby secondary school. I want to put on record a declaration of interest because of personal friendships that I have with David Benson, the principal of Kensington Aldridge Academy, which is at the foot of Grenfell Tower, and with Adam Whitlock, its head of sixth form.
Fire safety in high-rise buildings is also incredibly important in places such as Stoke-on-Trent. We have 18,000 properties on the council books, of which 3,200 are apartments. I am very lucky in Stoke-on-Trent to have a council led by Councillor Abi Brown and one of the very best fire services in the country—Staffordshire Fire and Rescue Service, led by our fantastic chief fire officer, Becci Bryant—due to their forward thinking and dynamic work. Staffordshire fire service and Stoke-on-Trent City Council have been working hand-in-glove to retrofit sprinklers in all the high-rise blocks of flats managed by Unitas, the council’s housing company. I was delighted to host a delegation of MPs from the all-party parliamentary fire safety and rescue group in Stoke-on-Trent just last week, to show them what they have been working on.
It all kicked off in 2016, when Staffordshire Fire and Rescue Service launched its community sprinkler project. Its end goal is to see sprinklers fitted in all five-storey blocks of flats across Staffordshire. Working with councils, social housing providers and charities that provide accommodation, such as the YMCA, the project has been going full steam ahead: 15 high-rise blocks have been retrofitted so far across Staffordshire, with a commitment to install sprinklers in a further 16 buildings.
That is great progress when we consider that in 2017, only one high-rise block had been retrofitted with sprinklers. Obviously, the impact of the tragedy we saw at Grenfell Tower, which, as the hon. Member for Vauxhall (Florence Eshalomi) said, is burned into all our memories across the country, meant that charities and other partners came forward to push ahead with the scheme.
In the Potteries so far, seven of the high-rise buildings that Unitas manages have had sprinklers retrofitted, and the council has committed to installing sprinklers in the other 11 high-rise properties that it manages. I am pleased to say that Stoke-on-Trent City Council is already looking ahead to the medium and low-rise blocks of flats across its area. Encouragingly, because some of the groups that Staffordshire Fire and Rescue Service has been working with own properties around the country, such as the housing association Bromford, the best practice adopted in Staffordshire is being copied elsewhere and enhanced fire safety is being spread around the United Kingdom.
Of course, fire safety is not just about sprinklers, but they are an effective and low-cost option. I understand from Becci that on average it costs £3,000 to £5,000 per flat to retrofit a sprinkler, and research done by the National Fire Chiefs Council and the National Fire Sprinkler Network also showed that they are incredibly effective. In 99% of cases, they were able to control or extinguish fires.
Sprinklers save lives. People are only half as likely to be injured in a dwelling fire where sprinklers are present, and sprinklers greatly reduce the chance of serious injury, with the data showing that people are 22% less likely to require hospital treatment if they are in a fire that is controlled by a sprinkler system.
The case for getting sprinklers installed could not be clearer. I urge councils and fire services around the country to follow what Staffordshire Fire and Rescue Service and Unitas have been doing in Stoke-on-Trent.
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
It is a pleasure to serve under your chairship, Ms Rees. I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing this important debate. I know the amount of work he has done in this area, as well as on electrical and white goods safety.
When we speak about the Building Safety Bill, we often focus on ensuring that no unfair costs are passed on to leaseholders. I am grateful that this debate shifts the spotlight back on to residents in social housing, such as those in Grenfell Tower whose tragic loss of life is the reason we are debating this matter today.
Like many of us, last week I watched the Channel 4 documentary “Grenfell: The Untold Story”, and found myself struck by how preventable the tragedy was. To see it unfold, immortalised by film, as residents’ concerns were waved away was heartbreaking with the benefit of hindsight. One resident tells us that we cannot describe what happened as an accident, and he could not have been more right. Sheila, who lived on the 16th floor of the tower and sadly perished in the fire, had confronted the tenant management organisation, telling them she was so exhausted from fighting with them that she had collapsed in the hallway.
Sheila’s words truly struck home with me when she said:
“Whoever runs this place, you never see them; they become faceless. But never ever once have you heard them mention a human being who lives there. It’s all about the building.”
How could we have ever allowed anyone to feel that pieces of brick and mortar were valued more than the human lives within them? Grenfell showed us that these tower blocks are more than just a collection of people living nearby each other. They are communities: neighbours who know each other and look out for one another, who have built meaningful friendships and who care deeply for those friendships.
Most overwhelmingly, there was a clear feeling that this had happened because the tenants lived in social housing. They were unseen, less important, less valuable because of their tenancy arrangements. Social housing is a great privilege in the UK, and who is anyone to judge a life based on their home?
It is undeniable that Grenfell happened because corners were cut to keep costs down. How do you put a monetary value on a human life? But Rydon did just that when it chose the cladding by Celotex, which as we now know was on the market as a result of a fraudulent fire safety test. I would like to know what steps the Government are taking to ensure that future tests of products can never be bypassed or rigged.
The documentary tells us that Rydon was saving about £375,000. If we break that down by the 72 lives lost, we arrive at a little over £5,000. Rydon valued those people’s lives at £5,000. Even worse, we now know that the actual saving was much higher and Rydon intended to pocket the rest. It is the most horrific case of profit before people.
Grenfell was a case of failure after failure—a failure to ensure that safe materials were used, a failure to ensure that the building was properly compartmentalised and a failure to put the residents at the heart of the project. What is imperative now is that the lessons are learned and absorbed into the consciousness of every person with fire safety responsibilities, be that architects, builders, construction product manufacturers, developers—anyone with a part in building and refurbishing these homes. It is important that the Government fund the removal of cladding on all high-risk buildings. Crucially, that funding must be provided to social housing landlords. Not doing so risks unfairly pushing the cost of remediation on to social tenants or, worse still, it could take so long for remediation to happen that we see another tragedy. Regardless of what the monetary cost might be, it will never be as high as the value of the people living in these high-rise blocks to their families, friends and neighbours.
Tony Lloyd (Rochdale) (Lab)
May I say what a real pleasure it is to serve under you in the Chair today, Ms Rees? I also thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for a genuinely excellent speech, both in its range and its detail. I do hope that the Minister—I say this kindly to him—will dwell on every word, even if he cannot respond to every word today.
I want first to pick up on the important point that my hon. Friend made about the impact of this new generation of costs on social landlords and, indeed, on landlords more generally, because these extra costs were unanticipated. Whether rightly or wrongly, they were unanticipated; they are not built into any cost programme. And certainly at the margins they would make a material difference in terms of the capacity for social landlords to make a decision, as is the case at the moment with tower blocks in my constituency, between demolition, which the social landlord would like, and retention and improvement, which the tenants of those tower blocks would want. If the extra cost is of such a nature that it causes these things to tick over, it is the wrong kind of financial matrix for housing policy. Equally, my hon. Friend is right when he says that if now we see huge tranches of money having to be devoted to remediation and that then is at the cost of improvement and new build, we simply exacerbate what is already a housing crisis in my constituency and across the country.
I shall take a couple of moments to discuss the Seven Sisters tower blocks in Rochdale. Sometime in the early part of last year the housing association discovered, because it was able to do work or investigation not previously available to it, that unlike Grenfell and equivalent types of cladding, there was a problem in the nature of work that had been done, probably in the late 1990s, that meant that any fire in any individual flat risked spreading to flats on the same floor. That kind of risk was, again, unanticipated, but it is qualitatively different from the situation at Grenfell and other places.
I have a very specific question for the Minister. Is any information available about the range of such challenges to our housing stock? Do we have that analysis—that national picture? I ask because of course that must inform any debate about what is available in terms of funding the remediation work necessary. Equally, because this is qualitatively different, as we look at remediation for cladding solutions—and, post Grenfell, we must look at that—will that also cover problems of the type that arose in Rochdale with the Seven Sisters? Again, that is different; nevertheless, the work is equally vital, if we are to ensure that tenants and residents feel safe in their homes.
When that was discovered, the social landlord quite rightly introduced a waking watch scheme, in negotiation with the fire and rescue service in Greater Manchester. That is a system whereby people tour the estate to ensure an evacuation if a fire is identified, and to enable the fire and rescue service to take the necessary action. That did happen: a fire broke out in the tower blocks, sometime after 2 o’clock one morning. The fire service was there within four minutes of being informed by the waking watch, which is excellent. The system worked, leading to the evacuation of a small number of tenants, and it put people’s safety first, which is the right and proper way.
Since then, the social landlord has installed an alarm system in every flat, which again is the right way forward. However, in the end, this is about evacuation in the event of fire rather than prevention of fire. I endorse the comments of my hon. Friend the Member for Hammersmith and others about the need to maintain or improve electrical standards. Certainly, the operation of sprinklers is one demand that people would inevitably have, but fires will take place. My own mother, rather sadly, caused her own house to catch fire. She was a heavy smoker, she dropped her cigarette, and the result was a house fire—in her case, not with the kind of results that we would fear. Nevertheless, that kind of action will take place in the future. We cannot guarantee that we can stop fires; we have to make sure, though, that the homes that our residents live in are safe, because safety is paramount.
My final question to the Minister is simply this. Four years on from Grenfell, what progress can we expect in the coming months that will make a material difference, so that the residents in my tower blocks and those up and down the country can see their homes as a place of safety? That is what they expect, it is what I expect for them, and it is what every Member of this House should believe is right and proper.
Joanna Cherry (Edinburgh South West) (SNP)
May I say what a real pleasure it is to serve for the first time under your chairpersonship, Ms Rees? I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing this important debate, on his usual thoughtful and thorough contribution, and on raising the real concerns of his constituents with his usual passion and commitment.
Before I say a bit more about what the hon. Member had to say, I would like to start by paying my respects to all the victims and bereaved of the Grenfell fire, and also paying tribute to the doughty campaigners for justice that have grown up from that bereaved community. I was very moved by the various contributions by hon. Members about the impact on mental health of living in substandard social housing. It is something that most of us have probably not experienced, but most of us have constituents who have, and that is most unfortunate.
The hon. Member also raised the issue of electrical safety and left us very much with the message that where someone lives and who their landlord is should not determine their safety from fire. That point was picked up on by the hon. Member for Vauxhall (Florence Eshalomi), who is my MP when I am living in London—I do not think I could hope for a more assiduous MP. She said that Grenfell was a result of callous inaction and should never be allowed to happen again, but she fears that it will.
The hon. Member for Crewe and Nantwich (Dr Mullan) made a thoughtful speech about various risks, including from the increasing use of timber in properties, and how we counter that. He also mentioned the importance of sprinklers, as did his colleague, the hon. Member for Stoke-on-Trent North (Jonathan Gullis), who spoke movingly of the impact of the Grenfell fire on people he actually knows, as well as the importance of sprinkler installation.
The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), who I know is a hard-working constituency MP, spoke of the careful attention she has given to the rights of her constituents who are tenants of social housing. I know she will bring to their cause the energy and vigour that she brings to fighting for all her constituents.
Margaret Ferrier
I had a constituent case recently that has raised some questions about how the Scottish Government are dealing with this across the border. My constituent is trying to sell a flat. As we know, Scotland does not have a leasehold system. Non-ACM cladding has left the property in limbo with disagreement from all involved parties about its safety and, therefore, the need for remediation. I do not doubt that this is a widespread issue in private and socially-owned properties, but will the hon. and learned Lady shed some light on the Scottish Government’s plan for funding remediation for such buildings?
Joanna Cherry
I will come to that and am grateful to the hon. Lady for raising that issue, because I will address the position in Scotland. Before I do, I would lastly like to refer to the speech by the hon. Member for Rochdale (Tony Lloyd) and say what a pleasure it is to see him back, fully restored to health and making his usual thoughtful contribution on how we avoid exacerbating the housing crisis—again, mentioning the importance of sprinklers.
I now turn to the position in Scotland, where housing and local government are a devolved matter. Decisions on building materials, the removal of cladding and fire safety are the remit of the Scottish Government. This has enabled Scotland to require that buildings are constructed in a certain way that will aid the prevention of fires, which has contributed to Scotland’s having fewer properties with Grenfell-style cladding. Nevertheless, the Scottish Government are not complacent around the issue of cladding and have recently made a series of announcements in that regard.
On 19 March, before the general election in Scotland, the Scottish Government announced that subject to winning the election, which, of course, they did, homeowners whose flats had external cladding would be offered free safety assessments to determine which properties had material needing to be removed. This proposal, which was intended to pave the way for public funding for remediation, was a key recommendation in a report published last March. All the recommendations in that report were accepted by the Scottish Government, who are committed to invest all the funding received so far in consequentials from the UK Government to address cladding problems. Future consequentials are yet to be clarified and I would like to raise that with the Minister, but they will also be put to this work.
