Written Statements

Thursday 15th June 2023 Written Statements

Thursday 15 June 2023

Prescription Charge Upper Age Exemption: Consultation Outcome

Thursday 15th June 2023 Written Statements

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

In 2021, the Department of Health and Social Care held a public consultation on aligning the upper age for the NHS prescription charge exemption with the state pension age (SPA), which is currently 66, and due to increase to 67 and 68 in future years. The upper age for NHS prescription exemption was introduced in 1968 to be in line with the women's state pension age, which was 60 at that time. In the decades since, there have been increases to the state pension age, but the upper age exemption for prescription charges has remained the same.

The consultation received over 117,000 responses, the majority of which were opposed to the proposed change. Responses cited, among other issues, cost of living pressures and risk to health of people not taking prescribed medication correctly as reasons for retaining the current upper age exemption. The Government are committed to tackling cost of living pressures and has decided that the prescription charge upper age exemption will remain at 60, meaning that it will not change to align to state pension age.

It should be noted that, in England, a broad range of NHS prescription charge exemptions are in place to help those with greatest need. These measures include a variety of charge exemptions, and eligibility depends upon whether people are in receipt of certain qualifying benefits or tax credits, their age, receipt of a war pension or have a qualifying medical condition. The current exemptions mean that around 89% of NHS prescription items dispensed in the community in England are free of charge, in addition, those on a low income who do not qualify for an automatic exemption can seek help under the NHS low income scheme. For those who do not qualify for an exemption or the NHS low income scheme, prepayment certificates (PPC) are available to help those who need frequent prescriptions. The annual PPC can be paid for through 10 instalments, and covers all prescriptions in that period for just over £2 per week.

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NHS England: Government Mandate

Thursday 15th June 2023 Written Statements

[The Secretary of State for Health and Social Care (Steve Barclay)]

I am today laying in Parliament the Government 2023 mandate to NHS England. The Government have promised to cut NHS waiting lists, meaning that people can get the care they need more quickly. That promise is at the very heart of this mandate, which will help us deliver for patients, and we are delivering. To support delivery, the Government have made up to £14.1 billion available for health and social care over the next two years, on top of record funding to improve elective, urgent and emergency, and primary care performance.

In February 2022, NHS England published its delivery plan for tackling the covid-19 backlog of elective care. This set out a clear vision for how the NHS will recover and expand elective care and cancer services in the next three years. Since its publication, hard-working health and care staff have made great progress in recovering elective care despite continued pressures from covid-19, flu and industrial action. The NHS succeeded in meeting the ambition to virtually eliminate waits of two years or more in July 2022, and reduced by over 90% from the peak the number of patients waiting 78 weeks or more by April 2023. Patients will also get more choice about where they have treatment. Alongside this, I have set out that the NHS must recover the cancer backlog to pre-pandemic levels and go further to improve one-year and five-year survival for all cancers, achieved by maintaining and improving performance against the 62 and 31-day standards; diagnosing cancers faster and earlier; and continuing work to expand diagnostic capacity.

In January 2023, we published the delivery plan for recovering urgent and emergency care services, reduce waiting times, and improve patient experience. I want to see a system that provides more and better care in people’s homes, gets ambulances to people more quickly when they need them, sees people faster when they go to hospital and helps people safely leave hospital having received the care they need.

And in May 2023, the delivery plan for recovering access to primary care was published, committing to tackle the 8 am rush and make it easier and quicker for patients to get the help they need from primary care through empowering patients, implementing modern general practice access by making sure patients are either given an appointment immediately when they call or signposted to a more appropriate service, building capacity, and cutting bureaucracy. Later this year, subject to consultation, the NHS will enable patients to access prescription medication directly from a pharmacy, without a GP appointment, for common conditions such as earache, sore throat or urinary tract infections.

All of the above priorities will be enabled by supporting the workforce and by accelerating digitalisation, and this will also support ongoing delivery of the NHS long-term plan, including on maternity and neonatal services, mental health services and prevention. The NHS will need to support the workforce through delivering the long-term workforce plan, and building on the functions formerly held by Health Education England: training, retention, and modernising the way staff work. Following the merger of NHS Digital and NHS England, I have also asked the NHS to do more to utilise the power of technology and the skills, leadership and culture that underpins it, to drive a new era of digital transformation. This will allow the health and care system to thrive long into the future, delivering vast benefits for patients—such as using AI to give better treatment, the latest screening techniques to detect illness sooner and equipment that allows more people to be treated at home.

The mandate meets my duties under section 13A of the NHS Act 2006 to set out objectives that NHS England should seek to meet in carrying out their functions. It will apply from today until the date it is replaced. The mandate complements the general duties on NHS England to provide a comprehensive health service with planning and prioritisation done by integrated care boards and integrated care partnerships for their areas.

