Westminster Hall

Tuesday 16th May 2023 Westminster Hall

Tuesday 16 May 2023

[Dr Rupa Huq in the Chair]

People with Disabilities: Cost of Living

Tuesday 16th May 2023 Westminster Hall

09:37

[Marion Fellows (Motherwell and Wishaw) (SNP)]

I beg to move,

That this House has considered the cost of living for people with disabilities.

It is a real pleasure to serve under you, Dr Huq. In the years in which I have had the privilege of being the Member of Parliament for Motherwell and Wishaw, I have received loads of briefings from many organisations to support my work in these types of debate. For this debate, I have received a record number of briefings, and they have come from these organisations, which I shall name check: Scope, the Food Foundation, Guide Dogs, the British Association of Social Workers, the MS Society, Which?, Mencap, the Cystic Fibrosis Trust and the Motor Neurone Disease Association. That tells its own story.

Those organisations are so worried. They are telling me that the Government have continuously failed disabled people, their carers and their families; that the Government are tinkering around the edges of a cost of living crisis that is affecting millions of people across the United Kingdom; and that the impact of the crisis affects those with disabilities, their carers and their families even more seriously than it affects the rest of the population.

I woke this morning to the news that the Prime Minister is having a farm-to-fork summit on the cost of food—the figure of 19.1% is being bandied about as a headline for food price inflation—and when I opened my iPad, I read about a father who had admitted to stealing baby formula to feed his child because his wife had been watering down the formula. That is the UK in 2023, and the situation is even worse for disabled households.

Scope’s recent disability price tag report shows that the cost of being disabled in 2023 has risen to £975 per month for a disabled household, inclusive of disability benefits. People do not get disability benefits on top; that is inclusive. The personal independence payment was designed to offset the additional costs associated with being disabled, but it is now totally inadequate. That figure represents a £300 per month increase from 2016-17, when Scope last did this. Scope also says that it would be £1,122 per month if the figure were updated to accommodate the inflationary costs for the 2022-23 period. The bottom line is that Government support for those with disabilities has been wholly inadequate throughout the cost of living crisis. Disability Rights UK has said that the cost of living payments “don’t touch the sides”.

[Christine Jardine (Edinburgh West) (LD)]

The hon. Lady is making a powerful argument. The Resolution Foundation said recently that those with disabilities have 44% less available to spend in the current economic crisis than those of us who are fortunate enough to be fully abled. At a time when energy costs have made life more difficult for everyone, does she think that we have perhaps missed a vital opportunity to support the disabled by helping them more with those costs?

[Marion Fellows]

The hon. Lady will know that I do not often agree with her, but in this case I totally agree. There are many other organisations—she mentioned the Resolution Foundation, and the MND Association has outlined that those with motor neurone disease face additional costs of £14,500 per year. Naturally, those with the condition have much higher energy needs in order to power their essential, life-saving equipment.

[Margaret Greenwood (Wirral West) (Lab)]

The latest Government statistics show that 68% of PIP decisions appealed by a claimant were overturned. Does the hon. Member agree that there is a pressing need to improve the PIP assessment to ensure that people who are disabled or have a serious health condition do not have to fight continually through reassessments and tribunals to get the support that they so desperately need?

[Marion Fellows]

I could not agree with the hon. Lady more. This is a scandal, and it is a huge waste of public money with the number and cost of appeals and tribunals.

[Justin Tomlinson (North Swindon) (Con)]

To follow on from that point, why would the Scottish Government seek to make it harder for people to access support through the PIP system for when it is fully devolved to the Scottish Government?

[Marion Fellows]

I wish that the hon. Member would take that back. In Scotland, we treat people with dignity, fairness and respect. We help them to fill in their adult disability payment applications, and we make it much easier for them—[Interruption.] The hon. Member is shaking his head, but he is wrong. We make it easier for people with long-term illnesses from which they will not recover. They do not have to go through continuous reassessments.

[David Linden (Glasgow East) (SNP)]

Will my hon. Friend point out to the hon. Member for North Swindon (Justin Tomlinson) that unlike the UK Government and their pernicious welfare system, the Scottish Government have actually worked with people with experience of the benefits system and those who have disabilities in designing that system? It is rather rich that he lectures us from a Tory Government who have been found to have treated people rather inhumanely.

[Marion Fellows]

I thank my hon. Friend for that. I am appalled at the remarks being made. I shall move forward and I will not take any further interventions in the meantime; I need to make progress.

The insufficient cost of living support, combined with an inadequate system of social security and an economic crisis created by this Government and their predecessors, have created an unwelcome perfect storm for those with disabilities, plunging millions into poverty. Disabled people often face higher costs for their energy, and they are saying that they need more heating—most disabled people need more heating to stay warm. Others say that they must use more electricity simply to plug in their assistive technologies. Those extra costs mean that disabled people have less money in their pockets and, in many cases, go without. The result is that disabled people are more likely to have a lower standard of living, even when they earn the same as a non-disabled person.

According to the British Association of Social Workers, 7 million people—almost half of those living in poverty in the UK—are either disabled or live with someone who has a disability. Families with a disabled loved one are seriously struggling as they have to make difficult decisions and cutbacks. Guide Dogs UK has highlighted how families with a child with visual impairment are being hit incredibly hard, and the mental health of parents is suffering.

The disabled poverty figures are unsurprisingly reflected in food bank usage, with the Trussell Trust advising the Work and Pensions Committee that disabled people are hugely overrepresented in food poverty. More than half of food bank users in the UK are disabled.

The covid pandemic deepened pre-existing inequalities in society for disabled people, and the rise in inflation has disproportionately hurt the most vulnerable in society. Disabled people and their households have, on average, lower incomes than their non-disabled counterparts in spite of incurring higher costs. Poverty and disability are often mutually reinforcing, particularly for working-age adults.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

The hon. Lady is making a powerful speech about the absolute travesty of the Government’s treatment of disabled people and the social security cuts that have been added to by the cost of living crisis. Is she as concerned as I am that there will be consequences, including, as we have seen over the past few years, disabled people on social security who will die?

[Marion Fellows]

That is the most awful fact and the most worrying thing that has been said today. Many of us in this Chamber will have direct knowledge of that from casework and constituents we have had to deal with.

As I said, disabled people tend to spend more on essential goods and services. People with special dietary requirements have been particularly hard hit by food inflation. Statistics from January this year show that households with specific dietary requirements pay up to 73% more for food than those who do not need to buy “free from” products, according to analysis by The Allergy Team.

In December 2022, the Food Standards Agency found that households with food hypersensitivity—food allergy, intolerance and coeliac disease—spent an extra 14p for every £1 compared with those who did not need to buy alternatives. For example, pea milk is £2 a litre—50% more expensive than cow’s milk. Gluten-free penne pasta at Morrisons jumped by 125% in 12 months, from 60p in January 2022 to £1.35 in January this year. I have many other examples.

The SNP urges the Government to use all the powers at their disposal to tackle the cost of living crisis on the scale required. We continue to push them to use their powers to tackle the cost of living crisis, including access to borrowing, providing benefits and support to households, VAT on fuel, taxation of windfall profits and regulation of the energy market. The reversal of the planned increase in the energy price guarantee is welcome, but bills will still be unsustainable for many people. Disabled people and their carers and families across the UK are paying a steep price for the economic mismanagement of the UK Government, with the cost of living forcing many to choose between heating their homes or eating.

Everyone welcomes the UK Government’s increase in benefits by 10.1%. However, the Chancellor has yet again failed to reinstate the universal credit uplift and scrap the unfair benefit cap and two-child limit. Scope stated that a further long-term solution was required to address the crisis of costs that many disabled households now face. Legacy benefit claimants, many of whom are long-term sick or disabled, have been unjustly denied the additional uplift that universal credit claimants got during the pandemic. The SNP has consistently called on the Government to reinstate the uplift and increase it to £25 a week, and to extend it to all means-tested legacy benefits, as well as getting rid of the benefit cap and the two-child limit. The UK Government’s continual refusal to fix the extensive known problems with universal credit is unacceptable and is subjecting vulnerable people to additional unnecessary hardship.

Although a one-off additional payment of—wait for it—£150 to disabled people is welcome, it will not provide the same kind of long-term assistance as a benefits uplift. As I said, Disability Rights UK says that the lack of “meaningful increases” in disability benefits over recent years means that the payment is not enough and does not “touch the sides” of what disabled people, families and carers need. Rising food bank need demonstrates that more and more people are going without the essentials, and the Trussell Trust said:

“The level of benefits, especially benefits for people who are sick and disabled, needs to be high enough for people to live.”

I remember sitting in the main Chamber and listening to a Tory Member who was surprised that sickness benefit was £92-something, which she thought was quite generous. She thought that was a daily rate. It is a weekly rate, and it has not increased by that much. We cannot continue like this. We are punishing the most vulnerable people in our society.

According to a 2020 report from the Royal British Legion and Poppyscotland called “Making the benefits system fit for Service”,

“households containing working age adults in the ex-Service community are over twice as likely to receive sickness or disability benefits as UK adults. Within that increased likelihood there will be veterans in receipt of military compensation who may rely on welfare benefits more than their peers, such as those who are unable to undertake civilian employment due to their injury or disability having left Service ”.

Research participant responses demonstrated common themes, from problems completing applications to difficulties explaining the impact of service-related conditions on wellbeing. The research was conducted prior to the introduction of the adult disability payment in Scotland. I should like to ask the Minister: what are the Government going to do about this scandal? Organisations are telling me that the measures already announced have little or no impact because of spiralling food inflation and energy costs.

According to the House of Commons Library, the Government’s planned expenditure on Trident renewal for 2023-24 is £3 billion. The UK Government are making a political choice to spend vast amounts during a cost of living crisis—an obscene commitment to spend money on the renewal of nuclear weapons in the face of the difficulties being met day and daily by the most vulnerable people in the United Kingdom.

The UK’s recent spring Budget was another missed opportunity for the Government to take meaningful action to boost income and support households, including disabled people—really, you have to do better. The changes to UK benefits and the wider support to better meet the needs of disabled people are welcome, but the effect of those changes must not force more people into low-paid and insecure employment. The disability pay gap must be looked at seriously by the Government. Will the Minister tell us what they are actively doing to end it?

The health and disability White Paper introduces a new universal credit health element, with eligibility through PIP that could be much more restrictive than the work capability assessment. Around 45% of “no work requirements” universal credit recipients in Scotland are not in receipt of either a disability benefit—such as attendance allowance, disability living allowance or personal independence payment—or carer’s allowance. Once the policy is enacted, divergences between PIP and ADP could result in diverging conditionality and spend on universal credit. As the Minister will no doubt acknowledge, I have already raised this issue with him. Can we have an update on what is happening there? Disability organisations are concerned that the changes are likely to see fewer sick and disabled people getting the support they need.

The new in-work progression offer to help people into work, increase their earnings and move them into better-paid jobs will inevitably mean that disabled people are exposed to the sanctions regime. By September this year, 600,000 people claiming universal credit, including disabled people and those with physical and/or mental health conditions, will be required to meet a work coach to increase their hours or earnings or risk being sanctioned. We know that sanctions do not work; the Government admitted that in the paper they kept hidden for quite a long while.

The health and disability White Paper is a missed opportunity to implement much-needed changes. The MS Society has outlined how the Government’s White Paper does not include substantive plans for how the PIP process will be improved or any information on how the criteria may be reformed. Those are real issues right now and there is not much hope, looking forward, for people with disabilities.

The Scottish Government have taken action, within their devolved powers and fixed budget, that will help disabled people facing the combined effects of higher energy bills, rising inflation and UK Government policies. In Scotland, the Government believe that disabled people should have freedom, dignity, choice and control over their lives, and they want to remove barriers that prevent disabled people from enjoying equal access to full citizenship.

The Scottish Government have therefore introduced things such as the fuel insecurity fund. They also work with Fuel Bank Foundation, the Scottish Federation of Housing Associations, Advice Direct Scotland and the Wise Group. Similarly, core staff costs will be provided to Energy Action Scotland, as Scotland’s national fuel poverty charity. The Scottish Government are trying their best; I do not see that level of commitment and action from the UK Government.

Throughout February and March this year, almost 400,000 low-income households in Scotland automatically received £50 in financial support towards their energy bills, in addition to what the UK Government have done. The Scottish Government are also doing a lot of other things, including increasing carer’s allowance. They are doing their best but, without the full powers, including borrowing powers, it is impossible for them to do much more. I should also point out that partnership working is much more normal practice in Scotland. No Government policy is introduced without taking into account the lived experience of people affected by that policy, and I urge this Government to take the same approach.

I realise we are short of time, so I would like to close by pleading with the Government once again to exercise some empathy and compassion for those with disabilities and to try to embody the sense of humanity demonstrated by Kevin Sinfield towards his friend Rob Burrow on Sunday. We must remember that each and any one of us can become disabled. The Government must act now to offer greater support to those with disabilities to offset the additional costs during the cost of living crisis.

[Mr Gregory Campbell (East Londonderry) (DUP)]

The hon. Lady alluded to the moving and emotional scenes of Kevin Sinfield carrying his friend over the finishing line. Does she agree that that eloquent video spoke more to the heart of the nation than any moves by any Government could ever do, unless they put money where their mouths are?

[Marion Fellows]

I could not have put that better myself; that is so true. I had help writing this speech, as many of us do, and my young researcher put in that reference; I did not see that event, because I did not watch any TV over the weekend—I completely switched off. It is true that something like that brings a nation together to understand how we must be more caring. It is not about being nice to people; it is about enabling them to live full lives as full citizens.

[Debbie Abrahams]

Kevin Sinfield is my constituent and a good friend. The House should know that his fundraising started because he was concerned about the future of his friend and his friend’s family. The families of severely disabled people are worrying for their futures—for their survival. That is what prompted him to start fundraising—not just to do the research, but to ensure they had a future together.

[Marion Fellows]

The question of people becoming disabled through no fault of their own is germane to the entire debate. The perception is often that disabled people are the folk we see in wheelchairs who have always been unable to do things. So many people suffer from disabilities through accident or disease, and none of that is foreseeable—whole lives change.

This is my conclusion, I assure you, Dr Huq. Let me lay out disability organisations’ simple asks, which will improve the lives of so many people. Will the Minister talk about Government funding for a social energy tariff that discounts energy bills by 50% for disabled people, carers and those on low incomes? Could people be automatically enrolled in that scheme and could it be mandatory for all suppliers? Will the Government reverse the warm home discount eligibility criteria changes, uprate benefits in line with inflation and ban all forced installations of prepayment meters? Can hon. Members believe that people with disabilities are having prepayment meters forced on them in 2023? May I have the Minister’s assurance that he will look at all those asks, make sure they are acted on and thus end the misery for so many of our disabled citizens, their carers and their families? They are not asking for charity; they are asking for equity. All the people I have spoken about deserve so much better.

[Dr Rupa Huq (in the Chair)]

There are three Back Benchers down to speak. I will take the three winding-up speeches from 10.28 am—we do not get any extra time because of the late start—so speeches should be limited to about eight and a half or nine minutes. I call Justin Tomlinson.

10:02

[Justin Tomlinson (North Swindon) (Con)]

Thank you, Dr Huq—a double thank you for your late substitution this morning, for which we are all very grateful. It is a pleasure to follow the hon. Member for Motherwell and Wishaw (Marion Fellows), who clearly demonstrated a real passion for this important subject. I think her constituents would recognise that she is a real champion for those who need a voice in this area, and I pay genuine tribute to her.

I also pay tribute to the Minister, who I know will respond in full. He has immersed himself in the details of his role and has always shown himself willing to engage with stakeholders. I think we would all agree that there is a wealth of knowledge and expertise in local and national organisations, and the Minister is passionate to utilise that wherever possible. That has come through very clearly in his time as a Minister.

I pay tribute to local and national organisations up and down the country that provide people with advice and support in accessing the often complex and daunting layers of support that are potentially available. For example Tim Saint, of the Swindon Carers Centre, does a huge amount of work in our community to help people access support. During my time as a Minister, I was surprised to see how many people miss out on the various forms of support that we have all voted to give them, often because they are faced with a complex and daunting system.

We have made progress. Under PIP, including the legacy benefits of DLA, and attendance allowance, we are now spending £12.5 billion more in real terms on help for those with disabilities or long-term health conditions. Under the old legacy system of DLA, only 16% of claimants would access the highest rate of support. A few years ago, that figure had reached 33%, and for some health conditions, in particular mental health conditions, people are now six times more likely to access the higher rates of benefits. So we are very much heading in the right direction, and there are further opportunities to turbo-speed improvements with the forthcoming White Paper.

There are two key lessons the Government can focus on: speed and specialisation. First, on speed, there are lessons that can be learned from the welcome changes to the special rules for terminal illness. We were able to apply a policy change that was co-designed by stakeholders, their policy teams and end users—people with real-life experience. Using the same principles, we can widen the severe conditions criteria in the PIP system, removing up to 300,000 unnecessary assessments or reassessments each year.

The principle behind that is that we would look at specific conditions. We could then be fairly confident about the trajectory of that condition and set in place a timetable of support. For those people whose condition has perhaps changed more quickly than expected, there would still always be the option to have a light-touch assessment to speed up their access to the increased rate of support.

There is a sort of principle around this, which already exists with universal credit and the industrial injuries disablement benefit. An independent panel could look at these conditions, and one example would be motor neurone disease—I cannot understand what the point would be of putting somebody with MND through an assessment. Where we can be fairly confident of the deterioration of health conditions, we could put in place an automatic right to support, with the backstop that, if somebody’s condition, sadly, deteriorates more quickly, a light-touch assessment could then move them to the higher level of support much more quickly. Removing 300,000 people a year would mean we have more resources available to speed up the process for those who would go through the more standard, traditional route.

During covid, we made sure we kept the gateway open for new entrants, and it is a tribute to staff up and down the country that disability benefits continued. We used video and telephone assessment, a further benefit of which is that it allows for greater specialisation in terms of the assessors. Rather than relying on a fixed number of staff in each geographical location, we can assign someone with a particular health condition via telephone or video to other locations in the country. That also helps with the point about making sure that the assessments are right first time, so that people do not have to go through an appeals process further down the line.

I know that these broad themes are being considered as part of the White Paper, but they are a real win-win and they are probably things that people could rally around, regardless of which political background they are from. I certainly know from my time working with our very knowledgeable stakeholders and policymakers that there would be huge support for them.

A broader point is that not everything is black and white. As much as I admire the passion and drive of the speech by the hon. Member for Motherwell and Wishaw, there was a presumption that everything the Government do is terrible and that everything the Scottish Government do is good. I say that because I have a brother who is a proud Labour party supporter, another brother who is an SNP supporter, a sister who is a sort of Lib Dem/ Conservative and a cousin who is a Green, so we cover all the bases, and I was very much brought in the belief that things are not black and white.

To their credit, the Scottish Government identified that we could and should have made changes to the special rules for terminal illness and to PIP, which is the main disability benefit. The Scottish Government have had challenges; they had hoped to complete both those tasks many years ago, but that has proved a lot more complex, particularly when we start to unravel the complicated machinery behind those benefits.

In my former life, I attended inter-ministerial meetings with Scottish officials and Scottish Ministers, who were always a great pleasure to work with, and I absolutely admired their end goal. However, they also had that presumption that the system was completely broken and had to be completely changed. Therefore, they sometimes would not listen to stakeholders and policy experts in disability and health charities who wanted changes but not necessarily the changes the Scottish Government had settled on.

For example, there is a principle that the Scottish Government do not like assessors. I understand that, given a lot of the media coverage of the earlier years of PIP, in particular. However, there is a reason why, under DLA, only 16% of claimants got the highest rate of support, compared with 33% under PIP. Many of the people who navigate the system are the least well equipped to do so. Therefore, we are relying on a system where, in effect, their evidence—self-supplied—is the only basis for them to get DLA. However, assessors tease out additional things and fill in the gaps, which is why we have gone from 16% to 33%.

[David Linden]

The hon. Gentleman is giving an incredibly thoughtful speech, but I have a fundamental objection to assessments. However, even if I was to follow the former Minister down the assessment route, we would find ourselves in a ridiculous situation where the people carrying out the assessments have no professional qualifications to enable them to adjudicate on the condition. For example, in one recent constituency case, someone was actually asked, “Does your son still have autism?”. That is the level of expertise we are dealing with and that, I am afraid, shows that the system is broken.

[Justin Tomlinson]

That shows the slight misunderstanding here—and I say that in a good spirit. All the health practitioners who carry out assessments have at least two years’ experience and come from health professional backgrounds. However, the point where the hon. Gentleman is right is that they are not necessarily specialists in certain areas. If someone goes to a GP, the fact that they are the initial gatekeeper to the NHS does not mean they are an expert in everything—they refer people on to specialists. There would generally be five or six assessors in each location, so we cannot expect the collective knowledge of those assessors to cover every single health issue. Through the introduction of telephone and video assessments, however, we can refer people, and that is what I am pushing for. The point is: the role of the assessors was not broken, but it needed improving. That is what both the UK and Scottish Governments were looking to do.