The single building assessment programme in Scotland was launched in August and safety assessments are commencing on a number of properties. It has been welcome across the board, particularly because the cost for the assessments is to be borne by the Scottish Government, not homeowners. The assessments will be undertaken by suitably qualified professionals working to a common standard and will encourage collaboration between individual owners, residents and factors.
On 19 August, the current Scottish Government Housing Secretary, Shona Robison, explained that 25 buildings deemed to be most at risk have been identified for the assessment scheme, which will be delivered free, as I said. Physical inspections are under way to identify buildings that may need dangerous cladding removed or highlight other potential issues, such as flammable insulation or missing fire barriers. The Scottish Government have said they are fulfilling their commitment to support homeowners and improve building safety. Their priority is to ensure the safety of people in their homes.
These assessments are available for all buildings, regardless of tenure. That includes local authority and registered social landlord buildings, although the remediation of local authority buildings is a matter for each individual council. Clearly, this assessment procedure and the funding available will cover the social sector. As I said, the Scottish Government have not yet been given clarity about how much or when they will receive further funding promised by the UK Government. I would like to press the Minister for any clarity that he can give on that today.
Finally, before I leave the floor to other speakers, as we have heard there is far more to fire risk than cladding alone. We must have a holistic approach to address the overall issue of fire safety, particularly in high-rise buildings. That is an approach that my colleagues in the Scottish Government have endeavoured to follow.
In October 2019, the Scottish Government introduced new regulations that lowered the height at which combustible cladding could be used from 18 metres to 11 metres, to align with firefighting from the ground. They tightened controls over the combustibility of cladding systems on hospitals, residential care buildings and entertainment and assembly buildings, regardless of building height. They introduced a regulation requiring two escape stairs, evacuation alert systems and floor-level indicator signs in all new high-rise domestic buildings.
They have also recognised the importance of the installation of sprinkler systems. A requirement to install sprinkler systems in all new-build flats, new social housing and certain multi-occupancy dwellings was introduced from 1 March 2021. Funding was put in place to assist social landlords in meeting the new standards for fire and carbon monoxide protectors in Scotland by February 2022. The Scottish Government have provided an interest-free loan fund, repayable over five years, which has paid out over £15 million.
Andy Slaughter
The hon. and learned Lady is coming to the end of her speech, but she is making a very strong point about the factors that are missing—the lacunae—in what the Government are proposing at the moment. Maintaining the height at 18 metres allows new buildings to be constructed that are already potentially dangerous. I have 20-storey buildings being constructed in my constituency that have a single staircase. We must get all these things right. As she correctly says, this is not just about cladding.
Joanna Cherry
I entirely agree. We must get these things right and we must base new regulations on evidence. In particular, the Government need to liaise closely with the fire service, which has happened in Scotland. The Scottish Government have provided funding of £870,000 per year for the last two years to the Scottish Fire and Rescue Service to support its home safety visits to ensure that vulnerable and high-risk people can get the necessary alarms installed at no cost to them, so that they are safe in their homes.
To draw to a close, it is grossly unfair and unjust for any tenant or leaseholder to be left with the burden of removing cladding that they were not responsible for installing and to be left with the weight of fear and worry, and the impact on mental health that hon. Members have described, particularly since the horrors of the Grenfell fire. The UK must deliver the necessary funds for the remediation of cladding for all, and not leave tenants and leaseholders responsible for paying for the removal of this dangerous cladding. I look forward to hearing from the Minister in his summing up about the consequentials of funding that will be available for the devolved Governments.
Lucy Powell (Manchester Central) (Lab/Co-op)
It is a real pleasure to serve under your chairpersonship today, Ms Rees. I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this important and timely debate. As ever, he gave an excellent, knowledgeable, forensic and right speech.
We heard some other excellent contributions. The hon. Member for Crewe and Nantwich (Dr Mullan) made some important points, as did my hon. Friend the Member for Vauxhall (Florence Eshalomi), the hon. Member for Stoke-on-Trent North (Jonathan Gullis), my hon. Friend the Member for Rochdale (Tony Lloyd), the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) and the Scottish National party spokesperson, the hon. and learned Member for Edinburgh South West (Joanna Cherry). Given her excellent speech, I look forward to working with the hon. and learned Lady on the Building Safety Bill, and I hope that the SNP will play a full and active role in that Bill.
It is timely because we are very much in the midst of the building safety crisis post the terrible events at Grenfell Tower four years ago, and timely because, as mentioned, we are in the Committee stage of the Building Safety Bill, which has come about because of that tragedy. This week Parliament will be lobbied by leaseholders and others calling for justice for leaseholders and to end the building safety scandal. I want to put on the record my admiration for those campaigners and their tireless work while suffering from mental health and financial anxiety and worry that has a life-defining toll.
Stephen Doughty
I praise my hon. Friend for her work on this topic in the months since her appointment. I, too, will be meeting leaseholders from my constituency of Cardiff South and Penarth on Thursday. There are huge concerns about mental health and finance. One of their great frustrations is the lack of clarity on the money from the UK Government to the Welsh Government and the lack of clarity on the consequentials. Is it not right that the UK Government now explain what is going to the devolved Administrations so that they can move forward with their plans?
Lucy Powell
Absolutely. As I will come on to say, the Government’s handling of the crisis has been characterised by delay, a lack of clarity and uncertainty.
I also want to put on the record my thanks to my hon. Friend the Member for Hammersmith for his campaigning on fire safety in social housing blocks. He has campaigned tirelessly for many years—before the tragedy at Grenfell Tower and following the fire at Shepherd’s Court. I hope that the Minister and the wider housing sector will take on board many of his proposals for the inspection of electrical goods by social landlords and will look further at the regulatory regime. I will come on to some of his wider questions about the impact on the social housing sector.
What began as a cladding scandal after Grenfell, as we have heard, has now led to a total breakdown in confidence in most tall and multi-storey buildings in this country. The building safety crisis, as it has now become, affects hundreds of thousands of people. Buyers and tenants who dreamt of a safe, stable home to live in, who often spent their lives working towards that, are now living in a waking nightmare.
I am sorry to say that the Government’s approach has been characterised by dither and delay. They are leaving it to the market, which caused the mess in the first place, rather than intervening strongly to get a grip of the crisis and resolve it. They have managed to get a £5 billion fund from the Treasury, which I applaud them for because that is not a small amount of money by any means, but they are not giving effect to the money as they stand back and watch costs soar while the remediation works required get out of control. They limit the scope and the timetables, and they are not doing anything to ensure certification and assurance. Leaving it to the market and those that created the crisis in the first place will not resolve anything. As we have heard, social landlords are inexplicably excluded from the fund.
We now face a total breakdown in the approach to risk. What are reasonable risks? Who decides that? Who will certify risk proportionately, and who can ensure that insurers will insure reasonably and that lenders lend? Nobody is standing by to do that at the moment. What are the appropriate policies to mitigate the risks, such as evacuation plans, sprinklers, and the capacity of fire services and so on? Is waking watch worth the costs that people pay for it?
Florence Eshalomi
Does my hon. Friend agree that there has to be an evacuation plan for disabled residents, who feel that their voices have not been heard on this really important issue?
Lucy Powell
Absolutely. I was going to mention that later in my speech, but I will say it now. Evacuation plans for disabled people are pretty poor in most cases, leaving them especially vulnerable, as others have said.
At the moment, there is an absence of clear and reasonable guidance, process and professionally indemnified experts. The result is that people are standing back and letting others pay the price and take responsibility for the risk. Ultimately, that leaves leaseholders, social landlords, those in shared ownership and others with the financial responsibility and risk. It leaves them living in fear, as we have heard.
More could be done on prevention, as many hon. Members have said. We have heard that waking watch patrols have been necessary in some cases, but they are extremely expensive. The Government’s own data estimates that they cost £130,000 a year for just one building. They are supposed to be a temporary measure, but many are still trapped with them. The Government keep talking about the problems with the lack of proportionate risk and the lack of confidence in the system, but what are they actually doing about it? Perhaps we will hear a little more on that today.
There are similar issues when it comes to regulation, accountability and oversight. The Building Safety Bill, which is in Committee, will set up a new building safety regulator. That is a long-overdue and much-needed step, but there are a number of areas where it falls short. The Government have stuck to their crude height limit of 18 metres to define higher-risk buildings. They are right to say that, for buildings over 18 metres, the choice over which building control body to use leads to serious conflicts of interest. That is one of the key issues that has got us here, so why is that not the case for buildings under 18 metres, for which developers can still choose their own building control bodies?
The fire service, which we have heard much about today, used to play a much greater role in inspecting buildings. The Fire Brigades Union has raised the alarm about the fact that the building safety regulator will still be able to contract out that advice to the private sector. What are the Government proposing to do about that?
As many leaseholders and tenants have discovered in recent years, since Grenfell and before, the bodies that exist supposedly to provide recourse and accountability very rarely do, and are largely toothless and totally inadequate. Fire safety issues have shone a light on that, but yet again the Government seem incapable or unwilling to act with the necessary true leaseholder reform, and are not giving voice to tenants.
We have heard about some particular issues affecting social housing. In contrast to many private developers and freeholders, social and council housing providers were the quickest to react post Grenfell. Analysis has shown that housing associations have paid six times more than developers to remediate dangerous cladding. Given the huge profits in the private sector, it is a scandal that it is not doing more to pay for the faults it created. The Government have been incredibly slow in using the stick they kept threatening, leaving many to disappear before they are made to pay.
According to the G15—an umbrella group of the biggest housing associations in London—associations have set aside nearly £3 billion for historical remediation costs. In contrast, the UK’s largest developers have collectively set aside half a billion pounds—the difference is stark. Housing associations have warned that building safety costs will put at risk their ability to build much-needed affordable housing. With an estimated required subsidy per affordable home of £50,000, nearly £3 billion for remediation costs could mean 58,000 fewer affordable homes over the next 10 years. That is a huge number, and that is before we even get to the impact on quality and much-needed investment in existing stock and things such as the zero carbon agenda.
Housing associations and local authorities have been all but excluded from the Government’s building safety fund. To be approved, they must demonstrate that the costs would otherwise have been borne by leaseholders, which they have not been able to do in many cases. This approach is wrong, and it ultimately falls on the shoulders of tenants and potential future tenants, who will no longer be able to get social housing because the stock will diminish. We have called for a building works agency to fix this problem. Our mantra has been “assess, fix, fund and certify”; that is what needs to be done, and we need a team of experts who are given the power to do all of those things. What will the Government say about that?
Leaseholders and tenants will be shouting from the rooftops about building safety on Thursday. However, as we have seen from the excellent reporting of Dan Hewitt and “ITV News”, social tenants are often not listened to by housing providers. “Surviving Squalor” was a shocking reminder of the conditions that some people are forced to live in, their pleas for action ignored by social housing providers. It is just not acceptable. It is a mark of shame on the sector, which should be putting tenants’ experiences first, not ignoring them. If the past few months have taught us anything, it is the importance of home, and that housing is a public health issue, a mental health issue, and an economic issue, as well as a bedrock of success.
It is a shocking indictment of our country’s housing system, and the blame should be laid at the doors of some of these providers, as well as the Government. They have diminished and defunded social housing, and they have reneged on the promises made after Grenfell to bring forward legislation to provide a real voice and teeth to the views and needs of social housing tenants. When is that coming forward? We still do not know. We have been tabling amendments on this matter in the Building Safety Bill.
The building safety crisis is having a profound impact on the lives of so many, and the impact on social housing providers worsens the measly number of social homes already being built. The building safety crisis requires the serious leadership and intervention that it is not getting, and we need major reform to give tenants and leaseholders trapped in these situations a real voice, recourse and accountability. It really is about time the Government got a grip on this.
Christina Rees (in the Chair)
This is where I usually ask the Minister to leave a couple of minutes at the end for Andy Slaughter to wind up.
The Minister for Regional Growth and Local Government (Luke Hall)
It is a pleasure to serve under your chairpersonship and to be back in Westminster Hall, Ms Rees. I thank the hon. Member for Hammersmith (Andy Slaughter) for securing this important debate; he gave an incredibly thoughtful, forensic and detailed speech that really showed his passion for the issue. I also thank the other Members who have spoken—there have been some really thoughtful, important contributions.
This issue impacts so many of our constituents. That is why we are taking action, as has been described, by providing that £5 billion of grant funding for the remediation of unsafe cladding, to support building safety. The hon. Gentleman noted at the start that the Minister for Housing, my right hon. Friend the Member for Tamworth (Christopher Pincher), and the Minister for Rough Sleeping and Housing, my hon. Friend the Member for Walsall North (Eddie Hughes), are currently on the Building Safety Bill Committee. I know that they would like to be here to respond to his points, but it is my pleasure to respond on their behalf. I want to give an overview of the work the Government have been doing, but I will try to come to the points he has raised and give him satisfactory answers.