I have listened to what the health system has asked for: fewer, focused priorities, giving systems clarity on what I am asking them to deliver. This mandate is deliberately shorter than the previous mandate and both emphasises the Government commitment to delivery on the public’s key concerns while allowing integrated care systems the freedom to deliver effectively. The NHS provides a comprehensive health service, and by focusing on these priorities, we can help to make sure everyone gets the treatment they need.

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Daniel Morgan Independent Panel Report: Government Response

Thursday 15th June 2023 Written Statements

[The Secretary of State for the Home Department (Suella Braverman)]

The former Home Secretary, my right hon. Friend the Member for Maidenhead (Mrs May), on 10 May 2013 announced the formation of the Daniel Morgan independent panel. Two years ago, on 15 June 2021, the report of the Daniel Morgan independent panel was published. Today I report on the progress made against the recommendations made in that report.

The panel made 23 recommendations as a consequence of the failings of process and accountability it identified in the course of its work. Most of the recommendations were for policing, however there were several for the Government to address. The Government response focuses on four main themes: investigations; tackling corruption; working with inquiries; and information management. Those recommendations relating to the investigations were primarily directed at the Metropolitan Police and policing.

In response to the report’s publication, the previous Home Secretary, my right hon. Friend the Member for Witham (Priti Patel), asked His Majesty’s Inspectorate of Constabulary and Fire and Rescue Service to investigate the issues raised by the panel. HMICFRS concluded its inspection and reported on 22 March 2022. This report was troubling and outlined several failures of the Metropolitan Police, particularly in tackling corruption.

It is not for the Government to respond on behalf of the police or individual forces. But it is clear from the independent report that serious failings occurred over a period of three decades that run counter to the British tradition of policing by consent and the code of ethics this Government introduced in policing in 2014. I expect chief constables to do all they can to ensure that HMICFRS’ recommendations are delivered upon, that similar failings do not reoccur, and that the damage done to public trust is repaired.

In recent years, several steps have been taken by Government to combat police corruption. A new offence of police corruption, applicable solely to police and National Crime Agency officers, now sits alongside the existing offence of misconduct in public office. The new offence carries a maximum prison sentence of 14 years. To prevent corrupt police officers evading accountability by resigning or retiring, the Policing and Crime Act 2017 enabled the extension of disciplinary procedures to former officers, ensuring that misconduct proceedings can still take place, even where an officer has resigned or retired from policing.

Vetting acts as the first line of defence against corruption within police forces. In January this year, I asked the College of Policing to strengthen its statutory vetting code of practice and make clear the standards expected of all chief officers. I also asked HMICFRS to undertake a rapid review of progress on improving vetting—HMICFRS’ findings were published in May 2023.

Further to improving existing vetting arrangements, I also launched a review in January to ensure that the police officer dismissal process is fair and effective at removing those who are not fit to serve the public. We are considering the findings of this review very carefully and expect to make announcements on next steps in the coming weeks.

The media play an essential role in holding all public institutions to account and it is vital that journalists are able to do their job freely and without restriction. The very fabric of the panel’s report, however, focused on the police’s inappropriate relationships with private investigators and journalists. HMICFRS’s report in response to the panel’s report shows that policing still has work to do to ensure that these types of conflicts of interests are properly investigated.

There were several issues raised by the panel about how they were unable, at times, to progress their work. HMICFRS and the Independent Office for Police Conduct did not find any deliberate obstruction by the Metropolitan Police but there was, at least initially, insufficient support from the force for the panel’s work. We are working across Government to ensure that inquiries and panels of a similar type are able to do their job without hindrance, and we will also work with the police to make clear their responsibilities in this respect.

Policing as a profession is fully aware of the importance of public scrutiny and that shifting the culture away from defensiveness needs to start from within. In 2020 the Home Office introduced a statutory duty of co-operation for police officers, to ensure that officers participate openly and professionally with investigations, inquiries and other formal proceedings. In addition, the College of Policing is currently reviewing the code of ethics, which I expect to further promote a culture of openness and accountability.

I am very grateful to Baroness O’Loan and her panel for their tenacious efforts to review the handling of this matter, and to ensure that lessons are learned for the future. The torment experienced by Daniel Morgan’s family must not be repeated.

The Government response (Cmd 857) has been laid before the House and is also available on gov.uk.