I am urging the Scottish Government to be cautious about relying too much on the claimant, because not all claimants are in a position to argue their case and understand the conditions. It is not even just a case of that; it is also about people being unaware of additional health conditions. I made a point earlier about those with mental health conditions now being six times more likely to get access to the highest rate of PIP. Many people do not realise that their mental wellbeing is being impacted by their physical health condition. They would enter the PIP system thinking, “My physical health condition is impacting on me. I’ll fill in all the bits on that and answer the questions.” However, the assessor’s questions on how that impacts mental wellbeing then begin to identify additional challenges that the claimant was either unaware of or had got used to and took for granted. That then gives them the additional points that allow them to enter the higher rate.

It is same around the special rules for terminal illness. We extended that from six months to 12 months, working with hospices, the health and disability charities and GPs. The Scottish Government, with very good intentions, tried to create a system where it was automatic. They then realised that not everyone can be dealt with automatically, because we are all terminally ill in the sense that nobody lives forever. Conditions then have to be put in, but that inadvertently creates a more complex system. It would have just been easier to say, as Northern Ireland did, “Actually, on this occasion, the UK Government—having listened to the stakeholders and health and disability charities—might be on to something. In this case, we ought to do the same.”

[Dr Rupa Huq (in the Chair)]

Order. I remind the former Minister that he has spoken for 10 and a half minutes, and I did want speeches to be kept within nine minutes. If he wishes to give us a concluding sentence, I will allow it, but we do have other Back Benchers.

[Justin Tomlinson]

Understood, Dr Huq. In conclusion, I urge the Minister to keep a laser-eyed focus on disability employment, ensuring that we provide support for not just the individuals seeking work but employers. The majority of people with disabilities develop them during working age, and we need to ensure that employers—particularly small and medium-sized employers—are equipped to support people with changing health conditions.

[Dr Rupa Huq (in the Chair)]

I call Wendy Chamberlain. Keep it within seven minutes, if you can, and then Marion Fellows gets time to wind up.

10:13

[Wendy Chamberlain (North East Fife) (LD)]

I shall keep my remarks short. I am grateful to take part in the debate, and I congratulate the hon. Member for Motherwell and Wishaw (Marion Fellows) on securing it.

At a basic level, it is more expensive to be disabled in this country, in the same way that it is more expensive to be poor. On every measure, disabled people and households have higher routine living costs than non-disabled households. In her opening remarks, the hon. Member referred to analysis from Scope’s disability price tag, published only last month, which stated that disabled households need on average an extra £975 to achieve the same standard of living as non-disabled households. Accounting for current inflation, that is over £1,100.

The reasons for that extra need are simple. Disabled households need to divert funds to pay for specialist products and services. They need to think about disability-related products that are often essential and costly, and they have increased energy costs as a result, both for heating and for electricity in relation to nutrition needs, as the hon. Member for Motherwell and Wishaw mentioned. A greater percentage of a disabled person’s disposable income is spent on food and energy, so the cost of living crisis has a disproportionate impact on them even before we think about things like the higher insurance premiums that disabled people face. The reality is that there has been a lack of financial support, and issues with PIP assessments mean that many are not accessing the payments to which they should be entitled.

I have particular concerns about the assessment of fluctuating conditions such as MS, ME and long covid. As has been highlighted, the expertise is simply not there for those kinds of complex conditions. On one day—and that day might happen to be the assessment day—a person may experience a better period of health than the rest of the time. I want further work on the health and disability White Paper to consider those things.

We are discussing Scotland quite a bit, but as a Scottish MP I cannot help doing so. I am conscious that MPs may sometimes have a bit of confirmation bias because people come to us from a casework perspective after trying every other source of help, so they are often desperate and some of the cases are quite complex. The Scottish Affairs Committee, of which I am a member, conducted an inquiry on welfare in Scotland 18 months to two years ago. I heard from stakeholders in Scotland that there was a more compassionate approach towards setting up the social security system in Scotland.

I will also say, however, that I am seeing casework on delays in adult disability payment processing in Scotland, so I hope that we will not end up in a similar position to elsewhere in the UK. I am concerned that the lack of a dedicated social security Minister in the new First Minister’s Scottish Government means a potential dilution of focus; I hope that that is not the case. The reality is that means-tested benefits are set too low, and the £150 cost of living support payment for disabled households, which was welcome given everything that I have outlined about the additional costs, was not enough.

In my remaining remarks, I will focus on carers. Hon. Members may not be aware that my private Member’s Bill, the Carer’s Leave Bill, has been progressing through Parliament; I am pleased to say that it should have its Third Reading in the House of Lords on Friday and I am hopeful that it will receive Royal Assent shortly thereafter. The Bill intends to offer people who are working as unpaid carers but are in employment the right to request time off from their employer. That is because the vast majority of disabled people will have support from an unpaid friend or family member, which could be to meet physical caring needs or to do the admin and emotional support around caring.

Carers provide unpaid work worth £530 million a year. However, 44% of working-age adults providing unpaid care for more than 35 hours a week are living in poverty. Frankly, that means that the people they are caring for are also living in poverty. When I was engaging with constituents about my Carer’s Leave Bill, it was very difficult to find constituents who would actually benefit from the Bill. The reality was that their caring responsibilities meant that they had eventually had to give up work because they just could not combine them both. Although I am hopeful that my Bill will help people—indeed, Carers UK estimates that it will help 2.4 million carers—there is clearly much more to do.

I want to take the opportunity to mention the very sad death of Kirstie Howell, the chief executive of Fife Young Carers. She did a great deal of work, and so does the charity, across Fife, including North East Fife. I send my condolences to the organisation and to her family.

If we do not provide the right support for young carers who are caring for disabled family members, they will not get into work in the first place and their household will continue to live in poverty. One way for the Government to help would be by raising the earning limit on the carer’s allowance. The reality is that caring never stops, so if we allowed those who are caring to work more before losing the carer’s allowance, it would potentially help disabled people and their families to deal with the cost of living crisis that we are facing. The Government have done a number of things during the cost of living crisis, but we feel that they have not done enough.

I will leave hon. Members with one last thought. I chair the all-party parliamentary group on ending the need for food banks. Along with the hon. Member for Motherwell and Wishaw, we conducted our first inquiry, which looked at cash or food in different responses to food poverty. A very telling statistic for me was that the one period of time during covid when food bank use went down rather than increasing was when the £20 universal credit uplift was in place. That tells us that when people get additional support, they are spending it on food, provisions and things they need for their families. For disabled people, we need that more than ever.

10:20

[Sarah Green (Chesham and Amersham) (LD)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank the hon. Member for Motherwell and Wishaw (Marion Fellows) for securing this debate on an important matter.

I rise to speak today as the daughter of a woman who lived with disabilities. Her daily challenges were significant, but I did not think of her as disabled until well into my late teens or early 20s, when I fully grasped her reality. That is because she lived a full and active life; she was ferociously independent and did not want her challenges to affect the rest of us or affect how she was treated by other people. I think we all know of people living with disabilities who show immense courage and fortitude. I pay tribute to them, because they do not want to be dependent. They want to live full, independent lives.

We know that the cost of living crisis has had a severe impact on many of our constituents. Last year, I ran a cost of living survey in my constituency. The responses from those caring for people with disabilities and from those living with disabilities were particularly heart-wrenching. One mother made the difficult decision to turn off her disabled son’s oxygen concentrator because she could no longer afford to pay her energy bills. He now relies on oxygen cylinders, which run out and which must be replaced on a regular basis. That brings its own challenges, but effectively their lives are now more complicated than they need to be.

Another constituent, in addition to having a spinal condition that has left him unable to work, is diabetic. He told me that because of the cost of living crisis and food inflation, he can no longer afford to follow the recommended diet for his diabetes. In his own words, he is playing Russian roulette with his health.

We all have examples we could share from our constituents. The simple truth is that the increase in the cost of living has had a disproportionately detrimental effect on people with disabilities. Disabled individuals and their households have, on average, lower incomes than those without disabilities. Furthermore, many people with disabilities have additional costs related to the treatment and mitigation of their condition. Those who encounter difficulty in leaving their home also have the added costs associated with being at home more often, such as higher energy bills.

What is more, even with existing disability-related financial benefits, those with disabilities are more likely to find themselves in relative income poverty. That has been compounded by benefits not having previously kept pace with inflation. Without drastic action, we risk a situation in which the most vulnerable in society are driven further into poverty. Reintroducing the universal credit uplift and extending it to all claimants on legacy benefits is a request that I have had from a number of constituents. What assessment has the Minister made of the help available to those with disabilities in the cost of living crisis?

[Dr Rupa Huq (in the Chair)]

I call the first of the three Front Benchers, David Linden for the SNP.

10:24

[David Linden (Glasgow East) (SNP)]

It is a pleasure to serve under your chairmanship, Dr Huq. I pay tribute to you for getting here in double-quick time as a late substitution. I commend my hon. Friend the Member for Motherwell and Wishaw (Marion Fellows) on securing this debate on a very important topic.

The cost of living crisis has permeated so many different aspects of our communities. The topic is brought up continually in my weekly advice surgeries, where sadly constituents have repeatedly told me that they are struggling to afford their weekly food shops and monthly energy bills. It is very much either/or. I am sure that other MPs in Westminster Hall today can relate to that—how helpless it feels to be sat across the surgery table from people who are clearly struggling and who desperately need support.

In far too many cases, people fall between the cracks and end up without the help that they not only deserve, but are entitled to. That is far too often the case for disabled people, who incur hidden costs through no fault of their own. As we have heard repeatedly this morning, disabled people and their families spend a greater share of their income on food and energy, the commodities that face the steepest rises in inflation. Again, as we have heard, people with special dietary requirements are being hit particularly hard by food inflation, with statistics from January showing that households with specific dietary requirements are paying up to 73% more for their food than those who do not need to buy “free from” products.

Disabled people face many additional costs related to the treatment and mitigation of their disability, such as equipment or therapies. In some utterly awful cases, disabled people face the impossible choice between powering essential medical equipment such as wheelchairs and ventilators and putting food on the table. All those extra costs hit harder because disabled individuals and their households have, on average, lower incomes than their non-disabled counterparts, with 27% of disabled people living in poverty compared with 21% of non-disabled people. The result is that disabled people are more likely to have a lower standard of living, even when they earn the same.

According to research from Scope, on average, disabled households need an additional £975 a month to have the same standard of living as non-disabled households, and if that figure is updated to account for inflation over 2022-23, those extra costs rise to £1,122 a month. The price tag on disability feels incredibly dystopian. What kind of Orwellian society are we living in when having a disability incurs a price tag?

We have only to reflect on the words of Nye Bevan to understand the absurdity of the situation. Bevan said:

“Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community.”

Let me make it clear: illness is not an indulgence or an offence. People should not have to pay or be penalised. If Nye Bevan could understand that in the 1940s, I am puzzled as to why the current British Government are having so much difficulty with the concept.

The Government must do more—so much more—to use all the powers at their disposal to tackle the cost of living crisis on the scale that is required. While the uprating of benefits in line with inflation was welcome, for far too many it sadly came too late. The additional payment of £150 to disabled people, while welcome, will not provide the same long-term assistance as a sustainable benefit uplift. Indeed, Disability Rights UK is on record as saying that the “lack of meaningful increases” in disability benefits over recent years means that the extra £150 “doesn’t touch the sides”, and it is right.

As my hon. Friend the Member for Motherwell and Wishaw said, the Scottish Government are taking action within their devolved powers and within their fixed budget to try to help disabled people with the combined effects of higher energy bills, the general rise in inflation and the impact of Westminster policies. Yes, there are things that we can do—for example, the winter heating payment; the Scottish Welfare Fund; spending money on discretionary housing payments, such as the £84.1 million being made available this year; the council tax reduction scheme; and the most generous concessionary bus scheme—but the reality is that devolution was not, and in my view never has been, set up to be a sticking plaster for bad welfare policies made here in London.

Yes, the Scottish Government are doing all that, but they are doing it with one hand tied behind their back. The brutal reality is that every additional pound that we spend on those measures to help with rising costs has to be funded by budgetary reductions elsewhere, given our largely fixed budget and our limited fiscal powers. Scotland has already suffered a decade of British Government-imposed austerity since the financial crisis, which has disproportionately hurt the most vulnerable people in society and has resulted in under-investment in our crucial public services. The SNP Government in Holyrood are using their limited powers and resources to do everything they can, but that has to be matched by the British Government. With every day that Westminster fails to use its reserved powers to adequately tackle the cost of living crisis, it is demonstrating that independence is the only way for people in Scotland to boost their income and build a truly fairer society.

In closing, I emphasise what is at stake for my constituents, whether they are in Barrowfield or Baillieston. We find ourselves in a dire situation in which it literally costs to be disabled—there is a price tag on being diagnosed with a disability. The additional monetary costs associated with being disabled are compounded by the myriad ways in which society is set up to penalise disabled people.

The social model of disability tells us that people are disabled by barriers in society, not by their impairment or by indifference. The barriers can be physical, such as in buildings that do not have accessible toilets or libraries that do not have Braille versions of books; attitudinal, such as the assumption that disabled people cannot do certain things; or systemic, as in this case, when the cost of simply living as a disabled person is higher and Government support has systemically failed. It is only by removing those barriers that we can achieve equality and offer disabled people more independence, choice and control. That is why I believe that the Government must do so much more to protect the most vulnerable in society.

[Dr Rupa Huq (in the Chair)]

I call shadow Minister Vicky Foxcroft for the official Opposition.

10:31

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

It is a real pleasure to serve under your chairship, Dr Huq; I am very happy that you could make it here today. I pay tribute to the hon. Member for Motherwell and Wishaw (Marion Fellows) for securing this important and timely debate. There is no doubt that disabled people are being disproportionately impacted by the cost of living crisis, and it is right that we are here to debate the issue. As the hon. Member outlined, a number of organisations have been in touch to outline their fears and worries about how disabled people are struggling, and I hope that the Minister will respond positively to the many points that the hon. Member and others have raised.

The economic impact of disability is significant. Many disabled people are excluded from full economic participation. According to the most recent figures from the Office for National Statistics, the employment rate for disabled people is just over 53%, which compares with almost 83% for non-disabled people. In other words, the disability employment gap stands at just under 30 percentage points. From speaking to many disabled people, I know that many of them want to work but are prevented from doing so by societal barriers.

The difficulties do not stop with getting into employment. Once they are in work, disabled people also face a disability pay gap. As of 2021, the gap stands at 13.8%, which means that disabled people earn almost £2 per hour less on average than non-disabled people. As other hon. Members have outlined, the other side of the economic impact is the extra cost associated with having a disability.

[Margaret Greenwood]

My hon. Friend is making an excellent speech. When I met representatives of Scope a few months ago, one issue they raised was the household support fund. It is designed to help vulnerable people across England and is administered by local authorities, but it has not helped many disabled people. Many people are not aware of its existence. Does she agree that that is shocking and that, as the Government have extended the fund until the end of March 2024, it is vital that people are made aware of the support that is available?

[Vicky Foxcroft]

My hon. Friend raises an important point, and I completely agree.

The costs will vary depending on the specific disability or disabilities that an individual has, but they might include assistive equipment, care and therapies—things that are essential for them to live their lives. My hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) raised the fear of more disabled people dying, and my hon. Friend the Member for Wirral West (Margaret Greenwood) rightly pointed to problems with PIP decisions and the need for the reform of the assessment process.

We all know that disabled households tend to spend more on essential goods and services such as heating, food and travel. As we have heard many times, last month the disability equality charity Scope released updated research on the extra costs associated with having a disability—the so-called disability price tag. When Scope last calculated the price tag in 2019, it stood at £583 per month. The update makes for very sober reading: over the last four years the price tag has risen to a shocking £975 per month, which is equivalent to 63% of household income. That means that disabled households need to find almost £12,000 extra per year to achieve the same standard of living as non-disabled households.

The hon. Member for North East Fife (Wendy Chamberlain) rightly articulated the escalating rise in food costs, which under the Conservatives have risen at the highest rate for more than 45 years. Depending on the nature of their disability, some people have difficulty preparing certain foods and rely on pre-prepared or convenience food, which frequently works out to be more expensive than buying raw ingredients. The price of ready meals rose by almost 22% in 2022. If someone has difficulty standing or sitting for long enough to prepare a meal from scratch, they might feel they have no choice other than to pay those prices.

The hon. Member for Chesham and Amersham (Sarah Green) raised the case of a constituent who could not afford their energy costs and had to switch off important equipment. Disabled people have been hit hard by rising energy prices not only because they might have difficulty keeping warm and spend more time at home, but because many have to run life-saving medical equipment. In the Commons Chamber at the end of last year, I raised a case in which the actor Kate Winslet stepped in to help a family faced with a £17,000 bill.

I am sure the Minister will tell us that the Government have taken steps to support disabled people through the crisis by delivering the disability cost of living payments. Disabled people may also benefit from broader support measures such as the energy price guarantee and other cost of living payments for those on means-tested benefits. What the Government will probably not remind us of is that hundreds of thousands of people are no longer entitled to the warm home discount since the Government excluded those who claim disability living allowance, personal independence payment and attendance allowance.

I find myself in the odd position of agreeing with the hon. Member for North Swindon (Justin Tomlinson) that we should abolish reassessments for conditions that we know will not improve or are deteriorating. I am interested in how the Minister will respond to that idea.

Among many others, Disability Rights UK has said that the support given to disabled people has barely touched the sides. Trussell Trust figures show that even in early 2020, 62% of working-age people referred to food banks were disabled. A Mencap survey has revealed that 35% of people with a learning disability have skipped meals to cut back on costs and 38% had not turned on their heating despite being cold. I could go on, but others have already stated the case very eloquently this morning, so I will finish by asking the Minister to commit to working closely with disabled people and disabled people’s organisations to find a sustainable solution to the crisis. As many have already said, they genuinely are the experts by experience.

10:39

[The Minister for Disabled People, Health and Work (Tom Pursglove)]

It is a pleasure to serve under your chairmanship, Dr Huq. I thank you profusely for stepping in and taking on these proceedings to allow this important debate to go ahead.

I also thank the hon. Member for Motherwell and Wishaw (Marion Fellows), who is passionate about these issues. We have a constructive working relationship, and I always enjoy spending time with her and talking about the issues that are important to her constituents and people across Scotland. I continue to engage with her and am always willing to engage with colleagues from all parties on such matters. In that spirit, I thank Members for their contributions, which have covered a wide range of points. I will endeavour to address as many of them as possible, while making sure that the hon. Lady has the opportunity to sum up the debate.

I thank the many charities, both locally and nationally, that do so much good work supporting people, particularly those who are vulnerable or disabled. They do so in an effective way by working collaboratively with those individuals, often in difficult and challenging circumstances. Perhaps most importantly, charities make sure that there is awareness of the support that is available to people.

I want to make it clear at the outset that the Government recognise the difficulties that many households have experienced during this period. It has been incredibly difficult, and it is impossible for any Member of Parliament not to be acutely aware of that, given our constituency correspondence, and our conversations when we are out and about and in our surgeries. A lot of that is explained by high global gas prices—I think we all recognise the root causes—and the market volatility that has flowed as a result. That has undoubtedly had an impact on affordability for individual households. It has put a considerable strain on the cost of living, and I would argue that it explains why the Prime Minister is absolutely right to have set getting inflation down as one of the Government’s key missions.

[Margaret Greenwood]

One of the things that charities representing disabled people have been campaigning for is a social tariff for energy—the Minister was just talking about energy—to give disabled people, older people and carers who face high energy costs discounted energy bills. In January, I asked the Government what plans they had to introduce a social tariff for energy, and the Minister at the time replied:

“The Government has committed to work with consumer groups and industry to consider the best approach, including options such as social tariffs”.

Will the Minister please provide an update on that? Also, I urge him to have discussions with disabled people and the charities that represent them, as well as industry and consumer groups.

[Tom Pursglove]

I am extremely grateful to the hon. Lady for her intervention. If I may, I will come to that point a little later, because I want to address the social tariff issue directly.

We understand and recognise that many households in the United Kingdom include vulnerable people who may be elderly or disabled, or who may have a medical condition. Often, that inevitably leads to higher energy costs. We are clear that everybody must be able to afford their energy usage, particularly to be able to power any machines and equipment that they might require. With that in mind, I would argue that the Government acted decisively and rapidly by putting in place a significant and comprehensive package of support to assist with the cost of living challenges. It is worth more than £94 billion in 2022-23 and 2023-24—an average of more than £3,300 per UK household. It is also important to note the 10.1% uplift to benefits across the board.

To reflect back on 2022-23, one of the vehicles through which we were able to deliver that support was the cost of living payments—the £1,100 payments for some households during the 2022-23 financial year. It was a remarkable achievement that, from the first announcement back in May last year to delivery, more than 30 million cost of living payments were paid last year. More than 8 million households received up to £650 across two payments; more than 8 million pensioner households received an additional £300, on top of their winter fuel payments; and 6 million people receiving an extra-costs benefit such as personal independence payment or adult disability payment in Scotland received a £150 disability cost of living payment.

Those payments came alongside a wider package of cost of living support, with the energy price guarantee capping fuel bills at £2,500 for average use, the £400 off domestic electricity bills that was received by every household in Great Britain, and then the council tax reductions for properties in bands A to D in England, as well as—this was an important part of the package, recognising that people’s circumstances are often not neat and that there is a risk that people fall between the cracks of the structured support—the household support fund, including funding in that envelope for the devolved Administrations. We extended that support twice, and the total has been £1.5 billion since October 2021.