The £5 billion of grant funding specifically supports the remediation of unsafe cladding on high-rise buildings. This means that we will fund the cost of replacing unsafe cladding for leaseholders in residential buildings 18 metres and over in England. Work to remediate unsafe aluminium composite material cladding has progressed: 100% of high-rise buildings in the social housing sector identified as having that unsafe cladding at the start of last year have already been made safer or have remedial work under way. To date, the social sector ACM cladding remediation fund has approved £277 million of funding for the removal and replacement of unsafe ACM in England.
Tony Lloyd
The tragedy of Grenfell was as a result of a specific type of remediation of those buildings. Other types of work have had a similar but different effect, such as the example I gave in my constituency. Is the Minister telling us that they will not be covered by the £5 billion fund—that they will be outwith—and that there will be no funding available for other types of necessary fire prevention work?
Luke Hall
If the hon. Gentleman could be slightly patient, I will address the points raised today, including that one. For social sector buildings with unsafe, non-ACM cladding, we will meet the cost of remediation where a registered provider of social housing becomes financially unviable due to the cost of remediation. We will provide funding equivalent to the amounts that providers would otherwise have been entitled to pass on to leaseholders, including shared owners.
I heard the point made by the shadow spokesperson, the hon. Member for Manchester Central (Lucy Powell), about local authorities approving some of the burdens placed upon them. I am happy to take away any examples she wants to investigate and raise with my colleague the Housing Minister, or I will speak to them myself as the Minister for Local Government Finance.
Social housing owners, with private sector leaseholders, may also be able to benefit from the finance scheme, which the Government have announced for all buildings from 11 metres to 18 metres in height. In the small number of cases where unsafe remediation may be necessary on buildings of that height, the scheme will protect leaseholders from unaffordable costs, by ensuring that no leaseholder will pay more than £50 a month towards the cost of cladding remediation.
Of course, in all of those cases, Government funding does not absolve building owners of their responsibility to ensure that their buildings are safe. They should consider all routes to meet costs, protecting leaseholders where they can. It is also right that the industry that caused this legacy of unsafe buildings contributes to setting things right. That is why we have consulted on a new residential property developer tax, which aims to raise around £2 billion over the next 10 years. We will also introduce a building safety levy on developers of high-rise buildings, which we plan to introduce at the gateway 2 stage of the new building safety regime.
Stephen Doughty
Will the Minister be clear about when the Welsh Government will get clarity? The fund was announced in February and, more than eight months since, there is still no clarity on the funding consequentials, nor has there been adequate co-operation on the tax and levy he refers to, as I understand it. When is that going to happen? They want to work in co-operation, as this is affecting leaseholders across the UK, but they are not getting that co-operation.
Luke Hall
Regarding consequentials, I was coming on to answer the hon. Gentleman’s point and that made by the hon. and learned Member for Edinburgh South West (Joanna Cherry) later in my speech. On co-operation, I am always happy to meet with them on finance matters and to raise the issue with my relevant colleague in Government, if that is helpful to the hon. Gentleman and to colleagues in the devolved Administrations.
Looking forward, the package of changes that we are making through the Building Safety Bill will help to ensure that the problems identified with the current building and fire-safety regimes are rectified. Those responsible for buildings where they are occupied, will be required actively to manage building safety risks, evidenced through a safety-case regime. The new regime will allow fire and structural hazards to be effectively and proportionately managed, mitigated and remedied, through effective steps that consider both safety and costs.
Building owners, including local authorities and social housing providers, will need to appoint a building safety manager, who will be responsible for the day-to-day management of fire and structural safety in the building, and must have the relevant competence to perform the role for that specific building. Residents of high-rise buildings will no longer be ignored when they raise safety concerns about their building, and the Bill will make securing resident and building safety a critical objective of the accountable person. The new building safety regulator will give residents a strong voice through a statutory residents’ panel.
We will also use the powers in the Bill to make regulations that place duties on those who procure, plan and manage to undertake building work. That will ensure that the designs, as well as the building work, comply with building regulation requirements. That more stringent regulatory regime will apply to the design and construction of high-rise residential properties that are at least 18 metres in height or have seven storeys. It also applies to hospitals and care homes. The new regulator will also have new powers to ensure that those who are responsible for building safety are held to account if they fail to do the right thing.
We take electrical safety extremely seriously. We have introduced electrical safety regulations, where it is proportionate and practical to do so. The building regulations require work to the fixed electrical installation in homes, regardless of tenure, and to be carried out safely to protect people from fire or injury. The accountable person for occupied high-risk buildings that come under the scope of the Building Safety Bill must take all reasonable steps to mitigate or control building safety risks, the spread of fire and structural failure, regardless of the cause.
All landlords must ensure that electrical installations and any electrical equipment provided are safe at the outset of a tenancy, and kept in good working order. Last year, as the hon. Member for Hammersmith highlighted, we introduced regulations requiring private landlords to ensure that electrical installations in their properties are inspected every five years.
The social housing White Paper that we published last year sets out the actions that we will take to ensure that residents in social housing are safe, are listened to, live in good-quality homes and have access to redress when things go wrong. In the White Paper, we committed to consulting on measures to keep social housing residents safe from electrical harm; subsequently, we formed a working group to help develop proposals for the consultation. Clearly, it is too early at this stage to say what the outcome of that consultation will be, but I am happy to confirm that we will consider introducing the five yearly checks to bring about parity with the private rented sector. I will ensure that the views of the hon. Member for Hammersmith and of the hon. Member for Vauxhall (Florence Eshalomi), who raised this in a very powerful way, are fed into that thought process and raised with the Housing Minister.
Alongside the social housing White Paper, we published a consultation on smoke and carbon monoxide alarms. The proposed changes would make smoke alarms mandatory in all social rented homes and extend requirements for carbon monoxide alarms in both the private and socially rented sectors. The reforms that we have set out will drive real cultural change throughout the social housing sector. Everyone, from board members and councillors to senior officers and contractors, who has direct contact with residents will listen to what they say and treat them with the courtesy, dignity and respect that they deserve. The regulatory proposals will help to create a culture of accountability and compliance on health and safety requirements.
The hon. Member for Hammersmith asked for assurance that we are moving in the right direction, and I believe that we are. We will consider the point that he made extremely carefully. I hope that he feels that we are moving in the direction, and with the intention, that he suggests. The hon. Gentleman also asked what actions the Government are taking to deliver affordable housing. We will be delivering the £12 billion affordable housing programme over five years, the largest investment in social housing in a decade. It will provide over 180,000 new homes, and 32,000 of those will be for social rent. That is more than double the current programme. We do think that we are making progress there.
My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) spoke movingly about his own constituency and the experiences of his constituents. We recognise that timber has some environmental benefits, but we have always tried to be clear that the material should be used only when it is safe to do so. We have commissioned some work on this particular point, so perhaps I can suggest that he and I meet and discuss that in more detail. It would be interesting to hear the views of his constituents on the issue.
The hon. Member for Rochdale (Tony Lloyd) raised the issue of a forum to bring all of this together and make sure it is available. Perhaps I can write to him after the debate to try to bring that together in the most appropriate way, so that he can share it with his local authority, constituents, housing associations and others. I am afraid that I have to say to him and the hon. and learned Member for Edinburgh South West, on the point about consequentials, that I will raise it today with the Housing Minister and get back to them as soon as I can.
I know that there is a united desire to ensure that those living in high-rise social housing feel safe in their homes. We will restore the right for everyone in our country to live somewhere that is safe, decent and secure—a place that they are proud to call home. We want to drive meaningful change in the building industry and ensure that residents know that they are being properly supported and listened to. We can do that, and help drive the biggest improvements to building safety for decades: improvements that restore public confidence in our housing sector and that together create a robust, strengthened building safety system that has the welfare of residents at its heart.
Andy Slaughter
I genuinely thank everybody who has contributed today, including the Front-Bench spokespeople, for the thoughtful, measured way in which these issues have been addressed. We are not going to agree on everything, but I hope we can find some common ground. Perhaps, in the few minutes I have left to wind up, I will say, politely, where the areas are that still need some work and that are currently not being addressed by the Building Safety Bill, whose consideration is running in parallel with this debate.
I will just mention three areas. First, we need a more holistic approach to building safety, very much as the SNP spokesperson, the hon. and learned Member for Edinburgh South West (Joanna Cherry) said. This is not just about cladding or about buildings over 18 metres; we must look at medium-rise buildings as well. Responsible landlords, which includes most social landlords, are looking at those and making no distinction in relation to them, and it is artificial for the Government to continue to make that distinction for no other reason than additional costs.
The same is true for other defects. It is about not just cladding but, as we have heard, the way buildings are constructed, escape mechanisms, alarms, compartmentalisation, sprinkler systems and other things. There is a whole range of defects, and fixing those must be funded in some way. This is not even just about residential buildings; it is about schools, care homes, hotels and other places where people, for one reason or another, will find themselves vulnerable.
Secondly, we do not have, and neither has there been proposed, adequate law or enforcement of that law, whether we are talking about building safety or electrical safety. This is the opportunity to get those things right so that people can feel safe and secure in their homes. The most poignant thing that came out of the documentary on Sunday that we have all been talking about was people feeling that they were vulnerable in their own home, whether through extreme disrepair or lack of fire safety.
Finally—I hope everybody would share this view, including those on the Government side, but I noted it particularly in the speeches of my hon. Friend the Member for Vauxhall (Florence Eshalomi) and the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier)—we should really champion social housing. Let us no longer have the Conservative party as the party that bashes social housing. If the Conservatives genuinely care about levelling up, they have to care about social housing.
That means housing conditions, planned maintenance and housing development cannot be the victims here. It cannot be that they have to fail in order for fire safety to be addressed. That is vital for millions of our fellow citizens. I hope the Minister understands that; from the tone in which he as addressed the debate today, he appears to understand it, and I hope that is true of him and his colleagues. If so, we will not have wasted an hour and a half in Westminster Hall today—although in any case, Ms Rees, it has been a real pleasure to be here under your chairship.
Question put and agreed to.
Resolved,
That this House has considered reducing fire risk in high rise social housing.
Decarbonising the UK: Role of Shipping Emissions
(3 years, 3 months ago)
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
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This information is provided by Parallel Parliament and does not comprise part of the offical record
Christina Rees (in the Chair)
Before we begin, I encourage Members to wear masks when they are not speaking, in line with Government guidance and that of the House of Commons Commission. Please give each other and members of staff space when seated and when entering and leaving the room. Members should send their speaking notes by email to hansardnotes@ parliament.uk. Similarly, officials should communicate electronically with Ministers.
Alexander Stafford (Rother Valley) (Con)
I beg to move,
That this House has considered the role of shipping emissions in decarbonising the UK.
I refer the Chamber to my entry in the Register of Members’ Financial Interests. It is a pleasure to speak in this important debate with my fellow MPs from across the House, and I hope my position reflects their views that decarbonisation is an issue where we need to be truly united in our approach. In truth, the title of the debate is a misnomer, as I wish to discuss the positive contribution that the shipping industry and our excellent port infrastructure across the UK can make to achieving a low-carbon future. In particular, in the year of COP26, I wish to highlight the role that shipping carbon dioxide and hydrogen can play in ensuring a prosperous and environmentally sustainable future for British industry.
In the year of COP26, when the United Kingdom will be placed on the global stage, we must make significant progress towards our collective net zero targets. While we know that great strides are being made to decarbonise our electricity networks, with arrays of wind farms and solar panels covering our countryside, we must also pay attention to industry, where hundreds of thousands of jobs and significant segments of our economy are deployed. These sectors, such as our world-leading cement, glass, steel and petrochemicals, are not easy to switch to electrical power and will need to utilise carbon capture, utilisation and storage technologies—CCUS—to decarbonise.
The North sea has been the bedrock of our economy for decades, providing an economic shot in the arm to UK plc and delivering a world-leading expertise base that has been exported globally. Now is the time to turn our attention to putting the skills and infrastructure of this valuable national industry into the ports developing carbon capture and storage, which is essential in helping hard-to-abate sectors to decarbonise and in ensuring that natural gas supports the development of the emerging hydrogen economy. In essence, it is putting the upstream industry in reverse to develop CCUS.
We must recognise the support the Government have already placed behind this emerging sector, with a significant programme to support four industrial clusters. However, we should also recognise the guidance from the Committee on Climate Change, which calls for more ambition and the need to support as many potential CCUS industrial clusters as possible, whether that is in the Acorn Project in Scotland or projects in Teesside, Humberside or the north-west. These clusters are blessed with some of the best sub-surface geology to support permanent carbon dioxide storage. The projects are relatively simple to understand, whether they are reforming hydrogen from natural gas coming onshore and then pumping the CO2 captured back into depleted reservoirs, or perhaps CCUS-enabled power stations, such as the innovative net zero Whitetail clean energy NET power station planned for Teesside.