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Thurrock Council: Best Value Inspection Report

Thursday 15th June 2023 Written Statements

[The Parliamentary Under-Secretary of State for Levelling Up, Housing and Communities (Lee Rowley)]

I am today publishing the best value inspection report into Thurrock Council, authored by their inspector, Essex County Council. The final version of this report was submitted to the Secretary of State on 19 May 2023, following a representations process whereby any particular individuals criticised were given an opportunity to read and respond to those relevant parts of the report before it was published.

This publication follows my update to the House on 16 March in which I confirmed that the Secretary of State for Levelling Up, Housing and Communities and I had formally expanded the Government intervention in Thurrock Council, appointing Dr Dave Smith as an independent managing director commissioner, and providing commissioners with further powers over Thurrock’s governance and staffing functions.

The best value inspection report details widespread failure in Thurrock Council’s financial, governance, and leadership functions. The challenges facing Thurrock “stem from a series of self-sustaining, systemic weaknesses which have allowed for repeated failure over many years." Although individual officers and members made significant mistakes, particularly in relation to financial investments, they were operating within broken systems at the council which are in urgent need of reform and improvement.

The report clearly sets out the events which led to the collapse of the council's commercial investment strategy last year, after that strategy was allowed to operate in an environment with wholly inadequate scrutiny and governance arrangements.

That failure has had profound consequences for the council’s financial sustainability, and the inspection report confirms that Thurrock is unable to balance its budget without exceptional financial support from Government, which has now been granted in principle for the financial year 2022-23. Going forward, the report makes it clear that in addition to realising extensive efficiency savings, the council will have to review the scope of its local services.

The report reveals that the pattern of failure which has characterised the council’s approach to commercial investment can also be seen in its delivery of major infrastructure and regeneration projects. These failings have resulted in the loss of substantial sums of public money. The council’s lack of openness and transparency prevented these failings from being properly scrutinised, and these losses were often concealed, or not properly reported.

The report concludes that these failings are attributable to the breakdown of political and managerial leadership; inadequate governance arrangements; and profound weaknesses in the council’s control environment.

The Government’s Response

The best value inspection report makes a number of recommendations, some of which pertain to actions that the council should take, for example to expand the scope of its improvement and recovery plan, and some of which relate to expanding the powers of commissioners.

I am pleased to confirm that the majority of the report’s recommendations have already been addressed by the expansion to the intervention I announced on 16 March, which provided commissioners with the powers to drive forward change in Thurrock council’s finance, governance, and staffing functions, which the report highlights as areas of particular concern.

The recommendation in the report on member development, and the importance of engaging residents in local democracy, accords with the concerns about leadership and member training raised in the first commissioner’s report and best value inspection update letter. The importance of strengthening member capacity at the council cannot be overstated, because all members will have a vital role to play in the council’s recovery. I expect Thurrock council to carefully consider this recommendation, and to work closely with commissioners to ensure that it is taken forward, for example, by being incorporated into the council’s improvement and recovery plan. I would expect that equally close attention is paid to the section of the report which focuses on the council’s delivery of major projects, where there are clearly lessons to be learnt.

The report also recommends that Thurrock council change its scheme of elections, from electing its members in thirds, to “all-out” elections, where all members are elected at the same time. The report recommends that if the council does not make this change by 31 July, that the Secretary of State should consider making an order under section 86 of the Local Government Act 2000 to secure this.

Given the pressing need to bring stability to the council, the Secretary of State has concluded that he wishes to seek representations on using his powers under section 86 of the 2000 Act, to bring about a move to whole council elections from May 2025. The May 2024 elections of one third of members will go ahead as planned, to ensure residents have the opportunity to have their say. It is important that Thurrock council can express its view on this proposal before a final decision is made. I have written to the leader and commissioners of Thurrock council today to notify them of the Secretary of State’s proposals, and representations should be received, from the authority or any other interested party, by 29 June.

This report lays bare a rare but significant case of a council failing to comply with its best value duty across several fronts. As I noted in my statement to the House on 16 March, I am hopeful that the recent expansion to the intervention will help the council to address the concerns set out in the best value inspection report, and to continue its vital work to improve the way in which the council is run.

The people of Thurrock deserve a well-run council that can fund the delivery of good-quality services in a sustainable and responsible way. Progress has been made in recent months but this will require significant improvements in the COUNCIL’S leadership, finance, and governance functions at both the political and managerial level. Commissioners will play a significant role in securing these improvements and informing Ministers’ ongoing response to the situation in Thurrock. The Secretary of State and I look forward to receiving the commissioners’ second report at the end of this month.

This will be a challenging time for Thurrock’s officers and members as they reflect on the findings and recommendations of the best value inspection report. The Government will continue to work closely with Thurrock council and its commissioners, and we remain fully committed to supporting them in their improvement journey.

A copy of the best value inspection report will be placed in the Libraries of both Houses.

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