I certainly feel that the household support fund has been a helpful vehicle for us to get support out to people by working with local authorities. I totally accept that we should look at what more we can do about awareness of it and getting the message out. Of course, many of our partners, such as Citizens Advice and advice services, are invaluable in helping the Department and local authorities to get the word out about it, but I would certainly be keen to look at any suggestions about what more colleagues think we can do about awareness, because it has been an effective means of getting help to people who require it.

[Margaret Greenwood]

I thank the Minister for giving way again; he is being extremely generous. He is talking about what else we could do. Will he recognise the erosion of advice centres for constituents? I am sure that many of us in this room are acutely aware that there has been an erosion of the provision of advice to people, and particularly to disabled people. Perhaps the Minister could speak to his colleagues about looking at funding such centres, because a lot of them came about through local authority funding, which has been squeezed to such a degree that there is no longer the same level of advice available in our communities as there should be.

[Tom Pursglove]

I will certainly and gladly take that point back to the Department. I am sure it is something I can pick up on during the many engagement sessions that I have, particularly with disability charities and disabled people’s organisations. I would be keen to hear their views on how the issue is best approached and what more we can do in the advice space.

I want to touch on the cost of living support in place for 2023-24. Members will recall the commitments that my right hon. Friend the Chancellor of the Exchequer made in the autumn statement, including a firm commitment to support the most vulnerable people in our society. That will be delivered through 8 million low-income households getting £900 cost of living payments. I am delighted to say that my Department has already delivered 99% of the first cost of living payment of £301 to the 7.3 million households in receipt of a means-tested benefit such as universal credit. That in itself represents a £2.2 billion injection of help for households.

I am also pleased to confirm that we will shortly lay in Parliament regulations that will allow us to pay the additional £150 disability cost of living payment to 6.5 million people throughout the UK who receive an extra-costs disability benefit. Those payments will land in people’s bank accounts in the summer. We will also shortly lay regulations that mean that this winter pensioner households will again get an additional £300 on top of their annual winter fuel payment, as they did last year.

[David Linden]

There has been a bit of a problem whereby some of the cost of living payments have excluded those who have previously been sanctioned by the UK Government. In essence, that means that people are doubly penalised. Will the Minister confirm that any regulations he introduces will not include any provision such that people will be doubly punished, if they have been sanctioned, by not receiving the cost of living payment?

[Tom Pursglove]

I will gladly take that point back and speak to ministerial colleagues in the Department about that aspect. The hon. Gentleman will recognise that the Under-Secretary of State for Work and Pensions, my hon. Friend the Member for Mid Sussex (Mims Davies), has generally led on the legislative efforts to put this package in place, but I would be happy to raise that with her and to get him a proper, full, considered answer to that point.

Let me deal directly with one key issue that has come up in the debate: the structure of the cost of living payment and the argument that the payment is itself too low. I stress that the rationale is different for each of the cost of living payments. The Government’s view is that it is right that the highest amount goes to those on means-tested benefits, given that those on the lowest incomes are most vulnerable to rises in the cost of living. Having said that, we estimate that nearly 60% of individuals who receive an extra-costs disability benefit will receive additional support through the means-tested benefit payment. More than 85% will receive either or both of the means-tested and pensioner payments.

I assure colleagues that we are absolutely committed to ensuring that disabled people and people with health conditions receive the support that they need, which is why in 2022-23 we spent nearly £69 billion in real terms on benefits to support disabled people and those with health conditions. We will continue that throughout 2023-24 by uprating disability benefits in line with last September’s consumer prices index inflation figures. That means we expect to spend around £78 billion in 2023-24, which is 3.1% of GDP. That is a stark statistic. I recognise that Trident is a significant issue for the Scottish National party, and the figure of £3 billion was raised, but I and the UK Government would argue that there are strong reasons why we have a nuclear deterrent, which is a debate for another day.

The scale of support that we provide—to the tune of £78 billion in 2023-24—to people with disabilities and health conditions is significant. By 2027-28, total disability benefit spending is forecast to be more than £41 billion higher in real terms compared with 2010-11. Spending on extra-costs disability benefits alone will amount to £35 billion this year, all paid tax free, and in addition to any other financial or practical support that disabled individuals may receive.

The hon. Member for Chesham and Amersham (Sarah Green) asked about the adequacy of the disability cost of living payment and its evaluation. We are committed to an evaluation of the cost of living payments later this year. The disability unit is also working to build an evidence base to better understand and evidence the full impact of cost of living challenges for disabled people, across a range of sectors. It is trying to do that collaboratively and is drawing on the expertise, views and experiences out there to help us to shape that work.

[Wendy Chamberlain]

Given that the Minister is committing to take some things away for further discussions with ministerial colleagues, may I repeat my plea in relation to carer’s allowance? It would help if we let carers work and at the same time keep their carer’s allowance.

[Tom Pursglove]

I am happy and willing to keep that aspect of our policy under review to see whether there is more we can do to unlock that. That is a commitment I make to the hon. Lady; I am interested in looking at and exploring that further.

There were several references in the debate to energy costs, particularly in relation to the cost of equipment. The Government supported families across the UK last winter through the energy price guarantee, which places a limit on the price that households pay per unit of gas or electricity. Colleagues will know that that has been extended until the end of June at the £2,500 level, thereby ensuring that families will save on average around £160 per household throughout that period.

Existing support is also available through cold weather payments and the warm home discount. The property services register, which is run by energy suppliers, offers additional free services to people of pensionable age, who are registered disabled, who have a hearing or visual impairment, or who have long-term ill health. That register helps to ensure that people in vulnerable situations are able to access extra help when needed, such as when there is a power cut.

Let me talk about the situation moving forward. This is more a matter for colleagues in the Department for Energy Security and Net Zero but, of course, engagement on this issue goes on across Government. On the energy market reforms in the energy security plan released in March, which were touched on, the Government intend to consult on options for a new approach this summer. We will invite and welcome the public and our stakeholders to use the consultation to provide feedback on our proposals.

To directly respond to the hon. Member for Wirral West (Margaret Greenwood), I am keen that our work does involve engagement. I will assist in facilitating that with disabled people, their organisations and their representative bodies, to make sure that their views are heard, particularly in relation to the social tariff, for which there is a significant body of support. It is right that we look at that in detail as part of the wider reform package.

There is also significant Government help for energy insulation, ensuring that people are properly supported to better protect themselves from the cold and making homes as energy efficient as possible.

I will touch quickly on prepayment meters, which have been asked about. Ofgem published a new code of practice on 18 April, which has been agreed with energy suppliers, to improve protections for customers being moved to a prepayment meter involuntarily. We argue that that is a step in the right direction, providing better protections for vulnerable households. The code of practice, however, is not the end of the process. We have always been clear that action is needed to crack down on the practice of forcing people, especially the most vulnerable, on to prepayment meters. The Department for Energy Security and Net Zero will continue to work closely with Ofgem and industry to ensure that the code leads to positive changes for vulnerable customers, and will not hesitate to intervene again if necessary.

Finally, I will touch on the various contributions made on the personal independence payment. On appeals, 4% of all PIP decisions have been successful at appeal. I am not complacent, but I am pleased to say that the journey time for PIP is now down to 14 weeks. I want to stretch that and see if there is more that we can do to improve it. On assessments more generally, I want hon. Members to think about some of the opportunities that the White Paper presents. The tests and trials of the severe disability group have been touched on. Matching expert assessors is a positive thing to do to help ensure that we get more decisions right first time, and scrapping the work capability assessment also provides an opportunity to focus on quality. I have no doubt that we will have plenty of opportunities to say more about that, as well as on fluctuating conditions.

Thank you, Dr Huq, for stepping into the breach. I am confident that the Prime Minister and the Chancellor will continue to show leadership on these issues. We keep the package of support that we provide under constant review, and I have no doubt that this Government will continue to be on the side of working people, disabled people, pensioners and those in our society who are vulnerable, to ensure that they get through these challenging times.

10:58

[Marion Fellows]

I really do thank you, Dr Huq, more than anyone else in the Chamber. I thank all Members who have taken part. Most of all, however, I thank all our disability organisations and advisory services, which do such valuable work to help the most vulnerable people in our society—disabled people, their families and their carers.

How we treat our most vulnerable citizens is a political choice for any Government. Tinkering around the edges, which has been the pattern for this Government for a long while, is not what we should be doing. I commend the Minister for the work he has done, as I do his predecessor, with whom I also worked closely, but it takes more than a disabilities Minister to change things in this country. We need full support from the Government and the Treasury, and a change in how we think of disabled people and what we do for them. Politics is the art of the possible. More support is possible, and I can assure everyone here that I will continue to press for it.

Question put and agreed to.

Resolved,

That this House has considered the cost of living for people with disabilities.

Abuse and Sexual Assaults in the NHS: Investigations

Tuesday 16th May 2023 Westminster Hall

11:00

[Dr Rupa Huq (in the Chair)]

I will call Daisy Cooper to move the motion and then the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as this is a 30-minute debate.

[Daisy Cooper (St Albans) (LD)]

I beg to move,

That this House has considered the adequacy of investigations into abuse and sexual assaults in the NHS.

It is a pleasure to serve under your chairship, Dr Huq. Today’s topic is one that I never in a million years thought I would have to table for debate, but because of two brave constituents and two investigative journalists, I am here to share their stories and shine a light on the shocking scale of the problem.

It should go without saying that hospitals should be places where all patients, visitors and staff should feel safe and be safe. Vulnerable patients entrust themselves and their care to strangers in an unfamiliar environment. Overworked nurses and other NHS staff work long shifts in understaffed buildings, often arriving or leaving their place of work in the hours of darkness. Patients, visitors and staff can find themselves isolated in cupboards, clinics or car parks out of public sight, and it is seemingly in those places that thousands of instances of sexual assault, misconduct and rape are perpetrated every year.

A brave constituent of mine—let us call her Joan, which is not her real name—told me that she was a survivor of sexual misconduct by a medical professional during her treatment. Soon after it happened, Joan disclosed it to her GP, who raised a complaint to the specific NHS trust. The complaint was treated by the NHS trust’s human resources team as an employer-employee dispute. What was Joan’s status in this? Not a victim, not a complainant. She was relegated to being nothing more than a third-party witness: a third-party witness who not only was treated appallingly by the medical professional’s council, but was not even entitled to know the outcome of the case—the case in which she was the victim.

Joan did not know whether any other complaint mechanisms were available to her or what the scope or limitations of each one might be, and she was not medically fit enough to find out. She trusted that the NHS trust would do the right thing. Thanks to her GP, Joan was then contacted by the General Medical Council, which wanted to investigate the professional concerned, but Joan was not mentally or medically in a position to progress the case. She tried to progress it about seven years later, but she was prevented from doing so by the GMC’s five-year rule, which prevents the GMC from investigating a professional’s fitness to practice if the case is older than five years. The GMC can, of course, still investigate where there are exceptional circumstances in the public interest, but the GMC told me that Joan’s case did not meet the threshold. It would not tell me how it defined “exceptional circumstances” and refused to disclose the legal advice that it had received about the definition.

Joan attempted to raise the case with the Parliamentary and Health Service Ombudsman. The PHSO replied that its remit is more procedural and administrative, and that it would not be the appropriate organisation. It redirected Joan to other organisations that were better suited to investigate—the GMC and the trust’s own disciplinary process, both of which she had used and both of which had failed her. The Professional Standards Authority oversees the GMC and other health regulators, but it too said that it could not investigate the case itself. Separately, Joan had a personal injury case against the hospital and secured a significant payment as a result, but we believe that the medical professional concerned is still practising.

Since 2020, I have sent 14 letters to different organisations, including three to the Government, and have tabled a number of written parliamentary questions to work out how this could have gone so badly wrong. What we have uncovered is shocking. First, there is no tailored support available for patients reporting incidents of a sexual nature. Patients are unclear about which organisations they can complain to, with NHS trusts, the GMC and the PHSO sometimes suggesting that each of the others is better placed to investigate. The GMC’s five-year rule continues to be a major barrier for investigating the fitness to practise of medical professionals perpetrating sexual misconduct on patients or other medical professionals.

Secondly, there has been no discernible progress on implementing the recommendations of three inquiries and reports from the Professional Standards Authority. Thirdly, no clear or systemic collection of data of reports of sexual abuse and misconduct within the health service is available for public or parliamentary scrutiny. Fourthly, the recent revelations by investigative journalists, which were published in Byline Times, of thousands of rapes and sexual assaults across the NHS mean that immediate action is needed to make our hospitals safe from sexual predators.

On the first issue—the staggering lack of support for survivors and the opaque reporting process—the NHS directs all patients to the patients advice and liaison service for complaints in the first instance. However, the route to escalate a complaint of sexual misconduct is not straightforward. A search online fails to direct individuals to NHS or Government resources that are instantly and clearly available. The options that do exist to address sexual abuse and misconduct often have limitations that patients are unaware of when embarking on a complaint, meaning that they discover them only in the course of trying to make such a complaint.

I have already explained through Joan’s case how the NHS’s disciplinary hearings, and the processes of the PHSO and the GMC all have shortcomings. We urgently need a simple and clearly signposted process that is designed for complaints of a sexual nature. We also need the five-year rule to be scrapped. Any case of sexual misconduct in the NHS should meet the tests of being both exceptional and in the public interest to investigate, but that is clearly not how the rule has been interpreted.

Two years ago, in 2021, the Department of Health and Social Care held a consultation on proposed regulatory reform of the GMC that would include the removal of the five-year rule. That would rightly reduce barriers to the investigation of serious cases of sexual misconduct where patients may not have felt in a position to report them at the time or where they were simply unaware that they could do so. The GMC itself is in favour of scrapping the five-year rule but, two years later, the Government refuse to say when they will respond and scrap the five-year rule, which I hope they will do. Perhaps the Minister will be able to tell us in this debate.

The second major problem that I identified was the repeated failure to follow up on three inquiries and the Government’s own report. Each inquiry found systemic failures in the NHS’s handling of reports of sexual misconduct. One called on the Government

“to develop and publish specific accessible information for patients on what they should and should not expect in consultations and who they can speak to for advice and assistance in relation to disclosures of alleged abuse.”

But to the very best of my knowledge and research, there has been no subsequent publication or announcement by the Government or any other responsible agency that seeks to act on the recommendations of those three inquiries.

The third problem on which urgent intervention from Government is needed is the shocking lack of data that prevents anyone from identifying the real scale of the abuse in health services. I tabled a series of parliamentary written questions over the past two years about the recording and monitoring of sexual abuse in the NHS. The Minister may remember the responses she gave on 9 November 2021 and 17 February 2022. She advised that

“all National Health Service organisations must prepare an annual report covering the number of complaints the organisation received”.

She later confirmed:

“While there is no specific requirement in legislation to categorise complaints by allegations of sexual abuse, NHS organisations are required to record the subject matter of complaints. NHS organisations must ensure that their complaints annual reports are available to any person on request.”

However, when I asked NHS England about accessing that data, it said that

“there is not a specific code for complaints of a sexual nature. Therefore in order to extract this data would require us to review every complaint received. In each year we receive between 6,000-8,000 complaints. If this information was requested under the Freedom of Information Act, this would most likely be exempt as it would exceed the threshold for time taken to provide a response.”

That is gravely concerning, first and most obviously because the Government are currently unable to gauge the scale of the problem, and, secondly, because local organisations tasked with commissioning much-needed advocacy support services simply are not able to do so. Will the Government mandate NHS England to create a specific code for complaints of a sexual nature?

Tenacious investigative journalists have uncovered some data. Sian Norris and Sascha Lavin have revealed that more than 4,000 patients, visitors and NHS staff were raped or sexually assaulted in hospitals in England and Wales during the past four years. However, this data could not be collected from the NHS trusts themselves. Instead, it had to be gleaned from police force records, because—incredibly—the NHS does not collate this information.

I am sure the Minister will be aware of a survey for Nursing Times in 2021 that found that three in every five nurses had been sexually harassed at work, with barely a quarter of these incidents being reported to employers, because nurses just do not believe it will get them anywhere. I mentioned at the beginning a second constituent who is a medical professional. She raised a complaint with her managers, only to come to the same conclusion—namely, that her complaint just would not go anywhere.

Although all of this is incredibly shocking, none of it should be news to the Minister here today. She will know that I put all of this detail to the former Secretary of State more than a year ago, on 13 May 2022. I did not receive a response for several months, but when I did I am afraid to say that it simply regurgitated all of the routes that I had complained about in my original correspondence. In further letters to and fro, the replies told my constituents and me nothing that we did not already know, and a promised ministerial meeting, which was rearranged four times, never came to pass. Although my constituents are not physically in attendance, they are following this debate closely on parliamentlive.tv. I have no doubt that many more survivors of these abhorrent crimes will be listening, too. They all want to know what the Government will do.

I have a series of questions for the Minister. First, will the Government finally respond to the GMC consultation and scrap the GMC’s five-year rule, which allows perpetrators of sexual misconduct to evade investigation after five years and continue working in the NHS? Secondly, will the Government create a specific and clearly signposted complaints system for complaints of a sexual nature, so that patients, visitors and staff can report allegations within health services and are able to identify which organisations they should approach in order to do so?

Thirdly, will the Minister make a statement about the handling of sexual abuse cases in the NHS and say whether any recommendations from the previous three inquiries and the PSA reports will be incorporated into the existing systems? Fourthly, will the Government mandate the NHS to create a specific NHS complaint code to register, collate and monitor data on sexual abuse and misconduct within health services, which can be made readily available for public and parliamentary scrutiny, and for local bodies that commission advocacy services for victims?

Finally, but most urgently, will the Minister set out what action she has taken or will take to make our hospitals a safe place for patients, visitors and staff, free from the sexual assaults, misconduct and rapes that are seemingly happening in our NHS every single day?

11:15

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Dr Huq, and I thank the hon. Member for St Albans (Daisy Cooper) for securing this important debate. First and foremost, I want to express my utmost respect for the bravery and resilience shown by all those individuals, whether patients, staff or visitors, who come forward to report sexual safety concerns in the NHS. None of those incidents is acceptable, and I reassure hon. Members that we are taking this matter extremely seriously. We have been doing significant work in this space for a while, and sexual abuse is one of the key priorities in the women’s health strategy published last year. We believe sexual abuse and violence is a health issue.

The Secretary of State and I held a meeting a few weeks ago with health leaders from across the NHS to discuss how sexual misconduct, harassment and abuse in the NHS are being dealt with. We discussed the actions that the Government are taking in collaboration with the NHS to combat the problem. We expect every NHS trust to take action to ensure the safety of patients, staff and visitors on its premises.

I will come back to the data in more detail, but we know that victims and perpetrators can span a mix of patients, staff and visitors, and that the highest number of cases occur in mental health settings. We take that very seriously indeed. A rapid review is happening at the moment. It is looking at in-patient mental health settings and, specifically, sexual abuse and the data around it. We will respond to the review shortly.

Tackling sexual violence and abuse, and ensuring that all patients and staff who experience sexual violence and abuse are supported, are top priorities for NHS England. Domestic abuse and sexual violence are more likely to be disclosed to a healthcare professional than to any other professional, and often, some data that records sexual violence is not always about sexual violence that happens within the trust, but if a report is made to a healthcare professional—by a fellow member of staff, a visitor or a patient—it is reported through NHS data systems. That is not to say that abuse does not happen within the setting itself, but it does explain why the figures are sometimes significantly higher—healthcare professionals have a duty to report any complaints they receive.

Sexual safety covers a range of inappropriate sexual behaviours with different legal and operational definitions, including language of a sexualised nature, sexual harassment, sexual assault and rape, but every one of those is unacceptable.

The hon. Member asked what we are doing. We are taking action. We expect local NHS employers to be proactive in fully supporting staff and patients, and ensuring that their concerns are listened to and acted on. We encourage anyone who has been a victim to come forward and report that, in the knowledge that the report will be taken seriously. Every organisation within NHS England systems, whether community trusts, hospital trusts or any other setting, has robust systems in place not just for reporting allegations and concerns, but for following them up. All reports must be recorded, investigated and dealt with by NHS providers. That includes, where necessary, taking action against the perpetrator, but also involving the police.

While local leaders of NHS organisations have a statutory duty to look after their staff and patients, we are taking action in this space nationally. NHS England has expanded the remit and scale of the domestic abuse and sexual violence programme to co-ordinate work on sexual safety in healthcare settings, and it has recently appointed the first national clinical director, Dr Peter Aitken, to make our NHS safer, with a focus on areas such as data collection and reporting, prevention, and early intervention and support for those who have experienced sexual violence and abuse within the NHS.

Data is important, and data on sexual safety is being recorded. We can see that through the national reporting and learning system, which takes all the data from local datasets. Where local risk management systems from trusts around England are reporting in, that is fed through to the national reporting and learning system, so that we have oversight of the scale and types of problems that are being seen.

Building on commitments in the women’s health strategy, NHS England is collecting more consistent and granular information on patients who experience sexual violence and domestic abuse. The domestic abuse and sexual violence programme is consolidating NHS England’s data improvement actions into a single cross-cutting project. Data is important so that we know the type of incidents that are happening, where they are occurring and in which settings. It means we can quickly pick up any single perpetrator who may be acting in one or multiple trusts and can ensure safeguards are put in place as quickly as possible.