The UK is also seeking to become a global leader, with Europe’s first at-scale direct air capture facility being developed by the UK-based Storegga in north-east Scotland, sucking CO2 from the air and storing it underground. Whether we seek to reuse existing oil and gas infrastructure or to deploy new pipelines, CCUS has the potential to support communities and regional economies around the North-sea coastline for decades to come, as well as places further inland like Rother Valley.
Climate change is not an issue that is confined to the North sea or the Irish sea. The United Kingdom must come together to develop a net zero future. In Scotland, we see the UK’s first hydrogen-powered community, but equally the Thames estuary and the Solent are embracing the potential for transitioning to a hydrogen-fuelled grid and energy generation. That presents a challenge. Without suitable geological storage, these hard-to-abate emissions are not able to sequester the carbon and prevent it from reaching the atmosphere. This is where our proud island nation is able to respond to the challenge and work collaboratively to provide a vibrant, low-carbon shipping and transportation network, connecting industrial clusters, such as refineries on the south coast, the south Wales emitters and the Thames estuary, to regions such as north-east Scotland. The latter possesses a world-leading geological storage resource, with more than a third of the UK’s identified storage resource located within 50 km of existing gas pipeline infrastructure, which can be repurposed to take CO2 offshore.
The Scottish cluster is a superb example, with the Acorn Project one of the most mature UK CCUS and hydrogen projects, with the backing of both the UK and Scottish Governments and even, dare I say it, the European Union. It will enable carbon capture deployment across a diverse set of emitters, capturing at least 6.2 megatonnes per annum of carbon dioxide by 2030. That represents around 60% of the ambition set out in the Government’s great 10-point plan and is a vital part of it. To make that a reality, emitters from across the UK are seeking to make use of that national resource, along with storage locations along the east coast and the north west. The UK’s port network needs to stand ready to respond to that demand and needs to invest in the significant infrastructure required to create a UK port network capable of handling large volumes of CO2 and hydrogen shipping. Shipyards from Appledore to the Clyde will also need to mobilise to build the shipping tonnage needed to support this nascent industry.
From Peterhead port, Europe’s largest fishing port, to Grangemouth, Scotland is readying itself to make investments to ensure that it can support the transition to a low-carbon economy. Existing jetties can be repurposed to support the berthing of ships bringing CO2 for storage, and proximity to the network of existing oil and gas pipelines offers the possibility of easy access to eventual storage sites. For example, with the conversion of Peterhead power station to gas, which will be delivered by pipe from St Fergus, the jetty can be repurposed for handling both bulk CO2 imports and hydrogen exports. That will allow shipping to commence on a more cost and time-efficient basis than would have been the case for a cold start, and that would save up to about £50 million in up-front investment and three years for consenting and construction. We are already on the way and that provides a natural advantage.
Supported by associated infrastructure, pipe routes and with nearby land suitable for development, Peterhead port can play a strategically important role in the emerging energy transition, especially in handling CO2 for eventual storage and hydrogen for eventual export. That is important. We want to export the hydrogen. We do not just want to make it for the UK; we want to be a world leader and export the technology and the resource abroad. As the sector evolves, and to take maximum advantage of the opportunities available for national and international trade, it is likely that a second berth will be required in the port within a few years to handle the volumes of potential CO2 and hydrogen shipments, requiring further investment of up to £30 million.
Similar infrastructure and expertise can be used to support the import or export of hydrogen at other ports around the UK, such as the Forth ports. Given the proximity of the Forth ports to proposed blue hydrogen projects and to the UK’s biggest source of offshore wind, that could be vital for the deployment of the UK’s hydrogen sector, although it is worth saying that we should be aiming for green hydrogen, rather than blue. Blue is only the journey to get to where we want with green hydrogen. I want to make that perfectly clear: blue hydrogen is not the ultimate answer.
That port infrastructure and the shipping industry can also play a central role in supporting other areas of the UK to reduce emissions. The south Wales industrial cluster is the second largest CO2 emitting cluster in the UK. It contains several key UK assets, including the UK’s largest steelworks, where my father-in-law used to work, and the UK’s largest combined-cycle gas turbine, the UK’s largest energy port, the UK’s only nickel refinery and the Royal Mint, as well as several key and core manufacturing industries. Around 20% to 30% of the UK’s natural gas supply is imported into the UK through south Wales. With steel, cement, chemicals, refining and natural gas supplies all present in the region, CCUS will be essential for delivering net zero in south Wales. However, south Wales does not have any known local geological storage of CO2 available, which means the development of a CO2 shipping fleet would be essential for its decarbonisation. The south Wales industrial cluster includes several deep-water harbours and ports that could accommodate CO2 shipping, and with the right investment, can develop a shipping network that can effectively ship and store CO2 from this cluster at the Acorn Project and other sites.
On Teesside, meanwhile, innovative net zero power stations will also need access to resilient geological storage of CO2. The Whitetail clean energy plant itself uses the highly innovative NET power technology, which combusts natural gas with oxygen, rather than with air, and uses supercritical CO2 as a working fluid to drive a turbine instead of steam. As a result, nearly all air emissions, including traditional pollutants and CO2, are eliminated and pipeline-quality CO2 is produced, so that it can be captured and sent by ship from Teesside to storage locations. That is further proof of the UK being a global science and technology powerhouse. It is critical that this plant and further plants have optionality to send CO2 to distributed stores.
Similarly, the Cavendish project in the Thames estuary is a large-scale, low-carbon hydrogen generation project. Based on the Isle of Grain, the hydrogen production facility will be near gas and electricity networks, power stations and a liquefied natural gas facility. It is expected to meet the large energy demand of London and the south-east for power, heating and transport. Again, this project will need the ability to capture and sequester its CO2 emissions, but there is no suitable geological storage nearby, so shipping infrastructure will be essential for the project to sequester its CO2 in suitable storage locations.
These are just a few examples of vital low-carbon projects for which access to port infrastructure and a shipping network capable of transporting CO2 and hydrogen is not just nice to have but absolutely business-critical if we are to hit our ambitious targets. They are ambitious targets, but I know we will get there. However, we can only get there as one country—one country of England, Wales, Scotland and Northern Ireland combined—and if we can move around the CO2, which is to say the “bad” CO2. We need that shipping infrastructure to help us do that.
We are an island nation; we are Nelson’s nation. We are a nation of sailors, and that is what we should do with our CO2. We should embrace our former fleets; we should have the same clarion cry that we had with the merchant fleets of old, to move our CO2 around and defeat the enemy that is climate change.
In this year of COP26, I am sure that the Minister and colleagues across the House will recognise the importance of shipping’s role in reducing CO2 emissions and I hope that we can work together to ensure that policy supports the development of the shipping infrastructure we must successfully transport CO2 emissions and hydrogen, as needed, to achieve a net zero future for the whole of the UK. That will bolster the economy, lower our emissions and really turbocharge UK plc into the next millennium. I know that will happen and I also know that, although ports are important, Rother Valley will still be at the heart of hydrogen production in the future.
The Lord Commissioner of Her Majesty's Treasury (Michael Tomlinson)
First of all, may I apologise on behalf of the Minister who was going to respond to the debate, as both she and I were detained?
I congratulate my hon. Friend the Member for Rother Valley (Alexander Stafford) on securing this important debate. Not only in this debate but throughout his time in Parliament, he has championed this issue and similar issues, and I congratulate him, once again, on being at the forefront of the debate on these issues.
It is indeed London International Shipping Week and, as my hon. Friend has said, we are “Nelson’s nation”, so this debate is incredibly timely. The shipping of carbon dioxide and hydrogen can play an important role in ensuring a prosperous and sustainable future for British industry, and in supporting efforts to meet our domestic net zero targets.
We have already made huge progress in decarbonising the electricity sector. In 2019, greenhouse gas emissions were down by 13% on 2018 levels. However, it is right to say that, in order to reach net zero emissions by 2050, we must go further. That is why in March we published the UK’s industrial decarbonisation strategy. This document is the first to be published by a major economy and it sets out how industry can decarbonise in line with net zero while remaining competitive. Carbon capture, utilisation and storage, or CCUS, is one key abatement technology and it will be vital as we make this transition.
In May, we launched phase 1 CCUS cluster sequencing process. Its aim is to provisionally sequence those clusters that are most suited to deployment in the mid-2020s. This summer, we also published the UK’s first ever hydrogen strategy, which will put the UK at the forefront of the race to develop low-carbon hydrogen, driving innovation, jobs and investment to scale up the technology. CCUS and low-carbon hydrogen are vital to transform sectors such as steel, cement and chemicals, which lack viable alternatives to achieve deep decarbonisation. The UK can become a world leader in CCUS and low-carbon hydrogen, helping to create world-leading low-carbon manufacturing clusters. Connecting industrial clusters, such as those in south Wales, the south coast of England, the Thames estuary and the firth of Forth in the northeast of Scotland will be critical to enabling the decarbonisation of our steel, chemical and refining industries. That is where the shipping sector can be crucial in realising that vast potential. In our business model update, published in May, we indicated our desire to accommodate the shipping and the non-pipeline transportation of carbon dioxide and, as part of the cluster sequencing process, we asked clusters to include details of future carbon dioxide shipping capability in their cluster sequencing proposals.
Turning to the future direction, we recognise the importance of non-pipeline transportation and shipping for decarbonisation of the broader economy and allowing deep decarbonisation. We are currently working with industry and the devolved Administrations to understand how best to incorporate non-pipeline transportation and shipping within a UK carbon dioxide network.
This is an extremely important issue for the sector, but more importantly, for the planet. I apologise for missing the beginning of the speech by my hon. Friend the Member for Rother Valley, and I make a commitment that if there is any point that he raised in my absence, the Minister will address it directly in writing and leave a copy in the Libraries of both Houses. This is an extremely important issue, and I endorse my hon. Friend’s view that shipping will play an important role in reducing carbon dioxide emissions. I look forward to working across the House, and with the Minister, to ensure that the UK develops the appropriate infrastructure to enable new low-carbon technologies such as low-carbon hydrogen, and meet the challenges that we face.
Question put and agreed to.
Real Fur Sales
(3 years, 3 months ago)
Westminster HallRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Christina Rees (in the Chair)
Before we begin, I encourage Members to wear masks when they are not speaking, in line with current Government guidance and that of the House of Commons Commission. Please also give each other and members of staff space when seated and when entering and leaving the room. Members should send their speaking notes by email to hansardnotes@parliament.uk. Similarly, officials should communicate electronically with Ministers.
Christian Wakeford (Bury South) (Con)
I beg to move,
That this House has considered real fur sales in the UK.
It is a pleasure to serve under your chairmanship, Ms Rees. Banning fur is increasingly an issue of public concern, reflected in the decision that the vast majority of consumers now make to avoid buying fur products and the huge support for the Fur Free Britain campaign—try saying that five times fast—led by the Humane Society International UK. In 2000, this House set an example for the world by banning fur farming in England and Wales, and Scotland and Northern Ireland enacted bans in 2002. We are clearly a nation of animal lovers, yet our existing legislation on the fur trade contradicts that fundamental aspect of being British.
Pressure for change is growing both inside Parliament and among the broader public. More than 1 million people have signed Fur Free Britain’s petition to ban fur sales, and a group of more than 100 MPs and peers signed my cross-party letter to the Secretary of State for Environment, Food and Rural Affairs just last month, which called on the Government to ban the import and sale of animal fur. A similar number of MPs signed the live early-day motion on the same issue, tabled by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), and the hon. Member for Coventry North West (Taiwo Owatemi) tabled a ten-minute rule Bill on this matter in April, so it is clear that Members want the animal fur trade to end.
Tracey Crouch (Chatham and Aylesford) (Con)
I am extremely grateful to my hon. Friend not just for securing this debate but for being kind enough to mention the early-day motion in my name, which is currently live and has been signed by the highest number of MPs in this Session. In the previous Session, 140 MPs signed the early-day motion. Does he agree that that shows that there is huge cross-party support on this issue, reflecting public opinion? There is really only one outcome, which is to ban fur sales, full stop.
Christian Wakeford
How could I not agree with my hon. Friend, given that I name-dropped her in my speech? That shows that there is clear support not only in this Chamber but in the main Chamber and both Houses.
I invite hon. Members to imagine a scene—I apologise in advance for the picture that this will paint. A nearby neighbour is keeping two dogs outside the house in a wire cage. The cage measures not more than 1 square metre and has a wire floor and a wire ceiling. The dogs are never allowed to leave the cage, and over time exhibit signs of mental distress. They take their frustration out on one another and repeatedly pace. Over time, one dog’s legs become deformed and have open sores from standing on the wire floor. The other has untreated diseased eyes. They have no escape from the intense summer sun or the freezing winter nights. One day, the neighbour forces electrical probes into either end of each dog and ends their pitiful lives.