Data collection is not the only tool we have; this is also about reporting. The data is only as good as the information that is reported, and that is why we are encouraging people to come forward if they have been a victim or if they have witnessed an incident about which they have concerns. Unless we know about it happening, the action that can be taken to prevent incidents happening again is limited.

The hon. Member spoke about professional regulators. If staff, patients or visitors go to a trust and either feel that the complaint was not taken seriously or that action has not been forthcoming, there are also professional regulators. She talked about the GMC and I will come to the five-year issue in a moment. Professional regulators take action and have complaint systems in place that allow anyone to report a concern. We also have freedom to speak up guardians, particularly for staff. They can whistleblow if there are concerns about the culture or behaviour in a particular setting, so that staff can feed in concerns without having to go to their line manager or a member of their team. That will be treated confidentially.

We are committed to making it easier for patients to report historical concerns and are looking at modernising the GMC’s five-year rule. There was a consultation recently on regulating healthcare professionals. The Government responded to that in February and said they would take that forward, so there are plans to modernise the GMC’s five-year rule on complaints. I will happily update the hon. Member on timelines after the debate. The patient safety commissioner, who looks after patient safety across the board, is in post, and I am happy to discuss with her how we can co-ordinate responses from trusts and regulators so that they are joined up and so patients and staff feel their responses are not being passed from one organisation to another.

However, better data collection and good reporting is not enough on its own. We have to take action to stop sexual safety incidents happening in the first place. That is why NHS England has committed to a number of preventive actions, including creating a gold standard for policies, support and training relating to staff who experience sexual violence. That is being rolled out across ICBs, trusts and royal colleges, because it is important to create a culture where people feel safe to come forward and where, if their complaints are not taken seriously, they have someone else to go to who will listen to them and their complaints will be responded to.

In particular, in mental health settings, the NHS patient safety strategy is running a mental health safety improvement programme specifically focused on sexual safety. It is important to ensure that safeguards are in place to protect vulnerable patients who may not be able to say no but do not have the capacity to consent.

Where sexual incidents do occur in the NHS, the right support must be available. NHS England has commissioned 48 sexual assault referral centres across England, which are open 24/7. They provide medical, practical and emotional support to victims, whether their sexual assaults occurred outside the NHS, but they are reporting it to NHS practitioners, or the incidents occurred within the setting.

We have rightly focused on patients, but I want to make the point that the data shows that staff are the most common victims of sexual assault, so work is being done to support staff and to make their workplaces safer. We have a high number of patient-on-patient incidents, too, so it is not always staff-on-patient incidents. We absolutely need to take robust action against any staff who assault or commit sexual violence or abuse on any patient, but we also need to ensure that patient-on-patient abuse is identified as quickly as possible, that safeguards are in place and that our staff are protected from violence from patients or visitors.

In the short period of time that I have had, it has been difficult to go through all the initiatives we are putting in place to adequately and accurately record the scale of the problems. We want people to come forward and we want numbers to be recorded. We need to ensure that the reporting processes are in place and that action is taken at a national level, by each individual trust and by the healthcare regulators. Delivering on this agenda is a top priority and I cannot overstate my personal commitment to progress in this space. Again, I recognise the bravery of every patient and staff member who has witnessed or been the victim of sexual abuse. I am happy to keep Members updated on the progress we are making in this space over the coming weeks and months.

Question put and agreed to.

11:26

Sitting suspended.

Dental Services: East of England

Tuesday 16th May 2023 Westminster Hall

[Sir Mark Hendrick in the Chair]

14:30

[Mr Richard Bacon (South Norfolk) (Con)]

I beg to move,

That this House has considered dental services in the East of England.

It is a pleasure to serve under your chairmanship, Sir Mark. I am particularly pleased to have the opportunity to introduce this debate on dental services in the east of England, as I have been applying to Mr Speaker for a debate on the subject for several months. I am sure that I am not alone among hon. Members in finding that the subject of access to a dentist is one of the largest in my constituency postbag and inbox. It has been the topic of numerous Back-Bench debates in recent times. I pay particular tribute to the efforts of my hon. Friend the Member for Waveney (Peter Aldous) and the hon. Member for Bradford South (Judith Cummins), who have jointly sponsored a trio of debates in the last year or so, most recently on 27 April. My hon. Friend the Member for Broadland (Jerome Mayhew), who is also present, led an Adjournment debate on the need to establish a dental training college in East Anglia on 11 October last year. I will not say much more about that, but I ask the Minister to reconsider the Government’s position on it, because my hon. Friend made some very good points in that debate.

There have been many other interventions on many occasions by many hon. Members from both sides of the House. Indeed, another of my parliamentary neighbours, the hon. Member for Norwich South (Clive Lewis), secured question No. 1 in Prime Minister’s questions last week and asked about dentistry. He also managed to include a rather third-rate joke—something to do with rotten teeth and rotten Governments—but before he is tempted to repeat that, should he grace us with his presence, I point out to the House that I have a fourth-rate joke just for him. Colleagues may have noticed that the debate was scheduled to start, and indeed did start on time, at tooth-hurty pm.

Given the—[Laughter.] It got there eventually. That is Lincolnshire for you, Sir Mark. Given the enormous cost of dealing with the pandemic, and the inevitable financial consequences and constraints that it imposed, I think that the Government have done rather well, but that is not to say that they cannot do better. We all expect them to do better, as do our constituents. The Commons Health Committee has studied the reform of dental services and noted concerns that the Government have

“transferred financial risk from the NHS to dentists”,

adding:

“The fixed-term contract may make dentists reluctant to make long term investments in their practice.”

The Committee observed that the chief dental officer appeared in evidence to argue that if commissioners and dentists

“acted more flexibly and used common sense and good will the new arrangements would work”,

but it concluded that

“we see little evidence that this will happen.”

The Committee also reported that the total number of dentists working for the NHS and the activity that they have provided has fallen, and that the total number of patients seen by an NHS dentist has fallen by 900,000. The conclusion of the Health Committee was that the contract was

“failing to improve dental services measured by any of the criteria.”

If hon. Members find any of those conclusions eerily familiar, it would not surprise me, because they are from the Health Committee’s report in July 2008, when the Committee had a Labour majority and a Labour Chair, and there was a Labour Government. I hope that we can all agree that this is a long-standing problem that is not confined to any one Government or party.

There is widespread agreement that the dental contract introduced in 2006 lies at the root of many of the problems that we see today. The old item of service method that existed prior to the 2006 contract may have had some issues, but as one dentist said to me:

“It was a system that allowed you to be entrepreneurial”.

A dentist could set up a dental practice, put a sign outside and get on with it. Under the old NHS contract, dentists were paid for each item of treatment that they provided—an examination, a filling, a crown or a denture. Now they are paid per course of treatment, irrespective of how many items are provided, thus a course of treatment involving one filling attracts the same fee as one containing five fillings, a root treatment and an extraction. As the Duke of Norfolk is rumoured to have said about the rhythm method of contraception, there is only one problem: it “doesn’t bloody work”. We have had this problem since 2006. We have a contract that is, effectively, not fit for purpose.

In fairness, the problems go back beyond 2006. Indeed, my hon. Friend the Member for Waveney said in his last debate on the subject on 27 April:

“The fundamental causes of the collapse of NHS dentistry”

—I do not like saying that as a supporter of the Government, but I do not think the “collapse of NHS dentistry” is too extreme when we see what is happening; I hope that the Minister notes that—

“go back over 25 years with a gradual withdrawal of funding by successive Governments and the poorly thought-through 2006 NHS contract.”

My hon. Friend added:

“Covid was the final straw that brought the edifice crashing down.”—[Official Report, 27 April 2023; Vol. 731, c. 995.]

The problems in NHS dentistry have been so well canvassed in so many recent debates that I do not want to rehearse them again. I will, however, reprise one story from my constituency. The Manor House dental practice in Long Stratton in South Norfolk was run for many years by a respected and successful dentist called Dr Mark Ter-Berg, who, after many years of service, retired and sold his practice. After a period, the new managers of the practice got into financial difficulty and the business went under, owing money both to its corporate owners and the NHS. Dr Ter-Berg offered to come out of retirement and take over his old practice. He was quoted as saying in a local newspaper:

“You would have thought that”—

NHS England—

would have bitten my hand off”.

After months of making the offer and getting nowhere, I intervened on his behalf with NHS England, but it did not make much difference.

Dr Ter-Berg finally gave up waiting and decided instead to set up an entirely separate new dental practice in Long Stratton. I drove past it the other day, and there was a sign that read, “Open from 4 May”. I spoke to him yesterday and he is now very busy. He does not have an NHS dental contract; it is all private work and he is extremely busy—and Long Stratton is not by any means the most prosperous part of my constituency.

As Allison Pearson wrote on 10 August 2022 in The Daily Telegraph, which is not a notable bastion of left-wing journalism:

“I can’t think of a better example of a two-tier NHS than the one that currently exists in dentistry.”

Indeed, I understand that the providers of dental plans—for example, Practice Plan, which styles itself

“the UK’s leading provider of practice-branded dental membership plans to help you leave NHS dentistry or switch providers”—

are so busy that they are rushed off their feet.

Colleagues will have seen the British Dental Association briefing for this debate, which references a much-reported BBC investigation showing that no dental practice in Norfolk, Suffolk or Cambridge was taking on new adult NHS patients, and that this was also true of nearly all dental practices in Hertfordshire, Bedfordshire and Essex. At the end of March, Bupa announced that it will close many dental practices across the country; 85 practices were to be affected, with 38 set to close immediately. That includes two in Norfolk, with one in Harleston in my South Norfolk constituency—although I understand that Bupa is hoping to sell that practice to a new owner and that it will not close on 30 June as previously expected. The truth is that successive Governments have made NHS dentistry a place where dentists increasingly do not want to work. We need to focus on that, and we would all like to know what the Minister will do about it.

Let me say a word about money. The thing that struck me most in preparing for this debate was how little money the NHS spends on dentistry—indeed, how little is spent on dentistry at all compared with what it spends on other things. The figure is currently about £3.2 billion a year—that fluctuates a bit—and about 20% to 32% of that is actually paid through patient charges, paid by the patients themselves.

A recent National Audit Office study showed NHS spending rising from £123.7 billion in the financial year that ended in 2020 up to £151.8 billion—more or less £152 billion—at the end of the financial year that just finished. Further big rises are expected and planned—going up to £162.6 billion—by the end of the financial year 2025. Those are huge sums. In comparison, the annual cost of dentistry is tiny. I tend to compare anything under £3 billion with the NHS national programme for IT in the health service—one of the less successful parts of the last Labour Government. The Health Committee and the Public Accounts Committee studied that extensively at the time, and showed that the electronic patient record element, which cost £2.7 billion, had achieved basically nothing. The Public Accounts Committee’s report—this was its third report on the issue—from around August 2011 stated:

“The Department is unable to show what has been achieved for the £2.7 billion spent to date on care records systems.”

In other words, that nearly £3 billion achieved precisely nothing. I know that this is not quite comparable, being an annual number, but talk of a few hundred million or a couple of billion pounds means a few failed Government computer projects, in terms of the quantum. Compared with the £124 billion or £152 billion or £160-something billion that we are talking about, £2 billion or £3 billion here or there is of very little account.

I am sure that the Minister will refer to the fact that the Government are aware they need to reform NHS dentistry and that he is working on a plan. Some hon. Members might press him for a date on that plan, but I will not do that. I am much more concerned about ensuring that, when he gets the plan, it is right. I do not think it is any one Government’s responsibility that this has gone wrong. In fairness to the Labour Government of the mid-00s, in 2006, they were trying to correct what they thought was a big problem—that the item of service method led to a bill that was difficult to control. It was more akin to annually managed expenditure in the social security Department.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend is making some very good points, and I congratulate him on securing the debate. He will recognise that there is a tension between payment by activity, which is not necessarily a desirable way to manage health—be that dental or physical health—and moving towards a more preventive model, which was the aim, if not the reality, of the changes to the 2006 contract and subsequent changes. What does he think about finding a way to lock in dentists to the NHS for maybe five years, post-graduation, to ensure that they pay back some of the training that cost the taxpayer many hundreds of thousands of pounds?

[Mr Bacon]

My hon. Friend makes several good points. We did payment by activity for acute hospitals, and we got a huge amount of activity in acute hospitals. Mental health was then the Cinderella service, with what little was left. Of course, there are tensions, and my hon. Friend, as a practising hospital doctor, will know that better than most. How that needle can be threaded to get the desired results has confronted Governments for many years.

On my hon. Friend’s specific point, having gone through medical school or dental school and come out the other end, junior doctors and, I am sure, junior dentists are at the moment struggling in the way that many others are—including young professionals—to afford anywhere to live. We have hundreds of thousands of acres of public land, including Ministry of Defence land, NHS land, railway land and church land, which has a quasi-public flavour to it. Norfolk County Council alone owns 16,000 acres of land. I would say to these people, “Come and work for the NHS for a few years full time. Commit yourselves completely to this, and we will help you design, build and rent from us at a decent rent. And then, depending on the calibrated loyalty package, which I am sure we can easily work out, you will get the chance in future to buy the house that you have designed for yourself.”

To go back to the point that my hon. Friend the Member for Broadland has made, getting people to stay in a particular area has proved difficult, not least because we do not have a dental training college. However, this is also about people understanding that the area they are going to work in is particularly attractive. That is true of much of the east of England, except people do not realise it because not enough of them, certainly in dentistry, are educated there. There is a huge opportunity for the Government to get this right, and I am more concerned about ensuring that the plan that comes from the Minister in the next few weeks or months is correct.

The fear I have is the potential downside. My constituent who, before Christmas, booked an appointment for her children for 9 May but found out recently that it was cancelled in a text message from the Harleston Bupa practice—she has been phoning to find out what is going on—will not care or know about the interstices of the 2006 dental contract, which was perhaps well intentioned but is deeply flawed and has led to many of the problems we are grappling with. She will just care that she cannot get an appointment.

Although the Opposition have not been particularly fleet of foot in recent years, even they can see that this will become a very salient issue at the next general election. We have our five points: halving inflation, growing the economy, reducing the national debt, cutting NHS waiting times and stopping the boats. Those are fine, but they are not a programme for Government. We need to do those things to restore confidence after the events of last autumn and—it might be best if I quote Mark Twain—to try and draw a veil and hope that not too many people remember them. However, the fact is that we need a better programme for the election, and I am sure we will have one.

The hon. Member for Denton and Reddish (Andrew Gwynne) will be sitting there with his chums, thinking, “What are our five points going to be?” If we do not get this right—mark my words, Sir Mark—the Opposition parties will say, “They have had 13 years to talk about it. It started with the 2006 dental contract, but they have had long enough and have not yet sorted it.” It will then become one of their five points. We are talking about such piffling sums of money compared with the overall cost of the NHS that it is simply incomprehensible that we would not deal with this properly.

The issue of dental care has been of growing concern to our constituents for many years, and the concern has only grown as successive Governments have failed to grapple with the issues properly. On present trends, it will continue to get worse—much worse—unless the Government make a decisive step change and match that decision with the right resources in the right places within a contractual framework that incentivises the right behaviour. That is what the Government need to do.

[Sir Mark Hendrick (in the Chair)]

I remind Members that they should bob if they wish to be called in the debate. I call Andrew Selous.

14:46

[Andrew Selous (South West Bedfordshire) (Con)]

I congratulate my colleague and good friend, my hon. Friend the Member for South Norfolk (Mr Bacon), on an excellent and passionate speech. I agreed with every word that he said.

I, too, am a veteran of these debates. I dusted off the speech that I made on this subject—probably in this very chair—on 10 February 2022, and things are not better, so I am back, as we all are. It is the duty of Back-Bench Members of Parliament to speak out on behalf of constituents. In February 2022, I had been told a month or two before by NHS England that of the 47 dental practices in my constituency, six were taking NHS patients, but I do not think that was accurate because it was not the experience of my constituents. When NHS England told me that it had done a search on dentists available to take NHS patients in my constituency, I do not think that it had knocked on doors and gone in and asked them. I think it had sat and looked at what an out-of-date website said, and that is not good enough. For a public service that matters, it should not look at an out-of-date website and give Members of Parliament inaccurate information.

The situation is still not better. If we look at the figures from the House of Commons Library briefing on the percentage of children who have seen a dentist, just before the pandemic in September 2019, it was not high enough—it was 58.5%, so just under six out of 10 children saw a dentist every year. The pandemic has a lot to answer for in a lot of areas of our national life, and the latest figures that we have from the Library show that in June 2022, the figure for children seeing a dentist in the last year had declined from 58.5%, which was not high enough anyway, to 46.2%. Less than half of the children in England see a dentist every year, yet we know how important it is for them to do so. Children go to hospital to have teeth taken out, and so on, but regular trips to the dentist, proper prevention and proper brushing could prevent that.

The situation is no better for adults. We have similar figures for adults going to see a dentist in the last two years; I am not sure why it is two years for adults and one for children. In September 2019, just before the pandemic, 49.5% of adults had been to see a dentist in the past two years. That has crashed down and, as at June 2022, is now barely more than a third at 36.9%. Just over a third of adults in England go to see a dentist every two years.

Serious work clearly must be done, because oral health matters. It matters for young children, as I have said, far too many of whom turn up in hospital having to have teeth taken out. It is important that we teach children to brush their teeth well, and we all need to be reminded of that. A Radio 4 programme that I was listening to the other day reminded us that we should not rinse the toothpaste out of our mouth but should only spit it out. You might think that is rather piffling, Sir Mark, but if it helps the nation’s teeth to be a bit healthier by leaving the fluoride on our teeth, it is actually quite important information. There is a job to be done of educating the whole nation about how to look after our teeth properly.

I am passionate about dental care for older people as well. With busy adult social care staff, it can get forgotten, and in nursing homes and care homes it has not always been given the priority that it needs. I had a debate in the main Chamber a while ago on this subject and domiciliary care. The care needs to be there, because poor oral health can contribute to a whole host of other problems and can make them worse. For example, someone might have a low-level bacterial infection in their mouth because they do not have good dental hygiene. We need to get this right.

I was very taken with the suggestion from my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) about NHS dental students giving some time to the NHS. I think five years was suggested. I am conscious that, unlike when I went to university, there are grants and that students leave with quite a lot of student debt, but there is something we could and should do there. If someone is training to be a doctor or a dentist, they receive a large amount of taxpayers’ money, and taxpayers can reasonably ask what they are getting back in public service. Whether we could do something on the amount of debt they have, or vary or pause the interest rate, if they gave those five years to the NHS, that would be worth looking at, and having a greater supply of dentists would make a significant difference.

I come back again to say that the situation is not as I would want it to be. I want my constituents to be able to see a dentist easily. I spoke to the Minister before the debate, and I know the Government are earnestly working on the subject and will come up with a plan in the next few months. I have particular confidence in this Minister—sparing his blushes—because he has been incredibly helpful to me on general practice provision in my constituency. He is an outstanding Minister: highly intelligent, does the detail, delivers and asks the questions that need to be asked. I have hope and confidence in him, but I say to him today, as all hon. Friends do, that this is urgent and it matters. Please deliver—deliver properly and deliver quickly.

14:53

[Peter Aldous (Waveney) (Con)]

It is a pleasure to serve with you in the Chair, Sir Mark. I congratulate my hon. Friend and neighbour the Member for South Norfolk (Mr Bacon) on securing and leading the debate. That said—some faint praise there—it is easier for an MP to secure a debate on NHS dentistry in this place than it is for one of our constituents to actually see an NHS dentist.

As we know, the east of England is the most arid region in the country. That is certainly the case with rainfall and probably also with NHS dentistry. As we have heard, it has been the No. 1 item in many of our inboxes over the past two years. There are no signs of that abating, though, from what the Minister has said, I get the sense that the first steps are being taken to provide an improved service. There is much work to do and I await the Government’s plan for NHS dentistry. I am very much aware of the hard work that my hon. Friend has been carrying out and I hope he will be able to provide a publication date when he responds. I want to highlight what I believe should be included in the NHS dentistry plan, with a slight slant towards the east of England.

The first item is, of course, that NHS dentistry requires fair funding. The British Dental Association has estimated that we would need £1.5 billion a year to restore budgets to their 2010 level. I recognise that that will not be achieved overnight, but there does need to be a meaningful start.

I want to highlight two further points on funding. As I understand it, the annual budget for NHS dentistry is of the order of £3 billion; just over 10% of that is due to be clawed back because it has not been spent. I do not know whether the Minister has given an assurance elsewhere, but that money must remain ringfenced for NHS dentistry. The fact that there is money not being spent shows that the whole system is broken. We saw that at the beginning of January 2022, when the Government announced £50 billion of funding for what was described as a dentistry treatment blitz; only 30% of that was spent. There is a lot of work to do on the funding side.

I turn to funding issues from the east of England perspective. The British Dental Association carried out some work before the pandemic that showed that spending on NHS dentistry in England lags way behind that in Scotland, Wales and Northern Ireland. Homing in on what is happening in England, some recent research commissioned by the University of East Anglia and carried out by Health Economics Consulting very much showed that the east of England is the poor relation compared with the rest of the England.

The research showed that, for 2018-19, in the midlands, spending on NHS dentistry was £78 gross expenditure per head. In the north-west, it was £75; in the north-east and Yorkshire, £70; in London, £69; in the south-east and south-west, £69. The east of England is the tail-end Charlie, at £39 per head. There are a great many steps that we need to be taking to address that particular inequality.

My second point is about contract reform. The 2006 contract is discredited, and needs to be replaced. From what I can gather from what the Government and the BDA say, we have moved beyond what I would describe as the “talks about talks” phase of negotiations, and they are in meaningful discussions. This must not just be a tinkering with the contract—it must be a complete root-and-branch reform.

Some of the ingredients we need for a new contract include a clear break with the units of dental activity system of funding; and we must discard the straitjacket on how many patients NHS dentists can see. If they do not see enough, they get fined; if they see too many, they have to pay for it. We must also ensure that more complex and lengthy treatments are properly rewarded and that NHS dentists are not discouraged and penalised for performing them; we must prioritise prevention; and, particularly from the east of England’s perspective, somehow we must find a way of motivating NHS dentists to come and work in rural and coastal areas.

My third point is about recruitment and retention. Another plan that we are awaiting is the Government’s workforce plan for the NHS and the care sector, and dentistry must feature extremely prominently in that plan. In the short term, we need to recruit more dentists from overseas. We have a situation in the Lowestoft area—actually, it is in Beccles, where there is an NHS dental contract with a group called the Dental Design Studio. That group has been trying for some months to recruit three dentists from overseas. I think they are moving forward, but progress on the overseas registration examination, as carried out by the General Dental Council, is fairly slow. I have liaised with the Minister on the issue in the past and there is a backlog of applicants that needs to be addressed as quickly as possible.

Moving on from that, we need to train our own dentistry practitioners, which means hygienists and support staff as well as dentists. With that in mind, the University of Suffolk has set up a community interest company with the objective of carrying out both treatment and training, with the creation of hubs. The initiative is up and running, but it needs additional funding so that it can be rolled out further across the region. I ask the Minister to do all he can to provide that funding.

In the longer term, there is the issue of a dentistry school; we do not have one in the east of England. Both the University of Suffolk and the University of East Anglia have thrown their hats into the ring. What the Government need to do is just to assess strategically which regions need dentistry schools, but I believe there is a very big vacuum in the east of England. UEA and the University of Suffolk probably need to get together to come forward and put one case, rather than competing with each other.

My fourth point is about prevention. As we have mentioned, the new NHS dental contract must have an emphasis on prevention and the NHS needs to work closely with local councils in promoting better public health. I will quickly highlight fluoridisation. It is not a particular issue in the east of England, but I remember that in one of the many debates that we have had on NHS dentistry in this very Chamber, my hon. Friend the Member for Mole Valley (Sir Paul Beresford), who is a practising dentist, highlighted the situation in Birmingham, where he, as a dentist, can tell which part of the city someone comes from by looking at their teeth, because he knows whether the water is fluoridated in that particular area. Fluoridisation is a compelling issue that needs to be addressed.

Let me also highlight children’s dental health. Two years ago in Lowestoft, an organisation called Lowestoft Rising got together with some local councillors and bought toothbrushes and toothpaste for the under-sevens. It was an extremely successful project and very quickly parents were coming back and saying, “Can we have more?” Unfortunately, more was not available, but it was suggested to me that we should perhaps consider zero-rating toothbrushes and toothpaste for under-sevens. Longer term, we need to look at that very closely.

My final point is about accountability and transparency. There needs to be improved accountability and transparency with NHS dentistry. We have made a significant step forward with the transfer of procurement from NHS England to the new integrated care boards. In the Norfolk and Waveney area, that happened from 1 April, and it is important that dentistry is properly represented on those ICBs. Judging from the feedback that we have had from the Norfolk and Waveney ICB, it is very much getting to work on the problem. It is producing a one-year plan for short-term interventions and next March it will look to produce its long-term dental strategy. From my perspective, I can cite one major improvement. If I have a complaint about NHS dentistry, I can now go to the local NHS commissioners, who I go to on other issues and who give me very good, quick and proactive responses.

To conclude, in geographical terms East Anglia is probably the largest dental desert in the UK, and we need, metaphorically at least, to bring in the irrigators and sink the boreholes with immediate effect. There has been some preparatory work that will enable us to improve the situation, but we need the Government NHS dentistry plan as soon as possible. The plan will cover the whole of the UK, but it must also address the specific problems in the east of England—our historical poor funding, the challenge in recruiting and retaining dentists in our region, and the lack of training facilities. I look forward to the Minister’s response. He impressed me with the way he went about this task, but the plan that he produces needs to be ambitious, visionary and innovative, not just a sticking plaster.

15:05

[Jerome Mayhew (Broadland) (Con)]

One of the unifying features of the speeches today is that we have heard them all before. Not only have we all heard it before, but we have all said it before, so I will try—I may fail—not to do that. However, I do have to highlight some elements of the problem, which has been ably covered by my hon. Friend the Member for Waveney (Peter Aldous).

Access to NHS dentistry in Norfolk, which is the worst in the east of England, was surveyed in 2020 to 2021, and of the 150 sub-regions of the country, Norfolk came 147th. As I said to the Minister in a previous speech, we have to follow the money. As my hon. Friend the Member for Waveney pointed out, the best areas spend nearly £80 per mouth per year on dentistry; in the east of England, the figure is £39—a full 50% less. Does the Minister have an explanation for that? I genuinely struggle to understand how spending on NHS dentistry in the east of England is so far below that in the rest of the country. It seems to be without explanation.

More locally still, in Broadland the lack of dentists of any description is profound. I was lucky enough to persuade the Department to advertise a new contract for NHS dentistry in Fakenham last year. The money was available and the contract was advertised; not a single organisation applied for the contract, and it is still vacant. In Sheringham, in the constituency of my hon. Friend the Member for North Norfolk (Duncan Baker), who is unable to speak in this debate, there is a dental practice that is owned by an organisation that has an equivalent practice in London. The organisation has been advertising consistently for a new private dentist in Sheringham for 10 years, and it has yet to fill the role, whereas during the same time multiple positions in its London practice have been advertised and filled. It is therefore not just a regional issue; geography really matters.

I am sorry to say that just last week the latest in long and ignoble line of announcements came when Brundall Dental Practice, which is an NHS practice, contacted patients to say that it would no longer be accepting adult NHS patients from 1 September this year. People are being asked to move on to monthly subscriptions for dental care, which are between £150 and £400 a year. I struggle to know what to say to the many constituents who have contacted me, because not a single NHS practice in the county of Norfolk is currently accepting new patients under an NHS contract. The £11 a month is only for check-ups and hygienists; it is not for dental care, which is an extra charge.

People might say that many can afford to pay for dentistry if they have to, but we have to also consider those who are excluded from paying dental charges because of their financial circumstances. What are we asking of those constituents? Where are they to turn not a single provider in the county of Norfolk is accepting NHS dentistry? The answer, of course, is that they will go to the Norfolk and Norwich University Hospital when their dental problems become acute, and we merely transfer the problem from the dentistry budget to the NHS and acute budget. The problem will be so much worse, and so much harder and more expensive to treat, because we are not nipping things in the bud but dealing with acute emergencies. That cannot be the right answer.

The reason I do not want to prolong the agony of discussing the problem is that I know that the Minister gets it. If he was not educated before, he has certainly been educated on numerous occasions, either here or in the main Chamber, by many of the Members present—the problem has already been fed back. Government Members have great confidence in the Minister and in his grip, grasp and focus on the issue. We know that a dentistry plan is imminent—the sooner that it is published, the better, and more power to the Minister’s elbow—but there are a number of suggestions I hope will find their way into the plan.

In the short term, we need additional improvements to the current dentistry contract—other Members have spoken eloquently about that, and I would highlight it as being very important. As regards the medium term, we have had reference to centres for dental development. The University of Suffolk has progressed far in its application, and there is a necessity for a similar venture at the University of East Anglia, or at least similar work in Norwich. However, in the long term, we simply have to train more dentists. We have to open the market to allow people to access a lucrative and fulfilling career that is currently not being explored in the east of Anglia and in Norfolk, in particular.

We need to train people in the east of England. The University of East Anglia has put forward proposals for a dental school. The medical school it founded in Norwich about 10 years ago knows definitively, from surveying all its graduates each year, that about 40% go on to take their first job locally. The single act of setting up a dental school in Norwich, linked to the Quadram Institute and the research work at the Norwich Research Park on the human microbiome, is the long-term solution.

I hope the medical plan will look beyond the national numbers. I was told by the NHS that roughly the right number of dentists are being trained each year, but I dispute that. It has been seven years since it surveyed what those dentists are up to. It has no idea whether the dentists notionally on its books have retired, gone abroad, are working in the NHS, are working part-time in the NHS, are working privately, or none of the above.

[Andrew Selous]

My hon. Friend is making a powerful point about the link between where people train and where they work. I would gently make the point to the Minister that the east of England is quite a large area. Norfolk and Suffolk are deeply wonderful places, with which I have a great affiliation, but they are quite a long way from Bedfordshire, which is also in the east of England. If we were to think that it was job done because we had trained dentists in Norwich or wherever, I would want to know what that meant for the good people of Leighton Buzzard, Dunstable, Houghton Regis and the surrounding villages. I put that marker in the Minister’s mind.

[Jerome Mayhew]

That is fair enough. However, if someone grows up in the east of England, whether in Norfolk, Suffolk or even Bedfordshire, there are only two places where they can train: Birmingham and London. There is no other place in the entire east of England where they can train, so is it surprising that we have a dearth of dentists? Is it surprising, particularly in rural areas, that we do not attract dentists who are newly qualified and therefore likely to be in their early to mid-20s? Do they wish to relocate in large numbers at that stage to a rural location? Many do not, so we need to bring the beauties of East Anglia, including Bedfordshire, to trainees so that we can benefit from the stickiness of tertiary education and location.

Finally, my hon. Friend the Member for Waveney raised the issue of fluoridation, which I wish to develop. There is no fluoridation in Norfolk at the moment, and perhaps it shows. The data suggests that the level of decay across the teeth of Norfolk is not universal but is substantially located towards west Norfolk and King’s Lynn. All sorts of factors may account for that, but areas of higher dental decay correlate with those that have reduced natural levels of fluoridation in the water, with the lowest levels around King’s Lynn. I raise that as an issue that I hope the plan will address.

15:15

[Matt Warman (Boston and Skegness) (Con)]

I congratulate my hon. Friend the Member for South Norfolk (Mr Bacon) on securing the debate. Although my constituents use the facilities of the east of England, I welcome his hospitality in the debate as well. This is a shared issue, especially for many in the southern part of my constituency.

I wanted to speak today because, as we have heard from many other hon. Members, this is not just a top issue, but the top issue, in the postbag and particularly on social media. We all feel the immense frustration of our constituents on this important issue. In Lincolnshire, nearly a quarter of five-year-olds are suspected to have tooth decay. Last year, a dozen Boston children had teeth removed. The problems we have heard about in the east of England are present in my part of the world too, and the burden of that partly falls on the services provided in the east of England, which is why it is relevant for me to speak today. These are real problems.

I asked my office to do what I called a secret shopping exercise because, like my hon. Friend the Member for South West Bedfordshire (Andrew Selous), I did not trust the data NHS England had provided. On that secret shopping exercise, we see that just a single NHS practice is offering access to new patients and, even then, only to children. There are huge problems with local provision. When I spoke to the ICB, which has recently taken on the responsibility, it said that there are particularly acute issues in coastal and rural areas and, as we have heard, that there are no silver bullets. However, it raised a few issues, which I will use to augment previous speakers’ excellent contributions.

First, there is the enormous backlog in the General Dental Council exams. I gather that 1,700 people are seeking to take the part 1 exam and that the GDC website does not even say when it plans to put another one on. When it does, it is likely to put just 150 people through it. I know that the GDC is an independent body, but will the Minister do all he can—I know he is already doing so—to encourage the GDC to pull its finger out?

Secondly, on the issue of having a dental school in the east of England, there is a medical school in Lincoln; if it were to train dentists, that would benefit the broader area. As we have heard, there is a clear need for many more dentists to be trained across the country, so perhaps we could do something for East Anglia and see benefits for the whole region from having Lincoln-trained dentists.

Thirdly, the issue of fluoridation affects my constituents as well. I do not think anyone, except those on the outer edges of the internet, could possibly argue against fluoridation, and we should encourage it as quickly as possible. On the outer edges of the internet, I give way to my hon. Friend the Member for Broadland (Jerome Mayhew).

[Jerome Mayhew]

I try not to inhabit that area. Does my hon. Friend not think that it is surprising that only 10% of the country’s drinking water is fluoridated?

[Matt Warman]

It is a surprising number. As I am sure my hon. Friend knows, the water companies have raised issues that are legitimate to some extent, but the overall public good from increasing that number is obvious and would pay real dividends relatively quickly. It would be public money well spent.

[Peter Aldous]

In this place, fluoridation is recognised, but the feedback I get from water companies is that conspiracy theories on the internet cause them concern. Does my hon. Friend agree that there is a need for the Government to lead a public awareness campaign on the benefits of fluoridation to dispel these urban myths?

[Matt Warman]

I was the Minister responsible for 5G during covid, and we all remember that, apparently, 5G caused covid—I should be very clear that it did not. However, there is a clear dilemma for the Government as to how much they engage with genuinely fringe conspiracy theories and risk giving them a degree of salience and credibility that they simply do not deserve. I encourage the Minister and his colleagues in the Department for Environment, Food and Rural Affairs simply to get on with it and engage, where necessary, with people who are genuinely worried. However, we sometimes have to acknowledge that the extremities of the internet are not a place where rational debate can always be had, be it on 5G and covid or on fluoridation and tooth decay.

I will make two other points before I end my jaunt to the east of the England. The first is that I know the Minister is looking—as we do with GPs and the NHS more broadly—at what work can be done by people who are not fully qualified dentists to help the nation’s oral health. Along with the expansion of people who have trained abroad, I think that would be welcome and could make a difference, but it is not a silver bullet either.

My final point is that, although my secret shopping exercise was valuable and instructive, it is a huge sign of failure, because the data about which dentists are accepting patients should be freely and easily available so that constituents can easily see which practices are offering help. Given the structure of NHS dentistry, we will always have some dentists with open lists and some with closed lists, even in a healthy system. Easy access to that information would benefit our constituents and NHS England.

I know that the Secretary of State is a huge fan of data and is making such information as open and as easily available as possible, and I hope it can form part of the eagerly anticipated dentistry plan, which is coming “soon”—I think that is the current Government parlance. In a world where the autumn runs into February, I would hope that “soon” is well before the summer. I know it will make a difference in the medium term, but the biggest frustration for all our constituents is the fact that there is no silver bullet.

I hope the dentistry plan includes, for instance, the experimental ways of employing dentists that some trusts are using up and down the country, because that will provide some of the interim measures that I hope will come before the opening of the three dental schools that we have secured in this debate alone. Those will make a huge difference, but it takes time to train dentists, and constituents need solutions as quickly as possible. In pursuing that, we will save people from turning up at A&Es and emergency dental appointments, which will come as a consequence of failing to deliver the basic services I know the Minister is keen to offer as quickly as possible.

15:24

[Andrew Gwynne (Denton and Reddish) (Lab)]

As ever, it is a pleasure to serve under your chairmanship, Sir Mark. I commend the hon. Member for South Norfolk (Mr Bacon) for securing this important debate and for setting out some really important points not just for the people of the east of the England—although it has been impressed on me in the course of the debate that there is a specific issue that is pertinent to that area—but for the whole of England, because dentistry is nowhere near where we would want it to be in any part of the country, notwithstanding the differences in regional funding and access that we have heard about.

We have had a really good, thorough debate, and there has been consensus across the Chamber on the state of NHS dentistry. I thank the hon. Members for South Norfolk, for South West Bedfordshire (Andrew Selous), for Broadland (Jerome Mayhew), for Waveney (Peter Aldous) and for Boston and Skegness (Matt Warman) for the veritable tour of the east of England and south Lincolnshire that I have been sent on. I am well aware that south Lincolnshire is not in the east of England, although it is close to it and uses lots of public services within it. That is not least because my wife is from Bourne, in Lincolnshire, so I know how the area connects into Cambridgeshire and beyond.

I want to mention the hon. Member for North Norfolk (Duncan Baker), because he will have constituency issues that he would have dearly loved to raise in the debate. Having been a parliamentary private secretary myself, I know that they must be seen and not heard—it is one of the curses of the job. The great part of the job is getting to work with wonderful Ministers and being able to lobby them behind the scenes on all these issues. The downside is that constituents do not see the benefit of their MP most of the time. In addition, I thought the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) made some really important interventions.

It has been said already that we have been here before. I recently participated on behalf of the shadow health and social care team in a Backbench Business debate, which the hon. Member for South Norfolk co-sponsored. I spoke about people having to remove their own teeth, patients waiting over three years to access dental care, and individuals becoming addicted to painkillers because they cannot get treatment. I could go on and on with examples, but they all point to a simple fact: NHS dentistry is in crisis and is not working for the people who need to access treatment now. We have all heard from constituents at a loss about what to do, who are waiting day in, day out in utter agony and crying out for action on NHS dentistry.

As the hon. Member for South Norfolk made clear, the problem is particularly acute in the east of England. In 2022 no dentists were registering new patients in the whole of Suffolk, Norfolk or Cambridgeshire. In Norfolk, and indeed Waveney, there are only 38 NHS dentists per 100,000 people. It is little wonder that we hear stories of DIY tooth extraction, of Norwich hospital treating more people than ever before for opiate addiction and, in some parts of Norfolk, of 40% of under-fives suffering from dental decay.

We cannot go on like this—nationally, across England or in the east of England. Over the last decade, net spend on dental practices in England has been cut by over a third, with 2,000 NHS dentists quitting in 2021 alone. It is not just about this Government; there have been issues for a long period of time, and those have been compounded over a long period of time.

The hon. Member for South Norfolk and others mentioned the 2006 dental contract. As I pointed out in the Chamber in the Backbench Business debate, there was consensus on the effects of the 2006 contract by the 2010 general election.

The last Labour Government recognised that the dental contract needed reforming and pledged to do so in their election manifesto of 2010. So too did the Conservative party in its election manifesto in 2010. It would be remiss of me not to make this point, as the hon. Gentleman indicated I would: you guys have had 13 years to fix that dental contract. It is of deep frustration that in a decade and three years, that has not happened.

I have said this before: there was not a golden era of NHS dentistry before the 2006 contract. The hon. Member for South Norfolk mentioned that before 2006, dentists were paid for each treatment. That worked in the interests of dentists, but not always in the interests of patients. I have also said this before: there is a reason why my mouth is full of metal—crowns and fillings—and it is not because I ate more sweets than my children did or because I brushed my teeth less well. It is because dentists were incentivised to maximise the amount of work they did because that is how they got paid—drill and fill—and that was not always in the interests of public health or the patient.

It was not a bad thing that the Labour Government sought to make changes to bring NHS dentistry more in line with private dentistry, where the emphasis was on prevention rather than on drilling and filling, but it did not work—I make no bones about it. That contract needed to be reformed.

In a similar vein, there is still no sight of the NHS workforce plan—I say that at every opportunity when I face this Minister or others in his Department. We know it currently resides on the Secretary of State’s desk, despite the fact that 90% of dental practices with a high NHS commitment still find it difficult to recruit a dentist, so the key question to the Minister is: what does he plan to do to address the crisis in dental care across England? How do the Government plan to tackle the dental deserts that are causing misery to millions of people, particularly in the east of England? I would also appreciate an update on why the Government are yet to publish the workforce plan in full and when we can expect its release.

It is also important that the Minister recognises the extreme health inequalities that are widening to record levels. Children living in the poorest parts of England are around three and a half times more likely to have rotten teeth removed than those in more affluent areas. That problem is set to get much worse, with families unable to access basic oral hygiene products because of the cost of living crisis. I was very interested to hear of the project in the constituency of the hon. Member for Waveney. Such projects can make a big difference for a small amount of cash at a very local level.

What steps is the Minister planning to take to address the growing inequalities, and what assessment has he made of the continued impact of the cost of living crisis on families who are unable to access oral hygiene products? Labour Members have been clear since 2010 that tackling the crisis in dentistry has to be an absolute priority for any incoming Government, and I include the possibility of an incoming Labour Government. We have a big job of work to do across the whole NHS.

I understand the predicament that the current Government are in, but the previous Labour Government brought waiting lists down across the NHS from 18 months to 18 weeks, and we will do the same again. We want to secure the future of NHS dentistry, and we would provide the staff, equipment and modern technology needed to ensure patients get the care they deserve.

The hon. Member for South Norfolk was absolutely right: if the Government do not move on this territory, the Labour party is there. We have set out how we will pay for the next generation of doctors, nurses, healthcare workers and dentists, with our workforce investment paid for by abolishing the non-dom tax status. We can begin to chip away at the dreadful oral health inequalities that we see across England. We will train 5,000 new health visitors who work closely with families to promote and prevent ill health. We already know that health visitors have the potential to improve dental attendance and oral health in the families who are least likely to engage with dental services—a role that cannot be overlooked.