That scene would be utterly intolerable for any right-thinking person. I imagine that in witnessing such treatment of animals, a great many, if not all, of my colleagues, friends and the great British public would have called either the police or the Royal Society for the Prevention of Cruelty to Animals, and would have rightly expected that individual to be prosecuted for animal cruelty. But in all important ways, the scene I describe is not hypothetical. If we simply switch the animals in the cages from dogs to foxes and move the location to Finland, Poland, China or another in a decreasing list of nations still permitting fur farming, that animal cruelty is a daily reality for far too many animals. More than 100 million animals—foxes, mink, raccoon dogs, chinchillas and others—are kept like that daily.
Hilary Benn (Leeds Central) (Lab)
The hon. Gentleman is making an excellent speech. As well as being cruel, is it not utterly illogical that Britain, having rightly taken the decision to ban fur farming here, continues to be willing to allow the products of cruel fur farming to be imported into the country? Does that not strengthen the case, supported by so many right hon. and hon. Members, for banning its sale in this country?
Christian Wakeford
I completely agree. It is a cruel irony that we have illegalised the practice in this country but offshored cruelty. It is not something that I am particularly happy about, and hopefully we will see change.
The 5 million or so animals caught for their fur in barbaric traps that are banned in the UK fare no better. Sometimes they are left languishing in traps for days, and often chew off their own limbs to escape.
Our debate today should allow us to discuss whether the UK should be playing any part in an industry that we find so unconscionable in our own country. Despite our previous world-leading progress in banning this outdated and cruel practice, we have since continued to allow the import and sale of fur from abroad, effectively outsourcing animal suffering. Since 2003, we have imported—
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
The hon. Gentleman is making an excellent speech. On wanting to ban imports, we know that at the moment the Government are interested in doing trade deals with other countries. Could it not be a condition that we do not wish to do trade deals with countries that continue to exploit animals in this way?
Christian Wakeford
I completely agree; in fact, it is almost as if the hon. Member has read part of my speech in advance. If we are exporting and importing cruelty, it is fundamentally wrong. Any sane, normal-minded person would find it absolutely intolerable.
Since 2003, we have imported more than £800 million of animal fur from countries including China, Finland, France and Poland. HSIS estimates that this equates to some 20 million animals—to let that sink in, 20 million animals have gone through this cruelty.
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
I congratulate the hon. Gentleman on securing this important debate. Does he agree that the health risk presented by the fur trade needs to be better publicised so that consumers may make more informed decisions? The intensive breeding conditions in these fur farms lead to poor hygiene, stress and low genetic diversity, creating a perfect breeding ground for disease.
Christian Wakeford
I completely agree with the hon. Lady. The fact that we have to advertise where our food is coming from but not where our clothes are coming from is wrong on so many levels.
We must now be strong enough to eradicate our involvement—I hope any involvement—in the perpetuation of these animals suffering for such a completely unnecessary, frivolous purpose as to be turned into a pompom on a hat or a trim on a collar. If we can legislate to say that the practice is too cruel in our country, we must take the next step and legislate to say that it is too cruel for us, in effect, to underwrite it in other countries as well.
John Spellar (Warley) (Lab)
From his representations to Ministers, has the hon. Gentleman had any indication as to the reasons for their reluctance to do something that would be so popular—justifiably so—with the public, in order to prevent this cruel trade and make a major contribution to eliminating it not only in the United Kingdom but across the planet? Would this not only be a major exercise, but one that is fairly simple and straightforward to do?
Christian Wakeford
Again, I completely agree. I hope I am not putting words in the Minister’s mouth when she responds, but it is the right, fair and humane thing to do. There is overwhelming public—
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
I thank the hon. Gentleman, who is making an excellent speech and being so kind in taking so many interventions, for bringing this debate to the Chamber today. Does he agree that it is not just the humane thing to do, but that there is also a public health interest in making sure this happens? Humane Society International has reported that there are covid-19 outbreaks on more than 400 mink farms in 12 countries to date. While we are all grappling with the pandemic, surely we must also have the public health interest at the forefront of our concerns.
Christian Wakeford
That is not a matter I was going to cover in this speech, but the hon. Lady makes a very educated and well-informed point. Certainly, in pandemic Britain, we need to think about this. If we allow more people to be infected across the globe, it is obviously going to come back to our shores as well.
As I said, there is overwhelming public support for a fur ban. A recent Yonder poll in May found that more than seven in 10 members of the public would support a ban on the import or sale of fur in the UK, including more than 50% who stated their strong support.
Kirsten Oswald (East Renfrewshire) (SNP)
The hon. Gentleman makes an important point. Does he agree that, while there are goods with fur attached—for pompoms, for instance, as he indicated—that level of public supports suggests that perhaps the public neither know nor wish to be purchasing real fur? If the Government here took steps to prevent that from happening, the public would be very grateful.
Christian Wakeford
I completely agree. People’s shopping habits have fundamentally changed in recent years, and there has been a growth in the import of faux fur, but again this comes down to a labelling issue. Far too often, people who buy faux fur end up wearing real fur, so there needs to be a wider conversation around that.
A YouGov poll from 2020 revealed that the public consider fashion brands selling real fur to be “unethical”, “outdated”, “cruel” and “out of touch”. Is it not time to bring our legislation in line with public feeling and sever our ties with this inhumane industry for good?
We also have a duty to protect this nation of animal lovers from unwittingly funding this industry, which they so despise. In recent years, scores of British retailers have been found to be mis-selling real fur products as faux fur, leading unsuspecting customers to prop up the industry. It is essential that we take action to ban this duplicitous practice. Banning fur imports and sales could create appropriate penalties for retailers found to be selling real fur, and could be a significant step forward in this regard.
Jason McCartney (Colne Valley) (Con)
I thank my hon. Friend for giving way and add my voice to the cross-party support for banning the import of fur sales. Does he agree that when we set the standard, some 20 years ago, by banning fur farming here in the UK, other countries followed our lead? If we can set the example here, not only will we help animal welfare in this country, but other countries will follow. Does he agree that we should take the lead?
Christian Wakeford
I completely agree. As I have said in the Chamber in other debates on different topics, we are global Britain. We have a proud reputation across the globe and when we speak, people should listen. Other countries have followed, and we need only look at Israel, which has a complete fur ban across the country already.
British high streets generally mirror public opinion on fur. The vast majority of our stores are now fur free, including Marks & Spencer, Selfridges and Next, as well as high-end fashion and designers, such as Stella McCartney, Burberry and Chanel. Businesses are moving away from using fur of their own accord, driven by the most profound moral argument for doing so and by changing customer spending habits, proving that a ban would only have a limited impact on businesses.
There are a relatively small number of organisations still working in the fur industry. A managed period to phase them out should ensure that they can transition to alternative humane materials and products.
Sir Roger Gale (North Thanet) (Con)
We agree, first of all, that in this day and age there is no justification whatsoever for using real fur, because so many good synthetic alternatives are available. I do not want to broaden the debate too far, but is this not also yet another form of trophy hunting? This kind of trophy, whether a fur coat on somebody’s back or an animal mat on a floor, has no place in a civilised society.
Christian Wakeford
I would disagree slightly, because some out there would try to picture hunting with some degree of romanticism, but that is just not true of the fur trade, which is barbaric and cruel. It is not hunting, but catching animals in traps and leaving them to bleed out or even worse, so although I disagree on that point, I completely agree with my right hon. Friend’s sentiment.
Brexit has given us a unique opportunity to forge a new standard for animal welfare and protection, in keeping with our values as a country. Previously, 80% of animal welfare legislation came from the European Union, and last year the Minister of State, Lord Goldsmith, confirmed that following the end of the Brexit transition period we will be able to properly consider raising our standards on the fur trade even further. We must now move forward from those words and legislate for real change.
Leaving the European Union has started a new chapter in our trading relationship with the rest of the world, and banning fur will send a strong message that our trading principles will be synonymous with our high standards of animal welfare. Cities, states and countries around the world are implementing their own versions of this legislation, with Israel recently becoming the first country in the world to ban the sale of fur. Our new trading freedoms are ours to become an integral part of the global movement against this outdated industry, and we must not let this opportunity pass us by.
Supporters of the fur industry—unfortunately there are a few, and I have been trolled by many of them in the last few days—claim that it should be left purely to the market and consumer choice. Yet despite the unpopularity of fur and its almost complete absence from the high street, the UK is still responsible for importing a large amount of animal fur and online sales are persistent.
We already have laws in place banning the sale of cat, dog and seal fur. We do not leave the fate of these species to market forces, nor should we, but we do for other fur-bearing animals. A ban on both imports and sales of fur can guarantee an end to the UK’s status as a global trading hub for fur.
Backers of fur have also claimed that an import and sales ban could jeopardise the UK’s effort to strike new trade deals around the world. This claim is little more than hyperbole and fearmongering. A ban not only would be consistent with our World Trade Organisation obligations but would be unlikely to be a red-line negotiation issue in any trade deal, because trade in fur is not economically significant enough.
I would also take this moment to pre-empt any suggestion that such a thing as humane fur farming exists. That is a fallacy and a downright lie, but do not take it from me alone. I would like to read a brief quote from a former CEO of the British Fur Trade Association, who recently, of his own volition, left the industry after 10 years and now supports a fur ban. He said:
“Over time I realised that whatever soundbites we devised to reassure consumers, retailers and politicians, neither welfare regulations nor any industry certification scheme, would ever change the reality of these animals being stuck in tiny wire cages for their entire lives.”
It is now time that we end the double standard of having a ban on fur farming while importing the same cruelty from overseas. The fur industry is outmoded and out of touch with the modern values and principles of the humane treatment of animals. I implore my parliamentary colleagues to join me in condemning it to the history books, as we have so many other cruel and archaic treatments of animals.
In conclusion, following the Government’s call for evidence on the fur trade over the summer, given the strong public and parliamentary support for this measure and noting the Government’s commitment and ambition to be a world leader on animal welfare standards, I ask the Minister to use her response to today’s debate to reassure me and everyone in this room that legislative action to end the UK’s involvement in the global fur trade will be imminently forthcoming. It is not just a popular thing to do; it is the right thing to do.
Christina Rees (in the Chair)
We will put an informal time limit on of about four or five minutes, and we should get everyone in.
Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)
It is a pleasure to serve under your chairmanship, Ms Rees.
Historically, the UK was the foremost leader when it came to animal welfare—the first island of nations in the world to implement legislation protecting animal rights. Fur farming has rightly been banned in the UK since 2003, yet we continue to import tens of millions of pounds of animal fur each year. If it is too cruel an industry to have on our shores, how can we justify importing fur that is farmed using the same inhumane methods that are illegal in the UK? As the hon. Member for Bury South (Christian Wakeford) said, all we have managed to do is outsource our animal cruelty overseas.
The slaughter methods used on fur farms are horrendously cruel. Before an animal reaches its first birthday, it will be slaughtered using one of the following methods: by electrocution, with probes inserted into the animal’s mouth; by gassing, slowly starving the animal of oxygen; or by brutally beating the animal to death. Alternatively, many animals have their necks broken or are poisoned with noxious chemicals that result in organ failure. In some particularly horrific cases, animals may even be skinned alive. How can we really, truly call ourselves a progressive and caring society when we allow such actions to take place, purely for commercial purposes?
The fur trade not only has a devastating impact on innocent animals but also creates a risk to human welfare from zoonotic diseases. Last year, we witnessed a devastating cull of mink in Europe because of large outbreaks of covid-19. Dangerous viruses thrive when animals are kept in filthy, crowded conditions. By allowing the sale of fur in Britain, we are inadvertently supporting a reservoir of deadly viruses. The UK public overwhelmingly reject these barbaric and entirely outdated practices. One YouGov poll shows that 72% of our population want to see a ban on the importation and sale of fur.
Alex Davies-Jones (Pontypridd) (Lab)
The hon. Gentleman mentioned that 72% of people want to see a ban. In Wales, the number is actually higher: 82% of people in Wales want to see a ban on the UK fur industry. It is vital that the Minister works with all nations of the United Kingdom and all devolved Administrations to tackle this problem head-on.
Steven Bonnar
I absolutely agree with that sentiment. I know that people in Wales are very conscious when it comes to farming and other sentient animals. I take that fully on board, and I hope that the Minister will do the same.