People in the east of England and across the nation deserve much better NHS dental services than they are getting. Slowly but surely, we are seeing the creation of the two-tier system that the hon. Member for South Norfolk set out in his opening remarks, where those who are able to pay are receiving essential care, and those who are not are languishing in utter agony, unable to find an NHS dentist. The next Labour Government stand ready and waiting to act to rebuild NHS dentistry. Until then, I urge this Government to get to work. Too many people are suffering, and the current state of crisis must not be allowed to become the new normal.

15:25

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I start by thanking my hon. Friend the Member for South Norfolk (Mr Bacon) for securing this important debate. It was reminder of what a brilliant speaker he is. Dentistry is the number one issue that I am working on; I have had two meetings on it already today. It is something that we are working on at pace. I know there are challenges accessing dentistry across the country, and recently there have been particular issues in my hon. Friend’s constituency. We are committed to tackling those issues, not only in the east of England but right across the country.

My hon. Friends are quite right about the scale of the challenges, which are particularly acute in the east of England. Colleagues who are here today, and others from the east of England, are first in my mind when I think about those who are contributing ideas to our forthcoming dentistry plan. My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) talked about how we get students to do more for NHS dentistry. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) talked about how we must encourage preventative work, particularly for children—I completely agree with him.

My hon. Friend the Member for Waveney (Peter Aldous) talked about the challenge of under-delivery, the need to have proper rewards for complex types of treatment and how we incentivise dentists to move to areas such as the east of England. Those are all things that we are working on. My hon. Friend the Member for Broadland (Jerome Mayhew) talked about the unjustified variations in coverage and investment around the country, frozen in time by the 2006 contract. He also talked about the imbalances in training in different parts of the country. I was glad to hear various hon. Friends and Members talk about the importance of fluoridation. Across last year, we legislated to enable that to make progress for the first time since the 1960s.

My hon. Friend the Member for Boston and Skegness (Matt Warman) talked about how we must bust the backlog at the GDC. I met the GDC again yesterday to work on that. He also talked about the importance of accountability and greater transparency. Again, that is something that we are working on now. It would be remiss of me not to mention my hon. Friend the Member for North Norfolk (Duncan Baker), although the rules of this place do not allow him to speak in this debate. Hon. Friends from the east of England will not be surprised to hear that he, as the son of a dentist, is playing a leading role in pressing us forward to move even more quickly on dentistry.

My hon. Friend the Member for South Norfolk talked about fundamental reforms of the NHS dental contract. He is correct that we need to go further, but we have started to reform the contract for the first time since 2006, with the package of changes that we brought in last July. Those are an important first step in addressing some of the challenges facing the sector. We know, of course, that we need to go further. Those initial reforms have been received well by the profession and are starting to have a positive impact.

We created more UDA bands to better reflect the fair cost of work and incentivise NHS work. We introduced the first ever minimum UDA value to help to sustain practices where UDA vales are particularly low—the east of England is a good example of a place where that is the case. We allowed dentists to deliver 110% of their UDAs for the first time, to encourage more activity from those who want to do more. We made it a requirement for dentists to keep their availability for NHS patients up to date on the NHS website, which is an issue that a number of hon. Members have mentioned.

We also started the process of making it easier for dentists to come to work in the UK, and last month there came into force legislation that enables the General Dental Council to increase the capacity of the overseas registration exam, as hon. Friends have argued for in this debate. As some people have mentioned already, plans for a centre for dental development in Ipswich are advancing, and further plans are emerging elsewhere, including in Norfolk. We are also doing longer-term preventive work on expanding fluoridation; changing the law last year was part of that, and we also secured funding to expand fluoridation first across the north-east, subject to consultation later this year.

The reforms to split band 2 have been welcomed by the profession, as has the introduction of the 110% option. I am pleased to say that the proportion of the new band 2Bs is increasing and dentists are using the new flexibilities we introduced to prioritise those with higher needs. In terms of delivery, the number of patients seen in the year to March is up by nearly a fifth on a year earlier, but we must go further, and the changes we have made are just the start—I am under absolutely no illusion that there are significant challenges to address. The reforms that I have talked about and the forthcoming dental plan will draw on the ideas that hon. Members have put forward in this debate and offline. They will build on those initial banding changes and improve the payment model; ensure that we continue to improve access, particularly for new patients; look at how we address historical UDA variations; and look to make NHS work more attractive to ensure that NHS dentists are incentivised to deliver more NHS care.

The delegation, or devolution, of dentistry from NHS regions to ICBs, which various hon. Members have pointed out, is an improvement. It provides an opportunity for much closer integration with other local care services and much more accountability and transparency. People can much more easily go to see the person responsible for delivery in their area, and our dentistry plan will build on that.

I thank my hon. Friend the Member for South Norfolk for securing this important debate. I hope he is reassured that we have started to reform NHS dentistry and to improve services not just in the east of England, but in all areas. We will continue to build on those reforms in our plan for dentistry, on which we are working at pace.

15:42

[Mr Richard Bacon]

I enjoyed listening to the remarks of every contributor, including my parliamentary neighbour, my hon. Friend the Member for Waveney (Peter Aldous). I was going to say “the Member for Aldous”—going around my constituency, one finds quite a lot of Aldouses; I have not yet established whether they are all related, but if one scrapes under a stone in East Anglia one quickly comes across an Aldous. He gave us a tour d’horizon—a tremendous summary of the expertise that he has gathered over the last few years. Together with the hon. Member for Bradford South (Judith Cummins), he has led the way in drawing the issue to the attention of other hon. Members. I pay tribute to him for that, and I am deeply in his debt, because reading his speeches was a great way to read my way into the subject—one that I was drawn to not because of any expertise, but because of my constituency postbag. We have heard that the same is true for all hon. Members.

Opinion pollsters are sometimes behind the curve on what is a salient issue, but hon. Members on both sides of the House know that this is the top issue facing us. My plea to the Minister is not to go so fast that he gets it wrong, but to bide his time and ensure that he has taken everything into account. He should talk to his Secretary of State, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay)—an east of England MP who has the same problems in his constituency postbag—and come up with an answer that is attractive and provides lasting change. That is what we want to see.

My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), another of my parliamentary neighbours, raised the interesting point of how we encourage people who have had money spent on them by the NHS to stay in the NHS, even if they are paying fees themselves, as my hon. Friend the Member for South West Bedfordshire (Andrew Selous) said. I would be open to a wide variety of methods for doing that, including forgiveness of part of or perhaps all student loans. We need to make radical changes.

My hon. Friend the Member for Broadland (Jerome Mayhew) quoted a startling statistic: £80 per head is spent on dentistry in the areas that have the best dental care, and only £39 in parts of the east of England. What annoys me more than anything else is that, outside London and the south-east, the east of England is the fastest growing area of the country. It contributes the most gross value added to the economy outside London and the south-east. That is an argument that MPs in Norfolk and elsewhere in the east of England have been making for many years. We have been saying for years, “Give us the infrastructure, give us the broadband, give us the rail connectivity and give us the mobile telephony that actually works, without the need to go 100 yards down the road, stand on one leg and hope there is an “r” in the month to get a mobile telephone signal. Then we will provide the economic growth.”

Going back to the Prime Minister’s points, I seem to remember that one of them is about economic growth. Here we are contributing so much to the economy and yet not getting our fair share back, when the opportunity in the east of England is unrivalled in the UK. A golden triangle could exist between the economic heat, innovation and intellectual firepower of Cambridge; the Norwich Research Park in my constituency, where scientists look at world-leading advances in genomics and plant science; and technology in Ipswich at the BT labs at Martlesham. That golden triangle represents an extraordinary opportunity for the whole United Kingdom.

I was recently at the Cambridgeshire Development Forum, where I heard people talking about east-west rail and comparing themselves with Boston and Silicon Valley, but saying that they do not have enough room to grow. I say to my hon. Friend the Member for Boston and Skegness (Matt Warman) that that is, of course, Boston in America. The obvious answer is, “You have got loads of room to grow. You have got the whole of the east of England.” To an investor from Dubai or Shanghai, it all looks like Cambridge. We have a huge opportunity, but we need not only the infrastructure but the world’s best medical and dental services.

[Andrew Selous]

In an uncharacteristic slip and momentary lapse of memory, my hon. Friend forgot to mention the world-leading research in Cranfield, which I am sure he was going to add to his golden triangle of opportunities in the east of England. I am sure that that slipped his mind accidentally.

[Mr Richard Bacon]

It might make it more of a pentagram, but I did mean to mention Cranfield, of course. My hon. Friend knows that in South Norfolk we speak of little else. I do not want to take up too much time, although we are slightly ahead.

My hon. Friend the Member for Boston and Skegness said that he is not technically in the east of England. I had a mad great-great aunt who lived in Brigg in Lincolnshire, and Lincolnshire has always been in the east of England, as far as I am concerned. He is very welcome at this debate, and I had a great interest in what he said. However, if it is true that the wilder fringes of the internet have got worse in recent years, and if my hon. Friend was responsible for 5G, to whom should we attribute the extra growth in the wilder fringes of the internet, if not to him? I only pose the question.

The hon. Member for Denton and Reddish (Andrew Gwynne) surprised me. I remember when he was shadow Secretary of State for the Ministry of Housing, Communities and Local Government portfolio. He mostly appeared at the Dispatch Box like an angry avenging angel. The fact that he is capable of sounding rather rational and sensible was a surprise to me. I am afraid he also confirmed my worst fears—

[Sir Mark Hendrick (in the Chair)]

Order. Can we confine ourselves to the issue of dental services, please?

[Mr Richard Bacon]

As the hon. Member for Denton and Reddish said, dentistry definitely needs to be improved. He has confirmed my worst fear, which is that if the Minister does not focus on this sufficiently, the hon. Member and the Opposition will. They will produce a solution which—whether it is delivered or not—too many people will find attractive, I fear.

Fortunately, we have in the Minister someone in whom several colleagues have reposed confidence, and have said so publicly. On one occasion, when we were both on holiday, I bumped into the Minister in a second-hand book shop in Hay-on-Wye. I know he is a cerebral fellow who thinks carefully about these issues, and I take seriously the assurances I have had from colleagues that he is looking at this extremely closely.

I say one thing to him in conclusion, and this is the acid test. If he produces a dental plan that can be delivered speedily, and if he negotiates successfully not just with his Secretary of State and east of England MPs, but with the Treasury, to produce the resources required to do that, he will quickly give our constituents reassurance that NHS dental provision can be a place where dentists want to work, thrive and have successful careers. If he can do that, he will make a significant contribution to our success at the next general election. Not to put any pressure on him, but I believe that getting this right—reflecting on what I said about the issue being such a salient one—puts on his shoulders the enormous burden of getting the right answer so that our constituents have dental provision that works.

Question put and agreed to.

Resolved,

That this House has considered dental services in the East of England.

15:50

Sitting suspended.

Farmers, Supermarkets and Food Supply Chains

Tuesday 16th May 2023 Westminster Hall

[Sir Mark Hendrick (in the Chair)]

I will call Gordon Henderson to move the motion and I will then call the Minister to respond. Unfortunately, as is the convention for 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

15:59

[Gordon Henderson (Sittingbourne and Sheppey) (Con)]

I beg to move,

That this House has considered farmers, supermarkets and food supply chains.

It is a pleasure to serve under your chairmanship, Sir Mark. I start by paying tribute to farmers, in particular those in my constituency, for their contribution to food security in the United Kingdom.

Food security is becoming increasingly problematic. A combination of unprecedented events has culminated in many farmers facing unsustainable pressures on their businesses, which could have long-term implications for our domestic food production capacity and food security if measures to support British farmers are not taken immediately.

The huge spikes and uncertainty in energy prices since the end of 2021 have had significant cost implications for primary producers. Annual inflation measures are now understating the cost pressures facing businesses and consumers, given that inflation has been apparent for over a year. According to data from the Department for Environment, Food and Rural Affairs itself, compared to the 2019 average, farm input cost inflation stands at 42%, with wholesale energy prices being one and a half times higher.

The UK is seeing a significant decline in production, as horticulture businesses struggle with unprecedented inflation, most notably in energy and labour costs. There are also seasonal shortages of business-critical workers, particularly in the horticulture sector. In the first half of 2022 alone, at least £22 million-worth of fruit and vegetables was wasted, directly because of such gaps in the workforce.

Two of the National Farmers Union’s key asks for the horticulture sector are for a minimum five-year rolling scheme for seasonal workers and the inclusion of horticulture in the energy and trade intensive industries scheme, to help to remove uncertainty and inject confidence in production.

Declining self-sufficiency, coupled with supply chain problems abroad, has resulted in empty supermarket shelves, and the more that we become reliant on imports, the more likely it is that we will see the level of market failure that has led to images of empty shelves across the UK.

In the national food strategy, the Government outlined their ambition to sustainably expand the national production of fruit, vegetables, plants and flowers. British farmers and growers are ready to meet this challenge. However, to achieve that, the Government’s growth agenda must be twinned with reform in the marketplace that levels up the balance of power in the agrifood supply chain and delivers a fair and functioning supply chain.

[Robin Millar (Aberconwy) (Con)]

My hon. Friend has just said something very helpful: British farmers stand ready. My farmers in Aberconwy have made the point that they are ready to step forward. However, does he agree that supermarkets have a duty to support farmers, and that they should not put undue cost pressures on farmers? Farmers need to be there tomorrow in order to deliver tomorrow, and there is a role for supermarkets in promoting farming, not just for their own interests but so that it is there tomorrow.

[Gordon Henderson]

I can only assume that my hon. Friend has been reading my speech, because if he is patient he will find that I will come on to that point.

British growers want to deliver on the Government’s vision for climate-friendly and sustainable land management, but there is a significant risk to our shared endeavour if we do not address market risks in parallel. Only profitable businesses can be sustainable and continue to invest in productivity and environmental outcomes. It is critical that retailers support British farmers and growers to be sustainable, achieve meaningful environmental gains, and invest in innovation and new technology. Food producers should have an equal stake in the value chain, with food processors and retailers sharing risk, data on performance and value gain.

Farm costs are a significant driver of food price inflation. According to the results of the 2022-23 NFU farmer confidence survey, farmers’ primary concern over the next 12 months is input prices, with 88% expecting negative effects. Data released by DEFRA in March shows that agricultural inputs have risen almost 42% since 2019. Inputs closely related to energy have seen the biggest inflation: energy and lubricants are up 58%. Although wholesale energy prices are falling, they remain one and a half times higher than normal. Fertilisers and soil improvers are up 161%, and animal feeds are up 50%. That is directly linked to the disruption caused by the war in Ukraine.

In recent months, the pressures in the horticulture supply chain have led to supermarkets rationing fresh fruit and vegetables. Soaring energy costs and the continued lack of people to pick crops pose a serious threat to the future of the UK’s fruit and vegetables industry. As a result, the industry is not able to mitigate the current supply chain shortages.

A report by Promar International in 2022 found that growers’ production costs increased by as much as 27% in the preceding 12 months, and that products such as tomatoes, broccoli, apples and root vegetables were most affected. The main drivers are energy, fertiliser and workforce costs. Farmers and growers across many sectors are doing what they can to mitigate rising costs, but they cannot be expected to absorb the additional pressure and risk in the supply chain alone.

[Ben Lake (Ceredigion) (PC)]

I am grateful to the hon. Gentleman for making such an important speech on what I consider to be a matter of strategic importance to the UK. He is right to point out that farmers and growers cannot continue to absorb the input cost increases. Does he share my concern about the fact that, according to the latest NFU survey, 40% of beef farmers and 36% of lamb farmers have already said that they expect to reduce production in the light of the rising input costs?

[Gordon Henderson]

I certainly agree with the hon. Gentleman, and it is not just livestock. In the garden of England—Kent—too many of our orchards have been dug up because they are not profitable any more. There is a growing lack of transparency in the communication received from retailers, in particular, and that leaves farmers in a vulnerable position. They have to absorb additional risk and are unable to plan and make important financial decisions during this extremely challenging period. If farmers and growers are unable to recoup costs, it will become unfeasible for them to run their businesses, resulting in a reduction in production. Ultimately, that will reduce competition.

I have spoken to a number of farmers in Kent, and I can cite examples of unfair practices by some retailers—particularly supermarkets. However, to do so would make it possible for those farmers to be identified, which they do not want for fear of losing business. That in itself is testament to the malign power of some supermarkets.

It is true that the groceries supply code of practice and the Groceries Code Adjudicator have had a transformative impact on the behaviour of buying teams and have helped to curb some of the worst abuses of market power. That is why I share the NFU’s view that any consideration of transferring the GCA’s functions to another public body, such as the Competition and Markets Authority, or removing it altogether, is misguided; that would have a hugely damaging impact on the groceries sector and, ultimately, consumers.

In my view, the farming industry is in crisis. In 2019, there were 149,000 registered agricultural businesses. In 2022, there were 142,000. That means that there are more than 7,000 fewer agricultural businesses today than in 2019.

[Richard Foord (Tiverton and Honiton) (LD)]

In the south-west of England, direct payments fell from 95% of total income from farming in 2016 to just 62% in 2021. Does the hon. Gentleman share my view that that is affecting not only regions such as Kent, but the south-west? Both have seen a dramatic reduction in total income from farming as a result.

[Gordon Henderson]

I do agree. We are all in this together. That is the old saying, and it is true. Farmers across the UK—not just in England or Wales—are struggling. Without sustained, consistent and responsible action from all parts of the supply chain, we risk deepening a crisis that will lead to a significant contraction in supply to the marketplace and reduced availability of British produce, ultimately leaving many farmers and growers with no other option than to leave the sector altogether, which is what is happening.

To create a fair supply chain that supports food security, the sector needs to ensure sustainable farm-gate prices. In all farming sectors, DEFRA lacks the data it needs to monitor the market sufficiently and ensure that it is working properly. Without better data, the Government are unaware of what is happening in the marketplace and are therefore in no position to assess the market effectively, as required by section 20 of the Agriculture Act 2020. The Government need to support and invest in sufficient market infrastructure to enable markets to work efficiently, equitably and in the interest of food security. DEFRA needs capacity and expertise to conduct investigations of actual and potential market issues, and farmers need a concerted joining up of policy across Whitehall to unlock growth in the sector.

Finally, I want to explain what the NFU would like the Government to do. I appreciate that the Minister probably knows, but, given the current crisis in farming, the wish list bears repeating. The NFU wants the Government to produce an enhanced, policy-focused food security report that looks beyond food supply and supermarket shelves to assess the short, medium and long-term health of the food sector. The report should be published annually, as opposed to the three-year commitment in the Agriculture Act.

The NFU wants the Government to use section 20 of the Agriculture Act to conduct an urgent value chain inquiry into market failure in the poultry, meat, eggs and horticulture sectors, and to use powers under section 29 of the Act to continue progress with the dairy contracts code, develop equivalent approaches for other sectors and ensure that all are fit for purpose before legislation is introduced.

The NFU wants the Government to cement the role of the Groceries Code Adjudicator and publicly set out their commitment to its independence and powers. The NFU also wants the Government to publicly commit to supporting the work of the Food and Drink Sector Council and deliver a clear mandate for Departments to support its ambitions for sustainable growth.

The NFU wants the Government to establish a regular food forum with the DEFRA Secretary and senior executives, to support business engagement across the food sector—a similar concept to the Prime Minister’s Business Connect platform. The NFU wants the Government to set out their plans to invest in agricultural technology and innovation centres that bring benefits to UK farming, for example by taking the opportunity created by the Genetic Technology (Precision Breeding) Act 2023.

The NFU wants the Government to ensure that food and farm businesses make a growing contribution to renewable energy generation and have affordable access to transmission infrastructure, improving the sector’s energy resilience and lowering greenhouse gas emissions from food. Finally, the NFU wants the Government to make changes to the planning system to permit development for the purposes of growing and processing fruit, veg, crops and livestock.

I thank Kent’s farmers and the NFU for feeding our nation. I assure them that they will always have my full support.

16:13

[The Minister for Food, Farming and Fisheries (Mark Spencer)]

It is a pleasure to serve under your chairmanship, Sir Mark. I thank my hon. Friend the Member for Sittingbourne and Sheppey (Gordon Henderson) for securing this important debate. I draw attention to my entry in the Register of Members’ Financial Interests, which is a matter of public record.

Food is part of our local and national identity, and farming is vital to our country. The food and drink industry contributes £30 billion to our economy and employs over 4 million people. As the Secretary of State has said, we want to support our farmers and fishermen to grow their businesses and to help our rural communities grow and thrive. I have just returned from the Prime Minister’s UK Farm to Fork summit in No. 10, which brought together the Government and the whole food supply chain. It was a great opportunity to boost co-operation and promote all elements of our world-renowned farming and food industries.

I recognise that this has been a challenging year for farmers and consumers alike. Russia’s illegal war in Ukraine, aftershocks from the pandemic and a historic outbreak of avian flu are having a global impact. That is why we are supporting our farmers by reinvesting £2.4 billion per year into the sector through new farming schemes, and by paying direct payments in England in two instalments—the next one is due in July—to help farmers with their cash flow.

Responding quickly to global challenges, we continue to provide support through the energy bills discount scheme, and we have announced 45,000 visas for seasonal workers in the horticulture sector next year, to give security to those in the sector so that they can plan their business for the next 12 months.