According to the Humane Society International, around 100 million animals are bred each year to be slaughtered in intensive fur farms, including foxes, chinchillas, mink, raccoons, dogs and rabbits. The majority of this fur—around 85%—is produced by intensively farming animals in callous, claustrophobic battery cage systems to specifically supply the fashion industry. The ban on the sale of real fur is long overdue. Subjecting animals to extreme cruelty in the name of fashion is an abhorrence in direct opposition to animal welfare standards, and the values we hold dearly in Scotland—and of course in Wales and across the devolved nations.
While the farming of animals for fur has been illegal in the United kingdom since January 2003, and the sale and importation of cat and dog fur has been illegal since December 2008, each year the UK still imports around £75 million-worth of fur sourced from other animals. That is roughly 3 million dead animals. It is undoubtedly clear that the Government cannot be trusted on animal welfare. In response to an open petition calling for an end to the fur trade, the UK Government stated that
“national bans are less effective than working at an international level on animal welfare standards.”
They went on to say that they were helping to phase out cruel practices, as well as encouraging an outright ban on fur from species such as cats and dogs.
The answer from the UK Government is a total cop out. In Scotland we see all fur production as cruel and inhumane; there is no need to differentiate between species in such a way. No animal is more or less important than the other. Once again, this proves that Scotland is leading the UK on the issues that matter, not for the first time and not just in this area. There is no more important a step that we can take towards ending this cruelty than to simply end our participation with it. If this Government continue to allow the sale of fur from overseas, then we will remain complicit in an industry that causes immense animal suffering and environmental harm. The sale of fur is simply not aligned with the ethical trajectory of Scotland. This is what Scotland wants and has asked for from this Tory Government from day one.
Animal welfare is an area that the Scottish National party takes extremely seriously, and I would urge the UK Government to follow the Scottish Government’s leading example on these issues. We have created new legislation to further protect animals and wildlife, with the Animals and Wildlife (Penalties, Protections and Powers) (Scotland) Bill, which enforces tougher penalties on perpetrators of animal abuse, increases sentences from a maximum of 12 months in prison and a £20,000 fine to five years in prison and an unlimited fine, and also enshrines animal sentience into law. Nevertheless, regulation of international trade remains a reserved matter, and as such, it is a decision for this Government. We are imploring them to make the right decision. I urge the UK Government to listen to the people, listen to the morality of the argument, and prohibit the import of new fur products.
Christina Rees (in the Chair)
I remind Members to indicate that they wish to speak by standing between speakers.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
It is a pleasure to be part of this debate, Ms Rees, and I thank the hon. Member for Bury South (Christian Wakeford) for securing it. I will be quite brief, as the UK can be proud of its extremely high animal welfare standards and the fact that we have banned fur farms. I intervened on the hon. Member for Bury South to talk about the opportunity we have with the trade deals coming up to not just stop the importation of fur, but to maintain those animal standards in all our imports. I would press on the Minister the need when making these trade deals to say that we should not have any reduction in animal welfare standards—be that in fur, in meat production or in any way whatsoever.
I am pleased that the hon. Member for Bury South mentioned that consumer choice is very important. However, sometimes consumers mistakenly buy fur products because they are incorrectly labelled, and because they cannot clearly identify where the products come from. He made the point that we know the country that our meat has come from, but we do not have the same knowledge with fur products; that is something else I would encourage the Government to look at. There are really high-quality synthetic alternatives, and if they were clearly labelled and made available, I think consumers would certainly want to choose them.
The evidence suggests that the great British public are overwhelmingly against fur farming and that they want to see high standards of animal welfare maintained. The opinion polls show that they think that fur farming is absolutely unacceptable. I conclude by saying to the Minister that I would like see this commitment to animal welfare reflected in the trade deals the Government reach with other countries.
Patricia Gibson (North Ayrshire and Arran) (SNP)
I am delighted to speak in the debate, and I congratulate the hon. Member for Bury South (Christian Wakeford) on securing it. I recall participating in a debate on this very issue on 4 June 2018—that date is important because it was the same day that Scotland became the first country in the United Kingdom to enact legislation banning the use of wild animals in circuses. The same week, a similar ban was imposed in Slovakia, and yet the UK Government insisted that we could not impose such a ban unilaterally as a member of the EU. Another day, another EU membership myth busted.
The fact is that the farming of animals for fur is not permitted in the UK. As we have heard, the next logical step is to ban the sale of animal fur products. Anything else is sheer hypocrisy—outsourcing our poor fashion choices. The contradiction suggests that although our law recognises the cruelty and barbarism of farming animals for their fur, as long as these animals are not farmed here, we are content for their fur to be imported into the UK. That position is illogical and hypocritical, and we must take the next step of banning the importation of animal fur products. It is quite a simple choice.
The demand for fur products in the UK has been in steady decline for decades, as consumers increasingly find them unethical and unacceptable. The inboxes of the people in this room are testament that our constituents continue to be concerned about this matter. Where consumers lead, businesses will follow.
Margaret Ferrier
Many large retailers such as Marks & Spencer and John Lewis are already proactively moving away from fur sales and, as the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) said, public opinion is overwhelmingly in support of a ban on the importation and sale of fur. Would the hon. Member for North Ayrshire and Arran (Patricia Gibson) agree that there is no need for a regulated industry and that, instead, an outright ban is the only viable way forward?
Patricia Gibson
The hon. Lady makes an excellent point. It is true that shops such as Marks & Spencer, Adidas and H&M have now rejected the fur industry, and designers such as Stella McCartney and Vivienne Westwood have supported calls for Britain to become the first European nation to ban fur sales. Of course, businesses are in the business of making money, and they are following where customers are taking them. It is about time that instead of continually playing catch-up, the UK Government responded to consumers and constituents in the UK. Israel is leading on the issue, and its ban on the sale of fur will come into force by the end of this year. For the UK to do the same would be a very logical next step given that the sale of cat, dog and seal fur is already banned. What are we waiting for?
I hope that the Minister is listening, and that we do not have to come back in another couple of years to repeat the same calls for something so humane, which has both widespread public support and firm cross-party support. Let us just get on and do it. There is no reason to hang about and not get it done.
Taiwo Owatemi (Coventry North West) (Lab)
Thank you, Ms Rees. I am grateful to be able to speak in this important debate, although I am frustrated that we need it in the first place.
In April, I introduced a Bill to the House that called for the fur trade to be banned once and for all in Britain. I called on colleagues across the House to step up and make history, making the UK the first country in the world to prohibit the sale of fur in full. I am therefore extremely disappointed that this cruel practice continues to be an issue in the United Kingdom. Twenty-two years ago, my hon. Friend the Member for Garston and Halewood (Maria Eagle) introduced a Bill to ban fur farming. She said it was time to
“put an end to a cruel barbaric practice”.—[Official Report, 5 March 1999; Vol. 326, c. 1339.]
That Bill was taken up by the last Labour Government and a year later it became law, making Britain the first country in the world to ban fur farming outright.
Despite that decision, the products of fur farming have continued for the past 20 years to be imported into our country and sold in our shops. We do, however, have the option of eliminating that double standard and once again making history by becoming the first country in the world to ban the importation and sale of fur. The Government have shown some willingness and stated that they want to drive up animal welfare standards in the United Kingdom. Banning the fur trade in its entirety, including fur imports, would be a bold step toward reaching these aims.
We need actions, not just warm words from the Government. In banning the fur trade, we will have the overwhelming support of the animal-loving British public. Many Members have spoken about the YouGov poll commissioned by the Humane Society International, which showed that 72% of the British public support a complete ban and that only 3% of people even wear animal fur. This year alone, over 60 of my constituents have reached out and asked me to take action against ongoing fur sales. I am sure every Member participating in the debate has received similar correspondence. My constituents have made it clear that they have had enough of this cruel and often violent industry. Fur stoles in the UK are often taken from animals that are killed by electrocution after having spent their short, unhappy lives inside crowded cages.
John Spellar
Given that there is such overwhelming support in this House and among the public for taking this measure, can anyone understand why the Government are so reluctant to do something that might, for once, make them popular?
Taiwo Owatemi
I am hoping the Minister will be able to answer that. We all hope that the Government will be able to provide some clarity on when they hope to ban the sale of fur.
Fur is regularly imported from the EU and several other countries. This is completely unacceptable. It is once again up to this House to set the highest standard possible, deciding what trade we believe to be ethical and wish to permit. I urge colleagues across the House to join me in saying that Britain no longer wishes to permit the barbaric trade in animal fur, instead choosing to make history instead by being the first country in the world to ban the trade in full. I call on the Government to step up and support tough legislation that would see the fur trade consigned to history. I thank the hon. Member for Bury South (Christian Wakeford) for securing the debate. We must all continue to speak out against the terrible practice.
Christina Rees (in the Chair)
I want to call Front Benchers at 5.08 pm, so will the remaining two speakers be wary of that?
Sir Roger Gale (North Thanet) (Con)
Thank you, Ms Rees; I can be very brief. I had not intended to intervene at all, but I want to reinforce the point made by my hon. Friend the Member for Bury South (Christian Wakeford) and congratulate him on securing the debate.
It is many years since I went out on the ice with the International Fund for Animal Welfare and watched baby seals being clubbed to death and then skinned—either alive or dead—in the interest of what I believe is known as fashion. I do not think the animal knows very much whether it is a caged animal bred for fur or whether it is a wild animal slaughtered for fur. The fact of the matter is that neither of these practices should be acceptable in civilised society. Neither is necessary, because, as I said earlier, the synthetics are so good.
We know that a considerable amount of material is imported, very often as trim. Half the time, the people that are buying a pair of kids’ slippers or something with a fur trim on it do not actually know that it is real fur, and they would be horrified if they did know. There is only one way around this. My friend the right hon. Member for Leeds Central (Hilary Benn) said very correctly that it is completely anomalous that we should abandon fur farming in the UK and then allow the product to be imported from other countries. It has got to stop. It can stop now. The Government have a good track record of bringing forward animal welfare legislation, and I urge my hon. Friend the Minister to make sure that this is added to that portfolio. Let us stop it now.
Allan Dorans (Ayr, Carrick and Cumnock) (SNP)
It is a pleasure, as always to serve under your chairmanship, Ms Rees. Sometimes, we—[Interruption.]
Christina Rees (in the Chair)
Order.
Sitting suspended for Divisions in the House.
Christina Rees (in the Chair)
The debate may now continue until 5.54 pm, and I intend to call the Front Benchers at 5.32 pm.
Allan Dorans
Sometimes we imagine that our concern for the wellbeing of other species is very modern, but in 1783—nearly a quarter of a millennium ago—a young ploughboy, Rabbie Burns, Scotland’s bard, who was born in my constituency, wrote of the feelings of animals in his famous poems “To a Mouse”, “On Glenriddell’s Fox Breaking His Chain” and many others, clearly displaying his understanding that animals have feelings and suffer pain. By 2021, we have so much evidence of animal sentience that we must reconsider all our behaviour towards them.
In my short time as an MP, I have found myself writing to Ministers and speaking in the House, urging them to act on a wide range of animal welfare-related matters, including the Animal Welfare (Sentience) Bill, an end to lab testing with animals, stiffer penalties for cruelty to animals, a ban on the use of cages, traps and puppy farms, and of course an end to the fur trade. As the RSPCA put it:
“Evidence from multiple scientific studies has helped us to understand that a wide range of animals are sentient beings. This means they have the capacity to experience positive and negative feelings such as pleasure, joy, pain and distress that matter to the individual.”
As many as 2,500 scientific studies have proven the existence of animal sentience across a dizzying array of species. To put it simply, like us they know what it is to experience the horror of what we do to them, to live in agonising fear of it and—if they survive—to have to live with the memory of it.
The fur trade also means terror for sentient creatures. As one of my constituents put it to me:
“I don’t wear fur because I think it’s cruel. Every year around the world millions of animals are kept in small wire cages or caught in metal leghold traps before being brutally killed, all for a product no one needs, a frivolous piece of fur trim. The practice of keeping and rearing animals in cages unfit for purpose and to kill them for their fur for profit is barbaric, cruel and inhumane and for any country to condone and allow such fur to be imported and sold is equally as barbaric.”
The message is clear; the call for evidence is complete. A total ban on fur imports and sales is required, and it is required now.
Martyn Day (Linlithgow and East Falkirk) (SNP)
It is a pleasure to take part in the debate, and I am grateful to the hon. Member for Bury South (Christian Wakeford) for securing it, for the way in which he opened it and for his activity on this issue to date, leading up to it.
This has been a genuinely positive debate, with speakers from all parties in the House in common cause on banning fur imports. With regard to fur sales, my own attitude can quite simply be summed up as, “I just dinnae like it”, and I wholeheartedly agree that fur sales should be banned.
The process of fur farming can too often lead to unacceptable and cruel conditions for far too many animals. As fur imports in the UK are currently a reserved matter, it is incumbent on the UK Government to introduce a ban on the import of fur products. I know that view is shared by many of my constituents and indeed by many people throughout these isles. Indeed, several opinion polls in recent years have shown that a ban on fur imports would be overwhelmingly supported by the public.