[Helen Morgan (North Shropshire) (LD)]

It has been widely reported by farmers in North Shropshire, particularly dairy farmers, that although their input prices are astronomically high, for all the reasons the Minister has mentioned, they are being squeezed by supermarkets and their milk prices are starting to come down. Does the Minister welcome the announcement by the CMA this morning that it is going to look into price gouging by supermarkets, which the Liberal Democrats have called for over the last few weeks?

[Mark Spencer]

We will look with interest at what the CMA finds. That is something we have looked at closely ourselves. It will require food producers and farmers to come forward with evidence to support the CMA, but that is why we launched our own investigation into the dairy sector. We are due to come back any moment with our findings and recommendations for how to support dairy farmers.

We have also indicated that we are going to support the pork sector and ensure that contracts are fit for purpose. Once we have delivered on that, we will be keen to look at the horticulture sector and the egg sector to ensure that the marketplace is working fairly for all in the industry. That demonstrates how seriously the Government take these challenges and issues. We will step in when we feel the market is not working equitably for all involved.

Last June, we published the Government food strategy, in which we set out our vision for a prosperous agrifood sector that ensures secure food supply in an unpredictable world and contributes to the levelling-up agenda through good-quality jobs all around the country. In the last year, farmers have continued to put great-quality food on our plates. The UK Farm to Fork summit is the next step in growing the thriving food and drink sector, with the aim of seeing more British produce on supermarket shelves in the UK and around the world. The summit focused on how Government and industry can work together to bring great British food to the world, build resilience and transparency across the supply chain, strengthen sustainability and productivity, and support innovation and skills—many of the things that my hon. Friend the Member for Sittingbourne and Sheppey called for.

The Prime Minister has been clear that growing the economy is one of his top priorities, and growing the food and farming sector is key to that.

[Gordon Henderson]

Does the Minister accept that farmers will only be able to help grow the produce if they are making a profit? Does he also accept that farmers are frustrated at retailers that too often force farm-gate prices down so that supermarkets can maintain their margins in the shops? We have to address that.

[Mark Spencer]

I understand my hon. Friend’s statement. It is right that we have a sharing of risk and responsibility in the supply chain and that primary producers get a fair price for their products. We also have to bear in mind that our consumers and constituents want to enjoy reasonable food prices. We do not want to drive food price inflation through the market, so it is important that we co-operate and work with retailers and those who manufacture in the food sector.

My hon. Friend referred to the Groceries Code Adjudicator and hoped that we would commit to keeping that as a separate authority. I can tell him that the Prime Minister announced this morning that we will keep the Groceries Code Adjudicator as a separate authority and it will not become part of the CMA, which I think is an indication of how important the sector is and that it requires its own Groceries Code Adjudicator.

Farmers should be paid a fair price for their produce. We have introduced new powers through the Agriculture Act 2020 to support the sector. We have made great progress in our reviews of the pig and dairy supply chains. We have recognised the impact of global events on the sectors in recent months, and the next reviews will take place in the egg and horticulture sectors, as I have already mentioned.

We can confirm, as I have said, that the proposed merger of the GCA will not go ahead. My Department has championed precision breeding, as my hon. Friend the Member for Sittingbourne and Sheppey indicated, through the Genetic Technology (Precision Breeding) Act 2023. Building on the successful passage of the Act, we will convene a working group to bring plant breeders, food manufacturers and retailers together to agree an approach that enables precision-bred products to reach the shelves as soon as possible.

We will also improve future support for horticulture by replacing the retained EU fruit and vegetable producer organisation scheme when it closes in 2026 with an expanded offer, which will include controlled environment horticulture as part of our new farming

schemes. We will help the controlled environment horticulture sector overcome barriers to accessing future support and make it easier to build new glasshouses through changes to national planning policy.

[Robin Millar]

I welcome the support that the Minister is outlining, including that farmers should be paid a fair price. Right now in Aberconwy, upland farmers are being told that their land is no good and that it would be put to better use if planted with trees to help the environment. They are being told that meat is not a good part of the diet and that they should not raise livestock. Does he agree that meat does form part of a balanced diet, that raising livestock is among the best of upland farming practices, and that supermarkets have a role to play in talking about that because they occupy a privileged position right next to the customer?

[Mark Spencer]

I hesitate slightly because agriculture is a devolved issue, so it would probably be better for my hon. Friend to lobby the Welsh Government, although I acknowledge what he says. The beautiful landscapes on Dartmoor, Exmoor and the North York Moors are created by the sheep that graze those uplands. We as consumers can play our role in eating the view, as it were. The view that we see is directly related to the food that we consume. If we want to eat beautiful, top-quality Welsh lamb, we must do our bit to support beautiful, rolling landscapes such as the Brecon Beacons—I call it the Brecon Beacons because I have no idea how to pronounce the name that it is now called.

Recent global events facing growers and the wider food sector underline the importance of working together at every stage of the food system, from farming to manufacturing, distribution and retail. Following productive conversations at the summit, I am pleased to say that food security is still at the heart of the Government’s farming agenda. Fulfilling the Prime Minister’s priority on economic growth, we will continue working with the industry to champion UK food and drink at home and abroad, helping more businesses to invest in domestic production and innovation.

I am grateful for hon. Members’ contributions to this important debate. It has been a stimulating debate and I am grateful for the support, comments and questions. Together we will support our great British farmers.

Question put and agreed to.

16:24

Sitting suspended for Divisions in the House.

Corporate Profit and Inflation

Tuesday 16th May 2023 Westminster Hall

16:50

[Richard Burgon (Leeds East) (Lab)]

I beg to move,

That this House has considered levels of corporate profit and inflation.

It is a pleasure to serve under your chairship, Sir Mark. I secured this debate because the discourse on inflation in Parliament, in Government and in the Bank of England has been dominated by the need to curb workers’ wages. Government policy has focused on driving down workers’ real wages. In the words of the Bank of England’s chief economist, people should just

“accept that they’re worse off”.

That approach has ignored the elephant in the room—the role that corporations are now playing in driving up inflation through price hikes designed to boost their profits. There is mounting evidence that such corporate profiteering is playing a very significant role in the latest wave of inflation. It has been called many things: price gouging, profiteering and, most commonly, greedflation. The US Senate Committee on the Budget has held a special hearing on this subject, but there has been very little focus on it in Parliament so far. Today, that situation changes. I believe that this is the first specific debate on greedflation in this House. It should not be the last one. Indeed, I hope that this debate kicks off a serious discussion in this House about how we tackle greedflation.

Of course, higher inflation since late 2021 has been affected by big problems in supply chains, as a result of post-covid trade disruption and the war in Ukraine. However, two excellent studies have highlighted how soaring profits are now having a big impact. The Institute for Public Policy Research and Common Wealth think-tanks have shown that profits were up 34% at the end of 2021 compared with pre-pandemic levels and that nearly all of that increase in profits was due to just 25 companies. As the IPPR has recently said:

“It’s time for policymakers to look at ‘greedflation’ and prioritise reining in corporate profits, instead of blaming workers’ wages for driving up inflation.”

Using the latest available figures for the largest 350 companies on the London stock exchange, Unite the union has shown how profit margins for the first half of 2022 were nearly double—89% higher—than for the same period in 2019, before the pandemic. Unite’s report finds that in the last six months company profits are responsible for almost 60% of inflation. As its general secretary, Sharon Graham, correctly states:

“Make no mistake, profiteering has resulted in the high prices we’ve all had to pay”.

I pay tribute to those organisations for bringing attention to this issue. For example, Unite the union has secured press coverage for its recent study. However, I fear that the Government, in their reply, will simply dismiss these studies as coming from left-of-centre organisations and will plough on regardless. Therefore, I want to use the next part of my speech to focus on how this issue goes well beyond the centre-left and is now a mainstream debate. The financial press, investor bodies and central bank officials are openly discussing how corporate profits are, in fact, driving inflation. It seems that it is just the Government who are ignoring this issue.

Let us look at some of the recent headlines in the financial press. One Financial Times headline said:

“‘Greedflation’: profit-boosting mark-ups attract an inevitable backlash.”

A Wall Street Journal headline said:

“Why Is Inflation So Sticky? It Could Be Corporate Profits.”

That article went on to explain:

“Businesses are using a rare opportunity to boost their profit margins.”

MoneyWeek, the UK’s best-selling financial magazine, had a piece entitled:

“What should we do about greedflation?”,

which noted:

“Companies’ price hikes have been driving inflation.”

Fortune said:

“‘Greedflation’ is the European Central Bank’s latest headache amid fears it’s the key culprit for price hikes”.

Meanwhile, an Investors Chronicle headline said:

“‘Greedflation’ is only making things worse”,

adding:

“Business using inflation as cover for unjustifiable price hikes are on borrowed time”.

Likewise, economists and investment strategists are openly saying that corporate profits are driving price hikes.

[Kim Johnson (Liverpool, Riverside) (Lab)]

I thank my hon. Friend for raising the issue of corporate greed. The spotlight has been shone today on the crisis of unaffordable baby formula, with parents forced to steal or settle for black market alternatives, putting the health of their babies at risk. Given that the revenue in the baby food segment of the UK food market is set to increase by £265 million, or nearly 15%, over the next four years, will my hon. Friend join me in calling on the Minister to put an end to the scandalous profiteering that takes money directly out of desperate parents’ pockets and into shareholder profits, fostering a public health crisis whose repercussions we will suffer for decades to come?

[Richard Burgon]

As ever, my hon. Friend makes the point about what is really happening out there. She gives a powerful example about baby food. I will come on to food and a policy suggestion for price caps later.

The chief economist of UBS global wealth management, Paul Donovan, has stated that

“much of the current inflation is driven by profit expansion. Typically one would expect about 15% of inflation to come from margin expansion, but the number today is probably around 50%.”

Albert Edwards, the global strategist at Société Générale, one of the largest financial services groups in Europe, tweeted:

“More Greedflation? When are government going to force a halt to this price gouging?”

Elsewhere, he explained how companies have

“under the cover of recent crises, pushed margins higher”.

In more technical language, but saying the same thing, Goldman Sachs economists said of the eurozone:

“Unit profit growth now accounts for more than half of GDP deflator growth, with compensation per employee growth explaining a little over a third.”

Central bankers are also raising concerns. In fact, the European Central Bank’s Fabio Panetta said that

“there could be an increase in inflation due to increasing profits.”

He has also said that

“unit profits contributed to more than half of domestic price pressures in the last quarter of 2022”.

Meanwhile, Lael Brainard, formerly of the Federal Reserve and now a White House official, said:

“Reductions in markups could also make an important contribution to reduced pricing pressures.”

[Margaret Greenwood (Wirral West) (Lab)]

I congratulate my hon. Friend on securing this debate and his excellent speech. He is reframing the whole debate, which is incredibly important.

According to the Office for National Statistics, during the 12 months to March the price of food and non-alcoholic drinks rose at its fastest rate in more than 45 years. Cheese was up 44% and the average price of bread and cereals increased by 19.4%. My hon. Friend is discussing what the economists are talking about now: greedonomics. Does he agree that that will chime with people out there in the shops, trying to feed their families? We all have casework involving people who simply cannot afford to put the food that their children need on the table.

[Richard Burgon]

As always, my hon. Friend makes an important point. I will come on to that in the remaining passages of my speech, because people out there are really feeling in their day-to-day lives the consequences of this greedflation and the opportunistic pushing up of prices by so many companies.

In the United States, an Economic Policy Institute study found:

“Corporate profits have contributed disproportionately to inflation”,

and that

“over half of this increase…can be attributed to fatter profit margins, with labor costs contributing less than 8% of this increase. This is not normal.”

Let us take a moment to note that a broad range of officials at UBS, Unite the union, Goldman Sachs, the ECB and the US Economic Policy Institute are all suggesting that over half of the current price mark-up is to do with profiteering.

[Nadia Whittome (Nottingham East) (Lab)]

My hon. Friend is making some excellent points. Is he aware of comments made last month by the International Monetary Fund’s chief economist, Pierre-Olivier Gourinchas? He said that he remains “unconvinced” that we should be worried about the risk of a wage-price spiral, highlighting that wage inflation continues to lag far behind price inflation, while profit margins have “surged”. Does my hon. Friend agree that the Government should be exploring all avenues to boost wages, including a £15 an hour minimum wage, above inflation public sector pay rises and, of course, scrapping anti-union laws?

[Richard Burgon]

I have to say—and this will come as no surprise—that I agree with my hon. Friend’s three policy demands. A £15 an hour minimum wage is more necessary now than ever before. When people first started talking about it, we of course supported it then. Fewer and fewer people can argue against that policy now. Of course, the anti-trade union laws need scrapping. It is wrong to suggest that it is workers’ wages that have been driving inflation. I hope this debate gets people in this place talking about what a lot of economists, who are certainly not on the left, have been talking about—namely, greedflation.

I will move on to some solutions. While workers’ real wages continue to fall, the Financial Times recently noted that across western economies, profit margins reached record highs during 2022 and remain historically high. It is increasingly clear that some corporations are hiking prices to gain those profits, and it is that, not wages, that is a major cause of the inflation crisis. What should be done about that? In the words of Robert Reich, the prominent economist and former US Secretary of Labor under Bill Clinton:

“To control inflation, we must take aim at corporate profits, not working people.”

I have three proposals. First, there should be an excess profits tax. The kind of tax we have seen on the super-profits of oil and gas firms should now be extended to all the other sectors of the economy making excess profits from this crisis at the expense of ordinary people. That would send a clear message to those companies that their profiteering must stop. There has rightly been a huge focus on the eye-watering profits of energy firms, though the Government’s windfall tax has failed to deal with that properly and should be amended to close all the loopholes.

Excess profits are in evidence in other sectors, too. The five big banks have reported soaring profits, as they take advantage of high interest rates. Supermarkets, food manufacturers and agribusinesses have benefited from profit spikes recently. The Treasury should set up a special unit for this excess profits tax that could go after all those companies that are blatantly profiteering, ripping off customers, fuelling inflation and deepening the cost of living crisis.

[Margaret Greenwood]

My hon. Friend is being very generous in giving way. Does he agree that it adds insult to injury that so many of these companies are not paying decent wages to their staff? On the one hand, they are making massive profits, essentially ripping off consumers, and on the other they are not paying the rates they should to the people who actually do the work.

[Richard Burgon]

That is absolutely right. It is scandalous when workers are not fairly paid, the public are being ripped off, and all this profiteering is causing the price crisis that we see. It is not for nothing that people call it greedflation.

On price caps, for all its obvious flaws in not being set low enough, the Government’s energy price guarantee, which was introduced last year, was an important break with the idea that the Government cannot interfere in market pricing to protect people. Surely such price caps should be extended to other sectors. It is very welcome that London Mayor Sadiq Khan has called for powers to allow him to impose private rent controls in London. Other countries do this, so why can we not do so here? On soaring food prices, the French Government have secured a deal with some of the country’s major retailers to place a price cap on staple foods to ease the pressure of inflation on consumers. Why not here?

[Ian Lavery (Wansbeck) (Lab)]

Is it not absolutely perverse that in the fifth richest economy in the world we are seeing, on the one hand, supermarkets and retailers making billions and billions of pounds and, on the other, parents criminalising themselves by stealing baby formula because they cannot afford to feed their newborns? What on earth has gone wrong in this country?

[Richard Burgon]

That is exactly right. That state of affairs is completely perverse in one of the richest countries on earth.

I mentioned that the French Government have secured a deal to place a price cap on staple foods to ease the pressure of inflation on consumers. Why can we not do that here? The public backs it. A poll last year showed that 71% of voters support price caps that place limits on what companies can charge for certain goods and services such as energy, housing and other essentials, including food. That 71% even included the overwhelming majority of Conservative party voters.

My final point is about the need for public ownership. Returning energy, rail, water and other key utilities to public ownership, to be run for people and not profit, is the best way of ensuring a permanent end to the profiteering that so many of these privatised companies are gratuitously engaged in. I hope the Minister will respond by admitting what all the leading economists and financial institutions say about greedflation, and I hope that today’s debate is the start of the Government listening and Parliament talking more about the fact it is greedflation, not workers’ wages, that drives inflation. Corporate giants are taking advantage in the most heartless way, using this crisis as an excuse to hike up the prices of essentials. As ever, it is ordinary people who pay the price.

[Several hon. Members rose—]

[Sir Mark Hendrick (in the Chair)]

Order. I remind Members that they should bob if they wish to be called in the debate. I can see at least four people bobbing.

17:08

[Kate Hollern (Blackburn) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important debate. In the short time available, I will echo many of the excellent points set out in my hon. Friend’s opening remarks.

The false narrative being perpetuated by the Government that wages are driving up inflation is misrepresentative of the reality facing many of my constituents in Blackburn. The Government have argued that workers should accept pay restraints to manage inflation, but substantial research suggests that corporate profiteering and so-called greedflation, not wage levels, are fuelling the inflation crisis. There is a clear disparity between the Government’s narrative and reality. Only today we learned that shareholders of the failed TransPennine Express received a £15 million bonanza last year, while people in the north-west could not get a train.

A report into profiteering by Unite the union in March revealed that the 2021 profit margins of the FTSE 350 jumped 73%. For the first half of 2022, they were 89% higher than the same period in 2019. Meanwhile, working people cannot afford to heat their homes or feed their families.

The huge recent profits of major oil and gas companies are well known. Leaked Treasury forecasts—they should not be leaked; they should be public knowledge—stated that producers and electricity generators could make excess profits of up to £170 billion over two years, yet time and again we hear the Government say we cannot afford many basic services. Meanwhile, 16.6% of households in Blackburn are living in fuel poverty. That is higher than the national average of 13.2% and the regional average of 14.4%. A proper windfall tax, which Labour would introduce, is urgently needed to address this. The Government’s actions do not go far enough, and it is disappointing that no Conservative Members are present to hear the shocking statistics that have been repeated today.

We have talked about food poverty. Only today, when faced with a question about the fact that the cost of making a cheese sandwich at home has risen by 37%, we heard an ex-Conservative MP respond by saying, “If you cannot afford a cheese sandwich, don’t make one.” That is so out of touch with the reality of how families are struggling to feed their children. It is disgraceful.

The Trussell Trust’s annual statistics paint a dark picture. In 2022-23, almost 350,000 food parcels were delivered in the north-west. That is up significantly from approximately 200,000 in 2017-18. The most recent survey carried out by the Bakers, Food and Allied Workers Union found a shocking increase in food insecurity among members. It reported an increase in food bank usage from 7% to 17%, while those who reported relying on friends and family went from 20% to 34%. Some 55% said they have skipped meals to feed their children. The survey points to a clear disparity between supermarket profits and the experience of those working and shopping at supermarkets.

Profits have clearly not been reflected in workers’ wages. While for many the pandemic was a time of extreme anxiety and, in some cases, tragic loss, the Resolution Foundation estimates that the top 10% each gained £50,000 during the pandemic. Similarly, new analyses by economists at the Institute for Public Policy Research and the Common Wealth think-tank show that the profits of the largest non-financial companies were up 34% at the end of 2021 compared with pre-pandemic levels, rising significantly faster than inflation and wage growth, so companies are getting richer and people are getting poorer. The problem is systemic and must be addressed at a policy level, with windfall and wealth taxes to ensure that those with the broadest shoulders pay their fair share.

17:13

[Zarah Sultana (Coventry South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important debate and giving us an opportunity to shine a light on the lie that it is workers’ wages that are driving inflation, rather than the profiteering of big business. The truth is this is not just a cost of living crisis. There is no doubt that it is a crisis for the working class and for millions of people struggling to make ends meet across the country, but it is not a crisis for big businesses and the super-rich. For them, it is record profits, a record number of billionaires and record wealth for the top 1%. It is a cost of living crisis for the many, but a bonanza for the few.

An investigation by Unite the union found that the profit margins for FTSE 350 companies rocketed by 73% between 2019 and 2021 and were up an even more staggering 89% in the first half of 2022. From the well-known, obscenely high windfall profits of the oil and gas giants BP and Shell to the supermarket chains Tesco, Sainsbury’s and Asda, which saw a 97% increase in profits between 2019 and 2021, big businesses have seen their profits soar, but that is just one side of the coin.

On the other side are soaring prices for our constituents: energy bills through the roof, roughly doubling in 12 months; food prices up nearly 20%; rent inflation at eye-watering record levels; and mortgage payments continuing to rise. It is no wonder that living standards are set for the biggest fall since the 1950s, with the real value of wages falling at the fastest rate on record.

Let me be clear: wages have been lagging well below price rises, so they cannot be their fundamental cause. This is not wage-price inflation. It is something else, and that something else is greed inflation—inflation driven not by workers’ wages but by corporate greed. Big businesses are exploiting droughts and wars, post-pandemic demand and supply-side shocks from climate breakdown. That is, in effect, what even the likes of the International Monetary Fund and the European Central Bank have said. They both asked whether wages were driving higher prices, and both found that explanation wanting. Instead, the ECB found that profits contributed to two thirds of the rise in inflation in 2022 alone, having been responsible for just one third in the previous two decades.

The next time we hear policymakers call for pay restraint or see Tory Ministers hit out at greedy workers for fighting for pay restoration, let us ask: why do they not call for profit restraint? Why do they not condemn chief executive officers for taking record pay packages, or complain about companies handing out hundreds of millions in dividend deals? With the Tories, why is it always workers who make the sacrifices while the rich reap the rewards?

17:16

[Ian Byrne (Liverpool, West Derby) (Lab)]

It is an honour to serve under your chairship, Sir Mark. I thank my hon. Friend the Member for Leeds East (Richard Burgon) for securing this incredibly important debate.

Two thirds of my constituents in West Derby are having to cut back on hot water, heating and electricity. One in three in my city are in some kind of food poverty, and 3.7 million children across the UK—one in five—have eaten less, skipped meals or gone without meals for an entire day. Meanwhile, Unite the union’s analysis of the industries that together have the biggest impact on inflation has found industry profit increases of over 20,000% for the big eight shipping firms, 366% for oil refineries, 255% for giant agribusiness food corporations and 84% for the big four energy companies. While many of my constituents have been forced into fuel poverty, oil and gas company BP has made a record $28 billion profit and doubled the salary of its CEO to £10 million. The immorality of this position—leaving the most vulnerable hungry while corporations are awash with profits—shames this place.

Let me touch on corporate profits and food poverty specifically. In the past 12 months, there have been extreme rises in the cost of staple foods: cheese is up 50%, two pints of milk is up 40%, eggs are up 28% and white sliced bread is up 21%—and there are locks on baby formula milk. Tragically, the rises affect the poorest households most of all, because they spend a larger percentage of their household income on food. The poorest fifth of the population would need to spend 43% of their disposable income on food to afford the recommended healthy diet in the Government’s “Eatwell Guide”. With so many other pressures, that is simply not achievable.

Unite the union highlights:

“Despite the rise in wholesale prices, Tesco, Sainsbury’s and Asda still managed to increase their profits by an astonishing 97% in 2021…Profiteering is happening right along the food supply chain”.

Eight of the UK’s top food manufacturers made a combined profit of £22.9 billion—up 21% since before the pandemic. The four giant agribusiness corporations ADM, Bunge, Cargill and Louis Dreyfus made $10.4 billion, which is up 255%—absolutely staggering profits.

In the food industry, the workers who grow, distribute and supply our food are left unable to purchase the very food that they produce. The latest survey from the Bakers Food and Allied Workers Union found that four in 10 food workers are forced to skip meals, and over 60% of respondents said that their wages are not high enough to meet their basic needs. One worker wrote:

“I don’t have running hot water, so I can’t wash my hands thoroughly. Either trying to keep warm in bed or running on the spot. Staying at work longer to keep warm.”

In a letter I received this week, the Minister for Food, Farming and Fisheries told me:

“It is not for the UK Government to set retail food prices nor to comment on day-to-day commercial decisions by the companies.”

That is a cowardly response.

However, at a recent Environment, Food and Rural Affairs Committee session, we heard evidence from the United Nations special rapporteur on the right to food, who told us that corporations have a significant amount of power in markets, and there is not much being done to hold them accountable. Food prices are at the mercy of speculation, but Governments have the tools to stabilise prices. The inequality and levels of profiteering we are seeing are not inevitable. They are a result of a political decision by this Government—a Government that could intervene if they had the political will to do so.

It is one of the gravest and most frightening crises seen in our lifetimes, and yet many of my constituents tell me that they feel abandoned and ignored by a Government who are supposed to protect them. The situation cannot go on. I urge the Minister to heed the advice of the United Nations special rapporteur and use the tools to tackle this injustice. Do not leave the most vulnerable at the mercy of the greed and morality of those corporations.

17:21

[Claudia Webbe (Leicester East) (Ind)]

It is a pleasure to serve under your chairship, Sir Mark. I congratulate the hon. Member for Leeds East (Richard Burgon) on securing this important debate.

The UK economy was already facing a crisis of high inflation driven by corporate greed, which was squeezing living standards and forcing millions deeper into poverty, but while large corporations have exploited the crisis and the Government’s inaction to make record profits and pay hefty dividends to shareholders, the Bank of England has again increased rates, which punish ordinary people who are not the cause of inflation the Bank supposedly wants to bring down. Worse than that, the Bank knows that people and wages are not driving inflation. Even the Governor of the Bank of England, Andrew Bailey, admitted at the press conference to announce the latest crippling interest rate hike that he knows that wages and renumeration are not causing high inflation. Instead, he said that the main drivers are the high prices being charged for food and clothes—two essentials that people have no choice but to spend money on.

Anyone would think that the workers of Leicester would be wealthy, such is the scale of the food and garment factories in the area, clothing and feeding the nation. However, 42% of children in my constituency of Leicester East are living in poverty. According to the ONS data from 2022, the median annual wage of workers in Leicester East is £19,960, compared with averages of £25,837 in the east midlands and £27,756 in the rest of the UK. There is no union recognition in those factories to protect workers from the profiteering supermarkets and billionaire garment-brand owners.

What is the interest rate hike meant to do? Is it meant to force people to eat less and wear rags or cheap, unsustainable garments? When all they have is an interest rate hammer, ordinary people—even the poorest—look like a nail. The Government need to force the Bank of England to work with them to bring about an effective approach to controlling inflation by capping prices. That would hit companies in their profits when they stoke so-called greed inflation, not hammer innocent ordinary people over and over.

Last week, former Monetary Policy Committee member, Danny Blanchflower, said that the Bank of England was guilty of terrible group-think and incompetence, and should just quit, because its decision to raise interest rates was so appalling. Corporations, brands and retailers are abusing the people of this country for the sake of profit. The Bank of England is attacking the wrong people, and this Government are failing in their primary duty of protecting the people. When are the Government going to step in and end this greed-driven, greedflation madness?

17:24

[John McDonnell (Hayes and Harlington) (Lab)]

I want to try to take the argument on from the discussions that have taken place so far. My hon. Friend the Member for Liverpool, West Derby (Ian Byrne) spoke about food, which is such a basic need. If we cannot control the supply and price of food, to be frank, we lose control of our overall economy and our society itself. The food increases that my hon. Friends have spoken about relate partly to short-term issues such as the breakdown of the supply chain post covid and the Ukraine war, and partly to two seemingly more permanent issues. The first is the impact of climate change, which is undoubtedly impacting the supply of food, and the second is the almost permanent installation into our economy of profiteering. That is why the Unite report, which introduced the concept of greedflation, is so important.

My hon. Friend cited several instances of greedflation, but food is a good example. There has been a 97% increase in supermarket profits, and a 255% increase in the profits of agribusinesses themselves. Unless we can develop policies to tackle climate change, including by accommodating to it in some areas, and get greedflation under control, these rises will be a permanent factor that will undermine the quality of life of all our constituents in the long term.

This debate is not just an exposition of the problems; it has to be a way for the Government and Opposition parties to talk about solutions to address the immediate problems and look at the long term. My hon. Friend the Member for Leeds East (Richard Burgon)—I congratulate him on securing this debate—mentioned some. The first is the need for immediate action, which must mean price controls. Price controls on basic foodstuffs have been introduced in this country in the past, particularly to deal with short-term problems. I do not think that permanent price controls are effective, but on a temporary basis—12 months, for example—they can be. Other countries, including Switzerland and Hungary, are already developing price controls, and France has introduced its own mechanisms for negotiating prices down on the basis of the expectation of price levels.

My view is that price controls are needed because of the urgent situation our constituents are facing. I think the Unite report said that there has been a 57% increase in the number of households that are restricting their food intake, and in which parents are choosing not to eat so their children can. Unless we can do something urgently to assist them, we will be inflicting human suffering on our society. To be frank, my generation has not seen that before; it is almost reminiscent of the ’30s.

Secondly, let us just talk about excess profits. I want to quote a senior Conservative Minister, who introduced excessive profit taxes across the whole of the economy. He said:

“At a time like this sacrifices should be equally borne. We are not prepared to see excessive profits”.—[Official Report, 11 March 1952; Vol. 497, c. 1289.]

He introduced a new levy, which was charged on the amount by which current profits exceed standard profits. That was Rab Butler in the 1950s, who introduced a model that we could draw upon now. It would extend across the whole economy and would expose and properly tax those who are exploiting the current economic situation.

The other issue is something I have raised in previous debates. During the banking crash—some of us were here at the time—we witnessed a shift in investment from the crashing mortgage economy. The crash at one point brought our banking system to a halt, and almost did something more fundamental, in terms of destroying confidence in the financial system. Money moved out of property, where prices were crashing, and into food speculation, and we saw rapid increases in food prices. In fact, in some areas of the globe, we even saw famine as a result.

Then, on a global basis, an agreement was reached and we inserted into the regulatory regime after the banking crash certain controls on food speculation—for example, how much food wealth could be owned by a particular speculator. The Government at the moment, in their Financial Services and Markets Bill, are removing those protections. Already food speculation is taking place and causing some of the profiteering that is happening, but we are inviting even further speculation, which I think in the short and medium term will result, in the same way it did after the banking crash of 2007-08, in people going hungry and famines occurring in parts of the world.

My final point is that if the Government are not willing to act so decisively with price controls, regulation of speculation or an excess profits tax, the minimum that we should ask for is an inquiry into the anti-competitive market practices taking place in certain sectors. I would like to start with the food sector. We are seeing this demand being met in the US now; an investigation is taking place into the anti-competitive market practices that are happening. The US is at the moment looking at the fertiliser and agricultural business sector. In this country, we need an investigation into the profiteering and greedflation in particular—that is the No. 1 issue—that is taking place in the food and agricultural sector.

We cannot stand by and watch people line their pockets and corporations make excessive profits while our people, in some of our constituencies, are actually starving—they are actually going hungry. That is why, in this period, special measures are needed. They are measures that we have used in the past, that people are using in other countries and that have proved to be effective. If nothing else, if they were even temporary measures, they would alleviate the situation that our constituents face. This is a matter of urgency. That is why I keep repeating time and again, in as many debates as I possibly can, the need for action.

I will just say this to my own party: this crisis of greed inflation, combined with the climate crisis, means that when we take over and go into government next year—as soon as possible, I hope—we will have to address this issue. We will have to have the radical solutions that need to be put forward; otherwise, we will not be fulfilling our historic mission of looking after working-class people in this country.

[Sir Mark Hendrick (in the Chair)]

Now we move to the Front-Bench contributions. I call the spokesperson for the SNP.

17:32

[Ronnie Cowan (Inverclyde) (SNP)]

I congratulate the hon. Member for Leeds East (Richard Burgon) on securing the debate. Profits can be good if they are used wisely—if people reinvest them in their workforce and to pay their employees proper salaries. The question is: how big do profits have to be, and how were they created? Were they created on poor wages and poor working conditions? Were they created on inflated prices in the first place?

It was Thatcher who told us that greed was good. She saw it as a driver—something to push people hard to make them generate bigger profits. People would be “fulfilled” by their ability to gather more—more money, more houses, more cars, more wealth. We see this in our society today; it did not end with Thatcher, unfortunately. We have kings and queens in gold coaches, wearing diamond-encrusted crowns, flashing orbs and swords dripping in jewels, and being dragged through the streets as exemplars of what our society should be looking up to. Currently, money makes the world go round. A few people possess the most, and the message to those without is, “Money makes you happy.” It is an insecurity that these people have—how much is enough? If someone is a millionaire, do they need two million? Do they need five million? Do they need a billion? How big is their insecurity if they think money and wealth is going to fill that hole for them? Corporations push for more and more, while many are being left behind by this greed attitude. It is not new, but years of Tory austerity have increased the number of people living in a precarious fashion.

We need to reset the goals. Rather than measuring success in money and incentivising profits over people, we need to prioritise wellbeing, and promote a four-day working week and a universal basic income. As artificial intelligence advances and the gig economy takes hold, tinkering around the edges will not solve the problems. The land belongs to the people; the water and the trees belong to the people. We need a return to community. We need government closer to the people.

The Beveridge report in 1942 was a clarion call to create a fairer society, and it is as true today as it was 80 years ago. While this Government curtail the powers of the trade unions, and suppress the right to strike and the ability to vote, they are propping up the greed in society. That is unsustainable; history has taught us that. If we are to create a fairer society, we need to reprioritise the aims of this Government. We must be prepared to put people before profit.

17:35

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Mark. I congratulate my hon. Friend the Member for Leeds East (Richard Burgon) on securing this important debate.

As I think everyone in this House will know, working people are facing the biggest hit to living standards since records began. Real wages are lower than they were 15 years ago, with families in the UK going into the cost of living crisis significantly poorer than those in comparable European countries. The price of everyday essentials has risen by an eye-watering £3,500 since 2020 and there have been 24 tax rises since 2019 alone, with working people facing the highest tax burden in 70 years.

After the former Prime Minister crushed the economy last year, the resulting rise in interest rates and economic instability has added hundreds of pounds a month to first-time buyers’ bills. Whether it is stagnant wages, rocketing prices and bills or sky-high taxes, at every turn it is hard-working people in our constituencies who are paying the price of economic instability. The Opposition have been calling for policies to support people with the cost of living crisis and rampant inflation. For example, since last August we were calling for a fairer deal for those paying a premium on energy prepayment meters. The Chancellor finally gave in in his 15 March Budget—after months and months of lobbying from the Labour Benches.

Since this crisis began, Labour has been calling for a windfall tax on energy giants to support working people with their energy bills. After months of the Prime Minister dismissing our proposals as “disastrous”, he was forced into a U-turn in May last year. But even after his party supported our idea of a windfall tax, the Government still did not adopt a comprehensive windfall tax as we have been suggesting. By refusing to backdate the tax to January 2022, end the investment allowance tax loophole and raise the rate in line with other countries, the Government has left £10.4 billion on the table, leaving working people to foot the bill.

The Labour party will always put ordinary families first, which is why we would: reverse the expensive cash giveaway to the wealthiest pension savers and introduce specific measures to keep doctors in work; scrap the unfair non-dom tax status, which cost the UK over £3 billion a year, in order to pay for free breakfast clubs and the biggest ever expansion in the NHS workforce; and slash business rates for small shops—paid for by properly taxing online giants—to cut the eye-watering cost of everyday items.

With the ONS figures confirming that 2022 was a record year for North sea oil and gas profits, Labour would prioritise the needs of working people by introducing a proper windfall tax to raise an additional £10.4 billion. We would use the additional funds to cut energy bills for domestic food manufacturers and processors to bring down food prices for people across the country.

Fundamentally, we understand that the UK needs a long-term economic plan to boost living standards for working people and bring down the prices of everyday essentials. The crisis has exposed structural problems in the British economy, and our constituents have been trapped in a cycle of stagnant growth, low wages and high tax. If our growth rate stays where it has been over the past 13 years, families in the UK will be poorer than those in Hungary and Romania by 2040.

That is why a Labour Government’s first mission will be to secure the highest sustained growth in the G7 and to create well-paid jobs in every part of the country. We want to achieve that through an active partnership with business and our modern industrial strategy, while our green prosperity plan will drive bills down and let British businesses and workers compete in the global race for the jobs and industries of the future. The US has passed the Inflation Reduction Act, and the EU has its own Net Zero Industry Act. The UK has fallen behind. In contrast, the Labour party’s economic plan will get the UK growing again. Our new deal for working people will ensure that they benefit from that growth by boosting living standards and wages across the country.

That is why I hope the Minister will listen to all the comments made in this debate and, in his closing remarks, finally commit to putting working people before the energy giants and lend his Government’s support to Labour’s windfall tax to help tackle inflation and the cost of living. More than that, I hope he will reflect on everything he has heard today from colleagues across the Chamber and get behind Labour’s mission to secure the highest sustained growth in the G7.

17:40

[The Economic Secretary to the Treasury (Andrew Griffith)]

It is a great pleasure to see you again in the Chair, Sir Mark. I congratulate the hon. Member for Leeds East (Richard Burgon) on securing this well-attended debate, and for his valiant attempt to leave his mark on the lexicon on this topic. I thank all Members for their contributions. Clearly, the issue of high prices and inflation is affecting everybody across the country—all our constituents, who send us here—and I welcome the opportunity to respond on the Government’s behalf.

The reality is that costs in the UK have primarily risen because of Putin’s illegal invasion of Ukraine and global supply pressures post covid. The right hon. Member for Hayes and Harlington (John McDonnell) was the only one of the eight contributors we heard from, including both Front-Bench spokesmen, to even go so far as to mention those two unprecedented facts.

[Richard Burgon]

That is not true.

[Zarah Sultana]

I mentioned that.

[Andrew Griffith]

I stand corrected. I was being diligent and attentive, but I was clearly so taken by the force of the arguments made by the hon. Members that I missed that.

[John McDonnell]

Will the Minister explain the role that Putin played in ensuring that Tesco, Sainsbury’s and Asda increased their prices to such an extent that they have increased their profits by 97%?

[Andrew Griffith]

If the right hon. Member lets me make some progress, I will address precisely his point. Domestic inflation pressures have risen. The UK labour market has remained very tight, reflecting a real cost headwind to employers. There have been real challenges, as we saw in the labour figures today, in getting people off welfare and into work. That has pushed up the cost to firms, including Tesco and others, of producing goods, which has resulted in inflation. The UK is not alone, and I hope Members will reflect on and understand that. We are seeing high inflation in all major global economies. Food inflation in Germany is above 20%.

[Margaret Greenwood]

Will the Minister come back to the question from my right hon. Friend for Hayes and Harlington? Why have profits increased so much?

[Andrew Griffith]

With respect, I have not heard an awful lot of analysis in the debate. I have heard many mentions of Unite the union, and I am familiar with its work, but I did not hear any analysis from Members. Let us talk about food prices for just a moment.

[Richard Burgon]

Will the Minister give way?

[Andrew Griffith]

I will give way because it is the hon. Member’s debate, but I will talk about food prices, if that is what I am being asked to do.

[Richard Burgon]

The Minister said he heard very little analysis from Opposition Members other than reference to research by Unite the union. Does he accept, however, that as well as Unite the union, officials at UBS, Goldman Sachs, the European Central Bank and the US Economic Policy Institute all suggest that more than half of the current price mark-up is to do with profiteering? If so, what are his Government going to do about it?

[Andrew Griffith]

I listened to the citations and I will go away and inform myself about them, but one can find a million citations in support of any argument, however spurious.

Let us get to the heart of food inflation. After reading the report from Unite the union earlier today, I went and did some research. I am keen to understand the level of alleged profiteering that we see, so I looked into costs at the Co-op, a mutual organisation that I believe supports many Opposition Members. I compared the alleged profiteering by our major supermarkets with what is happening in an organisation that I hope we can all agree—and join hands across the House—is not indulging in profiteering. The cost of four pints of milk at the Co-op is 20p more expensive than at Tesco. I have a wonderful chain of Co-operatives in my constituency and it serves our rural community magnificently, so I pay great tribute to the Co-op, but six eggs in the Co-op cost 35p more than at Tesco. The Co-op was retailing the same loaf of white bread for 56p more, and chicken breasts for £1.70 more, than Tesco. The Co-op is retailing butter, tea and Heinz baked beans for 40p more than Tesco—I would be very happy to give Hansard the details of this. I will stop at the emotive category of baby milk: an 800g pack of Cow & Gate baby powder retails for £10.50 at Tesco, but the same product retails for £11.50 at the Co-op.

I put it to you, Sir Mark, that we are seeing either a vibrant and competitive market in food retail—which includes the Co-operative mutual organisation, although its prices seem a little higher—or a level of anti-competitive practices. But if it is the latter—right hon. and hon. Members should be enormously careful about this—those anti-competitive practices and that profiteering extend to no less an organisation than the Co-operative mutual society, which supports Opposition Members. If any of them want to intervene on me, I would be very interested to hear their view of the Co-operative’s business practices.

[John McDonnell]

Let me explain this to the Minister. There is such a thing as the Co-op party, of which some people on this side of the House will be members, and there is such a thing as the Co-op store. The Co-op store is not related to the Labour party; it is a completely separate commercial entity. The Co-op party is separate completely, so there is no relationship between the Members here and the Co-op store, although some of them might shop at it.

[Sir Mark Hendrick (in the Chair)]

Order. John McDonnell has made a good point, but for clarification, as a Labour/Co-op MP—

[Andrew Griffith]

Declare your interest!

[Sir Mark Hendrick (in the Chair)]

I do declare an interest. What you call “profits” for the Co-op actually get reinvested in it; they are not given out to shareholders in dividends. That is the difference.

[Andrew Griffith]

As I said, the Co-operative, as a food retailer, is a marvellous organisation. My point is that we should be very cautious about simply making the assumption that an increase in the prices that consumers are paying, which is spread across very different parts of the producer sector, automatically leads to the sorts of outcomes that we heard from Opposition Members.

We have strayed quite a long way away from the topic of debate. I would dearly love to be a fly on the wall, or a passenger on the train as it returns to both Leeds East and Leeds West, because there is some dissonance in my mind about the position of the Opposition today. We have had a very refreshing debate that has been honest and open in its candour. We have heard about the need for the minimum wage to increase to £15 an hour, the need to scrap all anti-trade union laws and to give an above-inflation pay rise to workers, the need for an excess profits tax and for wealth taxes, the need for private rent controls, the need to impose price controls on food staples—there is lots of nodding, so please intervene on me—and the need to return to public ownership every water, rail and energy company. These points were all raised in the debate—

[Sir Mark Hendrick (in the Chair)]

Order. Because of the Divisions, we have run short of time.

17:50

Motion lapsed, and sitting adjourned with Question put (Standing Order No. 10(14)).