So it will come as no surprise that I was delighted to be one of more than 100 MPs and peers to have signed the cross-party letter to the Environment Secretary organised by the hon. Member for Bury South, and to have been a signatory both to early-day motion 193, on “The fur trade in the UK”, which was tabled on 14 June 2021, and early-day motion 267, on “Real fur imports”, which was tabled on 9 March 2020. Indeed, many of my colleagues in the Scottish National party have also supported these calls. Animal welfare is an issue that we take extremely seriously and we support the steps to strengthen animal welfare legislation in the Scottish Government’s programme for government. As I have said, international trade is a reserved matter, and until we have the power to determine this matter for ourselves in Scotland we will continue to urge the UK Government to make the right decision, to listen to the people and to morally end the import of new fur products.
As we have heard, fur farming across the UK was banned in 2003 because of the related cruelty and suffering, and the importation of cat and dog fur has been illegal since December 2008. The import, export and sale of cat and dog fur, and of seal pelts, is already banned in the European Union. However, the UK Government continue to be guilty by proxy of that cruelty and suffering, with the equivalent of fur from around two million animals being imported to the UK each year.
Investigations show that the physical and mental abuse suffered by animals kept in barbaric conditions, which the industry professes to be humane, include the use of leghold traps and keeping animals for their entire lives in cages that are 1 metre square. Their deaths are equally horrific, with animals being beaten to death or even skinned alive, as we have heard from a number of speakers today.
Banning fur farming across the UK was world-leading and, with almost 20 European countries following suit, it showed what good leadership can achieve. The UK Government’s response to an e-petition calling for a fur import ban back in 2018 said that such a ban would be unlikely while Britain was a member of the EU. Now, it will not have escaped anyone’s attention that we are no longer a member of the EU, so I wonder whether the Minister can tell us what excuse the UK Government have now. Even the former chief executive of the British Fur Trade Association and director of standards at the International Fur Federation accepts that nothing
“would ever change the reality of these animals being stuck in tiny wire cages”.
In conclusion, although we have missed the chance to lead the world by banning the sale of fur across the UK—Israel has passed an amendment to its wildlife protection law to ban the sale of wild animal fur from any source and so has the state of California—can we not at least be among the front-runners in bringing an end to this brutal and inhumane industry?
I look forward to hearing the Minister’s response.
Olivia Blake (Sheffield, Hallam) (Lab)
It is a pleasure to serve under your chairship, Ms Rees. I thank the hon. Member for Bury South (Christian Wakeford) for calling this debate on an issue of great importance for so many of our constituents around the UK. The hon. Member referred to us as a nation of animal lovers and he painted a picture of an intolerable situation that the Government have the power to solve easily. We have had a good debate and we have heard a lot of support for action from across the Chamber.
It has been great to hear the different arguments made by many Members from different parties. We heard about how good synthetic fur quality is from the right hon. Member for North Thanet (Sir Roger Gale). We heard about the brutal treatment of animals and an upsetting description of the conditions they live in from the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar). We also heard that this issue matters to people across the UK. As my hon. Friend the Member for Pontypridd (Alex Davies-Jones) pointed out, in Wales a greater proportion of people—82%—back a ban.
I wanted to make some remarks about how long this journey has been. I am proud that my hon. Friend the Member for Garston and Halewood (Maria Eagle) introduced a Bill to ban fur farming in the UK that was turned into reality and made law over 20 years ago by a Labour Government. Britain was the first country to enact a ban on this cruel industry and I am pleased to see countries across Europe have since followed suit.
The ban was a huge step forward and as my hon. Friend the Member for Cambridge (Daniel Zeichner) eloquently said almost four years ago, while it halted the production of fur in the UK, fur farming was outsourced—a comment that was echoed today by my right hon. Friend the Member for Leeds Central (Hilary Benn). It was also pointed out that we have a huge opportunity and things have changed since then.
My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) raised the point that trade deals could help halt the trade and could hold countries to account to stop these practices. We know that other countries have less stringent animal welfare regulations, and that should be pursued. Although the public mood against the fur trade is overwhelming, we have yet to cut our economic ties to the trade completely and the UK continues to import and export tens of millions of pounds of fur products each year. This must stop. As long as we are trading these products, we are complicit in their production. It is right that we support a ban on trading fur in the UK and part of that must involve addressing the scandal of real fur being passed off as fake, as was mentioned today.
Some argue against a ban by claiming the need for fur to be ethically sourced instead, but it is well known that these so-called ethically sourced schemes unfortunately fall short. It is difficult to understand what best practice could mean as regards the conditions these animals are kept in. We know best practice in animal welfare can be so poor that it means very little. How could best practice be anything but poor? It is impossible to keep wild animals in captivity in the conditions we have heard about and to tend to their welfare.
Perhaps the most damaging examples to advocates of ethical sourcing are places like Germany and Sweden where the fur industry is being phased out. That is because the rules in those countries for the welfare of foxes and mink in captivity are so high that businesses are simply not profitable. We heard about the impact on public health and those examples demonstrate that cruelty cannot be regulated out of the industry and that it poses extra risks—unfortunately, it is a requirement for the industry to function successfully.
There is a direct contradiction between the ethical treatment of animals and the commercial viability of the fur trade, so I welcome the Government’s consultation on the sale of fur in the UK. I wonder why it has not come sooner. When I was preparing for this debate, I read through the robust Westminster Hall debate on the issue almost four years ago. My hon. Friend the Member for Cambridge concluded by praising the standard of the contributions just as I have, but warned:
“My worry is that they will think that all we have had is a debate. That is the challenge for the Minister to go away to think about.”—[Official Report, 4 June 2018; Vol. 642, c. 32WH.]
The Minister has been thinking about it for a long time now. What is the timetable for the consultation, and when does the Government hope to legislate?
My hon. Friend the Member for Coventry North West (Taiwo Owatemi) was right in her recent speech in the House that our moral objection to the fur trade should not be bargained away in any future trade deals. There really is no time to lose. I was so pleased to hear her excellent contribution today. I hope the Minister can provide us with more answers on timescales and where we want to get to. Clearly, the whole House is behind this.
Christina Rees (in the Chair)
Would the Minister be so kind as to leave a couple of minutes at the end for summing up?
The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Rebecca Pow)
Of course I will, Ms Rees. I thank my hon. Friend the Member for Bury South (Christian Wakeford) for bringing this debate, and all other hon. Members who have spoken today. It is obvious from the speeches and all those interventions that there is great strength of feeling on this topic. I spoke on it myself as a Back Bencher when I was in the all-party parliamentary group for animal welfare. Similarly, the support for the early-day motion that my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) has tabled shows the strength of feeling.
We know that we are a nation of animal lovers. We were the first country in the world to pass legislation to protect animals, and we have developed a lasting legacy of improving and enhancing animal health and welfare. I do not think anyone in this room would deny that. Since 2010 we have banned the use of conventional battery cages for laying hens, made CCTV mandatory in slaughterhouses, modernised our licensing system for dog breeding and pet sales, introduced the popular Finn’s Law, banned the commercial third-party sales of puppies and kittens and led work to implement humane trapping standards. However, we do have the opportunity to do more and go further. Animal welfare is an absolute priority of the Government, as I think that raft of measures demonstrates.
We have outlined our aims and ambitions for improving animal welfare in our action plan, published on 12 May. We have introduced landmark legislation in this Session that will recognise animals as sentient beings in UK law, and we are establishing an expert committee to ensure that animal sentience is considered as part of policy making. We have launched the Animal Welfare (Kept Animals) Bill, which will introduce new powers to crack down on puppy smuggling, a ban on the live export of animals for fattening and slaughter, a ban on keeping primates as pets, and new powers for police to provide greater protection to livestock from dangerous and out of control dogs. I think Members will agree that it is an impressive list.
As Members know, fur farming has been banned in England and Wales since 2000 and in Scotland and Northern Ireland since 2002. There are also restrictions on some skin and fur products that cannot be legally imported into the UK. Those include fur and products from cats and dogs and sealskin products from commercial hunts. There is a small exemption there for subsistence seal farming by individual groups. We have established controls on fur from endangered species protected by the convention on international trade in endangered species—CITES—and we do not allow imports of fur from wild animals caught using methods that are not compliant with international humane trapping standards.
However, it is still possible to import other types of fur from abroad. In our action plan for animal welfare, the Government committed to exploring further action in this area, which we are free to do now that we have left the EU. I wanted to stress that point particularly, and it has been mentioned by a number of Members today. Bear in mind, as well, that some nations in the EU still have fur and mink farming and so on. We are building a strong evidence base on which to inform any future policy, noting information from a range of sources, including industry associated with the fur trade and notable retailers who have recently gone fur free. A list was mentioned just now, but they include the likes of Adidas, H&M, Lacoste, Mango, Marks & Spencer, charities and other organisations, as well as a range of fashion designers including Stella McCartney, Vivienne Westwood, Prada, Armani, Burberry and Chanel. I am sure lots of hon. Members and hon. Friends are wearing some of those brands today, because it is Second Hand September; I am.
Alex Davies-Jones
The Minister makes the important point that high street retailers and consumers want to do the most ethical thing by buying items marketed as faux fur or synthetic fur, but when tests are carried out unfortunately it turns out they are real fur, because it is cheaper to use real fur than faux fur. Can the Minister outline what she is doing to counteract this? Consumers think they are doing the right thing, but we need to make sure that they really are.
Rebecca Pow
That point was raised by a number of Members today, including the hon. Members for Rutherglen and Hamilton West (Margaret Ferrier), for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), who is no longer in her place, and for Kingston upon Hull West and Hessle (Emma Hardy). It is a good point and the Government recognise the moral concern that some consumers have about whether the fur is real and whether labels are correct.
Information has been given to businesses requiring them to be accurate and not misleading. Labelling that contains false or misleading information, or omits material information that consumers need to make an informed decision, is prohibited. The textile labelling regulations require that the presence of fur and other non-textile parts of animal origin, such as leather and pearls, are labelled. We have a clear system and if anyone feels there is a breach it should be reported to the Citizens Advice consumer service.
Tracey Crouch
The Minister may well be aware that a Humane Society International and YouGov poll has shown that 93% of the British population do not want to wear fur. While I press her to ban the import of fur, will she also please sit down with the British fashion industry and encourage it to take a lead on this issue across the world as well?
Rebecca Pow
I thank my hon. Friend for that; it is a good point. I work with the fashion industry on a range of issues, not least recycling and fast fashion. When I speak to them about those issues I will be pleased to make reference to that point as well.
I was asked about faux fur. I have a faux fur jacket, but I am now afraid to wear it in case anybody thinks it is real. It is clearly faux fur and has all the labelling, but I have steered away from it.
Moving on, we are building a strong evidence base. We published our formal call for evidence on the fur trade on 31 May. That was a key step in helping us to improve our understanding of the sector and we have received an incredible 30,000 responses from businesses, representative bodies and individuals, demonstrating the strong feeling in this area, as many have suggested today.
Officials have been analysing the responses that we have received and we have been engaging directly with stakeholders in order to further the Government’s understanding of the sector. That has included meeting with industry representatives and the British Fur Trade Association, as well as animal welfare groups, such as the Humane Society International. We will use all the evidence to inform any future action on the fur trade. A summary of responses to the call for evidence, setting out the results and any next steps in the policy, will be published at a later date.
As ever, we will work closely with the devolved Administrations, and the formal call for evidence on the fur sector in Great Britain was published jointly with Scotland and Wales. As was pointed out earlier on the international front, the matter is devolved, but the call was published together.
Olivia Blake
It sounds as though the Minister has a collection of information to inform her, but it is unclear when the matter will be considered again. Is there a timeline for when a law could be brought forward?
Rebecca Pow
As I just said, we received an awful lot of data—30,000 responses that must be ploughed through in the correct manner—so we will publish the results at a later date.
Touching on the disease issue raised by several hon. Members, the emergence of covid and its global impact reminds us of the importance of interactions between humans, animals and the environment. That is another reason why we need to work together to understand better how our behaviour, supply chains and cultures can change those interactions and create risks. The Government are committed to building a clear body of evidence on that, because it is really important.
To wind up, I hope that Members here will understand that I am not in a position to announce any next steps on the fur trade, and it is vital that any future policies are based on robust evidence. I hope that past action and recently introduced legislation demonstrate this Government’s clear commitment to treat our animals in the right way. I listed the many measures that we have brought in recently, many of which also address unacceptable practices abroad. We have an opportunity to set a clear global sense of direction, including on international conservation and trade. I thank my hon. Friend the Member for Bury South for securing today’s debate.
Christian Wakeford
I now face the audacious task of trying to read my own writing. Parliament is truly at its best when there is clear cross-party support, although I hope the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) will forgive me for disagreeing slightly about this being a reason to push further for Scottish independence.
I thank the Minister for her response. There were certainly some very warm words, and it looks like the start of us heading in a certain direction. However, I urge haste because for every day we delay, millions of animals face these conditions, which is clearly incorrect. I invite the Minister to my fur-banning reception in the Palace on 16 November. Indeed, if she wants to hear more, I am also speaking at the Conservative Animal Welfare Foundation during the party conference.
In closing, Gandhi said that the
“greatness of a nation…can be judged by the way its animals are treated.”
Let us be a fair, humane and compassionate Britain but, more importantly, let us be a great Britain.
Question put and agreed to.
Resolved,
That this House has considered real fur sales in the UK.
Written Statements
(3 years, 3 months ago)
Written StatementsRead Full debate Read Hansard Text
Controls on Incoming Goods from EU
(3 years, 3 months ago)
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The Paymaster General (Penny Mordaunt)
My noble Friend the Minister of State in the Cabinet Office, the right hon. Lord Frost CMG, has today made the following written statement:
On 31 December 2020, the UK left the EU’s Single Market and Customs Union. The Government put in place the staffing, infrastructure, and IT to ensure a smooth transition. Thanks to the hard work of traders and hauliers, we did not see disruption at our ports; and, despite dips in trade value with the EU in the early months, the monthly value of exports to the EU has recovered strongly.
Now the UK is an independent trading country, our intention is to introduce the same controls on incoming goods from the EU as on goods from the rest of the world.
The Government initially announced a timetable for the introduction of the final stages of those controls on 11 March. The Government’s own preparations, in terms of systems, infrastructure and resourcing, remain on track to meet that timetable.
However, the pandemic has had longer-lasting impacts on businesses, both in the UK and in the European Union, than many observers expected in March. There are also pressures on global supply chains, caused by a wide range of factors including the pandemic and the increased costs of global freight transport. These pressures are being especially felt in the agri-food sector.
In these circumstances, the Government have decided to delay further some elements of the new controls, especially those relating to sanitary and phytosanitary goods. Accordingly:
The requirement for pre-notification of agri-food imports will be introduced on 1 January 2022 as opposed to 1 October 2021.
The new requirements for export health certificates, which were due to be introduced on 1 October 2021, will now be introduced on 1 July 2022.
Phytosanitary certificates and physical checks on SPS goods at Border Control Posts, due to be introduced on 1 January 2022, will now be introduced on 1 July 2022.
The requirement for safety and security declarations on imports will be introduced as of 1 July 2022 as opposed to 1 January 2022.
The timetable for the removal of the current easements in relation to full customs controls and the introduction of customs checks remains unchanged from the planned 1 January 2022.
The Government will work closely with the Devolved Administrations on the implementation of this new timetable, given their devolved responsibilities for agri-food controls.
Full guidance to stakeholders will be provided on www.gov.uk shortly.
[HCWS285]
AQUIND Interconnector: Application for Development Consent
(3 years, 3 months ago)
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The Secretary of State for Business, Energy and Industrial Strategy (Kwasi Kwarteng)
This statement concerns an application for development consent made under the Planning Act 2008 by AQUIND Ltd for the construction, operation, maintenance and decommissioning of the UK elements of a 2,000MW bi-directional subsea electrical power interconnector between Normandy in France and Lovedean in Hampshire.
Under section 107(1) of the Planning Act 2008, the Secretary of State must make a decision on an application within three months of the receipt of the examining authority’s report unless exercising the power under section 107(3) of the Act to set a new deadline. Where a new deadline is set, the Secretary of State must make a statement to Parliament to announce it. The deadline for the decision on the AQUIND interconnector application was 8 September 2021.
I have decided to set a new deadline of no later than 21 October 2021 for deciding this application to allow an opportunity for further information in respect of compulsory purchase powers to be provided and considered.
The decision to set the new deadline for this application is without prejudice to the decision on whether to grant or refuse development consent.
[HCWS286]
Covid-19: Booster Programme
(3 years, 3 months ago)
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The Minister for Covid Vaccine Deployment (Nadhim Zahawi)
The UK’s covid-19 vaccination programme is a recognised success. As of 12 September 2021, 89% of people aged 16 and over in the UK have received one dose of a covid-19 vaccine, and 80% have had their second dose. Public Health England estimate over 143,600 hospitalisations and 108,600-116,200 deaths have been prevented to date by the vaccination programme in England to date[1].
The independent Joint Committee on Vaccination and Immunisation (JCVI) has published its advice on covid-19 booster vaccinations. Her Majesty’s Government (HMG) have accepted this advice and all four parts of the UK intend to follow the JCVI’s advice.
In JCVI’s view, the primary objective of a 2021 covid-19 booster programme is to maintain protection against severe covid-19 disease, specifically hospitalisation and deaths, over winter 2021-22. They have noted that this is exceptional advice aimed at maintaining protection in those most vulnerable, and to protect the NHS.
The JCVI’s advice is based on evidence from a number of sources, including UK data on the duration of vaccine-induced protection against severe covid-19. The Committee note that, as not enough time has passed to enable a clear understanding of the level of protection six months after completion of the primary vaccine course in all persons, extrapolation of some data has been required. Taking a precautionary position, JCVI considers that on balance, it is preferable to ensure protection is maintained at a high level throughout the winter months in adults who are more vulnerable to severe covid-19, rather than implement a booster programme too late to prevent large increases of severe covid-19 in previously double vaccinated individuals.
JCVI advises that for the 2021 covid-19 booster vaccine programme individuals who received vaccination in phase 1 of the covid-19 vaccination programme—priority groups 1-9 —should be offered a third dose covid-19 booster vaccine. This includes:
Those living in residential care homes for older adults.
All adults aged 50 years or over.
Frontline health and social care workers.
All those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe covid-19—as set out in the Green Book—and adult carers.
Adult household contacts of immunosuppressed individuals.
As most younger adults will only have received their second covid-19 vaccine dose in late summer or early autumn, the benefits of booster vaccination in this group will be considered at a later time when more information is available. In general, younger, healthy individuals may be expected to generate stronger vaccine-induced immune responses from primary course vaccination compared to older individuals. Pending further evidence otherwise, booster doses in this population may not be required in the near term. JCVI will review data as they emerge and consider further advice at the appropriate time on booster vaccinations in younger adult age groups, children aged 12-16 years with underlying health conditions, and women who are pregnant.
JCVI advises that the booster vaccine dose is offered no earlier than six months after completion of the primary vaccine course, and that the booster programme should be deployed in the same order as during phase 1, with operational flexibility exercised where appropriate to maximise delivery. Persons vaccinated early during phase 1 will have completed their primary course approximately six months ago. Therefore, it would be appropriate for the booster vaccine programme to begin in September 2021, as soon as is operationally practicable.
JCVI advises a preference for the Pfizer vaccine to be offered as the third booster dose irrespective of which product was used in the primary schedule. There is good evidence that the Pfizer vaccine is well tolerated as a third dose and will provide a strong booster response.
Alternatively, individuals may be offered a half dose (50pg) of the Moderna vaccine, which should be well tolerated and is also likely to provide a strong booster response. A half dose (50pg) of Moderna vaccine is advised over a full dose due to the levels of reactogenicity seen following boosting with a full dose within the CoV-Boost trial.
Where mRNA vaccines cannot be offered e.g. due to contraindication, vaccination with AstraZeneca vaccine may be considered for those who received AstraZeneca vaccine in the primary course.
With deployment of booster vaccines imminent, I am now updating the House on the liabilities HMG has taken on in relation to further vaccine supply via this statement and a Departmental Minute containing a description of the liability undertaken. The agreement to provide indemnity with deployment of further doses to the population increases the statutory contingent liability of the covid-19 vaccination programme.
Given the proximity between receiving JCVI advice and deployment, we regret that it has not been possible to provide 14 sitting days’ notice to consider these issues in advance of the planned booster vaccination in the UK.
Deployment of effective vaccines to eligible groups has been and remains a key part of the Government’s strategy to manage covid-19. Willingness to accept the need for appropriate indemnities to be given to vaccine suppliers has helped to secure access to vaccines with the expected benefits to public health and the economy alike much sooner than may have been the case otherwise.
Given the exceptional circumstances we are in, and the terms on which developers have been willing to supply a covid-19 vaccine, we along with other nations have taken a broad approach to indemnification proportionate to the situation we are in.
Even though the covid-19 vaccines have been developed at pace, at no point and at no stage of development has safety been bypassed. The MHRA approval for use of the currently deployed vaccines clearly demonstrates that these vaccines have satisfied, in full, all the necessary requirements for safety, effectiveness, and quality. We are providing indemnities in the very unexpected event of any adverse reactions that could not have been foreseen through the robust checks and procedures that have been put in place.
I will update the House in a similar manner as and when other covid-19 vaccines or additional doses of vaccines already in use in the UK are deployed.
HM Treasury has approved the proposal.
A Departmental Minute will be laid in the House of Commons providing more detail on this contingent liability.
[1] PHE covid-19 vaccine surveillance report: 9 September 2021: https://www.gov.uk/government/publications/covid-19-vaccine-surveillance-report
[HCWS288]
Covid-19 Vaccine: 12-15 Year Olds
(3 years, 3 months ago)
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The Minister for Covid Vaccine Deployment (Nadhim Zahawi)
Her Majesty’s Government (HMG) have decided, based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) and further advice from the UK Chief Medical Officers (CMOs), that a first dose of Pfizer-BioNTech covid-19 vaccine should be offered to all children and young people aged 12-15. This is the remaining group not already eligible for vaccination under earlier JCVI advice on 12-15 year olds at risk of serious outcomes from covid-19.
The JCVI advised on 3 September that for healthy 12-15 year olds the health benefits from vaccination were marginally greater than the potential known harms but that the margin of benefit, based primarily on a health perspective, was too small for the Committee to advise a universal programme of vaccination. The JCVI suggested that the Government might wish to seek further views on the wider societal and educational impacts from the CMOs of the four nations.
The CMOs worked with a range of experts including representation from the JCVI looking at this wider picture. The advice, received on 13 September, sets out that overall the view of the UK CMOs is that the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI to recommend in favour of vaccinating this group. The CMOs recommend that on public health grounds that Ministers extend the offer of universal vaccination with a first dose of Pfizer- BioNTech covid-19 vaccine to all children and young people aged 12-15 not already covered by existing JCVI advice.
HMG has accepted this advice and all four parts of the UK expect to follow the advice and align their deployment in each nation.
For children and young people, the risk of serious outcomes from covid-19 is much lower than for older people and we recognise that decisions on vaccination for this group are therefore much more finely balanced than for adults.
All 12 to 15-year-olds will now be offered a first dose of Pfizer-BNT162b2 vaccine. The JCVI will be asked to consider in due course whether a second dose is appropriate taking into account emerging international evidence. This is in addition to the existing offer of two doses of vaccine to 12 to 15 year-olds who are in ‘at-risk’ groups as described in Public Health England’s Green Book, last updated on 3 September 2021.
I am now updating the House on the liabilities HMG has taken on in relation to further vaccine deployment to this group via this statement and a Departmental Minute containing a description of the liability undertaken. The agreement to provide indemnity with deployment of further doses to the population increases the statutory contingent liability of the covid-19 vaccination programme for the vaccine the JCVI has recommended should be used in those aged under 18, the Pfizer/BioNTech vaccine.
Deployment of effective vaccines to eligible groups has been and remains a key part of the Government’s strategy to manage covid-19. Willingness to accept the need for appropriate indemnities to be given to vaccine suppliers has helped to secure access to vaccines with the expected benefits to public health and the economy alike much sooner than may have been the case otherwise.
Given the exceptional circumstances we are in, and the terms on which developers have been willing to supply a covid-19 vaccine, we along with other nations have taken a broad approach to indemnification proportionate to the situation we are in.
Even though the covid-19 vaccines have been developed at pace, at no point and at no stage of development has safety been bypassed. The MHRA approval for use of the currently deployed vaccines clearly demonstrates that this vaccine has satisfied, in full, all the necessary requirements for safety, effectiveness, and quality. We are providing indemnities in the very unexpected event of any adverse reactions that could not have been foreseen through the robust checks and procedures that have been put in place.
Given the proximity between the announcement and deployment to this group, we regret that it has not been possible to provide 14 sitting days’ notice to consider these issues in advance of the planned vaccination of these groups in the UK.
I will update the House in a similar manner as and when other covid-19 vaccines or additional doses of vaccines already in use in the UK are deployed.
HM Treasury has approved the proposal.
A Departmental Minute will be laid in the House of Commons providing more detail on this contingent liability.
[HCWS287]